The Healthy Blogger

Response to 4-MMC/Mephedrone

I’m using this post to respond to recent commenters.  Thank you for reading my blog and sharing your thoughts.  And special thanks to those who can express their views without having to resort to swearing.

The blogging world is both personal and impersonal.  You can express very personal views without revealing your identity.  Of course, those who are sufficiently determined would find a way to discover a blogger’s identity.  Some people have such strong views that we cannot help but get a reaction.  And reactions are important to stimulate debate.

Most of the reactions recently have been related to drugs, legal or not.

First of all, I would like to emphasize the point that I do not favour tobacco or alcohol any more than I do the illegal drugs.  Despite “scientific” evidence that moderate drinking is good for you, I would never encourage anyone to even have a drink a day.  That would be irresponsible.  There is nothing I can say that is positive about tobacco.  The damage from tobacco is more long-term, though some short-term effects, such as shortness of breath, cough, and wheeze does exist.  Alcohol gives a “buzz” to most people, and again, it has long-term consequences.

The effects of illegal, or unregulated, drugs are less well-known.  This is in part due to the fact that they are not as readily available, so fewer people use them and there is less “study” of them.  I will admit that I do not have “data” to show that these drugs, such as 4-MMC, are deadly.  But, having worked in the ER and seeing kids brought in dead on arrival after a night of mixing drugs, the best conclusion is that those drugs are linked to the death, even if current testing cannot conclusively show that any one specific drug is to blame.

Enough is known about the class of drugs which 4-MMC, or mephedrone, belongs to that scientists can say that it acts as a stimulant.  Similar drugs include amphetamines, ephedra, and ecstasy.  Based on that alone, I cannot see why 4-MMC should be treated any differently from those drugs.  It is interesting that drug users demand to be given scientific evidence that something is harmful, yet they are willing to risk their lives before scientific evidence proves that something is not harmful.

Anyone who has read my blog would know that I tend to be sceptical about any scientific study.  There always seem to be some flaw which leads to different groups studying the same thing and getting different results.  Though I’m not advocating willy-nilly beliefs, I do feel that we need to be careful of drawing conclusions based solely on science.  Sometimes, observational studies are just as important.

Drug users will then argue that if you go to a club and observe those getting high you will see that they are all tranquil.  That’s baloney.  Try holding down someone on a real “trip”.  You wonder how that little person could be so strong.

So, why does tobacco and alcohol have such special status?  I can’t answer that except to say that it is such a huge source of revenue for the government that they would be unable to reverse things.  They are available and at the same time, they are discouraged.  Or, in the case of alcohol, “drink responsibly”.   I agree that the various methods for smoking cessation should be made accessible and well-regulated.  I only warned against using products that are unregulated, as there may be hidden dangers.

Can they really do that with other drugs?  It would be extremely irresponsible for the government to just turn a blind eye to other drugs.  We have laws in place in to protect people from themselves and from others.  Some may argue that the government should not be our moral authority, but wouldn’t that just encourage anarchy?

Education is important to prevent the misuse and abuse of drugs.  It is not enough just to say that drugs are bad and leave it at that.  Some people are not willing to take that at face value.  They have to experience it themselves and make their own conclusions.  Sometimes, unfortunately, they are not given another chance.

Regulation is important.  If a drug is illegal, it should be banned.  If it is not deemed illegal, there should be regulation.  What would this mean?  First, it would mean the government gets a cut.  They would have to have people in place to test drugs to see that they are not adulterated.  Part of the danger in using drugs that are bought online and unregulated is that they may contain contaminants which make the drugs cheaper and more deadly.  Regulation would mean that there is less of a problem with inherent crime associated with the drug.  Perhaps it may decrease the attraction of the drug.  For young people and early experimenters, it is the thrill of doing something not quite legal that contributes to the “high”.

Does 4-MMC deserve to be regulated rather than banned?  It would be very difficult to defend this drug when so many other countries have already banned it based on its effects and associated risks.  Some would argue that its risk lay in overdosing, but what is an overdose?  Drug levels are never the same in everyone.

Alcohol and marijuana for osteoporosis treatment?

It is very frustrating for the average public to make any sense of health reporting these days.  It is no wonder that people no longer listen.  It can become irresponsible reporting as well.

Just a few days ago, there was a report that marijuana may help stop osteoporosis.  The work was done in mice, of course.  But they stated that cannabis is harmful to young bones, but protective in older bones.  What’s interesting, and confusing, is that the cannabis’ interaction with the cannabis receptor activates the receptor to cause destruction, yet it prevents bone loss in older mice.  It did not reveal how it did this, but the study showed that there was less fat in bones, which is a marker of healthier bones in humans.  First of all, we cannot always equate mice and human models.  Secondly, were there confounding factors that could explain the decrease in fat in bones?  Is it safe to say that less fat in older mice bones meant protection?

Now, another report states that a study in Spain shows moderate drinking can boost bones.  The study defined moderate drinking as being up to 5 units a day; yet, experts warn that more than two drinks will harm bones.  Since we also know that each person’s ability to tolerate drinking is variable, how can we really estimate moderate drinking?  By tolerance, I do not refer to sobriety, but to liver damage.  Furthermore, it is not the alcohol, but the natural products that go into the drinks that confer the benefit.  So, shouldn’t they concentrate on studying the “phytoestrogens” rather than stating the benefits of drinking?

It is hard to say whether it’s the media or the scientists who are doing the research who are doing a disservice to the general public by reporting on such contradictory findings.  And, especially when the research involves such controversial issues.  Will they next be calling for leniency on the use of alcohol and marijuana?  Of course, those who support such “mildly illegal” drugs will hail these scientific reports as more evidence of their utility.

It will be dangerous to advocate the use of alchol and marijuana to treat osteoporosis, especially as they will increase the likelihood of falls, which is one of the biggest risks for fractures, regardless of how strong the bone is.

Alcohol and the beer belly

Recently, it was announced that many food outlets will start displaying calorie counters on their menus. Now, it appears that the government would like to make drinkers aware of the calorie count in alcoholic drinks. Whether or not they will start demanding that the labelling includes the calorie count is not known.

The campaign aims to focus not just on the health risks but on the weight risks. Though much has been said about alcohol being “empty calories”, it appears that most people are either not aware of what this means or they choose to ignore it. Simply, it means that alcohol is loaded with calories without any other nutritive value. There is a reason that people refer to that paunch as “the beer belly”. The Know Your Limits campaign performed a survey which revealed that many people were unaware of the calorie contents of their alcoholic drinks. For example, a pint of beer is equal in calories to a doughnut, or a glass of wine is equal to a slice of cake.

Focusing on the health risks has not deterred people from drinking, so will focusing on calories and weight do it? It seems unlikely, since obese people are not deterred from eating all those fatty foods. Of course, campaigners argue that drinkers also eat unhealthy foods and this new awareness may change some of their eating habits. If it does, perhaps they can come up with some new ideas on how to curb the eating habits of those who are obese and consume enormous amounts of fat and cholesterol.

The influence of ads on alcohol consumption

A study showed that people drank more when exposed to movies and ads containing alcohol. It does seem like a very novel theory. The same arguments were used against cigarettes and cigarette ads were pulled from TV. Similarly, many shows started to cut down on use of smoking, except to portray negative images.

The research, led by a team from Netherlands, placed young people in groups and showed them two different movies, with varying references to alcohol, and ads, some with alcohol, some without. They also placed a refrigerator in the room, filled with soft drinks, beer, and wine. They did not state what the results were for all groups, but they did report that those watching the movie with excessive alcohol references and alcoholic ads drank nearly 3 bottles of alcohol as compared to 1.5 bottles for the group who watched the movie with less reference to alcohol and no alcohol ads.

But several questions pop up. First, what was the behaviour of the groups in the middle? Did they control for alcoholic consumption patterns before the test? How would they account for the behaviour of one group, if that group had been placed in a different one? For example, what would have happened had the group that watched the movie with less reference to alcohol and no alcohol ads been put in the group that watched the movie with excessive alcohol references and alcoholic ads? Would they have increased their consumption? Obviously, they would have to run the study over a period of time to account for all variables. But did they?

Though I believe people can be influenced by what they see, they may also be influenced by their peer group. Therefore, if they are in a group that is likely to drink alcohol, they will more likely participate. I am not discounting this study, but there are some unanswered questions and it would not be fair to completely ban alcohol from movies and ads based on just this one.

Risks and benefits of alcohol

A doctor once asked me, “What is the definition of an alcoholic?” The answer: “Someone who drinks more than their doctor.” Typical doctor joke, but what is one to do when there are mixed messages regarding drinking alcohol? OK, so drinking too much (that definition will vary depending on the person as the joke implies) is definitely bad for you. Not to mention the damage to your heart and liver.

But the recommended daily dosage of alcohol to remain safe does vary depending on who you ask. That French study years ago suggested that a glass or two of wine a night could be good for your heart. However, some government agencies would put a limit of 3-4 drinks (again, the type of alcohol varies) a day as safe. Now, there is data to suggest that even one drink increases your risk for certain types of cancer, with breast cancer being most prevalent in women. The study was not done in men, so perhaps, they will ignore the advice.

My own conclusion is that there is no safe limit to alcohol. A person may consume the recommended dose and probably will not be helping his heart or increasing his risk of cancer. At the same time, that dose may actually be hurting his liver. Government agencies have reported an increase in the rate of cirrhosis, which they blame on young people drinking more and at an early age. This may be true, but it may be that the youth only consumed the recommended dosage. You see, not everyone’s constitution is the same. Your body can metabolise the alcohol in different ways, at different rates, etc.

That’s where the risks and benefits come in. Each person will have to assess his particular risks and benefits individually. It can be daunting if you had to sit down and realistically and rationally look at your own health and well-being. If you are honest, you will find that all the information out there only serve to confuse you. And the reason so many people make bad choices is because they don’t want to have to examine their life in that detail. They would rather accept the fact that best supports their decision. Those who enjoy drinking will point to the benefits, while those teetotallers will emphasise the risks. The debate will never end.