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Health24.com | Surgery may trigger opioid abuse in teens and young adults

Opioids are a class of drug that include illegal substances like heroin, as well as prescription pain relievers like oxycodone, hydrocodone, codeine and morphine.

The reason why opioids can be highly addictive is because they cause the brain to release dopamine, a neurotransmitter that brings about feelings of pleasure. With repeated exposure, these drugs can however become habit-forming.

Teens and young adults who have surgery may be at increased risk for opioid painkiller abuse, a new study indicates.

Substances believed not to be addictive

Opioids such as oxycodone (OxyContin) and hydrocodone (Vicodin) are commonly prescribed for pain after surgery.

“And until recently, it was generally believed they were not addictive,” said study lead author Dr Calista Harbaugh. She’s a general surgery resident at the University of Michigan Medical School.

“The study is an important step toward recognising that the [US] opioid epidemic is affecting adolescents and young adults in a major way,” Harbaugh said in an American Academy of Pediatrics news release.

Persistent opioid use

For the study, researchers analysed data from nearly 90 000 privately insured US patients aged 13 to 21 (average age 17) who underwent one of 13 common surgeries in this age group. The patients had no history of opioid painkiller prescriptions before their surgery.

The investigators looked for persistent opioid use – defined as continued prescription refills 90 to 180 days after the surgical procedure and beyond what is expected after routine surgery.

The overall rate of persistent post-surgical use was nearly 5%, ranging from less than 3% to more than 15% depending on the type of surgery and other factors, the findings showed.

The rate was 0.1% in a “control group” of teens and young adults who did not have surgery.

Leftover prescriptions

Patients who underwent gallbladder removal and colon surgery had the highest risk of persistent opioid use. Older youth with other chronic conditions, depression, anxiety or prior substance use disorders also had an elevated risk, according to the study.

Recent research has found that many adults become addicted to opioid painkillers after surgery, but this is the first study to suggest this problem also occurs in teens and young adults post-surgery, the researchers said.

“Most adolescents who misuse prescription opioids get the pills from leftover prescriptions of their family, friends, or their own,” Harbaugh explained. “We need to make sure that we treat pain after surgery, but it must be balanced with the risk of providing more opioid than necessary to patients and their communities.

Alternative treatments

Health24 recently mentioned a study where alternative pain treatments were explored. These include:

  • Acupuncture
  • Electrotherapy (the use of electric energy to stimulate nerves and muscles)
  • Cryotherapy (the application of extreme cold to the region of surgery)
  • Machine-based rehabilitation (continuous passive motion)
  • Pre-surgery exercise regimens

Image credit: iStock

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Health24.com | Fake sugar may not be a safer option for diabetics

A while back, Health24 featured a study that mentioned the link between artificial sweeteners and diabetes.

Now there is even more evidence that artificial sweeteners could lead to diabetes. 

A small Australian study suggests that consuming high amounts of artificial sweeteners might affect how the body responds to sugar – and might raise a person’s risk of diabetes.

‘Exaggerated’ spikes in blood sugar

“This study supports the concept that artificial sweeteners could reduce the body’s control of blood sugar levels,” said lead author Richard Young, an associate professor at the University of Adelaide’s medical school.

High sweetener intake might lead to “exaggerated” spikes in people’s blood sugar levels after a meal, he explained, which over time “could predispose them to developing type 2 diabetes.” He spoke in a news release from the annual meeting of the European Association for the Study of Diabetes in Lisbon, Portugal, where the findings were to be presented.

Blood sugar response hampered

 In the study, 27 healthy people were randomly picked to consume capsules containing either artificial sweeteners – either sucralose or acesulfame-K – or a “dummy” placebo.

The capsules were taken three times a day before meals for two weeks. The total dose included in a day’s worth of sweetener capsules was equal to drinking a little more than 1.5 quarts of an artificially sweetened diet beverage daily, the researchers noted.

At the end of the two weeks, tests showed that people who had taken the artificial sweeteners had changes in their body’s response to sugar, while those who had taken the placebo pills did not.

The study was small and lasted just two weeks, so more research would be needed. However, the findings bring up interesting questions, said one US diabetes specialist.

Dr Roubert Courgi is an endocrinologist at Southside Hospital in Bay Shore, New York. Reading over the Australian research, he noted that it “proved glucose [blood sugar] response is hampered” in heavy users of artificial sweeteners.

Increased risk of type 2 diabetes

“This study reaffirms that artificial sweeteners can still affect your body’s response to glucose,” he said.

Young noted that prior research has shown that regular consumption of large amounts of artificial sweeteners is associated with increased risk of type 2 diabetes.

factoid, honey

A US nutritionist agreed that while artificial sweeteners may seem like a healthy alternative to sugar, these products aren’t without their downsides.

‘Not a free pass’

“Artificial sugars are lower in calories but can still be an unhealthy addition to the diet,” explained Dana Angelo White, a registered dietitian who teaches at Quinnipiac University in Hamden, Connecticut.

“Just like eating too much sugar, too much fake sugar can also lead to health problems,” she said. “The bigger concern seems to be the long-term, large-quantity consumption, so, just like nutrition experts are always saying, moderation is key.”

For his part, Courgi said that sometimes the use of “low-cal” sweeteners simply encourages other unhealthy eating behaviours.

“These artificial sweeteners may offer less sugar than other products, but they are not a free pass to mass consumption,” he said. “Consumers should use discretion with these products because of the risk of diabetes.”

Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Use honey sparingly

There seems to be a big notion out there that honey is a more “natural”, healthier alternative to sugar. While honey in it’s purest form certainly has benefits, one should be mindful that some brands of honey can still contain pure glucose. Honey should be used sparingly.

If you can’t seem to shake your sweet tooth, ween off sugar gradually by making small changes to your diet and incorporating naturally sweet fruit into your diet. 

Image credit: iStock

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