A Silent Killer: High Blood Pressure

Hypertension, or high blood pressure, is a common disease in both men and women. Hypertension is called the “silent killer” because it generally produces no obvious symptoms even while it causes widespread damage to the heart, brain, kidneys, and other vital organs. Although it can strike anyone at any time of their life, it’s most commonly seen in older individuals. In fact, over 70% of American women and 50% of American men over the age of 70 have hypertension. Other risk factors for this disease include high cholesterol levels, smoking, obesity, and diabetes.1

Normal blood pressure is defined as a systolic pressure of 130 mm Hg or below and a diastolic pressure of 85 mm Hg or below. High normal is pressures of 131-139 systolic and 86-89 diastolic. Hypertension is defined as a pressure of 140 systolic over 90 diastolic and above.

Blood pressure generally rises and falls throughout the day in a cyclic rhythm and is influenced by many factors, such as exercise and emotional stress.  To get the most accurate picture of your blood pressure, take numerous measurements at different times and average them.

Although doctors still don’t know what causes this most common type of hypertension, current research indicates that a complex interaction between genetic, environmental, and other variables is a significant factor. Secondary hypertension, which is much less common, is high blood pressure caused by known medical conditions, such as kidney disease, pregnancy, and sleep apnea.

The real dangers arise when blood pressure is elevated over a period of years or decades. Over such a time span, hypertension can cause significant damage to blood vessels that supply life-giving oxygen and nutrients to all parts of the body. The heart, brain, and kidneys, along with all other major body parts, can suffer irreparable harm from long-term hypertension.

It’s important to remember that an unhealthy elevation in just one of the two pressures (systolic or diastolic) can have disastrous long-term health consequences. Isolated high systolic pressure, which is the most common form of high blood pressure in older adults, is thought by many to be a significant indicator of heart attacks and strokes in people middle-aged and older. Isolated high diastolic pressure is a strong risk factor for heart attacks and strokes, especially in younger adults.

Hypertension Can Be Controlled Naturally

For those who hesitate to use anti-hypertensive drugs for whatever reason, non-drug strategies may significantly help in supporting healthy blood pressure. The Dietary Approaches to Stop Hypertension (DASH) diet is now recommended as a first-line approach in managing the disease. The DASH diet is high in fruits, vegetables, and other nutritious foods that are rich in potassium, calcium, and magnesium. People following the DASH diet are encouraged to decrease their saturated fats and replace them with foods that are high in monounsaturated fats and omega-3 fatty acids.

Other natural ways to control hypertension include not smoking, obesity control, and salt restriction – the current recommendation is for people with hypertension to limit their salt intake to 2400 mg (about 1 teaspoon) per day.

Arginine – The Source of Nitric Oxide

Another natural way to help support healthy blood pressure is through the use of L-Arginine based supplements.  L-Arginine is an amino acid that plays a vital role in promoting vascular health through the production of Nitric Oxide (NO).

Nitric oxide penetrates and crosses the membranes of almost all cells in the body, and it helps regulate many functions. It is even involved in memory function. In blood vessels, NO is vitally important because it regulates the tone of the endothelium, the layer of smooth cells that line the inside of the vessels. If these endothelial cells become dysfunctional, they can cause spasms or constrictions of the blood vessels that can then lead to hypertension.

Learn more about your options today. Visit www.hypertensa-adv.com for more information. 

  1. https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/know-your-risk-factors-for-high-blood-pressure

Amino Acids, Neurotransmitters and Pain Relief

Chronic pain is a complex condition that can change the way your body works. The natural chemicals (neurotransmitters) that your nervous system depends on to help manage pain and inflammation are in high demand, so making sure you have enough of them available is vital for proper relief.

Did you Know?

Amino acids and nutrients are the building blocks of  the neurotransmitters your nervous system uses to reduce the volume and frequency of pain and inflammatory signals. Addressing amino acid depletion with medical foods is a safe and easy way to restore the foundation of your nervous system’s health and an important part of any comprehensive pain management program.

5 Reasons Most Diets Fail (and How to Succeed)

How to Achieve Your Diet Goals

It is very important to know the facts of how to properly diet. On average, a person gains about 11 pounds for every diet they go on. In addition, the person loses both muscle and fat while on a diet, only to gain back the fat. Ultimately, this leads to a slower metabolism and more difficulty maintaining weight.

There are 2 crucial components to sustaining weight loss through a healthy diet.

  1. Reduce appetite in a slow and measured way by regulating the neurotransmitters in your gut and brain that drive hunger and overeating.
  2. Increase your metabolism so you are burning more calories throughout the day than you are consuming.

Here are 3 simple ways to achieve these 2 components:

Eat the Right Food at the Right Time:

Eating whole, fresh food to satisfy your appetite can cut down on the carbs and sugary foods that increase hunger and slows metabolism. Never skip breakfast and avoid eating 3 hours before bed.

Less Calories is not Always Good:

Eating fewer calories to lose weight is an idea that is quickly fading. Recent studies have shown that some calories make you fat while others can make you thin. The staples of your diet should be low-glycemic foods. For example, nuts, seeds, chicken, fish, grass fed meat and greens. Grains and bean consumption should not exceed more than half a cup once a day each. Use sugar sparingly in small doses and avoid artificial sweeteners.

Low-Fat is not Always Good:

Eating fat is not what makes you fat but eating sugar does. Studies have shown that low-carb, high-fat vegan diets were more effective at weight loss than a low-fat vegan diet. Also, eating more fat and less carbs is shown to increase metabolism. Good fats makes you feel full faster and should be eaten at every meal. Examples of good fats include avocado, nuts, seeds, coconut oil, organic eggs, chicken, grass fed meats and fish.

Are you Overweight or Obese? Here is what you should know

Know your body mass index (BMI) so you can improve it.

You BMI is a measurement of body fat that is based on your height and weight. Your BMI is a major factor that your healthcare provider considers when determining treatment protocols. A person with a BMI of between 25 and 29.99 is classified as ‘overweight,’ and a BMI of 30 and above is classified as obese. People who are overweight or obese are at a higher risk for chronic conditions such as high blood pressure, diabetes and high cholesterol. Click here to calculate your BMI.

What is causing the obesity epidemic?

Simply put, too many calories. If you are eating more calories than you are burning throughout the day, you will inevitably gain weight. The increased availability and accessibility of energy dense foods is contributing to an unhealthy increase in weight across the world. Combine that with a steady decline in physical activity and the results are fatal and very costly.

Can the course of obesity be changed?

For most people struggling with obesity, the answer is yes! Unfortunately the process is not simple, as reducing calories and increasing physical activity is not easy and not always the answer.

If you are looking to improve your diet try reading this post. Drastically reducing calories is not the best answer, because not all calories are bad. There is no quick fix to obesity, but rather micro lifestyle changes that are implemented daily and maintained for long periods of time.

To simplify your journey to a healthier you, try starting with these tips:

  1. Avoid eating saturated fats
  2. Increase the amount of fruits, vegetables, whole grains and nuts you eat daily.
  3. Cut out sugars and sodium from your diet gradually.
  4. Exercise 15 minutes every day for the first two weeks, then push to 30 minutes every day for the next two weeks, then try an hour every day.

Enjoy the process and don’t go at it alone! Work in teams to meet your goals.

Quick Diet Tips to Naturally Boost Metabolism

Tip # 1 – Eat More Whole Grains

Why? Because your body burns twice as many calories breaking down whole foods, especially those rich in fiber such as oatmeal and brown rice, than processed foods.

Tip # 2 – Eat More Lean Meats

Why? Because protein has a high thermogenic effect, helping you burn about 30% of the calories the food contains during digestion (so a 300-calorie chicken breast requires about 90 calories to break it down).

Tip # 3 – Eat Low-fat Dairy Products

Why? Because dairy is rich in calcium and vitamin D, which help preserve and build muscle mass, an essential part of maintaining a robust metabolism.

Tip # 4 – Try Drinking Green Tea Daily

According to the American Journal of Clinical Nutrition, drinking four cups of green tea each day can help you lose weight over time. Why? Because a compound called EGCG in the brew can temporarily speed up your metabolism. Try keeping a jug of iced green tea in the fridge for easy access.

Tip # 5 – Add Lentils to your Daily Diet

Why? Because one cup of lentils can pack up to 35% of your daily iron needs in addition to fiber which helps you feel full for longer periods of time.

Tip #6 – Eat Some Hot Peppers (or Hot Sauce) When You Can

Why? Because hot peppers contain a compound called capsaicin. This helps give chili peppers their kick that heats up your body, helping you burn additional calories. Try adding cayenne or hot sauce to soups, eggs, and meats for the added effect.

Is exercise better than drugs for cancer fatigue?

March 7, 2017

A recent study suggests that cancer patients may ease fatigue more effectively with exercise and psychotherapy than with medications.

Researchers conducted a meta study, which looks at data from 113 previously published studies involving more than 11,500 cancer patients with fatigue.

According to the data, exercise and psychotherapy were associated with a 26 percent to 30 percent reduction in fatigue during and after cancer treatment, the study found. Drugs, however, were tied to only a 9 percent decline in fatigue.

Cancer-related fatigue is common and may be tied to the effects of tumors or treatments. Unlike other types of exhaustion, just getting more sleep or giving aching muscles a break from strenuous activities can’t address fatigue associated with tumors.

Fatigue tied to cancer can persist for years and may be worsened by other cancer-related health problems like depression, anxiety, sleep disturbance and pain.

Most participants in the studies were female, and almost half of the studies involved women with breast cancer.

Age, gender, cancer type and forms of exercise didn’t appear to influence how effective exercise or psychotherapy was relative to medications, researchers found.

Overall, the analysis included 14 drug studies, mostly looking at stimulants or drugs designed to promote wakefulness.

Among the 69 evaluations of exercise, most looked at aerobic activity alone or in combination with other types of movement.

Of the 34 psychological interventions tested in the studies, most involved therapies focused on behavior and education.

One benefit of the current study is that researchers were able to pool the data from several individual research efforts that were, alone, too small to draw meaningful conclusions about the relative advantages of different treatments, the authors note.

Limitations include the varied designs in the studies, which made it difficult to assess how factors such as race, education, income or other demographic differences might have impacted the results, the researchers also point out.

Exercise and/or psychological interventions are beneficial for treating cancer-related fatigue and based on the results of this meta study both appear superior to current pharmaceutical treatments.

SOURCE: http://bit.ly/2mUd4Yv JAMA Oncology, online March 2, 2017.

READ NEXT: Managing Pain without Drugs

Everyday Medications that Increase the Risk of Heart Attack

Data out of Stanford University suggest that Proton Pump Inhibitors (PPI’s) such as Prilosec, Prevacid, and Nexium are associated with a higher risk of heart attack.  Published in the journal PLOS One online, researchers looked over 2.9 million patients over a several year period to determine if patients who took PPI’s for gastro esophageal reflux had an increased risk for myocardial infarction than patients who did not.  Concern was raised when scientists discovered that PPI’s potentially reduced the antiplatelet effect of clopidogrel, a drug use to prevent clotting after a heart attack or stroke.  The clopidogrel is used after heart attack to prevent clotting which could lead another heart attack.  They were concerned that if heart attack was raised in this population, it could extend to lower risk patients.

The study showed that patients taking PPI’s had a 16% increased risk of heart attack.  H2 Blockers, such as Zantac and Pepcid were not associated with an increase risk.  Perhaps more importantly, the risk was not just associated with high risk categories such as having had a previous heart attack, the elderly or taking clopidogrel.  It was applicable to all ages and risk groups.

The study has several limitations including the attempt to look back at charts and determine what medications are being taken.  Often patients will take over the counter PPI’s and may not be accurately reporting it to their physician.  Also, retrospective analyses like this are subject to certain biases and are not as valuable as preplanned double-blind clinical trials.  However, the large number of patients reviewed does give the study significant credence.

PPI’s are one the most commonly used medications in the United States and around the world, with over 113 million prescriptions filled globally each year.  PPI’s are used to treat stomach and intestinal ulcers and heartburn, as well as to prevent gastrointestinal bleeding from NSAID’s in higher risk populations.  NSAID’s have been associated with a number of serious complications in addition to bleeding ulcers including kidney and liver issues, fluid retention with swelling in the legs, elevated blood pressure and possibly increasing the risk of heart attack.

Medications that are often used to treat or prevent the side effects of another medication create a potentially vicious cycle for patients who will ultimately end up taking more and more medications to manage an illness. The risk of adverse events increases with the number of medications prescribed, and the number of medications prescribed increases with age.

The avoidance of polypharmacy and therefore reducing the risk of dangerous medication side effects is crucial for patients and providers.  Alternative therapies, such as FDA regulated medical foods, which by definition must be on the FDA GRAS list (generally recognized as safe), may have similar efficacy to standard pharmaceuticals but without the side effects. Understanding the risks and benefits of medications is an important part of being a patient and a healthcare provider. Exploring the medication options that may be better tolerated is something every patient and physician should do.

 

Prescription Drug Overdose Deaths on the Rise

The Trust for America’s Health, a nonprofit organization, reported that in 2013 over 44,000 Americans died as a result of drug overdose.  Drug overdoses have been rising since 2009, despite federal and state efforts to better monitor and control use of narcotics and other potentially addictive medications.  Over half of these deaths were related to prescription drugs and in fact, in 36 states more people died from a Rx drug overdose than from automobile accidents.  These numbers are staggering, especially when you consider that drugs such as narcotics (Vicodin, Percocet, etc.) do not cure any disease, they only mask a symptom, pain.

Physicians are under increased scrutiny for prescribing these dangerous drugs and are constantly looking for reliable, clinically proven alternatives.  Until recently, options were limited to NSAIDs, such as ibuprofen and naproxen, which can have significant side effects most specifically on the gastrointestinal tract, and medications used to treat other conditions such as SSRIs, anti-epileptics, and SNRIs,  but that may also help pain as well. The efficacy of these options are limited at best and often cause significant side effects without providing adequate pain relief.

 

Evidence Based Options for Patients and Providers

Theramine, a amino acid based treatment for pain, has been shown in multi-center clinical trials to significantly reduce pain in patients with chronic low back pain without any appreciable side effects better than over the counter doses of ibuprofen or naproxen.  Theramine is regulated as a medical food by the FDA and is manufactured in the United States at a cGMP facility using ingredients that are Generally Recognized as Safe. As a medical food, Theramine is subject to much tighter regulatory oversight than dietary supplements, providing patients and providers with piece of mind knowing that the formulations are tested and evaluated for efficacy.  There have been over 40 million individual doses of Theramine administered since 2004, without a single reported GI bleed, adverse cardiac event or stroke reported the most commonly known side effects of NSAIDs.  Theramine is not addictive and can be taken with other medications or medical conditions.  Theramine provides chronic pain patients a safe, effective and proven alternative to other potentially more dangerous pain medications.

Is Your OTC Pain Reliever Going to Kill You?

Although acetaminophen (Tylenol) is heavily marketed for its safety, FDA recommends health care professionals to discontinue prescribing and dispensing drug products with more than 325 mg of acetaminophen due to the high risk of liver injury.  Severe liver injury may occur in patients who:

  • Took more than the prescribed dose of an acetaminophen containing product in a 24 hour period.
  • Took more than one acetaminophen containing product at the same time.
  • Drank alcohol while taking acetaminophen products.

Acetaminophen is widely used as an over the counter pain reliever and fever medication and is often combined with other ingredients such as cough and cold ingredients.  Patients may be unaware that many products (both prescription and OTC) may contain acetaminophen, making it easy to accidentally take too much [1-5]. In fact,  acetaminophen poisoning accounts for approximately one-half of all cases of acute liver failure in the United States and Great Britain[16].

Ibuprofen (Motrin, Advil) is also widely used for pain and inflammation but not without risk.  Ibuprofen carries a black box warning from the FDA regarding the cardiovascular and gastrointestinal risks associated with its use.  Patients taking ibuprofen have an increased risk of serious cardiovascular thrombotic events including myocardial infarction and stroke. Researchers in Denmark observed a nearly threefold increase in the number of deaths from gastrointestinal bleeding within one year of ibuprofen prescription [14].  The risk of side effects is so high for elderly patients the American Geriatrics Society has recommended that patients over the age of 65 avoid NSAID use if at all possible [6-10].  This real risk was studied by RE Tarone who noted a marked rise in baseline rate of gastrointestinal bleed with advancing age with the large majority of cases occurring among persons age 65 or older.  The average relative increase in risk of gastrointestinal bleeding was found to be fourfold or slightly higher in NSAID users and six fold or higher at heavy prescription levels [15].

NSAID High Risk Groups

Medications such as Tylenol and ibuprofen, which are readily available over-the-counter, are perceived to be safe medications; but research has proven that they are not without risk.  Physicians, payers and patients are requesting a safe more effective alternative to treat pain which becomes increasingly important as the population ages.

Medical foods such as Theramine treat the dietary deficiencies that are associated with pain and inflammation.  Pain reduction is accomplished by moderating responsiveness to noxious stimuli, regulating the transmission of pain signals and controlling inflammation. The use of medical foods has been long standing and there have been no reports of GI bleed in over 10 years on the market.

Two multi-center double-blind clinical trials established the safety and efficacy of Theramine in the treatment of chronic back pain.  In a clinical study comparing the medical food Theramine and a non-steroidal anti-inflammatory medication, Theramine was shown to be more effective than low dose NSAIDs in treating low back pain.  Clinical data indicate significant reduction in back pain with the administration of Theramine alone, while administration of a low dose NSAID had no appreciable effect on pain.

An important observation by researchers EL Fosbol and L Kober note that, “Individual NSAIDs have different cardiovascular safety that needs to be considered when choosing appropriate treatment.  In particular, rofecoxib and diclofenac were associated with increased cardiovascular mortality and morbidity and should be used with caution in most individuals.  This notion is also valid for healthy individuals and underlines the importance of critical use of NSAID therapy in the general population and also that over-the-counter retail of NSAIDs should be reassessed.”[13]

 

REFERENCES

 

1.  Wolf M; King J; Jacobson K; et al “Risk of Unintentional Overdose with Non-prescription Acetaminophen Products”  J Gen Intern Med 2012 Dec; 27(12): 1587-1593

2.  “Acetaminophen Toxicity in Children” Pediatrics vol. 108 No. 4 Oct. 1 2001

3.  Farrell S; Tarabar A; et al “Acetaminophen Toxicity” Medscape June 24, 2011

4.  Plaisance K “Toxicities of Drugs Used in the Management of Fever” Clinical Infectious Diseases 2000 31 Supp 5: S219-S223

5.http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm381650.htm

6.http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm085282.htm

7.  Pilotto A; Franceschi M; Leandro G; Di Mario F; “NSAID and aspirin use by the elderly in general practice:  effect on gastrointestinal symptoms and therapies:  Drugs Aging 2003; 20(9): 701-10.

8.  Smith SG “Dangers of Non-steroidal Anti-inflammatory drugs in the elderly” Can Fam Physician vol. 35 March 1989

9.  American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

10.  Gurwitz JH; Everitt DE; Monane M; Glynn RJ, Choodnovskiy I; Beaudet MP; Avorn J; “The impact of ibuprofen on the efficacy of antihypertensive treatment with  hydrochlorothiazide in elderly persons” J Gerontol A Biol Sci Med Sci 1996 Mar; 51 (2): M74-9

11.  Shell WE; Charuvastra E; DeWood M; May L; Bullias D; Silver D “ A Double-blind controlled trial of a single dose naproxen and an amino acid medical food Theramine for the treatment of low back pain”  Am J of Ther 2010

12.  Shell WE; Pavlik S; Roth B; Silver M; Breitstein M; May L; Silver D “ Reduction in pain and inflammation associated with chronic low back pain with the use of the medical food Theramine”  Amer J of Ther 2014

13.  Fosbol EL; Kober L; Torp-Pedersen C; Gialason GH “ Cardiovascular safety of non-steroidal anti-inflammatory drugs among healthy individuals”  Expert Opin Drug Saf 2010 Nov; 9(6): 893-903

14.  Lipworth L; Friis S; Blot Wj; McLaughlin JK; Mellemkjaer L; Johnsen SP; Norgaard B Olsen JH “ A population based cohort study of mortality among users of ibuprofen in Denmark”  Am J Ther 2004 May-Jun; 11(3): 156-63

15.  Tarone RE; Blot WJ; McLaughlin JK “Nonselective non-aspirin non-steroidal anti-inflammatory drugs and gastrointestinal bleeding:  relative and absolute risk estimates from recent epidemiologic studies”  Am J Ther 2004 Jan-Feb; 11(1): 17-25

The Problem with Prescription Pain Killers

Pain is a big deal. On one level, it’s very useful. It tells us when there’s something wrong, and is pretty efficient at giving us a handy indication when what we’re doing may not be particularly good for us. Those who cannot feel pain [1] suffer from horrendous associated problems, and frequently damage themselves quite badly without being alerted to the fact that they’re doing so by pain. However, unlike a man-made alarm, the body does not come with an ‘off’ switch which one can hit once one’s been made aware of the problem. Chronic pain is a major issue, and one of the most troubling symptoms of a great many medical conditions. It’s a factor which seriously affects people’s lives, and good pain management is recognized as being vital to the all-important quality of life [2] experienced by those needing medical treatment. Having said this, however, it is also being increasingly recognized that the people of North America are becoming dangerously dependent upon prescription painkillers. All too often, we pop a pill when we do not really need to, and plenty of us are relying on prescribed narcotic painkillers when we would undoubtedly be a lot better off with some other method of pain-relief. While there is certainly a place for narcotic painkillers in the management of seriously painful conditions, it needs to be recognized that these drugs do come with a major health warning – and alternatives or avoidance should be the preferred options if at all possible.

Narcotic Painkillers

Opioid painkillers were originally designed for cancer pain and somehow over time have become a first line therapy for many physicians despite the potential for addiction. What may be lesser known, however, are the dangers inherent within these drugs, and the startling scope of America’s dependence upon them. Put simply, opioids such as Vicodin and codeine bind to opioid receptors within the brain, which dulls the brain’s pain response. These receptors are designed to work with the body’s natural opioids – endorphins [3]. Endorphins are released during exercise, and numb pain as well as promoting a feeling of wellbeing, enabling and motivating us to stay on the move and thus potentially to survive for longer. Narcotics fulfil the same role – but in hyper-exaggerated form. Narcotic analgesics swamp our opioid receptors, saturate them to the point where we’re utterly numbed and frequently rather high. They’re very effective as a method of pain relief, but also quite dangerous and are associated with a host of dangerous side effects.

Painkiller Addiction

It’s very easy to develop a taste for opioid painkillers. Why wouldn’t you? They keep pain at bay, and they make you feel good. They’re also, unfortunately, highly addictive. Their very nature means that you’re inclined to seek out more and more – and America’s healthcare system doesn’t exactly discourage you from overdoing it. Big pharmaceutical companies do, after all, stand to make a lot of money from plenty of pill-popping patients. North America has the world’s worst rate of prescription painkiller addiction by a long, long way [4]. Places with nationalized healthcare (in which pharmaceutical companies would have nothing to gain from touting their product to the public) are not in any more pain than the people of America, but they’re far less addicted to painkillers. The solution for someone from the USA to the slightest malady invariably involves popping a pill, while those from other countries are put on courses of pills only when necessary, and given alternative pain-relief methods more often. Each system obviously has its pros and cons – but in this particular case the figures concerning painkiller addiction speak for themselves. More overdose deaths in the USA have been caused by prescription narcotics since 2003 than cocaine and heroin put together – partly (if not wholly) because narcotic prescription rates have increased enormously in this time [5].

An Easy Death

A major issue with opioid painkillers is that they’re not only all too easy to get hold of, and highly addictive – they’re also unpredictable killers. While medical science is pretty good at estimating doses according to body weight and so on, the problem of tolerance is always going to rear its ugly head. The body develops a resistance to opioids over time which means that one must take a higher and higher dose in order to achieve the desired effect. And, at any moment, that dose might prove just too high for the body to cope with. Opioids kill in a number of ways. The most common of these is respiratory depression. This can be reversed – but only if the overdose is low and medical aid arrives quickly [6]. If this is not the case, then the overdoser finds themselves unable to adequately fill their lungs and essentially starves of oxygen. It is far better not to risk this, not to get addicted, and to seek alternatives to narcotic analgesics whenever possible!

[1] Gillian Mahoney, “Meet the Child Who Feels No Pain”, ABC, Oct 2013

[2] Nathanial Katz, “The Impact of Pain Management on Quality Of Life”, Journal of Pain and Symptom Management, Jul 2002

[3] PBS, “Role of endorphins discovered, 1975”

[4] Arnold M. Washington, “America’s Painful Love Affair With Painkillers”, Rehabs

[5] National Safety Council, “Opioid painkillers: How they work and why they can be risky”

[6] Ben Wolford, “Respiratory Depression Reversed In Trials With Drug That Fights Opioid Side Effect”, Medical Daily, Aug 2014