A Prescription for Healthy Living

Have ever experienced that very annoying headache you get when wake up late and decide to skip having your daily coffee? I have, and it seems as if almost everything goes wrong when it happens.

Is this addiction? Am I in serious trouble? Is it time to gather up all my will and seek help? I don’t think so, and one cup of coffee every day isn’t going to hurt me.

But if you care about someone that may be in trouble, either a friend or a family member, then it’s very important to read this to help him/her before it’s too late. You may be able to save someone’s life by understanding more about addiction, its factors, its victims and most importantly, it’s treatment.


Addiction is a physical or mental dependence on a behavior or substance that a person feels powerless to stop.


Addiction is one of the most costly public health problems in the United States. It is a progressive syndrome, which means that it increases in severity over time unless it is treated. The term has been partially replaced by the word “dependence” for substance abuse. Addiction has been extended, however, to include mood-altering behaviors or activities. Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, and smoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There was as of 2004 a growing recognition that many addicts are addicted to more than one substance or process. Substance abuse is characterized by frequent relapse or return to the abused substance. Substance abusers often make repeated attempts to quit before they are successful.


The National Survey on Drug Use and Health (NSDUH) is conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services. Among the findings of the 2003 study are the following:

•In 2003, an estimated 19.5 million Americans, or 8.2 percent of the population aged 12 or older, were current illicit drug users. Current illicit drug use means use of an illicit drug during the month prior to the survey interview. The numbers did not change from 2002.

•The rate of illicit drug use among youths aged 12–17 did not change significantly between 2002 (11.6%) and 2003 (11.2%), and there were no changes for any specific drug. The rate of current marijuana use among youths was 8.2 percent in 2002 and 7.9 percent in 2003. There was a significant decline in lifetime marijuana use among youths, from 20.6 percent in 2002 to 19.6 percent in 2003. There also were decreases in rates of past year use of LSD (1.3 to 0.6%), ecstasy (2.2 to 1.3%), and methamphetamine (0.9 to 0.7%).

•About 10.9 million persons aged 12–20 reported drinking alcohol in the month prior to the survey interview in 2003 (29.0 percent of this age group). Nearly 7.2 million (19.2%) were binge drinkers and 2.3 million (6.1%) were heavy drinkers. The 2003 rates were essentially the same as those from the 2002 survey.

•An estimated 70.8 million Americans reported current (past month) use of a tobacco product in 2003. This is 29.8 percent of the population aged 12 or older, similar to the rate in 2002 (30.4%). Young adults aged 18–25 reported the highest rate of past month cigarette use (40.2%), similar to the rate among young adults in 2002. An estimated 35.7 million Americans aged 12 or older in 2003 were classified as nicotine dependent in the past month because of their cigarette use (15% of the total population), about the same as for 2002.



In 2003, the rate of substance dependence or abuse was 8.9 percent for youths aged 12–17 and 21 percent for persons aged 18–25. Among persons with substance dependence or abuse, illicit drugs accounted for 58.1 percent of youths and 37.2 percent of persons aged 18–25. In 2003, males were almost twice as likely to be classified with substance dependence or abuse as females (12.2% versus 6.2%). Among youths aged 12–17, however, the rate of substance dependence or abuse among females (9.1%) was similar to the rate among males (8.7%). The rate of substance dependence or abuse was highest among Native Americans and Alaska Natives (17.2%). The next highest rates were among Native Hawaiians and other Pacific Islanders (12.9%) and persons reporting mixed ethnicity (11.3%). Asian Americans had the lowest rate (6.3%). The rates among Hispanics (9.8%) and whites (9.2%) were higher than the rate among blacks (8.1%).


Rates of drug use showed substantial variation by age. For example, in 2003, some 3.8 percent of youths aged 12 to 13 reported current illicit drug use compared with 10.9 percent of youths aged 14 to 15 and 19.2 percent of youths aged 16 or 17. As in other years, illicit drug use in 2003 tended to increase with age among young persons, peaking among 18 to 20-year-olds (23.3%) and declining steadily after that point with increasing age. The prevalence of current alcohol use among adolescents in 2003 increased with increasing age, from 2.9 percent at age 12 to a peak of about 70 percent for persons 21 to 22 years old. The highest prevalence of both binge and heavy drinking was for young adults aged 18 to 25, with the peak rate of both measures occurring at age 21. The rate of binge drinking was 41.6 percent for young adults aged 18 to 25 and 47.8 percent at age 21. Heavy alcohol use was reported by 15.1 percent of persons aged 18 to 25 and 18.7 percent of persons aged 21. Among youths aged 12 to 17, an estimated 17.7 percent used alcohol in the month prior to the survey interview. Of all youths, 10.6 percent were binge drinkers, and 2.6 percent were heavy drinkers, similar to the 2002 numbers.


Rates of current illicit drug use varied significantly among the major racial-ethnic groups in 2003. The rate of illicit drug use was highest among Native Americans and Alaska Natives (12.1%), persons reporting two or more races (12%), and Native Hawaiians and other Pacific Islanders (11.1%). Rates were 8.7 percent for African Americans, 8.3 percent for Caucasians, and 8 percent for Hispanics. Asian Americans had the lowest rate of current illicit drug use at 3.8 percent. The rates were unchanged from 2002. Native Americans and Alaska Natives were more likely than any other racial-ethnic group to report the use of tobacco products in 2003. Among persons aged 12 or older, 41.8 percent of Native Americans and Alaska Natives reported using at least one tobacco product in the past month. The lowest current tobacco use rate among racial-ethnic groups in 2003 was observed for Asian Americans (13.8%), a decrease from the 2002 rate (18.6%).


Young adults aged 18 to 25 had the highest rate of current use of cigarettes (40.2%), similar to the rate in 2002. Past month cigarette use rates among youths in 2002 and 2003 were 13 percent and 12.2 percent, respectively, not a statistically significant change. However, there were significant declines in past year (from 20.3% to 19%) and lifetime (from 33.3% to 31%) cigarette use among youths aged 12 to 17 between 2002 and 2003. Among persons aged 12 or older, a higher proportion of males than females smoked cigarettes in the past month in 2003 (28.1% versus 23%). Among youths aged 12 to 17, however, girls (12.5%) were as likely as boys (11.9%) to smoke in the past month. There was no change in cigarette use among boys aged 12 to 17 between 2002 and 2003. However, among girls, cigarette use decreased from 13.6 percent in 2002 to 12.5 percent in 2003.

Causes and symptoms

Addiction to substances results from the interaction of several factors.


Drug chemistry

Some substances are more addictive than others, either because they produce a rapid and intense change in mood or because they produce painful withdrawal symptoms when stopped suddenly.



Some people appear to be more vulnerable to addiction because their body chemistry increases their sensitivity to drugs. Some forms of substance abuse and dependence seem to run in families; a correlation that may be the result of a genetic predisposition, environmental influences, or a combination of the two.


Brain structure and function

Using drugs repeatedly over time changes brain structure and function in fundamental and long-lasting ways. Addiction comes about through an array of changes in the brain and the strengthening of new memory connections. Evidence suggests that those long-lasting brain changes are responsible for the distortions of cognitive and emotional functioning that characterize addicts, particularly the compulsion to use drugs. Although the causes of addiction remain the subject of ongoing debate and research, many experts as of 2004 considered addiction to be a brain disease, a condition caused by persistent changes in brain structure and function. However, having this brain disease does not absolve the addict of responsibility for his or her behavior, but it does explain why many addicts cannot stop using drugs by sheer force of will alone.


Social learning

Social learning is considered the most important single factor in causing addiction. It includes patterns of use in the addict’s family or subculture, peer pressure, and advertising or media influence.



Inexpensive or readily available tobacco, alcohol, or drugs produce marked increases in rates of addiction. Increases in state taxes on alcohol and tobacco products have not resulted in decreased use.



Before the 1980s, the so-called addictive personality was used to explain the development of addiction. The addictive personality was described as escapist, impulsive, dependent, devious, manipulative, and self-centered. Many doctors in the early 2000s believe that these character traits develop in addicts as a result of the addiction, rather than the traits being a cause of the addiction.


When to call the doctor

The earlier one seeks help for their teen’s behavioral or drug problems, the better. How is a parent to know if their teen is experimenting with or moving more deeply into the drug culture? Above all, a parent must be a careful observer, particularly of the little details that make up a teen’s life. Overall signs of dramatic change in appearance, friends, or physical health may signal trouble. If parents believe their child may be drinking or using drugs, they should seek help through a substance abuse recovery program, family physician, or mental health professional.



In addition to noting a preoccupation with using and acquiring the abused substance, the diagnosis of addiction focuses on five criteria:

•loss of willpower

•harmful consequences

•unmanageable lifestyle

•increased tolerance or escalation of use

•withdrawal symptoms on quitting



According to the American Psychiatric Association, there are three goals for the treatment of persons with substance use disorders: (1) the patient abstains from or reduces the use and effects of the substance; (2) the patient reduces the frequency and severity of relapses; and (3) the patient develops the psychological and emotional skills necessary to restore and maintain personal, occupational, and social functioning.


In general, before treatment can begin, many treatment centers require that the patient undergo detoxification. Detoxification is the process of weaning the patient from his or her regular substance use. Detoxification can be accomplished “cold turkey,” by complete and immediate cessation of all substance use, or by slowly decreasing (tapering) the dose that a person is taking, to minimize the side effects of withdrawal. Some substances must be tapered because cold-turkey methods of detoxification are potentially life threatening. In some cases, medications may be used to combat the unpleasant and threatening physical and psychological symptoms of withdrawal. For example, methadone is used to help patients adjust to the tapering of heroin use.


The most frequently recommended social form of outpatient treatment is the 12-step program. Such programs are also frequently combined with psychotherapy. According to the American Psychological Association (APA), anyone, regardless of his or her religious beliefs or lack of religious beliefs, can benefit from participation in 12-step programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). The number of visits to 12-step self-help groups exceeds the number of visits to all mental health professionals combined. There are 12-step groups for all major substance and process addictions.


Alternative treatment

Acupuncture and homeopathy have been used to treat withdrawal symptoms. Meditation, yoga, and reiki healing have been recommended for process addictions; however, the success of these programs has not been well documented through controlled studies.



The prognosis for recovery from any addiction depends on the substance or process, the individual’s circumstances, and underlying personality structure. People who have multiple substance dependencies have the worst prognosis for recovery. It is not uncommon for someone in a treatment program to have a relapse, but the success rate increases with subsequent treatment programs.


Recovery from substance use is notoriously difficult, even with exceptional treatment resources. Although relapse rates are difficult to accurately obtain, the National Institute on Alcohol Abuse and Alcoholism cites evidence that 90 percent of alcohol dependent users experience at least one relapse within four years after treatment. Relapse rates for heroin and nicotine users are believed to be similar. Certain pharmacological treatments, however, have been shown to reduce relapse rates. Relapses are most likely to occur within the first 12 months of having discontinued substance use. Triggers for relapses can include any number of life stresses (problems in school or on the job, loss of a relationship, death of a loved one, financial stresses), in addition to seemingly mundane exposure to a place or an acquaintance associated with previous substance use.



The most effective form of prevention appears to be a stable family that models responsible attitudes toward mood-altering substances and behaviors. Prevention education programs are also widely used to inform young people of the harmfulness of substance abuse.

Parental concerns

Parents and guardians need to be aware of the power they have to influence the development of their kids throughout the teenage years. Adolescence brings a new and dramatic stage to family life. The changes that are required are not just the teen’s to make; parents need to change their relationship with their teenager. It is best if parents are proactive about the challenges of this life stage, particularly those that pertain to the possibility of experimenting with and using alcohol and other drugs. Parents should not be afraid to talk directly to their kids about drug use, even if they have had problems with drugs or alcohol themselves. Parents should give clear, no-use messages about smoking, drugs, and alcohol. It is important for kids and teens to understand that the rules and expectations set by parents are based on parental love and concern for their well- being. Parents should also be actively involved and demonstrate interest in their teen’s friends and social activities. Spending quality time with teens and setting good examples are essential. Even if problems such as substance abuse already exist in the teen’s life, parents and families can still have a positive influence on their teen’s behavior.

Few things feel more terrifying and random than a atroke, which can strike without warning. And fear of stroke — when a blood vessel in or leading to the brain bursts or is blocked by a blood clot, starving brain cells of oxygen and nutrients — is well founded. After all, stroke is the number-three killer in the U.S., affecting more than 700,000 people each year. Here are five foods that cause the damage that leads to stroke.

1. Crackers, chips, and store-bought pastries and baked goods

Muffins, doughnuts, chips, crackers, and many other baked goods are high in trans fats, which are hydrogenated oils popular with commercial bakeries because they stay solid at room temperature, so the products don’t require refrigeration. Also listed on labels as “partially hydrogenated” or hydrogenated oils, trans fats are found in all kinds of snack foods, frozen foods, and baked goods, including salad dressings, microwave popcorn, stuffing mixes, frozen tater tots and French fries, cake mixes, and whipped toppings. They’re also what makes margarine stay in a solid cube. The worst offenders are fried fast foods such as onion rings, French fries, and fried chicken.

Why it’s bad

For years scientists have known trans fats are dangerous artery-blockers, upping the concentrations of lipids and bad cholesterol in the blood and lowering good cholesterol. Now we can add stroke to the list of dangers. This year researchers at the University of North Carolina found that women who ate 7 grams of trans fat each day — about the amount in two doughnuts or half a serving of French fries — had 30 percent more strokes (the ischemic type, caused by blocked blood flow to the brain) than women who ate just 1 gram a day. Another recent study, also in women, found that trans fats promoted inflammation and higher levels of C-reactive protein, which have been linked to an increased risk of diabetes, heart disease and stroke.

What to do

Aim to limit trans fats to no more than 1 or 2 grams a day — and preferably none. Avoid fast-food French fries and other fried menu items and study packaged food labels closely. Even better, bake your own cookies, cakes, and other snacks. When you can’t, search out “health-food” alternative snacks, such as Terra brand potato chips and traditional whole grain crackers such as those made by Finn, Wasa, AkMak, Ryvita, and Lavasch.

2. Smoked and processed meats

Whether your weakness is pastrami, sausage, hot dogs, bacon, or a smoked turkey sandwich, the word from the experts is: Watch out.

Why it’s bad

Smoked and processed meats are nasty contributors to stroke risk in two ways: The preserving processes leave them packed with sodium, but even worse are the preservatives used to keep processed meats from going bad. Sodium nitrate and nitrite have been shown by researchers to directly damage blood vessels, causing arteries to harden and narrow. And of course damaged, overly narrow blood vessels are exactly what you don’t want if you fear stroke.

Many studies have linked processed meats to coronary artery disease (CAD); one meta-analysis in the journal Circulation calculated a 42-percent increase in coronary heart disease for those who eat one serving of processed meat a day. Stroke is not the only concern for salami fans; cancer journals have reported numerous studies in the past few years showing that consumption of cured and smoked meats is linked with increased risk of diabetes and higher incidences of numerous types of cancer, including leukemia.

What to do

If a smoked turkey or ham sandwich is your lunch of choice, try to vary your diet, switching to tuna, peanut butter, or other choices several days a week. Or cook turkey and chicken yourself and slice it thin for sandwiches.

3. Diet soda

Although replacing sugary drinks with diet soda seems like a smart solution for keeping weight down — a heart-healthy goal — it turns out diet soda is likely a major bad guy when it comes to stroke.

Why it’s bad

People who drink a diet soda a day may up their stroke risk by 48 percent. A Columbia University study presented at the American Stroke Association’s 2011 International Stroke Conference followed 2,500 people ages 40 and older and found that daily diet soda drinkers had 60 percent more strokes, heart attacks, and coronary artery disease than those who didn’t drink diet soda. Researchers don’t know exactly how diet soda ups stroke risk — and are following up with further studies — but nutritionists are cautioning anyone concerned about stroke to cut out diet soda pop.

What to do

Substitute more water for soda in your daily diet. It’s the healthiest thirst-quencher by far, researchers say. If you don’t like water, try lemonade, iced tea, or juice.

4. Red meat

This winter, when the respected journal Stroke published a study showing that women who consumed a large portion of red meat each day had a 42-percent higher incidence of stroke, it got nutrition experts talking. The information that red meat, with its high saturated fat content, isn’t healthy for those looking to prevent heart disease and stroke wasn’t exactly news. But the percentage increase (almost 50 percent!) was both startling and solid; the researchers arrived at their finding after following 35,000 Swedish women for ten years.

Why it’s bad

Researchers have long known that the saturated fat in red meat raises the risk of stroke and heart disease by gradually clogging arteries with a buildup of protein plaques. Now it turns out that hemoglobin, the ingredient that gives red meat its high iron content, may pose a specific danger when it comes to stroke. Researchers are investigating whether blood becomes thicker and more viscous as a result of the consumption of so-called heme iron, specifically upping the chance of strokes.

What to do

Aim to substitute more poultry — particularly white meat — and fish, which are low in heme iron, for red meat. Also, choose the heart-healthiest sources of protein whenever you can, especially beans, legumes, nuts, tofu, and nonfat dairy.

5. Canned soup and prepared foods

Whether it’s canned soup, canned spaghetti, or healthy-sounding frozen dinners, prepared foods and mixes rely on sodium to increase flavor and make processed foods taste fresher. Canned soup is cited by nutritionists as the worst offender; one can of canned chicken noodle soup contains more than 1,100 mg of sodium, while many other varieties, from clam chowder to simple tomato, have between 450 and 800 mg per serving. Compare that to the American Heart and Stroke Association’s recommendation of less than1,500 mg of sodium daily and you’ll see the problem. In fact, a nutritionist-led campaign, the National Salt Reduction Initiative, calls on food companies to reduce the salt content in canned soup and other products by 20 percent in the next two years.

Why it’s bad

Salt, or sodium as it’s called on food labels, directly affects stroke risk. In one recent study, people who consumed more than 4,000 mg of sodium daily had more than double the risk of stroke compared to those who ate 2,000 mg or less. Yet the Centers for Disease Control estimate that most Americans eat close to 3,500 mg of sodium per day. Studies show that sodium raises blood pressure, the primary causative factor for stroke. And be warned: Sodium wears many tricky disguises, which allow it to hide in all sorts of foods that we don’t necessarily think of as salty. Some common, safe-sounding ingredients that really mean salt:


  • Baking soda
  • Baking powder
  • MSG (monosodium glutamate)
  • Disodium phosphate
  • Sodium alginate

What to do

Make your own homemade soups and entrees, then freeze individual serving-sized portions. Buy low-sodium varieties, but read labels carefully, since not all products marked “low sodium” live up to that promise.


Everyone has a go-to the “hangover remedy”—burnt toast, greasy food, a Bloody Mary. I even know a guy who swears by the harrowing concoction called “The Bull’s Eye,” raw egg mixed into a glass of OJ. I’ll pass. While the placebo effect is powerful, there are better ways to silence the house DJ playing in your skull—ways that actually work.

First, understand that a hangover is caused by more than dehydration—though it does play a large role. Your body metabolizes alcohol into acetaldehyde, which is toxic to brain cells, says Robert Swift, M.D., Ph.D., a professor at Brown University’s Center for Alcohol and Addiction Studies. Another byproduct of booze breakdown is adenosine, a neurochemical that dilates blood vessels in the brain and causes a splitting headache. Pile on low blood sugar, a loss of electrolytes, stomach irritation, and poor-quality sleep, and it’s no wonder you feel the way you feel.

Don’t feel too shabby? You could be lucky; studies suggest that 25 to 30 percent of people are virtually immune to hangovers. That, or you might still be buzzed. It takes a full 8 to 11 hours for your blood alcohol content (BAC) to hit zero after you reach the amount of booze necessary to trigger a hangover. So, you still need to take precautions in the morning —even if you feel fine.

Follow these research-proven tips to fend off your nausea, pounding head, and general hatred of life.


1. Don’t Gulp Gallons

You’ve heard that dehydration is a major hangover cause, and it’s true. The problem: Too much water will only stretch out an already-irritated stomach, leading to (even more) nausea or vomiting. Instead, gulp 8 ounces of water every hour you’re awake after drinking.

2. Take the Right Painkiller


That’d be ibuprofen. Acetaminophen (Tylenol) can risk liver damage after a night of drinking. Because both acetaminophen and alcohol are metabolized by the liver, boozing disrupts your liver from fully breaking down the toxins in the pain pills, And aspirin can upset your stomach.

3. Grab Gatorade

After a few cups of water, switch to a sports drink. The extra salt helps your body absorb the fluids more quickly.

4. Brew Tea—But Don’t Drink It

Need to look presentable today? Steep black, chamomile, or green tea bags in boiling water for 3 to 5 minutes. After you let them cool, lie down and place a bag over each eye for 5 to 15 minutes. The tannins in the tea constrict blood vessels, pulling the skin taught to battle puffiness.

5. Eat Oatmeal for Breakfast …

When researchers gave breakfasts to hungover college students, those who ate slowly digestible carbohydrates, like oatmeal, performed better on mood and memory tests than subjects who chose simple sugars. To add protein and digestion-slowing fiber, stir a tablespoon of crunchy peanut butter into plain instant oats.

6. … With a Side of Eggs

The amino acid cysteine might help your liver recover from the stress of breaking down alcohol. Egg yolks, yogurt, and poultry are good sources.

7. Meet with Joe

Caffeinated coffee will increase your alertness and ease the dilated vessels in your brain, says Frederick Freitag, D.O., medical director of the Comprehensive Headache Center for Baylor Health Care System in Dallas. Just limit it two one or two cups to avoid caffeine’s potentially dehydrating effects.

8. Get Busy

Distraction—whether it’s taking down holiday decorations, or working out—will take your mind off the hangover. It won’t solve anything, but you’ll at least feel better in the moment.

Ah, it’s that time of year again. It seems ironic that we make weight-loss resolutions in winter, when there’s no shortage of warm pies fresh from the oven or crock-pots full of comfort food, rather than in summer when we can look forward to fresh berries and cool salads. But while researching my latest New York Times best-selling book, The Digest Diet, I was really struck by how much of weight loss is mental rather than physical. It’s not just about what you eat, but how you eat, when you eat—and how you present your food. For instance, studies have reported that people eat a whopping 40 percent more food when watching TV than during other activities. Imagine how much healthier we could all be if we stepped away from the tube!

I’ve pulled out my five favorites below, because I promise you, they make for completely achievable New Year’s resolutions. Start making 2013 the year of a happier, healthier you!

1. Eat just one less cookie a day.

Or consume one less can of regular soda, or one less glass of orange juice, or three fewer bites of a fast-food hamburger. Doing any of these saves you about 100 calories a day, according to weight-loss researcher James O. Hill, Ph.D., of the University of Colorado. Ask yourself if you really want it before you pop that bite in your mouth. Because that 100 calorie deficit alone is enough to prevent you from gaining the two-plus pounds most people pack on each year.

2. Avoid any prepared food that lists sugar, fructose, or corn syrup among the first four ingredients on the label.

You should be able to find a lower-sugar version of the same food, even items you wouldn’t think are loaded with sugars like ketchup, mayonnaise, or salad dressing. Also, think about how you can “thrive in five”: Look for fiber, protein, vitamin C, calcium, or dairy in all of your food choices. Seeking out these fat releasing groups of vitamins and nutrients on labels makes it easier to fill up without filling out and burn fat naturally.

3. Clean your closet of “too-big” clothes.

As you move toward your target weight, throw out or give away every piece of clothing that’s too loose, baggy, or ill-fitting. The idea of having to buy a whole new wardrobe if you gain the weight back will serve as a strong incentive to maintain your new figure. And what better time to start fresh than January 1st?

4. Downsize your dinner plate.

Studies find that the more food that’s in front of you, the more you’ll eat—regardless of how hungry you are. So instead of using 10 to 14 inch dinner plates that look empty if they’re not heaped with food, serve your main course on salad plates, which are only about 7 to 9 inches wide. The same goes for beverages. Instead of 16-ounce glasses and oversized coffee mugs, return to the “old” days of 8-ounce glasses and 6-ounce coffee cups. You’ll probably find you don’t miss the additional portion. You may already know this tip, but now is a great time to put it in action.

5. State the positive.

We’ve dubbed 2013 the year of optimism. You can, too! Instead of focusing on the things you think you can’t do—resisting junk food, or getting in a daily walk—repeat positive thoughts to yourself. “I can lose weight.” “I will get out for my walk today.” “I know I can resist after-dinner dessert.” Repeat these phrases like a mantra every day. Before too long, they will become your own self-fulfilling prophecy.

Happy New Year!