TIME Innovation

Five Best Ideas of the Day: August 5

1. The grinding stress of life in poverty – not the scarcity of healthy options – leads the poor to unhealthy eating.

By James McWilliams in Pacific Standard

2. Cutting out the middlemen: Loan servicers aggravate the college debt crisis.

By Chris Hicks in the Reuters Great Debate

3. We must treat addiction as a learning disorder.

By Maia Szalavitz in Substance

4. Stop trying to be the “next Silicon Valley.”

By Ross Baird and Rob Lalka in Forbes

5. A first step: The Ugandan Constitutional Court strikes down that country’s vicious anti-gay law, but more fight remains.

By James K. Arinaitwe and Adebisi Alimi from the Aspen New Voices Fellowship

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

MONEY Shopping

Seriously, Here’s How You Know If You’re Addicted to Shopping

Woman with shopping bags
Peter Cade—Getty Images

For those who shop to relieve stress, "retail therapy" is no joke.

“It’s not just shopping, it’s retail therapy.”

As a bumper sticker or a joke between friends, this may be amusing. For those who shop to relieve stress, it’s not nearly so funny. Medicating or soothing painful feelings with money is no healthier a behavior than medicating with alcohol or food. When stressed or in difficult circumstances, some people drink, some people eat, and some people shop.

As a financial adviser, I’ve worked with several clients with extreme forms of this behavior, who described their spending clearly as an addiction. It gave them a physical “high” similar to that experienced by an alcoholic or drug addict. Like other addictions, it had destructive consequences, such as overwhelming debt, loss of life savings, ruined relationships, and even theft from family members or employers.

Using spending as a medicator does not always show up in such dramatic ways, however. Even people who seem to live moderately and manage money responsibly can be “therapy shoppers” who spend in order to make themselves feel better.

When I met Alexandra, for example, she was single, in her 40s, with a well-paying job and a substantial net worth. She was investing part of her income, was current on all her financial obligations, and had only a modest amount of debt. She was certainly not spending beyond her means or jeopardizing her future security. She didn’t appear to be in any financial difficulty.

When we looked at her budget, however, Alexandra was clearly uncomfortable with some of her spending habits. Instead of simply reassuring her that she was managing her money well and not overspending, I explored this issue with her. Eventually I brought up the possibility that she might be medicating her difficult emotions with spending. It was an “aha!” moment for her. She told me, “I’ve been doing that for years.”

Alexandra’s problem wasn’t the amount she spent. It was the reasons behind her spending. If she had a stressful day at work, she would go to the mall, in much the same way another person might stop at a bar for a couple of drinks on the way home. Shopping, finding bargains, and buying herself gifts were unthinking actions she used to soothe herself when she was upset.

She never stopped to ask herself whether she needed or even wanted the things she bought. She didn’t spend more than she could afford, but she was spending time as well as money unproductively. She was also cluttering her house and her life with clothes she didn’t wear, knickknacks she didn’t care about, and gadgets she didn’t use.

Once she realized the emotional reason for her shopping, Alexandra was able to find more constructive ways to deal with stress. She learned healthier responses to difficult days. Talking with a friend, writing in her journal, meditating, or taking a walk could serve the same purpose as a trip to the mall.

For Alexandra, simply recognizing that she was using shopping to soothe her emotions was enough to help her change. People with more deeply ingrained behavior might find change more difficult. In such cases, clients could benefit greatly from working with a financial therapist with the expertise to help them look at the emotions underlying their spending patterns.

The important point for a financial planner is to look beyond the numbers. The main issue isn’t whether a client’s “retail therapy” is affordable or whether it is causing serious financial difficulties. If a behavior is creating discomfort for clients, as it was for Alexandra, helping them explore what lies behind it can be a valuable service.

TIME Addiction

America Has a Painkiller Problem, CDC Says

A new CDC report shows some states prescribe more painkillers than others

In the United States, 46 people die from an overdose of prescription painkillers every day, according to a recent report from the CDC.

The report, which looked at opioid prescriptions in the U.S. found that physicians wrote 259 million prescriptions for painkillers in 2012, which is enough for every adult in the U.S. to have a bottle of pills. The states with the highest number of painkiller prescriptions are in the South. The CDC reports that in 2012, health care providers in the states with the highest number of painkiller prescriptions wrote nearly three times as many prescriptions per person as the state with the lowest number.

The number of prescriptions are very alarming, considering that the high prescriptions is linked to more deaths from overdose.

IMS, National Prescription Audit (NPATM), 2012 CDC
SOURCES: NY, TN: PDMP Center of Excellence at Brandeis University, 2014. FL: Vital Signs Mortality and Morbidity Weekly Report, July 1, 2014. CDC

The CDC says states should increase use of prescription drug monitoring programs that track painkiller prescriptions by state. ProPublica has created a database that shows the doctors and providers who prescribe the most painkillers.

TIME Marijuana

Six Ways Science Says Marijuana May Hurt Your Health

New Year Celebration
Partygoers smoke marijuana during a New Year's Eve party at a bar in Denver, celebrating the 2014 start of retail pot sales in Colorado. Brennan Linsley—AP

With the increasing push for the legalization of marijuana across the country, science is rolling out research on why pot may not be so harmless.

Boosters of marijuana legalization often speak about the relative harmlessness of the drug, especially when compared to alcohol and tobacco, which kill millions of people a year worldwide. But while the evidence suggests that pot is less damaging than some other legal drugs, the exact effects of marijuana on human health have not been well studied. Existing research is often limited in scope and rarely shows a clear causal connection.

But there have been some worrying findings, especially considering the increasing use of marijuana by American adults. A paper published this year in Forensic Science International, for instance, described two rare deaths of young men that were attributed to heart conditions resulting from marijuana use.

With legalization taking place in Colorado and Washington State, more research will now be possible. For now, here is a tour of what has been documented so far about marijuana’s negative effects.

1. It can interfere with learning

Marijuana interferes with the brain’s cannabinoid receptors, affecting cognitive functions such as movement, memory, and emotional control. A recent small study found that impairment in working memory occurs immediately after marijuana use. Subjects who received a higher dose of THC—marijuana’s main active chemical—took significantly longer to complete immediate recall and mental calculation tasks.

2. It can lead to dangerous driving

Pot impairs functions key to driving, including reaction time, hand-eye coordination and depth perception, a study by the University of Chicago reported. In the first full year after medical marijuana was legalized in Colorado, there was a 12% increase in traffic fatalities, according to data analysis by researchers at Columbia University. However, studies have not been able to provide consistent evidence to prove that the effects of marijuana cause an increased rate of collisions. According to a different study published in Accident Analysis and Prevention, the closest comparison to the culpability of accident when under the influence of marijuana is to a driver who has taken penicillin, anti-depressants or an antihistamine, which suggests marijuana’s effects have a nominal impact on accident risk. More research is needed.

3. It may harm the developing brain.

Although a causal connection has yet to be found, studies show regular marijuana use—once a week or more—can change the structure of the teenage brain. Marijuana affects memory and problem solving abilities, both of which can impact academic performance. Researchers from the Harvard School of Medicine and Northwestern University Feinberg School of Medicine surveyed a small group between the ages of 18 and 25 and noticed structural abnormalities in the brain, specifically in grey matter, the nucleus accumbens, and the amygdala, after recreational marijuana use.

4. It could make you panic.

Marijuana may alleviate anxiety for some, but for others it can cause it. THC can cause increased heart rate, poor coordination, or lightheadedness, which can be triggers for anxiety attacks. Some research suggests that people who frequently use of marijuana—and who started using it as young adults—were more likely to have anxiety disorders or depression. Whether cannabis use causes anxiety disorders, however, is not known.

5. It can be addictive.

One in 10 users exhibits symptoms of dependence, according to the American Psychological Association. Marijuana’s rate of dependence liability of 9% is comparable to that of anti-anxiety medications and is well under the liability rates of alcohol (15%) and tobacco (32%), according to a study by the Institute of Medicine. However, the reason why some become addicted and others don’t remains unclear. Genetic studies have suggested that the involvement, or lack thereof, of CB1 receptors in response to cannabis can influence the likelihood of addiction. The receptor gene has been found to have a connection to the development of dependence to drugs and alcohol. Studies done on animals suggest that cannabis triggers reward centers in the brain, including neurons that produce dopamine, which could also encourage continued use.

6. It can stress your heart

Marijuana-related deaths are so rare as to be treated as mythological by marijuana boosters, but a paper published this spring in Forensic Science International does describe the deaths of two healthy men, ages 23 and 28, who experienced heart trouble after using marijuana. “To our knowledge, these are the first cases of suspected fatal cannabis intoxications where full postmortem investigations, including autopsy, toxicological, histological, immunohistochemical and genetical examinations, were carried out,” the authors write. The authors surmise that the cardiovascular events were the result of increased heart rate that can happen in some pot smokers, particularly in the first hours after using marijuana. Nonetheless, the authors conclude, that the “absolute risk of cannabis-related cardiovascular effects can be considered to be low, as the baseline risk for most cannabis smokers is low and cannabis-induced changes are transient.”

TIME medicine

Chicago Sues Painkiller Makers for Deceptive Marketing

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Rafe Swan—Getty Images/Cultura RF

Five pharmaceutical companies stand accused of marketing a highly addictive painkiller, normally used for cancer treatments, as an answer to everyday aches and pains

The city of Chicago filed suit against five pharmaceutical manufacturers on Monday, for allegedly marketing a class of highly potent painkillers for common aches and pains, while masking the risks of addiction.

The lawsuit charges Purdue Pharma L.P., Cephalon, Inc., Janssen Pharmaceuticals, Inc., Endo Health Solutions Inc. and Actavis plc for marketing highly addictive opioids normally used in cancer treatments as a remedy for everyday pains, including back pains, arthritis and headaches.

“This has led to a dramatic rise in drug addiction, overdose and diversion in communities across the nation, and Chicago is not immune to this epidemic,” said Mayor Rahm Emanuel in a statement.

The city is seeking compensation for approximately $9.5 million in prescription payments. It also alleges drug abuse burdened local hospitals with an influx of patients. The mayor’s office said painkiller abuse had climbed 65% between 2004 and 2011, resulting in 1,080 trips to the emergency room.

 

 

TIME Addiction

Scientists to WHO: Don’t Classify E-Cigs As Tobacco Products

A woman smokes a "Blu" e-cigarette in Washington, D.C., on Sept. 25, 2013.
A woman smokes a "Blu" e-cigarette in Washington, D.C., on Sept. 25, 2013. Jim Watson—AFP/Getty Images

The move by the WHO would push 178 countries to impose tough restrictions on the products, which some scientists say provide a less harmful alternative for smokers.

A group of 53 top scientists warned the World Health Organization Thrusday not to classify e-cigarettes in the same category as other tobacco products, a move that would lead to significant restrictions on the devices in most countries around the world.

The scientists say that electronic cigarettes are in fact “part of the solution” in the fight against smoking because they can provide a healthier alternative to traditional cigarettes, Reuters reports.

“Even though most of us would prefer people to quit smoking and using nicotine altogether, experience suggests that many smokers cannot or choose not to give up nicotine and will continue to smoke if there is no safer alternative available that is acceptable to them,” the scientists wrote.

The devices have exploded in use and spawned a $3 billion industry worldwide, but the scientific research on their safety and their potential to be a “gateway” to other tobacco products is still developing.

If the WHO were to classify e-cigarettes as tobacco products—a move they are rumored to be considering, according to Reuters—178 signatories to the Framework Convention on Tobacco Control would be expected to impose strict measures on them to restrict demand, like raising taxes and banning some forms of advertising. The U.S. is one of the few non-signatories to the FCTC, though the Food and Drug Administration has moved to regulate e-cigs.

The FCTC is scheduled to meet in October in Moscow, where it will consider any proposed regulations.

[Reuters]

TIME Food

Junk Food May Be “Addictive” to Kids

We all know that junk food like pizza, ice cream, and soda is bad for our health, but is it also addicting?

The study of food addiction is an emerging and controversial field. But according to Ashley Gearhardt, a researcher who focuses on food addiction at the University of Michigan and helped establish the guidelines for the Yale Food Addiction Scale, highly processed foods can lead to classic signs of addiction like loss of control, tolerance, and withdrawal. A growing body of research backs her up—and that’s especially concerning in children because an addiction forged in a child’s early years could put the child at more serious risk for chronically unhealthy eating into adulthood.

First Lady Michelle Obama, in a rare overtly political speech on Tuesday, admonished Congressional Republicans for a proposal that would weaken nutritional standards in school lunches, dismantling a policy she has personally fought for. “The stakes couldn’t be higher on this issue,” the First Lady said. She may be right in more ways than one.

Less is known about food addiction in kids than in adults, but some research suggests that kids, like adults, have a relationship with food that looks an awful lot like traditional addiction to alcohol or drugs. A 2011 qualitative study of almost 30,000 people ages 8-21 examined poll responses, chat room transcripts and message board comments from overweight and obese children on a website launched as an overweight intervention tool for teens and preteens. The researchers found that children used classic addiction language when describing their relationship to food, including an inability to cut down, continued use despite negative consequences, and withdrawal symptoms when those foods were not available. The research was published in Eating Disorders: The Journal of Treatment & Prevention.

Kids may be even more prone to addiction than adults, says Gearhardt, because their brains haven’t developed impulse control yet. And though the research hasn’t begun on this idea, it isn’t a stretch to posit that early exposure to addicting foods might lead to worse impulse control later in life. Research suggests that teenagers who abuse substances like alcohol and cigarettes are at greater risk for substance abuse later in life. Gearhardt explains: “The more kids are exposed to [junk foods] early in life, the more it is going to set them up for problems. They’re brains are still pretty plastic.”

The best way to keep kids healthy, says Gearhardt, is to eliminate the option to eat junk food all together (yes, that means getting rid of vending machines in schools), rather than simply giving them more access to healthy fruits and vegetables. “No one is binging on broccoli. No one eats strawberries until they throw up. If these kids are so used to eating junk foods, those other foods just can’t compete” she says. “

“If you keep offering more water at a bar, people are still going to drink alcohol.” But unlike a bar, she points out, kids don’t have the option of going elsewhere, making it even more imperative to make school lunch healthy.

 

TIME Addiction

Handing Out Crack Pipes May Not Be Such a Crackpot Scheme

Though city officials have spoken out against the effort, locals are handing out free crack pipes with hopes of combatting disease

Crack started rocking America in the 1980s. The form of cocaine, which provides a brief, intense high, peaked in popularity by the end of that decade, but big cities are still struggling with the fallout—including how to curb the spread of diseases like HIV and Hepatitis C among users. In San Francisco, a controversial new experiment by a group called Urban Survivors Union is hoping to reduce harm among users by giving away some 200 free crack pipes. Unsurprisingly, not everyone agrees that’s a good idea.

Though it has also been done in a few other cities, including Seattle, the idea of doling out crack pipes caused a media frenzy when it was first floated at a city health department meeting in January. In response, the city stated they do not support the practice. “We aren’t doing it because there is no evidence that demonstrates that it’s effective,” Rachael Kagan, spokesperson for the Department of Public Health, tells TIME. “Our harm-reduction programs are evidence-based and part of a comprehensive program of care. ‘Let’s start handing out crack pipes’ is way too reductionist and too narrow for the department to take on.”

Why crack pipes? Many users glass fashion pipes out of whatever they can get their hands on (including broken glass, lightbulbs, vials and other tube-shaped things), which can cause cuts and open sores in the mouth, which can then spread disease to anyone sharing that pipe.

There’s no research on the effect of handing out free crack pipes in the United States, but north of the border, an intriguing pilot is underway. In British Columbia, Vancouver Coastal Health provides healthcare to about 1 million people in that city, including crack users. As part of a pilot study started in late 2011, officials have been handing out 7,500 “safer smoking kits” per month. Each kit comes with information about detox and places to seek help as well as heat-resistant glass stems and disinfecting alcohol swabs. The aim was threefold: use demand for the kits to gauge how widespread crack use is; find out if free, safe pipes do in fact lessen the spread of disease; and use the moment of contact with a user as an opportunity to discourage drug abuse.

Though their sample hasn’t been big enough to provide concrete results about the spread of HIV, Vancouver Coastal Health spokesperson Anne-Marie D’Angelo says, they have found the giving out the kits reduces the number of wounds people experience and the amount that people share pipes. Despite their lack of data on disease transmission, she adds, “if you reduce the number of wounds and you reduce the sharing, you can extrapolate.”

Research on needle exchanges has found that free drug-paraphernalia programs do not lead to more drug use, according to the CDC. While the data bank for crack pipes is still being built, if the same holds true, there may be a cost-based argument for setting up pipe exchanges like needle exchanges. The advocates in San Francisco, led by the activist Isaac Jackson, say their kits cost less than $1 each, a fraction of the money taxpayers might pay to account for disease or injury that those kits might be avoiding.

Despite the city officially washing its hands of the effort, Jackson has said they expect to expand. “Our goal is to demonstrate that you can do this,” Jackson told the San Francisco Examiner, “and all hell won’t break loose.”

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