TIME medicine

First Human Head Transplant Could Happen Within Two Years

Sergio Canavero, a doctor in Italy, has drawn up the plans for a human head transplant

A surgeon says the first human head transplant could take place within the next two years.

Sergio Canavero, a doctor in Turin, Italy, has drawn up the plans for the radical surgery and hopes to begin assembling a team this June, the Guardian reports.

“If society doesn’t want it, I won’t do it. But if people don’t want it, in the U.S. or Europe, that doesn’t mean it won’t be done somewhere else,” he said. “I’m trying to go about this the right way, but before going to the moon, you want to make sure people will follow you.”

Although Canavero says the technology isn’t far off from making this surgery possible, he could confront a range of ethical issues. “The real stumbling block is the ethics,” Canavero told New Scientist magazine. “Should this surgery be done at all? There are obviously going to be many people who disagree with it.”

The first successful head transplant was completed in 1970 on a monkey. The monkey couldn’t move its body and died after nine days.

Read next: Scientists Find a Black Hole 12 Billion Times More Massive Than the Sun

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TIME medicine

7 Dizzying GIFs of Spinning Cannabis Strains

This new approach to cannabis photography was created by the San Diego based company Nugshots. Applying traditional still-life photography techniques, the company began by photographing buds of marijuana for local dispensaries. The images are created using a computer-controlled motor, rotating the marijuana buds only a few degrees at a time. The resulting 50 photographs were then color-corrected and uploaded onto a custom-built player that allows the viewer to rotate the images by dragging their cursor.

Each crop of plants produces unique buds, which requires the dispensaries to commission new photography for each shipment that comes in.

Nugshots has turned its attention toward more stable forms of marijuana-related income. They recently released T-shirts with their macro images printed on them. Soon they will be releasing a book of marijuana photography entitled Green: A Field Guide to Marijuana, featuring hi-resolution macro photography of over 170 different strains.

TIME medicine

The Surprising Way to Treat Peanut Allergies

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In a breakthrough study, researchers show that it’s not only possible to tamp down allergic reactions to peanuts, but by eating small amounts of them infants can avoid getting allergic in the first place

More studies hint that it’s possible to “train” the immune system to tolerate peanuts even if it doesn’t want to by giving children with peanut allergies small amounts of peanuts over a period of time. But researchers now report that it may be possible to prevent peanut allergies altogether. In a study published Monday in the New England Journal of Medicine, researchers led by Gideon Lack, a professor of pediatric allergy at King’s College London and Guy’s and St. Thomas’ Hospital, found that non-allergic young infants who ate small amounts of peanuts at an early age had a much lower rate of peanut allergy than those who avoided nuts altogether for five years.

MORE This ‘Peanut Patch’ Could Protect Against Peanut Allergies

“We are actually preventing the immune response from going along a pathway that leads to clinical reactivity, and it’s like, wow,” says Dr. Rebecca Gruchalla, professor of medicine and pediatrics at University of Texas Southwestern Medical Center who wrote an accompanying editorial. “It’s pretty cool to actually divert and keep the immune system from developing along a pathway that we don’t want it to go.”

Lack and his senior co-investigator George Du Toit, a pediatric allergy consultant at the College, conducted their study on 640 infants with severe eczema or egg allergy. These babies were chosen because of their increased risk of developing other food allergies, including to peanuts, and were enrolled when they were between four months and 11 months old. That’s an important window of opportunity, says Lack, to intervene and retrain the immune system to become tolerant to peanuts.

MORE The Bacteria That May One Day Cure Food Allergies

The group was divided into babies who showed a positive skin prick test to peanuts, and another who were negative. Each group was then randomly divided into those who were given to small amounts of peanuts to eat and those who were told to avoid it for five years. (Those with positive skin tests were given smaller amounts in gradually increasing doses if they could safely tolerate them, while those who were negative for peanut allergies were given larger doses.) Because the babies started out with varying levels of egg allergy and eczema, they also had differing levels of antibodies against peanuts; some had higher levels indicating they were already on the path toward developing allergic reactions to peanuts, even if they hadn’t tested positive and weren’t already allergic.

What’s noteworthy about the findings are that all groups that ate the peanuts, regardless of how far along they were toward developing peanut allergies, showed lower rates of peanut allergy when they were 5 compared to the babies who didn’t eat peanuts at all. The fact that even babies who were negative for peanut allergies at the start of the study, but who might go on to develop them, could prevent the allergy is a potentially game-changing idea.

“In primary prevention we can halt the process before the disease starts,” says Lack. “In secondary prevention, in the babies who already were positive for peanut allergy, the ball is already rolling downhill, but we can still prevent it, and push it back up the hill. We showed both primary prevention and secondary prevention were effective.” Overall, only 2% of the babies who ate peanuts were allergic to peanuts when they were 5, compared to nearly 14% of those who didn’t eat any peanuts during that time. For those who were already positive for peanut allergies at the start of the study, nearly 11% of those who ate small amounts of peanuts ended up getting a peanut allergy compared to 35% of those who avoided them.

MORE Why We’re Going Nuts Over Nut Allergies

It’s not clear how long the protection from peanut allergies lasts; other studies that used similar food exposure strategies in children with egg and milk allergies showed that as soon as the exposure to the allergy-causing food was stopped, the tolerance waned and the allergic reaction returned. Lack and his colleagues are continuing their study by asking all of the participants to avoid eating peanuts for one year and then giving them peanuts to see whether the peanut-consuming group remain non-allergic. “That will tell us whether we truly prevented peanut allergy in the long run or just put the brake on the development of peanut allergy,” he says.

Whether the approach will work on other food allergies, or even other allergies to cats, dogs or pollen, isn’t clear. Lack and his team have not, for example, fully analyzed the data on whether the peanuts helped the babies’ eczema or egg allergies to abate. But the results hint that the immune response may be redirected, at least for some allergens, toward a non-allergic response.

MORE Can Peanut Allergies Develop in the Womb?

It also hints that the rise in peanut allergies, especially in the U.S., may be in part of our own making. For years, the American Academy of Pediatrics (AAP), for example, advised parents to avoid giving their babies peanuts in order to protect them from develop allergic reactions. Mothers-to-be were even advised to avoid eating peanuts during pregnancy to reduce their babies’ chances of becoming allergic. But recent studies in animals show that the immune system’s response to things like peanuts, egg, milk and other allergens may be a balance between exposure through the gut and exposure through the skin. Skin exposure tends to trigger aggressive immune responses that treat most new objects, including peanut protein, as foreign, and therefore sensitizes the body to recognize the food as foreign and dangerous. Eating such proteins, on the other hand, presents them in a different way to the immune system that recognizes their nutritious value. When these two routes are in balance, the gut-based system overrides the skin-based signals and the body sees peanuts as friend rather than foe.

But if babies aren’t eating peanuts, then the signals about peanut proteins entering via the skin become dominant, and nuts become an unwanted intruder rather than a welcome source of food. That’s why, for example, Lack and others believe that rates of peanut allergy are higher in countries like the U.S. where parents have been advised to avoid feeding their babies peanuts, compared to countries like Israel, where infants are given peanuts early on.

Based on recent findings, the AAP in 2008 changed its advice and now does not say parents should avoid feeding their babies peanuts. They haven’t concluded yet whether giving peanuts to infants early in life is a better choice, but given their latest data, Lack ,Du Toit and Gruchalla believe that it’s something that parents should discuss with their pediatricians and allergy specialists. We recommend that peanut be introduced very early on once weaning has been established,” says Du Toit. “Our study demonstrated that it’s safe as long as whole nuts are avoided for their choking hazard.” For children who come from families with no history of food allergies and whose parents or siblings don’t have other food allergies, peanuts can be started right away. For those who have a family history of food reactions, parents should consult with an allergist to get a skin prick test and then work with the specialist to determine the safest way to gradually introduce peanuts into their babies’ diet.

Such exposure to possible food allergens “is not part of clinical practice yet, but I think it will be likely that there are going to be experts who are going to get together and revise the guidelines to make it more common,” says Gruchalla. And hopefully lower rates of food allergies in coming years.

Read next: New Guidelines Help Doctors Diagnose Food Allergy

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TIME Infectious Disease

What You Need to Know About the California ‘Superbug’

The CRE bacteria kills up to half of infected patients

A Los Angeles hospital revealed Wednesday that more than 100 patients may have been exposed to a deadly “superbug” while being treated at the facility between October and January. Two have been reported dead already at the Ronald Reagan UCLA Medical Center, the hospital announced Wednesday.

So what is the ominous-sounding bacteria, and just how dangerous is it? Here’s a quick guide:

What is this “superbug”?
The term superbug refers to microbes that have become resistant to the antibiotics typically used to treat bacterial infections. In the most recent case, in Los Angeles, the term refers to the bacteria called Carbapenem-Resistant Enterobacteriaceae (CRE). Once the antibiotic-resistant bacteria gets into the bloodstream or bladder, it causes infections that are difficult to stop. It also transfers its anti-biotic resistant properties to other germs so they can also resist medicine.

How do you catch it?
CRE infection typically occurs in hospitals or other medical care facilities. This is largely because its spread requires close contact between the bacteria and a vulnerable part of the body, something like an open wound. In the most recent case, as in others in the past, patients were infected due to medical instruments that were improperly sanitized.

How deadly is it?
Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), called it a “nightmare bacteria” in 2012, and with good reason—it kills up to half of infected patients.

Read more: New Antibiotic Could Help Fight ‘Superbugs’ of the Future

How is it treated?
Doctors can try some antibiotics that may still work despite CRE’s resistance, but it can be difficult to treat, sometimes impossible.

How can it be kept from spreading?
The CDC provides health care facilities with more than 30 pages of guidelines on how to prevent CRE from spreading. Separating patients with CRE from other patients, tracking CRE patients’ movements between hospitals and strong enforcement of protocols to prevent the spread of infection count among the report’s most important recommendations.

Should I be worried about other superbugs?
You probably should, yes. CRE is one of a number of antibiotic resistant bacteria that pose a serious public health concern. MRSA (methicillin-resistant Staphylococcus aureus), for example, kills about 64% more people than those infected with a non-resistant form of the disease. A 2014 study projected that, if governments worldwide don’t act, “superbugs” could kill an extra 10 million people a year by 2050 — making them deadlier than cancer.

TIME medicine

Here’s Why You May Soon Be Using Sunscreen in the Dark

The latest studies reveal some surprising things about melanin, the compound responsible for tans, and the need for sunscreen after sun exposure

The guidelines for sun exposure are pretty familiar by now—cover up exposed skin, steer clear of the peak UV streaming hours of 10 am to 2pm, and always, always wear sunscreen.

Now, in a series of experiments described in the journal Science, researchers say that may not be enough to shield against skin cancer. Working with human cells in a lab dish, as well as with mouse models, they found that melanin—which is produced in response to UV exposure to protect sensitive skin from being damaged—may have a dark side to its skin-protecting role. And, even more concerning, the harm triggered by the sun’s rays may linger long after the sun sets.

MORE: You Asked: Is Sunscreen Safe—And Do I Really Need It Daily?

Douglas Brash, professor of therapeutic radiology and dermatology at Yale University School of Medicine, and his colleagues say that activating melanin has lasting effects—some positive, but mostly negative—on the body’s chemistry for up to three hours after sun exposure. That could mean that the risk of skin cancer from agents generated by UV damage continues even in the dark, they add.

Melanin is supposed to be the body’s natural sunblock. It’s released in response to UV light and protects delicate skin from burning, as well as the DNA deeper in skin cells from being scrambled so they don’t cause cancer. But when the scientists exposed mouse cells to UV light, they found that the melanin-containing cells produced mutations, and continued to do so for three hours after the light was removed. Similar cells from albino mice, which are missing melanin, didn’t show the same effect. Human melanin-containing cells also generated these damaging changes long after exposure.

MORE: We’re One Step Closer to Better Sunscreen

The vast span of time during which damage could occur after exposure surprised the researchers. “To have the [changes] made after exposure is like having a process that should have taken a second during the time of the dinosaurs just finish up today,” says Brash. “That’s how bizarre this is.”

Once activated, he says, some of the melanin is highly energized, and in that state, starts to degrade. “When you create high-energy molecules, the energy has to go somewhere,” says Brash. In some cases, it transfers to the DNA where it continues to monkey with normal DNA codes for hours.

MORE: Obama Signs Law for Better Sunscreen

The good news is that this process can be interrupted, as long as the excess energy has an outlet. “If we can divert some of that energy to another molecule and change it into heat, it doesn’t cause problems,” says Brash. In the study, he experimented with some agents including vitamin E, which eliminated the harmful high-energy agents, and kojic acid, which reduced them by 85%.

But it’s not clear yet how these agents should be used or for how long after sun exposure. The findings do make a strong case, however, that applying sunscreen after being out in the sun might become just as important as slathering them on while outside. In the meantime, “continue doing what you’re doing and use sunscreen,” says Brash. “Sunscreens do block UV wavelengths, and will prevent some of these processes from starting. And the lower dose of exposure you have, the better off you are. We just might have to start considering continuing that protection a little longer than we thought.”

TIME medicine

What the Year’s Health Films Got Right—And Wrong

Medical experts dish on how Hollywood handles health

In 2014, health-centered films were some of the most watched and most applauded. Films like The Theory of Everything and Still Alice are nominated for Oscars, and The Fault in Our Stars made well over $124 million at the box office. But how true to health were they?

We asked medical experts, from Alzheimer’s physicians to pain specialists, to grade five of this year’s films for medical accuracy and the authenticity of patient experience. Find out which passed with flying colors—and which ones need a checkup.

  • The Theory of Everything

    THE THEORY OF EVERYTHING, Eddie Redmayne as Stephen Hawking, 2014. ph: Liam Daniel/©Focus
    Focus Features

    The film tells the story of Stephen Hawking, the brilliant physicist who lives with amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease. It’s nominated for five Oscars: Best Picture, Best Actor, Best Actress, Best Original Score and Best Adapted Screenplay.

    Reviewer: Dr. Jeffrey D. Rothstein, director of the Brain Science Institute and the Robert Packard Center for ALS Research at Johns Hopkins University

    Grade: A

    What the film got right: In summer of 2014, the Ice Bucket Challenge forever and dramatically changed our exposure to ALS, a relatively rare and fatal neurological disease. As a physician scientist experienced in diagnosing patients with ALS, caring for them, and carrying out research on the disease, I always feel it’s important that Hollywood portray medical disorders accurately. It’s as important as getting the plot right. In my opinion, the director, writers and, most importantly, the actors did a pretty darn good job at educating viewers about this condition.

    First, the film authentically portrays the subtle and typical early-onset changes that characterize the disease, like the occasional tripping, fumbling or dropping of objects. These changes reflect early hand, foot and leg muscle weakness. The slowing of Hawking’s walk, his clumsy writing and his stumbling when he tries to walk up steps and hold chalk are all common in the early stages of the disease. The actor also so movingly and faithfully shows the terrible frustration patients feel when simple tasks like eating and picking up a spoon become so difficult. The loss of these simple actions rob an individual of their independence in daily activities. The film’s depiction of Hawking’s eventual tracheotomy—the hole in the windpipe which allows for better breathing—accurately shows the tragic loss of speech and communication, and the terrible and primitive way patients years ago had to spell out words to produce simple sentences. The film also successfully relays the emotional and physical stress ALS places on spouses and loved ones. I’ve seen it often in my own practice.

    What the film got wrong: The discussion Hawking and his doctor have about his diagnosis in a hallway is not how physicians tell a patient about such a terrible and impactful diagnosis. It lacks the privacy and respect you need when you’re meeting with a patient, and I hope Hawking had a more appropriate encounter in real life. Sometimes movies get everything wrong when it comes to diseases and treatments, but overall, I don’t think The Theory of Everything got much wrong at all.

  • Still Alice

    STILL ALICE, Julianne Moore, 2014. ©Sony Pictures Classics/courtesy Everett Collection
    Sony Pictures

    A well-respected linguistics professor at Columbia University, Dr. Alice Howland, is diagnosed with early-onset Alzheimer’s disease. The film is Oscar-nominated for Best Actress.

    Reviewer: Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology at University of California, San Francisco and member of the Alzheimer’s Association Medical & Scientific Advisory Council

    Grade: B

    What the film got right: In Still Alice, we watch a highly accomplished woman trying to hold onto her life while future is transformed by Alzheimer’s disease. Julianne Moore, who plays Alice, is successful at capturing the initial memory and interrupted thought symptoms of the disease, followed by denial, then attempts at control, and finally solace and grace.

    Since Alzheimer’s disproportionately affects women, the focus on a woman keeps with the statistics. Women are at slightly higher risk of developing Alzheimer’s, and many more women have the disease because they live longer. It almost goes without saying that women are also much more likely to provide care to people with dementia.

    Scientifically, the first phase of Alice’s symptoms and the encounter with her consultant neurologist are very realistic and deeply moving. The movie accurately demonstrates the early word-finding challenges, occasional memory lapses and sense of becoming overwhelmed in once familiar situations.

    What the film got wrong: The course of Alice’s decline from Alzheimer’s was too fast by almost any standard. The character went from early symptoms while lecturing at a conference in Los Angeles to being almost mute, not recognizing her daughter and requiring full-time care all in about a year. While this helps the tempo of the movie, it does not match the often decade-long disease progression we see.

    The viewer may also inaccurately conclude from the movie that Alzheimer’s disease is more definitively diagnosed with neuroimaging (brain scans such as PET and MRI) than it can be, and more genetically influenced than it often is.

    Neuroimaging is among the most promising areas of research focused on early detection of Alzheimer’s, but for now, these tests are appropriately used only to clarify a difficult diagnosis when it is not clear what is causing the dementia symptoms. It’s also used for unusual cases, such as early onset of symptoms.

    Slight reference is given in the film to the young onset type of Alzheimer’s being more grounded in genetic risk. But the jump to genetic testing on the second medical visit, followed by testing Alice’s children and even possibly the pregnant daughter’s offspring was unrealistic and over-simplified. It is important to note that young onset Alzheimer’s affects perhaps only 2 or 3% of the total population of people with the disease—or about 200,000 out of the more than 5 million people living with Alzheimer’s in the U.S. today.

    It was hard for me to connect with any character other than Alice and her youngest daughter. They were the only ones in the film with real intimacy, emotion and connection. In real life, Alzheimer’s disease explodes family dynamics and pushes the diagnosed individual and their family to deal with a disease that slowly strips an individual of certain strengths.

  • Obvious Child

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    A24

    A young woman has a one-night stand, an unplanned pregnancy and an abortion.

    Reviewer: Dr. Mary Jane Minkin, professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine

    Grade: B

    What the film got right: In Obvious Child, Donna, a 28-year-old aspiring stand-up comic, breaks up with her boyfriend and meets Max, a very eligible young man who has shown up at her comedy club. They hit it off immediately; much alcohol and a wild night of sex ensue. As you correctly surmise, she conceives, and ultimately at the movie’s end she has an abortion, with Max’s emotional support.

    The film brings attention to some very important themes. One half of the pregnancies that occur in this country are unplanned. Donna is drinking way too much alcohol to conceive a healthy pregnancy. Max speaks about how much he wants to be a father, and one would certainly hope that their relationship will develop well. As an obstetrician, I’d like to see a happy ending: Donna’s stand-up career takes off, she stops drinking such a significant amount of wine, she starts taking a folic acid vitamin every day, and then she conceives. (And of course they live happily ever after!) But that’s not exactly how things play out. However, Donna’s pregnancy symptoms, sore breasts and nausea, were accurately depicted, as was her use of a home pregnancy test kit.

    What the film got wrong: One primary “obvious choice” wasn’t made in the film. After the liaison, one would expect a sophisticated New Yorker to think to herself that during a very intoxicated evening, a condom might not have been used correctly, and that she should proceed to her nearest pharmacy to purchase a morning after contraceptive. Morning after contraception is widely available over the counter to women of all ages, and is extremely effective when used right after the event, actually up to 72 hours later, and is very well tolerated. But then we would have had no movie!

    Donna, quite reasonably, goes to an office of Planned Parenthood. However—and this is what’s most problematic to me—the physician there tells Donna that she is “too early for an abortion.” Donna is about 5 weeks from her last menstrual period, or about 3 weeks pregnant. The doctor is quite correct in suggesting that a suction abortion would not be the appropriate choice at this point, since the gestational sac is so small that it might well be missed during the procedure. But the doctor does not mention any of the medicinal methods of termination, such as the RU-486 pill, which is ideal to use earlier in the gestation. Then again, if Donna takes RU 486, we have no drama. Donna won’t be waiting for two weeks, and we wouldn’t overhear the discussion Donna has with her mother about her mother’s experience having an illegal abortion in the 60s. There would be no dramatic scene in the waiting area of the clinic. Women using RU 486 miscarry at home, and not on a schedule.

  • The Fault in Our Stars

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    20th Century Fox

    A love story about teenage cancer patients who meet in a support group.

    Reviewer: Steven Gonzalez, teenage leukemia survivor and member of MD Anderson Children’s Cancer Hospital’s teen advisory council

    Grade: A

    What the film got right: At age 12, I was diagnosed with AML leukemia and was given a 2% survival chance. That year entailed a lot of chemotherapy, a bone marrow transplant and about 130 days of isolation in the hospital and at home. Though I try not to, I tend to view any cancer-related literature with a pretty critical eye. There’s simply too many little details, emotions and events that are left out. The Fault in Our Stars was different, however, and captured a lot of those little details that are so rarely shown.

    For starters, the nonchalant way that the characters addressed cancer was spot-on. I’ve found that the ability to joke about cancer is pretty common among survivors and a lot of patients. For us, it’s a topic that we have lived with and have become more or less comfortable with. I’ve found that cancer survivors make some of the best cancer-related jokes. I also have to applaud the characters’ emotional breakdowns. For example, when one of the main characters, Augustus, breaks down by a gas station, he wasn’t crying for sympathy or attention. He was just too medicated or had too many emotions with no way of controlling them. Those scenes gave me flashbacks.

    Another accurate moment was when Hazel’s mom tells her, “It’s okay to let go.” That foggy, in-and-out, dream-like state is exactly what I remember experiencing as a doctor told me, “You’re gonna be alright, bud,” right before my treatment took effect. The movie also gets points for not portraying the whole bald-but-somehow-still-has-eyebrows look that some television shows and movies seem to like.

    While I understood why everyone else in the theater was crying at the end, I had a different reaction. I thought the ending was happy. I felt the movie captured the tiny details and I felt like my story was finally being told right. The movie reminds us that even though Augustus and Hazel had little time together, they made the most of it and enjoyed every moment. That is the ultimate end goal in life.

    What the film got wrong: The film has a few flaws. The biggest problem I had was that while it made an effort to include details of life with cancer that aren’t usually depicted, it still showed a very Hollywood approach. At first I couldn’t put my finger on it, but after rewatching the movie, I think it boils down to the fact that cancer just isn’t that neat and clean. Literally. It involves a lot of emotions, bodily changes and a lot of bodily fluids coming out in many different ways. I’m not trying to say that cancer is all sadness and pain all day every day—some of my fondest memories, in fact, came from that year I had cancer—but it still feels like an overly polished view. Cancer can be one of the messiest-sterile environments, and The Fault in Our Stars doesn’t quite capture that concept.

  • Cake

    Cinelou Releasing

    A drama about a grieving woman suffering from chronic pain and painkiller addiction, Cake was nominated for a Screen Actors Guild Award and Golden Globe Award.

    Reviewer: Dr. Charles Kim, a pain specialist at Rusk Rehabilitation at NYU Langone Medical Center

    Grade: B+

    What the film got right: Cake embarks on a very difficult task of exploring the complicated condition of chronic pain in a way that people can hopefully appreciate and sympathize with. The movie cogently touches on many things I have seen in some of my patients, such as isolation, depression, addiction and self-realization. Also quite accurate in some patients are the pill-hoarding behaviors, sleeplessness and painful sex depicted in the film. Chronic pain can be described as a nebulous and complex medical condition, at best. It is poorly understood in the medical world and traditionally thought of as a symptom and not a disease condition. But it afflicts about one in five Americans—about 60 million people, more than diabetes, heart disease and cancer combined.

    It was quite apparent to me as a clinician that Claire, played by Jennifer Aniston, was not only inappropriately overusing the pain medications OxyContin and Percocet for her physical pain, but was also self-treating underlying depression from her unresolved grief over the tragic loss of her son. It becomes a vicious cycle. She needs higher and higher doses of these pills, likely due to her built-up tolerance. This under-recognized vulnerability is often experienced with chronic use of painkillers, but often goes untreated until it is too late. Chronic pain is associated with suicide, a point Cake doesn’t hesitate to make known. In fact, chronic pain sufferers are up to three times more likely to commit suicide than those in the general population, presumably due to insufficient control of pain and under-recognition of coexisting depression.

    From a clinical perspective, Cake is a well-executed and contemplative peek into the dark world of uncontrolled chronic pain, depression, and addiction. The film can be thoroughly appreciated by those who have chronic pain, or those close to them, and appreciated by those who have seen the gratifying life outcomes that occur when the condition is well-controlled and managed.

    What the film got wrong: Some parts of the film are exaggerated and amplified for theatrical effect, such as the fuzziness separating the boundaries of hallucination and reality, or the desperate trip to Tijuana for more medication. Very rarely are chronic pain patients in the extremes of hallucination-driven, desperate addictive behaviors. Overall, I give Cake a B+: a “B” for the respectable attempt to tackle the 800-pound gorilla of chronic pain, despite some of the glorified theatrics and excesses, and a “+” for Jennifer Aniston’s laudable portrayal of a chronic pain sufferer in our society.

TIME Research

Scientists Say Aggressive New HIV Strain Discovered in Cuba

Reports of people in Cuba infected by new strain developing AIDS in less than three years

A recently-discovered form of HIV in Cuba has been found to progress into AIDS some three times faster than the most common strains of the virus, according to a recent study.

The study, conducted by researchers from the University of Leuven in Belgium, followed several reports of HIV-infected people in Cuba developing AIDS in less than three years, far faster than the usual 10 years it typically takes. All patients infected with CRF19, a recently-discovered strain of the HIV virus, had higher levels of it in their body.

They were also more likely to have developed AIDS within three years, the study published in the journal EBioMedicine found. The researchers, who looked at 95 patients at various stages of infection, concluded that the strain must be “particularly fit.”

Approximately 35 million people worldwide are living with HIV or AIDS, and nearly 40 million have died of the disease since the 1980s. Drugs exist to keep the worst effects of the disease at bay, but this new strand threatens to take a toll on patients before they realize they need treatment.

TIME Research

This Is What’s Keeping Teens From Getting Enough Sleep

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STUDIO BOX—Getty Images

The biggest factor keeping teens up at night isn't technology

Up to a third of teens in the U.S. don’t get enough sleep each night, and the loss of shut-eye negatively impacts their grades, mental well-being and physical health. Biologically, adolescents need fewer hours of slumber than kids — but there’s a bigger reason for teens’ sleep loss, according to a new study in the journal Pediatrics.

MORE: The Power of Sleep

Katherine Keyes, an assistant professor of epidemiology at Columbia University, looked at survey data from more than 270,000 eighth-, 10th- and 12th-grade students at 130 public and private schools across the country, gathered between 1991 and 2010. Each student was asked two questions about his or her sleep habits: how often they slept for at least seven hours a night, and how often they slept less than they should.

MORE: School Should Start Later So Teens Can Sleep, Urge Doctors

She found that over the 20-year study period, adolescents got less and less sleep. Part of that had to do with the fact that biologically, teens sleep less the older they get, but Keyes and her team also teased apart a period effect — meaning there were forces affecting all the students, at every age, that contributed to their sleeping fewer hours. This led to a marked drop in the average number of adolescents reporting at least seven hours of sleep nightly between 1991–1995 and 1996–2000.

That surprised Keyes, who expected to find sharper declines in sleep in more recent years with the proliferation of cell phones, tablets and social media. “I thought we would see decreases in sleep in more recent years, because so much has been written about teens being at risk with technologies that adversely affect the sleep health of this population,” she says. “But that’s not what we found.”

MORE: Here’s How Much Experts Think You Should Sleep Every Night

Instead, the rises in the mid-1990s corresponded with another widespread trend affecting most teens — the growth of childhood obesity. Obesity has been tied to health disturbances including sleep changes like sleep apnea, and “the decreases in sleep particularly in the 1990s across all ages corresponds to a time period when we also saw increases in pediatric obesity across all ages,” says Keyes. Since then, the sleep patterns haven’t worsened, but they haven’t improved either, which is concerning given the impact that long-term sleep disturbances can have on overall health.

Keyes also uncovered another worrying trend. Students in lower-income families and those belonging to racial and ethnic minorities were more likely to report getting fewer than seven hours of sleep regularly than white teens in higher-income households. But they also said they were getting enough sleep, revealing a failure of public-health messages to adequately inform all adolescent groups about how much sleep they need: about nine hours a night.

“When we first started looking at that data, I kept saying it had to be wrong,” says Keyes. “We were seeing completely opposite patterns. So our results show that health literacy around sleep are not only critical but that those messages are not adapted universally, especially not among higher-risk groups.”

TIME medicine

Why Doctors Should Start Prescribing Downward Dog

downward dog yoga
Getty Images

Complementary medicine is gaining traction with adults and kids alike

Americans are slowly but surely embracing complementary medicine—alternative practices to go with standard treatment—according to new data from the National Center for Health Statistics (NCHS).

Two new surveys show that while the overall use of complementary health approaches has remained relatively stable over the years at 34%, certain types are rapidly gaining popularity, especially yoga. Other common complementary practices are taking dietary supplements, doing tai chi and qi gong, meditating and getting chiropractic care.

More and more children are also doing yoga, the survey finds, and they typically use it for ailments like back or neck pain, nerve conditions and anxiety. Interestingly, the majority of children didn’t just practice yoga for exercise, but for meditation and deep breathing. Other new research is showing that when kids practice mindfulness and meditation, they gain a range of health benefits from more self-control to higher math scores.

“The low cost and the ability to practice in one’s own home may contribute to yoga’s growing popularity,” the authors write. “Furthermore, public school systems are beginning to incorporate yoga into their fitness programs, which may accelerate use by children in the future.”

Even though many complementary practices are ancient in other countries, it’s still relatively new in the United States. Medical institutions are increasingly willing to meet patients halfway with therapies that won’t cause harm, as long as practices are safe and don’t ignore the need for conventional medicine and pharmaceuticals when necessarily. In January 2014, the Cleveland Clinic opened a Chinese herbal therapy clinic, and experts at the Mayo Clinic in Minnesota say the appetite for more integrative medicine in the hospital setting is growing. “Acupuncture is a huge practice [here],” says Dr. Brent Baur, director of the Mayo Clinic Complementary and Integrative Medicine Program. “Right now our demand for acupuncture outstrips our ability to meet that demand probably three to one. We can’t even come close to keeping up.”

“I think [interest] is being propelled by economics because our health care system is in such desperate trouble,” says Dr. Andrew Weil, founder of the Arizona Center for Integrative Medicine and a pioneer of integrative medicine in the U.S. “The great promise of integrative medicine is that it can lower costs while increasing outcomes. It does that by emphasizing lifestyle medicine and by bringing into the mainstream techniques that do not involve expensive technology.”

In a World Health Organization survey of 129 countries, 80% recognize the use of acupuncture. The U.S. may be catching up; other research shows that about four in 10 U.S. adults and one in nine kids use some form of complementary and alternative medicine.

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