Opioid Crisis

Let’s Talk About The Current Opioid Crisis & Pain Prescription Crackdown

Recently there has been so much news about pandemics such as COVID 19, but nobody is talking about an epidemic that is causing more deaths than this global crisis. The Opioid Crisis is an epidemic is expanding on a global scale. In Australia, the rise in prescribing of pain medications, particularly opioids has increased signficantly. This is having has had devastating results, with the levels of harm and deaths due to opioid misuse rising exponentially.

In Australia, over three million people were prescribed 15.4 million opioid scripts in 2016–17. What is most concerning is that opioids now account for 62% of drug-induced deaths, with pharmaceutical opioids now more likely than heroin to be involved in opioid deaths and hospitalisations. In 2016–17 there were 5,112 emergency department presentations and 9,636 hospitalisations due to opioid poisoning, with three deaths per day attributed to opioid harm – higher than the road toll.(2)

The global crisis of opioid crisis is increasing and is very concerning. About 275 million people worldwide (5.6 per cent of the global population aged 15–64 years) used drugs at least once during 2016. There were an estimated 27 million people who suffered from opioid use disorders in 2016. Roughly 450,000 people died as a result of drug use in 2015. Of those deaths, about 118 thousands with opioid use disorders.

Overdose deaths contribute to between roughly a third and a half of all drug-related deaths, which are attributable in most cases to opioids. Lifetime prevalence of witnessed overdose among drug users is about 70%. There are effective treatments for opioid dependence yet less than 10% of people who need such treatment are receiving it. The inexpensive medication naloxone can completely reverse the effects of opioid overdose and prevent deaths due to opioid overdose.

Due to their pharmacological effects, opioids in high doses can cause respiratory depression and death.

In Australia today, unrelieved pain is a major issue. Up to 80 percent of people living with chronic pain are missing out on treatment that could improve their health and quality of life. Some of these people are dismissed and feel isolated and suffer constant pain, anxiety, depression and even attempt suicide. It is big issues that needs to be address.

Opioids and pain medications should never be regarded as the sole approach to people with chronic pain. They should be regarded as one component of a multimodality approach and management plan, and should only be used on a limited basis and monitored regularly so as not to develop and addiction.

A well-defined and well-structured multimodality management pain plan, set out be a qualified healthcare professional, is essential in improving pain outcomes, improving overall health and helping with the complications of withdrawal of pain medications and opioids.

In this video I talk about the current reforms here in Australia and the ongoing opioid crisis that needs urgent attention and people do need to be managed better on all levels.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Men and Women’s Health Advocate

-The Headache, Migraine and Pain Experts

 

References

  1. Deloitte Access Economics (2019), The cost of pain in Australia.
  2. Royal Australian College of General Practitioners (2018). Australian overdose deaths are increasing – and the demographics are changing. News GP. Access online here.
  3. WHO- Information sheet on opioid overdose (click here to access)
  4. Pain Australia (fact sheets)

 

serious complications of low iron

The Serious Health Complications Of Low Iron

In the last couple of weeks I have been talking about the serious complications of people not having their health managed properly. It seems to be a big issue and with my latest post, the issue of unmanaged, or undiagnosed low iron is also becoming a very serious issue indeed. So for this post I will be talking about the serious health complications of low iron.

Two thirds of body iron is present in circulating red blood cells known as haemoglobin. Each gram of haemoglobin contains about 4gms of iron and each ml of blood lost from the body results in a loss of about half a milligram of iron.

Bleeding is the most common cause of iron deficiency.  This could be from either a diagnosed, or undiagnosed gynaecological issues (endometriosis, adenomyosis, fibroids, polyps, other) or it could be from a parasite infection. It could also be from bleeding as part of a gastrointestinal issue, or part of inflammatory bowel diseases (IBS, Crohn’s Coeliac disease).

There could be other reasons for blood loss in the body, or reduction of iron and many of these conditions, and the conditions above, can go unrecognised and then cause iron deficiency anaemia. Some of these issues can be very serious, or even fatal.

Excessive menstrual losses are often overlooked with many women. This is something that should not happen and should be part of the questioning with any low iron status. The problem is, unless the menstrual flow changes, patients typically do not seek medical attention for heavy menstrual bleeding. Sometimes when a healthcare practitioner asks, these patients generally report that their menses are normal. It may be normal to them, but we need to educate women that heavy blood loss is not normal and can lead to anaemia.

Because of the marked differences among women with regard to menstrual blood loss (10-250 mL per menses), patients meed to be asked about their menstrual history and about a specific history of bleeding, blood flow, abnormal bleeding in between cycles,  clots, cramps, and the use of multiple tampons and pads. These are very important questions to ask and sadly many women are not being asked these questions, or having further questioning about their menstrual, or overall health, including dietary intake etc.

What is iron deficiency anemia?

Anaemia occurs when you have a decreased level of haemoglobin in your red blood cells (RBCs). Haemoglobin is the protein in your red blood cells that is responsible for carrying oxygen to your tissues.

Iron deficiency anaemia is the most common type of anaemia that women present with, and it occurs when your body doesn’t have enough iron. Your body needs iron to make haemoglobin. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs. Today in a recent post I talked about iron being like trucks, or the transporters of oxygen around the body.

While iron deficiency may be common, many people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever having it diagnosed, or the cause of the iron deficiency diagnosed either. It is a very serious issue that needs some serious attention.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Women who adopt a vegan diet will also be prone to being iron deficient and vitamin B12 deficient.

Disruption to the microbiome and leaky gut syndrome can also cause iron deficient anaemia too.

One of the best ways to treat the condition is through iron infusion, and also with iron supplements, or changes to diet. We also need to make sure the cause of the iron deficiency is addressed as well.

Symptoms of iron deficiency anaemia

The symptoms of iron deficiency anaemia can be mild at first, and some people may not even notice them. Many people are completely unaware that they may be low in iron, or are actually iron deficient.

The symptoms of moderate to severe iron deficiency anaemia include:

  • general fatigue
  • weakness
  • pale skin
  • Bruising easy
  • shortness of breath
  • Palpitations
  • dizziness
  • Strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  • Tingling or crawling feeling in the legs
  • Tongue swelling or soreness
  • Cold hands and feet
  • Tachycardia
  • Brittle nails
  • Headaches and migraines
  • Sore joints
  • Brain fog and lack of concentration.

The serious complications of unmanaged iron deficiency.

Undiagnosed, or unmanaged iron-deficiency may cause the following severe complications:

  • Heart problems.If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. When your heart has to work harder, this can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur, an enlarged heart, or even heart failure.
    Severe anemia due to any cause may produce hypoxemia and enhance the occurrence of coronary insufficiency and myocardial ischemia.
  • Increased risk of infections- Research has shown that iron deficiency anaemia can affect your immune system (the body’s natural defence system), making you more susceptible to illness and infection.
  • Motor or cognitivedevelopment delays- This mainly occurs in children. Children deficient in iron may exhibit behavioral disturbances.
  • Behaviour issues and mood disorders- Behavioral disturbances may manifest as an attention deficit disorder, or mood disorder such as : Depression Unipolar depressive disorder, Bipolar disorder, Anxiety disorder, Autism spectrum disorder, Attention-deficit/hyperactivity disorder, Tic disorder, Delayed development and other some other psychiatric issues.
  • Pregnancy complications- Iron deficiency can lead to preterm delivery or giving birth to a baby with low birth weight.
    The neurologic damage to an iron-deficient foetus results in permanent neurologic injury and typically does not resolve on its own, or by supplementation.
  • Chronic Health Conditions worsened- In people with chronic conditions, iron-deficiency anaemia can make their condition worse or result in treatments not working as well.
  • Dysphagia (Difficulty swallowing)- This may occur with foods due to abnormal muscle and nerve control. This could result in choking. It can also lead to throat cancers.
  • Atrophic gastritis – This occurs in iron deficiency with progressive loss of acid secretion, and causes inflammation of the gastric mucosa with loss of the gastric glandular cells and replacement by intestinal-type epithelium, and fibrous tissue
  • Tiredness- As iron deficiency anaemia can leave you tired and lethargic (lacking in energy), you may be less productive and active at work. Your ability to stay awake and focus can be reduced, and you may not feel able to exercise regularly.
  • Fainting– Low iron can cause fainting and this could be dangerous in many situations, especially at work places, or working on machinery, or driving a car.
  • Cold Intolerance– Cold intolerance develops in one fifth of patients with chronic iron deficiency anaemia and is manifested by neurologic pain, vasomotor disturbances, or numbness and tingling.
  • Issues with Brain and Optic Nerve– Rarely, severe iron deficiency anaemia is associated with papilledema (optic disc swelling), increased intracranial pressure, and the clinical picture of pseudotumor cerebri. These manifestations are all corrected with iron therapy.
  • Migraines– Research has now shown that there are certain types of migraines caused by iron deficiency
  • Death – Caused by some of the issues mentioned above

The importance of proper management

Hopefully now everyone can see why iron is so important and that people with iron deficiency need to see their healthcare practitioner for proper help and proper management .  Iron deficiency anemia isn’t something to self-diagnose or treat. It needs to be diagnosed, treated and managed properly. In many cases an iron infusion is the best and quickest way to get iron levels back up. Have a read of my post about iron infusions. Click here

Iron infusions are the quickest way of getting iron levels back up

In the case of low, or severely low iron, supplements just are not enough. They take too long to get levels up and the damage to your body in waiting too long can also be serious.  Always see your healthcare practitioner, or specialist, for a diagnosis rather than trying to manage low iron on your own, or just taking iron supplements on your own. Overloading the body with too much iron can be dangerous too, because excess iron accumulation can damage your liver and cause other complications.

Final Word

This is why everyone needs to be managed by a properly trained healthcare professional with any health issue, especially low iron. If your practitioner is not able to assist you, please make sure you get a second or third opinion. Some practitioners may not be well versed in the serious complications of low iron, or know much about iron infusions etc.

If you do need help with managing the symptoms of low iron, you can call my friendly staff and find out how I can assist you. For more information please call +61 07 38328369 or email info@drandreworr.com.au

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicince

-Master of Reproductive Medicine

-Women’s and Men’s Health Advocate

 

 

microbiome for weight loss

Let’s Talk About Prebiotics & Probiotics & Their Role in Health & Weight Loss

In my latest post I thought it was important to talk about Prebiotics and Probiotics and their role in health and weight loss. With the upcoming new years resolutions of weight loss and overall health, I thought it was important to discuss this topic. Strain specific probiotics and prebiotics not only assist with weight loss, but they assist with the mind, the gut, reducing inflammation and overall health. Of course, to lose weight, you also need to cut refined carbohydrates, increase good protein sources and also exercise. Just to be clear on that. But, we also need to acknowledge the role of beneficial bacteria in this process as well.

I’ve talked about the importance of a proper microbiome restore before (click here), but I thought I would explain it in person, rather than just in word form, so that people understand this topic better. Before you start any weight loss challenge, you need to listen to my latest video post first.

If you do need assistance in losing weight, maintaining health and doing a proper microbiome restore, please give my staff a call and find out how I may be able to assist you.

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Insight Into How I Assist People & What A Good Practitioner Should Be Doing

On a daily basis I get people calling, or emailing various questions and asking about my services and how I assist people. So I have done a video with an Insight into how I assist people and what a good practitioners should be doing.

This is to explain a bit more about how I do things, how in depth my consultations are, my referral networks, the symbiotic working relationships, my “No Stone Left Unturned” approach, the multimodality treatment approach, and some other information. This is to give people more of an idea of how I work with people and guide people, but also help them with a step by step approach to their healthcare management. By being their guide through their health journey, I can help them every step of the way, so that they don’t have to wade their way through not knowing where to go, or who to see. I help them make the journey much easier and help them take the stress out of guessing.