Clean Needles Save Lives. In Some States, They Might Not Be Legal.
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Kim Botteicher hardly thinks of herself as a criminal.
On the main floor of a former Catholic church in Bolivar, Pennsylvania, Botteicher runs a flower shop and cafe.
In the former church’s basement, she also operates a nonprofit organization focused on helping people caught up in the drug epidemic get back on their feet.
The nonprofit, FAVOR ~ Western PA, sits in a rural pocket of the Allegheny Mountains east of Pittsburgh. Her organization’s home county of Westmoreland has seen roughly 100 or more drug overdose deaths each year for the past several years, the majority involving fentanyl.
Thousands more residents in the region have been touched by the scourge of addiction, which is where Botteicher comes in.
She helps people find housing, jobs, and health care, and works with families by running support groups and explaining that substance use disorder is a disease, not a moral failing.
But she has also talked publicly about how she has made sterile syringes available to people who use drugs.
“When that person comes in the door,” she said, “if they are covered with abscesses because they have been using needles that are dirty, or they’ve been sharing needles — maybe they’ve got hep C — we see that as, ‘OK, this is our first step.’”
Studies have identified public health benefits associated with syringe exchange services. The Centers for Disease Control and Prevention says these programs reduce HIV and hepatitis C infections, and that new users of the programs are more likely to enter drug treatment and more likely to stop using drugs than nonparticipants.
This harm-reduction strategy is supported by leading health groups, such as the American Medical Association, the World Health Organization, and the International AIDS Society.
But providing clean syringes could put Botteicher in legal danger. Under Pennsylvania law, it’s a misdemeanor to distribute drug paraphernalia. The state’s definition includes hypodermic syringes, needles, and other objects used for injecting banned drugs. Pennsylvania is one of 12 states that do not implicitly or explicitly authorize syringe services programs through statute or regulation, according to a 2023 analysis. A few of those states, but not Pennsylvania, either don’t have a state drug paraphernalia law or don’t include syringes in it.
Those working on the front lines of the opioid epidemic, like Botteicher, say a reexamination of Pennsylvania’s law is long overdue.
There’s an urgency to the issue as well: Billions of dollars have begun flowing into Pennsylvania and other states from legal settlements with companies over their role in the opioid epidemic, and syringe services are among the eligible interventions that could be supported by that money.
The opioid settlements reached between drug companies and distributors and a coalition of state attorneys general included a list of recommendations for spending the money. Expanding syringe services is listed as one of the core strategies.
But in Pennsylvania, where 5,158 people died from a drug overdose in 2022, the state’s drug paraphernalia law stands in the way.
Concerns over Botteicher’s work with syringe services recently led Westmoreland County officials to cancel an allocation of $150,000 in opioid settlement funds they had previously approved for her organization. County Commissioner Douglas Chew defended the decision by saying the county “is very risk averse.”
Botteicher said her organization had planned to use the money to hire additional recovery specialists, not on syringes. Supporters of syringe services point to the cancellation of funding as evidence of the need to change state law, especially given the recommendations of settlement documents.
“It’s just a huge inconsistency,” said Zoe Soslow, who leads overdose prevention work in Pennsylvania for the public health organization Vital Strategies. “It’s causing a lot of confusion.”
Though sterile syringes can be purchased from pharmacies without a prescription, handing out free ones to make drug use safer is generally considered illegal — or at least in a legal gray area — in most of the state. In Pennsylvania’s two largest cities, Philadelphia and Pittsburgh, officials have used local health powers to provide legal protection to people who operate syringe services programs.
Even so, in Philadelphia, Mayor Cherelle Parker, who took office in January, has made it clear she opposes using opioid settlement money, or any city funds, to pay for the distribution of clean needles, The Philadelphia Inquirer has reported. Parker’s position signals a major shift in that city’s approach to the opioid epidemic.
On the other side of the state, opioid settlement funds have had a big effect for Prevention Point Pittsburgh, a harm reduction organization. Allegheny County reported spending or committing $325,000 in settlement money as of the end of last year to support the organization’s work with sterile syringes and other supplies for safer drug use.
“It was absolutely incredible to not have to fundraise every single dollar for the supplies that go out,” said Prevention Point’s executive director, Aaron Arnold. “It takes a lot of energy. It pulls away from actual delivery of services when you’re constantly having to find out, ‘Do we have enough money to even purchase the supplies that we want to distribute?’”
In parts of Pennsylvania that lack these legal protections, people sometimes operate underground syringe programs.
The Pennsylvania law banning drug paraphernalia was never intended to apply to syringe services, according to Scott Burris, director of the Center for Public Health Law Research at Temple University. But there have not been court cases in Pennsylvania to clarify the issue, and the failure of the legislature to act creates a chilling effect, he said.
Carla Sofronski, executive director of the Pennsylvania Harm Reduction Network, said she was not aware of anyone having faced criminal charges for operating syringe services in the state, but she noted the threat hangs over people who do and that they are taking a “great risk.”
In 2016, the CDC flagged three Pennsylvania counties — Cambria, Crawford, and Luzerne — among 220 counties nationwide in an assessment of communities potentially vulnerable to the rapid spread of HIV and to new or continuing high rates of hepatitis C infections among people who inject drugs.
Kate Favata, a resident of Luzerne County, said she started using heroin in her late teens and wouldn’t be alive today if it weren’t for the support and community she found at a syringe services program in Philadelphia.
“It kind of just made me feel like I was in a safe space. And I don’t really know if there was like a come-to-God moment or come-to-Jesus moment,” she said. “I just wanted better.”
Favata is now in long-term recovery and works for a medication-assisted treatment program.
At clinics in Cambria and Somerset Counties, Highlands Health provides free or low-cost medical care. Despite the legal risk, the organization has operated a syringe program for several years, while also testing patients for infectious diseases, distributing overdose reversal medication, and offering recovery options.
Rosalie Danchanko, Highlands Health’s executive director, said she hopes opioid settlement money can eventually support her organization.
“Why shouldn’t that wealth be spread around for all organizations that are working with people affected by the opioid problem?” she asked.
In February, legislation to legalize syringe services in Pennsylvania was approved by a committee and has moved forward. The administration of Gov. Josh Shapiro, a Democrat, supports the legislation. But it faces an uncertain future in the full legislature, in which Democrats have a narrow majority in the House and Republicans control the Senate.
One of the bill’s lead sponsors, state Rep. Jim Struzzi, hasn’t always supported syringe services. But the Republican from western Pennsylvania said that since his brother died from a drug overdose in 2014, he has come to better understand the nature of addiction.
In the committee vote, nearly all of Struzzi’s Republican colleagues opposed the bill. State Rep. Paul Schemel said authorizing the “very instrumentality of abuse” crossed a line for him and “would be enabling an evil.”
After the vote, Struzzi said he wanted to build more bipartisan support. He noted that some of his own skepticism about the programs eased only after he visited Prevention Point Pittsburgh and saw how workers do more than just hand out syringes. These types of programs connect people to resources — overdose reversal medication, wound care, substance use treatment — that can save lives and lead to recovery.
“A lot of these people are … desperate. They’re alone. They’re afraid. And these programs bring them into someone who cares,” Struzzi said. “And that, to me, is a step in the right direction.”
At her nonprofit in western Pennsylvania, Botteicher is hoping lawmakers take action.
“If it’s something that’s going to help someone, then why is it illegal?” she said. “It just doesn’t make any sense to me.”
This story was co-reported by WESA Public Radio and Spotlight PA, an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Maca Root’s Benefits For The Mood And The Ability
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Maca Root: What It Does And Doesn’t Do
Maca root, or Lepidium meyenii, gets thought of as a root vegetable, though it’s in fact a cruciferous vegetable and more closely related to cabbage—notwithstanding that it also gets called “Peruvian ginseng”.
- Nutritionally, it’s full of all manner of nutrients (vitamins, minerals, fiber, and a wide array of phytochemicals)
- Medicinally, it’s long enjoyed traditional use against a wide variety of illnesses, including respiratory infections and inflammatory diseases.
It’s also traditionally an aphrodisiac.
Is it really anti-inflammatory?
Probably not… Unless fermented. This hasn’t been studied deeply, but a 2023 study found that non-fermented and fermented maca root extracts had opposite effects in this regard:
However, this was an in vitro study, so we can’t say for sure that the results will carry over to humans.
Is it really an aphrodisiac?
Actually yes, it seems so. Here’s a study in which 45 women with antidepressant-induced sexual dysfunction found it significantly improved both libido and sexual function:
❝In summary, maca root may alleviate antidepressant-induced sexual dysfunction as women age, particularly in the domain of orgasm❞
~ Dr. Christina Dording et al.
Read in full: A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women
As for men, well these mice (not technically men) found it beneficial too:
Effects of combined extracts of Lepidium meyenii and Allium tuberosum Rottl. on [e-word] dysfunction
(pardon the censorship; we’re trying to avoid people’s spam filters)
It did also improve fertility (and, actually in real men this time):
Does Lepidium meyenii (Maca) improve seminal quality?
Oh, to be in the mood
Here’s an interesting study in which 3g/day yielded significant mood improvement in these 175 (human) subjects:
And yes, it was found to be “well-tolerated” which is scientist-speak for “this appears to be completely safe, but we don’t want to commit ourselves to an absolutist statement and we can’t prove a negative”.
Oh, to have the energy
As it turns out, maca root does also offer benefits in this regard too:
(that’s not an added ingredient; it’s just a relevant chemical that the root naturally contains)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Astrology, Mental health and the Economics of Well Being
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Ultimately can the mental health system single-handedly address the concerns of inequality and economic access in society?
Around 75 per cent of the Indian population lives in rural areas, but their access to quality mental health care is limited and traditional approaches continue to be in use. The shortage is to such a large extent that there are only 0.7 physicians per 1000 population and only one psychiatrist for every 343,000 Indians. While over the years the mental health sector has seen major developments, like the 2017 mental health care act. This act establishes equal access for all citizens, to avail government-run or funded mental health services in the country. However, it does not bridge the gap in society as the majority of the population remains deeply unaware or unable to access these services.
While the uncertainties of the pandemic brought mental wellbeing to the forefront, the national budget for the sector dropped, making this an issue of human rights. This accessibility to services is further corroborated by the recurring financial expenses of medications and frequent visits to government clinics. The cost of sessions is steep and a single session is not ideal. Spending exorbitant amounts on healthcare is a burden most families can’t afford leading to debt. In the absence of insurance and healthcare schemes and provisions, therapy remains a luxury to many Indians.
Economic struggles are only one of the causes of this discerning gap in the mental health sector. Barriers caused by sexuality, gender, caste and religion also play a major role in mediating people’s perception and access to therapeutic services. The persistent stigma surrounding mental health, especially in India continues to be a hindrance to seeking help. The supernatural inhibitions and disparity in knowledge across communities only create more confusion. The notion that mental well being is an optional expense is popular, even though the country’s population is in a dire state. Data collected in a WHO report found that nearly 15 per cent of Indian adults need active intervention for one or more mental health issues.
The population disregards the very prevalence of such mental disorders and more than often finds it fruitless to receive treatment. Some who are open-minded fail to afford the hiked fees that therapists in urban settings charge, leaving them with no option. While for years Indians attributed the systemic weakness of the mental health system to the people’s attitudes, a 2016 survey showed more than 42% of people have positive attitudes toward mental wellbeing and treatment. While the skeptics remain, these underprivileged sections of society too struggle to gain the accessibility they deserve.
This is where astrology, tarot card reading and other spiritual practices, have created a market for themselves in the well-being industry. The sceptics, and those from poor socio-economic backgrounds resort to these local and easily accessible ways of coping, to instil the faith they so desperately need. Astrology is a layman’s substitute for therapy, or for some even a supplement when they cannot afford extended periods of treatment. Visiting a local astrologer in many ways breeds the self-awareness one would expect from a session in therapy. These practices even hold certain similarities to actual psychotherapy settings, in the way they define, and alleviate aspects of one’s personality and behaviour.
Very often one simply needs an explanation, or an answer to the ‘why’ no matter how scientifically rooted that response truly is. Astrologers impart a level of faith, that things will get better. For those in rural areas, struggling to provide the bare necessities to their family affording therapy is impossible, so their local psychic, astrologer or pandit becomes their anchor during emotional duress. Tarot cards and other practices primarily focus on the future and act as a guide point for how to deal with the things ahead. For a farmer coping with anxiety, access to anti-anxiety medication is strained, and so is therapy. His best bet remains to consult his next-door jyotish about his burdens.
A famous clinician Caroline Hexdall in an interview said that “ Part of the popularity of astrology and tarot today has to do with their universal nature”. With growing technology and the pervasiveness of social media, people can gain easy access to self-care and astrology resources. Apps and web pages provide daily tarot cards, zodiac signs readings and astrological predictions for people, and almost serve the purpose of a therapist. Is reading the lines on our palm, and checking the alignment of the stars enough to cure the mental illness they undergo? Is it a solution or a quick fix as a consequence of an ignorant healthcare system?
Several studies have also shown the deteriorating effects of depending on astrology. Cases of worsening and onset of depression, anxiety and personality disorders are common for those who use astrology as more than just a temporary coping mechanism. It also becomes a source of losing control, as every feeling is attributed to fate and destiny, instilling a sense of helplessness. Ultimately can the mental health system single-handedly address the concerns of inequality and economic access in society?
Maahira Jain is a third-year student at Ashoka University studying Psychology and Media studies. She is a movie buff and is extremely passionate about writing and traveling.
This article is republished from OpenAxis under a Creative Commons license. Read the original article.
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How to Find Happiness In Yourself – by Michelle Mann
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A lot of books about happiness tell you what to pursue, generally. What things to focus on, and that’s good, but incomplete. This book does cover those things too (complete with academic sources to back up what really works), but also goes further:
Michelle Mann gives 25 key habits that will cumulatively build happiness, which is what it’s really about. After all:
- If you watch your favourite movie, you’ll be happy for 90 minutes (or 9 hours if it’s The Lord of the Rings).
- If you build daily habits that add happiness to you, your surroundings, and those around you, you’ll be happy for life.
They do also cover happiness while going through difficult times, such as divorce, job loss, illness, or bereavement.
Sometimes, knowing what we “should” do in theory is the easy part. Where Mann excels here is in providing explanations of each habit. This means that rather than it being some platitude, the principles underlying it are truly understood… and thus motivate us to actually apply the advice and build the habits into our life.
While the explanations are therefore the greatest value of the book, we do recommend copying out the 25 habits (which are effectively subchapter headings) and putting them somewhere to read often.
Bottom line: we recommend getting yourself (and/or your loved ones!) a copy of this book. You (and/or they) will be happy you did!
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State of Slim – by Dr. James Hill & Dr. Holly Wyatt
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The premise of this book is “people in Colorado are on average the slimmest in the US”, and sets about establishing why, and then doing what Coloradans are doing. As per the subtitle (drop 20 pounds in 8 weeks), this is a weight loss book and does assume that you want to lose weight—specifically, to lose fat. So if that’s not your goal, you can skip this one already.
The authors explain, as many diet and not-diet-but-diet-adjacent book authors do, that this is not a diet—and then do refer to it as the Colorado Diet throughout. So… Is it a diet?
The answer is a clear “yes, but”—and the caveat is “yes, but also some associated lifestyle practices”.
The diet component is basically a very low-carb diet to start with (with the day’s ration of carbs being a small amount of oats and whatever you can get from some non-starchy vegetables such as greens, tomatoes, etc), and then reintroducing more carbohydrate centric foods one by one, stopping after whole grains. If you are vegan or vegetarian, you can also skip this one already, because this advises eating six animal protein centric meals per day.
The non-diet components are very general healthy-living advices mixed in with popular “diet culture” advices, such as practice mindful eating, don’t eat after 8pm, exercise more, use small plates, enjoy yourself, pre-portion your snacks, don’t drink your calories, get 8 hours sleep, weigh all your food, etc.
Bottom line: this is a very mixed bag, even to the point of being a little chaotic. It gives sometimes contradictory advice, and/but this results in a very “something for everyone” cafeteria approach to dieting. The best recommendation we can give for this book is “it has very many ideas for you to try and see if they work for you”.
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Macadamias vs Hazelnuts – Which is Healthier?
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Our Verdict
When comparing macadamias to hazelnuts, we picked the hazelnuts.
Why?
In terms of macros first, hazelnuts have 2x the protein, and slightly more carbs and fiber. We call this a win for hazelnuts.
When it comes to vitamins, macadamias have more of vitamins B1, B2, and B3, while hazelnuts have more of vitamins A, B5, B6, B7, B9, C, and E. Notably, 28x more vitamin E, so that’s not inconsiderable. Also 10x the vitamin B9, and 5x the vitamin C, and the rest, more modest wins. In any case, clearly a strong win for hazelnuts here.
In the category of minerals, macadamias have more selenium, while hazelnuts have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Another clear win for hazelnuts.
In short, hazelnuts win in all categories. However, by all means enjoy either or both (unless you have a nut allergy, in which case, obviously don’t).
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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The Problem With Sweeteners
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The WHO’s view on sugar-free sweeteners
The WHO has released a report offering guidance regards the use of sugar-free sweeteners as part of a weight-loss effort.
In a nutshell, the guidance is: don’t
- Here’s the report itself: Use of non-sugar sweeteners: WHO guideline
- Here’s the WHO’s own press release about it: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline
- And it was based on this huge systematic review: Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis
They make for interesting reading, so if you don’t have time now, you might want to just quickly open and bookmark them for later!
Some salient bits and pieces:
Besides that some sweeteners can cause gastro-intestinal problems, a big problem is desensitization:
Because many sugar substitutes are many times (in some cases, hundreds of times) sweeter than sugar, this leads to other sweet foods tasting more bland, causing people to crave sweeter and sweeter foods for the same satisfaction level.
You can imagine how that’s not a spiral that’s good for the health!
The WHO recommendation applies to artificial and naturally-occurring non-sugar sweeteners, including:
- Acesulfame K
- Advantame
- Aspartame
- Cyclamates
- Neotame
- Saccharin
- Stevia
Sucralose and erythritol, by the way, technically are sugars, just not “that kind of sugar” so they didn’t make the list of non-sugar sweeteners.
That said, a recent study did find that erythritol was linked to a higher risk of heart attack, stroke, and early death, so it may not be an amazing sweetener either:
Read: The artificial sweetener erythritol and cardiovascular event risk
Want to know a good way of staying healthy in the context of sweeteners?
Just get used to using less. Your taste buds will adapt, and you’ll get just as much pleasure as before, from progressively less sweetening agent.
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