What you need to know about xylazine
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Xylazine is a non-opioid tranquilizer designed for veterinary use in animals. The sedative is not approved for use in people, yet it’s becoming more prevalent in the illicit drug supply.
Sometimes called “tranq,” it’s often mixed with other drugs, such as fentanyl, a potent opioid responsible for a growing number of overdose deaths. Last year, the White House Office of National Drug Control Policy declared fentanyl mixed with xylazine an “emerging threat.”
Read on to learn more about xylazine: what happens when people take it, what to do if an overdose is suspected, and how harm reduction tools can prevent overdose deaths.
How are people who use drugs exposed to xylazine?
Studies show people are exposed to xylazine—knowingly or unknowingly—when it’s mixed with other drugs like heroin, cocaine, meth, and, most frequently, fentanyl. When combined with opioids or other drugs, it increases the risk of a drug overdose.
What happens if someone takes xylazine?
Taking xylazine can cause drowsiness, amnesia, slow breathing, slow heart rate, dangerously low blood pressure, wounds that can become infected, and death, especially when taken in combination with other drugs.
Why does xylazine increase the risk of overdose?
Xylazine is a central nervous system depressant, which means that it slows down the body’s heart rate and breathing. It can also enhance the effects of other depressants, such as opioids, which may lead to suffocation.
What are the signs of a xylazine-related overdose?
Xylazine-related overdoses look like opioid overdoses. A person who has overdosed may exhibit a slow pulse, slow breathing, blurry vision, disorientation, drowsiness, confusion, blue skin, and loss of consciousness.
How many people die from xylazine-related overdoses in the U.S.?
Xylazine-related overdose deaths in the U.S. rose from 102 deaths in 2018 to 3,468 deaths in 2021. Most occurred in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. Fentanyl was the most frequently co-occurring drug involved in those deaths.
What should I do if an overdose is suspected?
If you suspect that a person has overdosed on any drug, call 911 and give them naloxone—sometimes sold under the brand name Narcan—a medication that can reverse an opioid overdose. You should also stay with the person who has overdosed until first responders arrive. Most states have Good Samaritan laws, which protect people who have overdosed and those assisting them from certain criminal penalties.
While naloxone cannot reverse the effects of xylazine alone, experts recommend administering naloxone if an overdose is suspected because it’s often mixed with opioids.
You can get naloxone for free from some nonprofit organizations and government-run programs. You can also purchase over-the-counter naloxone at pharmacies, grocery and convenience stores, and other retailers.
Learn how to use naloxone in this short training video from the American Medical Association, or sign up for a free online training.
How can people prevent xylazine-related overdoses?
Harm reduction programs are community programs that prevent drug overdoses, reduce the spread of infectious diseases, and connect people to medical care. These programs provide lifesaving tools like naloxone, as well as fentanyl and xylazine test strips, which can detect the presence of these drugs in a substance and prevent overdoses. Drug test strips can also be ordered online.
However, test strips are considered “drug paraphernalia” in some states and are not legal everywhere. Learn more about state laws around drug checking equipment from the Network for Public Health Law.
Learn more about harm reduction from the CDC.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?
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Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder) and how much does it matter for health e.g. waist size etc?❞
Let’s break it down into two parts:
Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder)?
Short answer: no
First, a quick anatomy lesson: while “abs” (abdominal muscles) are considered in the plural and indeed they are, what we see as a six-pack is actually only one muscle, the rectus abdominis, which is nestled in between other abdominal muscles that are beyond the scope of our answer here.
The reason that the rectus abdominis looks like six muscles is because there are bands of fascia (connective tissue) lying over it, so we see where it bulges between those bands.
The main difference genes make are as follows:
- Number of fascia bands (and thus the reason that some people get a four-, six-, eight-, or rarely, even ten-pack). Obviously, no amount of training can change this number, any more than doing extra bicep curls will grow you additional arms.
- Density of muscle fibers. Some people have what has been called “superathlete muscle type”, which, while prized by Olympians and other athletes, is on bodybuilding forums less glamorously called being a “hard gainer”. What this means is that muscle fibers are denser, so while training will make muscles stronger, you won’t see as much difference in size. This means that size for size, the person with this muscle type will always be stronger than someone the same size without it, but that may be annoying if you’re trying to build visible definition.
- Twitch type of muscle fibers. Some people have more fast-twitch fibers, some have more slow-twitch fibers. Fast-twitch fibers are better suited for visible abs (and, as the name suggests, quick changes between contracting and relaxing). Slow-twitch fibers are better for endurance, but yield less bulky muscles.
- Inclination to subcutaneous fat storage. This is by no means purely genetic; hormones make the biggest difference, followed by diet. But, genes are an influencing factor, and if your body fat percentage is inclined to be higher than someone else’s, then it’ll take more work to see muscle definition under that fat.
The first of those items is why our simple answer is “no”; because some people are destined to, if muscle is visible, have a four-, eight, or (rarely) ten-pack, making a six-pack unobtainable.
It’s worth noting here that while a bigger number is more highly prized aesthetically, there is literally zero difference healthwise or in terms of performance, because it’s nothing to do with the muscle, and is only about the fascia layout.
The density of muscle fibers is again purely genetic, but it only makes things easier or harder; this part’s not impossible for anyone.
The inclination to subcutaneous fat storage is by far the most modifiable factor, and the thus most readily overcome, if you feel so inclined. That doesn’t mean it will necessarily be easy! But it does mean that it’s relatively less difficult than the others.
How much does it matter for health, e.g. waist size etc?
As you may have gathered from the above, having a six-pack (or indeed a differently-numbered “pack”, if that be your genetic lot) makes no important difference to health:
- The fascia layout is completely irrelevant to health
- The muscle fiber types do make a difference to athletic performance, but not general health when at rest
- The subcutaneous fat storage is a health factor, but probably not how most people think
Healthy body fat percentages are (assuming normal hormones) in the range of 20–25% for women and 15–20% for men.
For most people, having clearly visible abs requires going below those healthy levels. For most people, that’s not optimally healthy. And those you see on magazine covers or in bodybuilding competitions are usually acutely dehydrated for the photo, which is of course not good. They will rehydrate after the shoot.
However, waist size (especially as a ratio, compared to hip size) is very important to health. This has less to do with subcutaneous fat, though, and is more to do with visceral belly fat, which goes under the muscles and thus does not obscure them:
Visceral Belly Fat & How To Lose It
One final note: fat notwithstanding, and aesthetics notwithstanding, having a strong core is very good for general health; it helps keeps one’s internal organs in place and well-protected, and improves stability, making falls less likely as we get older. Additionally, having muscle improves our metabolic base rate, which is good for our heart. Abs are just one part of core strength (the back being important too, for example), but should not be neglected.
Top-tier exercises to do include planks, and hanging leg raises (i.e. hang from some support, such as a chin-up bar, and raise your legs, which counterintuitively works your abs a lot more than your legs).
Take care!
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Kava vs Anxiety
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Kava, sometimes also called “kava kava” but we’re just going to call it kava once for the sake of brevity, is a heart-shaped herb that
bestows the powers of the Black Pantheris popularly enjoyed for its anxiolytic (anxiety-reducing) effects. Despite the similarity of the name in many languages, it is unrelated to coffee (except insofar as they are both plants), and its botanical name is Piper methysticum.Does it work?
Yes! At least in the short-term; more on that later.
Firstly, you may be wondering how it works; it works by its potentiation of GABA receptors in the brain. GABA (or gamma-aminobutyric acid, to give it its full name), as you may recall, is a neurotransmitter that is associated with feelings of calm; we wrote about it here:
So, what does “potentiation of GABA receptors” mean? It means… Scientists don’t for 100% sure know how it works yet, but it does make GABA receptors fire more. It’s possible that to some degree GABA fits the “molecular lock” of the receptors and causes them to say “GABA is here”; it’s also possible that they just make them more sensitive to the real GABA that is there, or there could be another explanation as yet undiscovered. Either way, it means that taking kava has a similar effect to having increased GABA levels in the brain:
As for how much to use, 20–300mg appears to be an effective dose, and most sources recommend 80–250mg:
Kava as a Clinical Nutrient: Promises and Challenges
This review of clinical trials found that it was more effective than placebo in only 3 of 7 trials; specifically, it was beneficial in the short-term and not in the long-term. For these reasons, the researchers concluded:
❝Kava Kava appears to be a short-term treatment for anxiety, but not a replacement for prolonged anti-anxiety use. Although not witnessed in this review, liver toxicity is especially possible if taken longer than 8 weeks.❞
Another review of clinical trials found better results over the course of 11 clinical trials, though again, short-term treatment only was considered to be where the “safe and effective” claim can be placed:
❝Compared with placebo, kava extract appears to be an effective symptomatic treatment option for anxiety. The data available from the reviewed studies suggest that kava is relatively safe for short-term treatment (1 to 24 weeks), although more information is required. Further rigorous investigations, particularly into the long-term safety profile of kava are warrant❞
Source: Kava extract for treating anxiety
Is it safe?
Nope! It has been associated with liver damage:
The likely main mechanism of toxicity is that it simply monopolizes the liver’s metabolic abilities, meaning that while it’s metabolizing the kava, it’s not metabolizing other things (such as alcohol or other medications), which will then build up, and potentially overwhelm the liver:
Constituents in kava extracts potentially involved in hepatotoxicity: a review
However, traditionally-prepared kava has not had the same effect as modern extracts; at first it seemed the difference was the traditional aqueous extracts vs modern acetonic/ethanolic extracts, but eventually that was found not to be the case, as toxicity occurred with industrial aqueous extracts too. The conclusion so far is that it is about the quality of the source ingredients, and the problems inherent to mass-production:
Meanwhile, short-term use doesn’t seem to have this problem, if you’re not drinking alcohol or taking medications that affect the liver:
Mechanisms/risk factors – kava-associated hepatotoxicity ← you’ll need to scroll down to 4.2.4 to read about this
Want to try it?
If the potential for hepatotoxicity doesn’t put you off, here’s an example product on Amazon ← we do not recommend it, but we are not the boss of you, and maybe you’re confident about your liver and want to use it only very short-term?
Take care!
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Chickpeas vs Mung Beans – Which is Healthier?
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Our Verdict
When comparing chickpeas to mung beans, we picked the chickpeas.
Why?
Both are great! But there’s a clear winner here:
In terms of macros, chickpeas have more protein, carbs, and fiber, as well as the lower glycemic index. The difference is very small, but it’s a nominal win for chickpeas.
When it comes to vitamins, chickpeas have more of vitamins A, B2, B6, B9, C, E, K, and choline, while mung beans have more of vitamins B1, B3, and B5. Again the differences aren’t huge, but by strength of numbers they’re in chickpeas’ favor, so it’s another win for chickpeas here.
In the category of minerals, chickpeas have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while mung beans are not higher in any mineral. An easy win for chickpeas on this one.
Adding up the sections makes for a clear overall win for chickpeas, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Plant vs Animal Protein: Head to Head
Enjoy!
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How Not to Diet – by Dr. Michael Greger
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We’ve talked before about Dr. Greger’s famous “How Not To Die” book, and we love it and recommend it… But… It is, primarily, a large, dry textbook. Full of incredibly good science and information about what is statistically most likely to kill us and how to avoid that… but it’s not the most accessible.
“How Not To Diet“, on the other hand, is a diet book, is very readable, and assumes the reader would simply like to know how to healthily lose weight.
By focussing on this one problem, rather than the many (admittedly important) mortality risks, the reading is a lot easier and lighter. And, because it’s still Dr. Greger advocating for the same diet, you’ll still get to reduce all those all-cause mortality risks. You won’t be reading about them in this book; it will now just be a happy side effect.
While in “How Not To Die”, Dr. Greger looked at what was killing people and then tackled those problems, here he’s taken the same approach to just one problem… Obesity.
So, he looks at what is causing people to be overweight, and methodically tackles those problems.
We’ll not list them all here—there are many, and this is a book review, not a book summary. But suffice it to say, the work is comprehensive.
Bottom line: this book methodically and clinically (lots of science!) looks at what makes us overweight… And tackles those problems one by one, giving us a diet optimized for good health and weight loss. If you’d like to shed a few pounds in a healthy, sustainable way (that just happens to significantly reduce mortality risk from other causes too) then this is a great book for you!
Click here to check out “How Not To Diet” on Amazon and get healthy for life!
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Indistractable – by Nir Eyal
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Have you ever felt that you could accomplish anything you wanted/needed, if only you didn’t get distracted?
This book lays out a series of psychological interventions for precisely that aim, and it goes a lot beyond the usual “download/delete these apps to help you stop checking social media every 47 seconds”.
Some you’ll have heard of before, some you won’t have, and if even one method works for you, it’ll have been well worth your while reading this book. This reviewer, for example, enjoyed the call to identity-based strength, e.g. adopting an “I am indistractable*” perspective going into tasks. This is akin to the strength of, for example, “I don’t drink” over “I am a recovering alcoholic”.
*the usual spelling of this, by the way, is “undistractable”, but we use the author’s version here for consistency. It’s a great marketing gimmick, as all searches for the word “indistractable” will bring up his book.
Nor is the book just about maximizing productivity to the detriment of everything else; this is not about having a 25 hours per day “grindset”. Rather, it even makes sure to cover such things as focusing on one’s loved ones, for instance.
Bottom line: if you’ve tried blocking out the distractions but still find you can’t focus, this book offers next-level solutions
Click here to check out Indistractible, and become indeed indistractable!
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What is a ‘vaginal birth after caesarean’ or VBAC?
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A vaginal birth after caesarean (known as a VBAC) is when a woman who has had a caesarean has a vaginal birth down the track.
In Australia, about 12% of women have a vaginal birth for a subsequent baby after a caesarean. A VBAC is much more common in some other countries, including in several Scandinavian ones, where 45-55% of women have one.
So what’s involved? What are the risks? And who’s most likely to give birth vaginally the next time round?
MVelishchuk/Shutterstock What happens? What are the risks?
When a woman chooses a VBAC she is cared for much like she would during a planned vaginal birth.
However, an induction of labour is avoided as much as possible, due to the slightly increased risk of the caesarean scar opening up (known as uterine rupture). This is because the medication used in inductions can stimulate strong contractions that put a greater strain on the scar.
In fact, one of the main reasons women may be recommended to have a repeat caesarean over a vaginal birth is due to an increased chance of her caesarean scar rupturing.
This is when layers of the uterus (womb) separate and an emergency caesarean is needed to deliver the baby and repair the uterus.
Uterine rupture is rare. It occurs in about 0.2-0.7% of women with a history of a previous caesarean. A uterine rupture can also happen without a previous caesarean, but this is even rarer.
However, uterine rupture is a medical emergency. A large European study found 13% of babies died after a uterine rupture and 10% of women needed to have their uterus removed.
The risk of uterine rupture increases if women have what’s known as complicated or classical caesarean scars, and for women who have had more than two previous caesareans.
Most care providers recommend you avoid getting pregnant again for around 12 months after a caesarean, to allow full healing of the scar and to reduce the risk of the scar rupturing.
National guidelines recommend women attempt a VBAC in hospital in case emergency care is needed after uterine rupture.
During a VBAC, recommendations are for closer monitoring of the baby’s heart rate and vigilance for abnormal pain that could indicate a rupture is happening.
If labour is not progressing, a caesarean would then usually be advised.
Giving birth in hospital is recommended for a vaginal birth after a caesarean. christinarosepix/Shutterstock Why avoid multiple caesareans?
There are also risks with repeat caesareans. These include slower recovery, increased risks of the placenta growing abnormally in subsequent pregnancies (placenta accreta), or low in front of the cervix (placenta praevia), and being readmitted to hospital for infection.
Women reported birth trauma and post-traumatic stress more commonly after a caesarean than a vaginal birth, especially if the caesarean was not planned.
Women who had a traumatic caesarean or disrespectful care in their previous birth may choose a VBAC to prevent re-traumatisation and to try to regain control over their birth.
We looked at what happened to women
The most common reason for a caesarean section in Australia is a repeat caesarean. Our new research looked at what this means for VBAC.
We analysed data about 172,000 low-risk women who gave birth for the first time in New South Wales between 2001 and 2016.
We found women who had an initial spontaneous vaginal birth had a 91.3% chance of having subsequent vaginal births. However, if they had a caesarean, their probability of having a VBAC was 4.6% after an elective caesarean and 9% after an emergency one.
We also confirmed what national data and previous studies have shown – there are lower VBAC rates (meaning higher rates of repeat caesareans) in private hospitals compared to public hospitals.
We found the probability of subsequent elective caesarean births was higher in private hospitals (84.9%) compared to public hospitals (76.9%).
Our study did not specifically address why this might be the case. However, we know that in private hospitals women access private obstetric care and experience higher caesarean rates overall.
What increases the chance of success?
When women plan a VBAC there is a 60-80% chance of having a vaginal birth in the next birth.
The success rates are higher for women who are younger, have a lower body mass index, have had a previous vaginal birth, give birth in a home-like environment or with midwife-led care.
For instance, an Australian study found women who accessed continuity of care with a midwife were more likely to have a successful VBAC compared to having no continuity of care and seeing different care providers each time.
An Australian national survey we conducted found having continuity of care with a midwife when planning a VBAC can increase women’s sense of control and confidence, increase their chance to be upright and active in labour and result in a better relationship with their health-care provider.
Seeing the same midwife throughout your maternity care can help. Tyler Olson/Shutterstock Why is this important?
With the rise of caesareans globally, including in Australia, it is more important than ever to value vaginal birth and support women to have a VBAC if this is what they choose.
Our research is also a reminder that how a woman gives birth the first time greatly influences how she gives birth after that. For too many women, this can lead to multiple caesareans, not all of them needed.
Hannah Dahlen, Professor of Midwifery, Associate Dean Research and HDR, Midwifery Discipline Leader, Western Sydney University; Hazel Keedle, Senior Lecturer of Midwifery, Western Sydney University, and Lilian Peters, Adjunct Research Fellow, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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