Onslaught of Ads Expected for New Blood Thinners

Last month when the FDA approved a new drug for people taking stroke-preventing blood-thinners (the first to challenge the current standard treatment--warfarin or Coumadin--in two decades) they also guaranteed a new onslaught of annoying TV ads. Even before the agency blessed the new drug, an article in Forbes point out, TV ads were advising viewers to ask their doctors about atrial fibrillation, the heart rhythm malady for which the first new drug, Pradaxa, is approved. Now, Bayer and Johnson & Johnson are trumpeting study results showing their clot-preventer, Xarelto, worked better than warfarin in atrial fibrillation patients. Bayer has said $2.73 billion is a conservative sales estimate for the new drug. With so much at stake, Forbes predicts pharmaceutical companies will hit the airwaves hard.

Good news for consumers is the new clot-preventers promise to be easier to take than warfarin, which requires frequent blood tests and dose adjustments. Bad news is we'll have to listen to more tedious lists of side-effects when we watch our favorite shows.

Fermenting a Revolution Off the Grid

Burkhard Bilger, eminence grise of food writers and regular New Yorker contributor for the last decade has written a doozy for this week's foodie issue of the New Yorker. It's a must-read for anyone interested in the subversive subculture that's cropped up around the local and sustainable food movement, which now threatens to tarnish the credibility of the movement's increasingly high public profile.

An excerpt from "Nature's Spoil's" by Birkhard Bilger for The New Yorker:

The house at 40 Congress Street wouldn’t have been my first choice for lunch. It sat on a weedy lot in a dishevelled section of Asheville, North Carolina. Abandoned by its previous owners, condemned by the city, and minimally rehabilitated, it was occupied perhaps infested is a better word--by a loose affiliation of opportunivores.  The walls and ceilings, chicken coop and solar oven were held together with scrap lumber and drywall. The sinks, disconnected from the sewer, spilled their effluent into plastic buckets, providing water for root crops in the gardens. The whole compound was painted a sickly greenish gray--the unhappy marriage of twenty-three cans of surplus paint from Home Depot. “We didn’t put in the pinks,” Clover told me.

Go to The New Yorker home page.

A New Wellness Guru in the Senate?

Is Senator Charles Schumer angling to become the nation's first Wellness Czar? Over the past six months he's fired off a series of letters to the FDA that suggest he's fighting for citizens' right to a healthy world. And of course, being a senator, there are no doubt some hidden agendas at play.

• In June he sent a letter asking the FDA to look into concerns that sunscreen may be increasing skin cancer rates. 
• That same month, he asked the FDA to intervene in what's been dubbed "Honey Laundering"--alleged adulteration, misbranding and fraudulent mislabeling of honey coming from China. This letter, which resulted in FDA seizures, called for an "official definition of honey." (Why didn't we think of that?) 
• July found him asking the FDA to adopt stricter enforcement of health regulations for airline caterers. (Thanks Chuck, we couldn't have said it better.) 
• And in the same month, he prophetically raised a red flag to the FDA about alcohol-energy drinks, singling out the now infamous Four Loko. (Kids would have been protected if the FDA had only listened to him on this one.) 
• Just last week, he called on the FDA to impose a ban on alcohol-energy drinks, which is now in place in at least 5 states--with New York joining the list today.Schumer displaying his "wellness" chops.

Then yesterday--he even writes letters to the FDA on Sundays!--he fired off another missive. (You have to wonder if they've assigned one person to the job of opening Chuck's letters.) This time it's about reusable grocery bags. In a twist that conjures images of a chopstick-wielding Megamind intent on taking down Americans' I.Q. scores, Schumer drew attention to findings in Florida that reusable grocery bags from China are made with materials containing lead, a neurotoxin, that threatens to spoil groundwater around land-fills (that is, when people finally throw the reusable bags away). This time Schumer wants an investigation. 

In September one of the nation's largest grocery chains, Wegmans, recalled some of its reusable grocery bags due to the presence of "elevated levels of lead." Somewhere there must be a shipping container from China full of unusable reusable grocery bags. It used to be if we wanted to pull China's chain we'd mention Human Rights. Now we just raise the specter of their products causing health problems. So it would seem the world really does revolve around wellness.

Kids Today Pay a Higher Price for Getting High

By Woodson Merrell, M.D.

I am deeply concerned about the increasing incidence of recreational drug use in younger adults and teens causing significant, sometimes permanent, psychological (or physical) damage. I am well aware drug use in this age group has been around in earnest since the 1960s. But in my experience as a physician, the medical and psychological harm associated with youthful experiments with drugs (and alcohol) have become more prevalent even in the past 5 years. I have been asking myself, what is different about these kids?

Now new information and recent events shed light on some answers that make much sense: illicit drugs now are different, often much stronger, than what's been available for many decades. And genomic research shows it is very likely there are changes taking place within the human genome as a result of generations of drug use that may be making kids more susceptible to use-related problems.Pineapple Express made it funny, but scientists are uncovering a much darker side of being stoned.

A recent Wall Street Journal article about the so-called "Legal High" business details how these stronger, potentially more harmful substances are getting into kids hands. In terms of alcohol, we know from recent publicized incidences of near-fatal alcohol poisoning that the new spate of alcohol-energy drinks (which can contain the alcohol-equivalent of 4 bottles of beer plus 3 shots of espresso in a single can!!) are a disastrous choice for a young person on a Saturday night.

While it seems the alcohol energy drinks may be banned out of existence (today, New York state Washington state, Michigan, Oklahoma, Utah and the Chicago City Council in imposing bans) banning so-called designer drugs is tougher. Illicit manufacturers are always trying to stay one step ahead of the Feds by inventing new substances not yet declared illegal. "Probably five years ago, the appearance of a new drug was notable-we'd all get together and talk about it-whereas last month, we found six," John Ramsey, a toxicologist at St. George's University in London told The Wall Street Journal. When even the experts are often stumped by the new designer drugs, we certainly can't expect kids to know what they are getting into.

Purchasing recreational drugs has always been a "caveat emptor" situation--meaning buy at your own risk--but today there are many more synthetic psychoactive compounds in circulation than at any time in history. Some of the substances start with one of the plethora of new legal psychoactive drugs such as Ritalin, which has been tweaked by black market drug labs into something resembling cocaine. All of these have potent effects on the brain and nervous system.

Marijuana (botanical name cannabis sativa), which many people think of as a soft drug--and which when medically supervised has a number of legitimate uses for people with chronic problems (notably chronic pain)--has become more and more perilous over the years in its black market incarnations. The northern California sensimilla commonly produced in the U.S. has been hybridized to be more than 300 times more potent (for its psychoactive compounds) than the marijuana common in the 60s. As if this weren't scary enough, now there are at least four different illicit synthetic cannabis compounds manufacturers spray onto herbs and sell as recreational drugs, sometimes called Spice or K2, sometimes just called pot. The illicit lab-made substances have many of the pharmacological properties of cannabis, except for one crucial difference.

There's clear evidence that black market synthetic marijuana (these are versions of cannabinoids--based on the most powerful, tetra-hydro-cannabinol (THC)--which are synthesized in illegitimate labs) is potentially more damaging than regular pot made from marijuana plants. Marijuana leaves contain an anti-psychotic chemical, cannabidiol (CBD), which counteracts the psychoactive properties of THC and other cannabinoids.(Black market plants, not grown for medical purposes but to increase a "high," have been bred to have much higher amounts of THC and lower amounts of CBD than marijuana plants twenty years ago.) Black market synthetic cannabis products, according to chemists who have analyzed them, lack similar anti-psychotic components. Psychiatrists who have treated people for psychosis developed after taking synthetic cannabis bought on the street have suggested that this important difference may make black market synthetic cannabis even more likely to induce psychosis than natural cannabis.

The potential potency of these drugs can turn youthful experimentation into a dangerous game. The typical age of drug use has been dropping over the years so that even 12 year olds are abusing substances. The effects on the developing brain, from fetal life to the early twenties especially, can be catastrophic. (The more mature brain--roughly after age 23--has more resilience to these effects.) But as far as youthful experimentation, messing with newer, high-potency marijuana and its black market synthetic cousins is becoming an increasingly bad idea.

For decades marijuana has been associated with problems with short-term memory and male fertility, but emerging research has identified adolescent use of the most widely used illicit drug as an environmental factor consistently associated with increased risk of schizophrenia and bipolar disorder. There is evidence that early marijuana use of all types can alter gene expression of the developing brain, most notably through the epigene region. This is the area just next to the DNA that not only helps direct DNA's activities, but can become permanently programmed within one generation to alter the way DNA behaves (and pass this on to the next generation). One of the things that recent research has shown is that especially cannabis can change the epigenes and predispose a young brain to major psychiatric disorders that become manifest in the teens and early twenties.

The newly documented mechanisms for permanent hereditary genetic changes resulting from "recreational drug use" has certainly increased by concerns about the innocence of adult--much less youthful--drug experimentation. Having a parent use a drug prenatally (and the more use, the greater risk)  can mean greater susceptibility in the child not only to more drug-seeking behavior but also to greater risks of sometimes permanent psychological damage. Scientists now believe this is likely due to a trait created through epigenetic pathways by the drugs themselves. The original sinner may have been chasing dopamine, but successive generations will do the same at a higher cost.

Now, with these more powerful agents, kids with no family history of schizophrenia or any other psychological disorder are reporting frightening experiences of dissociation after partaking. I personally have seen a number of young adults become dissociative (unable to pull their psychological state together) for weeks after a single use of what they believe to have been "ordinary" marijuana. The majority of people recover from these incidences, but some don't.

Talk to your kids about the dangers. Understand that illicit drugs are different today, and sadly, some kids may have more vulnerable neurological pathways than kids 30 or 40 years ago. Some parents, remembering their own youthful explorations, are inclined to be casual about their budding adolescent's experiments with drugs and alcohol, but the stakes today are too high. They just don't make drugs like they used to.

This article was published simultaneously in Dr. Merrell's blog, The Source of Healing, at psychologytoday.com.

Green Ennui

In a consumer report released in September, GfK Roper Consulting found a dramatic increase in the percentage of U.S. consumers wary of environmentally friendly product alternatives. The share of consumers who think green products are too expensive rose eight points in two years to 61%, while those who believe they don't work as well jumped nine points to 33% and those who believe they're not even as better for the environment in the first place increased eight points to 38%.

According to Advertising Age, Timothy Kenyon, director of the GfK Roper Green Gauge study, calls the attitude "green fatigue."

In recent months, sales have begun to slow in categories such as green cleaners, and they've grown in not-so-sustainable ones like bottled water. After more than two years for consumers to have experience with a huge number of so-called green products, skepticism is on the rise. Greener cleaners, which had been one of the hottest trends in household products in recent years, also show signs of a shakeout. Clorox Co. chief operating officer Larry Peiros attributed disappointing top-line results to a decline in the natural cleaning segment. "We remain," he said in a conference call with reporters, "in the No. 1 share position, but we're declining pretty much along with the category."

Measured sales of Clorox Green Works are actually up 5% for the 52 weeks ended Oct. 3, according to SymphonyIRI, thanks to the brand's launch into detergents last year. But that comes after a 17% average price reduction from the initial detergent introduction. And other, older Green Works products saw a 15% falloff in sales for the year, according to IRI data from the 52 weeks ended Oct. 3. SC Johnson's "Nature's Source" has also seen a loss of shelf space and prominence at some retailers this year.

Not everyone in green cleaners is singing the blues. Seventh Generation CEO Chuck Maniscalco said the green megabrand--which kind of sounds like a contradiction in terms--has seen double-digit growth this year after a flat 2009. Substantial additional distribution the brand has gotten (along with SC Johnson's other natural brand Mrs. Meyers) in more than 1,500 Walmart stores isn't even much of a factor in that growth yet. Method is also seeing a 20% sales hike so far this year after a tough 2009, said co-founder Eric Ryan, but he said there is a broader shakeout among green brands.

"We believe green sustainability is a macro trend that's going to continue well into the future," Mr. Ryan said. "But a lot of green choices require a change in behavior, and people are very slow to change."