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Varicose and Spider Vein Treatment

Varicose Veins and Spider Veins

varicose-veinsVaricose veins are big, raised, puffy blood vessels that weave. They typically create in the legs and can be seen through the skin.

Spider veins are smaller, red, purple, and blue vessels that additionally twist and turn. Spider veins are conveniently noticeable with the skin, also. They are generally noticeable on the legs and face.
Reasons for Varicose Veins and Spider Veins

A variety of factors predispose an individual to varicose veins and spider veins. These include:

Occupations that include a great deal of standing, such as registered nurses, hairstylist, educators, and factory workers
Weight problems
Hormonal impacts of maternity, adolescence, and menopause
Making use of contraceptive pill
Postmenopausal hormonal replacement
A history of blood clots
Problems that create increased pressure in the abdomen, such as growths, irregular bowel movements, and externally used garments like bands.

Various other reported reasons consist of trauma or injury to the skin, previous blood vessel surgical treatment, and direct exposure to ultraviolet rays.

Other Risk Factors for Varicose Veins and Spider Veins

Varicose veins and spider veins create more frequently in females than in guys. They enhance in regularity with age. An estimated 30% to 60% of adults have varicose veins or spider veins.
Signs and symptoms of Varicose Veins and Spider Veins

Lots of people with varicose veins experience pain, called an aching or cramping in the legs. Other common signs consist of exhaustion, uneasyness, burning, throbbing, tingling, or heaviness in the legs. Pain from these veins is normally relieved by raising the legs or by using support pipe.

In women, signs could be even worse throughout certain parts of the menstruation or during pregnancy. Less common is swelling, abscess and a darkening of the skin, especially in the ankle joint area. Occasionally, varicose veins can form an excruciating embolism with swelling of the vein, a condition called thrombophlebitis.

Treatment Options for Varicose Veins and Spider Veins

There are 7 significant kinds of treatment for varicose veins and spider veins:

1. Support stockings. The most conservative method is just to use properly-fitting assistance hose pipe, especially when the veins create agonizing or awkward symptoms. These stockings could usually be acquired at any surgical supply shop and at some drug stores. They are available in below-the-knee, above-the-knee, and pantyhose designs.

2. Way of living changes. Good skin health, weight-loss (if needed), and strolling can help deal with varicose veins and spider veins.

3. Sclerotherapy. This procedure, which has actually been readily available given that the 1930s, is an additional treatment alternative. This procedure uses an extremely focused saline (salt) remedy or a particularly made cleaning agent that is infused directly right into the vein, creating the blood vessel to vanish slowly over 3 to 6 weeks. The treatment is easy, relatively affordable, and can be executed in an outpatient setting.

4. Endovenous laser treatment is a treatment in which a little laser fiber is inserted into the vein. Pulses of laser light are delivered inside the vein, which triggers the vein to collapse. The treatment is done as an outpatient under local anesthetic.

5. Radiofrequency occlusion. A little catheter is put right into the blood vessel. The catheter supplies radiofrequency power to the blood vessel wall surface, causing it to warm, collapse, and seal shut. The treatment is typically performed in an outpatient or office setup, in some cases under regional anesthesia.

6. Surgical procedure. Surgical strategies to treat varicose veins include ligation (tying off of a vein) and stripping (elimination of a long segment of blood vessel). Another treatment, ambulatory phlebectomy, enables the removal of huge surface veins via extremely tiny incisions that do not need stitches. Surgery may be carried out making use of local, back, or general anesthetic. The majority of people return house the same day as the procedure. Surgical treatment is generally utilized to deal with big varicose veins.

7. Lasers and extreme pulsed light. Surface area laser or extreme pulsed light treatments, such as Vasculight and PhotoDerm, are various other choices. These gadgets use heat to precisely harm or damage irregular veins. A benefit of these treatments is that no needles or sclerosing remedies are called for; however, there might be some small discomfort. Negative effects do happen, including staining or discoloration and blister development. The results are typically frustrating.

Not everybody with varicose or spider veins has discomfort or other signs and symptoms. They might desire the veins eliminated, nonetheless, for aesthetic reasons.

Insurance Coverage for Varicose Vein and Spider Vein Treatment

Several insurer cover the price of dealing with varicose veins, yet normally not spider veins. The most effective method is to talk to your insurer before taking into consideration treatment options.

Altenative Alcohol Addiction Treatment

For those alcoholics who are not assisted by the conventional methods, there are alternative alcoholism treatments. Mostly, these treatments have not been researched well. Nevertheless, many individuals have actually had success with them.

Individuals utilize drums in a group setting to enhance their recuperation. Remarkably, the procedure seems to be an effective alternative alcoholism treatment.

Lots of alternative alcoholism treatments are based on conventional Chinese medication. This type of treatment is a more holistic treatment for alcohol addiction than simply Western means. There are numerous various treatments included.

Yoga is a great tool in combating the anxiety that comes with alcohol withdrawal and healing. The mild extending and spiritual focus assist the alcoholic to release the tension that adds to their desire to drink again. Meditation is an excellent alternative alcoholism treatment for the same factor.

Acupuncture can be utilized in combination with other treatments for a well balanced approach to the mind-body connection. It, together with yoga and meditation can make other alternative alcohol addiction treatment work much better. These approaches can make a big difference in an alcoholic’s recovery.

Nutrition is an important alternative alcoholism treatment that has actually come into favor in recent times. For the main thing, problem drinkers tend to experience bad nutrition. Not only do they consume badly as a guideline, but they have physical limitations to their nutrition as well.

The little intestinal tract is influenced by the alcohol the individual drinks. This keeps nutrients from being absorbed in the regular fashion. Hence, the alcoholic does not even get the nutrition from the food that she or he does eat. Alternative alcoholism treatment should address this issue if it to succeed.

Alternative alcohol addiction treatment that worries nutrition should cover the rebalancing of blood sugar levels. The nutritional values of the foods eaten by the alcoholic are essential too.

Lots of business offer dietary supplements as alternative alcohol addiction treatment. These are high in vitamins thought to have an affect on the withdrawal and recuperation phases. Vitamin C is utilized since of its power to reduce withdrawal signs and to remove the alcohol from the tissues of the body.

The B-complex Vitamins are practical during withdrawal also. They form a part of a dietary supplement alternative alcoholism treatment. Glutamine decreases the food cravings for alcohol that an alcoholic has, and so need to be continued for a time.

When a dietary plan is drawn up for an alcoholic, plenty of vegetables will be consisted of. This is a crucial part of an alternative alcohol addiction treatment due to the fact that fiber assists get rid of toxic substances from the system.

Alternative alcoholism treatment is definitely an exceptional part of an alcoholic’s recovery. The question of whether it can work without a more formal treatment is an excellent one. More research is being done to answer that riddle.

For those alcoholics who are not helped by the conventional means, there are alternative alcoholism treatments. Nutrition is a vital alternative alcohol addiction treatment that has come into favor in current times. Alternative alcoholism treatment that concerns nutrition needs to cover the rebalancing of blood sugar levels. They form a part of a nutritional supplement option alcoholism treatment. Alternative alcohol addiction treatment is certainly an excellent part of an alcoholic’s recovery.

Excessive Underarm Sweating– What is the Easiest and Safest Remedy?

Nobody desires to talk about extreme sweating or sweaty underarms, although it’s a typical issue for a lot of people. If you suffer from excessive sweating, it’s not since you have too many sweat glands, it’s because of the nerve cell activity of those glands.

Not remarkably, a minimum of 1 % of the population deals with excessive sweating, especially excessive underarm sweating. Everybody sweats more when they are hot or nervous, but excessive sweating might be partly due to our genes. It’s crucial to manage extreme sweating, and there are many different opinions and views on ways to accomplish this. If you suffer from excessive sweating, you’veprobably already attempted the industrial antiperspirants and deodorants, and you’re still searching for a treatment for your issue.

Diet control alone will not cure extreme sweating, however can help reduce it somewhat. Specific foods, such as onions, garlic, fish, and spicy foods like curry, can be smelled in the sweat. Attempt to minimize your consumption of these types of foods.

Underarm hair holds sweat and can make the problem worse. Shave your underarms to minimize the germs accumulation if possible.

There are other expensive and more uncomfortable cures available, such as Botox injections given up really small dosages into the skin which can stop excessive sweating for 2-8 months. Botox is a poison, and it’s natural to have issues about the long term results of such treatment.

As a last resort, surgery is typically considered, where the considerate nerves that control sweating are cut. Underarm skin can be removed and can be fairly efficient, however this is not a common operation due to the scarring and is not encouraged or performed very frequently.

Natural ways to treat excessive sweating are by far the easiest and least expensive way to control the issue. It’s certainly safer to attempt diet control and natural remedies.

If you suffer from extreme sweating, it’s not due to the fact that you have too numerous sweat glands, it’s since of the nerve cell activity of those glands. Not remarkably, at least 1 % of the population suffers from extreme sweating, particularly extreme underarm sweating. Everybody sweats more when they are hot or worried, however excessive sweating may be partially due to our genes. Diet plan control alone will not cure excessive sweating, but can assist lower it somewhat.


Chemical Peels Can Improve Skin Quality

A chemical peel is a skin treatment which is used to improve and smooth out the surface of the facial skin. A chemical solution is used to remove top layers of skin which allows the dead surface skin to peel off. The peeling process leads to new skin growth which is usually smoother, healthier and less wrinkled compared to the old skin. Chemical peels should be performed by aesthetic professionals such as aesthetic doctors, nurses and beauty therapists.

Which Peel is Right For Me?

There are three different types of peel, superficial, medium and deep peels, categorised by the strength of the acid solution used in the peel and how deeply they penetrate the skin. Deeper peels penetrate the skin further and would require greater recovery time.

Superficial Chemical Peel?

Superficial peels are a good option for many people as they have a gentler effect, require no pain relief, and can be used in more skin types, including darker skin tones, with little or no “down time” or recovery time. Whereas medium and deep chemical peels cannot be used in darker skin types and it may also take a few weeks for the skin to recover from the effects of the peeling, inflammation and redness.

What Skin Conditions are Peels used to treat:

Acne- Superficial chemical peels exfoliate the skin, allowing dead skin cells to be removed more effectively, excess oils on the skin are also removed. This action unblocks hair follicles and pores and reducing the appearance of pimples and improving skin texture that is damaged by acne.

Reduce fine lines and wrinkles- especially under the eyes and around the mouth in sun damaged or ageing skin.

Rough skin Texture- chemical peels can improve rough skin texture by increasing the amount of collagen in the upper layer of the skin.

Lentigines (large freckles) which appear as dark spots on the skin, they are also called liver spots, or age spots- Large freckles can develop as a result of sun exposure and are present on sites which are exposed to excess sun such as face and arms and neck. A course of chemical peels can lighten large freckles and improve the appearance of sun damaged skin.

Melasma- is a dark skin discoloration which appears as patches commonly found on the cheeks, nose, lips, upper lip, and forehead. It is common in women who are taking hormonal treatment in the form of contraceptives or Hormone Replacement Therapy (HRT) and pregnant women. A course of chemical peels can lighten the appearance of dark discoloured skin caused by melasma.

Hyperpigmentation- caused by excess skin pigment in the skin which can result in uneven skin tone. Chemical peels can lighten and even out the tone and appearance of the skin.

Superifical peels are suitable for ethnic skins.

Superficial peels are also good preparation for medium and deep peels and are appropriate for serial applications and as a companion treatment for microdermabrasion or IPL. They can be performed prior to microdermabrasion if the skin can tolerate it to enhance the effectiveness of the treatment.

Superficial Chemical Peels Cannot be Used for

  • Superficial peels cannot eradicate deep lines and wrinkles, cure sagging skin due to sun damage or ageing or decrease the size of skin pores.
  • Chemical peels should not be used in pregnant or breast feeding women
  • If you have active cold sores or warts on the face
  • If you have any inflamed rashes, skin reactions or open wounds on the skin
  • Sunburn, need to wait 4 weeks after excessive sun exposure before having a peel
  • If you have excessively sensitive skin, including atopic eczema or dermatitis, inflammatory rosacea in the area to be treated
  • If you have a history of severe allergy or known allergy to the components of the peel including allergy to aspirin
  • If you have taken Roaccutane (a medical treatment for severe acne), within the past 12 months
  • If you have been treated with radiotherapy or chemotherapy in the past 12 months
  • If you have a history of keloid scarring

How Many Peels Do You Need?

Whilst you may see some very minor benefits after a single superficial peel, the best results are seen after a course of six peels, performed two weeks apart. Superficial peels are gentler and so the full benefits of the peels build up over a course of six treatments.

Do I Need to Prepare Before A Peel:

Six weeks before a peel you should stop any products containing retinol. Avoid electrolysis, waxing, hair removal creams and laser hair removal for an entire week prior to a chemical peel.

You may be advised to prepare the skin with products and creams for two weeks before the peel and to continue during and after the peel course. These products will improve the results of the peel and are especially important for those going on a course of peels.

What Is The Peel Procedure

During the peel your skin will be cleansed and toned and the chemical peel will be applied to your skin using a gentle brush, the peel will be left on the skin for between three and five minutes, during which time some patients may experience a mild tingling or a mild burning sensation. The procedure is not painful. After the peel a cool compresses is applied to the skin. Your skin will be moisturised and an antioxidant and a sun screen will be applied to the skin.

What Is The Chemical Peel Aftercare

After your peel you may notice that the skin is more red than usual for two hours afterwards, you may also notice that the skin feels tight or dry and or you may experience some very mild flaky skin for a few days. Rarely you may experience crusting of the skin, swelling or a reactivation of cold sores. Do not pick any spots or peel off flaky skin, avoid physical activity for 24 hours after your peel and facials for one week after your peel. It is very important to use a sunscreen during the course of your treatment and for four weeks after to prevent uneven skin tone and excess pigmentation.

To find out if a Chemical Peel is right for you, give our office a call today at (818) 360-4949 and schedule an  appointment. We’re happy to provide you with more information over the phone as well.


Varicose Vein Treatments Are Available

Anyone with spider veins will want the perfect varicose veins treatment to eliminate spider veins. These veins are veins ruined by excessive factors like body weight, standing for long periods of time and hormonal changes.

Though veins don’t actually indicate anything serious to your health, it can ruin the appearance of your legs and any other parts of the body having varicose veins. So if you want to eliminate veins, your doctor will most probably suggest sclerotherapy treatment, a great treatment option for varicose veins.

Sclerotherapy treatment is basically a collection of injections that is injected into the affected skin areas. This means that you don’t receive only a single injection, but anywhere between fifteen and twenty injections per session.

Unlike other cosmetic procedures, no preparation is required for sclerotherapy. Though sclerotherapy treatment can be administered to anyone with unpleasant veins, it does have some possible side effects, like being a trigger for allergic reactions.

Moreover, some people tend to experience mild pain and itchiness during sclerotherapy treatment. Though there may also be some distension and bruising in the area where the injection is given, you can walk and continue with your life after your session.

Smokers are advised not to smoke for a few days before sclerotheraphy treatment as tobacco substances have an effect in the blood flow in your veins. Diabetics and those with blood clotting in their veins should refrain from using sclerotherapy to eliminate veins. Even those with complicated skin infections should not have any sclerotharapy treatment.

After your sclerotherapy treatment, you are ensured that there will be no more veins on the affected area. However remember that there always is a chance of veins developing in other parts of your body.

The success of your sclerotherapy treatment depends on the abilities of your doctor. This is why it is important that you approach a competent and reliable doctor for treatment to eliminate varicose veins

Sclerotherapy is a procedure that effectively removes unattractive spider veins. If you are thinking of undergoing sclerotherapy, give our office a call to schedule the next available appointment.


Joint Pain Treatment Opens Up With PRP

Platelet-rich plasma (PRP) is an ultraconcentrate of blood that contains a large number of platelets, roughly four to seven times baseline amounts. For example, normal peripheral blood contains about six per cent platelets. A platelet-rich plasma specimen contains ninety-four per cent platelets.

Platelets are cells in the blood that are responsible for a number of tasks. First, they have factors that aid in forming a clot. Second, they have multiple growth and healing factors that help tissue injuries with recovery. Examples of these factors include platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor (TGF). Healing occurs because platelet-derived growth factors stimulate the growth and multiplication of stem cells that aid in healing.

So where can PRP be used in a clinical setting? Fenton and colleagues have reported that in their hands they have been able to successfully treat a number of musculoskeletal problems including tendinopathies, ligament laxity and tears, osteoarthritis, cartilage injury, stress fractures, and non-unions. There are contraindications to the use of PRP. They are the use of anti-platelet and anti-inflammatory medication such as non-steroidal anti-inflammatory drugs, warfarin, aspirin, as well as high dose fish oil.

Patients with anemia, low platelet counts, and clotting or bleeding disorders are also not good candidates. There is some evidence that cigarette smoking also has a negative effect on the effectiveness of PRP.

In the spine, the sacroiliac joints, facet joints, costotransverse (rib) joints, and spinal ligaments have been treated.

In the shoulder, rotator cuff injuries, glenohumeral ligament issues, as well as arthritis involving the acromioclavicular joint and glenohumeral joint have been treated.

Elbow disorders such as medial and lateral epicondylitis, ulnar collateral ligament strains, biceps tendon partial tears, and osteoarthritis have been treated with PRP.

Problems in the wrist and hand such as osteoarthritis, tendon problems, and ligament strains have also responded to PRP.

In the hip, hamstring tendinosis, gluteus medius tendinosis, as well as osteoarthritis have responded to PRP.

Knee issues that have responded to PRP treatment include: tendinosis of the patellar and quadriceps tendon, collateral ligament strains, meniscus tears, osteoarthritis, and bursitis.

Disorders in the ankle and foot that have successfully responded to PRP are: tendinosis in the Achilles, peroneal, and posterior tibial tendons, as well as plantar fasciitis, osteoarthritis, ligament tears.

So it is abundantly clear that in the right hands, PRP can be a useful adjunct to current treatment measures for musculoskeletal injuries. One caveat: PRP must be administered using tenotomy technique and ultrasound guidance by an experienced practitioner.

Call us today at (818) 360-4949 to find out more about PRP and the treatment options available for your joint pain issues.


Botox Treatments Goes Beyond Cosmetic Procedures

Botox has been popular for anti-ageing treatments for many years. This exceptionally potent neurotoxin though, has found a variety of remarkable uses in modern medicine. The toxin was tested in late 1960’s by Alan Scott and Edward Schantz, who then standardised it for therapeutic use. However it was first used in 1980 to treat for conditions as “Crossed eyes” (Strabismus) a condition where the eyes are not properly aligned and “uncontrollable blinking” (Blepharospasm). Botox is approved in more than 75 countries for 20 different neurological indications and approved for cosmetic use in more than 40 countries. Let us see how Botox has transformed the lives of many people.

Migraine: Though the efficiency of Botox as a treatment for chronic migraine is under debate, studies have shown that after Botox treatment the pain caused by migraines are dormant for 3 – 4 months and the patient would hardly need any pain killers.

Back Pain: Traditional pain relief medication for back pain may not be effective on many patients. However initial studies have suggested that Botox injections are safe and provide relief to the lower back area without systemic side effects.

Cervical Dystonia: Also known as Spasmodic torticollis is a chronic neurological movement disorder involving the head and neck. Botox treatment is the commonly used to cure this disorder. It disables the movement of the antagonist muscle and allows the agonist muscle to move freely. Patients experience relief for approximately 12 to 16 weeks.

Excessive Sweating: Botox blocks the actions of the nerves that supply the sweat glands and prevents them from producing sweat.

Cerebral Palsy: Botox is injected into muscles that are either spastic or have contractures, the aim being to relieve the disability and pain produced by the inappropriately contracting muscle

Weak Bladder: Medics claim the Botox injected to the bladder wall will improve symptoms in the over 50 age group, impacting on their quality of life. It will assist them to sleep better and be more energetic reducing incontinence and would make a difference to a sufferer’s social life and general health.

Benign Prostatic Hyperplasia: A non-cancerous condition which affects half of males over 60 and is caused by abnormally large prostates. When the prostate enlarges, it squeezes the bladder triggering urinary problems, including the need to go to the toilet frequently during the day and at night. It is a progressive disorder which, if left untreated, can lead to the complete inability to urinate. This, in turn, can cause kidney damage. However, a study by scientists in Taiwan and at the American University of Pittsburgh found that just one Botox jab into the prostate eased symptoms and improved quality of life for three out of four men up to a year later.

Should you suffer from any of the above conditions; it is recommended that you consult your physician to get the correct treatment for your medical condition. The physician that you are consulting should be a qualified well experienced physician who has the knowledge and training to administer Botox.

To find out more information and whether or not Botox could be a viable treatment option for your condition, please give our office a call today at (818) 360-4949.


Substance Abuse Help Is Available

Substance abuse is defined as overindulgence and dependence on a toxic chemical/drug, which directly affects the human nervous system, behavior and various body functions. These substances or drugs have detrimental effects on the mental and physical health of an individual.

Substances that are abused include tobacco, alcohol, addicting medicines and heroin etc. People may start using drugs or indulge in substance abuse for fun, due to peer pressure, curiosity or any other reason, but due to this act, the society has to pay a significant cost. Abused substances are the psychoactive substances that cause dependence syndrome. If a person indulges in substance abuse, he/she feels a strong desire to use it, cannot control its use and cannot get over the addiction even after harmful consequences. Substance abuse can change the perception, judgment, physical control or attention of an individual.

The negative effect of substance-abuse can be seen at emergency departments and in various rehabilitation centers and hospitals. One can directly see the poor health conditions of substance-abusers and the physical trauma that they are suffering from. The rising number of substance abusers in prisons and jails also shows the connection between substance-abuse and crime.

Drugs and abused substances slow down the thinking ability, and the person is unable to judge between right and wrong. Many professionals, flourishing doctors, scientists or intelligent young students, when indulge in substance-abuse, deviate completely from their mission of life and face failure in life because of their drug habit. Some of them end up committing crimes, getting a dangerous disease, losing close relationships etc. They do not realize their true potential, forget their missions, their personal goals and hence, destroy their lives.

Substance-abuse can destroy lives by causing different diseases, impaired abilities, weak judgement and developing criminal behavior. Some drug abusers by violating laws kill innocent people and sometimes kill themselves. Common problems due to substance abuse are violent mood swings, marital problems, child abuse, rape, school problems, job problems, domestic violence, loss of friends, divorce, financial problems, suicide and loss of self-esteem and self-confidence.

Major life destroying effect of substance abuse is serious crimes. Researches and studies have revealed that a substance abuser has eighteen times greater chances of committing a crime. A person who is a poor performer, deprived and socially inactive is less likely to commit a crime than a bright socially active and economically strong substance abuser.

The mind altering effects of drugs are the root cause of violent crimes, committed by the abuser. Many of the substance abusers get into crimes like sexual assault and domestic violence under the influence of drugs. Sometimes, they get life sentence due to their crime or even years of jail. The abilities and talent of a substance abuser remains undiscovered and the person either becomes mentally retarded or commits suicide.

People lose their lives, get punished, suffer from guilt and catch fatal diseases like HIV and AIDS due to substance abuse. It is not only the life of substance abuser that is destroyed but also that of his/her family and loved ones. It is a tragedy for the family, friends and for the abuser. There is nothing positive about the substance abuse as they destroy their lives completely.

If you are looking for permanent solution for substance abuse treatment then contact our specialist today for advice and treatment. Call our office now at (818) 360-4949. We are here to help you lead the life you deserve.


Botox and Pain Management

Besides whisking away your wrinkles, is it possible that an injection of Botox can do away with those painful muscle spasms in your neck? Maybe Botox isn’t just for celebrities anymore! Can it help a person with chronic low back pain or a neck that is constantly in knots? The jury is still out on Botox, as most experts agree that there is a scarcity of completed testing. More research needs to be done but the drug holds out hope for some sufferers of chronic neck pain. Botox was originally approved by the FDA in 1989 for the treatment of severe muscle contractions, known as cervical dystonia.

This was long before it became the new panacea for wrinkled brows and furrowed facial creases – the Baby Boomer’s Delight. Botox is a purified form of botulinum toxin, Type A, that has been used for over 20 years. This derivative of the bacterium, Clostridium botulinum, produces a protein that blocks the release of acetycholine and relaxes muscles. Type A is just one of seven different types of botulinum toxins, each of which has different properties. In the 1960s, the muscle relaxing properties of the botulinum toxin were investigated for use in realigning ‘crossed eyes’. These early studies paved the way for other uses of the toxin.

Today, used in extremely small doses, Botox has helped over 1 million patients worldwide with conditions caused by overactive muscles. Botox is now authorized for the treatment of cervical dystonia, to help decrease the severity of the abnormal head position and associated neck pain. It has also been approved for the treatment of strabismus (crossed eyes) and blepharospasm, the involuntary muscle spasms around the face and eyes. Now, a new study has been released that shows Botox may be an appropriate treatment for the relief of pain, caused by chronically contracted neck muscles. This study was published in the January 2004 issue of the American Journal of Pain Management. Researchers evaluated the effects of a single injection of Botox into the affected neck muscles of 25 patients.

The injection was combined with physical therapy. After 3 months of follow-up, the patients with combined treatment showed a significant improvement. The study showed that pain relief from Botox lasted approximately 3 to 6 months. However, researchers question the results of this study and point out that it did not compare the effectiveness of Botox with physical therapy with results that could be gained by physical therapy alone. Experts speculate that the Botox injection relaxed muscles and maximized the potential for rehabilitation and the repair of damaged tissue. As it strengthening weakened muscles, it relieved pain. Other researchers indicate that treating muscle spasms with a Botox injection has an advantage over oral pain relievers because the injections into the muscle are local. They do not have side effects of sedation, lethargy, fatigue, and dizziness associated with oral pain medications. Botox advocates suggest that more extensive testing is needed to verify the benefits of its use in relieving back and neck pain.

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Substance Abuse Past and Present

stop_substance _abuseFor people interested in substance use, Dr. Jonathon Erlen has built a cave of wonders. Erlen is a history of medicine librarian at the University of Pittsburgh, and one of his projects is an ongoing bibliography of dissertations related to drugs.

To his knowledge, he is the only person in the world maintaining this sort of bibliography. One of the things that makes it fun, said Erlen, is that substance use intersects with so many fields.

“It’s an intellectual challenge because there is no rhyme or reason to where you’ll find the scholarship,” he said. “There’s health, there’s history, there’s social problems. There are dissertations talking about new drugs that come out, regional drug trade issues, drug use and HIV, drugs from the perspective of women’s studies, drugs and their relationship to religion or the lack thereof…”

Dissertations, said Erlen, can be considered “gray literature,” since they have not had the benefit of peer review. As such, many dissertations would never see the light of day, if not for his bibliography.

Erlen is quick to point out that he’s not an expert on substance use. As a librarian, his role is to seek, compile, and offer access to information. However, his decade-long work on the dissertation bibliography has given him an unusually broad perspective on drug-related issues.

For example, when I said that Americans seem increasingly to agree that we can’t arrest our way out of this problem, Erlen responded that this dialogue has been repeating itself for a hundred years.

Treat Versus Punish is Nothing New

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Dr. Jonathon Erlen

“There has been an ongoing dichotomy between treatment and punishment,” Erlen said. “Historically, we vacillate. And it’s very difficult for people to come down in the middle. They’re either really into punishment or really into treatment.”

What has the “punish” side of the debate sounded like? Well, there has been the rhetoric (“Public enemy number one in the United States is drug abuse,” – Richard M. Nixon), but more importantly, there’s been a century of public policy. Since the passage of the Harrison Narcotics Act in 1914, United States drug policy has almost always come down on the side of punishment as the solution to social problems caused by substance use and addiction.

Before the Harrison Act in 1914, opiates and cocaine were legal to buy, sell, and use. In fact, they were often recommended by doctors. The Harrison Act didn’t outlaw these drugs altogether, but made it illegal to possess cocaine or opiates that were not prescribed by a physician. People who had been obtaining and using these drugs freely were suddenly criminals.

And over time, they were considered much more dangerous criminals, since penalties for drug use got much stiffer. According to historian William White, “When the Harrison Tax Act was passed, the maximum possible penalty for violation of the Act was five years in prison. In less than fifty years, penalties had risen to include the option of life imprisonment and the death penalty.”

Three decades later, the War on Drugs (declared in the 1970s, peaked in the 1980s) introduced mandatory minimums and three-strikes policies, which dramatically increased the number of drug users serving long prison sentences.

All the while, the “treatment” camp voiced very familiar ideas, pointing out that criminalizing drug users is counterproductive and that addiction is a health issue. Treat, don’t punish, they said.

1938 – It’s not feasible to put everyone with an opiate addiction in prison, argued Henry Smith Williams. Let’s put every person who’s addicted to opiates under medical supervision and prescribe them the drugs they need.

1947 –  The enormous effort that goes into punishing drug users is useless and expensive, said Alfred Lindesmith. It’s also cruel to people with addiction. Addiction shouldn’t be the domain of policemen, but of medical professionals.

1956 – Law enforcement shouldn’t be making decisions about how to deal with addicted people, said Lawrence Kolb. Qualified physicians should be making these decisions. People with opiate addictions should be offered maintenance medications.

These arguments aren’t too different than the ones we hear today. But despite the fact that “treat, don’t punish” messages have been around pretty much since drugs were criminalized, public policy has reflected the opposite view.

This is still the case. In 2016, the Surgeon General recommended that we “implement criminal justice reforms to transition to a less punitive and more health-focused approach,” but that same year, we actually spent more money on domestic law enforcement related to drug use than we did in 2008. To be fair, spending on treatment also increased over the same period, but the shift in funding priorities was quite slow and small, considering the Obama Administration’s emphasis on “treating addiction as a public health problem.” The Trump Administration gives all indications of reversing that shift.

Why has it been so difficult for the “treat don’t punish” concept to get in a foot in the door?

Erlen pointed to an obvious issue.

But What Is Good Treatment?

“The problem that you keep running into,” Erlen continued, “Is what is good treatment? That’s what makes treatment a hard sell.”

Addressing the question of “what is good treatment” is an essential ingredient in the treat versus punish debate and, all too often, it’s ignored. Part of the reason this question is ignored is because effective addiction treatment is not well-understood.

“If there was a nice simple way to do it, we would probably do it,” said Erlen.

Despite the fact that treating addiction is not simple, we know that some approaches to addiction treatment are more effective than others. For a one-stop synopsis of what “good treatment” looks like, we suggest a review of the VA/DOD Clinical Practice Guideline for the Management of Substance Use Disorders, which was updated in 2015. It uses a rigorous methodology to assess research evidence about effective addiction treatment.

Although the VA/DOD Guideline isn’t the only source of information about good treatment, it’s a great place to start.

Get Off the Merry-Go-Round

As Erlen points out, the “treat versus punish” merry-go-round has been spinning for an awfully long time. Let’s step off.

We know addiction is a health condition and that treatment is more cost-effective (and compassionate) than punishment. But what we should really be talking about is good treatment. The longer we ignore that (complex) part of the conversation, the longer our drug policies will default to “punishment”—because at least we know what that looks like.

We are here to help. If you or someone you know needs help with a substance abuse problem, please call us at (818)360-4949. Help is just a phone call away. Do not delay, call us today.