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Study Drugs: Short Term Rewards at a Cost

10/20/2016

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by Shona Campden

One of the most exciting aspects of university is the freedom to be involved in extracurriculars, explore new hobbies and possible careers, and meet new people, all while taking classes that interest you. Although one of the best parts of university, balancing all of these may be one of the hardest parts, too. As the semester builds, so do assignments and obligations, and the stress of maintaining a balance between school, personal life, and health becomes a little bit harder.

Some students may turn to “study drugs” to keep up with demands during this time. In fact, according to the Centre on Young Adult Health and Development, nearly one third of university students have used non-prescribed stimulant drugs at one point during their undergraduate career. Students may sometimes even feel that using drugs gives them a competitive advantage in their courses. In the high pressure environment of university, it can be difficult to see the costs of artificial aids in learning.

Some argue that brain enhancing drugs, or “study drugs”, such as Ritalin, Adderall, and Vyvanse are no more effective than drinking copious amounts of coffee, as they both make you more alert. This increase in the ability to focus results in more attention committed to a  particular task. These so-called brain enhancing drugs also allegedly improve memory, learning and other cognitive skills, and are therefore termed nootropics (cognitive enhancers).

While there are many nootropics which do improve attention without harm, the same can’t be said for all brain enhancing substances. Little regulation on nootropic labelling has rendered the term almost useless - similar to the word  “natural” on some food items today. It’s an overarching term, used to give the impression of beneficial qualities in a drug, without careful quality control. Therefore drugs such as Adderall may have unexpected and unpleasant side effects. As a stimulant, it increases the rate of your “fight or flight” nervous system, exciting cardiac function, dilating pupils and increasing blood pressure. By increasing the availability of neurotransmitters in the brain, such as norepinephrine and dopamine, the sympathetic nervous system is activated.

​However, physiologically, this high-alert responsiveness is only meant to last for a short amount of time. Under the influence of brain-enhancing drugs, the effects of stimulation last much longer and begin to take a toll on the body. Side-effects include irregular heart beats, restlessness and anxiety, paranoia, headache and dizziness, to name a few. Although symptoms vary for individuals, it’s important to acknowledge the stress placed on the body when being held in a high-alert state for an extended period of time. Repeated use of brain-enhancing drugs will likely decrease the effects of the drug with each subsequent dose, a phenomenon known as desensitization. To get the same desired effect, users will have to continue to increase the amount of the drug they take.

While students may initially turn to brain-enhancing drugs as a short-term solution for coping with an increased workload, using these drugs often enough can lead towards a long-term addiction.

As we all prepare for midterms this year, and as assignments pile up, it’s important to remember that anything foreign put into the body may affect individuals differently, and in some cases have unforeseen side-effects. Remember, there are many ways to overcome stress, and ultimately the best way to deal with anxiety and feeling overwhelmed is to take the time that you need for yourself. Going for a walk and taking a break from studying, or talking to some friends is one way to regain focus and refresh your mind. As always, if it becomes too much at any point, there are always resources available to you on campus if you need to reach out.

Queen's Counselling Services
​AMS Peer Support Centre


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The Science of a Hangover: Homecoming Edition

10/13/2016

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by Lauren Waichenberg

I think it’s safe to say that the majority of university students have experienced the horrors of a hangover after a night of drinking. Everyone handles alcohol differently and hangover symptoms may  vary, but there are certain theories that are still being investigated by researchers looking at what exactly causes the hangover symptoms. With homecoming fast approaching, it’s helpful to understand  the science behind the pounding headache, the unrelenting nausea, and the fatigue that just won’t let up, in order to figure out prevention methods (so you can rally the next morning).

So what exactly is causing the hangover symptoms we so dread? It is theorized that a hangover is actually early stages of alcohol withdrawal. The symptoms are caused by acetaldehyde, which is a breakdown product of alcohol metabolism, as well as congeners, a chemical formed during alcohol processing and maturation. When looking at the hormones involved, it was found that alcohol greatly inhibits antidiuretic hormone, which leads to excessive urination and dehydration. I’m sure we have all been told to drink lots of water throughout the night to avoid or lessen the severity of a hangover. Why do we do this? To prevent dehydration, which greatly worsens hangover symptoms.

More modern theories suggest that it’s not actually the alcohol that plays an important role in producing a hangover, but the acetaldehyde (supposedly 30x more toxic to the body!). Alcohol is broken down into acetaldehyde by an enzyme called alcohol dehydrogenase (ADH), which is then further metabolized by acetaldehyde dehydrogenase (ALDH). A cofactor, NAD+, is needed for both of these reactions to proceed, but is also needed largely in other essential body processes, such as regulating electrolyte levels and absorbing glucose from the blood. So I’m sure you can understand that with sufficient NAD+ being used to break down copious amounts of alcohol, these other, more important reactions are significantly slowed.

So why are some lucky people spared while others never fail to get a hangover? A researcher at the University of Bath, suggests that genetics plays a large role, from her experiments comparing identical and non-identical twins. However, the exact genes involved have not been identified. There are multiple theories that suggest that people of Asian descent have a lower tolerance for alcohol due to a lack of sufficient alcohol dehydrogenase, but the problem mainly arises from the fact that alcohol processing occurs too quickly. Furthermore, multiple studies suggest that women report more severe hangovers due to their smaller body mass.

The moral of the story is that this homecoming weekend, make sure to stay extra hydrated! It’s a good idea to stick to one type of alcohol as mixing drinks can lead to a nastier  hangover. It’s also suggested that dark liquors (brandy, wine, tequila, etc) result in worse hangovers than clear liquors (vodka, gin, etc) due to a higher content of congeners. Most importantly, HAVE FUN (but know your limits).

*If you or a friend has had a little too much fun, the Campus Observation Room is available to help.


Sources:
https://www.scientificamerican.com/article/why-do-hangovers-occur/

http://www.medicaldaily.com/what-causes-hangover-everything-you-need-know-morning-after-drinking-alcohol-366042
​

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The Assisted Dying Debate: Where are we Now?

10/6/2016

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by Carolyn Abel
The assisted dying debate is far from over. Let’s start with the terms. What do you think of when you hear “grievous,” “irremediable,” or “reasonably foreseeable?” Hint: it’s different for everyone. This is especially true among the physicians, lawyers, journalists, and other healthcare professionals involved in the debate. Defining the language that is used is probably one of the most controversial areas of this topic (and there really is no one correct answer).

Bill C-14 is the legislation on medically-assisted dying in Canada. It is designed to provide mentally competent adults who are suffering with a choice to end their life with the help of a physician or nurse practitioner. Other eligibility criteria under the legislation include the patient making a voluntary request without external pressure, giving informed consent, and qualifying for government-funded health services.

Here’s a summary of the major events surrounding Bill C-14:

September 1993 - Rodriguez case
  • Who: Sue Rodriguez, a 42 year old suffering from ALS
  • The Claim: Section 7 Charter violation
  • The Outcome: upheld provision in Criminal Code (5 to 4)

In the early 90s, Sue Rodriguez fought to have a legal right to assisted suicide, which at the time carried a maximum 14 year prison sentence. She ultimately lost the case to the Supreme Court of Canada on September 30, 1993.

February 2015 - Carter case
  • Who: Kay Carter, a woman suffering from spinal stenosis; Gloria Taylor, a woman suffering from ALS, and others
  • The Claim: whether the prohibition on physician assisted dying violates section 7 and 15 Charter rights
  • The Outcome: unanimously struck down the provision in the Criminal Code, with some restrictions on who can ask for a medically assisted death

In Carter v Canada, the assisted dying prohibition was challenged again, this time with multiple plaintiffs. The case resulted in the Criminal Code provision being overturned, specifically giving mentally competent adults who are suffering intolerably the right to a doctor-assisted death. The decision only took effect in 2016, after the government had some time to amend the laws; in the meantime provincial courts could start approving applications for euthanasia.

June 2016 - Bill C-14 received royal assent

In other words, this means that the bill was approved, although there are still many ambiguities that need to be addressed.

June 2016 - First challenge to Bill C-14

Julia Lamb, a 25 year old from BC with spinal muscular atrophy, wants to defend her right to an assisted death under Bill C-14. Even though a sudden deterioration could remove the use of her limbs and make her dependent on a ventilator, she is still not eligible because of the requirement that patients be in an “advance state of irreversible decline” and that natural death is “reasonably foreseeable.” This clause denies rights to large groups of patients with chronic diseases. A fundamental Canadian value is autonomy, which is defined as the freedom from external control or influence, and is exactly what Lamb is asking for.

What does it mean now that we have a law?

It is important to note that as it is, this law is far from complete. Still, one of the more important results is that it means we will be able to collect data on assisted deaths. This kind of data would start answering the questions of how, when and why. As this legislation is so new, there is no quantitative information available (yet) so this would allow for improvements to be made in these areas. Another piece of data that would be useful is the number of patients denied a medically assisted death, and more specifically who is asking for one.

Further considerations

First, there is doctor-patient confidentiality. It can be a good thing in many situations, but in terms of assisted dying, I would argue more communication is always better. There are so many perspectives that need to be considered; the patient, family members, friends, just to name a few. Keeping critical information confidential might leadcan only lead to a more complicated and/or delayed process.

Another important consideration is that many patients already have a laundry list of advance directives, such as not wanting defibrillation or specific treatments. Some of these requests may seem practical at first, but when it comes to putting them into practice, it usually makes the situation more complex. These are very high stakes scenarios, and to further complicate things, patients may or may not be fully mentally competent at the time.

Conscientious objectors are another group that complicate this debate. How should, for example, a physician’s religious beliefs interact with their job? Here’s an analogy - would it be right for someone with a nervous tremor to become a dental surgeon? Probably not. In any case, what role should the medical institution play in dealing with individual physicians’ beliefs? Even if that physician was to refer the patient to someone else, that process both cuts down on the patient’s autonomy and takes up valuable time.

The conclusion (for now)

This debate is far from over, and there are likely to be even more challenges to Bill C-14. These are complex issues with various factors, possibilities, and ethical dilemmas that need to be taken into account. Then again, maybe no law IS better than a bad law.
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