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Skullcap: A Restorative, Relaxing Herb

By Dr. Mercola

American skullcap (Scutellaria lateriflora) is an herbal plant native to North America that's a member of the mint family. It has a long history of medicinal use, primarily as a mild nerve sedative or nerve tonic. During the 1800s and 1900s, skullcap was sometimes prescribed for nervousness or related symptoms, particularly muscle spasms, irritability, sleeplessness, tremors and restlessness.1

Named for the close-fitting metal skull caps worn during medieval periods, which resembled the plant's flowers, this calming herb has continued to receive praise for its stress- and anxiety-relieving effects, which it's said to exert without some of the side effects, like drowsiness, that other relaxing herbs may cause. Known as a nervine herb, which is one that acts on the nervous system, skullcap has such strong relaxant effects that it's sometimes used to treat barbiturate and tranquilizer withdrawal symptoms.2

Its popularity has been growing in recent years, with harvest and sales increasing 250 percent from 1997 to 2001, perhaps because many herbalists in Europe have taken to prescribing skullcap in lieu of kava kava, which has been linked to liver damage. Whatever the reason, if you're interested in herbal remedies, skullcap is one herb worth knowing, especially since it's easy to grow and has a variety of uses, from tea and tinctures to massage oil and supplements.

Skullcap May Boost Mood, Relieve Anxiety and More

In 2003, a double-blind, placebo-controlled study on healthy individuals revealed that skullcap had "noteworthy" effects for anxiety relief.3 Another study of 43 adults who took either skullcap or a placebo three times daily for two weeks revealed skullcap significantly enhanced global mood — without a reduction in energy or cognition.4 Although research into the herb is limited, as it is with many herbal remedies, surveys suggest that herbal medicine practitioners widely use skullcap.

"The results of the survey suggested that S. lateriflora is highly regarded amongst herbal medicine practitioners as an effective intervention for reducing anxiety and stress and is commonly prescribed for these conditions and related comorbidities," researchers wrote in the Journal of Herbal Medicine.5

When the herb was analyzed for its bioactive ingredients, 10 flavonoids and two phenylethanoid glyside compounds were isolated. Further, at least 73 different compounds have been identified in skullcap essential oil.6 Phenolic compounds, particularly flavonoids, are believed to be responsible for many of skullcap's beneficial effects.7 In addition to its uses for anxiety, skullcap has shown promise as an anticonvulsant and has been shown to be effective in rodents with acute seizures.8

It may also have anti-allergy potential, including helping to alleviate food allergy symptoms by regulating systemic immune responses of T helper (TH) cells. "These results indicate that skullcap may be a potential candidate as a preventive agent for food allergy," according to researchers.9

Skullcap Is a Strong Antioxidant, May Fight Oxidative Stress, Cancer

Bioactive compounds in many plants have powerful antioxidant properties known to neutralize or scavenge damaging free radicals, thereby neutralizing oxidative stress that can play a role in diseases such as Alzheimer's, Parkinson's, depression and anxiety. Skullcap is no exception, and it's been suggested that its antioxidants could be therapeutic against oxidative-stress-associated mental disorders.10

Another compound in skullcap, scutellarein, may have anticancer potential. In fact, the compound was even found to stop the development and spread of fibrosarcoma, an aggressive cancer of connective tissue.11 Traditionally, the herb was used by Native Americans for a variety of anti-inflammatory, immunomodulatory and antimicrobial purposes, including to treat:12

Hypertension

Hysteria

Epilepsy

Diarrhea

Headaches

Nervous exhaustion

Nervous disorders of the digestive system

Heartburn

Fever

Snake and insect bites

Skullcap Was Traditionally Used as a 'Woman's Herb'

In addition to the traditional uses above, Native Americans, particularly the Cherokees, used skullcap to promote menstruation as well as to help remove the placenta following childbirth. It was also believed to be useful for treating "premenstrual tension" and has been suggested as a remedy for mood changes that occur with menopause.

Little modern-day research has been done to confirm these effects, but skullcap does contain vitexin, an active compound found in the herb Vitex agnus castus, or chasteberry, which is commonly used for menstrual disorders.

It's thought that skullcap's benefits for menstrual conditions could be due to effects on hormone levels or neurochemicals that affect mood.13 Because there is a possibility that skullcap could promote menstruation, it should not be used by pregnant women because it could potentially cause miscarriage.14

Chinese Skullcap Has Its Own Benefits

American skullcap shouldn't be confused with Chinese skullcap (Scutellaria baicalensis). Although they belong to the same plant family, Chinese skullcap is native to China and has been used in traditional Chinese medicine for thousands of years, most notably in the treatment of diarrhea, dysentery, hypertension, hemorrhaging, insomnia, inflammation and respiratory infections.15

Flavones in Chinese skullcap include baicalin, wogonoside and their aglycones baicalein wogonin, which are known to have anticancer, antibacterial and antiviral, antioxidant, anticonvulsant and neuroprotective effects. When Chinese skullcap is prepared using its roots, it's known as Huang-Qin, and has shown antihistamine properties that can help relieve asthma and allergies like hay fever.

It's also an antioxidant that can reduce the risk of heart disease, limit damage after a heart attack and possibly serve as an herbal treatment for hepatitis.16

Be Careful With Adulterants in American Skullcap Supplements

If you're looking for a calming herb with the benefit of antioxidant properties, skullcap may be for you. But use caution when choosing to use the herb in supplement form, as its been plagued with problems of substitution and adulteration. In particular, American germander, sometimes called wild germander, wood sage and wild basil, which is potentially toxic, has been found to contaminate skullcap supplements since the 1980s, according to botanist Steven Foster.17

In one study of 13 skullcap-containing dietary supplements, four were found to contain American germander, three contained very low skullcap concentrations and one contained Chinese skullcap instead of American skullcap.18 It's unknown whether the adulteration was intentional or a case of mistaken identity. According to the American Botanical Council:19

"There are those who believe that skullcap and germander can look similar because they are both members of the mint family (Lamiaceae or Labiatae). Foster, and various herbal experts, believe that their physical characteristics are distinct enough to warrant an accurate identification with the naked eye, i.e., in the field

… [but] according to an extensive quality control and therapeutic monograph on skullcap … produced by the nonprofit American Herbal Pharmacopoeia (AHP), the relatively comparable appearances of skullcap and other herbs can lead to accidental adulteration."

Growing Your Own Skullcap

One way to ensure that the skullcap you're consuming is, in fact, skullcap, is to grow it yourself — and it's easy to do so. American skullcap is a perennial herb, which means if you plant it right, it will keep coming back year after year (be sure to plant is in a spot where you don't mind it spreading, which skullcap is known to do, rapidly). Skullcap should be planted in an area with moist soil and full to partial sun (partial sun especially if you live in a hot and dry area).

Keep in mind that many skullcap varieties require stratifying seeds before you put them in the ground. To do so, put the seeds in a sealed plastic bag with moistened sand (about three times as much sand as seeds) or a damp paper towel, then place them in the refrigerator for at least a week.20 The seeds can then be started indoors (germination will take about two weeks) and moved outdoors as seedlings, after the threat of frost has disappeared.

Seedlings can be planted one-inch deep into compost-amended soil. Keep them well watered and continue after the plant grows larger; they do best in moist soil.21 Skullcap can also be grown from cuttings or divided roots, which can be taken from a healthy, mature plant. Mature skullcap can grow to reach 1 to 3 feet tall.

Once the plant blooms, it's ready to harvest for use in teas or tinctures, and can be used fresh or dried. Use a pair of scissors or shears to harvest aerial parts like flowers and leaves. Ensure that there are still plant parts at least 3 inches above the ground.

How to Use Skullcap

Skullcap can be used in tincture, tea or essential oil form. As a massage oil, which can be used for muscle relaxation, try the following recipe from the book, "Healing Plants of the Rocky Mountains," by Darcy Williamson:22

Skullcap Massage Oil

Ingredients

  • 1 1/2 cups flowering skullcap tops
  • 1/2 cup fresh tall sagebrush leaves
  • 2 tablespoons dried cottonwood buds
  • 1/2 cup jojoba oil
  • 1/2 cup sweet almond oil

Procedure

Combine ingredients in a quart jar and cover loosely with several layers of cheesecloth. Allow mixture to stand in a warm place for three weeks. Heat jar in a pan of warm water for 15 minutes to liquefy oil, and then strain.

To make a calming tea, which you can enjoy before bedtime or when you need to soothe your nerves, infuse 5 grams of skullcap into 8 ounces of water for 15 minutes. You can also try adding half an ounce of dried skullcap to one-half pint of boiling water to make an infusion, or try the recipe below:23

Skullcap Tea Recipe

Ingredients

  • 1-2 teaspoons of organic skullcap herb to suit your taste
  • 1 cup hot, but not boiling, water

Procedure

  1. Bring water to a low boil. Add the skullcap herb.
  2. Cover with a lid to preserve essential oils from escaping.
  3. Steep for five to 10 minutes depending on how strong you like your tea. The longer you steep skullcap, the more benefits you may receive.

If you don't happen to have skullcap in your garden but still want to experiment with the herb's beneficial effects, there are many herbal teas available that contain skullcap, often in combination with complementary herbs, but be sure to purchase high-quality leaves or teas from reputable sources.

As always, you may want to start using skullcap under the guidance of a holistic medicine practitioner, and use it in moderation. High doses of this plant's tincture may result in undesirable side effects like giddiness, stupor, mental confusion, twitching, irregular heartbeat and seizures.

The Healing Benefits of Saffron and How to Grow It

By Dr. Mercola

Saffron, which is regarded as the world's most expensive spice by weight, is actually the stigmas of the purple crocus flower (Crocus sativus), which blooms once a year. Due to the fragile stigmas needing to be picked by hand, harvesting saffron is a labor-intensive job. As mentioned in the featured video, given the fact each saffron crocus plant contains just three stigmas it takes about 170,000 flowers to produce a single pound of this costly spice.

Notably, about 90 percent of the world's supply of saffron is grown in arid fields across Iran. Most of the crop is harvested by women who earn about $5 per day picking saffron threads by hand. Other countries producing saffron include Afghanistan, Italy, Morocco, Spain, the Netherlands and the U.S. Saffron gives many rice dishes, including paella, its characteristic taste and golden-yellow color. In addition, this prized herb is featured in bouillabaisse, a traditional French fish stew.

When buying saffron, it's best to choose the thread form over the ground spice because it has a longer shelf life. Beware of look-alike ingredients that may be mixed in including red marigold petals, stigmas from lilies or turmeric. None of these "fakes" will impart the distinctive color or flavor of saffron. To ensure you have access to high-quality saffron, you may want to consider growing your own.

What Makes Saffron Special?

If you are not familiar with this prized spice, which is a member of the iris family of plants, you may wonder what makes the bright orange-red stigmas of the saffron crocus so special. According to National Geographic:1

  • The delicate purple crocus is a sterile triploid, meaning it cannot grow in the wild, nor can it reproduce without human intervention
  • Being sterile, the plants are unable to produce viable seeds, which means reproduction can only take place when clusters of "corms" (bulbs) are dug up, divided and replanted
  • Each plant produces just three stigmas/threads; as mentioned above, about 170,000 flowers are needed to produce 1 pound of saffron threads
  • Saffron is a labor-intensive crop — the plants must be painstakingly propagated and harvested by hand — which explains why high-quality saffron sells for upward of $16 per gram

While it's difficult to pinpoint exactly when and where the cultivation of saffron began, according to one source2 it can be traced back to the Persian word zarparān, which means "having golden stigmas." Ancient texts, dating back thousands of years, also refer to saffron. The offering of adulterated saffron has been a long-standing problem, so much so that the "Safranschou code" was implemented in the Middle Ages to fine, imprison and sometimes even execute those suspected of putting forth fake saffron.3

For millennia, pharaohs, monks, kings and queens have bathed in saffron-scented water, consumed food and drink laced with saffron, offered prayers and sacrifices involving saffron, slept in beds adorned with saffron threads and wore saffron perfumes and saffron-dyed clothing.4 At various times in history, saffron was in such great demand and so highly prized that various thefts and wars have been noted. According to the Independent:5

  • In the mid-1300s, the Black Death, a global epidemic of bubonic plague, caused the demand for medicinal saffron in Europe to outpace supply; at the time, the spice also was used to alleviate illnesses such as insomnia and stomach ailments
  • In 1374, the theft of a shipment of saffron resulted in a 14-week "Saffron War" between Basel and Austria
  • Pirates were said to value saffron more than gold and it was equally prized by American colonists after it was adopted for cultivation by the Pennsylvania Dutch in the 16th century

Tips on Buying Saffron

Because saffron is famously expensive, you may be shocked at the price of it at your local grocery store. You can often find it somewhat more affordably in halal or Middle Eastern markets. Below are some tips on buying saffron:6

For a longer shelf life, choose saffron threads over the ground spice

Select a high-quality brand, or if purchasing it loose from a spice vendor, always buy from a reputable seller

Beware of the many saffron look-alikes, including red marigold petals, lily stigmas and turmeric

Due to its short shelf life, purchase saffron threads in small quantities and commit to use it within a six-month period

Look for saffron threads of deep-red shades and avoid varieties mixed with the yellow styles; the styles, which are attached to the stigmas, add no value or flavor

Choose threads uniform in appearance — wide and flat on one end and tapered at the other

When buying them loose, select saffron threads with a pleasant, fragrant aroma and avoid any with a musty odor

Pick threads that are dry to the touch and a little brittle; keep in mind moisture will cause the threads to become spongy and less fragrant

Why Is Saffron so Good for You?

Given the fact saffron is consumed in very small quantities, you may not think much of its nutritional benefits. In larger quantities, saffron is, however, a good source of iron, which purifies your blood and also helps your muscles store and use oxygen. It also contains magnesium, a mineral your body needs to maintain nerve and muscle function, regulate your heartbeat and promote bone health.

Saffron is high in manganese, which helps regulate your blood sugar, metabolize carbohydrates and absorb calcium, among other things. This vibrant red-orange spice also contains potassium, which is useful to support your adrenal and kidney function, and vitamins B6 and C. Vitamin B6 ensures your brain and nervous system function properly and helps make the hormones norepinephrine, which helps your body deal with stress and serotonin, which regulates your mood.

The vitamin C in saffron boosts your immune system and acts as a potent antioxidant and infection-fighter. In addition to those important vitamins and minerals, saffron contains more than 150 volatile plant compounds, including, most notably:

  • Crocin: A carotenoid chemical compound responsible for saffron's intense red-orange color, which is also an indicator of the powerful antioxidants and carotenoids in saffron that protect your body from free radical damage
  • Picrocrocin: A precursor of safranal, picrocrocin is the main substance responsible for saffron's distinctive earthy taste
  • Safranal: The compound known to provide saffron with its notable aroma

One source claims saffron was used historically to treat more than 90 ailments and has been used as a primary ingredient in herbal health remedies for more than 4,000 years.7 According to National Geographic, saffron has many beneficial uses:8

"Saffron has been used historically to treat everything from heartache to hemorrhoids ... Modern studies have shown the high levels of antioxidants found in saffron may help ward off inflammation in the body and it may be helpful in treating sexual dysfunction and depression. The jury's still out on its reported effects on cardiovascular disease and cancer."

How to Grow Saffron

While you may think saffron too exotic of a spice to grow in your flower bed or garden, you may not realize you can easily grow the saffron crocus from a bulb. In the U.S., saffron crocus blooms in the fall. Remember, each corm (bulb) produces only a single flower and each flower yields just three saffron threads. As such, you'll need to plant a generous number of bulbs to ensure a measurable amount of threads.

Purchase your saffron crocus bulbs from a reputable online retailer or nursery and expect to wait a year after planting for the flowers to bloom. Saffron crocus bulbs do not store well so plant them soon after receiving them, ideally in the early fall. Gardening experts suggest the following tips for growing this exquisite flower, which is best suited for U.S. Department of Agriculture (USDA) hardiness zones 5 to 9:9,10,11

Fertilizing: Although not required, you can help your plants thrive by fertilizing them annually

Dividing: As soon as the flowers fade, you can gently dig up your corms, separate them and replant them immediately; while dividing the corms is not required annually, be sure to do it every few years to ensure they do not become overcrowded and therefore less productive

Mulching: Although saffron crocus is hardy to about to minus 15 degrees F (minus 26 degrees C), if you live in a region where temperatures regularly dip lower, you'll want to add a layer of mulch around the plants as soon as they finish blooming

Planting: Place your saffron bulbs in the ground at a depth of 3 to 5 inches with the pointy end of the corm facing up; depending on the variety grown, plants reach 3 to 12 inches in height

Soil: Saffron plants need rich, well-draining silty soil (pH 6.0 to 8.0); they will rot in swampy, poor-draining soil

Spacing: When planting saffron crocus bulbs, ensure at least 6 inches of spacing on all sides

Sun: Plant saffron crocus in an area receiving lots of direct sun

Yield: About 50 to 60 saffron flowers will produce around 1 tablespoon of saffron spice, so plan on a large growing area if you love saffron

Water: Your plants will do fine with minimal water and you need only water them during the blooming season if you live in an area prone to dry weather; the plants are dormant June through August so do not water them at that time

Saffron Crocus Diseases and Pests

Saffron crocus, as with other bulb-based plants, is prone to damage from bulb-eating critters such as birds, moles, nematodes, rats and squirrels. Rabbits have been known to nibble on the flowers and leaves. The only diseases affecting saffron crocus are rust and corm rot, which is caused by fungal infections such as fusarium, Rhizoctonia crocorum and violet root rot.12

These diseases generally appear in the third or fourth years after planting. Since they do not respond to fungicides (and I would not recommend using fungicides anyway), you can combat these diseases by digging up any remaining healthy bulbs and replanting them in a new location.

Harvesting Saffron

As mentioned, harvesting saffron is tedious, time-consuming work. After the crocus flowers bloom, you'll need to handpick the red-orange stigmas from each plant. For best results, use tweezers to carefully extract them. Obviously, harvesting large quantities of this spice will take time and a lot of effort near ground level.

Once picked, you can spread harvested stigmas on a cookie sheet to dry at room temperature until they crumble easily. The yellow stamens and purple petals of the saffron crocus have no use and can be composted.

Cooking With Saffron and How to Store It

Given its price point, it's good to know that with saffron, "a little goes a long way."  Generally, for most recipes, you'll need just a pinch of saffron threads, which should be soaked, dried and crushed before use. In traditional Moroccan cooking, given the fact saffron needs to stand up to other pungent seasonings, larger quantities are commonly used in certain dishes. When cooking with saffron, it's helpful to know 1 teaspoon of saffron threads equals about one-eighth teaspoon of ground saffron.

Most saffron sold from reputable sources is presented in glass jars, which is the perfect storage container. If you buy saffron loose, you will want to store it in a glass jar and maintain it in a cool, dark place. It will retain its flavor and potency for at least six months. After that, you can still use your saffron, but it will be increasingly less flavorful. Homegrown saffron is said to be more fragrant after it is stored in an airtight container away from light for at least one month before use.13

Saffron Is Beneficial for the Treatment of Depression, Heart Disease and More

If you are still not convinced saffron is a spice worth checking out, consider the following research on some of the health benefits of this time-tested herb:14,15

Cancer: The anticancer potential of saffron was highlighted in a 2013 study published in the journal Pharmaceutical Biology.16 After reviewing the current research on saffron, the researchers stated, "Saffron possesses free radical-scavenging properties and antitumor activities. Significant cancer chemopreventive effects have been shown … Based on current data, saffron … could be considered as a promising candidate for clinical anticancer trials."17

Dementia: Saffron contains two chemical plant compounds — crocetin and crocin — both of which are thought to support your brain's learning and memory functions. As noted in the video above, a 2010 study involving 46 patients with mild-to-moderate Alzheimer's disease found participants taking 15 milligrams of saffron twice a day for 16 weeks demonstrated "significantly better outcomes on cognitive function" than those receiving a placebo.18 The study authors said, "This … study suggests, at least in the short term, saffron is both safe and effective in [cases of] mild-to-moderate Alzheimer's disease."19

Depression: A 2014 systematic analysis20 involving six clinical studies on saffron and depression suggests the spice was as effective as antidepressant medications. The study authors stated, "Saffron's antidepressant effects potentially are due to its serotonergic, antioxidant, anti-inflammatory, neuroendocrine and neuroprotective effects. Research conducted so far provides initial support for the use of saffron for the treatment of mild-to-moderate depression."21

Heart disease: Hypertensive lab rats were shown to benefit from an oral, daily dose of saffron in a 2015 Iranian study.22 Specifically, the rats received 200 milligrams of saffron daily per kilogram of body weight during a five-week period. Saffron prevented blood pressure from increasing beginning in the third week. About the outcomes, the researchers said, "Nutritional saffron prevented blood pressure increases and remodeling of the aorta in hypertensive rats. It may be useful for preventing hypertension."23

Premenstrual syndrome (PMS): A 2008 Iranian clinical trial24 investigating saffron as a treatment for PMS symptoms in women aged 20 to 45 with regular menstrual cycles suggests 15 milligrams of saffron taken twice daily is effective to relieve PMS symptoms.

A 2011 review published in the Journal of Psychosomatic Obstetrics & Gynecology25 that evaluated several herbal remedies for PMS, as well as the more severe premenstrual dysphoric disorder (PMDD), validated saffron as an effective treatment for addressing bothersome symptoms. The study authors noted, "Single trials also support the use of … Crocus sativus [for PMS]."26

This Common Drug Combo Raises Your Risk of Lethal Overdose Fivefold

By Dr. Mercola

Drug overdoses are now the leading cause of death among Americans under the age of 50.1 Preliminary data for 2016 reveals the death toll may be as high as 65,0002 — a 19 percent increase in a single year. Opioids, narcotic pain killers, are responsible for nearly two-thirds, about 42,000, of these deaths.3 Between 2002 and 2015, more than 202,600 Americans died from opioid overdoses.4

While such statistics are sobering enough, recent research5 suggests the death toll may still be underestimated due to incomplete drug reporting of overdose deaths. The researchers believe upward of 70,000 opioid overdose deaths were excluded from national estimates between 1999 and 2015, for the simple reasons that coroners routinely fail to specify opioid use as a contributing cause of death. According to lead author Jeanine Buchanich, research associate professor at University of Pittsburgh School of Public Health:6

Proper allocation of resources for the opioid epidemic depends on understanding the magnitude of the problem. Incomplete death certificate reporting hampers the efforts of lawmakers, treatment specialists and public health officials. And the large differences we found between states in the completeness of opioid-related overdose mortality reporting makes it more difficult to identify geographic regions most at risk.”

The most common drugs involved in prescription opioid overdose deaths include7 methadone, oxycodone (such as OxyContin®) and hydrocodone (such as Vicodin®). Extremely potent synthetic opioids like fentanyl are also being abused by a rising number of people. Now, researchers warn a particularly powerful combination of commonly prescribed drugs significantly raises your risk of death.

Benzodiazepine Overdoses Are Also Rising

While opioids make the most frequent headlines, another class of drugs — benzodiazepines8 or "benzos,” widely prescribed for anxiety and insomnia — also claims its share of lives. Prescriptions for these drugs, which include Valium, Ativan, Klonopin and Xanax, tripled from 1996 to 2013, but this doesn't fully account for the uptick in overdoses, which quadrupled during that time.9

As for why the rate of overdose deaths rose faster than the rate of prescriptions, Dr. Chinazo Cunningham, one of the study's authors, told STAT News,10 "Our guess is that people are using these prescriptions in a riskier way.” The number of pills prescribed to each adult increased over the study period, for instance, which suggests Americans may be taking higher doses or taking the drugs for longer periods, both of which increase the risk of overdose. 

Combining the drugs — which act as sedatives — with alcohol is also risky, as is using the drugs along with opioids. Prescription records also show the use of benzos has risen alongside the use of opioids, and that the sedatives are often used alongside the painkillers to enhance the high.11

According to Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Center in Toronto,12 "Prescribing opioids and benzodiazepines together is like putting gasoline on a fire,” adding that “Benzodiazepines are grossly overprescribed … and many people don't necessarily benefit from them."

Estimates suggest more than 4 in 10 seniors use benzos for anxiety or insomnia, even though their long-term effectiveness and safety remain unproven, and their use has been linked to a higher risk of Alzheimer’s disease.13

Older adults who used benzodiazepines for three months or more had a 51 percent greater risk of Alzheimer's disease than those who did not, and the risk increased the longer the drugs were used. According to the authors, “The stronger association observed for long term exposures reinforces the suspicion of a possible direct association …”

Opioid-Benzodiazepine Combination Raises Risk of Death Fivefold

A number of studies have already highlighted the deadly risk you take when combining opioids with benzos. Most recently, research14,15 published in JAMA looked at how the risk of overdose changes when you combine the two drugs for a number of days in a row.

As it turns out, during the first 90 days of concurrent use, your risk of a deadly overdose rises fivefold, compared to taking an opioid alone. Between days 91 and 180, the risk remains nearly doubled, after which the risk tapers off, becoming roughly equal to taking an opioid alone. According to the authors:

“Policy interventions should focus on preventing concurrent opioid and benzodiazepine use in the first place instead of reducing the length of concurrent use. Patients using both medications should be closely monitored, particularly during the first days of concurrent use.”

The study also found that the greater number of clinicians were involved in a patient’s care, the greater the risk of overdose — a finding that highlights the lack of communication between doctors prescribing medication to the same patient, and the clear danger thereof. As noted by senior study author Yuting Zhang, Ph.D., of the University of Pittsburgh Graduate School of Public Health, “These findings demonstrate that fragmented care plays a role in the inappropriate use of opioids.”

Other Studies Confirm Extreme Risk of Opioid-Benzo Mix

Other studies have come to similar conclusions. A 2013 study found the combination of opioids and benzos was the most common drug combination in cases where an overdose death involved two or more drugs.16 According to the National Institute of Drug Abuse, more than 30 percent of opioid overdoses involve concurrent use of benzos.17

Remarkably, another 2013 study18 discovered “substantial co-use” of opioids and benzos among pregnant women that led to death, which is doubly tragic. As reported in a third study that year, which stressed the importance of urine drug testing whenever patients are prescribed an opioid, to ensure their safety:19

“[C]oadministration of [opioids and benzodiazepines] produces a defined increase in rates of adverse events, overdose and death, warranting close monitoring and consideration when treating patients with pain. To improve patient outcomes, ongoing screening for aberrant behavior, monitoring of treatment compliance, documentation of medical necessity, and the adjustment of treatment to clinical changes are essential.”

A study20 published in 2017 found the ratio of patients, aged 18 to 64, who used opioids and benzos concurrently rose from 9 percent in 2001 to 17 percent in 2013, a relative increase of 80 percent. Not surprisingly, concurrent use of opioids and benzos for at least one day doubled the odds of an opioid overdose compared to taking just opioids.

Why Opioid-Benzo Combination Is so Deadly

In 2014, Ohio ended up using an opioid/benzo mix in a death row execution when the conventionally used drugs were unobtainable.21 That just goes to show this drug combination has an assured lethality at the “right” dosage. The reason these two drugs are so hazardous in combination is because both are potent central nervous system (CNS) depressants.

Your CNS, which includes your brain and spinal cord, coordinates and regulates the activity of automatic functions such as breathing. Respiratory depression, meaning slow and erratic breathing, can occur on both drugs, which leads to a buildup of carbon dioxide. In a sufficiently large dose, breathing can cease altogether, leading to death.

Like opioids, benzodiazepines are not intended for long-term use, yet many chronic pain patients end up staying on them for years, and may even take them with opioids for long periods of time. As noted by Dr. Len Paulozzi, medical epidemiologist at the Centers for Disease Control and Prevention, benzos “are prominent fellow travelers with opioids. The problem is, people get on them and they stay on them …"

Opioids Account for Three-Quarters of Drug Deaths Worldwide

In related news, the 2018 World Drug Report22 reveals pharmaceutically-produced opioids now account for more than three-quarters of all drug overdose deaths worldwide. Fentanyl abuse is rising in the U.S., while Africa and Asia are struggling with rising overdose deaths from Tramadol. While doctors are still a primary source of opioids, illegal drug traffickers have started cashing in on the opioid abuse trend, manufacturing and selling them illegally.

According to Yury Fedotov, executive director of the United Nations Office on Drugs and Crime, “We are facing a potential supply-driven expansion of drug markets, with production of opium and manufacture of cocaine at the highest levels ever recorded.” Between 2016 and 2017 alone, the global opium production rose by 65 percent.

In a June 26 address to observe International Day Against Drug Abuse and Illicit Trafficking, United Nations secretary-general António Guterres said,23 “I urge countries to advance prevention, treatment, rehabilitation and reintegration services; ensure access to controlled medicines while preventing diversion and abuse; promote alternatives to illicit drug cultivation; and stop trafficking and organized crime.”

Opioid Makers Shrink Payments to Doctors

One of the factors suspected of contributing to the burgeoning opioid epidemic is kickbacks to the doctors who prescribe them. According to a 2017 study,24 more than 68,000 physicians received drug company payments totaling more than $46 million between August 2013 and December 2015. This means 1 in 12 U.S. physicians collected kickbacks from drug companies producing prescription opioids.

The top 1 percent of physicians received nearly 83 percent of the payments, and fentanyl prescriptions was associated with the highest payments. Many of the states struggling with the highest rates of overdose deaths, such as Indiana, Ohio and New Jersey, were also those showing the most opioid-related payments to physicians, clearly demonstrating a direct link between doctors’ kickbacks and patient addiction rates and deaths.

Increasing pressure on drug companies — in large part brought to bear by lawsuits over deceptive marketing and charges being filed against executives and sales reps for their role in manufacturing demand — now appears to be paying off. According to a recent ProPublica analysis,25 drug company payments to doctors related to opioids decreased 33 percent between 2015 and 2016, from $23.7 million to $15.8 million.

The most significant decrease was related to Subsys, a fentanyl spray made by Insys. The company’s founder, John Kapoor, was arrested in October 2017, charged with bribing doctors to overprescribe the drug. Other Insys executives and sales reps were arrested on conspiracy and racketeering charges.26 In 2015, the company doled out more than $6 million in Subsys-related payments. In 2016, that amount shrunk to less than $2.4 million.

Purdue Pharma, heavily criticized for its deceptive marketing of OxyContin, no longer pays doctors to speak about the drug, and laid off its last opioid sales reps in June 2018.27 While the cutbacks in payments are a step in the right direction, research shows it doesn’t take huge sums of money to influence a doctor’s prescribing habits. A single free meal received in relation to marketing of an opioid has been shown to result in a greater number of prescriptions for the drug in the following year.28,29

Addiction Is a Very Real Problem with Benzodiazepines

Getting back to the issue of benzodiazepines, it’s important to realize these drugs are every bit as addictive and dangerous as opioids, and when taken together, the risk of death is magnified fivefold. Benzos exert a calming effect by boosting the action of the neurotransmitter gamma-aminobutyric acid (GABA), which in turn activates the gratification hormone, dopamine, in your brain.

Side effects include memory loss, hip fractures, impaired thinking and dizziness. Ironically, symptoms of withdrawal include extreme anxiety — in many cases worse than the original symptoms that justified the treatment in the first place. Other side effects of withdrawal include hallucinations, depersonalization and derealization, formication (skin crawling) and sensory hypersensitivity, perceptual distortions, convulsions and psychosis.

There are far safer ways to address anxiety and insomnia, starting with exercise, optimizing your gut microbiome and omega-3 level. The Emotional Freedom Techniques (EFT) is another effective tool that can help reprogram your body's reactions to the unavoidable stressors of everyday life. This includes both real and imagined stressors, both of which can be significant sources of anxiety. It can also help reduce pain.

In the following video, EFT therapist Julie Schiffman discusses EFT for stress and anxiety relief. Please keep in mind that while anyone can learn to do EFT at home, for serious issues like persistent or severe anxiety you should consult with an EFT professional to get the relief you need. Pain can also be safely addressed without opioids. For a list of suggestions, see “15 Natural Remedies for Back Pain.”

 
 
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