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  • Mindfulness and Hypnosis: Tools for Navigating Chronic Illness

    Mindfulness and Hypnosis: Tools for Navigating Chronic Illness

    Several years ago, I experienced what at the time I did not realize was the beginning of a life-changing journey into chronic illness. 

    It started with noticing shortness of breath when I bent over to pick something up off the floor, and rapidly snowballed. It felt as if I had stepped into an alternate reality, where I went from being a healthy person whose life was punctuated with hiking, dancing, and travel, to someone whose body would no longer cooperate with life. At my worst, my heart rate spiked throughout the day and night to levels that would send healthy friends running to the ER. I was exhausted and at times too weak to walk.

    Already a Buddhist meditation teacher and hypnotherapist, I found myself on a crash course in treating a complex medical condition and learning how to live a meaningful life inside a body that had fundamentally changed.

    This was the beginning of a complex condition involving almost every system in my body, eventually traced back to my time living in a small cottage that unknowingly housed an uninvited tenant: black mold. At the time, I couldn’t have imagined how profoundly this experience would change my body, my life, and my work.

    Already a Buddhist meditation teacher and hypnotherapist, I found myself on a crash course in treating a complex medical condition and learning how to live a meaningful life inside a body that had fundamentally changed. 

    Over the years that followed, I worked to carve out spaces of healing, resilience, and joy, rebuilding a life that in many ways felt happier and more free than the one I had lost. I also found myself supporting more clients navigating complex illnesses themselves. Again and again, I saw how mindfulness and hypnosis could help people feel a renewed sense of hope, agency, and capacity to relate to their lives and bodies differently.

    A Nervous System Mobilizing Against Threat

    When we live with chronic illness or pain, it can often feel like we are stuck on high alert—and with good reason. The body is designed to detect danger and mobilize quickly against threat. We have survived across generations of human evolution because of this finely honed system. It’s an incredible gift—until it’s not.

    Pain, stress, illness, and other issues can send signals throughout our body communicating that something is profoundly wrong. It’s our system’s way of saying, “Hey! Stop! Please take care of me.” 

    “Maladaptive neuroplasticity” happens when the body and mind begin to reorganize in order to address the ongoing threat that is occurring. Unfortunately, we don’t always reorganize in a way that helps us long-term or feels particularly good. To our brain and body, it’s about one thing and one thing alone: our survival. 

    But in chronic conditions occurring over time, this repeated activation can make our nervous system extra sensitive to threat. Our body’s warning system begins to fire over and over, responding to even small changes in posture, environment, or life conditions as if they were a five alarm fire. This is part of why hypnosis and meditation have been shown to be highly supportive for chronic illness and pain, when used in complement with appropriate medical care.

    You’ve probably heard the term “neurons that fire together wire together,” meaning that when we repeat anything over and over, we build strong neural pathways that operate automatically. This trait is fantastic in so many situations: we effortlessly remember how to drive a car, we see the face of someone we love and a feeling of warmth washes over us, we wake up and go to our meditation cushion because it’s a habitual part of our routine.

    Our brains are incredibly efficient. They want to save energy, so they create shortcuts to do so. This is often helpful, but when it comes to chronic pain and illness, this can result in heightened sensitivity, and what some researchers call maladaptive neuroplasticity. 

    What does that mean for us? Essentially, the body and mind begin to reorganize in order to address the ongoing threat that is occurring. Unfortunately, we don’t always reorganize in a way that helps us long-term or feels particularly good. To our brain and body, it’s about one thing and one thing alone: our survival.

    Over time, an inner algorithm is created in the brain, body, and nervous system: We get exposed to a trigger or feel the beginning of the symptom and automatically, a cascade of chemical, physiological, and emotional responses fire up within a fraction of a second. Emotions are heightened, thought loops start spinning, discomfort worsens, and the neural pathways connecting things like fear, grief, hopelessness, frustration, and physical symptoms grow stronger. 

    The wonderful thing about neuroplasticity is that you have agency over more of this process than you might imagine, especially when it comes to navigating habitual thoughts and reactions, distress, and overwhelm.

    Neuroplasticity Means You Have More Power Than You Know

    It’s understandable that these processes can feel big, automatic, and beyond our control, but that’s not the full picture. The wonderful thing about neuroplasticity is that you have agency over more of this process than you might imagine, especially when it comes to navigating habitual thoughts and reactions, distress, and overwhelm.

    This is where mindfulness and hypnosis can offer real support. Both practices help you notice when the alarm bells start going off, so that you can interrupt the cascade of reactivity and learn to steer it in a different direction. Through relaxation, breath, focused attention, visualization, and active work with the subconscious mind, you can begin to support the nervous system and create space where triggers, symptoms, and recurring attitudes and thoughts can be met and worked with. 

    The more you practice cultivating and resting in qualities like safety, compassion, kindness, and relaxation, the more hardwired and automatic they become. Just like you’ve strengthened the muscles of stress and overwhelm, you can strengthen the muscles of ease, trust, and permission to rest and take care of yourself.

    One of my clients has described this process as being able to access her “own little sanctuary”—a place where even in the midst of years-long, complex illness, she is able to rest, remember her wholeness, and feel relief. With that, her sleep has significantly improved along with her overall sense of hope, personal power, and wellbeing.

    Addressing the Whole Person

    Of course, this does not mean thinking we can just “meditate away” a condition that needs treatment. These practices are best done in conjunction with medical care, because they allow us to navigate the full spectrum of our experience—from stress around doctor’s appointments and treatment protocols, to changes in our relationships and career, to celebrating the wins and progress when they do come. Living with pain and illness touches our bodies but also our identities, spirituality, and outlook on the world. These practices can allow us to show up for all parts of it. 

    Adding meditation and hypnosis to our chronic illness care regimen can reveal that we have more power than we think: the ability to interrupt familiar thought loops, to create moments of relief and inner safety, and even to reshape the emotions, beliefs, and patterns that can make life with chronic illness feel harder than it already is.

    Adding meditation and hypnosis to our chronic illness care regimen can reveal that we have more power than we think: the ability to interrupt familiar thought loops, to create moments of relief and inner safety, and even to reshape the emotions, beliefs, and patterns that can make life with chronic illness feel harder than it already is.

    This is so powerful because in the type of mind states available through meditation and hypnosis, the mind becomes more flexible, creative, and adaptive. In fact, early research suggests that mind-body practices like meditation and hypnosis may influence brain-derived neurotrophic factor (BDNF), a molecule linked to neuroplasticity, learning, pain modulation, and the nervous system’s capacity to adapt in response to stress. 

    When we add these practices to our toolbox, we are partnering with the subconscious mind so that we can remodel our relationship to illness from the inside out.



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  • Is Personalized Genetic Testing Worth It?

    Is Personalized Genetic Testing Worth It?

    Overrated “precision medicine” may just be serving vested interests, and consumer DNA testing can be useless—or even worse.

    Today, you can get your DNA sequenced—the letters of your entire genetic code spelled out—for about a thousand dollars, a bargain compared to the $100 million or so it cost 20 years ago. And for around a hundred dollars, you can get partial DNA sequencing. Direct-to-consumer genetic testing is “only a click away,” like 23andMe, for “ancestry, health, love…and more.” Unfortunately, many tests that are available today haven’t been validated properly. And, as a result, the buyer may be buying something “that is ultimately useless.” Or, results may just be just flat-out wrong.

    There is growing public demand for direct-to-consumer genetic tests, but when put to the test, researchers found an “alarmingly high false-positive rate.” Test results indicated that people carried a high-risk gene, but it simply wasn’t true. And this happened 40% of the time, especially with the BRCA breast cancer gene (the one Angelina Jolie publicly revealed she carries), which you can see below and at 1:08 in my video Should You Get Personalized Genetic Risk Testing?.In addition to the 40% false-positive rate, some variants the tests did identify correctly were misclassified as being high risk when, in actuality, they weren’t high risk at all. You can see how it’s in these companies’ best interest to give scary outlier results, so customers will think the money spent was worth it and maybe even pay for additional testing. But false-positive results and variant misclassification can have serious consequences for a person, including unnecessary stress and even unnecessary medical procedures. What if you got a preventive double mastectomy because you falsely thought you were at high risk when you didn’t even have the BRCA mutation?

    Yes, now, these genome-wide association studies have identified thousands of common genetic variants that affect the risk of complex diseases, as I talked about in my video on personalized nutrition. “Nevertheless, the discovered gene variants do not markedly expand our predictive ability compared with what can be achieved by using only information from long-known traditional risk factors.”

    Take type 2 diabetes, for example. Researchers have identified about 50 genes that are linked to increased diabetes risk, but even when considered collectively, “obese persons with the lowest genetic risk for diabetes were nearly 5 times more likely to develop the disease than normal-weight persons with the highest genetic risk.” In other words, this would send out the wrong message to someone who is obese, giving them a false sense of security. Knowledge about type 2 diabetes genetic susceptibility based on what we know so far has “no implications for decisions about who should be targeted for intensive lifestyle interventions.” Everyone with excessive body fat, regardless of genetics, needs to slim down to reduce the risk of diabetes.

    What about the famous study that purported to show that personally tailored dietary interventions could improve blood sugar responses, to the extent that some commentators said it raised questions about the usefulness of universal dietary recommendations? But if you actually read the study, the results do not show high interpersonal variation in relative blood sugar responses; do not show the model is superior to current methods of detecting high blood sugars; and do not show that personalized nutrition advice is better than standard dietary advice to manage high blood sugar responses after meals.

    But what about personalized genetic risk counseling to at least motivate diabetes prevention? “In a somewhat forlorn bid to regain credibility, ‘knowledge’ of individual genetic risk profile has been touted as effective in motivating test-positive individuals to commit more strenuously to relevant disease prevention efforts….” However, again, available evidence doesn’t support that claim. And indeed, it did not seem to help those at risk for diabetes.

    Researchers randomized people to get genetic tests worth hundreds or thousands of dollars to profile their subtle differences in risk for up to 40 different diseases. In this case, it was Navigenics that described its goal as empowering people with personal genetic insights to help motivate them to improve their health. Yet, it didn’t work. There were no measurable changes in diet or lifestyle, even in the short-term.

    Randomizing people to personalized nutrition insights is like determining who might genetically benefit particularly well from eating more greens or eating to lower their cholesterol, yet when researchers put it to the test, there were no significant changes in diet at month six compared to those who didn’t get that personalized info, or even at month three. So, it’s no surprise there were no differences in weight, belly fat, cholesterol, or any of the other biomarkers.

    Put all the studies together, and what do we find? There are no significant benefits to telling smokers who are at particular risk for lung cancer, or who need to eat especially healthy, or who should be more physically active. The bottom line: Expecting that being aware of DNA-based risk estimates will change behavior is not supported by existing evidence. However, that was the stated reason for the big presidential push for precision medicine in 2015: to empower individuals to take a more active role in their own health.

    It is not surprising that the theme of personal empowerment is invoked. It’s great for marketing, but it’s not particularly empowering. In fact, if anything, it leaves patients even more reliant on authority, and it is not even very personal since the genetic contributions we know of are so small compared to how we actually live our lives. Then why is patient empowerment emphasized as a “cardinal virtue”? Because “it exploits the appeal…to generate political and public support” for an “increasingly industrialized medical-industrial and scientific complex, which moves trillions of dollars around the globe.”

    This isn’t some grand conspiracy theory; it’s just the way the system works. “Healthy living directly threatens many powerful corporations….” Eat less sugar? Eat less meat? Healthier populations, after all, only reduce the demand for doctors and drugs. “Seemingly willfully blind to this evidence, the United States continues to spend its health dollars overwhelmingly on clinical care,” cleaning up our lifestyle-induced messes. So, it’s not surprising that we far outspend other countries while at the same time having worse outcomes. While major new taxpayer gifts were being promised to high-tech medicine about a decade ago, the United States had already sunk to the bottom among comparable countries with respect to disease experience and life expectancy. “Overrated ’precision medicine’ promises may be serving vested interests,…justifying the exorbitant healthcare expenditure in our finance-based medicine.” In lots of ways, the U.S. health care system is the most advanced in the world, but all our “whiz-bang technology just cannot fix what ails us.” “Let’s start with the basics. Eat your broccoli, take the stairs, and don’t worry about whether you have a 5.6 percent or 7.7 percent lifetime risk for a grave disease because either way, a sensible lifestyle is the healthiest choice.”

    Doctor’s Note

    The video I mentioned is Friday Favorites: How Useful Is Personalized Nutrition?.



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  • FDA Approves New Immunotherapy Combination for High-Risk Early-Stage Bladder Cancer

    FDA Approves New Immunotherapy Combination for High-Risk Early-Stage Bladder Cancer

    The U.S. Food and Drug Administration (FDA) has approved a new treatment option for patients with high-risk non–muscle invasive bladder cancer (NMIBC), authorizing the use of durvalumab (Imfinzi) in combination with Bacillus Calmette-Guérin (BCG) on May 28, 2026. The decision represents an expansion of immunotherapy-based treatment strategies for a disease known for its high recurrence rate and long-term management needs.

    NMIBC is the most common form of bladder cancer and is characterized by tumors confined to the bladder’s inner lining without invading the muscle layer. Although generally less aggressive than muscle-invasive disease, it frequently recurs after treatment and, in some cases, can progress, requiring ongoing surveillance and repeated intervention.

    The approval is supported by data from the Phase 3 POTOMAC trial (NCT03528694), a randomized, multicenter study evaluating durvalumab plus BCG versus BCG alone in patients with high-risk NMIBC who had undergone transurethral resection of bladder tumor (TURBT).

    The trial enrolled more than 1,000 patients and followed participants after TURBT, with the primary endpoint defined as investigator-assessed disease-free survival (DFS), measuring recurrence, progression to muscle-invasive or metastatic disease, or death.

    Results showed that the durvalumab combination reduced the risk of disease recurrence, progression, or death by 32% compared with BCG alone (hazard ratio 0.68; 95% CI 0.50–0.93). Median disease-free survival was not reached in either group at the time of analysis.

    Researchers also reported fewer DFS events in the combination arm, with 67 events compared with 98 events in the BCG-only group, suggesting improved disease control with the addition of durvalumab.

    Durvalumab is an immune checkpoint inhibitor that blocks PD-L1, helping the immune system recognize and attack cancer cells more effectively. BCG, a long-established intravesical therapy for bladder cancer, stimulates a localized immune response within the bladder to target residual tumor cells.

    The combination is designed to enhance both systemic and local immune activity, with the goal of improving durable tumor control and reducing recurrence risk in high-risk patients.

    According to the FDA’s approval summary, the findings demonstrate a clinically meaningful improvement in disease-free survival, reinforcing the need for additional effective options beyond BCG alone in this patient population.

    With the approval, durvalumab plus BCG becomes an available treatment option for eligible patients with high-risk NMIBC. However, clinicians emphasize that routine cystoscopic surveillance remains essential, as recurrence risk persists even after therapy.

    Experts note that while the approval represents a significant advance in early-stage bladder cancer treatment, longer follow-up is still required to fully assess the durability of the benefit and its impact on overall survival outcomes.

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  • Irritable Bowel Syndrome (IBS) | Nemours KidsHealth

    Irritable Bowel Syndrome (IBS) | Nemours KidsHealth

    Overview

    What Is Irritable Bowel Syndrome?

    Irritable bowel syndrome (IBS) is a common intestinal problem that affects the colon (the large intestine). It can cause cramps, gas, bloating, diarrhea, and constipation. It’s sometimes called a “nervous stomach” or “spastic colon.”

    IBS can be uncomfortable and embarrassing, but it doesn’t cause serious health problems. Doctors can help kids and teens manage IBS symptoms with changes in diet and lifestyle. Sometimes they prescribe medicines to help relieve symptoms.

    Top Things to Know

    • Irritable bowel syndrome (IBS) is a common digestive condition that affects how the colon works and can cause ongoing belly discomfort.
    • Kids with IBS may have belly pain, bloating, gas, diarrhea, constipation, or changes in bowel habits.
    • IBS is managed with changes in diet, lifestyle, stress management, and sometimes medicine.
    • IBS can be confused with other digestive problems or dismissed as “just a nervous stomach,” but symptoms are real and often linked to stress, food triggers, or gut sensitivity.

    What Happens in IBS?

    Normally, the colon absorbs water and nutrients from partially digested food. Waste products aren’t absorbed, and move slowly through the colon toward the rectum. Then, they leave the body as feces (poop).

    Muscles in the colon help the body do this. They squeeze and relax as they push undigested food through the large intestine. They work with other muscles in the rectum or pelvis to push feces out of the anus.

    But with IBS, the colon’s muscles don’t work at the right speed for good digestion or don’t work well with the other muscles. Undigested food in the colon can’t move along smoothly. This can lead to belly cramps, bloating, constipation, and diarrhea.

    Signs & Symptoms

    What Are the Signs & Symptoms of IBS?

    The main sign of IBS is belly pain or discomfort. Other signs include:

    • changes in bowel habits (pooping)
    • bloating
    • belching (burping)
    • flatulence (farting)
    • heartburn
    • nausea (sick to the stomach)
    • feeling full quickly when eating

    But having gas or a stomachache once in a while doesn’t mean someone has IBS. Doctors consider it IBS when symptoms last for at least three months and include at least two of these signs:

    • pain or discomfort that feels better after a bowel movement (BM)
    • pain or discomfort together with changes in how often a person has to go to the bathroom
    • pain or discomfort along with changes in their stool (poop). Some people get constipated, and their poop is hard and difficult to pass. Others have diarrhea.

    Causes

    What Causes IBS?

    The specific cause of IBS isn’t known, but it tends to run in families.

    Some foods — like milk, chocolate, drinks with caffeine, gassy foods, and fatty foods — can trigger IBS symptoms. So can infections, anxiety, and stress. Some kids with IBS are more sensitive to emotional upsets. Nerves in the colon are linked to the brain, so things like family problems, moving, or taking tests can affect how the colon works.

    Kids with IBS may be more sensitive to belly pain, discomfort, and fullness than other kids. Sometimes, people never find out what brings on their IBS symptoms.

    Diagnosis

    How Is IBS Diagnosed?

    There is no specific test for IBS. To diagnose it, doctors ask about symptoms and do an exam. They’ll ask if anyone in the family has IBS or other gastrointestinal problems.

    Talking about things like gas and diarrhea can be embarrassing for kids. Reassure your child that the doctor deals with issues like this every day and needs the information to help your child feel better.

    The doctor may suggest keeping a food diary to see if any foods trigger your child’s IBS symptoms. The doctor might ask about stress at home and at school.

    Most of the time, doctors don’t need medical tests to diagnose IBS. Sometimes they order blood tests, stool tests, X-rays, or other tests to be sure another medical problem isn’t causing the symptoms.

    Treatment & Care

    How Is IBS Treated?

    There’s no cure for IBS. But many things can help reduce IBS symptoms, including:

    • Changes in eating. Some kids find that careful eating helps reduce or get rid of IBS symptoms. Your child might have to avoid milk and dairy products, caffeine, greasy foods, spicy foods, gluten, sugary drinks, or other foods that seem to bring on problems. Eating smaller, more frequent meals also might help.
    • Changes in lifestyle. If IBS is tied to stress, talk about what your child can do to manage pressures related to school, home, or friends.
    • Regular exercise. Exercise can help digestion. It’s also a great stress reliever.
    • Medicines. Doctors sometimes prescribe medicines to treat diarrhea, constipation, or cramps. Antidepressants may help some people with pain management and depression. Talk with your doctor before giving your child any over-the-counter medicines for diarrhea, constipation, cramps, or other digestive problems.
    • Counseling and coping strategies. If your child seems very anxious or depressed, your doctor might recommend seeing a psychologist or therapist. Therapy, hypnosis, breathing exercises, or other relaxation techniques can help some people manage IBS.

    IBS can affect your child’s quality of life. Talk with your doctor about ways to manage it to help your child lead an active and healthy life.

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  • Los Angeles Declared a Historic Win Against Fentanyl. Eight People Are Still Dying Every Day. Here Is What the Data Is Really Saying.

    Los Angeles Declared a Historic Win Against Fentanyl. Eight People Are Still Dying Every Day. Here Is What the Data Is Really Saying.

    When Los Angeles County officials announced in mid-2025 that overdose deaths had dropped 22 percent in 2024 — the most significant single-year decline in the county’s recorded history — the announcement was framed as a public health success story. District Attorney Nathan Hochman called it a vindication of prevention, education, and aggressive prosecution. The Los Angeles County Department of Public Health credited expanded naloxone access, harm reduction investments, and improved treatment availability.

    And on the narrow metrics cited in the press release, the numbers are genuinely encouraging. Deaths fell from 3,137 in 2023 to 2,438 in 2024. Fentanyl-related deaths specifically declined by 37 percent. Methamphetamine-related deaths dropped by 20 percent. These are not trivial improvements. In a crisis of this scale, every life saved represents a family intact, a child who still has a parent, a community that did not have to hold another funeral.

    But 2,438 people still died in Los Angeles County in a single year from drug overdoses and poisonings. That is an average of more than eight people every day. Every single day. Fentanyl — a synthetic opioid 50 times more potent than heroin and 100 times more potent than morphine — still accounted for 52 percent of all accidental overdose deaths in the county, even after the record decline. And the long-term trajectory of this crisis remains one of the most dramatic public health collapses in any American city’s modern history.

    The full LA County Department of Public Health data report on fentanyl overdoses: Data Report — Fentanyl Overdoses in Los Angeles County, October 2025. The official county announcement: Public Health Reports Most Significant Decline in Drug-Related Overdose Deaths in LA County History.

    ⚠ LOCAL DATA ALERT: In LA County, fentanyl overdose deaths surged 1,652% between 2016 and 2024. In the poorest communities (30%+ poverty rate), the fentanyl death rate is nearly FOUR TIMES higher than in the wealthiest neighborhoods — 39.1 vs. 10.0 per 100,000 population.

    THE LONG ARC: FROM 109 DEATHS TO 2,438 IN UNDER A DECADE

    To understand what Los Angeles County is actually facing, the short-term improvement must be placed in its proper context. In 2016, when routine toxicology testing for fentanyl began in LA County death investigations, 109 people died from fentanyl-related overdoses. By 2021, that number had risen to 1,504 — a 1,280 percent increase in five years. By 2023, the total had climbed to 3,137 — a 1,652 percent increase from the 2016 baseline. The 2024 decline brings the county back to roughly the 2022 level, which was itself an unprecedented crisis point.

    Fentanyl’s rise in Los Angeles has tracked a national pattern of drug supply contamination driven by illicit manufacturing. Unlike the opioid crisis of the 2000s and 2010s — which was substantially driven by overprescription of pharmaceutical opioids — the current crisis is primarily a fentanyl poisoning crisis. People who believe they are purchasing counterfeit prescription pills, cocaine, or methamphetamine are receiving products laced with illicitly manufactured fentanyl. Seven out of every 10 illicit pills seized in Los Angeles County contain a lethal dose of fentanyl, according to LA County District Attorney Nathan Hochman — who has characterized fentanyl as ‘an indiscriminate assassin.’

    The DA’s office announced several first-of-their-kind murder prosecutions for fentanyl distribution in 2025: LA County Sees Sharpest Decline in Overdose Deaths as DA Hochman Intensifies Fentanyl Fight.

    THE INEQUALITY BURIED IN THE DATA: GEOGRAPHY AND POVERTY AS DEATH SENTENCES

    The LA County October 2025 data report contains a figure that deserves to be front-page news in its own right. The rate of fentanyl overdose deaths in the least affluent communities — defined as areas where more than 30 percent of families live below the federal poverty level — was 39.1 deaths per 100,000 population in 2024. In the most affluent areas — where less than 10 percent of families are below the poverty line — the rate was 10.0 per 100,000. That is a nearly four-fold difference in death rates based solely on neighborhood income level.

    This disparity is not a natural phenomenon. It reflects differences in access to treatment and recovery services, differences in housing stability that affect treatment continuity, differences in access to naloxone and harm reduction infrastructure, differences in health insurance coverage, and differences in the concentration of street drug markets in lower-income communities. It also reflects the cumulative effect of decades of underinvestment in mental health and addiction treatment infrastructure in communities that needed it most.

    In practical terms, the geography of fentanyl death in Los Angeles correlates with neighborhoods on the south and east sides of the city and county — communities with higher concentrations of unhoused individuals, higher poverty rates, and lower access to primary care. These communities saw the highest absolute death rates at the peak of the crisis and will be the slowest to benefit from the percentage declines being celebrated at the county level.

    THE NATIONAL PICTURE: LA’S DECLINE IN CONTEXT

    Los Angeles County’s 22 percent improvement in 2024 is broadly consistent with a national trend. According to provisional data released by the CDC on May 13, 2026, approximately 69,973 people died from drug overdoses in the 12 months ending December 2025 — a 13.9 percent decline from the previous year. This represents the longest sustained decline in overdose deaths in decades: more than two full years of falling national mortality after the 2022 peak of 107,941 deaths.

    Full CDC overdose prevention data, updated May 13, 2026: CDC Overdose Prevention — About Overdose Prevention. National Institute on Drug Abuse death rate data: NIDA Overdose Death Rates.

    But as Brown University researcher Brandon Marshall noted in January 2026 reporting by U.S. News: ‘The monthly death toll is still not back to what it was before the COVID-19 pandemic, let alone where it was before the current overdose epidemic struck decades ago.’ The celebration of declining overdose numbers requires constant calibration against the baseline. Fewer people are dying than at the peak, but far more people are dying than in any year before this crisis began — and the crisis is showing no signs of resolving, only of moderating.

    THE FENTANYL VACCINE: A FUTURE SOLUTION THAT IS NOT HERE YET

    One of the most closely watched developments in overdose prevention science entering 2026 is the progression of an experimental fentanyl vaccine into early-phase human trials. The vaccine is not designed to treat opioid addiction directly but to prevent fentanyl from crossing the blood-brain barrier in individuals who use the drug — effectively reducing overdose risk by preventing the euphoric effect that drives compulsive use and by limiting the respiratory depression that causes overdose death.

    If successful, this approach could function as a pharmacological safety net for individuals in active recovery who face high relapse risk — a population for whom current naloxone-centered harm reduction strategies are important but insufficient. However, every addiction medicine specialist commenting on early trial data has been clear: widespread clinical availability of a fentanyl vaccine is likely years away, not months. It cannot be counted as a near-term solution to a crisis killing eight people per day in Los Angeles County alone.

    Background on the fentanyl crisis trajectory entering 2026: The Fentanyl Crisis in the United States Heads Into 2026 With Cautious Optimism.

    WHAT EVERY LOS ANGELES RESIDENT NEEDS TO KNOW

    Naloxone (brand name Narcan) is available without a prescription at pharmacies across Los Angeles County, and at no cost through Los Angeles County Department of Public Health distribution programs. It is the only pharmacological intervention capable of reversing a fentanyl overdose in progress. Every household in Los Angeles — not only those with someone who uses drugs — should have naloxone available. Fentanyl-laced counterfeit pills are indistinguishable from pharmaceutical tablets by appearance. A teenager who accepts what appears to be an Adderall or Xanax from a peer at a party is at risk. A young adult who takes a single pill at a social event is at risk. This is not a drug user’s problem. It is a community-wide threat.

    Fentanyl test strips — small, inexpensive paper strips that can detect fentanyl in a drug sample before consumption — are now legal in California and available through harm reduction organizations across Los Angeles. Their use does not enable drug use; it prevents death. Stigma around carrying test strips has cost lives. This is not a debate about whether drug use is acceptable. It is a debate about whether the appropriate response to a poisoned drug supply is to let people die from accidental contamination.

    Naloxone access and overdose prevention resources for Los Angeles residents: LA County Department of Public Health — Naloxone Access. National overdose prevention resource: CDC Overdose Prevention Resources.

    MEDICALDAILY.COM ASSESSMENT

    Los Angeles County’s 22 percent overdose death reduction in 2024 is real and meaningful — and it is also vastly insufficient relative to the scope of the crisis. Going from 3,137 deaths to 2,438 deaths is a step in the right direction. It is not a resolution. The nearly four-fold disparity in death rates between LA’s poorest and wealthiest communities tells a story that the headline percentage decline obscures: the communities that were hardest hit in this crisis are recovering the slowest, and the gap between them and more affluent neighborhoods may be widening rather than closing. The 1,652 percent long-term surge in fentanyl deaths since 2016 represents a civilizational failure in drug policy, mental health infrastructure, and social support systems that a single year of positive trend data cannot undo. Los Angeles has earned a moment to acknowledge the improvement. It has not earned a moment to declare victory.

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  • Cold Sores (HSV-1) | Nemours KidsHealth

    Cold Sores (HSV-1) | Nemours KidsHealth

    Also called: Fever Blisters

    Overview

    What Are Cold Sores?

    Cold sores are small painful blisters that can form on or near the lips or nose. They’re common and usually go away on their own in 1–2 weeks.

    Top Things to Know

    • Cold sores are small, painful blisters that usually form on or around the lips and nose. They are common in kids and are caused by a virus.
    • Kids with cold sores may feel tingling before blisters appear or have pain when eating, and they may also have a fever, swollen gums, or swollen neck glands.
    • Cold sores usually heal on their own, but pain-relief medicines and cold compresses can help them be less painful.
    • Cold sores can come back because the virus stays in the body.

    Signs & Symptoms

    What Are the Signs & Symptoms of Cold Sores?

    Kids may have tingling and numbness around their mouth before fluid-filled blisters form. When the blisters break, they become sores, which can make eating painful. The sores crust over and form a scab before they go away.

    Cold sores also can cause red and swollen gums, a fever, muscle aches, a generally ill feeling, and swollen neck glands.

    When Should I Call the Doctor?

    Call the doctor if your child:

    • is younger than 6 months old and gets a cold sore
    • has a weak immune system, which could let the infection spread and cause problems in other parts of the body
    • has sores that don’t start healing in 7–10 days
    • has any sores near the eyes or eye pain or redness
    • gets cold sores a lot
    • has symptoms of a bacterial infection, like fever, pus, or redness that spreads
    • has other symptoms, like a headache or confusion

    Causes & Prevention

    What Causes Cold Sores?

    The herpes simplex virus type 1 (HSV-1) causes cold sores. It’s contagious and spreads easily from one person to another. This isn’t the same virus as HSV type 2 (HSV-2), which causes sores in the genital area (genital herpes). But even though HSV-1 typically causes sores around the mouth and HSV-2 causes most genital sores, both viruses can cause sores in either body area.

    After a child has had cold sores, the virus can quietly stay in the body for a long time without causing symptoms. Later, symptoms can happen again because of things like:

    • other infections
    • fever
    • sunlight
    • cold weather
    • periods
    • stress, like before a big test at school

    How Do Kids Get Cold Sores?

    Kids can get HSV-1 by kissing or touching someone with cold sores or by sharing eating utensils (like forks, spoons, and chopsticks), towels, or other items with a person who has the virus. Many people with HSV-1 got it as kids during their preschool years (ages 3–5).

    Can Cold Sores Be Prevented?

    The HSV-1 virus is very contagious. To help prevent it from spreading, kids with a cold sore should:

    • Keep their drinking glasses, eating utensils, washcloths, and towels away from those used by other family members. These items should be washed well after use.
    • Not kiss others until the sores heal.
    • Avoid touching the cold sore.
    • Wash their hands well and often.

    To help prevent another cold sore, kids should:

    • Try to get enough sleep and eat well.
    • Try to manage stress, get lots of physical activity, and take time to relax.
    • Always wear sunscreen outdoors, particularly on the face, and use a lip balm with SPF.

    Treatment & Care

    How Are Cold Sores Treated?

    Cold sores usually go away in about 1–2 weeks. No medicines can kill the virus. But some treatments can help make cold sores less painful and not last as long.

    To ease pain, your child can hold a cold compress (a clean, cold, wet cloth) to their mouth. To make meals more comfortable, serve cool foods and drinks.

    You can also give pain medicine like acetaminophen or ibuprofen. Don’t give aspirin to kids with cold sores or other viral infections because it’s linked to a rare but serious illness called Reye syndrome. Your doctor may recommend other medicine to help cold sores feel better and go away.

    When your child has a cold sore, they should avoid touching it and be careful not to touch their eyes. If HSV-1 gets into the eyes, it can be very serious.

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  • Are Nuts and Peanut Butter Linked to a Longer Life?

    Are Nuts and Peanut Butter Linked to a Longer Life?

    Why are nuts associated with decreased mortality, but not peanut butter?

    According to the largest study of risk factors for death in human history, a poor diet causes more deaths than anything. Cigarettes only kill about 8 million people a year, whereas humanity’s diet kills millions more, as you can see below and at 0:20 in my video Do the Health Benefits of Peanut Butter Include Longevity?.What are the worst aspects of our diet? Processed meat? Twinkies? Soda? No, the five deadliest things about our diet are: not enough fruit, not enough whole grains, not enough vegetables, too much salt, and not enough nuts and seeds, as shown here and at 0:42 in my video.

    Nuts should come as no surprise since interventional trials have shown that eating nuts improves artery function, and arterial diseases like heart disease are among our leading killers. But that’s not all nuts can do. They may also improve blood sugar control, lower cholesterol, suppress inflammation, reduce oxidative stress, and feed our friendly gut flora. Do all nuts do that, or just tree nuts?

    What about peanuts and peanut butter? About half of peanut consumption in the United States is from peanut butter, but the link between peanut butter consumption and mortality has not been evaluated thoroughly. To get that specific, we can call on the National Institutes of Health-AARP study, the largest prospective health and diet study in history that followed more than half a million people since the 1990s.

    Researchers found that nut consumption in general appeared to protect against all-cause mortality, meaning nut-eaters live—on average—longer lives. Specifically, they are less likely to die from cancer, cardiovascular disease, liver disease, respiratory disease, kidney disease, and infectious causes (so, maybe nuts help immunity as well). However, no such associations were found for peanut butter. So, when it comes to living longer, peanut butter doesn’t seem to count. Why?

    Well, we know peanut butter consumers tend to eat more meat, smoke cigarettes, and are less likely to exercise, but the researchers controlled for all those factors, as well as their alcohol consumption, fruit and veggie intake, education, and more. So, it’s not like the peanut butter eaters were just eating more white bread sandwiches or something. (The researchers didn’t control for sugar, though, so it’s possible they could have been eating more sugary jelly.)

    Another explanation: It could be the processing that goes into making peanut butter—the added trans fat, oil, salt, and sugar. But regular nuts are also often eaten with added oil, sugar, and salt.

    Could it just be the peanuts themselves? Technically, they aren’t nuts, so maybe they don’t have the same benefits. But no, a meta-analysis of all such studies found the same nut-like benefits for whole peanuts, but not peanut butter.

    Well, one thing missing from even no-salt, oil-free, sugar-free nut and seed butters is intact cellular structure. As I noted in How Not to Diet, no matter how well we chew whole or chopped nuts, some of the nutrients remain trapped in tiny particles that deliver a bounty of prebiotic goodness to our friendly gut flora. That makes me wonder if there would have been any difference between chunky and smooth peanut butter.

    Meanwhile, there is “compelling evidence” to recommend eating nuts (preferably raw nuts over salted or toasted, and whole or chopped nuts rather than nut butters) at least three times a week to maximize our chance of living a longer and healthier life.

    Doctor’s Note

    The healthiest nut may be walnuts. See Walnuts and Artery Function.

    Won’t nuts make you fat, though? See Nuts and Obesity: The Weight of Evidence.

    I mentioned my book, How Not to Diet, which you can read more about here. (All proceeds from my books are donated to charity.)



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  • Scientists Develop Nasal Spray That May Help Reverse Brain Aging

    Scientists Develop Nasal Spray That May Help Reverse Brain Aging

    Source: Science Daily

    Sometimes, the simplest approach may be the most effective. Scientists at Texas A&M University have developed an experimental nasal spray that could one day help reverse brain aging and restore memory. The promising research is raising hopes for future treatments targeting dementia and age-related cognitive decline.

    The study found that the nasal therapy produced significant and long-lasting effects after just two doses. According to the researchers, the treatment showed highly promising results in brain activity, including reduced inflammation in the brain, improved memory performance, and restored cellular energy systems associated with aging.

    The nasal therapy works by delivering microscopic particles known as extracellular vesicles through the nostrils and into the sinuses. This approach allows the particles to bypass the brain’s protective barrier and travel directly into brain tissue. The spray contains microRNAs—tiny molecules designed by scientists to help regulate genes and cellular activity. These particles specifically target chronic brain inflammation, a condition long associated with aging, dementia, and neurodegenerative disease.

    To provide background on persistent low-grade brain inflammation associated with aging, often referred to as neuroinflammaging, it is an inflammatory process within the brain and spinal cord, primarily driven by immune cells such as microglia and astrocytes. Over time, this process may gradually impair memory, learning, and cognitive flexibility.

    The nasal spray appears to work by reducing and suppressing inflammatory pathways linked to this process while also reviving mitochondrial activity—the energy-producing systems inside cells that tend to weaken with age.

    Beyond reducing neuroinflammaging, researchers said the treatment helped brain cells regain their “spark.” This effect was achieved by lowering oxidative stress and restoring energy production. Behavioral testing also showed significant improvements in memory and object recognition tasks compared with untreated subjects.

    The findings, published in the Journal of Extracellular Vesicles, add to growing scientific interest in whether certain aspects of aging can be slowed—or even partially reversed—at the cellular level. Other recent studies have explored ways to target aging-related inflammation, senescent cells, and metabolic dysfunction to improve long-term brain health.

    Researchers believe the approach could eventually have applications beyond normal aging, including conditions such as Alzheimer’s disease, stroke recovery, and other disorders linked to cognitive decline. They also noted that the therapy produced similar effects across both sexes, something that remains relatively uncommon in biomedical research.

    Humankind has long sought ways to reverse aging, both of the mind and the brain. With the development of this nasal spray therapy—and, hopefully, with more in-depth research, further findings, and additional testing—researchers may have taken a step toward addressing this long-standing challenge. While aging has long been considered unavoidable, this medical breakthrough presents an intriguing possibility: brain aging may not be as irreversible as once believed.

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  • Spinach-Inspired Eye Drops May Offer New Hope for Treating Common Vision Condition

    Spinach-Inspired Eye Drops May Offer New Hope for Treating Common Vision Condition

    Source: Science Alert

    Spinach is best known as a leafy green staple in many kitchens. But what if it could also help treat dry eyes?

    A surprising new development in eye care is exploring spinach as a key ingredient in experimental eye drops that may help manage dry eye disease over time. Researchers are investigating whether compounds derived from the leafy green could support eye health and help protect against cellular damage linked to the condition.

    Researchers from the National University of Singapore, including biomolecular engineer Xing Kuoran, developed the experimental treatment using light-activated structures extracted from spinach leaves. These plant-based photosynthetic components were introduced into lab-grown human eye cells and mice engineered to mimic dry eye disease.

    When exposed to light, the nanoparticles produced NADPH, a molecule that helps cells defend themselves against oxidative stress and inflammation. Researchers say this process may help counter the cellular damage associated with dry eye disease.

    The technology was named LEAF, short for “light-reaction enriched thylakoid NADPH-foundry.” While the findings remain in the early stages of research, scientists believe the approach could eventually lead to a new class of light-powered treatments for eye conditions.

    This emerging approach to dry eye treatment combines plant science with modern medicine in an unusual but promising way. According to biomolecular engineer David Leong Tai Wei, the concept raises the possibility that human cells could one day possess a limited but beneficial form of photosynthetic ability—not only in the eye, but potentially in other parts of the body as well.

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  • Knee Injuries | Nemours KidsHealth

    Knee Injuries | Nemours KidsHealth

    Overview

    What Is a Knee Injury?

    The knee is a joint that joins the thighbone (femur) to the top of the shinbone (tibia). It’s made up of bones; muscles; and tissues called cartilage, ligaments, and tendons. These parts work together to let the legs bend, straighten, and turn.

    A knee injury is damage to one or more parts of the knee. 

    What Are the Types of Knee Injuries?

    Common knee injuries in kids and teens include:

    Signs & Symptoms

    What Are the Signs & Symptoms of a Knee Injury?

    Signs and symptoms of a knee injury depend on the cause. Most kids and teens with knee injuries have pain. The knee may also feel weak or like it’s “giving way” or “locking.” They might not be able to fully bend or straighten the knee, which also might be swollen or bruised.

    Causes & Prevention

    What Causes Knee Injuries?

    Kids and teens may hurt a knee in a fall or accident. Others get overuse knee injuries. These happen when someone trains too much for a sport or makes the same motions over and over with the knee.

    Can Knee Injuries Be Prevented?

    To help prevent knee injuries, make sure kids wear the right protective equipment for sports (like knee pads and shin guards). They also need supportive athletic shoes that are in good condition.

    Explain how to move safely. When jumping, kids should bend their knees while landing. And when changing directions or turning quickly (as in soccer), they can try crouching and bending at the knees and hips. This helps protect against an ACL injury.

    Remind them to warm up before a workout and cool down after it. They can also do regular strength training to support muscles, and stretching or yoga to be more flexible.

    Finally, encourage kids to stay active year-round, even if they’re not playing an organized sport. This can help keep their knees and the rest of them in shape.

    Diagnosis

    How Are Knee Injuries Diagnosed?

    To diagnose a knee injury, doctors ask how it happened and what symptoms it’s causing. They’ll also do an exam where they press on the knee and legs and move them in certain ways. This can help show what part of the knee is hurt.

    They might order imaging tests, like an X-ray to check for injuries to the bones, or a CT scan or an MRI to look inside the knee.

    Treatment & Care

    How Are Knee Injuries Treated?

    Treatment for a knee injury depends on the cause. Follow your doctor’s instructions for what activities are OK. If an activity causes pain, your child should stop, then try it later on or the next day.

    If your doctor says it’s OK, you can give your child acetaminophen or ibuprofen for pain. Follow the label directions for how much to give and how often.

    To help with swelling in the first day or two after the injury, you can:

    • Put ice in a towel on the knee for about 20 minutes every one to two hours.
    • Wrap an elastic bandage around the knee or use a compression sleeve.
    • Raise the knee above the level of the heart.

    Some kids and teens with a knee injury may need physical therapy or surgery.

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