Rising Opioid Addiction: What Is It and How to Treat It


More than 2.5 million Americans are opioid dependent and opioid addiction has tripled over a 10-year period.  As the nation’s fastest growing drug problem, the Obama administration calls opioid addiction an epidemic and a major public health and public safety crisis.  But who is suffering may surprise you.
A new survey conducted by the nonprofit organization National Alliance of Advocates for Buprenorphine Treatment (NAABT) shows that, while drug addiction may start early on in one’s life, it affects people of all ages and economic standing.  And, not so surprisingly close to 60 percent of respondents’ opioid addiction began with treatment of acute or chronic pain. 
The good news is that novel new treatments may help make it easier for people with addictive disorders to go into remission from this potentially deadly disorder because of more convenient formulations and improved side effect profiles.  Experts hope the options will improve treatment compliance and help patients stay off opioids so they can begin the process of rebuilding their lives.
Unfortunately, the survey also showed that 40 percent of patients who were seeking medical treatment for their addiction did not find a physician for weeks or months, and once they did there was a waiting list for 58 percent of respondents and over 25 percent reported obtaining treatment without a prescription.
For anyone struggling with addiction, experts urge them to get help.
Tim Lepak, president of the nonprofit organization National Alliance of Advocates for Buprenorphine Treatment (NAABT)
Richard Soper, MD, JD, MS, FASAM, Diplomat- ABAM; has treated, consulted, advised, taught, mentored and counseled for over eighteen years in private practice, Nashville, Tennessee. Dr. Soper is founding editor and current Editor-in-Chief of the American Society of Addiction Medicine e-weekly news journal with 16,000 subscribers.  His areas of expertise include childhood trauma, psychopharmacology of addiction, the scientific basis of addiction, substance abuse and medical-legal issues of treatment and addiction. He currently serves on several regional and national medical organizations committees and advisory boards.
Click here http://we.tl/GNfQCyS8KA for answers to:
·       What is an opiate and why is it so addictive?
·       Who is suffering from opioid dependence and why the surge in recent years?
·       Why is opioid addiction so difficult to treat?  Why do so many patients relapse?
·       How is opioid dependence treated? What can you tell us about new treatment options?
·       Why is it so difficult for some patients to find doctors who can/will prescribe this new class of drugs?
·       How do you know if you or someone you love is experiencing an active addiction to opioids?
·       What is the first step someone can take if they think they’re experiencing an active addiction to opioids?
·       Where can our viewers/listeners go to for more information?
 Visit www.naabt.org for more tips and information on available resources as well as more detailed survey results. Click here for interview with experts discussing how to overcome opioid dependence:  http://we.tl/GNfQCyS8KA
Stay healthy!  -Maria
 headshot1     MARIA DORFNER is the founder of MedCrunch, a division of Healthy Within Network (HWN).

10 Cold Weather Safety Tips


As temperatures drop this winter, the American Red Cross offers ten steps people can take to stay safe.

1. Layer up! Wear layers of lightweight clothing to stay warm. Gloves and a hat will help prevent losing your body heat.

2. Don’t forget your furry friends. Bring pets indoors. If they can’t come inside, make sure they have enough shelter to keep them warm and that they can get to unfrozen water.

3. Remember the three feet rule. If you are using a space heater, place it on a level, hard surface and keep anything flammable at least three feet away – things such as paper, clothing, bedding, curtains or rugs.

4. Requires supervision – Turn off space heaters and make sure fireplace embers are out before leaving the room or going to bed.

5. Don’t catch fire! If you are using a fireplace, use a glass or metal fire screen large enough to catch sparks and rolling logs.

6. Protect your pipes. Run water, even at a trickle, to help prevent your pipes from freezing. Open the kitchen and bathroom cabinet doors to allow warmer air to circulate around the plumbing. Be sure to move any harmful cleaners and household chemicals out of the reach of children. Keep the garage doors closed if there are water lines in the garage.

7. Better safe than sorry. Keep the thermostat at the same temperature day and night. Your heating bill may be a little higher, but you could avoid a more costly repair job if your pipes freeze and burst.

8. The kitchen is for cooking. Never use a stove or oven to heat your home.

9. Use generators outside. Never operate a generator inside the home, including in the basement or garage.

10. Knowledge is power. Don’t hook a generator up to the home’s wiring. The safest thing to do is to connect the equipment you want to power directly to the outlets on the generator.

For more information on how to stay safe during the cold weather, visit winter storm safety.

We’ll add make sure to use moisturize with SPF.  Snow reflects the sun and you can still get burned by sun or wind. Cover all exposed skin to prevent frostbite.  Drink lots of water to stay hydrated.  Questions? Write to us in comments below.

About the American Red Cross:
The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation’s blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or visit us on Twitter at @RedCross.
About MedCrunch:
MedCrunch covers what’s hot in health for consumers and is a division of Healthy Within Network (HWN).
Maria Dorfner is the founder of Healthy Within Network.  You can follow her @Maria_Dorfner or @DorfnerMaria
A few of her credits include being asked to create and host a health series for NBC Universal, writing and producing 21st Century Medicine documentary series for the Discovery Health Channel, developing, senior producing and co-hosting medical programming for CNBC (her program was the highest revenue generating one for 3 years airing weekly on CNBC), health and special projects producer for NBC Miami, launching CCNS (the Cleveland Clinic News Service), helped launch MedPage Today, Healthology, CNBC and NewsMD Communications, working as a reporter for the nationally-syndicated series, Top Cops on CBS (first reality show) pilot and series, and director of research and producer for Roger Ailes production company.  She is the author of 3 books including Healthy Within.  Her production company, NewsMD provides media training, marketing, publicity and PR services. Her clients have included a Who’s Who in health brands.

Healthy Freedom of Speech by Maria Dorfner


Freedom of Speech is not freedom to bully or to spew vitriol in the name of art.  The majority are screaming we must defend freedom of expression by creating comics and articles that are even more deplorable, crass and disgusting than the first ones. The majority isn’t always right. In fact, there are those in the majority wanting to monetize it and profit from it.  I have to question anyone in media smiling with dollar signs in their eyes immediately after twelve innocent men have been executed. I saw the comics. I have no desire to share them in the name of freedom.  They are not funny.  They do not stand for freedom of speech.  They are cringe worthy, at best.  They gave me that ill feeling I get when I go see a stand-up comic and instead of making people laugh the room gets awkwardly quiet.  We do not kill the comic. But we do hope he will know better when performing his next set.

Not everything  is funny.  All great comics know this. They test things. They push limits and boundaries. A smart comic takes notes of what works and what doesn’t and makes adjustments. A lot of political satire is hilarious.  A lot of it is not.  A lot of it is offensive, disrespectful and trash.  My newsfeed on Facebook is littered with filth from people using freedom of speech as their reason for posting the comics after the shootings in France.  They call those not publishing the comic cowards.

I call them people with good taste, class and self-respect.  It’s also hypocritical to be name calling others with differing views. One of my favorite books on comedy is Wake Me When It’s Funny by Garry Marshall.  That’s how I felt when I viewed the first comic strip. Wake me when it’s funny.  These are senseless killings.  The majority of media outlets jump on the bandwagon of airing these images even when the shooters were still missing.  Click  baiting on social media is desensitizing people to what is respectful and/or truthful.   There is also a lack of accountability for words or images and their power to heal or trigger bad things.  We saw this with peaceful protests that hypocritically chanted unpeaceful words.  Chaplinsky v. New Hampshire (1942) clearly states that so-called “fighting words” to incite a breach of peace are not protected under the First Amendment.

Wouldn’t it be wonderful if cartoonists and writers used their talent to promote peace. Wouldn’t it be wonderful for people of different religions to laugh at the same joke.  Truth and humor can be revealed without bullying. That would take actual thought before putting pen to paper. Lazy comics resort to crude jokes or cursing. Words and images are powerful. They can hurt. Or they can heal. They can do more damage than physical injury.This morning, I saw another horrific image of Obama. That does nothing to change any policy. Satirical cartoons and all comedy is intended to make people laugh and expose a truth.  Although, we all know this can be taken too far. This is the bully we all knew as a kid that uses words, drawings or humor to hurt.

Violence begets violence, even if the first bullet is shot from a pen.


All weapons need to be used responsibly. Responsibility and Freedom are related. This I can say or do whatever I want attitude is as ignorant as a toddler running into traffic. All our freedoms demand self-responsibility. We are seeing a downward spiral in journalism for no other reason than crude shock value. Write and draw whatever you want. You have that right. But do me and those who fought for your right a favor. Think about it first. People fought and died for your right to do that, so don’t abuse it. France and the rest of the world needs to know this will not happen again in the name of ideology while at the same time protecting freedom of speech.  It may be time to revisit what constitutes healthy communication. I may stand alone in this view (which takes more courage than following the masses), but it is people who abuse their own freedoms. Freedoms are privileges. They are a right that come with responsibility.  It’s a responsibility to know the difference between healthy v. hurtful humor.  There is a difference.  And most people understand this.


When tragedies happen there is a bigger message. It is not who wins and who loses. There are no winners. Twelve men are dead. Twelve.  The same number of apostles who were messengers.  The message is not one of censorship. It is one of respect when speaking and writing.

The pen is mightier…use it wisely.



What are Human Rights?  Here’s a refresher. 

The 1993 World Conference on Human Rights affirmed the crucial connection between international peace and security and the rule of law and human rights, placing them all within the larger context of democratization and development.

The United Nations is increasingly combining efforts to prevent or end conflicts with measures aimed at reducing human rights abuses in situations of internal violence. Special emphasis is placed on ensuring the protection of minorities, strengthening democratic institutions, realizing the right to development and securing universal respect for human rights. — United Nations, “Human Rights Today: A United Nations Priority.”

Human rights are the basic rights and freedoms to which all humans are considered entitled: the right to life, liberty, freedom of thought and expression, and equal treatment before the law, among others. These rights represent entitlements of the individual or groups vis-B-vis the government, as well as responsibilities of the individual and the government authorities.

Such rights are ascribed “naturally,” which means that they are not earned and cannot be denied on the basis of race, creed, ethnicity or gender.[1] These rights are often advanced as legal rights and protected by the rule of law. However, they are distinct from and prior to law, and can be used as standards for formulating or criticizing both local and international law. It is typically thought that the conduct of governments and military forces must comply with these standards.

Various “basic” rights that cannot be violated under any circumstances are set forth in international human rights documents such as the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, and the International Covenant on Civil and Political Rights. The rights established by these documents include economic, social, cultural, political and civil rights.[2]

While human rights are not always interpreted similarly across societies, these norms nonetheless form a common human rights vocabulary in which the claims of various cultures can be articulated. The widespread ratification of international human rights agreements such as those listed above is taken as evidence that these are widely shared values.[3] Having human rights norms in place imposes certain requirements on governments and legitimizes the complaints of individuals in those cases where fundamental rights and freedoms are not respected.[4] Such norms constitute a standard for the conduct of government and the administration of force. They can be used as “universal, non-discriminatory standards” for formulating or criticizing law and act as guidelines for proper conduct.[5]

Many conflicts are sparked by a failure to protect human rights, and the trauma that results from severe human rights violations often leads to new human rights violations. As conflict intensifies, hatred accumulates and makes restoration of peace more difficult. In order to stop this cycle of violence, states must institute policies aimed at human rights protection. Many believe that the protection of human rights “is essential to the sustainable achievement of the three agreed global priorities of peace, development and democracy.”[6] Respect for human rights has therefore become an integral part of international law and foreign policy. The specific goal of expanding such rights is to “increase safeguards for the dignity of the person.”[7]

Despite what resembles a widespread consensus on the importance of human rights and the expansion of international treaties on such matters, the protection of human rights still often leaves much to be desired. Although international organizations have been created or utilized to embody these values, there is little to enforce the commitments states have made to human rights. Military intervention is a rare occurrence. Sanctions have a spotty track record of effectiveness. Although not to be dismissed as insignificant, often the only consequence for failing to protect human rights is “naming and shaming.”

Interventions to Protect Human Rights
“Numerous reports, compiled by the United Nations (UN) and various human rights organizations, have cited gross violations of human rights in Africa, especially within the context of internal armed conflicts. In light of this scenario, the question of whether or not a right to humanitarian intervention exists has become even more pertinent.” – Kithure Kindiki, “Gross Violations of Human Rights

To protect human rights is to ensure that people receive some degree of decent, humane treatment. Because political systems that protect human rights are thought to reduce the threat of world conflict, all nations have a stake in promoting worldwide respect for human rights.[8] International human rights law, humanitarian intervention law and refugee law all protect the right to life and physical integrity and attempt to limit the unrestrained power of the state. These laws aim to preserve humanity and protect against anything that challenges people’s health, economic well-being, social stability and political peace. Underlying such laws is the principle of nondiscrimination, the notion that rights apply universally.[9]

Responsibility to protect human rights resides first and foremost with the states themselves. However, in many cases public authorities and government officials institute policies that violate basic human rights. Such abuses of power by political leaders and state authorities have devastating effects, including genocide, war crimes and crimes against humanity. What can be done to safeguard human rights when those in power are responsible for human rights violations? Can outside forces intervene in order to protect human rights?

Humanitarian Intervention

In some cases, the perceived need to protect human rights and maintain peace has led to humanitarian intervention. There is evidence that internationally we are moving towards the notion that governments have not only a negative duty to respect human rights, but also a positive duty to safeguard these rights, preserve life and protect people from having their rights violated by others.[10] Many believe that states’ duties to intervene should not be determined by proximity, but rather by the severity of the crisis.

There are two kinds of humanitarian intervention involving the military: unilateral interventions by a single state, and collective interventions by a group of states.[11] Because relatively few states have sufficient force and capacity to intervene on their own, most modern interventions are collective. Some also argue that there is a normative consensus that multilateral intervention is the only acceptable form at present.[12]

There is much disagreement about when and to what extent outside countries can engage in such interventions. More specifically, there is debate about the efficacy of using military force to protect the human rights of individuals in other nations. This sort of debate stems largely from a tension between state sovereignty and the rights of individuals.

Some defend the principles of state sovereignty and nonintervention, and argue that other states must be permitted to determine their own course. They point out that the principles of state sovereignty and the non-use of force are enshrined in the charter of the United Nations, which is regarded as an authoritative source on international legal order.[13]

This argument suggests that different states have different conceptions of justice, and international coexistence depends on a pluralist ethic whereby each state can uphold its own conception of the good.[14] Among this group, there is “a profound skepticism about the possibilities of realizing notions of universal justice.”[15] States that presume to judge what counts as a violation of human rights in another nation interfere with that nation’s right to self-determination. Suspicions are further raised by the inconsistent respect for sovereignty (or human rights for that matter); namely, the Permanent Members of the UN Security Council have tremendous say over application of international principles. In addition, requiring some country to respect human rights is liable to cause friction and can lead to far-reaching disagreements.[16] Thus, acts of intervention may disrupt interstate order and lead to further conflict.[17] Even greater human suffering might thereby result if states set aside the norm of nonintervention.

Others point out that humanitarian intervention does not, in principle, threaten the territorial integrity and political independence of states. Rather than aiming to destabilize a target state and meddle in its affairs, humanitarian intervention aims to restore rule of law and promote humane treatment of individuals.[18]

Furthermore, people who advocate this approach maintain that “only the vigilant eye of the international community can ensure the proper observance of international standards, in the interest not of one state or another but of the individuals themselves.”[19] They maintain that massive violations of human rights, such as genocide and crimes against humanity, warrant intervention, even if it causes some tension or disagreement. Certain rights are inalienable and universal, and “taking basic rights seriously means taking responsibility for their protection everywhere.”[20]

If, through its atrocious actions, a state destroys the lives and rights of its citizens, it temporarily forfeits its claims to legitimacy and sovereignty.[21] Outside governments then have a positive duty to take steps to protect human rights and preserve lives. In addition, it is thought that political systems that protect human rights reduce the threat of world conflict.[22] Thus, intervention might also be justified on the ground of preserving international security, promoting justice and maintaining international order.

Nevertheless, governments are often reluctant to commit military forces and resources to defend human rights in other states.[23] In addition, the use of violence to end human rights violations poses a moral dilemma insofar as such interventions may lead to further loss of innocent lives.[24] Therefore, it is imperative that the least amount of force necessary to achieve humanitarian objectives be used, and that intervention not do more harm than good. Lastly, there is a need to ensure that intervention is legitimate, and motivated by genuine humanitarian concerns. The purposes of intervention must be apolitical and disinterested. However, if risks and costs of intervention are high, it is unlikely that states will intervene unless their own interests are involved.[25] For this reason, some doubt whether interventions are ever driven by humanitarian concerns rather than self-interest.

Many note that in order to truly address human rights violations, we must strive to understand the underlying causes of these breaches. These causes have to do with underdevelopment, economic pressures, social problems and international conditions.[26] Indeed, the roots of repression, discrimination and other denials of human rights stem from deeper and more complex political, social and economic problems. It is only by understanding and ameliorating these root causes and strengthening both democracy and civil society that we can truly protect human rights.

Restoring Human Rights in the Peacebuilding Phase

In the aftermath of conflict, violence and suspicion often persist. Government institutions and the judiciary, which bear the main responsibility for the observation of human rights, are often severely weakened by the conflict or complicit in it. Yet, a general improvement in the human rights situation is essential for rehabilitation of war-torn societies. Many argue that healing the psychological scars caused by atrocities and reconciliation at the community level cannot take place if the truth about past crimes is not revealed and if human rights are not protected. To preserve political stability, human rights implementation must be managed effectively. Issues of mistrust and betrayal must be addressed, and the rule of law must be restored. In such an environment, the international community can often play an important supporting role in providing at least implicit guarantees that former opponents will not abandon the peace.[27] Because all international norms are subject to cultural interpretation, external agents that assist in the restoration of human rights in post-conflict societies must be careful to find local terms with which to express human rights norms. While human rights are in theory universal, ideas about which basic needs should be guaranteed vary according to cultural, political, economic and religious circumstances. Consequently, policies to promote and protect human rights must be culturally adapted to avoid distrust and perceptions of intrusion into internal affairs.

To promote human rights standards in post-conflict societies, many psychological issues must be addressed. Societies must either introduce new social norms or reestablish old moral standards. They must design programs that will both address past injustice and prevent future human rights violations. Human rights must not become just another compartmentalized aspect of recovery, but must be infused throughout all peacebuilding and reconstruction activities. Democratization implies the restoration of political and social rights. Government officials and members of security and police forces have to be trained to observe basic rights in the execution of their duties. Finally, being able to forgive past violations is central to society’s reconciliation.

Rights Protection Methods

Various methods to advance and protect human rights are available:

  • During violent conflict, safe havens to protect refugees and war victims from any surrounding violence in their communities can sometimes help to safeguard human lives.

As violent conflict begins to subside, peacekeeping strategies to physically separate disputants and prevent further violence are crucial. These measures, together with violence prevention mechanisms, can help to safeguard human lives. Limiting the use of violence is crucial to ensuring groups’ survival and creating the necessary conditions for a return to peace.

  • Education about human rights must become part of general public education. Technical and financial assistance should be provided to increase knowledge about human rights. Members of the police and security forces have to be trained to ensure the observation of human rights standards for law enforcement. Research institutes and universities should be strengthened to train lawyers and judges. To uphold human rights standards in the long-term, their values must permeate all levels of society.
  • Dialogue groups that assemble people from various ethnicities should be organized to overcome mistrust, fear and grief in society. Getting to know the feelings of ordinary people of each side might help to change the demonic image of the enemy group. Dialogue also helps parties at the grassroots level to discover the truth about what has happened, and may provide opportunities for apology and forgiveness.
  • External specialists can offer legislative assistance and provide guidance in drafting press freedom laws, minority legislation and laws securing gender equality. They can also assist in drafting a constitution, which guarantees fundamental political and economic rights.
  • Those who perpetrate human rights violations find it much easier to do so in cases where their activities can remain secret. International witnesses, observers and reporters can exert modest pressure to bring violations of human rights to public notice and discourage further violence. Monitors should not only expose violations, but also make the public aware of any progress made in the realization of human rights. In order to ensure that proper action is taken after the results of investigations have been made public, effective mechanisms to address injustice must be in place.
  • Truth commissions are sometimes established after a political transition. To distinguish them from other institutions established to deal with a legacy of human rights abuses, truth commissions can be understood as “bodies set up to investigate a past history of violations of human rights in a particular country — which can include violations by the military or other government forces or armed opposition forces.”[28] They are officially sanctioned temporary bodies that investigate a pattern of abuse in the past. Their goal is to uncover details of past abuses as a symbol of acknowledgment of past wrongs. They typically do not have the powers of courts, nor should they, since they do not have the same standards of evidence and protections for defendants. As such, they usually do not “name names” of those responsible for human rights abuses, but rather point to institutional failings that facilitated the crimes. Finally, they conclude with a report that contains recommendations to prevent a recurrence of the crimes and to provide reparations to victims.
  • International war crimes tribunals are established to hold individuals criminally responsible for violations of international human rights law in special courts. The international community rarely has the will to create them. As the experiences with the war tribunals for Rwanda and Yugoslavia indicate, even where they are created, they are imperfect. They cannot hold all perpetrators accountable and typically aim for the top leadership. However, it remains difficult to sentence the top-level decision-makers, who bear the ultimate responsibility for atrocities. They often enjoy political immunity as members of the post-conflict government. Incriminating a popular leader might lead to violent protests and sometimes even to relapse into conflict. Leaders may be necessary to negotiate and implement a peace agreement.
  • Various democratization measures can help to restore political and social rights. For sustainability and long-term viability of human rights standards, strong local enforcement mechanisms have to be established. An independent judiciary that provides impartial means and protects individuals against politically influenced persecution must be restored. Election monitors who help to guarantee fair voting procedures can help to ensure stable and peaceful elections. And various social structural changes, including reallocations of resources, increased political participation, and the strengthening of civil society can help to ensure that people’s basic needs are met.
  • Humanitarian aid and development assistance seeks to ease the impact that violent conflict has on civilians. During conflict, the primary aim is to prevent human casualties and ensure access to basic survival needs. These basics include water, sanitation, food, shelter and health care. Aid can also assist those who have been displaced and support rehabilitation work. Once conflict has ended, development assistance helps to advance reconstruction programs that rebuild infrastructure, institutions and the economy. This assistance helps countries to undergo peaceful development rather than sliding back into conflict.

The expansion of international human rights law has often not been matched by practice. Yet, there is growing consensus that the protection of human rights is important for the resolution of conflict and to the rebuilding process afterward. To achieve these goals, the international community has identified a number of mechanisms both to bring an end to human rights abuses and to establish an environment in which they will be respected in the future. They are not alternatives, but each provides important benefits in dealing with the past and envisioning a brighter future.

[1] Little, David. “Universality of Human Rights,” [available at: http://www.usip.org/research/rehr/universality.html] (no longer available as of March 5th 2013)

[2] endnote goes here**

[3] At the same time, some would argue that the hegemonic power of the West, whether through normative pressure or economic, is responsible for widespread ratification.

[4] Antonio Cassese, Human Rights in a Changing World. (Philadelphia: Temple University Press, 1990), 2.

[5] Little, “The Nature and Basis of Human Rights,” United States Institute of Peace.

[available at: http://www.usip.org/research/rehr/natbasis.html] (no longer available as of March 5th 2013)

[6] “Human Rights Today: A United Nations Priority,” The United Nations, 2000. [available at: http://www.un.org/rights/HRToday/]

[7] Cassese, 3.

[8] Cassese, 58.

[9] Don Hubert and Thomas G. Weiss et al. The Responsibility to Protect: Supplementary Volume to the Report of the International Commission on Intervention and State Sovereignty. (Canada: International Development Research Centre, 2001), 144.

[10] Hubert and Weiss, et al., 147.

[11] Kithure Kindiki, “Gross Violations of Human Rights in Internal Armed Conflicts in Africa: Is There a Right of Humanitarian Intervention?” in Conflict Trends, no. 3, 2001. ACCORD.

[12] Martha Finnemore, The purpose of intervention: changing beliefs about the use of force. (Ithaca, Cornell University Press, 2003), chapter 3.

[13] Kithure Kindiki, “Gross Violations of Human Rights”

[14] Hubert and Weiss, et al., 132.

[15] Hubert and Weiss, et al., 133.

[16] Cassese, 58.

z[17] Hubert and Weiss, et al., 133.

[18] Kithure Kindiki, “Gross Violations of Human Rights”

[19] Cassese, 55-6.

[20] Hubert and Weiss, et al., 135.

[21] Hubert and Weiss, et al., 136.

[22] Cassese, 58.

[23] Hubert and Weiss, et al., 136.

[24] Hubert and Weiss, et al., 137.

[25] Hubert and Weiss, et al., 141.

[26] Cassese, 59.

[27] See for example, Barbara F. Walter, Committing to peace: the successful settlement of civil wars. (Princeton, N.J., Princeton University Press: 2002).

[28] Priscilla B. Hayner, (1994). “Fifteen Truth Commissions – 1974 to 1994: A Comparative Study.” Human Rights Quarterly. 16(4): 604.

Maiese, Michelle. “Human Rights Protection.” Beyond Intractability. Eds. Guy Burgess and Heidi Burgess. Conflict Information Consortium, University of Colorado, Boulder. Posted: June 2004 <http://www.beyondintractability.org/essay/human-rights-protect>

Sympathies to the victims in France, their families and loved ones.  All lives matter.

Keep Your Teeth Healthy As You Age!


Fortunately, my family won the genetic lottery when it comes to teeth. My parents both have perfect smiles and good health.


And some say I have a trillion dollar smile.  But what happens to our smiles as we age?


Does everyone’s teeth eventually fall out?


Most people assume losing teeth are a natural part of aging. Not so. Adult teeth don’t fall out from natural causes.  Repeat.


Five things cause teeth to fall out:  1. Trauma 2. Severe illness (diabetes, cancer, osteomyelitis or autoimmune diseases)


3. Gum disease 4. Lifestyle, what you eat and drink along with your oral hygiene and 5. Drugs such as heroin and methamphetamine (also called speed, ice or meth), cocaine, crack cause severe tooth decay and teeth falling out in a very short amount of time.


Things that are harmful for your teeth acidic foods and drinks like soda, some mouth fresheners, some tooth whiteners and a lack of vitamin C and K. Foods high in sugar (sweets) and carbs can also cause tooth decay. You should see your dentist if your gums are bleeding or you’re feeling any pain or sensitivity, as that may be an early warning sign of gum disease.


Teeth do begin to age and shift in your mid-20s. In your 30s, you begin to lose bone, which makes gums recede.


In your 40s and 50s, top teeth will appear shorter as the lower teeth shift. Chewing, grinding and stress all affect your teeth. Women in perimenopause and menopause will have more stress than usual due to sleep problems as will men with high levels of stress.


A lot of stress goes to people’s jaws, which causes grinding and pressure on back teeth. Tooth grinding is also known as bruxism and can cause chipped, fractured and worn tooth enamel or increased sensitivity –even headaches.


If you have stress in your life, try to alleviate it with getting rest, exercise and fresh air. You can also get fitted for a night guard. This prevent clenching or grinding your teeth in your sleep.


Surprising new information from a recent issue of the Journal of Dental Research indicates that seniors who sleep in dentures are at a higher risk of developing pneumonia because bacteria from the mouth can be inhaled into the lungs.


The American Dental Association warns bacteria allowed to linger in the mouth can cause tooth decay, gum disease and tooth loss.


If you want to keep your natural teeth forever, it’s important to take care of them now.


There is a higher risk of dental disease leading to other health problems as we age.


Seniors may need to enlist family members and other loved ones to assist with dental hygiene.


The ADA encourages caregivers, whether the seniors are at home or in a nursing home, to supervise or aid in maintaining seniors’ dental health by making sure they brush twice a day, floss once a day, eat a healthy diet and visit the dentist regularly.


Hearing impairment is common among seniors.


For this reason, a caregiver can play an important communications role between a senior and the dentist by helping them prepare questions prior to their dental appointment.


Dentists providing written instructions helps in communicating with seniors too.


The ADA provides dental health tips for seniors and their caregivers


Judith Jones, DDS, from the American Dental Association is the director of the Center for Clinical Research at the University Goldman School of Dental Medicine in Boston. She is also a published researcher and serves on the editorial boards of The Journal of the American Dental Association.


Turns out, the same advice dentists gave you when you were a kid still holds true when you’re a senior.


BRUSH TWICE A DAY (Rinse with water anytime you eat)


FLOSS ONCE A DAY (My favorite are floss toothpicks. Portable and super easy to use)


EAT HEALTHY (Best foods for teeth are apples, cheese, yogurt, foods high in calcium)




Click here for Dr. Judith Jones answers to the following questions: http://bcove.me/v3of9lb0

•What are some specific oral health concerns of older Americans?
•What can caregivers do to help seniors maintain their dental health?
•Why is it important for people with dentures to visit their dentist?
•Are there any dental products that are particularly suited for the needs of older people?

Dr. Jones offers the following Dental Tips for caregivers:

Encourage seniors to:

  • Use an electric toothbrush twice a day with a fluoride toothpaste
  • Use an interdental cleaner to floss teeth once  day
  • Eat a healthy diet
  • Tell dentist if they develop dry mouth, which can lead to tooth decay
  • Clean gums daily and remove dentures at night if they wear them

INTERVIEW WITH DR. JUDITH JONES: http://bcove.me/v3of9lb0


For More Information including the ADA® Find-a-Dentist™ tool:




MANI1       MARIA DORFNER is the founder of MedCrunch.


Kidney Disease: More Common Than You Think


Twenty-six million Americans suffer from some sort of kidney disease –more people are unaware they suffer from it. Kidney disease kills 90,000 Americans each year, more than breast and prostate cancer combined.


One in three American adults are currently at risk for developing kidney disease, and many are unaware of it.


One of the lesser known diseases that injures the kidney is called vasculitis.




It can cause a need for a kidney transplant if it goes untreated.


We will learn more about it today in my interview with Dr. Giullian.


Jeffrey A. Giullian, MD/MBA, a nephrologist and partner at South Denver Nephrology Associates, in Denver, Colorado, practices both general and transplant nephrology, including care of patients with chronic kidney disease (CKD), end stage renal disease (ESRD), immunosuppression, hypertension and kidney stones.


In addition to his clinical responsibilities, he has an active research clinic focusing on phase 2 and 3 clinical trials.


He is active in renal research for patients with electrolyte abnormalities, polycystic kidney disease and diabetes.


Currently, Dr. Giullian is the Chairman of Medicine at Castle Rock Adventist Hospital, the Chief of Nephrology at Swedish Hospital, and a member of the Porter Hospital Kidney and Pancreas Transplant team. He is also a Group Medical Director for the APEX group of DaVita Dialysis covering dialysis centers in nine states.


After earning a MD from Vanderbilt School of Medicine in 2001, Dr. Giullian completed an internal medicine residency at Baylor College of Medicine in Houston, TX. He served as Baylor’s Chief Medical Resident from 2004-2005.


After completing his residency, he returned to Vanderbilt University Medical center for his nephrology training. During this time, from 2006-2007, he was Vanderbilt University Medical Center’s Chief Fellow for the division of nephrology. In addition to his MD degree, Dr. Giullian holds a MBA degree from the University of Colorado at Denver.


Learn about vasculities at red link below.

Click here for Interview with Dr. Giullian:

MariaDorfner MARIA DORFNER is the founder of MedCrunch.

Cynthia’s Story: Helping Women Who Live with Chronic Pain


Cynthia Toussiant is a former ballerina and actress (FAME) who has suffered with chronic pain disorder for more than thirty years.


The strong, graceful ballerina’s life changed when a minor ballet injury triggered chronic pain.


The chronic pain left the strong and graceful ballerina mute and in a wheelchair for years.


She visited countless physicians and was continually told it was all in her head.


Her husband, John Garrett, who has been with her for 34 years helped her get to the bottom of it.


Turns out, Cynthia had Complex Regional Pain Syndrome (CRPS) for 32 years. She later developed Fibromyalgia and Chronic Fatigue Syndrome.


I talk to Cynthia and John about it: https://www.hightail.com/download/UlRUTGs2bEpLVldjZDhUQw


According to the Mayo Clinic, Complex Regional Pain Syndrome is an uncommon form of chronic pain that usually affects an arm or a leg. Complex regional pain syndrome typically develops after an injury, surgery, stroke or heart attack, but the pain is out of proportion to the severity of the initial injury.


The cause of complex regional pain syndrome isn’t clearly understood. Treatment for complex regional pain syndrome is most effective when started early. In such cases, improvement and even remission are possible.


Signs and symptoms of complex regional pain syndrome include:
•Continuous burning or throbbing pain, usually in your arm, leg, hand or foot
•Sensitivity to touch or cold
•Swelling of the painful area
•Changes in skin temperature — at times your skin may be sweaty; at other times it may be cold
•Changes in skin color, which can range from white and mottled to red or blue
•Changes in skin texture, which may become tender, thin or shiny in the affected area
•Changes in hair and nail growth
•Joint stiffness, swelling and damage
•Muscle spasms, weakness and loss (atrophy)
•Decreased ability to move the affected body part

Symptoms may change over time and vary from person to person. Most commonly, pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) occur first.

Over time, the affected limb can become cold and pale and undergo skin and nail changes as well as muscle spasms and tightening. Once these changes occur, the condition is often irreversible.

Complex regional pain syndrome occasionally may spread from its source to elsewhere in your body, such as the opposite limb. The pain may be worsened by emotional stress.

In some people, signs and symptoms of complex regional pain syndrome go away on their own. In others, signs and symptoms may persist for months to years. Treatment is likely to be most effective when started early in the course of the illness.


If you experience constant, severe pain that affects a limb and makes touching or moving that limb seem intolerable, see your doctor to determine the cause. It’s important to treat complex regional pain syndrome early.

FOR MORE INFORMATION VISIT THE MAYO CLINC AT: http://www.mayoclinic.org/diseases-conditions/complex-regional-pain-syndrome/basics/definition/con-20022844


Once Cynthia and John learned more about it, they rechanneled their efforts to help other women.



Since 1997, she has been a leading advocate for women in pain. Cynthia gave testimony at two California Senate hearings. The first was dedicated to CRPS awareness. The second explored the chronic under treatment of and gender bias toward women in pain. Both of these efforts were the first of their kind in the nation.

Cynthia founded For Grace to raise awareness about CRPS and all women in pain.

In 2006, Toussaint ran for the California State Assembly to bring attention to her CRPS Education Bill that Governor Schwarzenegger vetoed after she got it to his desk in its first year. Her current Step Therapy bill will reform an unethical prescription practice used by the health insurance industry to save money in a way that increases the suffering of California pain patients.


Toussaint was the first CRPS sufferer to be featured in the New York Times, Los Angeles Times and on the Public Broadcasting System and National Public Radio. She is a consultant for The Discovery Channel, ABC News, FOX News, the National Pain Report and PainPathways, the official magazine of the World Institute of Pain. Also, she is a guide and guest contributor for Maria Shriver’s Architects of Change website. Her many speaking engagements include the National Institutes of Health and Capitol Hill.


She is the author of Battle for Grace: A Memoir of Pain, Redemption and Impossible Love. Also, Toussaint is experiencing her first-ever partial CRPS remission largely due to the narrative therapy of writing this book.

Toussaint continues to be a leading advocate for health care reform in California. She was instrumental in changing public opinion which sparked sweeping HMO reform legislation that was signed by Governor Gray Davis in 1999. Her focus has now shifted to creating a single-payer, universal health care plan in California that would provide a model for the rest of the country.

Cynthia’s husband, John serves as Director at For Grace and was instrumental in launching the organization in April 2002 along with his partner Cynthia Toussaint, who has suffered with CRPS (and later other over-lapping auto-immune conditions) for 32 years. Garrett has been partner and caregiver to Toussaint for 34 years. He has done extensive research about the gender disparity toward women in pain, compiling a comprehensive library on that issue along with specific chronic pain conditions.


Garrett has assisted Toussaint in all aspects of media relations and advocacy regarding CRPS awareness and the pain gender divide. His work focuses on speech presentation, grant writing, research, media outreach and the development of branding strategies. Garrett has also advised California’s Department of Managed Health Care and other state agencies regarding pain management practices in the HMO industry.


Commenting on her long-term partnership with Garrett, Toussaint says, “My story as a woman in pain is also a love story because John’s support has been total and unwavering. Without his loving presence in my life, I wouldn’t be here.”

Garrett made numerous writing contributions in Toussaint’s memoir, Battle for Grace: A Memoir of Pain, Redemption and Impossible Love. He candidly shares the virtues and challenges of the caregiving experience.





Elizabeth Taylor Quote on Living with Pain

Women with Chronic Pain, please visit:

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Angelina Jolie Unbroken by Chickenpox

Angelina Jolie

Jolie announces on YouTube she has chickenpox. The beautiful actress/director/philanthropist spoke in disbelief at the timing, but with a healthy attitude saying, “…such is life.” She had to cancel promotional events and attending the premiere of her film, Unbroken, which opens Christmas:

“I just wanted to be clear and honest about why I would be missing the Unbroken events in the next few days, which is that I found out last night that I have chicken pox,” she says in the video, posted to YouTube. “So, I will be home itching and missing everyone and I can’t believe it because this film means so much to me. I just can’t believe it, but such is life. There it is. Send everyone my love and I hope everything goes well!”


We wanted to give Jolie some Health tips to help her get through this.


The most important thing Jolie can do is not itch and leave the blisters UNBROKEN:









Since chickenpox is highly contagious she needs to stay away from hubby (ouch again!) and all their kids for at least two weeks. I don’t know who in her family has had it already or not, but you can get it again. It will be milder and symptoms will not last as long the second time. It’s still extremely uncomfortable.


I recall getting chickenpox as an adult myself. Insanely itchy. I looked like a monster. I slept with Calamine lotion all over me. My husband was supposed to stay away from me, but he insisted on staying by my side. I’m sure Brad is going to have an even tougher time.


I felt like Lucille Ball in that episode when she got a bad sunburn right before a big show. Angelina Jolie is probably feeling that way right now.


Lucy ended up going to the show. Hilarity ensues because she’s in great pain as people keep tapping her on the shoulder. Jolie made the healthy choice!


The next hardest part will be trying not to itch. We researched the best remedies.


When I was a kid, calamine lotion was used.


Today, people recommend the following anti-itch natural remedies:

OATMEAL – used in a bath (details below)
BROWN VINEGAR – also used in a bath (details below)
BAKING SODA – Stir one-half tablespoon of baking soda in a glass of water. Apply to affected areas with sponge. Allow it to dry.
HONEY – (details below)
CARROTS AND CORIANDER SOUP – Boil 1 cup of chopped carrots + 1/2 cup of fresh coriander leaves, Strain, Cool and drink once a day.
INDIAN LILAC – Take a handful of neem leaves, crush them and apply the paste on the affected areas, or apply in bath.






Oatmeal Bath

1. Grind 2 cups of oatmeal into a fine powder. Place it in 1/2 gallon of water. Let it sit 15 min.

2. Pour that into a cloth bag. Secure tightly. Drop it into tub of warm water. Swirl it around until water becomes milky in color. Soak in it for as long as it feels soothing and relieves itching.

Brown Vinegar

Add one-half cup of brown vinegar to lukewarm bathwater. Soak in it as long as needed.

Pure Honey

1. Place on affected areas two or three times daily.


I am a huge fan of AVEENO products. They have what looks like a modern day Calamine lotion, although I would still pick up the old kind too:





Chickenpox is caused by varicella zoster virus. It is usually mild unless person has impaired immune system.


Almost everyone gets chickenpox by adulthood.



Chickenpox has a characteristic itchy rash which forms blisters that dry and become scabs in 4�5 days. An infected person may have anywhere from only a few lesions to more than 500 blisters on their body during an attack (average 300�-400).



The rash may be the first sign of illness, sometimes coupled with fever and general malaise (“feeling lousy”), especially in adults.


Chickenpox is highly contagious. The virus spread from person to person by direct contact, or through the air. Approximately 90% of persons in a household who have not had chickenpox will get it if exposed to an infected family member.


Chickenpox develops within 10-21 days after contact with an infected person.


Chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs.
Adults are more likely to have a more serious case of chickenpox with a higher rate of complications and death.


Every year there are approximately 5,000-9,000 hospitalizations and 100 deaths from chickenpox in the United States.


Cases of disease due to the natural virus that may occur in a small proportion of vaccinees (people who have had the vaccine) are typically very mild with less than 50 skin blisters and no fever.

More than 6 million doses of varicella vaccine have been given since it was licensed in March 1995.
The Centers for Disease Control (CDC) recommends that all children be routinely vaccinated at 12-18 months of age and that all susceptible children receive the vaccine before their 13th birthday.

The vaccine is also approved for susceptible adolescents and adults especially those with close contact with persons at high risk for serious complications (e.g., healthcare workers, family contacts of immunocompromised persons).

A history of chickenpox is considered adequate evidence of immunity.


A blood test is available to test immunity in persons who are uncertain of their history or who have not had chickenpox. Many of these persons will find that they are immune when tested and thus will not need to be vaccinated.


Effective medications (e.g., acyclovir) are available to treat chickenpox in healthy and immunocompromised persons (e.g, those with cancers, HIV/AIDS, receiving medications that depress the immune system).

Varicella zoster immune globulin (VZIG), a type of immune globulin made from plasma from healthy, volunteer blood donors with high levels of antibody to the varicella zoster virus, is recommended after exposure for persons at high risk for complications (e.g., immunocompromised persons, pregnant women, premature infants <28 weeks gestation or < 1000 grams at birth and premature infants whose mothers are not immune).

(source: CDC)


According to WebMD, all adults who have never had chickenpox or received the vaccination should be vaccinated against it. Two doses of the vaccine should be given at least four weeks apart.

WebMD says if you’ve never had chickenpox or been vaccinated and you are exposed to chickenpox, being vaccinated right away will greatly reduce your risk of getting sick. Studies (they do not indicate which studies) have shown that vaccination within three days of exposure is 90% effective at preventing illness; vaccination within five days of exposure is 70% effective. If you do get sick, the symptoms will be milder and shorter in duration.


Call the Vaccine Adverse Event Reporting System at 1-800-822-7967 and seek medical attention.


You should not be vaccinated against chickenpox if you:

•Are moderately to severely ill at the time of vaccination
•Are pregnant (women should not become pregnant for one month after receiving the chickenpox vaccine)
•Have ever had an allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of chickenpox vaccine

These people should check with their doctor about getting the chickenpox vaccine:

•Patients undergoing chemotherapy or radiation for cancer
•People taking steroid drugs
•People with HIV or another disease that compromises the immune system
•Patients who recently had a blood transfusion or received other blood products


The worst symptoms will usually subside in two weeks, but you need about a month after any virus to build up your immune system. Remember, you’re losing sleep when symptoms are at their worst, which can wreak havoc on your already compromised system. The worst symptoms include fever, fatigue, loss of appetite, along with irritability and sleeplessness that come from the intense itching. It can hurt when you can’t find relief. It’s also difficult you feel unsightly because of them. It will subside.



Questions? Feel free to send them to maria.dorfner@yahoo.comJOLIE1

Hope this helps. It has to be extremely frustrating for this to happen right before a big event, and after having worked so hard on it.


Angelina Jolie still looks better with chicken pox than most folks look on a red carpet. Sometimes, these things are natures way of telling us we need to stop and rest. Wishing her the best and a healthy, happy and humor-filled recovery.

Maria :-)

logo2MEDCrunch is a division of Healthy Within Network. MEDCrunch blog is designed for educational purposes only. It is not intended to serve as medical advice. The information provided on this site is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.

MariaDorfner    MEDCrunch was created by veteran health and television producer, Maria Bianco Dorfner.  She founded NewsMD in 2000, a production company specializing in health stories.  Maria created HEALTHCARE CONSUMERS and HEALTHY LIVING in 1993 and co-anchored it for 3 years. She pitched the program to CNBC (which he helped launch in 1989) and it aired weekly nationally.  She went on to develop five more health series for the cable network. She also wrote, produced and directed 21st CENTURY MEDICINE for DISCOVERY HEALTH CHANNEL. She has interviewed a Who’s Who in pioneering medical discoveries and has specialized in health for 22 of the 30 years she has worked in Media.  She is the author of HEALTHY WITHIN: A Story About Loss and Gain. She is the founder of Healthy Within Network (HWN), a 24-hour health channel that will focus on positive news stories around the world and health, wellness and beauty from the inside out. Her stories have programs have won multiple awards including a Freddie for Excellence in Health Reporting and a Media Recognition Award from American Heart Association for her heart smart series. She is in Who’s Who in American Women.  Most recently, she created HEALTHY WITHIN pilot for NBC network at their request.

She can be reached at maria.dorfner@yahoo.com

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