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Write a brief paragraph summarizing the source and stating why it could make a good topic for the synthesis and response assignment. Add a link by clicking the tiled field and selecting "link."
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Organ transplantation is a medical procedure in which doctors harvest a particular organ, such as a heart, liver, or kidney, from a donor and use it to replace a critically damaged or failing counterpart organ in a patient's body. The organs used in transplants are sourced through organ donation, which refers to processes through which individuals permit medical professionals to harvest their organs for use in transplants. Some donations come from living patients. The majority of donations, however, come from deceased individuals whose organs are healthy enough to be viable for transplantation.

The first successful organ transplant surgery took place in 1954 when doctors replaced a patient's failing kidney with a healthy kidney from the patient's twin brother. In the 1960s surgeons reached new milestones with the first simultaneous transplantation of a kidney and a pancreas in 1966, the first successful liver transplant in 1967, and the first successful heart transplant in 1968. Doctors continued to achieve breakthroughs in the decades that followed, which saw the world's first heart-lung transplant in 1981, the first single lung transplant in 1983, and the first double lung transplant in 1986. The first successful living donor liver transplant followed in 1989 and the first living donor lung transplant in 1990. The number of living organ donors eclipsed the number of deceased donors for the first time in 2001. Organ transplant surgeries have since continued to improve their safety and reliability profiles. However, the risk of organ rejection remains ever-present, as recipients' immune systems sometimes react against donated organs and refuse to integrate them. Organ rejection can happen at any time, from minutes to years after the procedure, thus posing an ongoing risk for patients.

According to the United Network for Organ Sharing (UNOS), there were about 113,400 people in need of an organ transplant in the United States as of July 2019. Statistics tracking US transplants from January to June 2019 recorded 16,167 operations using organs from 7,743 donors. In 2018 kidney transplants were the most common organ transplant operation, followed by liver, heart, and lung transplants. Pancreas, intestine, and vascular allograft transplants remained relatively rare in the United States. A total of 36,529 organ transplants were performed nationwide in 2018, breaking the annual volume record for the sixth consecutive year.

While people at all stages of life receive donated organs, those ages fifty and older have the highest transplant volume in the United States. In 2018 nearly 62 percent of US transplant recipients were male and 38 percent were female. That same year, 55 percent of recipients were white, 21 percent were black, 16 percent were Hispanic, and 6 percent were Asian. American Indian/Alaska Native, Pacific Islander, and multiracial individuals together comprised only about 2 percent of US transplant recipients in 2018.

Main Ideas

Organ donation refers to the process through which individuals elect to have their organs or tissues harvested for use in organ transplantations, or medical procedures that replace a patient's damaged organ with a donor's counterpart organ.

Organ transplantation procedures and technologies developed across the second half of the twentieth century beginning with the first kidney transplant in 1954.

Living donors are those whose organs or tissues are harvested while alive, and deceased donors are those who, when still alive, had given consent to the harvesting of their viable organs upon death.

Federal legislation addressing organ transplantation includes the National Organ Transplant Act (NOTA) of 1984, which created the Organ Procurement and Transplantation Network (OPTN) to establish regulations and update policy.

The United Network for Organ Sharing (UNOS) manages the US organ transplantation system by maintaining donor lists, matching donors to recipients, tracking statistics, ensuring legal compliance, and running education and awareness campaigns.

Ethical debates within organ transplantation surround issues like balancing donor risk against recipient benefit; determining clinical death for donors on life support; prioritizing candidates on waiting lists; and accepting donations from special populations.

Regulation and Management

Federal lawmakers have passed multiple bills to regulate organ transplantation, including the flagship National Organ Transplant Act (1984). This act created the Organ Procurement and Transplantation Network (OPTN), which functions as a nonprofit public-private partnership that plays a leading role in establishing and updating organ transplant policies as the medical science continues to advance.

UNOS acts as the nonprofit private organization authorized to manage the national organ transplantation system in the United States. The network functions under contract to the federal government and maintains donor lists, matches donors to recipients, tracks statistics, and ensures compliance with all applicable laws and regulations. It also participates in public and professional education initiatives, offers policy guidelines, and assists patients and their family members as they move through the donation and waiting list processes.

The Transplantation Process: A Patient's Perspective

The kidneys, heart, lungs, liver, pancreas, and intestines lead the list of organs suitable for transplantation. In rare cases, a procedure known as vascular composite allografting can be used to transplant bodily systems including blood vessels, skin, bone, connective tissues, muscles, or nerves from a donor to a patient. These surgeries are usually performed on patients who have suffered severe traumatic injuries and require extensive reconstructive interventions. Doctors can also perform transplants involving abdominal walls, craniofacial systems, scalps, reproductive organs, and upper limbs.

If doctors determine that a patient has a pressing medical need for an organ transplant, the patient can go on a waiting list for a donation. While awaiting an organ, patients typically work with hospital or clinic coordinators to craft a financial plan for the operation, as health insurance policies may not cover the full cost of the procedure. Donated organs are also matched to patients on the waiting list using criteria such as blood type, but details of the actual matching process vary depending on the organ. Once a patient on the waiting list becomes eligible for a matching donated organ, he or she will undergo the transplant. Wait times can be long, with the National Kidney Foundation reporting averages in the range of three to five years.

Organ Donation

Doctors recognize two distinct types of organ donors: living donors, who offer all or part of a functioning organ to a patient in need, and deceased donors, who register to have their organs harvested and donated after their deaths. Living donors can provide one full kidney or lung as well as part of a liver, lung, pancreas, or the intestines. Additionally, they can also offer tissue such as skin and bone cells from bone marrow. While some living donors offer donations to people they do not know personally, many living donations-especially those involving kidneys, livers, or lungs-are undertaken to help a family member. Living family donations have a higher success rate because the body is less likely to reject organs donated by blood relatives. Deceased donors have viable organs harvested following death after voluntarily registering to take part in an organ donation program during their lifetimes. The US Health Resources and Services Administration (HRSA) notes that while 145 million Americans have registered as organ donors, only about 0.3 percent actually become donors due to factors including the condition and overall health of their transplantable organs and tissues upon death.

Myths and misinformation about organ donation continue to color public perceptions of both the living and deceased donor processes. The HRSA notes that anyone of any age and any health status can register to become a donor-a fact that contravenes misconceptions that older people and people with medical conditions do not qualify. Other mistaken beliefs include the notion that doctors and hospitals do not try as hard to save the lives of registered donors as a means of acquiring their organs. The HRSA also stresses that wealthy and influential people have no opportunity to jump the waiting list queue, as donors and recipients are automatically managed and matched by a neutrally monitored and regulated nationwide computer database.

In 2018 deceased donors supplied the organs used in nearly 30,000 transplant surgeries, while living donors provided organs for nearly 7,000. Living donors provided 30 percent of the kidneys and 5 percent of the livers transplanted in the United States in 2018. Lung transplants using organ material procured from living donors are extremely rare; they account for just 253 of the nearly 40,000 lung transplant surgeries performed between 1988 and 2019.

Critical Thinking Questions

Aside from cases in which organs and tissues are not healthy enough for transplantation, on what other grounds, if any, do you think people should be disqualified from donating their organs?

In your opinion, which factors should play the most significant roles in determining a new transplant candidate's position on the waiting list? Explain your answer.

Do you think selling one's own organs and tissue should be legal? Why or why not?

Ethics

Ethical questions have shaded organ transplantation since its earliest beginnings in the 1950s. One key issue is harvesting organs from willing living donors. Though living donors can save the life of a gravely ill person, they also expose themselves to major health risks. Doctors question whether it is ethically sound to improve the health of a sick person by endangering the health of an otherwise well person. Another ethical question asks whether it is morally sound to offer a living donor financial compensation in exchange for his or her organs. US law prohibits living donors from selling their organs to buyers, but some have questioned whether this should be permitted if the donor is of sound mind and fully understands the risks and implications of their actions. With regard to deceased donors, major ethical dilemmas tend to focus on precise definitions of death. For donors on life support, for example, the question becomes one of determining at what point organs can be harvested ethically. Does the absence of brain activity, the inability to survive off of life support, or some other marker mean a patient is clinically dead? These questions are particularly crucial with regard to heart transplants, as heart donation undoubtedly ends the donor's life.

Other ethical debates surround the criteria used to prioritize patients on waiting lists. Some medical professionals argue that patients should be prioritized according to the urgency of medical need, while others contend that differences in the potential to improve patients' quality of life should also be considered. Age cutoffs present another ethical question, as many organ transplant centers rarely accept patients over the age of seventy-five. Others disqualify transplant candidates with intellectual disabilities, mental illnesses, lengthy criminal records, histories of addiction and substance abuse, or HIV/AIDS. Opponents of such policies argue that they are shaped by the subjective application of moral values, and should be questioned on that basis. A particularly contentious issue in the United States surrounds clinics that deny candidates based on immigration status, restricting eligibility only to US citizens and legal residents while refusing to treat undocumented migrants.

Source Citation

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Organ transplantation is a medical procedure in which doctors harvest a particular organ, such as a heart, liver, or kidney, from a donor and use it to replace a critically damaged or failing counterpart organ in a patient's body.

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This article is about the train derailment that happened in Ohio on February 3rd. It talks about what hazardous chemicals the train was carrying. The article also talks about why the train derailed. I think this would make for a good topic because there has been a lot of controversy around train derailments lately.

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Residents of an Ohio town who had been evacuated after a toxic freight train derailment earlier this month are demanding answers from the railway company involved as well as elected officials over health concerns.

The big picture: As emergency crews continue to clean up the site of the Norfolk Southern train derailment in East Palestine, Ohio, lawmakers have drawn attention to the government's oversight of the freight train system. Meanwhile, the Biden administration has promised to hold the rail operator accountable for the wreck and its aftermath.

The train, which derailed on Feb. 3, was carrying hazardous materials, including at least five tanker cars of vinyl chloride, a colorless but hazardous and carcinogenic gas used to produce PVC plastic and vinyl products.

The latest

Transportation Secretary Pete Buttigieg sent a letter on Feb. 19 to the CEO of Norfolk Southern emphasizing the "urgent need" for the company to "demonstrate unequivocal support for the people of East Palestine and the surrounding areas."

"It is imperative that your company be unambiguous and forthright in its commitment to take care of the residents - now and in the future," Buttigieg said.

"Until the number of derailments is zero and rail workers are confident in being fully equipped to do their jobs safely, everyone involved in our rail system must make safety improvements a priority," Buttigieg said.

The letter also outlines previous train derailments, including two in 2011 and 2012 involving Norfolk Southern trains, that forced people near the crash sites to evacuate and the suggestions made by two federal agencies to help prevent future incidents, including the installation of electronic braking systems.

"Rather than support these efforts to improve rail safety, Norfolk Southern and other rail companies spent millions of dollars in the courts and lobbying members of Congress to oppose common-sense safety regulations, stopping some entirely and reducing the scope of others. As a result, Congress enacted language that undermined the ability of USDOT to sustain the [Electronically Controlled Pneumatic] brake requirements, and they were ultimately withdrawn under the Trump administration," the letter continued.

"Soon I will be laying out several steps that Norfolk Southern, and all major railroads, should take immediately to improve rail safety for workers and communities-in addition to prioritized actions planned at our department in furtherance of our safety mission," Buttigieg added.

Catch up quick: Norfolk Southern officials said some of the cars carrying the vinyl chloride were not breached during the crash but were at risk of exploding, so crews released and burned their contents on Feb. 6, creating a massive smoke plume above the town for several hours.

Hundreds of people evacuated East Palestine before the release and burn of the vinyl chloride but were allowed to return two days later.

Some East Palestine residents who have returned have complained of smells, headaches, nausea and other ailments, according to the Washington Post.

DeWine said on Feb. 14 he authorized the operation of the release and burning of the vinyl chloride at the crash site, saying officials faced two bad options between potentially letting a car containing the material explode or doing the release.

Mechanical issue

A mechanical issue with an axle of one of the 150 cars is believed to be the cause of the derailment of at least 50 of the cars, though the National Transportation Safety Board has not yet made an official determination of the cause.

Security footage captured in Salem, Ohio - around 20 miles west of East Palestine - before the derailment showed sparks or flames under at least one of the cars on the train, which was transporting goods from Madison, Illinois, to Conway, Pennsylvania.

At least four other tanker cars involved in the derailment were carrying at least four other different chemicals - ethylene glycol monobutyl ether, ethylhexyl acrylate, isobutylene and butyl acrylate, according to a list sent by Norfolk Southern to the EPA, which released it on Feb. 12.

In the list, Norfolk Southern said the cars carrying the butyl acrylate and the ethylhexyl acrylate were breached and either all or some of the chemicals were released during the crash.

It labeled the status of the car carrying ethylene glycol monobutyl ether as "unknown," while it said the isobutylene car was burned but not breached.

What risks the chemicals may pose to humans

Acute exposure to high levels of vinyl chloride, a classified human carcinogen, in the air has been linked to central nervous system effects, while chronic exposure has been shown to cause liver damage, including a rare form of liver cancer, according to the EPA.

Monitoring environmental impact

The Environmental Protection Agency has said it has not detected any "levels of concern" of hazardous substances released during or after the crash, though the agency is continuing to monitor the air throughout East Palestine, including inside at least 210 homes.

The EPA said it was also investigating soil and surface water contamination near the crash site and had collected spilled material in a nearby stream, Sulphur Run.

It said Norfolk Southern had installed a dam and water bypass system in the stream to prevent contamination of downstream waters, though it did not say when they were installed.

In a letter sent to the company on Feb. 10, the EPA said substances released during the incident "were observed and detected in samples from Sulphur Run, Leslie Run, Bull Creek, North Fork Little Beaver Creek, Little Beaver Creek, and the Ohio River" and were also observed entering storm drains.

DeWine said Wednesday that the water in East Palestine's municipal system is safe to drink based on the Ohio Environmental Protection Agency's results from the latest water tests.

Assessing wildlife impact

The Ohio Department of Natural Resources estimates that 3,500 fish of 12 different species, none of which are endangered, died after the crash across approximately 7.5 miles of streams south of the town, ODNR director Mary Mertz said on Tuesday.

Mertz added the department does not have evidence of non-aquatic species being affected by chemicals released during or after the derailment.

Tiffani Kavalec, chief of the Ohio EPA's Division of Surface Water, said the stream Sulphur Run remains polluted but the agency believes the contamination is contained and not moving downstream.

Federal response

On Feb. 17, Ohio Gov. Mike DeWine (R) said the Department of Health and Human Services will help state health authorities set up a clinic in East Palestine so that any resident, including those without insurance, may visit a doctor over any health concerns.

The clinic will open in the coming days, and information on its location and hours will soon be available, DeWine said. There will be local mental health resources available to residents as well.

The Federal Emergency Management Agency is also sending a team to East Palestine "to support ongoing operations, including incident coordination and ongoing assessments of potential long term recovery needs," the agency said in a joint statement with DeWine the same day.

"Just got word-FEMA will deploy a Senior Response Official and Incident Management Assistance Team tomorrow to monitor and support," Sen. Sherrod Brown (D-Ohio) said on Twitter. "This will be a huge help to the community."

DeWine and Brown both previously spoke with President Biden and requested federal assistance.

Context: The day before, DeWine said that despite being in "daily contact" with FEMA, the agency said "Ohio is not eligible for assistance at this time." The agency typically responds to disasters that involve extensive property damage.

The state filed a request to "preserve our rights" to receive help from the agency if the state becomes eligible, he later said.

"We believe that the railroad should continue to pay, and we're going to insist that they pay," DeWine said. "Whatever damages have been caused, the railroad is responsible for those damages."

Lawsuits and liability questions

The EPA sent Norfolk Southern a "General Notice of Potential Liability" letter on Feb. 10, in which it said it had determined that the company "may be responsible under [Comprehensive Environmental Response, Compensation and Liability Act] for cleanup of the Site or costs EPA has incurred in cleaning up the Site."

Connor Spielmaker, a senior communications manager at Norfolk Southern, told Axios on Monday that the company received the EPA's letter and has "confirmed to them that we have and will continue to perform or finance environmental monitoring and remediation."

So far, at least four class action lawsuits have been filed against Norfolk Southern over the crash, alleging negligence.

A spokesperson for Norfolk Southern did not directly respond to Axios' questions on the class-action lawsuits or the status of the car carrying the ethylene glycol monobutyl ether.

DeWine said Tuesday the train was not considered a "high-hazardous material train" despite the chemicals onboard, meaning Norfolk Southern was not required to notify the state of the contents of the cars. He also called on Congress to review how high-hazardous trains are classified.

Norfolk Southern's response to community

In a press release on Feb. 14, the company said it has donated $1.2 million to around 1,000 families to cover expenses they incurred from their evacuations and was in the process of providing aid to local businesses.

It said it has so far completed more than 400 in-home air tests with the EPA, which have not "shown any detections of substances related to the incident and does not indicate a health risk."

The company said on Feb. 13 it has donated $220,000 to the town's fire department to replace breathing apparatuses used by firefighters, $25,000 to the Ohio Red Cross to support a shelter set up at East Palestine High School, and around 100 air purifiers for residents.

On Feb. 15, Norfolk Southern pulled out of a town hall with local, state, and federal officials due to concern over the "growing physical threat" to its employees and members of the community, but it did not elaborate on what the threat entailed.

People at the town hall, which occurred without representatives from the railway company, sought answers for the potential of long-term exposure to chemicals released during and after the derailment, and what health dangers residents may face.

Go deeper: Ohio derailment prompts calls to investigate federal oversight of trains
Editor's note: This story has been updated with additional details throughout.

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federal emergency management agency (fema)

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What we know about the Ohio train derailment

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Residents of an Ohio town who had been evacuated after a toxic freight train derailment earlier this month are demanding answers from the railway company involved as well as elected officials over health concerns.

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Cybercrime is increasing every day. Hackers are finding new ways to steal vital information, currency, crypto and anything else valuable to either keep for themselves, or hold for ransom. In fact, Cybercrime is becoming increaingly more problematic than terrorism these days. It is sometimes hard to depict all that goes on, because not all crimes are reported, but the US government has a few tricks up their sleeves. We will not be left out in the cold, if something big hits on the horizon.

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This article is a great reference for the short version of marijuana and its life cycle in our society. Everything from its biological classification to its legality status and use for medicine. It's good to be informed by facts and statistics rather than influenced and misled by agenda and misinformation.

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Being in the agricultural field this project anger me and breaks my heart at the same time. The willow project dumbed down is letting companies drill holes in Alaska for oil. It recently got the green light even after all the calls and letters sent to the government to not let them approve this. This could be a good topic because it is prevalent today, handsome people are for this.

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COVID-19 took its toll on many individuals short term and possibly long term mental health as well. This article shows the results of studies' and the multitude of ways that COVID took effect on people while in battling the active infection and shortly after. Although there are not as many studies that show the long term effects, I'm sure there will be within the next 5 years as the pandemic (hopefully) begins to be a thing of the past.

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Highlights

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This is the first systematic review to assess longer term psychiatric symptoms experienced by COVID-19 survivors

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33 studies were included assessing 6,743 participants, with outcomes assessed between one and six months after diagnosis.

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From the included studies there was no clear evidence of survivors experiencing worse anxiety or depression as compared to general population levels.

Abstract

Background

Acute effects of COVID-19 can be life-threatening. Alterations in mental health during the active infection have been documented, but the long-term consequences are less clear.

Method

A systematic review was undertaken to investigate the effect of COVID-19 infection on long-term mental health outcomes. Three databases [PubMed, Medline (Ovid) and Cochrane library] were searched between 1st October 2019 and 29th August 2021 with additional hand searching to identify all published studies reporting symptoms of generalised anxiety, depression, post-traumatic stress disorder (PTSD), or sleep disturbance in participants at least one month after COVID-19 infection. The prevalence and mean symptom score of each were assessed.

Results

Eight hundred and eighty five studies were found, of which 33 were included in the review involving a total of 6743 participants. The studies' risk of bias were typically fair quality. The median study age of participants was 57.8 years (IQR 49.3-60.7), with 63.0% male (IQR 57.0%-73.0%). Participants typically experienced no or mild symptoms of long-term anxiety (GAD-7, STAI-S, HADS) and depression (PHQ-9, BDI, PHQ-2, HADS). Prevalence varied depending on the measurement tool. Sleep disturbances (primarily insomnia) were most commonly reported as mild. PTSD prevalence was similar to anxiety and depression.

Conclusion

The overall effect of the pandemic has been linked with worsening psychiatric symptoms. However, the long-term effect from direct COVID-19 infection has been associated with no or mild symptoms. Studies exhibited the long-term prevalence of anxiety, depression, PTSD, and sleep disturbances to be comparable to general population levels.

View Abstract

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Long-term effects of COVID-19 on mental health: A systematic review

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This is the first systematic review to assess longer term psychiatric symptoms experienced by COVID-19 survivors * 33 studies were included assessing 6,743 participants, with outcomes assessed between one and six months after diagnosis. * From the included studies there was no clear evidence of survivors experiencing worse anxiety or depression as compared to general population levels.

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This website is a non-bias website that talks about news topics. This specific article is about the child labor laws changing in the US. Some governors are starting to lower the age that children can work to fill in for the worker shortage. This is a good topic because most college students have already had a job and realize that making money at 13-15 years old is nearly impossible. Others can also point out that some jobs are not meant to be worked by kids.

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Legislators in multiple states are invoking a widespread labor shortage to push bills that would weaken long-standing child labor laws.

Why it matters: Some bills go beyond expanding eligibility or working hours for run-of-the-mill teen jobs. They'd make it easier for kids to fill physically demanding roles at potentially hazardous work sites.

Protections could be stripped for youth most at risk of being exploited by employers, like migrant children and kids from families facing financial problems.

Driving the news: A new Arkansas law signed by Gov. Sarah Huckabee Sanders (R) last week makes it easier for teens as young as 14 to work without obtaining a permit.

Between the lines: The laws and proposals have largely been introduced by Republicans but received support from some Democrats in Ohio and New Jersey.

Legislators say the bills are largely in response to the current hot jobs market, with employers posting an elevated number of openings but struggling to fill positions.

One Republican state senator in Ohio said allowing longer hours for teen workers would help understaffed businesses and build "leaders of the future," Axios' Tyler Buchanan reports.

Zoom in: Iowa lawmakers are considering Republican legislation that would allow 14- and 15-year-olds to work in industrial laundry services and freezers at meatpacking plants. It'd also prevent many of them from receiving worker's compensation if they are sickened, injured or killed on the job.

Democrats and Republicans in Ohio are considering removing a cap on the number of hours children as young as 14 can work during the school year as long as a parent or legal guardian approves.

In Minnesota, a GOP bill that missed a key deadline would have allowed 16- and 17-year-olds to work in construction or on building project sites.

New Jersey Gov. Phil Murphy (D) last year signed bipartisan legislation that allows people 16 and up to work 50 hours a week during summer break if they get permission from a parent or legal guardian.

Thought bubble, via Axios' Javier E. David:Employers in key sectors have been desperate for workers in the post-pandemic era.

It should come as no surprise that - deprived of able-bodied adults - companies are more willing than ever to hire youngsters to do the jobs their elders won't.

What they're saying: "The notion that you would put kids at risk in order to meet some claimed labor shortage is just preposterous," Michael Hancock, a civil rights and employment attorney and a former senior Department of Labor official, told Axios.

Hancock said younger workers risk falling behind in school and may be more likely to accept lower wages because they don't know the value of their labor.

Marcy Goldstein-Gelb, co-executive director of the National Council for Occupational Safety and Health, said the provision in the Iowa bill that shields businesses from some liabilities essentially acknowledges the legislation would create dangerous working environments.

"This one is so blatantly saying, 'We know that what we're doing is going to harm young people, so we may as well just call a spade a spade and exempt businesses from their responsibility for what we created,'" Goldstein-Gelb said.

The big picture: The federal government promised to crack down on illegal child labor last month after observing a 69% increase in companies employing underage workers since 2018.

One of the nation's largest food sanitation companies, Packing Sanitation Services, was fined $1.5 million for illegally employing more than 100 minors to carry out hazardous jobs at its facilities.

Hundreds of underage migrants work in factories and at construction sites across the country in violation of federal child labor laws, according to a New York Times investigation.

Reality check: States will still have to comply with federal regulations, which sets standards for the types of jobs minors can work.

"Amid a 69% increase in children employed in violation of the law, it is irresponsible for states to consider loosening child labor protections," Seema Nanda, solicitor for the U.S. Labor Department, said in a statement.

"Federal and state entities should be working together to increase accountability and ramp up enforcement - not make it easier to illegally hire children to do what are often dangerous jobs," Nanda's statement continued.

Go deeper: Company fined $1.5 million for hiring children to clean meatpacking plants

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Lawmakers target child labor laws to ease worker shortage

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Legislators in multiple states are invoking a widespread labor shortage to push bills that would weaken long-standing child labor laws. Why it matters: Some bills go beyond expanding eligibility or working hours for run-of-the-mill teen jobs. They'd make it easier for kids to fill physically demanding roles at potentially hazardous work sites.

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Addiction and chemical dependency are a big issue. Addiction affects so many people. Many of us personally know someone who struggles from addiction or chemical dependency. This article goes over the different factors and consequences of addiction.

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Chemical dependency occurs when a person repeatedly uses a chemical substance such as drugs or alcohol until the mind and body experience some discomfort without continued use of the substance. The most common chemical dependency is a reliance on caffeine, the most widely used drug on the planet, in the form of coffee, tea, or other beverages. The average American coffee drinker consumes about three cups of coffee a day and may experience withdrawal symptoms such as headaches without a regular caffeine fix. A chemical dependency in which a person is unable to take the steps necessary to curb their chemical dependency is referred to as an addiction. The body can become addicted to many substances. Some health professionals identify any habitual behavior that cannot be stopped without assistance, such as compulsive gambling or Internet use, as an addiction.

Some chemical dependencies, referred to as substance use disorders, can be detrimental to the addict, their loved ones, and society. The American Psychiatric Association (APA) defines a substance use disorder in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as "a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress." According to the parameters of the APA, a chemical dependency can be identified as a substance use disorder if it causes physical and social impairment, inspires unnecessary risks, and features physical symptoms such as tolerance and withdrawal. Substance use disorders can involve illegal drugs such as cocaine and heroin as well as legal substances such as alcohol, tobacco, and prescription drugs. While marijuana use does not cause extreme symptoms of addiction, repeated use can lead to chemical dependence in some users and can develop into a substance use disorder if it causes problems in the user's life. For similar reasons, psychiatrists hesitate to identify caffeine dependency as a substance use disorder, as it rarely causes major disruption in the life of the user. Severe substance use disorders have been linked to death, domestic violence, and crime. According to the Substance Abuse and Mental Health Services Administration, an agency of the US Department of Health and Human Services, nearly 21 million Americans had a substance use disorder in 2015, with 75 percent of those cases involving alcohol. Some agencies, such as the National Institute on Drug Abuse, use severe substance use disorder and addiction interchangeably.

While the term substance use disorder is used by the APA to describe a chronic problem, the term substance abuse refers to the act of using an illegal substance or a legal substance in a way that is harmful, prohibited, or not directed by a health-care professional. Examples of substance abuse include taking more than the prescribed dose of a medication, using substances like gasoline or glue for the purpose of intoxication, and taking prescription painkillers prescribed for someone else. Health-care providers, researchers, and policymakers have invested time and resources into better understanding the risk factors for substance abuse and why some individuals are more prone to substance abuse and substance use disorder. Debates continue over the causes of substance abuse, the best treatment practices, and which public policies are most effective in limiting the social ills caused by drug addiction.

Biological Factors of Addiction

People may choose to use drugs and alcohol for a variety of reasons, and not every user develops a substance use disorder or becomes addicted. While most doctors and researchers agree that genetics play a significant role in addiction, the nature of substance abuse makes it difficult to predict how the interaction of genetic and environmental factors will impact a person's risk for substance abuse. Furthermore, social stigma surrounding substance use has been an impediment to studying the science of addiction. Despite these obstacles, however, recent studies have provided scientists with a better understanding of how drugs affect the brain and behavior. Health-care providers now identify addiction as a disease, though it had previously been treated as a lack of willpower. This approach allows health-care providers to develop more pragmatic programs to treat and prevent substance abuse.

Since the 1970s, health-care professionals have recognized the importance of understanding a person's overall mental health in treating addiction. Understanding how an addict's brain works has led to more effective addiction treatments. The human brain is structured to ensure that individuals will repeat behaviors necessary to survival and well-being. To do this, the brain associates such behaviors with a "reward," or a feeling of pleasure. The brain chemical most closely associated with this reward system is dopamine, a neurotransmitter that carries messages between nerve cells in the brain.

Addictive substances overstimulate the brain's reward system by flooding it with excess levels of dopamine. Such drugs can release up to ten times as much dopamine in the brain as its natural reward system does, creating feelings of extreme well-being. The effects of this dopamine rush can last much longer than those the brain produces naturally. After experiencing the intense reward of a dopamine rush, a substance user might find normal levels of dopamine unsatisfying and may be motivated to seek out the intense experience again and again.

When the brain is flooded with extreme amounts of dopamine, however, it adjusts to this imbalance by either producing less of the chemical or reducing the number of brain cells that can send or receive it. In effect, the brain simulates a more normal level of the dopamine. For addicts, this level is not enough to produce any sense of wellness. Without extreme amounts of dopamine, addicts can feel lifeless and depressed. They must continue taking the addictive substance and increasing their dopamine levels just to feel normal.

Addicts develop tolerance from repeated use, which means that they need larger amounts of the drug to create the dopamine rush. While the brain may become less susceptible to a drug's pleasure-inducing effect, the body may not develop a tolerance for the drug's other effects, which can create dangerous conditions. For example, heroin causes pleasurable sensations in the brain, but it also causes the body's respiratory system to slow down. The respiratory system does not develop a tolerance, so as the user consumes more heroin to feel the pleasurable sensation for which they have developed a tolerance, their breathing slows in response to the amount of heroin consumed.

In addition to developing a tolerance for a drug, users develop a chemical dependency that may cause physical withdrawal symptoms when the user stops using the drug. The physical symptoms of withdrawal vary from substance to substance. The physical symptoms of opioid withdrawal, for example, include flu-like symptoms such as nausea, muscle spasms, chills, and depression. These withdrawal symptoms can be so severe that they result in death. Withdrawal symptoms from chronic alcohol abuse and chronic benzodiazepine use can also be life-threatening. Recovery from opioid dependency and alcoholism is difficult and usually requires professional support. Withdrawal symptoms from the chronic use of cocaine can include anxiety and discomfort, but do not lead to death.

Addiction also disrupts the circuits in the brain that regulate behavior. This diminishes the addict's ability to control his or her behavior and impulses and often leads to risky behaviors such as drunk driving or unprotected sex. Self-control diminishes as the addict continues to use the drug, which makes quitting the drug increasingly difficult even when the addict has a strong desire to quit.

Environmental Factors of Addiction

In addition to the biological factors that can make a person more susceptible to a substance use disorder, environmental factors can also play a significant role. Environmental factors can include access to drugs, community attitudes toward substance use, drug use in a person's social network, a person's level of engagement at work or school, or growing up in a situation where parents used drugs or where drug use was accepted. The National Institute on Drug Abuse reports that adolescents who try drugs for the first time, including teenagers who are not otherwise at risk, are highly influenced by their drug-using peers.

A 2005 study published in the Journal of Adolescent Health that examined children over a period of ten years as they entered adulthood found that tobacco use among youth was reduced if the parents instituted strict smoking rules, monitored their children, forged close relationships within the family, and did not smoke themselves. The recovery programs Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have recognized the importance of environmental factors in preventing and treating substance abuse in their recommendations that addicts in recovery avoid the "playmates, playgrounds, and playthings" associated with their drug use. Research has also found that reducing harmful social factors significantly aids with treatment of individuals with substance use disorders.

Social categories such as economic class, gender, and ethnicity can also contribute to a person's propensity for addiction. In a study conducted from 2002 to 2013 and reported by the National Bureau of Economic Research, researchers found strong indicators that economic downturns can increase the likelihood of a person developing a substance use disorder, especially among white men between the ages of twenty-five and fifty-four with below-average education levels. Among marginalized groups, discrimination and exclusion from the larger community can influence a person's decision to use drugs and alcohol. Alternately, membership in a social group that condones or participates in drug and alcohol use can also increase the likelihood that a person will engage in these behaviors and develop a substance use disorder.

The conditions in which a person encounters a drug can play a significant role in their decision to use. A person may be more likely to use drugs with a trusted friend or relative than a stranger. When a doctor prescribes a patient a drug for a legitimate reason, the user is exposed to several environmental risks for addiction. For example, the user may be opposed to using drugs in other circumstances, but the availability of the drug and the lack of social stigma around using prescription drugs remove some of the barriers that prevent people from using in the first place. In 1996, Purdue Pharma introduced a powerful synthetic opioid called Oxycontin with effects similar to heroin. The drug company promoted the product as being less addictive than other prescription painkillers, and doctors began prescribing the drug for short- and long-term pain management. The drug is highly addictive, however. Not only did many patients become addicted, but the drug quickly found its way onto the black market where people who used the drug recreationally also became addicted. In 2002, the Food and Drug Administration (FDA) established the Anesthetic and Life Support Drugs Advisory Committee to develop solutions for the growing opioid epidemic. The committee addressed the rise in all prescription painkillers such as other synthetic narcotics like meperidine, fentanyl, and hydrocodone as well as opium derivatives such as morphine and codeine. In 2015, over 2 million Americans had a substance use disorder related to prescription pain medicine and nearly 600,000 had substance use disorders involving heroin. That same year, over 30,000 of those disorders resulted in death from accidental overdose.

Consequences of Addiction

Addiction is associated with numerous health problems. Smokers, for example, inhale many carcinogens in tobacco smoke. They are at high risk for lung cancer and cancers of the mouth, throat, larynx, blood, stomach, pancreas, kidneys, bladder, and cervix. According to the Centers for Disease Control and Prevention (CDC), smoking causes approximately 90 percent of all lung cancer deaths and 80 percent of deaths from chronic obstructive pulmonary disease. Smokers are also two to four times more likely than average to develop coronary heart disease or stroke. Smoking is also associated with infertility problems, and smoking during pregnancy can cause complications, stillbirths, and impact the child's lifelong health.

Though moderate consumption of alcohol has been linked to health benefits such as reduced risk for heart disease and diabetes, long-term alcohol abuse contributes to many diseases. Alcoholics are at increased risk of dementia and stroke; psychiatric problems, such as depression, anxiety, and suicide; cancer of the mouth, throat, esophagus, liver, colon, and breast; gastrointestinal diseases, including pancreatitis and gastritis; and social problems such as unemployment and family dysfunction. Alcoholics are at very high risk of liver disease, including alcoholic hepatitis and cirrhosis, an incurable disease. In addition, alcoholics often have poor diets and suffer from lack of proper nutrition, as alcohol impairs the body's ability to absorb and use nutrients.

Addicts who use street drugs, such as heroin, also expose themselves to major health risks. The most extreme is accidental overdose and death. Other health risks arise because street drugs often are mixed with additives, including some poisons. For example, cocaine can be cut with laundry detergent, boric acid, and laxatives. In addition, addicts who inject drugs often share needles and equipment, exposing them to HIV, which causes AIDS, and to hepatitis C, which causes liver damage. A 2014 CDC study found that almost 70 percent of the reported cases of hepatitis C involved individuals with some injection drug use. Addicts who inject drugs also have increased risk of heart infection, kidney disease, pulmonary disease, and skin infections including necrotizing fasciitis, commonly referred to as flesh-eating bacteria. Methamphetamine, a highly addictive synthetic stimulant, damages skin tissue and contributes to dangerous weight loss. It can cause paranoia, hallucinations, violent behavior, convulsions, liver damage, and permanent brain damage. Cocaine addiction can lead to cardiac arrest, seizures, and respiratory arrest.

NA literature asserts that drug addiction leads to one of three possible outcomes: "jails, institutions, and death." Statistics reinforce this assertion. Drug offenders make up significant portions of state and federal prison populations. In March 2017, the Federal Bureau of Prisons reported that nearly half of all federal prisoners were incarcerated for drug-related offenses. Likewise, substance abuse accounts for a significant portion of the mental health services provided in the United States. According to a 2014 report released by the Substance Abuse and Mental Health Services Administration, public and private payers are projected to spend an estimated $42.1 billion annually on substance use treatment by 2020. As another destructive consequence of substance abuse, spurred in part by the rising opioid crisis, deaths from drug overdoses exceeded deaths by car accidents in the United States for the first time in 2009, and this trend has continued since.

In addition to negative health consequences and restrictions on a person's freedom that can result from a substance use disorder, addiction can impact the user's ability to maintain familial and social relationships, employment, and financial security. Failed drug tests can cause the loss of a job, scholarship, or other opportunity. Likewise, criminal convictions for drug offense can prevent a person from being hired and can threaten their immigration status.

Source Citation

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Chemical dependency occurs when a person repeatedly uses a chemical substance such as drugs or alcohol until the mind and body experience some discomfort without continued use of the substance. The most common chemical dependency is a reliance on caffeine, the most widely used drug on the planet, in the form of coffee, tea, or other beverages.

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Bryan Kohberger is the prime suspect in this murder case. These articles describe the evidence pointing in his direction and all of his wrongdoings in the case. Bryan was presumed to be a very smart man, but this case shows how sloppy of a job he was whiling to do. It is almost like he wanted to get caught. These murders show how fast something can change in the blink of an eye. No one was expecting this tragedy to happen. This world is changing into a cruel and grueling place to live. The world idolizes crime because it is an 'interesting' story.

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