Under the Influence

Yeah, it’s true! At one point in history cocaine, ecstasy, marijuana, LSD, opium and heroin were perfectly legal and in some cases given away- free. Now these drugs are considered illegal, harmful, and addicting. “It was better than sex; it was better than the best thing I ever tried; crack, marijuana, cocaine- put me in a state of mind where I did not care about anything or anyone I just wanted to get high.” These are all statements made to me by individual in jail or in drug rehab about how they felt being “Under the Influence” of drugs of abuse. How could chemicals that soothe pain, inspire intense euphoria, and temporarily allow us to escape from the problems of the day be harmful? Lets explore two of the popular drugs of the hip-hop culture and see how they affect the body.

Ecstasy (MDMA)
The “love drug” was first synthesized in a laboratory in Germany in 1912. Believed to have no medical use, it sat on the shelf for years; that was until 1977 when ya boi Alexander Shulgin, a chemist living in California, re-synthesized the compound and introduced it to local psychotherapist. It was not illegal and was given to patients by doctors to help couples communicate, to treat posttraumatic stress disorder, and treat anxiety and depression. The drug was called “empathy” until it hit the party scene where the name ecstasy was coined. Ecstasy was so wide spread in cities like Dallas, TX that you could buy it over the counter at bars- LEGALLY, doctors gave it to patients for group sessions and everything was all good, right? The sense of emotional well being, confidence and love produced by the drug comes from its effects on the brain. Ecstasy stimulates the release of serotonin, which affects our mood, energy and emotions. Normally in the brain, a little bit of serotonin gets released at time; when using ecstasy, all of the serotonin stored in the brain cells is released at once and the nerves goes “bananas” producing intense euphoria, strong emotions, and feelings of love, happiness, intimacy, openness, and empathy. This dramatic release of serotonin is also what makes the drug potentially dangerous, as the nerves may not ever function the same after repeated use of the drug. The agony begins when the ecstasy wears off and is often called “suicide Tuesday’s”. The user feels tired, fatigued, depressed, and is unable to sleep. Some ecstasy user’s have literally danced themselves to death or have seizures, go into to a coma, and die due to increased body temperature (up to 107 degrees) and water intoxication. An average 100-milligram dose last 6 to 10 hours and cost between $25 and $45 per pill depending on where you live. There is still a push to make this drug legal and to be used by psychotherapist.

Opium
Opium is a naturally occurring substance that is extracted from the seedpod of the opium poppy. Heroin, morphine, codeine, hydrocodone, and dihydrocodeine are all derivatives of opium. They are highly addictive substances that are commonly used by physicians for medical purposes: to treat diarrhea, nausea, and more commonly pain. Vicodin, Lortab, and Oxycotin (hillbilly heroin) are all examples of the prescribed derivatives of opium. They have legitimate uses in medicine, however the abuse potential is great. Prescription drug abuse has become a huge problem in our society and both the patient and the doctors are to blame. Have you heard of “dat Lean”, syrup, or sizzurp? Once just a “cough medicine”, this codeine based drink has become a cocktail of the hip-hop culture. Just mix your cream soda or fruit punch with some promethazine with codeine, and voila… you have the cheap, sweet drink made popular by the Houston hip-hop scene and DJ Screw who died from a mixture of codeine, alcohol, and marijuana. Codeine, a commonly prescribed and effective drug used to treat pain, diarrhea, and to suppress cough, is the most widely used and naturally occurring opiod or narcotic (medicines that produce pleasure and calmness) in the world. Promethazine, which does not contain codeine, is the generic name for a sedating, anti-nausea chemical that is often combined with codeine in cough syrups. Symptoms of codeine abuse include slow breathing, seizures, dizziness, weakness, confusion, tiredness, cold and clammy skin, small or constricted pupils, loss of consciousness, coma and possibly death! To experience the effects of codeine, the human body must convert the drug to morphine. The effects of codeine start 10-30 minutes after ingestion, peak within 1 to 2 hours and may last 4-6 hours, depending on how much taken. Within two to three weeks of repetitive use a physical and psychological addiction may develop. Misuse will lead to an apathetic, dulling-type effect, a lack of co-ordination and dulled responses.

Every illegal drug to date has started out perfectly legal, freely used and widely accepted. They are considered medical miracles until the side effects develop. One major problem with these illegal substances is that there is no long-term studies to tell us what will happen to the body after long-term use. What I can tell you is that destruction of lives, time spent in jail, and the risk of being infected with HIV or other STD’s, motor vehicle accidents, violence, and rape have all occurred “under the influence”. The fix is temporary and the cost is high. Lets seek out the natural highs in life: love, children, music, a good job, a loyal woman, great mix tapes, seeing bootleggers arrested for jacking music, and real hip-hop! Holla!

(c) 2008 Rani Whitfield. This article was published January 2008 by Ozone Magazine.

The Young and Invincible.

The Young and Invincible. Sounds like the title to a soap opera, but actually it’s the attitude that many young adults have about getting sick or injured. Young people think they are invincible and as a result neglect the most important thing that they possess: there health! Listed below are ten medical issues in young adults that I see in my Family Practice that I want to discus with you.

HIV/AIDS
The human immunodeficiency virus (HIV) has become one of the most devastating sexually transmitted diseases ever known to man. Once infected with HIV, the body’s immune system can become weakened and the infected individual will develop the acquired immune deficiency syndrome (AIDS). According to statistics reported by the Centers for Disease Control (CDC): an estimated 38,500 young people (age 13-24) in the United States received a diagnosis of AIDS; African American youth were the largest group of young people affected by HIV, accounting for 56% of all infections; young women, especially of African American and Hispanic decent are at increasing risk. Risk factors for infection with HIV include unprotected sex, multiple sex partners, use of IV drugs, the presence of an undiagnosed sexually transmitted disease, lack of awareness, and poverty. The key is to get tested if you don’t know your status, and if you decide to have sex, Rap It Up!

Obesity
In the past 20 years, there has been a significant increase in over weight and obese individuals in the United States. The Food and Drug Administration (FDA) estimates that almost two-thirds (64%) of all Americans are overweight; almost one third are obese. Childhood obesity is on the rise and we are now seeing shocking increases in diabetes, heart disease, and hypertension in this previously active and healthy population. Today, approximately 17 percent of young people are seriously overweight. One main problem that I see is the decrease in mandatory physical education classes for school aged children. Lack of exercise, poor diets high in fat and calories, and the fast food epidemic are the main reasons for this epidemic. Young people are stuck on computers and hove video games and don’t bike and or play outside as much studies have shown. So get moving! Exercise at least 20-30 minutes most days of the week and eat foods low in calories and fat.

Cervical Cancer
Cervical cancer, a disease of the female reproductive system, is more common in young women. It accounts for 6% of all cancers in women and is caused by the human papilloma virus (HPV) in 90-95% of the cases. The virus is passed from person to person usually by unprotected sex and in most cases the woman has no symptoms. Risk factors for HPV include multiple sex partners, cigarette smoking, and unprotected sex. The key point is that all women who are sexually active need to have a pap smear at least once a year whether you wear condoms or not. Even if you are not sexually active, annual pap smears are still recommended by the age of 18. Cervical cancer can be detected and treated if diagnosed early by pap smears. Talk to your doctor about the vaccine currently in use that may reduce your risk of cervical cancer.

Anabolic Steroids
Barry Bonds is not the first person accused of using steroids and won’t be the last. His situation, however, has brought much needed attention to the topic of steroids. The desire to be competitive and to gain an edge on one’s competitor is natural, however the facts still remain: steroids are illegal and are associated with short and long term effects which can be very damaging to the body. Don’t get it twisted; they do help to build muscle mass, however, with side effects like elevated cholesterol, high blood pressure, balding in men, breast development in men, facial hair in women, and mood swings just to name a few, there is no way I would recommend to anyone using them. The National Institutes of Drug Abuse (NIDA) reported an increase in steroid use among 8th and 10th grade boys in 2000. The primary reasons for using steroids among these young men where to enhance athletic performance and physical appearance. If you want to be the best, work hard and don’t use a substance that is illegal and might permanently damage your body. Also remember, never take or rub a substance on your body if you don’t know what’s in the solution.

Cigarette Smoking
Cigarette smoking is the single most preventable cause of death in the United States. Twenty three percent of high school students and 8% of middle school students in this country are regular smokers. There are more deaths each year from tobacco use than by HIV, drug abuse, alcohol abuse, motor vehicle injuries, suicides, and murders all together. The active ingredient in cigarettes and smokeless tobacco is the very addictive substance called nicotine. Cigarette smoking is associated with cancers of the lung, bladder, and cervix; heart disease; low birth weight babies; sudden infant death syndrome, and chronic obstructive lung disease (COPD). Smoke free facilities are becoming the norm as society is becoming more aware of the harmful side effects of second hand smoke. If you plan on living longer, then you need to stop smoking.

Mental Disorders
Mental health is just as important as physical health and everyone should be comfortable discussing these topics with their doctor. The most common mental health issues seen in my practice are anxiety and depression. Approximately 25% of young adults experience depression by the time they are 24 years old, but very few seek help. This is alarming and depression, if left untreated, can lead to suicide. Anxiety, the most common form of mental disturbance in the U.S., affects approximately 28 million Americans each year. Both anxiety and depression are major problems for society as they can interfere with work, school and family life. They contribute to high rates of substance abuse and alcohol abuse. If you or a loved one has been diagnosed with anxiety or depression, it is important to take your medicines as prescribed and see your doctor and/or therapist on a regular basis.

Suicide
Suicide is the end result of severe depression that is untreated or under-treated. Suicide is common in young adults and the elderly. In general women attempt more suicide than men; men are more “successful” in suicide attempts. Signs of depression include disturbances in sleep, loss of interest in things the person normally does, guilty feelings about a situation or situations, decreased energy, decreased concentration, decreased or increased appetite, abnormal and unintentional weight loss or weight gain, decrease sex drive, and suicidal or homicidal thoughts. These symptoms have to be present for more than two weeks for the diagnosis to be made. The challenge is to recognize these signs and symptoms and to get help for the affected person before a suicide attempt (s) occurs. Suicide is the permanent answer to a temporary problem. If you are someone you love is talking about suicide, get him or her help immediately!

Substance Abuse
Despite what some might try to convince you, drugs of abuse are mind altering and can put you at risk for STD’s, accidents, and time in jail. The trends of abuse have shifted in young adults somewhat from the gateway drugs marijuana and cocaine, to designer drugs such as ecstasy and the date rape drug, GHB. There are more potent forms of marijuana, which make them more addictive, and crystal meth is slowly becoming a drug of choice for many young Americans. The results of substance abuse are quite evident: mental disorders such as depression and anxiety, incarceration, STD’s including HIV, destruction of families, and untimely deaths due to accidental overdose, suicide, or crimes as a result of the drug’s influence. While under the influence of these mind-altering substances, an individual often makes poor decisions and will participate in behaviors that he or she would normally avoid. Education and awareness about the different drugs available and how they affect the body is one of the major ways to decrease abuse.

“Staph” Infections
Community acquired methicillin resistant staphylococcus aureus (CA-MRSA) infections are on the rise! What the hell is that you ask? Well if you have ever had a boil that was hard to treat and it came back to visit you on several occasions requiring multiple doctor visits, drainage by a physician, and sometimes hospitalization and antibiotics through an IV, chances are you had a staph (staff) infection. MRSA was at one time primarily seen in hospital patients with wounds and in individuals with weak immune systems. As a result of antibiotic overuse by physicians to treat simple skin infections and patient noncompliance with medications (not taking them like they are suppose to), these very intelligent bacteria have become resistant to the very basic and inexpensive antibiotics that we have available in our local pharmacies. Staph infections can be very dangerous and are now being associated with pneumonias in healthy individuals. MRSA can kill! If you develop a painful to the touch, red and swollen area on your body that produces pus (drainage), you could have a staph infection. See your doctor right away so that this can be treated quickly and effectively.

Sexual Transmitted Diseases/Sexually Transmitted Infections (STDs/STIs)
Chlamydia, gonorrhea, herpes, HPV, syphilis, and HIV are on the rise again. One out of every 2 Americans will have an STD/STI by the there 25th birthday. The reasons are many and include lack of education and awareness, having unprotected sex, and substance abuse. If a person is infected with one STD/STI, then he or she is at risk of getting another. The concept that oral sex is safe sex or not sex at all is garbage. Herpes, HPV, and gonorrhea can be spread via oral sex. The likely hood of being infected with HIV is very low in someone receiving oral sex compared to the “giver”. However, there is still some risk. Abstinence is still the best way to prevent the spread of sexually transmitted diseases, however, this method is not always practiced. If you choose to have sex protect yourself. Know your HIV status, practice monogamy, wear condoms, and if you perform oral sex learn how to use dental dams. They come in tasty flavors and colors.

This by no means is a comprehensive list of all the potential problems young people encounter, but it’s a great start. Hopefully this will give you a good foundation and help guide your own research regarding the medical issues that I commonly see in my practice.

(c) 2007 Rani Whitfield. This article was published November 2007 by Ozone Magazine.

Women and Steroids

No matter where you go, we are hearing more and more about the use and abuse of steroids in men’s sports. But when multi gold medallist and track super star Marion Jones recently announced that she used steroids after vehemently denying the allegations for years, it sent a shock wave across the country and mixed messages to her friends, family, and fans. This coming on the heels of Barry Bonds record breaking home run season tainted with accusations of steroid use and the recent rumors of talented boxers Sugar Shane Mosley and Jameel McCline’s use of steroids to prepare for there matches. The question most people are asking is why? Why are athletes, especially women athletes, using these illegal and potential harmful substances?

Before I get into the reasons why, let me first explain this class of drugs more correctly called anabolic androgenic steroids (AAS). AAS are the synthetic derivatives of the naturally occurring male hormone testosterone. The ability for steroids to build muscle and strength is the anabolic effect of the drug, while the development of MALE secondary sexual characteristics, like the pitch of someone’s voice and the pattern of body hair describe the androgenic effect of the drugs. AAS have been around since the 1930s to treat a condition in men called hypogonadism in which the testes do not produce a sufficient amount of testosterone for normal male development and sexual function. Other approved medical uses for testosterone include the treatment of impotency, the “wasting” or weight loss seen in persons infected with HIV or cancers, and delayed puberty.

Performance enhancing drugs like AAS are not new to the arena of sports. They date back to the early Olympic Game’s, which started in Greece and has now evolved into a multimillion-dollar industry due to marketing and advertising. As early as 1969, journalist Bill Gilbert was quoted in Sports Illustrated as saying, “The pill, capsule, vial, and needle have become fixtures of the locker room as athletes increasingly turn to drugs in the hope of improving performance.” The desire to win and to gain the edge over one’s opponent is innate, however in the “steroid” culture, there is a phrase used by some professional athletes: “If you are not using steroids, then you are not trying hard enough!” This quest for supremacy at the expense of one’s health has taken over and the all-mighty dollar is more important than health, longevity and loved ones. Steroids have been used and proven to build strength and endurance in competitive athletes for decades; however, AAS are illegal and potentially harmful and considered cheating! These are not the messages we want to deliver to young African American athletes.

The reason women use these illegal and potential harmful substances are very similar to the reasons men use them: to improve athletic performance, to become more muscular, to gain weight, to lose weight, to recover faster from fatigue and injury, and/or to increase speed and endurance. Women who are victims of rape or who have been physically abused also use AAS to improve strength and confidence so that they can protect themselves from future attacks. Muscle dysmorphia, also called bigorexia or reverse anorexia nervosa, is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough, hence uses AAS to “bulk up”.

AAS have become much more complex as proven by the “designer” steroids used by Marion Jones, some of which are undetectable with the latest technology in urine, blood, or hair samples. Steroids are administered in many ways including pills, needles, patches, or creams. Once in the blood stream they are soaked up my muscle cells and promote the production of protein, which stimulates muscle growth. Athletes will mix different types of AAS to achieve various effects, as there is no accepted medical dosing standard for the use of these drugs for performance enhancement. Side effects of AAS use/abuse include high blood pressure, strokes, elevated cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Women can experience reduced breast size, increased body and facial hair, a deeper voice, and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicular size have all been documented. Some of these side effects are irreversible and require surgical treatment.

This is a very unfortunate situation and I am truly saddened as Marion Jones was one of my favorite athletes. I hope that she will turn the negative into a positive and begin to educate young athletes on the only way to become successful in competitive sports while at the same time improving their health: hard work and proper nutrition.

For more information on steroids visit www.nida.nih.gov or visit my website at www.h2doc.com, view the Steroid Man, see a comprehensive list of individuals who have been associated with steroids and shoot me a question or comment at DrRani@h2doc.com. It’s Tha Hip Hop Doc, they call me H2D, come on now lets get Hip Hop Healthy. Peace, I’m out! (c) 2007 Rani Whitfield.

Steroids

I love wearing my throwback jersey’s, especially those from the Negro baseball leagues. These jerseys symbolize so many things: pain, suffering, success, fun. But most importantly they represent hard work that the individuals who wore them endured so that other African American players could achieve the American Dream: baseball, hot dogs, apple pie, and Escalade’s!? I wonder how my now 2-year-old daughter will feel about wearing the throwback jersey of the greatest player to ever play the game of baseball, Barry Bonds. Despite his success in this sport, his name and his records have been tainted with the accusations and stench of steroid use and his athletic prowess has come in to question. The “clear and the cream”, substances given to Bonds by his personal trainer who failed to inform him of what they contained, where actually illegal substances used to enhance performance. But why is this steroid thing such a big deal? Why is the home run record that Bonds now holds in question?

Simply stated, steroids are illegal, potentially harmful, banned in most professional sports and college, and is considered cheating. Among athletes on the elite level, some feel that if you are not using steroids, then you are not trying hard enough. Steroids can build muscle and increase an athlete’s speed and strength. That has been proven. The problem is that penalties are placed on athletes found to be using them and if used for long periods of time the side effects can be embarrassing and potentially life threatening. In women, the side effects of steroids include facial and body hair growth, male pattern baldness, deepening of the voice, reduced breast size and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicle size have all been documented. All individuals who use steroids are at risk for high blood pressure, strokes, high cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Some of these side effects like the breast development in men and voice changes in women are irreversible. It amazes me that I get continue to get request from athletes in my private practice for steroids.

Hip-hop has had its bout with accusations of steroid use. LL Cool J was rumored to have used steroids to transforms his body into that of a Greek god. He has denied using steroids as well as plastic surgery to improve his physique in his book LL Cool J’s Platinum Workout.

Whether it is to win at any and all cost or to look good and ripped in a shirts, success and vanity out weigh life and longevity in the psyche of steroid users; that is until something bad happens like being banned from your sport, having a heart attack, or not able to “get it up” when the time is right.

The road to success in sports is hard and education on proper nutrition, exercise, and rest is of the utmost importance. Commitment to the sport on all levels is the only way to be successful. Is Barry Bonds guilty; unfortunately some believe he is, despite being the greatest player to ever play the game of baseball. My advice to him and any young athlete is to never take or rub something on your body without knowing exactly what it is that you are taking or rubbing on you. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/.

Depression and Hip Hop: Are they related?

Images of strength have dominated hip-hop since its inception in the early 1970’s. MC’s often professed superiority over other MC’s with lyrical wizardry and dominance on the microphone. Weakness was not an option, especially outward signs of weakness. However, when it comes to saving your life or the life of someone you love, we have to admit that hip hop artist and those who love hip hop are at risk for one of the most common medical problems seen in the doctors office: Depression. Not that hip-hop itself has any direct relationship to this disease, but you must realize that no one is exempt and we must all be aware of the signs and symptoms of this treatable disease.

The untimely death of hip-hop DJ David “Disco D” Shayman is only a testament to this issue. I never met Disco D and I don’t know all the circumstances surrounding his death, but one thing I can tell you is that depression, left untreated, can lead to loss days of work, destruction of families, and in its worse form, SUICIDE! The old saying that suicide is a permanent solution to a temporary problem is very true. Once a person commits suicide, the opportunity to resolve issues and make amends is gone. Disco D will be missed, and I’m sure he would want those who loved his music to learn more about this problem. So, lets define depression, its signs and symptoms, and options for treatment.

Depression or a depressive disorder is a disease that affects the entire body. It is by no means a sign of weakness and does not have to be prompted by the death of a loved one, divorce, or losing your job, although these situations can be a factor. Depression is an extreme form of sadness that a person cannot pull himself out of or resolve easily with out help. There are several types of depression including major depression, dysthymia, and bipolar disorder. We will focus on major depression. Symptoms of major depression include problems sleeping (insomnia or oversleeping), loss of interest in things one normally does, feelings of guilt, decreased energy, decreased concentration, changes in appetite (not eating at all or overeating), decreased sex drive, and thoughts of suicide. If you have a family history of depression, this also increases your risk of getting the disease. These symptoms usually have to be present consistently for more than two weeks.

In general, women experience depression about twice as often as men, however, men with depression are 4 times more likely to commit suicide than women. There are also studies that show there may be an increased risk of heart disease in both men and women who are depressed.

Once the diagnosis is made, treatment must begin immediately! There are medical problems that can cause depression, such as thyroid disorders and viral infections, but once they are ruled out, the usual course of treatment includes consultation with a psychologist or psychiatrist, medications, and group or one-on-one therapy. Do not let depression take you out of the game. If you or someone you love is exhibiting any of the above signs or symptoms, seek help right away! It could very well save your life. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com.

HIV/AIDS: An Epidemic in the African-American Community

When the media announced that Eric “Easy E” Wright had full blown AIDS in 1995, I grab my Straight Outta Compton CD and head nodded for a few. Four years prior to his announcement, Magic Johnson shocked the world with a similar message… “I have the HIV virus…” It hit me like a rock as my best images of Magic and Eazy E came from the times when they where young and hungry for success. I believed that only gay men got the disease, not realizing that a second cousin moved to California after being diagnosed with an unknown illness and died a lonely death. HIV/AIDS was once thought to be a problem for gay white men only and was defined as the Gay Related Immunodefeciency Disease or GRID. However, ten days after being admitted to the hospital with pneumonia, a common complication of AIDS, Eazy E was dead. The HIV/AIDS epidemic was real and one of gangsta raps pioneers fell prey.

Today, African Americans are facing its greatest health challenge and the numbers reported by the Centers for Disease Control are staggering: African Americans make up only 13% of the United States population, yet we represent 50% of the cases of HIV/AIDS in this country; African American women are the fastest growing population of HIV positive people in the United States; and of the 1.2 million people in the US believed to be infected with HIV, 200-300,000 are unaware they are infected. In the month of October I personally diagnosed eight African American women of child bearing age with HIV- all but one, 25 years old or younger, was incarcerated. This unfortunately comes as no surprise when individuals like Elidor Kersaint (club promoter in Miami), Nikko Briteramos (former college basketball player), and Nushawn Williams (former drug dealer from Brooklyn) have knowingly spread the disease to women.

What was considered a gay white man’s disease has now become one of black and brown brothers and sisters. Debates continue on the origins of the HIV and the emphasis focuses on treatment, not prevention, immunization, or a cure. The bottom line is that the HIV, which is spread by blood and body fluids, is here!

Abstinence, wearing condoms, getting tested, dispelling the myths and educating ourselves about HIV are the only cure. Intravenous drug use (IVDA), promiscuity, men having sex with men (MSM), is the primary modes of infection among African Americans. The southern states have been hit the hardest and my hometown of Baton Rouge ranked number 6 in the country in AIDS cases followed by New Orleans. In 2005, Miami had the highest rates of new AIDS diagnoses in this country. Hip-hop has made several attempts to raise and help eradicate this illness from our communities. When hip-hop was “founded” in the early 1970’s, it was the result of crime and violence that brought about the movement to positively change things. “Coochie Bang” by Queen Latifah and “Go See the Doctor” by Kool Moo Dee, although not specifically addressing HIV, did address condom usage and sexually transmitted diseases. But as you know, the culture has evolved, the game has changed, and the call to do things not necessarily hip-hop is upon us. Rappers, MC’s, and DJ’s have been summoned to speak on politics, injustice, and health. "Hip-hop as a culture is getting a lot of backlash right now for its lyrics, for its public image, and the people are crying out for more responsibility," said KRS-One at the 2007 BET Hip Hop Awards. I applaud Common and Ludacris in their recent efforts to bring more awareness to the issue of HIV/AIDS. We need more of a collaborative effort, however, and I support KRS One for pulling MC’s together to “stop the violence”, but we need some love on the medical battlefield. The messages must be consistent and reinforced on and off the stage. The use of hip-hop as a tool for empowerment has been proven. Lets us use it to educate about health issues as well.

For more information on HIV visit http://www.blackaids.org/. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com.

Sexual Enhancement

In the pursuit of sexual success and fertility, the moon, and everything under it, has been touted as an aphrodisiac by some person or culture. Love potion peddlers stop at nothing to sell their sexual wares. "I'll make you the same promise that my wife made to me," says Theodore Maximillian in the provocative brochure for his "Maxim" product. "I'm going to cure your impotence immediately!" Maxim "acts as a potent aphrodisiac," according to the advertisement.
An aphrodisiac is a food, drink, drug, scent, or device that, promoters claim, can arouse or increase sexual desire, or libido. A broader definition includes products that improve sexual performance. Named after Aphrodite, the Greek goddess of sexual love and beauty, the list of supposed sexual stimulants includes anchovies and adrenaline, licorice and lard, scallops and Spanish fly, and hundreds of other items.

According to the Food and Drug Administration, the reputed sexual effects of so-called aphrodisiacs are based in folklore, not fact. In 1989, the agency declared that there is no scientific proof that any over-the-counter aphrodisiacs work to treat sexual dysfunction.
Countering Cultural Views

FDA's findings clash with a 5,000-year tradition of pursuing sexual betterment through use of plants, drugs and magic. Despite FDA's determination that OTC aphrodisiacs are ineffective--and sometimes even dangerous--people continue the optimistic quest for drug-induced sexual success.

Several principles help demystify some cultural views about aphrodisiacs. Sometimes the reason for an item's legendary reputation is obvious. It's easy to imagine how the sex organs of animals such as goats and rabbits, known for their procreativeness, have achieved their esteemed status as love aids in some cultures.

Chilies, curries, and other spicy foods have been viewed as aphrodisiacs because their physiological effects--a raised heart rate and sometimes sweating--are similar to the physical reactions experienced during sex. And some foods were glorified as aphrodisiacs based on their rarity and mystery. While chocolate was once considered the ultimate aphrodisiac, the reputation wore off as it became commonly available.

Many ancient peoples believed in the so-called "law of similarity," reasoning that an object resembling genitalia may possess sexual powers. Ginseng, rhinoceros horn, and oysters are three classical examples.

The word ginseng means "man root," and the plant's reputation as an aphrodisiac probably arises from its marked similarity to the human body. Ginseng has been looked on as an invigorating and rejuvenating agent for centuries in China, Tibet, Korea, Indochina, and India. The root may have a mild stimulant action, like coffee. There have been some experiments reporting a sexual response in animals treated with ginseng, but there is no evidence that ginseng has an effect on human sexuality.

The similarity of the shape of the rhinoceros horn to the penis is credited for its worldwide reputation as a libido enhancer. The horn contains significant amounts of calcium and phosphorus. The addition of the food to a deficient diet could improve general physical vigor and possibly lead to an increased sexual interest. But in most Americans' diets, which are usually not lacking calcium or phosphorus, the small quantities usually consumed would not affect physical performance.

Because Aphrodite was said to be born from the sea, many types of seafood have reputations as aphrodisiacs. Oysters are particularly esteemed as sex aids, possibly gaining their reputation at a time when their contribution of zinc to the nutritionally deficient diets of the day could improve overall health and so lead to an increased sex drive.

Shortage of Studies
There is no proof that ginseng, rhinoceros horn, or oysters have an effect on human sexual reaction. But might some foods and OTC drugs eventually be proven to affect sexual appetite? Some big obstacles exist to answering this question. The placebo effect is one scientific stumbling block.

"The mind is the most potent aphrodisiac there is," says John Renner, founder of the Consumer Health Information Research Institute (CHIRI). "It's very difficult to evaluate something someone is taking because if you tell them it's an aphrodisiac, the hope of a certain response might actually lead to an additional sexual reaction."

Because the psychological complications are absent in animals, some studies have been done on the effect of certain drugs on animals' sexual activity. One substance that was tested extensively in animals is yohimbine. Obtained from the bark of an African tree, yohimbine has been used for centuries in Africa and West India for its supposed aphrodisiac properties. It supposedly works by stimulating the nerve centers in the spine that control erection. FDA called the res ults of preliminary animal studies "encouraging," but animal studies cannot be relied on to show the effectiveness of the drug in humans.

In people, the only available evidence is anecdotal and subjective. To scientifically measure sexual stimulation, a valid human study would have to be performed in the laboratory, comparing a placebo (an inert pill with no active ingredients) to the test aphrodisiac. Preferably, neither the researchers nor the patients would know who was getting the test substance. Because of cultural taboos, few such studies have been undertaken.

A second obstacle to obtaining proof of aphrodisiac effects is that some drugs may not actually have specific sexual effects, but may change a person's mood and therefore seem to be an aphrodisiac. For example, alcohol has been called a "social lubricant." People drink for many reasons, including to relax, reduce anxiety, gain self-confidence, and overcome depression. Because sexual problems can be caused or worsened by psychological stress, moderate drinking might seem like a sexual enhancer. In fact, it merely lessens inhibitions.

Alcohol is actually a depressant, and so, as the porter in Shakespeare's Macbeth observed, it "provokes the desire, but it takes away the performance." And drinking too much actually decreases desire.

No Quick Fix
Despite the lack of scientific evidence of safety and effectiveness, the fraudulent OTC love potion industry thrives to this day. Marketers use a "blatant snake-oil approach," according to CHIRI's Renner. He estimates that the aphrodisiac sellers, who do much of their business by mail-order, take in revenues in the hundreds of millions of dollars a year.

The FDA sends warning letters to companies that make aphrodisiac claims, stating that the agency may take further regulatory action if the violations continue. "In the health fraud area, when they get a warning letter, most people take their profits and run," says Joel Aronson, director of FDA's division of nontraditional drugs. "They don't want to get into a legal battle with the agency becau se it could involve protracted, expensive litigation."

Aphrodisiac experimentation isn't just a rip-off--it can be deadly. Spanish fly, or cantharides, is probably the most legendary aphrodisiac--and the most dangerous. Made from dried beetle remains, the reported sexual excitement from Spanish fly comes from the irritation to the urogenital tract and a resultant rush of blood to the sex organs. But Spanish fly is a poison that burns the mouth and throat and can lead to genitourinary infections, scarring of the urethra, and even death.

To avoid being taken for their money or their lives, individuals with sexual problems should seek a physician's advice. A lack of sexual energy or ability in men or women could be caused by something as simple as stress or a medication one is taking, or as serious as an underlying condition like diabetes or high blood pressure.

A doctor can diagnose a sexual problem and recommend treatment. If necessary, a doctor can prescribe a drug to treat sexual dysfunction. Testosterone replacement therapy is one prescription option for men whose natural testosterone level is not within the normal range, but its serious potential side effects cal l for a physician's supervision. For those with an impotence problem that isn't caused by low testosterone levels, the new "Caverject" injection may be the answer.

"People will continue to have false hopes of finding easy ways of resolving their problems," says Aronson. And so the hunt for the elusive love drug persists. A universal aphrodisiac may never be found, but experts agree that what's good for your overall health is probably good for your sex life too.

A good diet and a regular exercise program are a more dependable path to better sex than are goats' eyes, deer sperm, and frogs' legs. A good mental state is equally important.
Maybe the wishful search for a cure-all drug should be abandoned in favor of an easier, more reliable mechanism: the erotic stimulation of one's own imagination. To quote renowned sex expert "Dr. Ruth" Westheimer, Ed.D.: "The most important sex organ lies between the ears."
Tamar Nordenberg is a lawyer with the Office of the Director in FDA's Center for Drug Evaluation and Research.

First Impotence Drug
For the 10 million to 20 million American men who suffer from impotence, the Food and Drug Administration's July 6, 1995, approval of Upjohn Company's prescription drug Caverject (alprostadil) may prove to be life-altering. Caverject is the first prescription drug approved for impotence, and is expected to successfully treat 70 to 80 percent of patients.
The drug provides an alternative to devices previously approved by FDA. A vacuum device involves placing a cylinder-like device and attached pump over the penis. By using the pump, blood is drawn into the penis, creating an erection. A constriction band is then placed at the base of the penis to maintain erection. A second treatment option, the penile implant, involves the surgical placement of cylinders in the penis and is available in a variety of designs. (See "Inflatable Penile Implants Under Scrutiny" in the January-February 1994 FDA Consumer.)
FDA approved Caverject to treat impotence caused by neurological, vascular or psychological dysfunction. While psychological factors such as anxiety and depression can lead to sexual dysfunction, more than 85 percent of impotence cases have a physical cause, according to the Impotence Institute of America. A complete physical examination is important so that any underlying condition can be diagnosed and treated. Some common causes of impotence are diabetes, arteriosclerosis (hardening of the arteries), and high blood pressure. Also, impotence has reportedly been caused by 16 of the 200 most commonly prescribed drugs, including drugs for high blood pressure, heart disease, and depression.

Caverject is self-injected into the penis shortly before sexual intercourse. The drug creates an erection by relaxing the smooth muscle tissue and dilating the major artery in the penis, which enhances the blood flow to the penis.

The drug's most common side effect is penile pain. Other side effects include bleeding at the injection site and an unhealthy, prolonged erection of four to six hours. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/