One in three American adults don’t get enough sleep. Though Johns Hopkins Medicine reports that as many as ninety percent of North Americans respond to this chronic lack of sleep with a regular dose of caffeine, that little pick-me-up doesn’t cut it. Sleep deprivation is still having an impact on the individual’s body. Failing to get at least seven hours of sleep at night for adults can have dangerous effects on individuals’ mental health. Here are three reasons why you should prioritize quality sleep for the sake of your peace of mind.

The brain needs regular cleaning. Throughout the day as the brain takes in environmental data and performs complex problem-solving, waste materials back up in the central nervous system. According to one study published in Science, the brains of sleeping mice were documented as significantly better at removing this neural waste material than the brains of waking mice. Without enough sleep the brain can’t clean itself, leaving us feeling groggy and disoriented the following day.

The brain needs time to process powerful experiences. Trauma survivors who sleep immediately following a traumatic incident have a lower risk of developing post-traumatic stress disorder (PTSD) than trauma survivors who do not sleep. A study published in the journal Sleep found that sleep immediately following a traumatic experience helps to consolidate and process that experience, decreasing the likelihood that the survivor will develop PTSD.

Many people who experience trauma go on to develop some combination of anxiety, hyper-vigilance or flashbacks of the traumatic event, all common symptoms of PTSD. An addiction to drugs or alcohol can begin as an unhealthy coping mechanism a survivor uses to treat symptoms of PTSD. Sleeping within a few hours of a traumatic event acts like a preventative treatment against developing PTSD, helping the brain get things in order so the survivor can effectively process and move on from the trauma.

Peace of mind contributes to peaceful sleep. Prioritizing quality sleep can also foster other mental health benefits typically associated with mindfulness practices. In a recent study conducted by researchers at the David Geffen School of Medicine at UCLA and the Keck School of Medicine at the University of Southern California, people who reported difficulty sleeping were treated with one of two interventions: a standardized mindfulness awareness practice (MAP), or a sleep hygiene education curriculum (SHE). After six weeks, participants who engaged in MAP interventions were more likely to sleep better and experience better quality sleep than those who went through the SHE program.

This research demonstrates that mindfulness techniques can be an effective way of getting more quality sleep without resorting to prescription or over-the-counter sleep aids. Many of the most common sleep aids have some risk for abuse or physical dependency. People with a history of addiction or who are concerned about this potential should consider cultivating a meditation practice during the day or before bed to help ease the mind into restful sleep.

Last week the National Academies of Sciences, Engineering and Medicine released a report surveying over 10,000 scientific studies to determine conclusively how marijuana interacts with the body. The review was especially concerned with marijuana’s efficacy as a medicine as well as its positive and negative short- and long-term effects on users.

Some of the Academies’ published conclusions were incredible. For example, there is conclusive evidence that cannabis and/or cannabinoids are an effective treatment for chronic pain in adults. It’s also clear that using cannabis prior to driving increases the likelihood of being involved in a motor accident, and smoking cannabis during pregnancy leads to a lower birth weight among newborns. These and other conclusions from the report will help create more effective public policy based in research and demonstrable fact, not moral bias.

Marijuana’s use as an alternative to prescription opioids for people experiencing chronic pain comes at a crucial time. In 2015, more than 20,000 people died from an overdose related to prescription opioids, and Congress will consider funding for at least two bills designed to curb the prescription opioid epidemic this session. Significantly, another recent study showed that states with medical marijuana laws had nearly 25% fewer fatal opioid-related overdoses than states without similar provisions. Recognizing medical marijuana as one alternative to prescription opioids could be the breakthrough the medical community needs to curb opioid-related deaths.

But the Academies’ report revealed another major element of the medical marijuana debate: how little is known about the drug’s immediate and lasting effects. For example, we don’t know conclusively whether cannabis or cannabinoids are an effective treatment for anorexia nervosa or whether inhaling marijuana smoke causes asthma. There are a host of cancers including cervical and prostate cancer that may be influenced by regular marijuana consumption, but the exact relationship to marijuana is still unknown.

The lack of health-related research has nothing to do with marijuana’s prevalence. Eight states and the District of Columbia have legalized marijuana for recreational purposes, and more than half of all U.S. states have legalized marijuana for varying medical purposes. According to the Centers for Disease Control and Prevention, approximately one in eight Americans reported smoking the drug at least once in the past 12 months. So why is there so little research on the acute and chronic effects of this drug?

Marijuana is classified as a Schedule 1 substance according to the Controlled Substances Act, which means the Drug Enforcement Agency (DEA) and federal government recognize no known medical purposes for marijuana and consider it to have a high potential for abuse. Without federally recognized medical uses, obtaining funding for research into the effects of marijuana is difficult to come by and often requires elaborate safety precautions. Yet despite the growing number of states that have legalized some form of marijuana use, the DEA is unlikely to change the drug’s Schedule 1 status anytime soon. In August of 2016, the DEA confirmed that marijuana would remain a Schedule 1 substance after a report from the Federal Drug Administration found no proof of marijuana’s efficacy as a medicine  at that time.

The lack of adequate research into the medical uses and long-term health effects of marijuana as highlighted by the Academies’ report is hurting Americans. Whether marijuana has a wide variety of uses or only a few specific applications, the public deserves to know how best to use or avoid marijuana. Ignoring medical marijuana as an alternative to prescription opioids is tantamount to negligence in a time when tens of thousands of people are dying from preventable opioid-related overdoses. It’s time the federal government gave its full support to further researching exactly how marijuana impacts our bodies.

Medication-Assisted Treatment (MAT) is one of the most under-utilized tools we have to fight our country’s ongoing addiction crisis. Ideally, this intervention employs specific pharmaceutical drugs combined with counseling and behavioral therapies, but its true power is often obscured by misunderstanding. Effective use of MAT can make the difference between a long, healthy life and an untimely death by overdose. Here’s what you need to know about MAT and why people battling addiction should consider it.

Decades of research shows that properly administered MAT is a safe, effective treatment option for substance abuse, increasing the likelihood that people in recovery from an opioid addiction will stay sober and in treatment longer than peers who don’t utilize MAT. The National Association of State Alcohol and Drug Abuse Directors (NASADAD), World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA) all strongly support access to MAT for drug abuse.

MAT is most useful when combined with intensive one-one-one psychotherapy, group support, and complementary therapies. The way in which MAT affects the brain effectively gives the addict breathing room and time to address the underlying causes of their addiction. MAT allows the addict to focus on their recovery instead of being compelled to use by co-opted neurological processes. MAT is a tool to be used in reaching that goal of long-term abstinence from drugs and alcohol. However, if MAT is used on its own, without other forms of supportive therapy, it is unlikely that recovery will last.

MAT covers both the immediate term use of naloxone to revive overdose victims and longer-term use by those in addiction treatment programs. Recent legislation, including the Comprehensive Addiction Recovery Act, has emphasized the importance of supplying first responders with naloxone, a powerful opioid overdose reversal drug. Other formulations of MAT are used in longer-term therapies by addiction treatment providers. Each can be effective.

One of the hurdles to those who would like to use MAT is that 12 step programs are not supportive of its use. Those programs define sobriety as complete abstinence from mind-altering substances, a category into which MAT falls. This is unfortunate because those who use MAT would very often benefit from the support that can be found in 12 step programs.

Like any treatment, MAT is not for everyone. Individuals should discuss all their concerns with their addiction treatment team, hopefully including a medical doctor who is an addiction specialist. All treatment protocols have benefits and disadvantages. Make sure you are comfortable with your choice and know that there are many different treatment options.

Ultimately, MAT is just one option to consider when creating a quality long-term addiction treatment plan. The most sustainable recovery plans aren’t oriented around any one treatment modality, but include a host of therapies to ensure the best results. There is no one intervention that can protect someone in addiction recovery from relapse. Freedom from addiction must be grown and nurtured continuously over time in order to yield a fulfilling, fruitful life.

For the first time in the city’s recorded history, more than 1,000 New Yorkers are expected to die from a fatal drug overdose in 2017. Key to this record-breaking statistic is the increased abuse of fentanyl, a cheap synthetic opioid up to 100 times more powerful than heroin. Relatively unknown to the general public until recently, this drug’s astounding lethality is tearing across the country as deaths related to fentanyl and other synthetic opioids surged more than 70% from 2014 to 2015. So where did this drug come from, and why are so many people dying because of it?

Fentanyl has been utilized in medical settings since the 1960s. Its most common uses include treatment for chronic pain in cancer patients and as surgical anesthesia. But as the opioid abuse crisis rages on, fentanyl is becoming infamous for its unsettling presence in a growing number of fatal overdose toxicology reports. In some parts of the Northeast, fentanyl has even surpassed heroin as the most commonly detected drug in fatal overdoses.

Several factors combine to make fentanyl an effective killer. For one, its extreme potency makes it very easy to accidentally overdose on, even in miniscule amounts. Non-pharmaceutical fentanyl is also much easier and cheaper to manufacture than heroin, making it a more cost effective product for drug dealers looking to stretch a batch of heroin and increase their profits. This means that some people ingesting fentanyl don’t even know they’re using the deadly drug, setting people up for reckless use with life-ending consequences.

Adding fentanyl to heroin also plays into a key component of addiction: escalation. The first time someone abuses an opioid like heroin or Oxycodone, the brain responds by dumping feel-good neurotransmitters like dopamine into the user’s neural reward pathways, producing feelings of euphoria and well-being. As an individual’s brain and body become accustomed to the drug over time, the brain stops responding as strongly, encouraging the user to seek out stronger and stronger substances. For long-term heroin users, adding fentanyl to their dope helps them reach those first-time highs again, but at the risk of losing their life.

Given the high likelihood of an overdose when using fentanyl, it’s more important than ever to make sure you have the opioid overdose-reversal medication naloxone on hand. But because of the potency of fentanyl, a single shot of naloxone may not be enough to revive someone who has overdosed on it. Depending on the amount of fentanyl that’s been introduced to the body, naloxone may not work at all.

Based on its insidious presence in heroin, resistance to overdose-reversal drugs and record-breaking fatalities, fentanyl is well on its way to becoming public health enemy number one. We must continue to fight the opioid epidemic with greater public education, an ongoing supply of naloxone for first responders and householders, and increased access to quality addiction treatment services for those ready to get help. As the New York City’s records show, this epidemic of drug abuse will not get better on its own; in fact, it’s getting worse.

Talking with friends or loved ones about being more careful when they drink alcohol can feel uncomfortable. But for thousands of Americans who die from alcohol poisoning every year or are killed by a drunk driver on New Year’s Eve, one uncomfortable conversation could have made the difference between life or death. Here’s how you can broach the subject with friends, children, siblings or parents, and help them stay safe and healthy as they welcome 2017.

Your loved one may brush off your concerns about their drinking on New Year’s Eve by blaming the holiday itself. In fact, the accepted social norm that people will drink alcohol to excess on New Year’s Eve makes it even more dangerous for the casual user. It is never a good idea to drink more than one alcoholic beverage in an hour, no matter what day it is. Don’t let the holiday obscure the difference between healthy, controlled use of alcohol with life-threatening, blackout abuse.

Still, some people might laugh off the threat. Because it’s so common for people to drink alcohol, your loved one might dismiss your concerns for their health and safety as unfounded. But while there’s plenty of evidence showing how dangerous and pervasive opioid abuse is, alcohol is overwhelmingly more lethal than opioids, killing over 30,000 more people every year than the notorious class of prescription drugs. Alcohol abuse is no joke, but rather an insidious behavior capable of ending your life and the lives of others in just night or one bad decision.

Even people accustomed to drinking often can easily get burned on New Year’s Eve. Caught up preparing for the night, it’s easy for people to forget to eat a full meal and drink plenty of water to help negate the effects of excessive drinking, setting your body up for failure. Alcohol poisoning really can happen to anyone who doesn’t take care of their body or respect their physical limits.

Remind your loved one that other people will be affected by their decisions. If they insist on drinking to excess, make sure they understand that other people at their party will likely want to match their pace regardless of their own tolerance. Other family members including younger siblings or children will also be influenced by a family member’s reckless drinking and receive the tacit message that excessive drinking is tolerated. If you have to make the conversation about being a good role model for peers or younger relatives, don’t hesitate to go there. You may end up saving more than one life.

Make sure you take a moment to talk with your loved ones about responsible alcohol use this New Year’s Eve. Your conversation about alcohol use may feel uncomfortable at first, but it will show your child, relative or close friend that you really care. Alcohol poisoning is deadly and can happen to anyone at anytime. Make sure your loved ones know you’ll need them in 2017 and every year to come.

Elephant Sedative Carfentanyl is the Latest and Deadliest Heroin Additive

One of the biggest risks associated with illegal drug use is that there’s no way to know for sure exactly what’s in the substance you’re consuming. Many drug cartels dilute their products with nearly indistinguishable substances, for example mixing powdered milk into a batch of heroin, in order to increase the overall quantity of the drug, sell more, and make more money.

One uncommon heroin additive that’s been making headlines recently is carfentanyl. An analogue of the more commonly known opioid analgesic fentanyl, carfentanyl was first produced in 1974 and intended for sedating large animals like elephants and moose. In August of this year, a Cleveland, Ohio medical examiner found evidence that the drug was contributing to the state’s high rate of fatal opioid overdoses and released a public health warning to that effect.

It can be impossible without testing equipment to tell if an additive like carfentanyl has been added to a small supply of heroin. Carfentanyl is odorless and colorless, making it effectively invisible and undetectable. There really is no way for an average user to test the purity of the substances s/he purchases.

Even worse than not being able to tell if carfentanyl has been folded into a batch of heroin, what makes carfentanyl really scary is its strength. Commonly described as 10,000 times stronger than morphine, 2,500 times more powerful than heroin and 100 times the strength of fentanyl, carfentanyl is one of the most powerful commercial opioids in use today. This outsized potency is the perfect level for quickly sedating a large animal but can prove lethal to humans if as little as one drop is absorbed through the skin.

It gets worse. People with loved ones who currently use heroin have been gaining access to naloxone, an opioid-reversal drug that can keep someone alive even after ingesting a lethal dose of heroin. Sold commercially as Narcan, a nalaxone overdose reversal kit usually comes with a few doses and these days can cost as much as forty dollars.  While carfentanyl is a synthetic opioid, because of its extreme toxicity, just one or two doses of naloxone are not enough to reverse an overdose, creating confusion among loved ones trying to administer the life-saving drug and opening the door to even more unnecessary suffering and death.

There is one bright spot. Carfentanyl is not a common additive to street-level heroin and we are still seeing only a few areas where the drug has popped up.

Even without any additives, heroin is capable of ruining lives and tearing apart families. But where carfentanyl has been introduced into an area’s supply of heroin, as we’ve seen in states like Ohio, the trail of death and destruction it leaves in its wake is unmistakable.

There are a million reasons to quit using heroin, including for family, loved ones, health, safety and happiness. The possibility of ingesting a drug capable of taking down an elephant should not have to be among those reasons, but it is. Get help now if you are using heroin.