Hard habits to break

National | A morbid drug hits the streets, heart patients fail to exercise, and doctors test a new "video pill"

Issue: "Heresy trials," Aug. 18, 2001

Dead man smoking
Some drug users have found a new favorite substance-embalming fluid. Experts say the curious chemical is gaining popularity despite the often violent and psychotic side effects. PCP has gone by the street name "embalming fluid" since the 1970s, but druggies now seek the real thing too: a mix of formaldehyde, methanol, ethanol, and other solvents. Users-typically in their teens or 20s-spend about $20 for joints or regular cigarettes that were soaked in it, then dried. The product goes by various names, such as "wet," "fry," and "illy" and is sometimes mixed with PCP. "What they're getting is often PCP, but the idea of embalming fluid appeals to people's morbid curiosity about death," said Dr. Julie Holland of New York University School of Medicine. "There's a certain gothic appeal to it." Hydrol Chemical, an embalming fluid supplier, warned funeral homes to store their product more securely. Users report a host of effects from the high, which may last from six hours to three days. These include hallucinations, euphoria, a feeling of invincibility, increased pain tolerance, anger, forgetfulness, and paranoia, according to a 1998 study by a Texas commission. Experts say more dangerous reactions may include coma, seizures, renal failure, and stroke. Julie Kirlin, a juvenile probation officer in Reading, Penn., says that use of the drug crosses economic lines. "This is a violent drug, and it will turn into a big fire if it's not watched very closely," she said. Attacking heart attacks
Patients may be ordered to exercise, but following the plan can be difficult. Even when their lives are at stake, building the habit can be hard. Now a three-year study concludes that doctors should make exercise more convenient. Researchers found that heart attack survivors drift away from their prescribed workout routines, even though exercise reduces the risk of another attack. Many start but few finish, according to the National Exercise and Heart Disease Project. (The researchers reported their findings in the journal Medicine and Science in Sports and Exercise.) The percentage of patients who exercise falls from 80 to 13 over three years, with smokers having the most trouble. Researcher Joan Dorn of the University at Buffalo, New York, said those most at risk were least disciplined. "It's hard to stick with behavioral interventions," she said. "People are looking for a drug and an easy way." Coronary heart disease is the top cause of death and disability in the United States, according to the National Institutes of Health. It kills half a million Americans annually. Regular, vigorous exercise can help reduce risk, particularly in those with routines prescribed by a doctor. Say cheese
The FDA approved a new way to see inside the human body: a miniature camera patients swallow that sends back color pictures of their small intestines. This "video pill" fits in a capsule and reminds many of the tiny submarine in the movie Fantastic Voyage. Dr. Blair Lewis of New York's Mount Sinai School of Medicine said he tested the Israeli-made Given Diagnostic Imaging System on 20 patients-and it works. He said that when he was first approached about the device, he distrusted it. "It's very sci-fi," he said. After a patient swallows the video pill, the camera travels through the digestive system and beams pictures to a receiver worn on his waistband. After a short period-from eight to 72 hours-it is excreted out of the body. The doctor then transfers the pictures off the receiver to his computer and looks for a diagnosis. Studies found no side effects. The downside is that the battery dies before the camera reaches the large intestine. Also, doctors must first buy a $20,000 workstation before using the cameras; each capsule costs $450. In addition, the FDA limits use to certain patients (in conjunction with other tests). Even so, the camera is said to be pain free and gives doctors views that weren't previously possible. "This is really the beginning of a long road for this type of technology," said Dr. Dan Schultz, FDA's director of abdominal devices.

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