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Killing Us Slowly Table of Contents:  Killing Us Slowly: The Relationship Between Type II Diabetes and Alcoholism  Killing Us Slowly: When What We've Been Told Is Wrong  Killing Us Slowly: When We Can’t Fight and We Can’t Run  Bibliography  Killing Us Slowly: The Relationship Between Type II Diabetes and Alcoholism  Ann Dapice, Ph.D., Clark Inkanish, ICADC, Barbara Martin, B.S. and Elizama Montalvo, M.D. (Published in Native American Times, June 2001) Onyx Mooney, a Choctaw, was heard to say recently, "Practically everyone in my family is either diabetic or alcoholic. I'm 38 years old and I'm not alcoholic so I wonder when the diabetes will hit." He didn't realize at the time how true his statement was, nor the physiological relationship between the two diseases. His observations are accurately demonstrated in the statistics. American Indians have had the highest incidence of Type II Diabetes of any racial group resulting in related cardiovascular disease, kidney disease and high amputation rates. American Indians also have the highest incidence of alcoholism, nicotine addiction and suicide of any racial group. Physiologically, these are all interrelated.  Conquest by Europeans resulted in genocide, great poverty and oppression for all Indians across the Americas, but until recently, diabetes and alcoholism were mainly seen as problems among Indians north of the US-Mexican border. This was true even for tribes divided by the border. Why? How is the present incidence of alcoholism and diabetes among Indians the continuing result of earlier European and US policy towards Indians from the beginning? A physiological relationship has been found between alcoholism and Type II Diabetes. Both are related to problems in blood sugar regulation. An elevated insulin response to carbohydrates exists in both the pre-diabetic and the alcoholic. Most people are unaware that between 75% and 95% of alcoholics are hypoglycemic. (It should be noted that not all people who are hypoglycemic are or will become alcoholic or diabetic.) Dr. Joan Larson author of Seven Weeks to Sobriety has written that Native Americans are particularly vulnerable to adult-onset diabetes when associated with drinking. Although long considered a moral weakness and still treated as an emotional problem, alcoholism, like diabetes, is a physical disease. There are mental, emotional and spiritual components to all illnesses, but at base, alcoholism is a physical disease.  Alcoholism in Native Americans is partly related to an allergic response. American Indians are allergic to a number of the foods brought by Europeans and especially to grains (e.g., wheat, barley, oats, etc.) Food allergy symptoms include fatigue, mental confusion, depression, physical aggression and suicide attempts. After repeated exposure, intense cravings for the allergen and physical addiction resulting in withdrawal symptoms are the maladaptive responses. This allergy was demonstrated by the initial reaction of Indians to grain alcohols described in historical accounts. Alcoholism is lowest in countries where these grains originated thousands of years ago (e.g., Africa, Italy, Greece, etc.) and highest in countries that received these grains more recently (e.g., Russia and northern European countries.) Indians in the US are a prime example of people most recently exposed to these grains and therefore most acutely affected by allergic symptoms. Corn is the grain indigenous to what is now called the Americas. However, traditionally Indians processed corn in a variety of ways using lye or lime. Science has since discovered that this process was required to release complete amino acids and the niacin required to regulate blood sugar. Different tribes had different recipes for treating corn using this method (e.g., softkey, hominy, etc.). Some tribes still have official "corn lyers." Mexican tortillas purchased in the US have this process listed on their labels presently. In the US, governmental policy demanded re-socialization of Indians to European ways--the English language, European dress, how to cook their foods, etc. The policy was known as "Kill the Indian, save the man." South of the border, oppressive but distinctly different policies allowed Indians to continue to cook in traditional ways. Meanwhile in the US, corn was purposefully engineered to achieve the sweetness found most desirable.  In addition to the proper processing of corn, traditional diets of buffalo, fish, turkey, deer along with roots, vegetables, nuts and wild fruits are now seen as important to the treatment of both diabetes and alcoholism for Indians and non-Indians alike. The key is a diet high in protein and fiber, low in carbohydrates, grains and refined foods. Unlike modern life, obtaining these foods once involved considerable exercise as well. Cokes, candy, fast food, cakes and pies were of course not traditional. Fry bread--made from refined wheat flour--was not traditional either. Many dishes now considered to be "Indian" are the result of Indians losing their lands and cultural ways. Forced to live on commodity rations, Indians made recipes from what they had in order to survive. Unfortunately, these wheat-based, sugared, refined foods keep us sick. Meanwhile, indigenous peoples are suffering increased problems with diabetes and alcoholism worldwide. For example, the Tarahumara Indians in Mexico, long known for their superior foot races, have also been recognized for their ability to drink corn beer without suffering from alcoholism. Until recently this tribe shunned European and industrials ways and lived in a close and strongly moral community. Now forced off their native lands and into factories for work, and with the adoption of refined western foods, they too are beginning to suffer problems with alcohol and diabetes. So the genocide continues. Yet, the effects of modern, refined foods are no longer limited to indigenous people. Related illnesses and addiction are a problem for all people worldwide. The need and effectiveness for addiction treatment that promotes physical healing and repair of physiologic damage has been studied for decades. Bill Wilson, the founder of Alcoholics Anonymous, first established the link between alcoholism and hypoglycemia and the need for biochemical treatment using niacin and B vitamins. His own experience suffering depression long after he'd been sober caused him to research the need for niacin in treating alcoholism. For some reason this information was never incorporated into present AA practice. Wilson's work has been supported in recent studies by considerable scientific research demonstrating that the physiological effects of sugar, caffeine and tobacco (up to 75% sugar cured) are the major causes of alcoholic relapse. Unfortunately, once thought to be appropriate substitutes for alcohol, these substances remain the mainstay of 12 step and drug rehab programs whose present success rates are only 7% after four years. Even after sobriety, hypoglycemia and maladaptive allergic responses continue unless treated. New technologies enabling scientists to view changes inside the brain have shown alterations in brain pathways after prolonged exposure to alcohol. After years of sobriety many sober alcoholics not treated for hypoglycemia remain depressed, irritable and anxious, often hostile and paranoid as well. These are what often have been referred to as "dry drunk" symptoms. They are the symptoms of hypoglycemia as well. This is related to a statistic showing that one in four deaths among sober alcoholics is due to suicide. Allergic response to grains and chemicals continue to cause intense cravings, trigger "addictive memory," and lead to relapse. These sustained effects often make the thought of sustained sobriety and wellness seem unattainable. Decades of research by others--and the research and practice at T. K. Wolf & Associates--show that cranial electrical stimulation and correct nutrition achieve healing. They provide the necessary electrical impulses to the brain cells along with the proteins and amino acids needed for neurotransmitter production allowing manageable withdrawal, prevention of cravings (sugar, caffeine, tobacco and alcohol), repair of the damaged brain and other organs, and prevention of relapse. They also respond to the related depression, anxiety, stress and insomnia of alcoholism. Unlike attempts at pharmacological solutions, there are no side effects. Curiously, well documented research using these methods to control withdrawal and promote biochemical repair have been published in major scientific journals for decades, yet have been implemented in only a few treatment facilities in the US. Fortunately, here in Oklahoma, as well as in California, Alaska and Canada, Indians are leading the way.  Killing Us Slowly: When What We've Been Told Is Wrong Ann N. Dapice, Ph.D. Clark Inkanish, ICADC Barbara Martin, B.S. (Published in Native American Times, August 2001) The Robert Wood Johnson Foundation recently declared substance abuse the number one health problem in the US (February 2001). Stating that substance abuse causes more deaths, illnesses and disabilities than any other preventable health condition, the Foundation noted substance abuse costs the nation more than $410 billion a year according to health care and justice records. Roughly half of all serious crimes are committed by people under the influence. Physical, emotional, family, and societal suffering are beyond calculation. As we noted previously in "Killing Us Slowly: The Relationship Between Type II Diabetes and Alcoholism," American Indians have the highest incidence of alcoholism, nicotine addiction and suicide of any racial group. Alcoholism, nicotine addiction and suicide, like Type II Diabetes, are all the results of physiological disease and are interrelated. In each, there is stigma and moral judgment: "Why can't they control their ways of living--eating, drinking, smoking, emotions?" In each case there is depression.  Also, as we noted previously, the mortality rates from these diseases in the Indian community are the highest for any group. The total cost of suffering is beyond comprehension. The symptoms with common base: depression, irritability, anxiety--and sometimes hostility and paranoia as well--are not socially attractive. The result is often summarized by the statement made recently by a kind-hearted physician, "I find alcoholics and diabetics the most difficult of all patients to treat." While most people try to be compassionate regarding diabetics, seeing diabetes as a legitimate disease, few are willing to be charitable to alcoholics and substance abusers.  Yet, highly successful, self administered and cost effective treatment has been scientifically researched in the US and other countries since the sixties. The treatment is safe, noninvasive, non-addictive and FDA sanctioned for use. It has proven to be effective in the treatment of numerous conditions such as substance abuse, drug withdrawal syndrome, depression, anxiety, and insomnia. It is called Cranial Electrical Stimulation (CES).  In spite of the success of CES, the following is true about typical substance abuse treatment: 1) Success rates from 12 Step and rehabilitation programs range between three and eight per cent after four years. (By 1980, CES treatment had success rates of 80 per cent after seven years [Patterson 1984] and the technology has improved since then.) 2) 12 Step and rehabilitation programs most often do not permit, or are even aware of, the use of CES. They continue to substitute substances (sugar, nicotine and caffeine) which are clinically demonstrated to lead to relapse for known physiological reasons.  3) Substance abusers are often given prescription medications for prolonged periods--medications that have major side effects and are themselves addictive. This leads to multiple addictions--and continued returns to treatment facilities--or prisons and death. 4) While these treatments may have once been the only treatment choices, this is no longer true. Comparative Benefits of CES CES normalizes the electrical activity of the brain as measured by electroencephalogram (EEG). CES has been researched and found effective in a variety of addictions including alcohol, cocaine, benzodiazapines, heroin, marijuana, methadone, and nicotine (including addictions to patches and gum). CES units can be held in the hand, clipped to a belt, or worn in a pocket. Tiny electrical currents similar to those naturally occurring in the body are applied through either clip electrodes to the earlobes or by leads attached behind the ears.  Even without government or health insurance payments, for the cost of alcohol or cigarettes (the least expensive addictions), substance abusers or their families can rent or buy their own CES units. No longer paying for their addiction, they will be financially ahead in six months to a year. In addiction withdrawal, CES is used during most waking hours during the first ten days and then as needed after that time. After three weeks the addiction is generally seen to be under control, but patients report using the units from time to time during stressful periods. We recommend its continued use self-enhancement and relapse prevention. No lasting side effects have been observed in more than 100 research studies carried out in a variety of institutions over decades using appropriate scientific protocol including double blind studies. In addition to those mentioned above, positive effects of CES include: enhanced cognition, reduced withdrawal symptoms, brain wave improvement of P300 (the wave associated with drug craving), enhanced neurotransmitter functions, relapse prevention, and prevention of substance abuse in high risk individuals.  Support groups, counseling and education may still be required to teach those whose lives have been dysfunctional, but these cannot work and do not work while individuals are still physically addicted. Support groups, counseling and education are readily available and they are cost effective--as long as they support the use of CES technology and do not encourage practices (e.g., eating candy, smoking, drinking coffee) which lead to relapse. Use in Indian Culture and Spirituality For the Indian community, the knowledge of healing through the use of electricity is well known. There has long been an understanding of the power of life forces--seen through the creative energy that emanates in all of life for healing as seen in the picture in this article.  Indians recognize the energy of electricity in the use of hands and fanning off ceremonies, as well as in blessing themselves with the energy of a plants and animals. The presence of the Creator from the center of the medicine wheel is experienced as energy in the form of electricity that may be felt or seen as a ball of white light. Other spiritual traditions report similar experiences and acknowledge its importance in healing.  In our office we combine the use of CES and native nutrition (see previous article) with counseling, the Medicine Wheel, and Native American ceremony for healing of the mind, heart, body and spirit. Killing Us Slowly: When We Can’t Fight and We Can’t Run Ann N. Dapice, Ph.D., Clark Inkanish, ICADC, Barbara Martin, B.S., and Pam Brauchi, MHR, LPC (Published in Native American Times, September 2002) In the American Indian community, the experience of reading current Indian Health Service statistics on death and disease among Indians is similar to that of reading about a third world country in the news. Yet, since American Indians are such a small percent of the US population, these numbers are not “statistically significant” to the US as a whole and thus are seldom seen. The numbers read, age group by age group, like a road map to disaster. What is less clear to most people is the relationship between these terrible numbers and their causes. The effects are the result of complex interactions between previously adaptive survival mechanisms, pre-Columbian culture and diet, and include past and present US policy. Even though many know that Indians suffer greatly from alcoholism and Type II Diabetes, our work demonstrating the physiological relationship between the two was, unexpectedly, groundbreaking. The other high morbidity and mortality statistics can be understood in the same way. Accidents, homicide and suicide kill Indian children and youth in far larger numbers than any other racial group. Later in life, heart disease, chronic liver disease/cirrhosis, and diabetes kill Indian adults greatly out of proportion to other groups. Physiologically and socially, these causes of death are all related to alcoholism, smoking, and other addictions such as those to food. Lung cancer is increasing among Indians but even though Indians smoke more than any other group (Indians—40%, all races—25%), they have usually suffered and died of other maladies before developing lung cancer.  History and factors which provide background to the problem— As noted in our article published in the Native American Times (See “Killing Us Slowly,” June, 2001), conquest by Europeans resulted in genocide, great poverty and oppression for all Indians across the Americas, but until recently, diabetes and alcoholism were mainly seen as problems among Indians north of the US-Mexican border. This was true even for tribes divided by the border. The present incidence of alcoholism and diabetes and related diseases among Indians are the continuing result of earlier European and US policy towards Indians from the beginning. The physiological relationship between alcoholism and Type II Diabetes and the allergic response to grains brought to the Americas by Europeans affects Indians in great numbers. But it is important to note that these phenomena are not limited to indigenous peoples, since modern processed foods and addictions are becoming a scourge around the world to all people. Genetic differences in alcoholism have long been noted. A number of researchers have demonstrated that EEG patterns are different in alcoholics and non-alcoholics. It has been determined that the differences are not that of alcohol use but that these differences are present at birth in identical twins. Individuals at risk for alcoholism can be differentiated on the basis of their EEG alpha activity. Alcoholics have greater increases in slow alpha activity and greater decreases of fast alpha activity after use of alcohol. A reduced P300 wave is a good predictor of alcoholism. Recent studies show that alcoholism relapse can be predicted by brain waves. Alcoholics are said to use alcohol, sugar, nicotine, and caffeine in vain attempts to quiet their irritable brain waves. The impact of stress— More recently understood however, is the reality of what happens to the body and brain during high or chronic levels of stress. The adaptive mechanism known as “fight or flight” that allows people to protect themselves in emergency conditions becomes destructive when people are not allowed to fight or flee, or when the stress becomes chronic. Cortisol, produced during these times, becomes toxic to the body and the brain, killing brain cells and leaving depression in its wake.  Ray Smith, Ph.D., speaker at last year’s Return to Your Roots Conference, has noted that human responses to physical and psychological threats seem not to have changed since our ancestors were hunting large animals. We humans survive periodic threats and challenges by maintaining homeostasis—a delicate, dynamic equilibrium. If that harmony is disrupted, neural and biochemical events in the brain, the endocrine, and immune systems are jolted into action to counter the effects of the physical or psychological stressor—and to reestablish homeostasis. If such homeostasis isn’t reset, debilitating illness results. When we are threatened, a series of responses occur—our physiological processes which have to do with conservation and restoration of energy are put on hold, and the processes which prepare us for fear, fight and flight takes over resulting in the release of cortisol into the bloodstream. Once the threat is addressed, the body returns to homeostasis and the brain is relaxed through the inhibition of several chemicals (the neurotransmitters serotonin, norepinephrine and dopamine). If the threat is not removed, a stress cycle develops where more cortisol is produced causing further problems. Now there is a permanent state of stress homeostasis which impairs our immune systems, decreases our bone density, weakens our muscles, increases heart and vascular diseases, and lowers our resistance to diabetes.  After prolonged exposure to severe stress the body secretes internally produced opium-like substances which inhibit pain and reduce panic. Memory is impaired in animals when they are no longer able to influence the outcome of a dangerous situation. The “freeze” response and panic interfere with memory processing—the internally produced adrenalin and opium-like substance interfere with the storage of experience in memory. This protective mechanism may serve to keep the individual from consciously remembering an event but often results in confusion regarding related emotional pain and behavior. It can also prevent learning from the experience. Post traumatic stress disorder, oppression and genocide— Post traumatic stress disorder (PTSD) resulting from traumatic events continues the effects of the stress over time, continuing a cycle of cortisol production with ongoing depression. PTSD patients typically continue to re-experience a trauma, avoid stimuli associated with the incident and feel numb. They demonstrate hyperarousal, irritability, insomnia and inability to concentrate.  In circumstances where we are under someone else’s power with little of our own—whether a child in an abusive family or in the extreme situation of genocide and slavery—we cannot fight or flee so stress becomes chronic and the levels of cortisol remain elevated. At some point in time we may no longer be able to produce the cortisol needed for times when it might actually help with fight or flight actions that are appropriate to a situation. Not only can we ourselves become cortisol depleted, but children born to mothers with low cortisol levels have often been found to have low cortisol levels as well. The related behavioral effects can be seen in situations of hopelessness and poverty where people no longer seem to be able to fight for their survival, leading to assumptions that they are lazy and don’t care—as opposed to depressed, hopeless—and cortisol-less! When powerlessness has been sufficiently abusive and lasted for a long enough time, an individual develops an expectation of ongoing abuse and even when moved to a safer situation often has great difficulty responding in any other way. New situations are interpreted as the same as those in the past so that fear continues to stimulate what small levels of cortisol may still be produced. Eduardo and Bonnie Duran, in their book, Postcolonial Psychology, write that American Indians experience intergenerational PTSD similar to that of survivors of the Jewish Holocaust. The authors note that not only did the survivors of the Jewish Holocaust suffer from PTSD but many of their children did as well—even though they had not directly experienced the events of the Holocaust. Normal human development is “mutilated by the traumas of loss, grief, danger, fear, hatred, and chaos” write the Durans, and dysfunctional patterns of behavior come to be seen as part of Native American tradition—the alcoholism, child abuse, suicide, and domestic violence (p. 35). Child abuse— Harvard researchers Martin Teicher and Carl Anderson have demonstrated through brain imaging technology that there are three major changes observed in the brains of adults who were abused as children: 1) Limbic irritability with increased incidence of clinically significant EEG abnormalities. 2) Deficient development of the left hemisphere of the brain (throughout the cerebral cortex and hippocampus). 3) Deficient integration of the left and right hemispheres of the brain with diminished development of the middle portions of the corpus callosum that serves as a bridge connecting the left and right brain. These changes do not require actual physical damage to the head but are most often the result of neglect, emotional and sexual abuse. Anderson found that repeated abuse affects the blood flow and function of the cerebellar vermis, a part of the brain implicated in the coordination of emotional behavior which is strongly affected by alcohol, cocaine, and other drugs of abuse and may help regulate dopamine, a neurotransmitter that is critically involved in addiction. Anderson and colleagues focused on this part of the brain because it is “exquisitely sensitive to stress hormones” and develops slowly. “Damage to this area of the brain resulting from neglect, emotional and sexual abuse may cause an individual to be particularly irritable and to seek external means, such as drugs or alcohol, to quell this irritability,” said Anderson.  Stress and substance abuse— As noted by the National Institute of Drug Abuse (NIDA), studies in the Journal Psychoneuroendocrinology indicate: 1) Stress and cortisol sensitize animals for drug-seeking behaviors and facilitate self-administration. 2) Animals that are under-aroused and have low levels of cortisol are more prone to develop drug-seeking behaviors. 3) Severe stress early in life induces a series of physiological, neurobiological, and hormonal events that result in dysregulation of biological reward pathways in the central nervous system and in stress response systems; these changes seem to prompt self-administration of drugs and alcohol later in life. 4) Prenatal exposure to stress and drugs predispose animals to drug-seeking behaviors in adulthood. 5) Post traumatic stress disorder is a risk factor for substance abuse. 6) The administration of cocaine to humans causes similar physiological reactions such as secretion of adrenalin and cortisol, and psychological reactions similar to arousal caused by stress.  Researchers at the Scripps Research Institute in California observed a few years ago that heavy drinking not only depletes the brain’s supplies of substances necessary for feelings of wellbeing and pleasure (dopamine, serotonin, GABA, and opioid peptides), but it also promotes the release of cortisol. This release of cortisol causes tension and depression which in turn causes the individual to drink more which leads to an ongoing vicious cycle. In a similar way, carbohydrate craving is self medication, with resulting physical destruction. Once adaptive, but no longer— Like insulin, cortisol levels may be high or low. There are physical and emotional consequences to both. Chronic over-stimulation of insulin (from too many carbohydrates) and cortisol (from too much stress) may cause depletion with negative impact. The production of insulin and cortisol are both important mechanisms to survival. The production of insulin in response to the ingestion of carbohydrates once allowed fat storage in the body for protection during long winter months or times of famine. In some parts of the world where famine still exists, this process still assists in survival. When refined fast foods are a constant, this is no longer the case. Similarly, the stress response was once important to survival, now that is rarely true. Solutions— We cannot change all the social and historical factors that have caused us disease and death in the past, but there are well researched, healthy and affordable solutions. We can now adjust our diets to the real needs of our bodies. We do now have the technology called cranial electrical stimulation demonstrated through research to balance the stress system and return the irritable brain waves to normal—without the use of addictive substances. We have other options— we don’t have to fight and we don’t have to run. 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