Tag Archives: health care

Music and Our Brains

Christina Rodriguez

By Leslie D. Green

Changing minds and bodies through musical experience

The Ford Motor Company Fund recognizes that creativity and artistic expression enrich lives and inspire innovation and that communities which support and provide access to the arts are stronger for it. In this collection of stories, we share how and why music affects us at all ages and stages of our lives.

Cristina Rodriguez, on the right, holding a ukelele, and Lauren Koff, third from left, holding a green microphone with Mind&Melody music enrichment specialists. Photo by Amanda Smith Photography

As a young student, Cristina Rodriguez adored music. But when a teacher announced a donation of instruments would allow her school to start an orchestra, she was unsure what to expect.

Then Rodriguez picked up the cello. And soon, she was smitten.

In high school, Rodriguez discovered the string instrument wasn’t the only thing that charmed her. She was fascinated by the way music touched people’s brains: How all the members of the orchestra had high grade-point averages; how most of the students in her honors and AP courses participated in the arts; and how time seemed to stop when she created music and played her cello.

“You are present the whole time you are playing and can’t really worry about anything,” Rodriguez said. In her teens, she volunteered at hospitals and conceived of various ways to share with others the comfort music gave her.

Years later, while working on her thesis for degrees in biochemistry and pre-med at Florida Atlantic University, Rodriguez found a way to combine her loves of music and medical science to help those in need.

In 2014, she and classmate Lauren Koff founded Mind&Melody to bring interactive music programs to individuals experiencing neurological impairment, such as Alzheimer’s disease, dementia, autism and Down syndrome. Based in Miami, Fla., the nonprofit engages musicians who perform music that represents patients’ favorite eras and personal cultures to help reengage their static minds and improve their cognitive and motor skills.

Mind and Melody music specialist demonstrates didgeridoo to elder adults

Ashlie, a Mind&Melody music enrichment specialist, demonstrates the didgeridoo an indigenous Australian instrument to older adults. Participants are fascinated by the sound and shape of the instrument.  Photo by Amanda Smith Photography

“They play a song that brings back memories for the patient,” Rodriguez explained, adding that the brain stores emotional memories in a different way from how it stores regular memories.

While listening to or playing music hasn’t been shown to prevent dementia or cognitive impairments, Rodriguez explained that music can reach hidden areas spared by diseases like Alzheimer’s and help patients reunite with the world around them.

Rodriguez recalled a formerly active married couple whose age-related cognitive difficulties made it difficult for them to connect with people. When the pair started therapy with Mind&Melody, they were able to socialize again.

“It helps them connect better with friends and family,” Rodriguez said. “They talk through music. It keeps their brains active and keeps them socially active.”

Violinist Diane McElfish Helle launched a similar program for the Grand Rapids Symphony. Her Music for Health Initiative at Spectrum Health in Grand Rapids, Mich., partners musicians with medical professionals to provide music therapy for people with myriad health issues. McElfish Helle has called the nonprofit agency her most important endeavor as a professional musician. In 2017, she received the Ford Musician Award for Excellence in Community Service from the League of American Orchestras for her work.

Musical chemistry

In addition to creating chemical reactions in the brain, researchers have also found that music produces a sense of comradery, or unity.

Ever notice that it only takes two or three claps to get thousands of people at a concert to synchronize their claps or foot taps on beat?

Research going back to naturalist and biologist Charles Darwin suggests that our ancestors were more fit to mate if they were able to not just feed, protect and provide for a family, but also were able to sing or make music in a pleasant way. Musical abilities, scientists contend, stimulate cohesion, which helped groups hunt for large game, outlast predators, and better survive the savage world where survival most often only was for the fittest.

Now, music-generated cohesion plays a role in community building and work productivity, according to four economists from Cornell University. They examined music’s impact on cooperation by having three groups of participants make decisions based on how much they would or would not pool resources with other people in the lab.

Kevin Kniffin, co-author of the 2016 study, reported music in the workplace can cause conflicts if people dislike the selections played. However, Kniffin said his research team found “a rhythm that was a common qualifier of happy music” and streamed that for one group. At the same time, they streamed unhappy music for the second group and did not stream any music for the control group.

Kniffin and the Cornell researchers found that those who received the established happy music had better moods and persistently higher levels of cooperative behavior. Meanwhile, the control group, which heard no music, and those who heard unhappy music, were less inclined to cooperate with colleagues.

Regardless of one’s workplace, medical diagnosis, age or stage of life, Mind&Melody’s Rodriguez said an important “chemical thing” happens when you listen to music, play an instrument or sing.

“If you’re having a terrible day or month, music is comforting,” Rodriguez said. “It can bring you back and ground you.”

 

Music’s Physical Benefits


Music initiates brainstem responses that normalize heart rate, pulse, blood pressure, body temperature, skin conductance, and muscle tension in people of all ages, according to Mona Lisa Chanda and Daniel J. Levitin, authors of a 2013 study conducted at McGill University of Montreal, Quebec, Canada.

Infants and children

• By routinely playing familiar music to premature babies, who are prone to neurodevelopmental disorders that include learning difficulties, doctors can enhance connectivity in the brain, according to researchers at the University of Geneva and University Hospitals of Geneva, Switzerland.

• Music therapy has been shown to help children with cancer cope with the stress of treatment by improving mood and relaxation and reducing exhaustion and anxiety.

• People begin developing affection for music in the womb through exposure to their mother’s heartbeat. And learning rhythms and melodies begins during the third trimester of development.

• A few years of music practice thickens part of the corpus callosum, a band of nerve fibers dividing the brain’s left and right hemispheres and integrates sensory processing between the two. As a result, music and musical training can foster academic and life skills in children.

Aging and neurological disorders

• The Johns Hopkins Center for Music and Medicine in Baltimore, Maryland, recently completed a 12-week study where 24 people with Parkinson’s disease played the guitar. They found the patients’ shaky hands, moods and levels of anxiety improved. Moreover, patients who participated in a study involving drum circle classes and choir singing lessons reported having a better quality of life, including enhanced communication with loved ones because of the classes.

• Group drumming counteracted age-related deterioration of immune functioning, in one study Chanda and Levitin cited.

• Music therapy creates entrainment, a simultaneous activation of neurons in disparate parts of the brain. So, even if we are not tapping, clapping, playing or singing along to music, scientists have found that our brains recognize and keep up with the beat. Knowing this, researchers are looking at how they can individualize the use of music in medicine to help people with motor-system disorders, like Parkinson’s.

Heart health

• Medical trials around the country have found that listening to music can help people to exercise longer during cardiac stress tests, cause heart rate and blood pressure to return more quickly to baseline levels after physical activity and alleviate anxiety in heart attack survivors.

Surgery

• Scientists are exploring whether music played during surgery causes surgical teams to provide better care or whether the music is directly helping patients, even those under anesthesia. Either way, music played during surgery and post-surgery has been found to improve moods by decreasing cortisol levels and reduce sedation, pain and infections.

This story was originally published at fordfund.org. The Ford Motor Company Fund supports a range of music-rich programming, including the Detroit Symphony Orchestra, the Mosaic Youth Theatre of Detroit, the Sphinx Organization, The Ark in Ann Arbor, Michigan, the League of American Orchestras in Washington, D.C., the GRAMMY Museum’s GRAMMY in the Schools program and Latin GRAMMY Cultural Foundation’s Latin GRAMMY in The Schools program.

Read more about why music matters

Business communities can help end the addiction crisis

Crain Content Studio, the marketing-storytelling arm of Crain’s Detroit Business, worked with Children’s Hospital of Michigan Foundation to convene, moderate and report on a roundtable discussion among experts in education, medicine and government about the problem of addiction among young people. The discussion took place on Jan. 16, 2019 and was originally published on crainsdetroit.com on March 11, 2019.

In 2017, the U.S. Department of Health and Human Services declared a public health emergency when 11.4 million people reported misusing opioids and 47,600 people died from opioid overdoses.

In Michigan, 1,941 people died from opioid overdoses that year, a 13.9 percent increase over the number of opioid deaths in the state in 2016, reports the Michigan Department of Health and Human Services.

Addiction is rampant in our society. According to the Center on Addiction, one in four Americans who began using any addictive substance before age 18 is addicted. Still, substance abuse experts are waging an uphill battle against the stigma surrounding addiction, describing a deep-seated culture of shame and fear that prevents parents, schools, and business leaders from engaging in meaningful dialogue on the subject.

The Children’s Hospital of Michigan Foundation in Detroit is trying to erase this stigma and change the culture and conversation around addiction and recovery.

As part of its efforts, the Foundation partnered with Crain Content Studio, the marketing-storytelling arm of Crain’s Detroit Business, to unite parents and experts from government, academic, and medical fields to discuss prescription drug addiction and how businesses can play a part in ending the crisis.

“Most of our initiatives for adolescents and young adults tend to be in mental health and in opioids and addiction. We strive to be a catalyst for change,” said Lawrence J. Burns, President and CEO of Children’s Hospital of Michigan Foundation. The $120 million independent nonprofit partners with more than 40 organizations to further its efforts to help children and young adults.

Children’s Hospital of Michigan Foundation has partnered with Detroit Red Wings announcer Ken Daniels and Lisa Daniels, who formed The Jamie Daniels Foundation in memory of their son, who died of an opioid overdose in 2016. The Children’s Hospital of Michigan Foundation will help The Jamie Daniels Foundation with fund development, financial management and generating awareness about opioid abuse. The Daniels’ foundation provides resources and support to the increasing numbers of people battling addiction.

Wreaking havoc on families and businesses

Ken Daniels once saw a billboard that rang all too true. It read: “The brain isn’t the only organ impacted by addiction. It also breaks hearts.”

Daniels and his family are well acquainted with the heartbreaking consequences of youth drug addiction, a widespread problem as devastating as it is complex. Jamie Daniels was a smart kid. He did well in school and had a family and friends who loved him.

And yet at age 15, Jamie deliberately faked symptoms of attention-deficit/hyperactivity disorder and failed clinical tests to obtain a prescription for Adderall, the stimulant drug used to treat the condition, said his mother, Lisa.

Though she harbored grave doubts about her son’s diagnosis and need for Adderall, Lisa followed professional recommendations, carefully dispensing the medication to Jamie at the prescribed dosage. “I thought I was in control of it,” she said.Source: National Institutes of Health-funded study by the Institute for Social Research at the University of Michigan

TEEN DRUG MISUSE

Percent of the estimated 3.6 million U.S. high school seniors who misused prescription and over-the-counter drugs in 2018:
5 percent: Sedatives, such as Valium and Xanax
4.6 percent: Adderall
3.4 percent: Opioids, such as Oxycontin and Vicodin
3.4 percent: Cough/cold medicine
0.9 percent: Ritalin, a stimulant used to treat attention-deficit/hyperactivity disorder

Source: National Institutes of Health-funded study by the Institute for Social Research at the University of Michigan

While attending Michigan State University, Jamie began abusing opioids as well as Adderall and other drugs. 

Jamie eventually completed two stints in rehab with his parents’ support. He moved into a sober living home in Florida and was under a physician’s care for depression and anxiety, conditions common in people suffering from addiction.

Until he was convinced by an acquaintance to switch to a less reputable recovery facility and doctor, Jamie was clean and on the road to recovery.

Less than two weeks after making the switch, 23-year-old Jamie died from an overdose of heroin laced with Fentanyl, a synthetic opioid 80 to 100 times stronger than heroin.

“There is a hole in my family’s heart that will never be filled,” said Ken Daniels. “And in the time we’re sitting here, we’ll lose eight more people (to addiction). So, we have to continue to talk about it. We need to talk about this in the home. We need to talk about it in the schools and at work; and hopefully in the long term, we can end this crisis.”

Young adults aged 18 to 25 comprise the largest segment of the population misusing and abusing prescription drugs, such as opioids.

But drug addiction doesn’t just impact families. Opioid addictions, specifically, cost businesses, educational and social institutions, criminal justice systems, and health care organizations billions of dollars yearly.

Altarum, an Ann Arbor-based nonprofit health research institute, estimates the economic burden of opioid addiction:

  • $800,000 per opioid overdose death in lost earnings and productivity
  • $1 trillion in costs to individuals, businesses and governments since 2001
  • $215.7 billion in health care costs for emergency and ongoing care from 2001 to 2017

In addition, employees with substance-use disorders miss an average 14.8 days of work a year — almost 50 percent more days of work than the typical employee average of 10.5 days, according to the National Safety Council. And about 70 percent of U.S. employers in construction, entertainment, recreation, and food service industries employ twice the average number of workers with substance use disorders than employers in other industries.

Equal-opportunity killer

Children’s Hospital of Michigan Foundation and its more than 40 partners are strategizing ways to end the addiction crisis. Solutions include ending the social stigma associated with addiction and recovery.

Despite the availability of accurate information, the perception persists that addiction is the result of an inherent character flaw, moral failing, or conscious decision and affects only a certain segment of society.“Nobody goes into their first use thinking, ‘Someday I’m going to be an alcoholic,’ or ‘Someday I’m going to abuse drugs,’” said Brian Spitsbergen, director of Community Relations for Growth Works Inc., a Plymouth-based facility that provides substance dependency and abuse treatments and solutions for adults and youth.

“There’s no one path to recovery that’s going to work for everybody, because every person is different and every brain is different,” Smith-Butterwick said. “So we are trying to do as many different things as we can to reach as many different parts of the population as we can.”

In 2017, Michigan lawmakers enacted opioid-related legislation that includes requiring the Michigan Department of Education, with direction from the Prescription Drug and Opioid Abuse Commission, to provide school districts with models for how to instruct students on the dangers of prescription opioid abuse.

The American Medical Association classifies addiction as a disease, and its task force reports that people who misuse and abuse opioids suffer from a chronic medical condition, like type-2 diabetes or high blood pressure.

Dennis Martell, director of Health Promotion at Michigan State University, added that addiction is not an epidemic.

“It is endemic,” he said. “It’s part of our culture. It’s always been around.”

Spitsbergen, who has been sober for more than 32 years, agreed. “Ten percent of the population will meet the criteria for a substance use disorder in their lifetime,” he said. “It can happen to anyone. That’s the persuasive power that addiction has. It isn’t about the gutter.”

There could be two middle school-aged children who go to the same church and same school and have the same family life, Spitsbergen said. But their responses to their first experience with alcohol could be completely different.

“Because of things that might happen in their brain state, their lives might never be the same,” he said.

The stigma surrounding addiction is so prevalent that parents often don’t participate in potentially beneficial events, said Robert Shaner, superintendent of Rochester Community Schools. He noted only 125 parents attended a recent information session on vaping, opioids and other dangerous drug trends provided by the parent-teacher association for his district, which has 15,400 students.

“People almost treat addiction like they don’t want to ‘catch it,’” Shaner said, adding that some parents think, “‘If I’m not around the people it happened to, it’s not going to happen to my kid.’ Nobody wants to say they’ve got it, and no one wants to say they’ve been treated for it. This is a non-partisan, equal-opportunity killer that we have to attack as a community.”

The challenge of easy access

“There’s no pain greater than losing a child,” Shaner said, adding that the heaviest burden a school administrator must bear is to help parents bury their children.

“Over the past six years, we’ve done this because of opiates well over a dozen times,” said Shaner. “Recently, we had five graduates from one high school lose their lives to opioid addiction. They didn’t start as street junkies; they didn’t start out looking to be addicts. Some of the addictions were caused by self-medicating because of mental health issues, some started because of athletic injuries, and for some it was having access to the drugs.”

The U.S. Drug Enforcement Agency says most teens find prescription and OTC drugs in their home medicine cabinets or on a kitchen shelf. And among those 12 and older who misused opioid pain relievers:

  • 40.4 percent got the drug from a friend or relative for free
  • 35.4 percent received a prescription from a doctor
  • 8.9 percent bought the drug from a friend or relative
  • 6 percent bought the drug from a dealer or stranger

Students as young as middle-school age hold “bowl parties,” said Carmen McIntyre, a physician who serves as associate chair for community affairs for the Department of Psychiatry and Behavioral Neuroscience at the Wayne State University School of Medicine.

“Everybody’s supposed to bring meds out of their parents’ medicine cabinet,” she explained. “They just take a few pills from each bottle so (parents) don’t notice anything. And then they put them all into this big bowl to share.”

McIntyre said children attending these parties also steal Narcan, a drug used to reverse the effects of an opioid overdose, though in her experience children panic and flee the scene rather than stick around and help the youth who overdosed.

When he was a high school principal, Shaner made a point of talking about drugs with his students. “I would say—and I don’t consider this a scare tactic—‘If you love your parents, don’t do these things. You don’t want them to feel that pain, if you truly love them.’”

One of the programs that Shaner, a former law enforcement officer, has helped implement in his district is a prescription drug drop-off program at parent-teacher conferences.

Prescription take-backs are a proven means of reducing the supply of unused, prescribed narcotics, preventing them from circulating among household and community members. Such programs allow members of the community to safely dispose of unused medications at designated locations staffed by law enforcement.

The prevention efforts of Michigan Opioid Prescribing Network, known as Michigan OPEN, include educating medical professionals, law enforcement and others on how to hold opioid collection drives in a manner that encourages participation and does not make community members feel uneasy or like criminals. So far the organization has helped organize drives in 60 cities, getting about 3,000 pounds of pills and 40,000 to 45,000 opioids off the street, said Chad Brummett, associate professor and director of the Division of Pain Research at the University of Michigan Medical School and co-director of Michigan OPEN.

10 WAYS THE BUSINESS COMMUNITY CAN HELP FIGHT DRUG DEPENDENCY AND ADDICTION

The experts say there’s considerable work to be done to reduce overdose deaths and prevent and treat addiction, but they can’t do it without the help of business leaders.
“If you’re thinking about something that takes away from your (company’s) bottom line, mental health and addiction are exponential problems,” Shaner said.
Roundtable participants shared their expert advice.
1. Advocate for more mental health services and counselors at schools: The largest percentage of prescription drug abusers are young adults aged 18 to 25 who are also beginning their careers with area businesses. “We all know K-12 education is important in solving the (opioid) problem, so we ought tobe funding it and supporting it in the right way,” Shaner said.
 
2. Sponsor youth peer programs: Eric Hipple, a former Detroit Lions quarterback and director of Outreach for the After the Impact program, suggests businesses underwrite programs that take a deeper dive into the problem of drugs and facilitate conversations and peer support among youths.
 
3. Support organizations that help: Provide meaningful support to nonprofits working to prevent and treat addiction. “Politics trump data, but business trumps politics,” said Martell.
 
4. Provide job training: People in recovery can’t return to the workforce without skills, said Smith-Butterwick. Helping recovery organizations incorporate job training would help recovering addicts support their recovery financially.
 
5. Make educating workers a priority:Hold human resources-developed programming on identifying, preventing, and treating opioid abuse.
 
6. Teach coping skills: People who develop a substance use disorder may begin using as a means of easing physical or emotional pain.Teaching alternative coping skills, such as meditation, can help promote healthy living.
 
7. Partner with insurers: Commit to offering employees robust, extended mental health treatment and addiction recovery services and challenge insurers to craft a benefit plan that reflects your commitment.
 
8. Become recovery friendly: Be mindful and welcoming of employees who suffer from addiction and/or are in recovery when planning social events. “They can’t tell anybody in the office, ‘I’m in recovery’ because it’s not comfortable,” said Smith-Butterwick. She recommends planning company events that don’t include alcohol.
 
9. Support employees in recovery:Workers often fear they will lose their jobs if their drug use is discovered. Instead, encourage and facilitate confidential addiction referral and recovery services for employees.
 
10. Engage in a community of businesses approach: Brummett emphasized the advantages of businesses combining resources as a community to financially support nonprofits dedicated to preventing and treating addiction. “Unfortunately, state and federal dollars will dry up, and we will still have issues with opioids, pain and mental health,” he said.

Prevention efforts

The number of medical professionals overprescribing potentially addictive medications drastically increased in the 1990s. The National Institute on Drug Abuse reports the number of opioid prescriptions dispensed at U.S. pharmacies tripled from 76 million prescriptions in 1991 to 219 million prescriptions in 2011.

McIntyre said one of her patients died from an overdose two days after another physician — who was aware the patient suffered from addiction — injected her with the benzodiazepine Valium and gave her a prescription for 120 Valium in pill form.

McIntyre also cited her own experience with a pharmacy dispensing 100 Vicodin to her following a dental procedure. She pointed out to pharmacy staff that her dentist likely prescribed 10 Vicodin, not 100, but said the pharmacy refused to take back the medication after it had crossed the sales counter.

Brummett said regularly prescribing opioids following dental procedures “just doesn’t make sense.” The more doses doctors prescribe, he said, the more patients take, regardless of whether their pain is reduced.

Those aged 13 to 30 who filled an opioid prescription immediately before or after having their wisdom teeth extracted were about three times as likely as their peers to still be filling opioid prescriptions long after they needed them, according to a Michigan OPEN study.

“If you think about surgery (alone), the two factors that determine whether and how many opioids a person is going to get are the surgery they’re having and the surgeon caring for them,” explained Brummett.

Not prescribing opioids to the 80 percent to 90 percent of people who don’t need them could significantly reduce exposure and access to the drugs, both primary and secondary, Brummett said. Consequently, in 2017, Michigan OPEN released the first evidence-based prescribing recommendations in the country.

Health care providers in and outside the U.S. don’t know how much of the prescribed drugs patients actually use, he said. “Unless you ask people, they don’t tell you. The only metric you have is whether or not they refill.”

Brummett said having conversations about prescribing recommendations helps create a culture of opioid stewardship that opens the door to progressively more detailed conversations, such as how to deal with chronic users, including the 6 percent to 10 percent of patients who undergo surgery and begin taking opioids as a result.

McIntyre added, “We don’t need to just talk about prevention, we need to talk about developing as normal human beings. We have to start teaching people that after surgery, (you’re) supposed to have pain. Part of the purpose of pain is to slow you down so your body can heal.”

To learn more about combating addiction and ending the opioid crisis, visit The Children’s Hospital of Michigan Foundation at chmfoundation.org.

 

Universities drive innovation in Michigan

Someone putting in a contact lens.

How Michigan health insurers are innovating despite uncertainty

The head of a man connected to exterior by threads

While officials in Washington battle over how to restructure health care legislation, insurers in Michigan say they will continue to bring innovative products to market, improve patient health, increase employee productivity and keep health care costs at bay.

They have considerable challenges to overcome. According to AARP and the Centers for Disease Control:

  • Retail prices for 261 of the 268 most commonly used brand-name prescription medicines rose 97 percent in 2015 — though inflation was only .1 percent.
  • More than 500,000 Americans died from opioid overdoses from 2005 to 2015.
  • Overweight employees with other long-lasting health conditions cost employers more than $153 billion annually in lost productivity.

On Sept. 12, Michigan Association of Health Plans and Crain Content Studio, the custom publishing division of Crain’s Detroit Business, gathered a group of health plan leaders and consultants to talk about their work amid these challenges and uncertainty.

Read the full story.

Read more:

The future of health care
Little pills, big bills
How insurers plan to combat the opioid crisis