Dear HealthSmart,

My 14-year-old son suffered a bad back injury a few years ago, and although healed, he constantly suffers from severe pain. Over the counter pain killers no longer cut it. His physical therapist suggested a low dose of OxyContin. I want my son to have pain relief, but I worry about the potency of the drug and its highly addictive reputation. Is it smart for us to pursue this option?

HealthSmart asked Dr. Andrew Kolodny, Executive Director at Responsible Opioid Prescribing (PROP). Here’s his response:

The addiction to opioids develops with their continued use across all populations, in children and adults. Children and individuals under the age of 25 are at particular risk because their brains are not fully developed. During this age, particularly in teenagers, the level of dopamine released after opioids are taken is much higher, resulting in a more euphoric high. This leads teens and young adults to be more inclined to repeat taking the drug. It also programs their brains to develop more severe addictions, which they have a harder time quitting than when habits of drug use and addictions are developed later in life.

Dear HealthSmart,

I’m a truck driver with multiple health problems—including high blood pressure and heart problems. Because I’m often on the road for long periods of time and short on sleep, I count on the sort of energy drinks sold at truck stops to keep me going. Do I have reason to worry that these could be harming my health? Is there any way to stay stimulated without resorting to these drinks?

HealthSmart asked Dr. James Liu, a neurosurgeon at Rutgers New Jersey Medical School. Here’s his response:

Popular energy drinks—which include high levels of caffeine and other ingredients —can have very deleterious effects on health. People are especially susceptible if they already have high blood pressure, heart rate and brain function problems. Although documented cases of death related to overuse of these beverages are rare, it’s clear they have risks such as arrhythmia for patients with heart issues. The caffeine in these drinks can also raise blood pressure significantly. Besides the caffeine, some energy drinks are loaded with other ingredients that have unclear effects, along with lots of sugar—which is linked to heart disease, diabetes and other major health concerns. Rather than resorting to energy drinks for stimulation, I recommend natural stimulants and particularly vigorous exercise, which releases endorphins and is very healthy for the brain. To a limited degree, consuming caffeine through coffee, chocolate and other dietary sources is fine. Many people finds naps, even if brief, to be very helpful for maintaining alertness.

Dear HealthSmart,

How can males prevent low sperm count and/or quality?

HealthSmart asked Dr. Shanna Swan, Ph.D., Professor of Obstetrics, Gynecology and Reproductive Science at Ichan School of Medicine at Mount Sinai. Here’s her response:

A man’s semen quality and count can be affected by what he was exposed to in utero as well as an adult. For example, men born to mothers who smoked during pregnancy have poorer semen quality. Of course, the man cannot control that. But his own obesity, stress, and diet, can play a role in his semen quality and count, as may his exposure to man-made chemicals. Stress is a huge variable in the number and quality of sperm – and this can become especially troublesome when a couple is trying to conceive and experiences excess pressure.

Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to Editor@WashNews.com. HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021