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Lovie Smith said the NFL had ‘a problem’ about Black coaches. A year later he was fired and the league is being criticized yet again about its lack of diversity | CNN

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CNN
—

When Lovie Smith was hired by the Houston Texans in February 2022 as the team’s new head coach, he said the NFL had “a problem” with hiring Black coaches and diversity.

“I realize the amount of Black head coaches there are in the National Football League,” Smith told reporters just under a year ago.

“There’s Mike Tomlin and I think there’s me, I don’t know of many more. So there’s a problem, and it’s obvious for us. And after there’s a problem, what are you going to do about it?”

Smith was fired Monday at the end of his one and only season at the helm of the Texans, finishing with a record of 3-13-1.

Smith is the second Black coach in two years to be relieved of his duties by the Texans, which fired David Culley at the end of the 2021 season.

Smith’s time in charge wasn’t full of wins and high points – though his parting gift to the organization was a last-minute Hail Mary victory over the Indianapolis Colts, which saw them relinquish the No. 1 pick in the 2023 NFL draft to the Chicago Bears. But his Texans team showed togetherness and competence, traits often desired by outfits undergoing a rebuild.

Houston general manager Nick Caserio said Smith’s firing was the best decision for the team right now.

“On behalf of the entire organization, I would like to thank Lovie Smith for everything he has contributed to our team over the last two seasons as a coach and a leader,” Caserio said in a statement.

“I’m constantly evaluating our football operation and believe this is the best decision for us at this time. It is my responsibility to build a comprehensive and competitive program that can sustain success over a long period of time. We aren’t there right now, however, with the support of the McNair family and the resources available to us, I’m confident in the direction of our football program moving forward.”

But the firing of the 64-year-old coach, the Texans organization as a whole, and the measures implemented by the league to promote diversity have been heavily criticized by former players and TV pundits.

“The Houston Texans have fired Lovie Smith after 1 year. Using 2 Black Head Coaches to tank and then firing them after 1 year shouldn’t sit right with anyone,” former NFL quarterback Robert Griffin III tweeted Sunday, when news of Smith’s firing broke.

On ESPN, Stephen A. Smith and NFL Hall of Famer Michael Irvin also condemned the decision. Smith called the Texans organization an “atrocity.”

“They are an embarrassment. And as far as I’m concerned, if you’re an African American, and you aspire to be a head coach in the National Football League, there are 31 teams you should hope for. You should hope beyond God that the Houston Texans never call you,” Smith said.

Irvin said Black coaches are being used as “scapegoats” by the Texans.

“It’s a mess in Houston and they bring these guys in and they use them as scapegoats. And this is what African American coaches have been yelling about for a while and it’s blatant, right in our face,” he said.

When CNN contacted the Texans for comment, the team highlighted the moment at Monday’s news conference when Caserio was asked why any Black coach would consider working for the team, and his response was that individual candidates would have to make their own choices.

Smith on the sidelines during a game against the Indianapolis Colts.

“In the end it’s not about race. It’s about finding quality coaches,” the general manager said. “There’s a lot of quality coaches. David (Culley) is a quality coach. Lovie (Smith) is a quality coach.

“In the end, each coach has their own beliefs. Each coach has their own philosophy. Each coach has their comfort level about what we’re doing. That’s all I can do is just be honest and forthright, which I’ve done from the day that I took this job, and I’m going to continue to do that and try to find a coach that we feel makes the most sense for this organization. That’s the simplest way I can answer it, and that’s my commitment.

“That’s what I’m hired to do, and that’s what I’m in the position to do. At some point, if somebody feels that that’s not the right decision for this organization, then I have to respect that, and I have to accept it.”

CNN has reached out to Lovie Smith for comment.

At the beginning of the 2022 season, NFL.com reported Smith was one one of just six minority head coaches in the NFL, a low number in a league where nearly 70% of the players are Black.

Since Art Shell was hired by the Los Angeles Raiders in 1989 as the first Black head coach in modern history, there have been 191 people hired as head coaches, but just 24 have been Black.

However, the NFL has taken steps to increase diversity in the coaching ranks.

Notably, in 2003, the NFL introduced the Rooney Rule to improve hiring practices in a bid to “increase the number of minorities hired in head coach, general manager, and executive positions.”

But the Rooney Rule hasn’t been an unqualified success.

In 2003, the Detroit Lions were fined $200,000 for not interviewing any minority coaches before hiring Steve Mariucci as their new head coach.

In response to criticism, the NFL announced it was setting up a diversity advisory committee of outside experts to review its hiring practices last March. Teams would also be required to hire minority coaches as offensive assistants.

Despite changes to the rule being implemented in recent years to strengthen it, a 2022 lawsuit alleges that some teams have implemented “sham” interviews to fulfill the league’s diversity requirements.

Last February, former Miami Dolphins head coach Brian Flores filed a federal civil lawsuit against the NFL, the New York Giants, the Denver Broncos and the Miami Dolphins organizations alleging racial discrimination.

Flores looks on during his time as the head coach of the Miami Dolphins during a game against the New York Jets.

Flores, who is Black, said in his lawsuit that the Giants interviewed him for their vacant head coaching job under disingenuous circumstances.

Two months after submitting the initial lawsuit, Flores added the Texans to it, alleging the organization declined to hire him this offseason as head coach “due to his decision to file this action and speak publicly about systemic discrimination in the NFL.”

In response to the lawsuit, the Texans said their “search for our head coach was very thorough and inclusive.”

The NFL called Flores’ allegations meritless.

“The NFL and our clubs are deeply committed to ensuring equitable employment practices and continue to make progress in providing equitable opportunities throughout our organizations,” the league said in response to the lawsuit.

“Diversity is core to everything we do, and there are few issues on which our clubs and our internal leadership team spend more time. We will defend against these claims, which are without merit.”

But 12 months after firing their last Black head coach, the Texans have fired another one.

“How do you hire two African Americans, leave them one year and then get rid them?” questioned NFL Hall of Famer Irvin.

“You know the mess that Houston is,” Irvin added. “We get the worst jobs and we don’t get the opportunity to fix the worst jobs, just like this.

“I don’t know any great White coach that would take the (Texans) job unless you give them some guarantees. ‘You’re going to have to guarantee me four years to turn this place around.’ But the African American coaches can’t come in with that power because Lovie wouldn’t have got another job.

“This was his last chance to get back into the NFL and you have to take what’s on the table to try to change that.”

Irvin speaks on media row ahead of Super Bowl LVI on February 10, 2022 in Los Angeles.

The Texans are now searching for a new head coach under general manager Caserio. The new appointment will be Caserio’s third coach in the role: It is almost unprecedented for a general manager to get the opportunity to hire a third head coach with the same team.

Texans chairman and CEO Cal McNair said he would take on a more active role in the hiring process. The next head coach will be the organization’s fourth in three years.

According to the NFL, the Texans have requested to speak to five candidates already about filling Smith’s position, a list that includes two Black coaches.

After Smith was hired in March 2021, McNair said: “I’ve never seen a more thorough, inclusive, and in-depth process than what Nick (Caserio) just went through with our coaching search.”

At that introductory news conference, Smith spoke candidly about how to bring greater diversity to the NFL coaching ranks.

“People in positions of authority throughout – head coaches, general managers – you’ve got to be deliberate about trying to get more Black athletes in some of the quality control positions just throughout your program. If you get that, they can move up, that’s one way to get more.”

Smith continued: “It’s not just an interview, if you’re interviewing a Black guy. It’s about having a whole lot of guys to choose from that look like me. And it’s just not about talk. You look at my staff, that’s what I believe in. And letting those guys show you who they are. That’s how we can increase it, then it’s left up to people to choose. We all have an opportunity to choose, and that’s how I think we’ll get it done.”

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Damar Hamlin could be released from a Buffalo hospital in the next day or two | CNN

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CNN
—

A week after suffering a cardiac arrest while playing the Cincinnati Bengals, doctors are hoping Buffalo Bills safety Damar Hamlin is healthy enough to be released from a Buffalo hospital within 24 to 48 hours, Michael Hughes, senior vice president and chief administrative officer at Kaleida Health, told CNN on Tuesday.

Doctors are finishing tests and are identifying possible causes of the event, including whether there were any pre-existing conditions that played a role in Hamlin’s January 2 cardiac arrest.

“Hamlin is going through a series of testing and evaluation today,” Kaleida Health said in a statement Tuesday. The Buffalo General Medical Center team will also “potentially treat any pathology that may be found, as well as plan for his recovery, discharge and rehabilitation.”

Hamlin himself updated his fans Tuesday afternoon.

“Not home quite just yet,” Hamlin tweeted. “Still doing & passing a bunch of test. Special thank-you to Buffalo General it’s been nothing but love since arrival! Keep me in y’all prayers please!”

Hamlin was transferred from a Cincinnati hospital to the Buffalo hospital on Monday after doctors determined his critical condition had improved to good or fair – surpassing expectations.

“We felt that it was safe and proper to help get him back to the greater Buffalo area,” Dr. Timothy Pritts, chief of surgery at the University of Cincinnati Medical Center, said Monday.

Hamlin’s parents flew from Cincinnati back home to Pittsburgh but then flew to Buffalo. They were en route Tuesday from the Buffalo Bills’ practice facility and were expected to arrive at the hospital to see Hamlin soon.

Hamlin, a second-year NFL player, has been regaining strength over the past several days after his sudden collapse after a tackle against the Bengals in Cincinnati.

“He’s certainly on what we consider a very normal to even accelerated trajectory from the life-threatening event that he underwent,” Pritts said, “but he’s making great progress.”

Normal recovery from a cardiac arrest can be measured in weeks to months, Pritts explained. But Hamlin has been beating that timeline at each stage and is neurologically intact.

Still, Pritts said it’s too early to say when Hamlin could get back to normal life or what caused his heart to stop, saying more testing is needed.

Hamlin was sedated and on a ventilator for days after his cardiac arrest. On Friday morning, the breathing tube was removed, and Hamlin began walking with some help by that afternoon, his doctors said Monday.

The safety’s condition was upgraded Monday because his organ systems were stable and he no longer needed intensive nursing or respiratory therapy, doctors said.

“He walks normally,” said Dr. William Knight, a neurovascular critical care expert who treated Hamlin at UC Health. “He is admittedly a little weak. I don’t think that’s of any real surprise after what he went through, just regaining his strength. And that’s part of his recovery process.”

Hamlin’s release Monday meant he could return to Buffalo, which prompted even more encouragement and eagerness for some of his teammates to see him again.

“Super excited that he’s back in Buffalo and what a job that the team of docs and the medical team did out in Cincinnati, and now he’s in great care here in Buffalo. We’re happy to have him back,” Buffalo Bills head coach Sean McDermott told reporters Monday.

After seeing him Monday, McDermott said Hamlin was “tired” but seemed happy. “Happy to be back in Buffalo and around a familiar area to him. I know he’s taking it just one step at a time.”

The coach also said his team has grown since Hamlin was injured, saying such experiences nurture growth.

“We will all have grown as people, and as men in this case,” McDermott said, noting there’s a plan in place for the players and staff to visit Hamlin “at the proper time.”

“Having him nearby will give us more comfort” and inspire the team as it prepares for the postseason, McDermott said.

Although Hamlin was not with the team when they played Sunday against the New England Patriots, his support was definitely felt.

When his team scored a touchdown, Hamlin set off alarms in the ICU, Pritts said.

“When the opening kickoff was run back, he jumped up and down and got out of his chair and set – I think – every alarm off in the ICU in the process, but he was fine, it was just an appropriate reaction to a very exciting play. He very much enjoyed it,” Pritts said.

Hamlin was “beyond excited” Sunday and felt “very supported by the outpouring of love from across the league, especially from the Buffalo area. We’ve learned this week that the Bills mafia is a very real thing,” Pritts added.

The immediate medical response to Hamlin’s collapse helped save his life, and the Buffalo Bills are now encouraging people to learn how to administer CPR.

Assistant athletic trainer Denny Kellington is credited with performing CPR when Hamlin lost his pulse on the field and needed to be revived through resuscitation and defibrillation.

The medical response was part of an emergency action plan that “involves team, independent medical and athletic training staff, equipment and security personnel, and is reviewed prior to every game,” a Monday statement from the Bills read.

The team pledged support for resources including CPR certifications, automated external defibrillator units and guidance developing cardiac emergency response plans within the Buffalo community, according to the statement.

“We encourage all our fans to continue showing your support and take the next step by obtaining CPR certification,” the Bills said.

Clarification: This story has been updated to clarify Hughes’ remarks about Hamlin’s injury and recovery.

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Report shares new details about death possibly linked to experimental Alzheimer’s drug | CNN

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CNN
—

The death of a participant in a clinical trial of an antibody treatment for Alzheimer’s disease, which is now under consideration by the US Food and Drug Administration, may be linked to the experimental drug, a new report shows.

The research letter, published Wednesday in the New England Journal of Medicine, shares details about what happened to the participant in the open-label extension phase of the trial of lecanemab.

In an open-label extension, there is no placebo arm; rather, all the participants get the medication in question because an earlier part of the trial has shown so much potential.

In this case, a 65-year-old who was in the early stages of Alzheimer’s was taken to an emergency room in a Chicago-area hospital within 30 minutes of the first signs of a stroke, the report says. Doctors at the Northwestern University Feinberg School of Medicine learned that the patient had gotten infusions of lecanemab four days before.

This patient is not the only one to die during the open-arm extension. The health publication Stat reported that an investigator told it about the death of another participant who had bleeding in the brain that may have been related to the drug. In that case, drugmaker Eisai pointed to other possible factors.

Lecanemab is meant to slow the progression of Alzheimer’s. In November, the company released a study showing that it slowed the progression of cognitive decline by 27% compared with a placebo. It also reduced amyloid levels – a protein that is one of the hallmarks of Alzheimer’s – and had positive effects on cognition and the ability to perform everyday tasks when compared with a placebo.

The research also showed that about 2.8% of trial participants who took the drug had a symptomatic side effect called ARIA-E, which involves swelling in the brain. None of the participants who got a placebo had that.

The new report says the medical team at the hospital gave the patient a common medication to break up blood clots that could cause a stroke, called t-PA bolus. Nothing in the patient’s medical background suggested that they would have a problem with that drug. But less than an hour into the treatment, their blood pressure shot up, so doctors stopped the infusion.

A CT scan showed extensive bleeding in the brain.

The doctors then administered a medicine that can control the bleeding, but the patient became severely agitated and developed communication problems. The patient also had frequent nonconvulsive seizures.

The medical team was able to treat the seizures, but the person’s condition did not get better.

After three days in the hospital, the person got a tube in their windpipe to help them breathe. Even with that and other supportive care, the patient died.

An autopsy showed that the patient had extensive brain bleeding and amyloid deposits within many of the blood vessels in their brain that probably contributed to the hemorrhage, the report said.

Essentially, the report says, the blood vessels in the patient’s brain must have burst after being exposed to the blood clot medicine t-PA.

“The extensive number and variation in sizes of the cerebral hemorrhages in this patient would be unusual as a complication of t-PA solely related to cerebrovascular amyloid,” the report says. But the combination of the clot-busting drug with lecanemab may have led to the cerebral hemorrhages.

Northwestern Medicine declined CNN’s request to interview the authors of the new report but said in a statement that it was “an effort to provide relevant data to the medical and scientific community.”

Eisai said it did not have an official response because of patient privacy.

The company and Northwestern Medicine pointed to a response published alongside the new report from clinicians and researchers who were involved in the lecanemab clinical trials.

Drs. Marwan Sabbagh and Christopher H. van Dyck wrote in that response that they “agree that this case raises important management issues for patients with Alzheimer’s disease.”

It is an “unusual case, and we understand why the authors want to highlight a potential concern,” they said.

Their response also pointed to other potential factors in the deaths of both trial participants.

In this case, the brain bleed could have been connected to a period of time after the stroke when the patient’s blood pressure was exceptionally high, they said. And the other trial participant was taking a drug for atrial fibrillation that may have been a contributing factor.

The doctors also write in the response that other patients who have gotten t-PA have died with these amyloid deposits within blood vessels in the brain.

Dr. Sharon Cohen, a behavioral neurologist who works with Alzheimer’s patients at the Toronto Memory Program and an investigator in the lecanemab trial, says it’s been difficult to develop a therapeutic for Alzheimer’s.

Cohen said that doctors have known for years that almost all of the drugs in this class can come with a side effect of ARIA, which stands for amyloid-related imaging abnormalities.

The safety of the drug “looks very acceptable,” she said. “It’s within the range of adverse events that we expected and seems very reasonable for this patient population.”

The rate of bleeding in the trial is considered very low, and most of the microbleeds seen in the trial have been asymptomatic, she said.

In the case of the patient in the new report, Cohen thinks the death was probably related to the blood clot drug but said the combination of that drug and lecanemab “gives us pause.”

If the FDA approves the treatment, there may be some discretion in terms of patient choice and what the prescribing physician feels is best for for someone who is taking anticoagulants or has other risk factors for hemorrhaging, she said.

In general, lecanemab has in many ways exceeded our expectations, she said, “because we haven’t seen such consistently positive results in an Alzheimer’s disease modification trial at all until now.”

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Myths and facts about treating a hangover | CNN

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CNN
—

Are you celebrating the first day of 2023 with a hangover?

If so, you might be looking for a method to ease your misery. There are certainly a lot of so-called hangover cures, some dating back centuries.

“The ancient Greeks believed that eating cabbage could cure a hangover, and the Romans thought that a meal of fried canaries would do the trick,” said Dr. John Brick, former chief of research at the Center of Alcohol Studies, Education and Training Division at Rutgers University in New Jersey, who authored “The Doctor’s Hangover Handbook.”

“Today, some Germans believe that a hearty breakfast of red meat and bananas cures hangovers. You might find some French drinking strong coffee with salt, or some Chinese drinking spinach tea,” he said. “Some of the more unusual hangover cures are used by some people in Puerto Rico, who rub half a lemon under their drinking arm.”

In truth, the only cure for a hangover is time, according to the National Institute on Alcohol Abuse and Alcoholism.

“A person must wait for the body to finish clearing the toxic byproducts of alcohol metabolism, to rehydrate, to heal irritated tissue, and to restore immune and brain activity to normal,” according to the institute. That recovery process can take up to 24 hours.

Are there things you can do to ease your transition? Possibly, experts say, but many common hangover “cures” may make your hangover worse. Here’s how to separate fact from fiction.

Having another drink, or the “hair of the dog that bit you,” is a well-known cure for a hangover, right? Not really, experts say.

The reason some people believe it works is because once the calming effects of alcohol pass, the brain on a hangover is overstimulated. (It’s also the reason you wake up in the middle of the night once your body has metabolized alcohol.)

“You’ve got this hyperexcitability in the brain after the alcohol is gone,” said Dr. Robert Swift, a professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School in Providence, Rhode Island.

“If you look at the brain of somebody with a hangover, even though the person might feel tired, their brain is actually overexcited,” he said.

Consuming more alcohol normalizes the brain again, “because you’re adding a sedative to your excited brain,” Swift said. “You feel better until the alcohol goes away and the cycle repeats in a way.”

The answer is yes, depending on hangover symptoms, Brick said. If you’re a coffee drinker, skipping your morning cup of joe may lead to caffeine withdrawal on top of your hangover.

But coffee can irritate the stomach lining, which is already inflamed by alcohol, Brick said. So if you are queasy and nauseous, coffee may only make matters worse.

“If you have a hangover, have a quarter of a cup of coffee,” Brick suggested. “See if you feel better — it takes about 20 minutes for the caffeine to start to have some noticeable effect.

“If coffee doesn’t make you feel better, don’t drink anymore. Obviously, that’s not the cure for your hangover.”

Forget eating a greasy breakfast in the wee hours after a night of drinking — you’re adding insult to injury, Swift said: “Greasy food is harder to digest, so it’s probably good to avoid it.”

Eating greasy food also doesn’t make much sense. The alcohol we drink, called ethyl alcohol or ethanol, is the byproduct of fermenting carbohydrates and starches, usually some sort of grain, grape or berry. While it may create some tasty beverages, ethanol is also a solvent, Brick said.

“It cuts through grease in your stomach much the same way it cleans grease off oily car parts,” he said.

Instead, experts suggest using food to prevent hangovers, by eating before you have that first drink.

“Eating food loaded with protein and carbohydrates can significantly slow down the absorption of alcohol,” Brick said. “The slower the alcohol gets to your brain, the less rapid the ‘shock’ to your brain.”

Alcohol dehydrates, so a headache and other hangover symptoms may be partly due to constricted blood vessels and a loss of electrolytes, essential minerals such as sodium, calcium and potassium that your body needs.

If you’ve vomited, you’ve lost even more electrolytes, and all of this can lead to fatigue, confusion, irregular heart rate, digestive problems and more.

Replacing lost fluids with water or a type of sports drink with extra electrolytes can help boost recovery from a hangover, Swift said.

Taking over-the-counter pain meds can be dangerous, especially if you take too many while intoxicated, experts say. Taking an acetaminophen, such as Tylenol, can further damage your overtaxed liver, while aspirin and ibuprofen can irritate your stomach lining.

“You should never, never take alcohol with acetaminophen or Tylenol,” Swift said. “You can actually cause liver damage from an overdose of Tylenol.”

But aspirin, ibuprofen and naproxen are “theoretically” OK, he added.

“Even though they tend to be anti-inflammatory in the body, they can cause inflammation in the stomach,” Swift said. “Don’t take them on an empty stomach; always take anti-inflammatories with food.”

While most alcohol is handled by the liver, a small amount leaves the body unchanged through sweat, urine and breathing.

Get up, do some light stretching and walking, and drink plenty of water to encourage urination, Brick said.

“Before you go to sleep and when you wake up, drink as much water as you comfortably can handle,” he said. You can also take a multivitamin “before you hit the shower in the morning (to) replenish lost vitamins, minerals and other nutrients.”

If you would rather have something warm and soothing, Brick suggested broth or other homemade soups.

“These will also help to replace lost salts, including potassium and other substances,” he said, “but will not make you sober up faster or improve impairment due to intoxication or hangover.”

Store shelves are packed with so-called hangover cures. Unfortunately, there’s no proof they work. In 2020, researchers published what they called the “world’s largest randomised double-blind placebo-controlled” trial of supplements containing vitamins, minerals, plant extracts and antioxidants and found no real improvement in hangover symptoms.

Even if one solution works, it likely won’t fix all your symptoms, experts say.

“The effects of alcohol and alcoholic beverages are so complicated, so complex,” Swift said, “that any solution might address one or two of the symptoms but won’t address them all.”

What does work for a hangover? Time. It will take time for your body to release all the toxins causing your misery, experts say. And the only way to prevent a hangover is to abstain.

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How to beat that New Year’s hangover before it starts | CNN

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CNN
—

Toasting the birth of the new year is an age-old ritual, and for many, so is that dreaded morning aftermath — a hangover.

What seemed like great fun at the time is now causing your hands to shake, your head to pound and your heart to race, not to mention other unpleasant symptoms such as dizziness, nausea, vomiting, light sensitivity and excruciating thirst.

Why are you suffering? Because the liquor that smoothly passed your lips is now wreaking havoc in your body, causing dehydration, stomach distress and inflammation. These ailments peak about the time all the alcohol leaves your body.

There is no scientifically proven way to cure a hangover, but experts say you can prevent one — or at least keep that morning-after misery to a minimum. Here’s how.

Forget a late-night meal after a night of drinking — that’s much too late, experts say. Instead, eat before your first drink and keep noshing as the night goes on.

“Food in the stomach slows gastric emptying and can reduce hangover symptoms,” said Dr. Robert Swift, a professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School in Providence, Rhode Island.

Why does food help? Because most alcohol isn’t absorbed by an empty stomach but via the intestinal tract just below it, Swift said.

“If somebody does shots on an empty stomach, for example, all that pure alcohol is not diluted by the stomach and is passed to the intestine very quickly,” said Swift, who has studied alcohol abuse since the 1990s.

“If the stomach contains food, however, there are gastric juices and enzymes that mix the food and the alcohol, and only small amounts of food are passed into the intestine,” he said. “Now the alcohol is diluted in the stomach, and only a small quantity of alcohol is absorbed at any time.”

The same principle applies to water and other nonalcoholic beverages, Swift said. “If alcohol is mixed with fluid, it’s diluted, so when it goes into your intestines, it’s not as irritating. You’re less likely to have inflamed intestines or an inflamed stomach lining.”

Drinking water can help reduce the dehydration that occurs from downing too many alcoholic drinks.

There’s another benefit to downing water between drinks, said Dr. John Brick, former chief of research at the Center of Alcohol Studies, Education and Training Division at Rutgers University in New Jersey.

“The primary cause of hangovers is dehydration and the loss of fluids, along with vitamins and minerals,” said Brick, who authored “The Doctor’s Hangover Handbook” and published scientific papers on the biobehavioral effects of alcohol and other drugs.

Downing just 3½ alcoholic drinks can result in the loss of up to a quart of water over several hours, Brick added. “That’s a good amount of water that has to be replenished.”

Dehydration from alcohol may affect a woman even more, and she is more likely to suffer a hangover, even if she drinks less than a man, Swift said. That’s because a man has a higher percentage of body water than a woman of the same height and weight, so the same amount of alcohol will be more diluted in a man, he said.

“The woman will have a higher concentration of blood alcohol because her body contains less water to dilute it,” he said. “Women are much more susceptible to the deleterious effects of alcohol (and they) get more intoxicated and develop alcohol liver disease sooner in life than men do.”

The alcohol we drink, called ethyl alcohol or ethanol, is the byproduct of fermenting carbohydrates and starches, usually some sort of grain, grape or berry. We use byproducts of fermentation in other ways: Ethanol is added to the gasoline in our cars, and methyl alcohol or methanol — a toxic substance — is used as a solvent, pesticide and alternative fuel source. Also called wood alcohol, methyl alcohol made by bootleggers blinded or killed thousands of people during Prohibition.

That’s not all — the list of byproducts or chemicals added by manufacturers for flavor and taste can read like a list of supplies at an industrial warehouse: ethyl formate, ethyl acetate, n-propanol, isobutanol, n-butanol, isopentanol and isoamyl alcohols. While these congeners, as they are called, are added in small, nontoxic amounts, some people are overly sensitive to their effects.

Overall, dark-colored beer and spirits tend to contain more congeners and thus may be more likely to cause hangovers, experts say. A 2010 study investigated the intensity of hangovers in people who drank the darker-colored liquor bourbon versus clear vodka.

“Congeners in bourbon … significantly increased hangover intensity, which is not too surprising since bourbon has about 37 times the amount of congeners as vodka,” Brick said.

Chemical preservatives called sulfites, known to cause allergic reactions in sensitive people, are also a natural byproduct of fermentation in small quantities. However, many manufacturers of beer and wine add sulfites to their products to extend shelf life. (Sulfites are also added to soda, cereals, sweeteners, canned and ultra-processed foods, medications and more.)

Sweet and white wines tend to have more sulfites than red, but red wines contain more tannins, which are bitter or astringent compounds found in the skin and seeds of grapes. Like sulfites, tannins can trigger allergic reactions in people who are sensitive.

As a result, limiting your drinking to light beers, clear liquors and white wine might help keep hangovers at bay.

In the end, however, experts say there is only one true preventive — or cure — for a hangover: Don’t drink.

“There’s no simple cure because there are so many complex factors that are producing the multiple symptoms of a hangover,” Swift said. “And that’s why the only real cure for a hangover is to not drink alcohol or drink such a low amount of alcohol that it won’t trigger a hangover.”

Correction: A previous version of this story misstated the process through which alcohol is absorbed in the body.

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Should you attend that New Year’s Eve party? Our medical analyst weighs in | CNN

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CNN
—

At the end of 2020 and 2021, many people greeted the start of the coming year hunkered down due to the risk of Covid-19. But now, New Year’s Eve events and celebrations are back in a big way. A lot of people have plans to attend social functions, whether they are crowded festivities with thousands or house parties with a few relatives and friends.

These gatherings are occurring as the United States is in the midst of a triple threat — a confluence of respiratory syncytial virus or RSV, influenza and Covid-19. All three viral infections are spread from person to person, and gatherings involving many people can increase transmission at a time when hospital capacity nationwide is at near-record levels: More than 70% of inpatient beds are in use across the country, according to the US Department of Health and Human Services.

What should you consider in deciding whether to attend New Year’s Eve parties? How can you gauge the risk of specific events? Are there individuals who may want to take more precautions, and which mitigation measures can reduce risk if they go? If you find out later that an attendee was ill, when should you test afterward to make sure you are in the clear? And what happens if you develop symptoms after an event?

To guide you through these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: What should people consider in deciding whether to attend New Year’s Eve parties?

Dr. Leana Wen: People should start by considering three factors. First, what is your risk and the risk of your household from severe outcomes due to respiratory viruses? If everyone is generally healthy and you have already resumed other aspects of pre-pandemic activities, it might be reasonable to do the same for New Year’s get-togethers. But if someone is elderly or severely immunocompromised, you may wish to take additional precautions.

Second, what’s the importance of these events to you, compared with the importance of avoiding infection? Virtually every in-person interaction has some level of risk. That doesn’t mean everyone should avoid in-person activities permanently, but if you do attend a higher-risk event, know that you have a chance of getting a respiratory infection from it. Whether you go depends on how you weigh the importance of that event versus your desire to not get sick.

Third, is there a specific timing issue for which you really don’t want to get sick heading into the new year? For example, someone who has an operation scheduled the week after New Year’s may wish to be extra careful, so they don’t get an infection and then have to postpone their surgery. Someone else may have an important work event or school exam, and the desire to avoid any infection before that occasion could outweigh the desire to participate in New Year’s Eve celebrations. These are all things to consider and will vary depending on individual preference.

CNN: How can people gauge the risk of different New Year’s Eve events?

Wen: The risk depends on the type of event and what kind of mitigation measures are put into place, if any.

The more people, the higher the risk. A small gathering of, say, 10 close friends means that you could potentially contract respiratory viruses from one of these 10. Especially if these friends have been fairly cautious themselves, chances are low that none of these 10 are infected coming into the party. Compare that with a large party of 1,000 people. In this case, chances are much higher that someone at that party is infectious.

An outdoor event will be lower risk than an indoor event. Indoor events where everyone is spaced out, and where there is good ventilation, will be safer than ones where people are crowded close together.

In addition to space and ventilation, another mitigation measure that can make a difference is testing. If the event requires same-day rapid Covid-19 tests, that reduces risk. And it helps if the organizers emphasize that people who are symptomatic should not attend.

CNN: What are some things people can do to reduce their risk if they do go to an event?

Wen: Flu, RSV and a lot of other respiratory infections are spread through droplets. Washing your hands well and often can reduce your risk. Bring hand sanitizer with you in case it’s not readily available and use it frequently, especially after shaking hands and touching commonly used surfaces like shared serving utensils.

You could also stand near windows and try to stay away from crowds, especially if people are gathering in areas that aren’t well-ventilated.

Covid-19 is airborne in addition to being transmitted through droplets. Studies have shown that masks reduce the risk of Covid-19 transmission. Some venues may require masks, but even if they don’t, if you are someone who is very concerned about Covid-19, you could wear a high-quality N95 or equivalent mask during the event.

If you find out a partygoer at an event you attended had Covid-19, take a test five days after the gathering, Wen advised.

CNN: If you find out that someone at an event had Covid-19, when should you test afterward to make sure you are in the clear?

Wen: If you are asymptomatic, you should test at least five days after the event. If you test earlier than that, the test result might be negative, and you could still have contracted Covid-19, even if the virus in your body hasn’t replicated enough for the test to detect it yet. To be certain, I’d test five days after and then again two days after that.

CNN: What if you saw other people on New Year’s — if you were exposed on New Year’s Eve, could you infect people the day after?

Wen: The incubation period for Covid-19 is at least two days. Even if you did contract Covid-19 on New Year’s Eve, you wouldn’t have enough virus in your system to infect other people the day after. By the next day, two days after exposure, it’s possible.

CNN: What happens if you develop symptoms after an event?

Wen: If you develop symptoms, you should test for Covid-19, and then, if you test positive and you are eligible for Paxlovid, speak with your health care provider about taking the antiviral treatment. Inform the event organizer right away so that they can alert others.

Viral symptoms are not just due to Covid-19, of course. If you are someone who is particularly vulnerable, you should call your health care provider, who can test you for influenza and prescribe the antiviral Tamiflu. Children and other vulnerable people should get tested for RSV, too.

Otherwise, the advice is the same as pre-pandemic: Refrain from going to public places while symptomatic. Use standard measures to treat viral syndromes — such as fluids, rest, fever-reducing medicines and other symptom-based treatment.

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What older Americans need to know before undergoing major surgery | CNN

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KHN
—

Larry McMahon is weighing whether to undergo a major surgery. Over the past five years, his back pain has intensified. Physical therapy, muscle relaxants, and injections aren’t offering relief.

“It’s a pain that leaves me hardly able to do anything,” he said.

Should McMahon, an 80-year-old retired Virginia state trooper who now lives in Southport, North Carolina, try spinal fusion surgery, a procedure that can take up to six hours? (Eight years ago, he had a lumbar laminectomy, another arduous back surgery.)

“Will I recover in six months — or in a couple of years? Is it safe for a man of my age with various health issues to be put to sleep for a long period of time?” McMahon asked, relaying some of his concerns to me in a phone conversation.

Older adults contemplating major surgery often aren’t sure whether to proceed. In many cases, surgery can be lifesaving or improve a senior’s quality of life. But advanced age puts people at greater risk of unwanted outcomes, including difficulty with daily activities, extended hospitalizations, problems moving around, and the loss of independence.

I wrote in November about a new study that shed light on some risks seniors face when having invasive procedures. But readers wanted to know more. How does one determine if potential benefits from major surgery are worth the risks? And what questions should older adults ask as they try to figure this out? I asked several experts for their recommendations. Here’s some of what they suggested.

Ask your surgeon, “How is this surgery going to make things better for me?” said Dr. Margaret “Gretchen” Schwarze, an associate professor of surgery at the University of Wisconsin School of Medicine and Public Health. Will it extend your life by removing a fast-growing tumor? Will your quality of life improve by making it easier to walk? Will it prevent you from becoming disabled, akin to a hip replacement?

If your surgeon says, “We need to remove this growth or clear this blockage,” ask what impact that will have on your daily life. Just because an abnormality such as a hernia has been found doesn’t mean it has to be addressed, especially if you don’t have bothersome symptoms and the procedure comes with complications, said Drs. Robert Becher and Thomas Gill of Yale University, authors of that recent paper on major surgery in older adults.

Schwarze, a vascular surgeon, often cares for patients with abdominal aortic aneurysms, an enlargement in a major blood vessel that can be life-threatening if it bursts.

Here’s how she describes a “best case” surgical scenario for that condition: “Surgery will be about four to five hours. When it’s over, you’ll be in the ICU with a breathing tube overnight for a day or two. Then, you’ll be in the hospital for another week or so. Afterwards, you’ll probably have to go to rehab to get your strength back, but I think you can get back home in three to four weeks, and it’ll probably take you two to three months to feel like you did before surgery.”

Among other things people might ask their surgeon, according to a patient brochure Schwarze’s team has created: What will my daily life look like right after surgery? Three months later? One year later? Will I need help, and for how long? Will tubes or drains be inserted?

A “worst case” scenario might look like this, according to Schwarze: “You have surgery, and you go to the ICU, and you have serious complications. You have a heart attack. Three weeks after surgery, you’re still in the ICU with a breathing tube, and you’ve lost most of your strength, and there’s no chance of ever getting home again. Or, the surgery didn’t work, and still you’ve gone through all this.”

“People often think I’ll just die on the operating table if things go wrong,” said Dr. Emily Finlayson, director of the UCSF Center for Surgery in Older Adults in San Francisco. “But we’re very good at rescuing people, and we can keep you alive for a long time. The reality is, there can be a lot of pain and suffering and interventions like feeding tubes and ventilators if things don’t go the way we hope.”

Once your surgeon has walked you through various scenarios, ask, “Do I really need to have this surgery, in your opinion?” and “What outcomes do you think are most likely for me?” Finlayson advised. Research suggests that older adults who are frail, have cognitive impairment, or other serious conditions such as heart disease have worse experiences with major surgery. Also, seniors in their 80s and 90s are at higher risk of things going wrong.

“It’s important to have family or friends in the room for these conversations with high-risk patients,” Finlayson said. Many seniors have some level of cognitive difficulties and may need assistance working through complex decisions.

Make sure your physician tells you what the nonsurgical options are, Finlayson said. Older men with prostate cancer, for instance, might want to consider “watchful waiting” — ongoing monitoring of their symptoms — rather than risk invasive surgery. Women in their 80s who develop a small breast cancer may opt to leave it alone if removing it poses a risk, given other health factors.

Because of McMahon’s age and underlying medical issues (a 2021 knee replacement that hasn’t healed, arthritis, high blood pressure), his neurosurgeon suggested he explore other interventions, including more injections and physical therapy, before surgery. “He told me, ‘I make my money from surgery, but that’s a last resort,” McMahon said.

“Preparing for surgery is really vital for older adults: If patients do a few things that doctors recommend — stop smoking, lose weight, walk more, eat better — they can decrease the likelihood of complications and the number of days spent in the hospital,” said Dr. Sandhya Lagoo-Deenadayalan, a codirector in Duke University Medical Center’s Perioperative Optimization of Senior Health (POSH) program.

When older patients are recommended to POSH, they receive a comprehensive evaluation of their medications, nutritional status, mobility, preexisting conditions, ability to perform daily activities, and support at home. They leave with a “to-do” list of recommended actions, usually starting several weeks before surgery.

If your hospital doesn’t have a program of this kind, ask your physician, “How can I get my body and mind ready” before having surgery, Finlayson said. Also ask: “How can I prepare my home in advance to anticipate what I’ll need during recovery?”

There are three levels to consider: What will recovery in the hospital entail? Will you be transferred to a facility for rehabilitation? And what will recovery be like at home?

Ask how long you’re likely to stay in the hospital. Will you have pain, or aftereffects from the anesthesia? Preserving cognition is a concern, and you might want to ask your anesthesiologist what you can do to maintain cognitive functioning following surgery. If you go to a rehab center, you’ll want to know what kind of therapy you’ll need and whether you can expect to return to your baseline level of functioning.

During the Covid-19 pandemic, “a lot of older adults have opted to go home instead of to rehab, and it’s really important to make sure they have appropriate support,” said Dr. Rachelle Bernacki, director of care transformation and postoperative services at the Center for Geriatric Surgery at Brigham and Women’s Hospital in Boston.

For some older adults, a loss of independence after surgery may be permanent. Be sure to inquire what your options are should that occur.

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The year in sport: A fond farewell for some, a glimpse of the future for others | CNN

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CNN
—

An athlete, former jockey AP McCoy said earlier this year, is the only person who dies twice, such is the pain of walking away from the intoxicating, all-consuming nature of professional sport.

McCoy retired from his long, decorated racing career in 2015, and since then has had to learn, in his own words, how to “start again and have another life.”

Based on the past 12 months, there are some notable sports stars who might have been listening extra closely to McCoy’s experience of retirement – or indeed to anyone else who has spoken candidly about the difficulty of ending a successful sporting career.

Among them is Roger Federer, who called time on his trophy-laden tennis career at the Laver Cup in September after years spent trying to recover from two knee surgeries.

In the letter announcing his retirement, Federer, like McCoy, alluded to the heightened emotions of being a professional athlete and how they make saying goodbye so hard.

“I have laughed and cried, felt joy and pain, and most of all I have felt incredibly alive,” Federer wrote. “To the game of tennis,” he signed off the letter, “I love you and will never leave you.”

Those final words were reassuring for fans who have admired Federer’s career for so many years, but also spoke to another issue: namely, of how hard it can be to walk away entirely from professional sport after retirement.

It remains to be seen exactly how Federer will remain involved in tennis moving forward, and the same can be said of Serena Williams, who announced she would “evolve away from tennis” ahead of this year’s US Open – but refused to say she was retiring.

On several occasions over the past three months, the 23-time grand slam champion has even teased fans about a potential return to tennis.

At the 2022 US Open, Serena Williams lost to Australian Ajla Tomlijanovic in the third round.

While Federer and Williams have stepped away from their careers as two of the greatest athletes of all time, other sports stars can’t seem to decide when, or how, to walk away.

Heavyweight boxing champion Tyson Fury has yo-yoed in and out of retirement this year, saying in October that he’s finding it “really hard to let this thing go.”

And earlier this year, Tom Brady announced he would be retiring from the NFL, leaving the sport as a seven-time Super Bowl champion and arguably the greatest quarterback of all time. the 45-year-old then reversed that decision and is still breaking records with the Tampa Bay Buccaneers during his 23rd season in the NFL.

However in September, Brady and Gisele Bündchen announced they were to divorce after 13 years of marriage.

“I think there is a lot of professionals in life that go through things that they deal with at work and they deal with at home,” the Bucs quarterback said on his weekly podcast a few days the couple’s divorce announcement.

“Obviously, the good news is it’s a very amicable situation, and I’m really focused on two things: taking care of my family, and certainly my children, and secondly doing the best job I can to win football games. That’s what professionals do.”

Brady has redefined what most believed to be the average shelf-life of an athlete, and he’s not the only person refusing to let the light dim on his career.

LeBron James is about to turn 38 but is still setting records in the NBA – in February passing Kareem Abdul-Jabbar for the most combined regular season and postseason points in NBA history.

Federer’s rivals Rafael Nadal, 36, and Novak Djokovic, 35, meanwhile, have added to their grand slam tallies this year – the Mallorcan at the Australian Open and French Open, where he became the oldest men’s singles champion, and the Serbian at Wimbledon. Djokovic’s Wimbledon triumph moved him to within one grand slam title of Nadal’s men’s record of 22.

Having been deported from Australia over his vaccination status at the start of the year, Djokovic is set to compete at the Australian Open at the start of 2023 – a tournament he has won on nine previous occasions and is favorite to win again next year off the back of his recent ATP Finals victory.

For Nadal, his future in the sport rests on the amount of strain his injury-ravaged body can continue to withstand.

In golf, Tiger Woods faces similar questions. The 15-time major champion completed a stunning return from serious leg injuries suffered in a car crash at this year’s Masters, scoring a remarkable one-under 71 at Augusta National before making the cut the following day.

Then there’s sprinter Shelly-Ann Fraser-Pryce, who turns 36 later this month but has shown no signs of slowing down. The Jamaican produced a string of consistently fast performances this year, running under 10.7 seconds for the 100 meters a record seven times and claiming her fifth world championship title over the distance in July.

Shelly-Ann Fraser-Pryce celebrates winning the women's 100m final at the World Athletics Championships in Eugene, Oregon, in July.

And it’s not just athletes who have defied the call of retirement this year. In November, 73-year-old Dusty Baker became the oldest ever manager to win the World Series when he guided the Houston Astros to a 4-2 victory against the Philadelphia Phillies.

Many of the athletes who stole the headlines in 2022 have been doing so for years.

No one is sure where an aging Cristiano Ronaldo will play his club football in January after ending his second spell at Manchester United in ignominious fashion, but the 37-year-old still appears to be set on extending his playing career after Portugal’s quarterfinal exit from the World Cup.

His rival Lionel Messi, meanwhile, ended the year on a sensational high, guiding Argentina to a third World Cup trophy. The 35-year-old Messi scored twice in an absorbing final against France and finally got his hands on the World Cup at the fifth time of asking, further staking his claim as the game’s greatest ever player.

That hasn’t been the only recent instance of an established superstar winning silverware. In last season’s NBA Finals, Steph Curry guided the Golden State Warriors to a fourth championship title in eight seasons – in the process picking up his first Finals MVP award as the Warriors beat the Boston Celtics.

In baseball, meanwhile, Aaron Judge enjoyed a season for the ages. The 30-year-old outfielder, who has reportedly just signed a nine-year, $360 million deal with the New York Yankees, hit 62 home runs last season, breaking Roger Maris’ single-season American League (AL) home run record from 1961.

On Wednesday, the Yankees named Judge, the reigning AL MVP, as the 16th captain in the franchise’s history.

Judge (left) hit a record-breaking 62 home runs last season.

But even as familiar faces have continued to shine, the past year has also seen future stars emerge.

The 19-year-old Carlos Alcaraz ends the year as the youngest No. 1 in the history of the men’s tennis having triumphed at the US Open, and in the women’s game, Iga Swiatek, who rose to No. 1 in the world following Ashleigh Barty’s decision to retire after winning the Australian Open, looks set to dominate for years to come.

This year, the 21-year-old Swiatek won her second grand slam title at the French Open – which came in the middle of a 37-match winning streak – and her third at the US Open.

In Formula One, Max Verstappen has cemented his position as the best driver in the sport, comfortably defending his world title with four races to spare, while Erling Haaland, regarded as one of the best strikers in European football, has been scoring goals at a record-breaking rate during his first season at Manchester City.

There was no stopping Max Verstappen this year.

At the Winter Olympics in Beijing, then-18-year-old freestyle skier Eileen Gu stole the headlines, winning two gold medals and a silver for the host nation; she also became the first freestyle skier to earn three medals at a single Olympics.

Another teenager, figure skater Kamila Valieva, had a memorable Games for different reasons. The 16-year-old tested positive for trimetazidine, a heart medication, in December 2021, but the result didn’t come to light until Valieva was already in Beijing and had won gold in the figure skating team event.

In that competition, she became the first woman to land a quadruple jump – which involves four spins in the air – at the Winter Olympics.

The outcome from the positive test remains unresolved, and in November, the World Anti-Doping Agency referred Valieva’s case to the Court of Arbitration for Sport after deeming the Russian Anti-Doping Agency had made no progress.

Eileen Gu performs a trick during the women's freestyle freeski halfpipe final at the Beijing Winter Olympics in February.

Russia’s invasion of Ukraine has cast a shadow over much of this year’s sporting calendar.

Athletes and teams from Russia and Belarus were banned from competitions across various sports, including qualification games for this year’s World Cup and participation at Wimbledon.

The decision from Wimbledon was perhaps the strongest stance taken by a sports organization, resulting in the ATP and WTA Tours removing ranking points from this year’s tournament.

At the start of the war, many Ukrainian athletes – like skeleton racer Vladyslav Heraskevych and MMA fighter Yaroslav Amosov – opted to put their careers on hold and support the country’s military efforts.

Boxer Oleksandr Usyk has also spoken passionately about serving his country, and in the ring has extended his undefeated record, beating Anthony Joshua in August to retain his WBA (Super), IBF, WBO, and IBO heavyweight titles.

Oleksandr Usyk lands a punch on Anthony Joshua during their

Throughout 2022, sport and geopolitics have been closely entwined. This month, WNBA star Brittney Griner returned home to the US having been detained in Russia for nearly 10 months on drug smuggling charges.

Despite her testimony that she had inadvertently packed the cannabis oil that was found in her luggage, Griner was sentenced to nine years in prison in early August and was moved to a penal colony in the Mordovia republic in mid-November after losing her appeal.

The 32-year-old’s arrest in Russia sparked diplomatic drama between the US and the Kremlin which played out alongside Russia’s war in Ukraine.

She was released in a prisoner swap that involved Russian arms dealer Viktor Bout. The exchange, however, did not include another American that the State Department has declared wrongfully detained, Paul Whelan.

Brittney Griner is seen getting off a plane in an undated photo posted to her Instagram.

Perhaps no sport has been as gripped by internal politics this year as much as golf, which was rocked by the launch of the Saudi-backed LIV Golf series in June.

LIV Golf has been criticized by some of the game’s leading players – including Woods and Rory McIlroy – while others – major champions Phil Mickelson and Dustin Johnson – have abandoned the PGA Tour in favor of the lucrative, breakaway series.

It has left the sport divided. Earlier this year, LIV Golf joined an antitrust lawsuit alongside some of its players, alleging that the PGA Tour threatened to place lifetime bans on players who participate in the LIV Golf series.

The suit also alleges that the PGA Tour has threatened sponsors, vendors, and agents to coerce players into abandoning opportunities to play in LIV Golf events.

The PGA Tour filed a countersuit in late September, claiming “tortious interference with the Tour’s contracts with its members.”

The LIV Golf series is backed by Saudi Arabia’s Public Investment Fund (PIF) – a sovereign wealth fund chaired by Mohammed bin Salman, the crown prince of Saudi Arabia and the man who a US intelligence report named as responsible for approving the operation that led to the 2018 murder of journalist Jamal Khashoggi. Bin Salman has denied involvement in Khashoggi’s murder.

LIV Golf’s launch is part of Saudi Arabia’s wider ambition to host and invest in global sports events. This year, it staged the rematch between Usyk and Joshua and even won a bid to host the 2029 Asian Winter Games.

But unquestionably, the most prominent sporting event held in the Gulf region this year has been the World Cup in Qatar.

The four-week-long tournament came to a thrilling conclusion on Sunday as Argentina lifted the trophy, bringing down the curtain on what FIFA president Gianni Infantino argued was the greatest World Cup of all time.

There were upsets, high-scoring games, and brilliant goals throughout – right up to Sunday’s showpiece when Messi reigned supreme and Kylian Mbappé scored a stunning hat-trick in a losing cause.

The match between Argentina and France at Qatar 2022 is being viewed as the greatest ever World Cup final.

It was the first time a country in the Middle East had hosted the World Cup, and Qatar, which has a population of just three million people, invested billions of dollars in building seven new stadiums, as well as new hotels and expansions to the country’s airport, rail networks and highways.

The tournament was also fraught with controversy, particularly when it came to allegations surrounding the country’s poor human rights record and treatment of migrant workers.

Since 2010, many migrant workers in Qatar have faced delayed or unpaid wages, forced labor, long hours in hot weather, employer intimidation, and an inability to leave their jobs because of the country’s sponsorship system, human rights organizations have found.

In the face of such criticism, Qatar has maintained it is an open, tolerant country and has seen the World Cup as a vehicle to accelerate labor reforms.

Elsewhere in international football, England won the Women’s European Championships for the first time in front of a record crowd on home soil, while Senegal claimed the Africa Cup of Nations (AFCON) title in February, also for the first time.

Outside international competitions, Real Madrid won its 14th European crown by defeating Liverpool in the Champions League final – a game that was marred by security issues.

Real Madrid defeated Liverpool in this year's Champions League final in Paris.

The match itself was delayed by more than 35 minutes after Liverpool fans struggled to enter the Stade de France and tear gas was used by French police towards supporters held in tightly packed areas.

Paris police chief Didier Lallement admitted in June that the chaos was “obviously a failure” and said he takes “full responsibility for police management” of the event.

Tragically, football has witnessed multiple serious stadium disasters this year. In October, more than 130 people were killed in a stampede in the Indonesian city of Malang – one of the world’s deadliest stadium disasters of all time.

Indonesia’s President Joko Widodo later said the country would demolish and rebuild the stadium, vowing to “thoroughly transform” the sport in the football-mad nation.

Players and officials from Arema Football Club gather to pray on the pitch for victims of the stampede at Kanjuruhan stadium in Malang.

A stadium crush in the Cameroonian capital of Yaoundé during this year’s AFCON also saw at least eight people killed and 38 injured during the game between Cameroon and Comoros.

Looking ahead to 2023, Australia and New Zealand is scheduled to host the Women’s World Cup in July and August.

The US Women’s National Team (USWNT) could become the first team to win the tournament three times in a row.

This year, the United States Soccer Federation (USSF), the USWNT’s Players Association (USWNTPA) and the United States National Soccer Team Players Association (USNSTPA) forged a landmark equal pay deal – the first federation in the world to equalize prize money awarded to the teams for participating in World Cups.

Next year will be the first time the USWNT has played a major tournament under such a deal.

Among the other major sporting events being held next year are the World Athletics Championshps in Budapest, Hungary, and the Rugby World Cup in France.

In the NFL, Super Bowl LVII in Glendale, Arizona is only weeks away, while the NBA Playoffs begin two months later in April.

With the men’s World Cup over, club football resumes in Europe and tennis’ first grand slam of the year, the Australian Open, begins on January 16.

For sports fans, that will hopefully serve as tonic to stave off the January blues.

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Pandemic fueled alcohol abuse, especially among women, but there are treatment options | CNN

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Editor’s Note: In the final two episodes of “This Is Life With Lisa Ling,” the series explores alcoholism in America (at 9 p.m. ET Sunday) and interracial marriages (at 10 p.m. ET Sunday).

CNN
—

Brook was 34 years old when her use of alcohol escalated, a way of coping with a breast cancer diagnosis.

“I just decided I’m not gonna go through this straight,” she told Lisa Lang in an episode of “This Is Life With Lisa Ling,” airing at 9 p.m. ET Sunday on CNN.

“I would drink before I went to my chemo sessions. It became more and more of a coping mechanism,” said Brook, who did not want to use her last name.

Brook survived the bout with cancer but says she became dependent on alcohol — and the pandemic only made it worse.

“When Covid started and I was home, I started drinking more and more and more,” said Brook, now 42. “I started not being able to eat, I started throwing up more often, and then I started throwing up blood.”

She recently ended up in the hospital, diagnosed with cirrhosis of the liver and a bad bleed from ulcers, which doctors said could take her life if not quickly treated.

“When they were talking to me afterwards, they said, ‘If you keep going like this, you’ll be dead in a year,’ ” Brook told Ling.

Alcohol use disorder is defined as compulsively using alcohol despite negative consequences on relationships and one’s ability to function at work, school or in the community. Over time, excessive alcohol use may even rewire the brain, making booze as desirable as natural rewards such as food or sex, experts say.

Researchers at University of California, Los Angeles showed pictures of alcoholic drinks to people who are and are not addicted while scanning their brains. Regions of the brain associated with craving, pleasure and reward lit up significantly more in those with an alcohol use disorder.

“It’s much more of a medical and brain disease than we initially thought,” Lara Ray, a clinical psychologist who runs the UCLA Addictions Lab, told Ling.

In addition, just one pint of beer or average glass of wine a day may begin to shrink the overall volume of the brain. The brains of nondrinkers who began consuming an average of one alcohol unit a day showed the equivalent of half a year of aging, according to a study published in March.

The damage worsens as the number of daily drinks rises, the study found — drinking four alcohol units a day aged a person’s brain by more than 10 years.

Alcohol use disorder is a growing problem in the United States, which experts say has been enhanced by the pandemic, especially among women.

“Last year, I took care of two women who were in their early 20s who had cirrhosis and needed liver transplants, and I’ve never seen that before in my entire career,” Dr. James Burton, medical director of liver transplantation at the University of Colorado School of Medicine in Aurora, told Ling.

A recent study found a significant increase in alcohol-associated liver disease and a 15% higher rate of waiting lists and subsequent liver transplants between 2020 and 2021 — the greatest increase occurred in young adults.

Since the pandemic’s onset, statistics show an overall 14% increase in the number of drinking days per month, but a “41% increase in heavy drinking days among women,” Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital, told CNN in January.

Why? Pre-pandemic mom wine culture, which “normalized and even glorified” drinking, is partly to blame, said Dr. Leena Mittal, chief of the women’s mental health division in the department of psychiatry at Brigham and Women’s Hospital in Boston.

In addition, “studies have shown the complexities of balancing home, work and caregiving responsibilities during the pandemic have fallen disproportionately on women,” Mittal said earlier.

Women are especially sensitive to the effects of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related problems appear sooner and at lower drinking levels than in men, said the institute, part of the US National Institutes of Health.

Women are more susceptible to alcohol-related brain damage and heart disease than men, and studies show women who have one drink a day increase their risk of breast cancer by 5% to 9% compared with those who abstain.

Pandemic lockdowns also forced many people to live and work from home — sometimes alone. A July study found drinking alone during adolescence and young adulthood can strongly increase the risk for alcohol abuse later in life, especially if you are a woman.

Victoria, who also did not want to use her last name, told Ling she began drinking as a teenager. Now 55, she still “can’t control it. It’s like a tension that builds up. And so then when I do drink, it’s like, ‘Ah! I’m drinking,’ you know, so it’s way too much, way too fast.”

Victoria says she continues to crave alcohol but goes regularly to support meetings for addiction recovery after moving in with her mother during the pandemic.

Binge drinking — defined as more than four drinks for women and five for men within a few hours — is on the rise. According to a study published in June, even older people who consider themselves moderate users of alcohol are downing multiple drinks in one sitting.

People who binged were about five times more likely to experience numerous alcohol problems, including injuries, emotional or psychological issues, and alcohol dependence at work or school or while caring for children, the study found.

“What this means is that an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner, even though their average drinking level is the same,” study coauthor Charles Holahan, professor of psychology at the University of Texas at Austin, told CNN previously.

The US Food and Drug Administration has approved only three drugs designed to reduce alcohol use since 1951: disulfiram, which causes headaches, nausea and vomiting when mixed with alcohol; acamprosate, which works on the reward centers of the brain to reduce alcohol cravings; and naltrexone, which reduces cravings and appears to help with heavy drinking.

There is help. Find it here

The National Institute on Alcohol Abuse and Alcoholism has a tool called the NIAA Alcohol Treatment Navigator that “helps adults find alcohol treatment for themselves or an adult loved one.” For teens, the institute recommends these resources.

The Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline active 24/7/ 365 days a year to provide information and treatment referrals to local treatment facilities, support groups and community-based organizations: 800-662-HELP (4357) and 800-487-4889 (TTY option).

All three have significant side effects that can deter people from using them consistently.

Researchers continue to experiment with various drugs to see if they can help cure cravings without major side effects. While not FDA-approved, the anticonvulsant drug topiramate has shown promise in some clinical trials but may affect cognition and memory. Other anticonvulsant drugs, such as zonisamide and gabapentin, and a smoking cessation drug called varenicline have shown mixed results.

At Ray’s lab at UCLA, small clinical trials have found promising results from the neuromodulator ibudilast, which hindered cravings and reduced the odds of heavy drinking for some people by 45%.

For Billy Flores, 45, the change happened quickly.

“In the first two days, I was upset in the stomach, but by the third day I was on it, I was off of alcohol, which is pretty amazing I thought,” he told Ling about using ibudilast.

Bill has struggled with alcohol but says he has found hope with a clinical trial.

Additional studies are needed to see if the benefits hold true for larger populations.

In the meantime, there are gold standard treatments for alcohol use disorder that don’t involve medications. Those include Alcoholics Anonymous and Self-Management and Recovery Training 12-step programs, cognitive behavioral treatments and mindfulness-based approaches.

A large 2006 clinical trial found behavioral interventions can be as effective as drugs — in fact, most of the medication clinical trials done to date have also included some form of social or behavioral treatment in combination with drugs.

Having support is critical to keeping a positive mindset that will ultimately win the battle with alcohol, experts say.

Brook agrees.

“When I was doing my therapy intake for rehab, one of the questions was, ‘What made you decide to do this?’ And I said, ‘I’m better than this,’ ” she told Ling.

“I still like to think that even with the relapses, I’m gonna still be that person who gets right back up and tries again.”

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Home delivery of medications can help improve access, especially when time is tight | CNN

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CNN
—

Covid-19 hospitalizations are on the rise in the United States, with more than 34,000 new admissions last week, but millions of vaccines and doses of antiviral treatments that could help prevent severe outcomes from the virus remain unused.

Research has found that many who could benefit most from the Covid-19 medication Paxlovid – including the elderly and Black and Hispanic people, groups that have disproportionately had the most severe illness – are less likely to take it.

As the supply of Paxlovid has grown, efforts have been made to improve timely, equitable access to the treatment.

“The driving distance to the nearest site or the geographic accessibility of the places where Paxlovid is being offered doesn’t seem to be the primary driver of why these populations are not getting the treatments they need,” said Dr. Rohan Khazanchi, a resident at Harvard Medical School and health equity consultant for the New York City health department.

Transportation is one significant barrier to health care access for many people, experts say, but creating equitable outcomes will involve a much more comprehensive approach.

In response to the White House’s call for pharmacies to help make this winter a healthier one for Americans, Walgreens launched a program Thursday in partnership with DoorDash and Uber Health that offers free home delivery of Paxlovid for those with a prescription. The initiative is meant to increase access to Covid-19 treatment, particularly for those in socially vulnerable or medically underserved communities.

Millions of Americans get prescriptions through the mail, a service that research has shown is used more frequently among seniors, adults with poor health and others who are also at high risk of severe outcomes for Covid-19.

But Paxlovid is most effective when taken within five days of symptoms starting, making timely treatment a critical piece of the puzzle and traditional mail-order delivery too slow.

Walgreens also plans to expand the service to include HIV treatment – in line with the Biden administration’s goals to accelerate efforts to end the HIV/AIDS epidemic in the US.

As with Paxlovid, early uptake is key with HIV treatment. And people who miss doses of HIV treatment risk developing drug resistance, making it crucial that they stick with the prescription.

“There are places across the patient journey that would divert a patient from being able to get treated and back to feeling better. But that’s where our teams have been working on really understanding that patient journey and then offering and identifying solutions to help address that,” said Rina Shah, vice president of pharmacy strategy at Walgreens.

Rite Aid adopted a prescription delivery program during the Covid-19 pandemic through a partnership with ScriptDrop. Service fees are currently waived for all eligible prescriptions, which excludes controlled substances and refrigerated medications but includes Paxlovid.

CVS also has one- or two-day delivery in most locations and on-demand delivery at some, which is provided free to people enrolled in the membership program.

In March, the Biden administration launched a federal Test-to-Treat initiative that streamlined access to Paxlovid for people who had Covid-19, with testing and prescribing all happening in one visit. In May, the program was broadened to specifically reach more vulnerable communities.

Khazanchi was author of a study published last month that found that Black and Hispanic people were more likely to live closer to Test-to-Treat sites than White people. But despite the physical proximity, these groups were less likely to get outpatient Covid-19 therapeutics – even though they’re at elevated risk of infection and severe disease.

Even if someone has a car or another way to get to the doctor’s office, pharmacy or other Test-to-Treat location, they’re often challenged by the time required to make that trip, said Dr. Rachel Werner, executive director of the University of Pennsylvania’s Leonard Davis Institute of Health Economics.

“It’s a combination of things that prevent access to care,” said Werner, whose research has focused on health equity. “Often, people have to take time off of work to do that, and they don’t always have paid sick leave. Everyone’s lives are complicated, and sometimes it’s hard to balance competing priorities.”

According to a report from health analytics company IQVIA, 9% of all new prescriptions in 2019 were “abandoned” at pharmacies, representing a gap in physician-recommended care that was not received by the patient. But home delivery programs that have expanded throughout the Covid-19 pandemic may help.

“I think it may be important to think about other medications or conditions where the time to treatment really matters. And those may be the ones that I think would be ripe for this kind of home-based delivery system,” Werner said. “These are urgent things that people might otherwise show up to an urgent clinic or ER for and instead could just get a medication.”

With the expansion of things like telehealth and options for home care, experts say, the Covid-19 pandemic helped widen the picture of what health care can look like.

“For far too long, we’ve been bound by the idea that health care is something that occurs within the four walls of a hospital or clinic,” Werner said. “What the Covid pandemic really did, which is important, is it made people realize that health care should be accessible where and when people need it, and it doesn’t have to be delivered in the physical structure of a health care setting.”

Experts say that while it’s critical to break down barriers in terms of access to medication, it’s important to also address the issue of trust.

In the research about accessibility to Test-to-Treat sites, Khazanchi and his co-authors suggested that programs should leverage trusted community stakeholders like local health-care providers for in-person outreach and other “low-tech, high-touch” methods to ensure equitable use.

Dr. Kedar Mate, president and CEO of the Institute for Healthcare Improvement and assistant professor at Weill Cornell Medical College, thinks about it in terms of supply and demand.

“Getting treatments to people who need them is principally an issue around access and ensuring that the supply goes to where the people are,” he said. “There’s a different problem, though, on the demand side. Are patients willing or interested to get tested and then get treated if they are found to be positive? That has everything to do with a totally different set of challenges which have to do with trust, information, disinformation, misinformation and belief in the health system overall.”

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