In Pursuit of Science

In Pursuit of Science Fall 2018

The Rise of Tesla

The Opiod Crisis VISA APPLICATION

H1-Bs in the Trump Era

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Table Of

Contents 2 The Space Race 4 Rise of Electric 6 10 Electric VS Gasoline Cars 12 Changing Times 16 The Top Five Deadliest Diseases The Crisis Conquering the Country 18 Game Pages 23 Letter from the Editors

The WorldĘźs Mission to Expand its Boundaries

Tesla is the Newest Car Competitor in the Fortune 500, How Will it Change the Game?

Comparing Electric Cars to Gasoline Cars

How New H1-B Policies are Threatening to Trump Immigrants

An Introduction into the WorldĘźs Deadliest Diseases

All About the Opioid Crisis and How it is Traumatizing the Nation

Knock Yourself out With a Crossword and Other Enjoyable Games

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First Tesla Retail StoreIn Credit: Tesla Press

Pursuit of Science

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Letter from the Editors 02

Dear Reader, Welcome to our magazine! We had a lot of fun working together to make this, and we hope you enjoy reading it as much as we enjoyed making it. We wanted to create this magazine to inform people about science and its impact on todayĘźs world. We tried to cover a broad range of topics, from the opioid crisis to electric cars to H1B visas. We hope that you will leave this magazine with a more open mind and a broader view on the world. Happy reading!

In Pursuit of Science

MAYA MARTINEZ

Maya is the copy editor for In Pursuit of Science. She is very interested in the political aspect of science and how it affects scientiďŹ c exchange. She enjoys playing her guitar and also has a brown belt in Seido karate, but is currently doing Kajukenbo. She hopes that you enoy reading this magazine and that you leave with new insights.

SADHANA KUMAR

Sadhana is the feature editor for In Pursuit of Science. She loves all things science and enjoys reading about science and other things in her free time. She also plays the violin and the guitar. She loves being around children, and volunteers at the Thinkery some weekends. She hopes that you enjoy reading this magazine!

NATHAN JACOB

Nathan is a freshman at LASA. He is currently interested in computer science, and in his free time, he enjoys creating magazines. He is constantly improving his graphic design skills in order to help along activities in this magazine.

He worked for half a year in order to create this magazine. He hopes you enjoy reading this magazine!

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Background image credit to NASA. Information from CNN.

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Humans have always been fascinated with space. Since the dawn of human existence we have tried to map the stars. Now we may be able to y among them.

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And companies like SpaceX, Orbital, and Boeing have begun our ight into the unknown. erical fligh m m co

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July 20, 1969

First rover lands on Mars

November 27, 1971

Orbital tourism is available to the public

2020

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It would cost around 2 million dollars to send civilians to space

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The Rise of Electric How Tesla is Lapping the Game

By Nathan Jacob

As Tesla pushes newer features to its cars, according to Google Trends, their popularity is at an all time high. With the rise of Tesla, interest in electric cars have been given a jumpstart.

Electric cars are powered by a battery rather than a gasoline engine, and include all types of vehicles from motorcycles to semi-trucks. As of 2018, the biggest electric car company is Elon Muskʼs Tesla Motors,

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which emerged in 2008 and grew to a $45 billion company.

Since then the company has been progressing faster than other companies in the same field.

“Well, Iʼm a big believer in go big or go home,” said Sam Hill, an Austin Tesla showman.

“Most hybrids are big, look kinda dumb and clunky, they have a puny battery”. majority of the fortune 500 car companies make incremental upgrades with their cars.

Photo Courtesy of Tesla Press

In a survey conducted by Consumer Reports, a consumer driven review site, about what features people want in cars, less than 12 percent of the desired features matched with the features added to newer gasoline cars.

“We are constantly striving to push innovation in automobiles”, said Katelyn Forrest, a Honda spokesperson.

“We are dedicated to ensuring customer satisfaction with our

products”.

Gasoline cars have also stepped up their game.

Companies like Honda have added their own autonomous driving functionality which is still in its early stages, according to most Honda owners. According to Hondaʼs reviews, more than

half of the userʼs say they wouldnʼt recommend Hondaʼs self driving feature to a friend.

“Well, I love how it looks, after using it just the exterior beats out any competitor, with that kind of

price tag, heck it looks better than most sports cars Iʼve Photo Courtesy of Tesla seen,” said Arnav Sharma, an Press Austin owner. Most of Teslaʼs competitors have made concept cars but have never sold or distributed a real car. Other more well-sold car brands have future dates for all electric cars.

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Digram of how Self driving calculations work.

Credit: Tesla Press In

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Sharma said that “Tesla is definitely doing well, since theyʼre the biggest electric car company, but I donʼt think theyʼll make it given their manufacturing shortages”.

“We all have deadlines for these and everyone gets in trouble when they arenʼt met”, said Mina Duran, a programmer for Tesla.

“Working at Tesla causes a lot of stress, The deadlines are always super unreasonable, and I always feel like corporate canʼt possibly expect us to meet them” Many might have heard about Teslaʼs money spending process, with one article on Time magazine stating that more than $7000 goes down the drain every minute. Elon Musk claims he isnʼt worried.

He is continuing to push sales in not only Tesla, but his other companies. Although according to a poll done by the board of Tesla, his support was at an all time low in October 2018, so he was forced to step down as chairman.

“I have a gasoline car simply because they are better, Teslaʼs simply canʼt compete … If I want to charge my car,

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In Pursuit of Science

Photo Credit: Porsche

Tesla is still a newcomer, more often than not we get complaints about defects, inspection failures and just straight up missing parts, which is worrying for most owners” Sam Hill, Austin Tesla showman

all I need is 10 minutes at a gas station” said Naomi Jones, an anti-electric consumer.

Investor advice website Investopedia predicts that given Teslaʼs improvement in such a little amount of time could lead Tesla to have a big future ahead of it, especially if it can get its manufacturing game together. In 2018, Tesla met manufacturing demands for the middle of 2018 on the Model 3, but itʼs unlikely that itʼll

catch up again because of their record for net worth to money spent.

I never had to worry that my car would never come, because A, my car comes from Subaru, a well established brand that is actually legally allowed to sell here, and B, thereʼs a higher manufacturing quality due to their experience” says Naomi Jones, a gasoline car owner.

“Tesla is racing towards the future, and theyʼre not planning on slowing down anytime soon”.

CJ Lu Sing, investor

Tesla has an ever increasing wait list, according to a recent report by Bloomberg, a tech centered news website. These waitlists can lead to customers, putting down a deposit of more than $5,000, still having to wait more than a year to get their car. “Tesla is still a newcomer, more often than not we get compl inspection failures and just straight up missing parts, which

is worrying for most owners,” Hill said.

In Texas it is illegal to sell cars directly to the consumer, because laws prevent manufacturers from cutting out dealerships. This hurts Teslaʼs abilities to connect with consumers and thereby lowering sales. Tesla faces other problems as well when it comes to manufacturing. These

problems are mainly attributed to Tesla being a relatively new car company, compared to the lifespan of other billion dollar car companies, and so itʼs less experienced when it comes to mass production and consumer goods.Tesla has invaded the streets, while still leaving thousands on their never ending waitlists “Tesla is racing towards the future, and theyʼre not planning on slowing down anytime soon” said CJ Lu Sing, one of the worldʼs largest investors.

Courtesy of Tesla Press

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Gasoline vs.

Electric Comparing the 2 types of cars

Most popular electric

Most popular Gasoline

Satisfaction rate: High

Satisfaction rate: OK

very fast, superb

mileage, it’s a car and

car

Comments: futuristic, acceleration

10

car

Comments: Good it does it’s job

#7 #1

In Pursuit of ScienceOverall

Overall

Photo Courtesy of Tesla and Lamborghini Statistics from Trusted Reviews

35 33 #2 <5 base price of a Tesla

Average price of a

Safety Ranking

average safety ranking

23.9 billion the net worth of Tesla, and itâ&#x20AC;&#x2122;s still

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expected to increase

cost to go 100 miles in dollars

sports car

of a sports car

2.9 billion the net worth of Ferrari, the biggest

10 sports car company

cost to go 100 miles in dollars without oil/maintenence

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Changing Times How The New Age of H-1Bs Threaten to Trump Immigrants

By Maya Martinez

Passport acompanied by typical visa application. Photo Courtesy of VIPDesignUSA.

Many H-1B immigrants coming to the U.S. are receiving anything but the “American Dream”.Theyʼre instead living in a country that ignores what they bring to the workforce.

The H-1B program is a program that gives opportunities for employers to hire non-

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In Pursuit of Science

U.S. born immigrants that have distinguished merit as a fashion model or in specialty occupations. An H-1B requires a company sponsorship, and a bachelorʼs degree or higher. It is a temporary, nonimmigrant work visa that allows and immigrant to work in the U.S. for a period of time.

“The intent of the H-1B provisions is to help employers

who cannot otherwise obtain needed business skills and abilities from the U.S. workforce.” said the United States Department of Laborʼs website on Wage and Hour Division.

An H-1B is popular in scientific fields, and for Indian tech immigrants wanting a higherpaying job in the United States.

However, U.S president Donald Trump opposes the usage

H-1B

Percentage of H-1B recipients in each tech sector. Graphic By Maya Martinez.

of H-1B visas for immigrants coming into the United States.

“I will end forever the use of H1B as a cheap labor program, and institute an absolute requirement to hire Americans,” said then-candidate Trump, in a statement in March 2016.

The election of Trump as US President has brought an “America First” viewpoint into the oval office, along with restrictions on H-1Bs. Through the “Buy American, Hire American Executive Order,” (BAHA) the administration made H-1B renewals no longer automatic, requiring face to face interviews, and proposed reforms on previously implemented rules.

The United States Citizenship and Immigration Services also suspended the premium processing for H-1Bs, which traditionally allowed an application to be reviewed faster for an additional price. Without premium, the visa petitions can take over eight months to be approved. And on June 28, 2018, the USCIS allowed the creations of “Notices to Appeal” which states that upon the denial of an applicant, they are present unlawfully in the United States and must leave.

These regulations further extend the waiting period for an H-1B. Through these measures, the Trump administration has sought to discourage the flow of H-1B immigrants into the United States.

According to the United States Citizenship and Immigration Services, the majority of H-1B immigrants work in science, technology, engineering, and math occupations. The USCISʼ data suggest that the decrease in H-1B visas will predominantly impact scientific institutions and tech companies that hire workers on H1B visas.

“We have a lot of

immigrants in higher up positions, so it would impact companies, for example Microsoft and Coca-cola,” said an immigrant currently seeking an H-1B, who requested their information not be disclosed due to fear of deportation.

Since H-1Bs are a popular visa for highly skilled immigrants, a decrease in H-1B immigrants would impact large companies like Cognizant, Microsoft, Coca-Cola, and Apple. In a company-wide memo in 2017, Sunar Pichai, CEO of Google, publicly voiced his dislike of recent policy changes regarding H-1B applicants, which could affect Google employees.

“Just because of stricter and stricter H-1B rules, the United States is losing really talented people in engineering and other services,” said Vishrut Gandhi, a structural engineer from India and a recipient of an H-1B visa.

The administrationʼs stance on H-1Bʼs seems to have

Rise and Fall of H-1B immigration. Graphic by Maya Martinez. *the number for 2018 is an aproximation

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*

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discouraged many applicants.

According to CNN Business, the number of H-1B applications fell below 236,000 in April 2017 for the first time since 2015. And since many H-1B applicants have a masters degree or above, the United States may be paying the price by discouraging foreign talent.

“If I look at the big picture every, every year there are only 80,000 H-1Bs granted,” said Gandhi. “And 80,000 is a really really small number for the United States, which is thirty million or more than that. So by reducing H-1Bs you are not really helping the U.S. economy, you are hurting the people,” According to the website of the Department of Labor, the number of H-1B applicants accepted is 85,000, but is still a relatively low number as estimated by Gandhi.

“On the other hand itʼs not like there is a shortage of skilled workers, and that there are skilled workers just roaming around without jobs that are U.S. citizens or who are not on H-1Bs.” Gandhi said.

Gandhi reminds us that H-1B immigrants are employed because those companies have a need for high skilled workers, and find H-1B applicants that fit the criteria. Since the total population of the U.S. is over 327,460,999 people, but the number of H-1B applicants in the U.S., according to Mark Stephens of the International Data Group, is about 700,000. This means only about 0.213765915 percent of the population are

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In Pursuit of Science

H-1B workers. There are far more Americans working than H-1B immigrants, and those immigrants were hired because of a need for high skilled workers.

“H-1B requirements make you less favorable in an employer job market,” said Gandhi.

“No matter how talented you are, or even if youʼre more talented than others, but just because you have and H-1B employers try to ignore you.”

Large companies, a majority of those in tech and science fields, heavily rely on H-1B non-immigrant visas, especially for high skilled

perspectives and ideas because of where they come from.”

H-1B applications have been recently put under more scrutiny, as the Trump administration encourages companies to hire more American employees, and discouraged the usage of H-1BʼS as a source of labor. The United States Citizenship Immigration Services tightened their view and implementation on many Obama-era policies to instead reduce the inflow of H-1Bʼs.

This caused many potential H-1B recipients to draw out of the application processes, as the risks seem to outweigh the

“Just because of stricter and stricter H1-B rules, the United States is losing really talented people in engineering and other services.”

-Vishruti Ghandi, structural engineer

workers with degrees. But with increased scrutiny and longer waiting times caused by policies like the BAHA, companies are hesitating to hire foreign immigrants, regardless of skill.

“I think this is a bit unreasonable to reject it so quickly,” said the immigrant who requested that their information not be disclosed due to fear of deportation . “[H1B applicants] bring a lot of stuff because they come from different places so they have different

chances of receiving an H-1B. “We must remain open to those pursuing academic study and scientific and engineering research,” the letter said. “In fact, our nationʼs security depends on a visa and immigration system that accomplishes both of these important tasks.

Global academic and scientific exchange is now constant and necessary, fueling the innovations essential to strengthening our nationʼs economy and improving the lives of U.S. citizens,” said

p e r s p e c t i ve a group b e c a u s e of fifty-six scientific and of their educational background, organizations Iʼm sure in a letter to t h e y ʼ r e the U.S. state bringing “Imagine a company just full of people thinking Department innovation or in the same direction and if you introduce in May 2018. creativity to T h o s e someone who has a different perspective ... Iʼm the table,” f i f t y - s i x said Gandhi. sure they bring innovation or creativity to the scientific A s table.” organizations, i t e rat e d - Vishruti Ghandi, structural engineer came out in by Vishrut support of G a n d h i , the H-1Bs Immigrants and other often do work related bring new policies. along with many others, recent policies on immigration, experiences and ideas, which believe that the inflow of working as they believed it stifles helped many U.S. companies immigrants into science-related scientific exchange. Their views to further their own educational fields encourages the global represent many of scienceʼs and financial gain. And in scientific exchange of ideas most prestigious organizations. that diversity is where many “Imagine a company just full employers have found true talent. and methods. In a letter sent to the U.S. State Department,they of people thinking in the same “I think diversity, and direction, and if you introduce voiced their disagreement intellectualism is quality that with the administrationʼs someone who has a different weʼre putting on the table, and hard work,” said Gandhi.

Main Recipients of H-1B Visas By Country T h e United States D e p a r tment of Labor was reached f o r comment, but did n o t respond.

Graphic by Maya Martinez

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THE TOP 5 DEADLIEST DISEASES

By Sadhana Kumar

CORONARY HEART DISEASE

CHD kills around 370,000 people in the United States each year. High cholesterol is the leading cause of CHD. A new class of drugs, called the PCSK9, could help people signiďŹ cantly lower their cholesterol.

TETANUS

Tetanus is an illness caused

by Clostridium bacteria. This infection causes tightening of the muscles and locking of the jaw, making it impossible to move. A vaccine given as part of routine childhood immunizations can prevent tetanus.

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In Pursuit of Science

ISCHEMIC HEART DISEASE Ischemic Heart Disease is a condition in which fatty plaque deposits itself on the walls of areteries leading to the heart. When the plaque ďŹ lls the artery, it can block blood ďŹ&#x201A;ow, resulting in a heart attack.

LUNG CANCER

Many Asian countries, especially India, still use coal for cooking.

Fuel emissions are the leading cause of respiratory cancer, accounting for 17% of deaths in men and 22% in women.

DEMENTIA

Dementia is a term that describes the decline in mental ability that is so severe, it interferes with daily life. Symptoms include memory loss, decreased ability to pay attention, and decreased visual perception.

Sources: Healthline, The Motley Fool

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The Crisis Conquering the Country What the Opioid Crisis is and Why it is Traumatizing the Nation

By Sadhana Kumar

Graphic by Sadhana Kumar

Throughout these past few years, starting in 2016, there have been many news stories about the opioid crisis and how much trauma it is causing the nation. This has resulted in a newfound interest in the opioid crisis and its prevalence in our world.

The term opioid use disorder refers to the misuse of the class of drugs known as opiates, used as painkillers and are often prescribed following surgery or injury. These drugs are sorted into three main categories: prescription opioids, prescribed by doctors to treat moderate to severe pain, fentanyl, a synthetic opioid pain reliever, and heroin, an illegal opioid that can be misused with misused with other drugs or alcohol.

Although physicians have

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been prescribing opioids for decades, there are many factors that determine why the opioid crisis is so prevalent today. Physicians have stopped prescribing opioids to patients already on drugs from other providers. This may seem like a beneficial predicament, as patients are not getting the same drug from multiple providers.

However, this can also have negative consequences because even though their physician may not be prescribing them a certain drug, a person will still want the drug to satisfy their dependence, and will get it even if acquiring it means using illegal methods. This is one of the major reasons that this topic has evolved into the opioid crisis from the opioid use disorder, according to Dr. Lucas Hill, who holds a pharmaceutical degree and is a professor at UT Austin.

“People ended up being

pushed to use heroin, because they couldnʼt get [a] prescription opioid anymore, and heroin is much more dangerous, itʼs much more potent, thereʼs more variability from one bag to the next, and now, weʼve seen a movement toward much more potent opioids that, in many parts of the country, have potentially replaced heroin,” Hill said. “So itʼs an ultrapotent, illicit market thatʼs really driving most of the overdoses and why weʼre seeing such a massive problem here in the past five years.”

Additionally, there has been a increase in the use of opioids for non-cancer pain.

Opioids are being used for pain such as chronic back pain or osteoarthritis, despite serious risks involved and a lack of evidence determining the long term effectiveness of opioids for these diseases, according to

Hill. to feel sick,” Hill said. “You For example, if a person comes Opioid addiction, similar to feel horrendous, and thereʼs an from low income household, are many other addictions, begins automatic trigger in your brain homeless, or their parents have when an opioid starts as a want now that says ʻin order to feel a history of substance abuse, but becomes an addiction. The okay, I need heroinʼ. Heroin they are more likely to use pleasure center of a personʼs becomes the answer to your illegal synthetic opioids. brain is moderated by a pathway physical symptoms, and also The way opioids are used in called the mesolimbic pathway, maybe pre-existing depression Texas is very different from how or reward pathway. When a or other problems that you might they are used in other parts of person starts using a drug, they be experiencing in your life… the nation, such as West Virginia activate the pleasure center Over time, you donʼt really get or North Carolina. This is one of their brain with a molecule a high anymore from the drug, of the main reasons that drug called dopamine, which results since youʼre able to avoid researcher Jane C. Maxwell, in a high or happy feeling. Over feeling sick, and you become who holds a doctorate in social time, this creates a dependence trapped in this cycle of needing work, focuses on looking at on activating that portion of the this drug just to not feel bad,” opioid use trends. brain; the person needs “We look very this drug in order to feel different and thatʼs happy. one of the lessons The first area of I learned early the brain that can get on: every area altered during addiction has different drug is the reward system, problems, different “So itʼs an ultrapotent, illicit according to addiction users, and different psychiatrist John markets…

You market thatʼs really driving most Nguyen. have to have access of the overdoses and why weʼre “What you see with to the data and seeing such a massive problem this altered reward keep thinking about pathway is that rewards the fact that there here in the past 5 years.” can be diminished are no concrete Lucas G. Hill, PharmD from normal stimuli; examples.

Things you can see what I call keep changing as hyperreactivity to cues new drugs emerge or triggers of substance and new dealers abuse,” Nguyen said.

Hill said. appear to be selling,” Maxwell Another area that can be The last aspect is the cognitive said. “Thatʼs what makes it altered is the withdrawal phase, aspect of addiction where really interesting is watching the which is said to be the leading there is an altered function trends.” cause of chronic addiction, in your prefrontal brain, the Many people assume that eventually leading to death. part of your brain that controls Texas has a high history of Withdrawing from an opioid decision making and impulse substance abuse and a high is not life threatening, just control. Studies have shown addiction related death rate, extremely uncomfortable, which that in addiction, the decision primarily because it is so close is why people continue to use making pathway gets distorted to the Mexican border. The drugs; they donʼt want to feel and impulse control is reduced, opposite may be true due to the sick. meaning you lose control of presence of black tar. Black tar “Say youʼve been using heroin how much of a drug you are is a form of heroin found West of every day, and you couldnʼt consuming. the Mississippi River. Although it get it anymore, your dose was Additionally, there are a erected and you didnʼt know number of socioeconomic In Pursuit of Science 19 where to buy it, you would start factors that can spur addiction.

I

is a less pure form of heroin, it is still as potent.

“Our deaths are low, thankfully so, and itʼs because of the presence of black tar.

Black tar, because itʼs a gummy lump, itʼs not easy to mix powdered fentanyl in with it…

So itʼs a protective factor for us, thatʼs why our death rate is much lower than it is in most of the US,” Maxwell said.

This information may be misleading, however. There are economic factors that one must take into consideration when comparing drug use trends across the nation. Because the rate of drug related deaths is calculated per 100,000 people, population must be taken into consideration when looking at the death rates across various states.

“Over time, Texas is gaining population, everybody is moving west and south. So our population is increasing,” Maxwell said. “If you take the numbers for the northeast, and their population is decreasing, so even if you kept the same number of this year that you had 10 years ago or 5 years ago, the rate is going to go down, because the population base is going down.”

Another factor that can hinder the accuracy of data related to abuse is the fact that the data we have is collected from hospitals or treatment centers. This means that people who do not have access to a treatment center are not included in this data.

One example of this is the data collected from the Texas-Mexico border. In this area, there is a

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significant difference between the number of reported deaths in this area as opposed to the number of deaths in other part of Texas. “[When] you get down into the border, the towns are smaller, theyʼre not going to have the treatment facilities we have here. Those numbers are lower based on the number of admissions,” Maxwell said.

Although there is no medication or treatment to end someoneʼs addiction, there are medications that can be used to help people cope with addiction. Additionally, there are other treatment options that can be used in conjunction with medications.

“Iʼd say for opioid use disorder, or any addiction really, medications are rarely going to be the only form of treatment thatʼs recommended. Most of the time, some form of psychosocial or psychological treatment is also really important,” Nguyen said.

As far as medical treatments, there are three medications that are most commonly used to treat opioid use disorder: buprenorphine, methadone, and naltrexone; however, the latter is less commonly used.

Buprenorphine and methadone work the same way in that they both activate the opioid receptors. Someone taking one of these medications would feel as though they are getting an opioid-like high.

“If youʼre someone who uses opioids daily, and you have a physical dependence on them, when you take those medicines they provide a stable guideline of opioids so you donʼt go into withdrawal. They donʼt give

anyone near the kind of high that someone might get from heroin or oxycodone. So theyʼre shown to reduce the rates of death among people who are using a drug like heroin because itʼs a much safer substitution,” Hill said However, some people are opposed to buprenorphine and methadone because they feel that when prescribed one of these medications they are just substituting one addiction with another.

“There are people who, again, are opposed to this idea and feel like itʼs just replacing one addiction with another, which is a moralistic view on it, itʼs not supported by evidence, but some people struggle with that,” Hill said.

Another issue with these medical treatments is that in order to prescribe methadone, the clinic must be federally licensed. Since there are very few licensed methadone clinics, it is often hard for people to get access to methadone, especially if they come from low income households or live in areas with limited treatment facilities.

The third medication commonly used to treat opioid use disorder is naltrexone. Instead of giving the patient an opioid-like high, naltrexone instead blocks the opioid receptors, preventing opioids from acting. Although naltrexone is useful to treat opioid use disorder, there are opposed views on this medication as it does not satisfy the physical dependence of a person on opioids. “[Naltrexone] does not have any opioid-like effect, it just blocks their effect. So basically if youʼre receiving that monthly,

and you tried to use heroin, “There has never been more Pittsburgh at a family medicine you wouldnʼt get any effect funding available from the practice. During his residency, because those receptors would federal government for opioid he started working with a be blocked by the naltrexone,” research intervention than there team of other doctors to start Hill said. “Unfortunately, the is now. A lot of it is directed at administering naloxone. After evidence supporting that drug expanding access to naloxone, receiving positive results, he isnʼt as good because people, or expanding access to those was inspired to create a similar they drop out of treatment three medications for opioid use program in Texas. often, they donʼt like being on disorder. There is additionally “I worked with a team of naltrexone because it wonʼt interest in making things like primary care physicians to start satisfy that physical dependence clean needles more readily distributing naloxone, which piece of their disorder, so itʼs available for people who do is the antidote for an opioid not as effective, but people like inject drugs, because if youʼre overdose, and we distributed it it because it canʼt possibly be using or reusing old needles, or to 97 patients, and five of them misused, you canʼt get high on sharing needles, thereʼs a huge came back and told us that they it.” risk of developing things like had saved a family member or In addition to friend with the these medications, naloxone that there is another we gave them,” medication called Hill said. “For naloxone which is me, that was a used to reverse the really important effects of opioid experience as “[T]his person is on the edge, theyʼre putoverdose when a professional, ting their life in the hands of a stranger, but someone goes into because as they felt seen and respected by the fact that respiratory arrest a pharmacist we were giving them access to this medication because of it.

I donʼt have Although naloxone in their life instead of just dismissing them as that kind of only acts for 30 to immediate life an illegal drug addict who doesnʼt deserve 90 minutes, that saving impact that kind of treatment.” could be enough for such a Lucas G. Hill, PharmD time to call an major issue.” ambulance and get Operation that person to the Naloxone has hospital and access had major to medical care. success in saving peopleʼs lives Apart from medications, Hepatitis C or HIV,” Hill said. through the use of naloxone. there is a surplus of funding One initiative taking place in “Thus far, we have distributed for opioid related initiatives. Austin is Operation Naloxone. more than 10,000 doses of Some of these initiatives focus Operation Naloxone, directed naloxone. It takes a while on offering affordable care to by Hill, is an organization to start collecting overdose people struggling with opioid based out of the UT College of reversal information and weʼre use disorder, while others are Pharmacy and the Steve Hicks dependent on people who get geared towards offering sanitary School of Social Work that naloxone from us to go to a materials to people who need focuses on providing access to website or download our app to take an opioid. A plethora naloxone and educating opioid and report it when they use the of organizations are working users and their families about naloxone. In addition to that in support of preventing opioid administering naloxone. program, we have an online overdoses and offering aid and Hill was inspired to start services to those addicted to an Operation Naloxone after In Pursuit of Science 21 opioid. completing his residency in

I

continuing education course for physicians, pharmacists, and social workers about this crisis that almost 1,000 healthcare professionals have completed.

At the University of Texas, we have stocked naloxone in our rooms, and train students and their parents on how to respond to an overdose, and use naloxone there. We have three UT Austin students whose lives have been saved by naloxone, and weʼre very fortunate to be able to distribute.” Hill said.

Not only is Operation Naloxone a source of protection for people who are coping with opioid use disorder, it is also a source of comfort for them.

Because they are receiving medical help and not being dismissed as just another drug addict, they feel seen.

Operation Naloxone provides bags with doses of naloxone in them to people who are coping with opioid use disorder, and often people who donʼt have stable housing will use these bags to hold their personal belongings.

“Right now, if youʼre a person that doesnʼt have stable housing, [you] have no safe, clean place to go and inject a drug. Youʼd do it in a Starbucks bathroom or somewhere else that isnʼt dangerous or isolated.

[One man] made a point of making sure that [his] bag was clearly visible, so if someone were to find him, he had written on it: please save me. And the way that struck me was that this person is on the edge, theyʼre putting their life in the hands of a stranger, but they felt seen and

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In Pursuit of Science

respected by the fact that we were giving them access to this medication in their life instead of just dismissing them as an illegal drug addict who doesnʼt deserve that kind of treatment,” Hill said.

In addition to these organizations, there is also a new law regarding the Texas Prescription Monitoring Program going into effect in Fall 2019. As of September 1, 2017, all Texas-licensed pharmacies were required to report any medications they prescribe to the Texas Prescription Monitoring Program no later than one business day after prescribing to the client. As of September 1, 2019, all pharmacists and prescribers will be required to check the program records before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol.

“I think this is going to make a significant difference. Because right now, a doctor, heʼs prescribing an oxycontin drug for pain. He may or may not check the computer to see if that patient is getting that same drug from somebody else. Patients will hit three or four doctors to get the same drug,” Maxwell said.

Although there are many organizations working to reduce the rate of opioid related deaths, there are many changes that can be made to further enhance this. One change that can be made is educating people about the signs of overdose so that they can respond quickly and effectively.

“Iʼve seen too many death certificates where it says the patient was snoring heavily and they heard him snoring and

didnʼt realize that that was a sign of overdose. [H]e couldnʼt breathe well and he died. We need to be training the family [that] these are the signs of overdose. Every family thatʼs got people on these pills needs to know the signs: the snoring, the [blue] fingertips,” Maxwell said.

Additionally, further initiatives are needed in educating people about mixing opioids and other drugs, which could be more dangerous than taking an opioid by itself.

“I am concerned about this group of people who are misusing pain pills, benzodiazepines, muscle relaxants. This whole host of pain and muscle pills are needed for people having serious pain problems. But we donʼt do a very good job of warning people about what happens if you take these and mix them,” Maxwell said.

With more education, more organizations, and the right research, we can work towards reversing the effect opioids are having on our country. In order for our country to progress, this must start with peers.

“We [often] forget about the people who have been addressing the problem in their communities for decades, and we often focus too much on the impact of prescription opioids that are no longer the primary driver of opioid overdose,” Hill said. “It is the people who ofen judge or dismiss who are the ones most in need of help, and they know better than many in the medical community how to solve the issue.”

In Pursuit of Science Crossword

Across: 1 an employment-based, non-immigrant visa for

temporary workers 6 a fast-acting sedative that is sometimes abused for its heroin-like effect 8 an instruction written by a medical provider that authorizes a patient to be provided medication 9 the rapid increase in the use of prescription and non-prescription opioid drugs 10 a car with an internal combustion engine with spark-ignition, designed to run on gasoline 11 a company that designs, manufactures, and launches advanced rockets and spacecrafts 12 a brand of electric cars

Down: 2 a form of heroin that is sticky like taror hard like

coal 3 a car that uses more than one means of propulsion 4 a car that uses energy stored in its rechargeable batteries, which are recharged by common houselhold electricity 5 a synthetic drug, similar to morphine, that blocks opiate receptors in the nervous system 7 the exchange of medical and scientiďŹ c informaiton or data

I In Pursuit of Science

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In Pursuit of Science Word Search

WORD BANK: ELECTRIC CAR HYBRID CAR, IMMIGRANT INNOVATIONS NALOXONE OPIOID CRISIS RESEARCH TESLA VISA

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In Pursuit of Science