Something You Should Know - What Distractions Do To Your Brain & What You Never Knew About Your Pharmacy

Starting point is 00:00:00 Metro Links and Cross Links are reminding everyone to be careful as Eglinton Crosstown LRT train testing is in progress. Please be alert as trains can pass at any time on the tracks. Remember to follow all traffic signals, be careful along our tracks, and only make left turns where it's safe to do so. Be alert, be aware, and stay safe. Today on Something You Should Know, what's the difference between ice cream, premium ice cream, gelato, and frozen yogurt? I'll explain that. Then, we live in a world of distractions. It's become hard to pay attention and focus. And yet... The pleasures of getting back your focus are so much greater than whatever TikTok or Instagram or whatever. When you can think deeply, your life is so much better.

Starting point is 00:00:55 Also, what you need to know about that four-digit PIN you use for your phone and the ATM. And making sense of the pharmacy. For instance, what's the difference between all those pain relievers? The bottom line seems to be that over-the-counter medications, acetaminophen, ibuprofen, or naproxen, aspirin, they all work about the same. Now, people are different. All this today on Something You Should Know. This winter, take a trip to Tampa on Porter Airlines. Enjoy the warm Tampa Bay temperatures and warm Porter hospitality on your way there.

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Starting point is 00:02:09 Today, something you should know with Mike Carruthers. Hi. You know, I don't think I've ever met anybody who doesn't like ice cream. So, I thought we'd start the episode today with a discussion about ice cream. There are a lot of choices out there in the marketplace. Premium ice cream, for example, has between 11 and 15 percent butterfat. It's richer and denser and it tends to come in those small gourmet containers. Regular ice cream is less dense, has about 10 percent butterfat, and that's why you'll usually find it in the bigger containers. Light ice cream means there's supposed to be either less fat or less calories, but there is actually no legal definition of light ice cream.

Starting point is 00:02:54 In the U.S., ice cream has a definition, and part of the definition is it must contain butterfat. So vegan ice cream isn't technically ice cream. Soft serve ice cream is great, especially if you're prone to brain freeze. It's stored and served at a lower temperature. It can be tastier too because it doesn't numb the taste buds as much. Gelato and ice cream are very similar. Traditionally gelato has very little air whipped into it while freezing, and that leaves it rather dense. So it's served semi-frozen, sort of near the consistency of soft serve. However, gelato

Starting point is 00:03:34 is not legally defined in the U.S., so the gelato that you get probably isn't really gelato, because the low milk fat and the dense consistency makes it unstable and prone to get icy, so it's not going to have a very long shelf life. Frozen yogurt, again, has no legal definition in the U.S., although some states do define it. Generally, frozen yogurt has to be lower in fat than ice cream, somewhat tart, and contain yogurt cultures that may or may not be alive and active. And there is a difference between sorbet and sherbet. Both are fruit-based, but sherbet has a little milk in there for creaminess.

Starting point is 00:04:17 And that is something you should know. Pay attention. How many times have you been told that in your lifetime? Pay attention. How many times have you been told that in your lifetime? Pay attention. Yet today, paying attention is hard because, well, there are so many distractions and other things to pay attention to. We try to multitask, and that doesn't work out too well. So instead of focusing deeply on the one thing we need to focus on, we focus a little bit on a lot of different things. And that's a problem.

Starting point is 00:04:50 Johan Hari is a journalist and best-selling author who has explored this problem of lack of focus and the damage that it does and what we can do to fix it. Johan is author of a book called Stolen Focus, Why You Can't Pay Attention and How to Think Deeply Again. Hey, Johan. Hey, Mike. Great to be with you. So I suspect most people have had that sense that, you know, you can't seem to pay attention to just one thing. We hear about attention deficit disorder. So what's going on here? What did you discover? Well, I would say to anyone listening, think about anything you've ever achieved in your life

Starting point is 00:05:29 that you're proud of, whether it's starting a business, being a good parent, learning to play the guitar, whatever it is, that thing that you're proud of required a huge amount of sustained focus and attention. And when your focus and attention break down, your ability to achieve your goals breaks down. Your ability to solve your problems breaks down. You actually become less competent. You start to feel worse about yourself. I could feel this happening to me with every year that passed. Things that require deep focus that are really important to me, Mike, like reading a book, having deep, proper conversations. were getting more and more like kind of running up a down escalator. You know what I mean? Like I could still do them, but they were getting harder

Starting point is 00:06:10 and harder. And I noticed this is happening to a huge number of people around me. For every one child who was identified with serious attention problems when I was seven years old, there's now a hundred kids who've been identified with that problem the average american office worker now focuses on any one task for only three minutes so i want to understand what's happening to us and crucially what do we do about it right so i went i traveled all over the world from moscow to miami and i interviewed over 200 of the leading experts on attention and focus different aspects of this. And I learned that there's scientific evidence for 12 factors that can make your attention better or can make

Starting point is 00:06:49 your attention worse. And loads of the factors that can make your attention worse have been hugely increasing in recent years. So anyone, if you're listening and you're struggling to focus and pay attention, this is not your fault. Your attention did not collapse. Your attention has been stolen from you by some very big forces. But once you understand that, we can begin to reclaim it for ourselves and for our children. So what are some of the things that are sapping our attention? I'll give you an example of one that will be playing out in the lives of almost everyone listening. I went to interview a man named Professor Earl Miller, who's one of the leading neuroscientists in the world. I went to see him at MIT where he's a professor. And he said to me,

Starting point is 00:07:29 look, you've got to understand one thing about the human brain more than anything else. You can only consciously think about one or two things at a time. That's it. This is just a fundamental limitation of the human brain. The human brain has not changed significantly in 40,000 years. It's not going to change on any time scale. Any of us are going to see, you can only think about one or two things at a time. But what's happened is we've fallen for a mass delusion. The average American teenager now believes they can follow six or seven forms of media at the same time.

Starting point is 00:08:00 So what happens is Professor Miller and his colleagues, scientists like him, they get people into labs and they get them to think they're doing more than one thing at a time. And what they discover is always the same. You can't do more than one thing at a time. What you do is you juggle. You're switching very quickly. You're going, wait, what did Mike just ask me? What's that message on WhatsApp? What does it say on the TV about Ukraine? What's the message on Facebook? Wait, what did Mike just ask me? We're all doing that juggling a huge amount of the time. And it turns out it comes with a really big cost. The technical term for it is the switch cost effect. What it shows is when you try and do more than one thing at a time, you will do all the things you're trying to do much less competently. You'll make more mistakes. You'll remember less of what you do. You'll be less creative. The evidence shows this is having a huge effect on us. I'll give you an example of a small study that's backed by a wider body of evidence that really helped me to

Starting point is 00:08:55 understand this. Hewlett Packard, the printer company, got a scientist in to study their workers. And what he did is he split their workers into two groups. And the first group was told, get on with your task, whatever it is, and you're not going to be interrupted. And the second group was told, get on with your task, whatever it is, but at the same time, you're going to have to answer a heavy load of email and phone calls. And then at the end of the experiment, he tested the IQ of both groups. The group that had not been interrupted scored on average 10 IQ points higher than the group that had. And I think that message of you can't do more than one thing at a time effectively has been getting through. So what else? What are some of the other things that are preventing people from focusing deeply? Our lack of sleep. There has been an

Starting point is 00:09:46 enormous decline in it. We sleep 20% less than people did a century ago. Children sleep 85 minutes less than they did a century ago. So I traveled all over the US and indeed the world interviewing the leading experts on sleep. And it was really kind of chilling. Dr. Charles Seisler, who's arguably the leading sleep expert in the world. He's at Harvard Medical School, did this experiment that really brought it home to me. It's kind of simple experiment. They get tired people. They're not even that tired. And he puts them into a machinery that both tracks their eyes to see what they're looking at and scans their brains at the same time. And what he discovered is when you're tired, you can appear to be awake. You can be looking

Starting point is 00:10:24 around you. You can appear to be as awake as you and me are now, but whole parts of your brain can have literally gone to sleep, right? So when we say we're half asleep, it turns out that's not a metaphor. A lot of us are half asleep a lot of the time. And when you sleep, all sorts of processes take place that are essential for focus and attention. And the whole time you're awake, your brain is creating something called metabolic waste. It's what Professor Roxanne Prashad told me we should think of as like brain cell poop, right? It's building up the whole time in your brain when you're awake. And when you go to sleep, your brain is washed with a kind of a watery fluid and your spinal fluid channels open up. And this brain cell poop is carried down out of your brain and eventually

Starting point is 00:11:09 out of your body. When you don't get at least seven hours sleep a night, your brain doesn't get to clean itself. It becomes literally clogged up. This is why people who sleep less are much more likely to become, get dementia later in life, but also really screws your attention. You know, if you stay awake for 19 hours, which doesn't sound like very much, your attention suffers as much as if you had got legally drunk. If you stay awake for six hours a night for a week, your attention becomes as bad as if you got legally drunk. So a lot of us are just profoundly impaired because we're not getting enough sleep. But this idea that I think everyone's heard that

Starting point is 00:11:45 multitasking is problematic, that you can't really do it very well, flies in the face of the old adage of, if you want to get something done, give it to a busy person because busy people are more productive. So let's reconcile that. You know, we've got to really challenge the story about productivity that we have in our culture, right? So we think the good worker is the worker who works themselves to the point of exhaustion. He's constantly available on their phone and works themselves to the point of exhaustion. You know, I feel that, right? Today I'm doing nine interviews. I'm going to go to sleep and I'm going to be completely exhausted. And there'll be a little bit of me, a little Puritan bit of me. That'll be good job, Johan.

Starting point is 00:12:28 You worked yourself to the point of exhaustion. But in fact, the evidence is really clear that that just wrecks you. Tomorrow I'll be useless, right? And my attention will be shot and I won't be able to think as clearly. In order to be able to think clearly, you've got to have space for mind wandering. You've got to have space for rest. You've got to have space for mind wandering. You've got to have space for rest. You've got to have space to do other stuff. Those are actually the people who come up with creative ideas, who work best. For example, I went to New Zealand and spent time with companies that moved from a five-day working week to a four-day working week for the same money. And they found that productivity massively increased. They achieved more in four days

Starting point is 00:13:02 than they had in five. And this has been found in companies all over the world, Microsoft in Japan, Toyota in Sweden. But it really fell into place for me when I went to interview a guy called Professor Jeffrey Pfeffer. He's one of the leading experts on organizational behavior in the world. He's at Stanford. And he said to me, it's not rocket science. Just ask any sports fan. Do you want your team to walk onto the pitch exhausted, you know, having worked 10 hour days for the last week? No, of course not. going so well, because that's kind of the opposite of what we've been talking about so far. Flow states are really important for understanding the debate about attention, because a flow state is both the deepest form of attention that human beings can provide. And once you get into it, the easiest form of attention to provide, it's not like, I don't know, memorizing facts for an exam where you're like, Oh, what year did president Lincoln

Starting point is 00:14:12 get killed? It's not like that. It just comes very easily. So obviously I want to think about this, right? If this is a gusher of focus that exists within us, it's pleasurable. Most people experience it at least once in their life. Where do we drill to get this gush? So I went to interview Professor Mihaly Csikszentmihalyi in Claremont, California. He's the man who first identified flow states in the 1960s and spent 50 years studying them, a completely amazing, one of the most important psychologists of the last hundred years. And he discovered a huge number of things, but I think for everyone listening, there's three things in particular that he found that can really maximize your chances of getting into flow. There's no guarantee, but they can hugely increase your odds. Three things you can

Starting point is 00:14:56 do. So the first thing is you have to narrow down to one goal. I want to paint this canvas. I want to write this chapter. I want to climb this rock. You've got to choose one goal and stick at it. If you're trying to do two, three, four, five, six things, you won't get into flow. Secondly, you've got to choose a goal that's meaningful to you. So for you, painting a canvas might be meaningful. For me, if I draw anything, it just looks like a child threw up on the canvas. It doesn't work, right? So it's got to be something that's meaningful to you. Attention evolves to attach to meaning. And the thirdly, and this felt counterintuitive to me at first, it will help if you choose something that's quite challenging for you. There's something that's at the edge of your abilities. So let's say that you're a medium talent rock climber. You don't want to

Starting point is 00:15:46 just climb over your garden wall. You won't get into floating. That's too easy. Equally, you don't want to suddenly try and climb Mount Everest. It's too hard. You'll just freak out. You want to climb a slightly higher and harder rock face than the one you did last time. So flow begins at the edge of your comfort zone. If you do these three things, so you narrow down to one goal, you choose a meaningful goal, you push yourself to the edge of your comfort zone. If you do these three things, you, uh, so you narrow down to one goal, you choose a meaningful goal. You push yourself to the edge of your abilities. You're much more likely to get, you maximize your odds of getting into flow. Now, I think even those people you're talking about who would say, Oh, I don't have a problem here. You know, I just like being

Starting point is 00:16:18 constantly addled and switching every couple of minutes when they get into a flow state, feel much better. Right. right so i think and would almost certainly at some point have experienced a flow state and if you remind them of that and go well was that better than switching every couple of minutes it probably almost certainly was for them um and the evidence on this is really clear everyone likes flow states once they get into them and it's a really one of the deepest most pleasurable experiences people and people get into it doing different things for some people it's making bagels for some people it's brain surgery it could it can be anything that's meaningful to someone but yeah so i think it's rare that you find someone where if you don't

Starting point is 00:16:53 bring up different aspects of of what i learned from these experts they kind of recognize nothing good about deeper focus like mind wandering or reading reading books. You might get some people, but I think it would be quite rare. I want to try brain surgery and see if I get into flow. My guest is Johan Hari. He is author of the book, Stolen Focus, Why You Can't Pay Attention and How to Think Deeply Again. At Wealthsimple, we're built for whatever you're building. Built for Jane, who wants to break into the housing market. We're built for Ted, who's obsessed with what's happening in the global markets. And built for Celine, who just wants to retire and explore the world's flea markets. So take a moment and think about what you're building for. We've got the financial

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Starting point is 00:18:18 That's BetterHelp.com. So, Johan, what you talked about, though, what I think a lot of people have trouble with is, as you said, you know, focus on one thing. Write that chapter. Climb that rock. But if you've got five things to do and you pick one, you've still got those other four things in the back of your mind that you've got to get done. It's very hard to stay focused when you know there's other things to focus on.

Starting point is 00:18:47 This is one of the reasons why you've got to deal with some of the collective elements of this. I'll give you an example. In France in 2018, they had a huge crisis of what they called Le Burnout. I don't think I need to translate that. The French government was put under a lot of pressure by labor unions to figure out, well, what's going on? Why are our workers getting so burned out? So they set up a government inquiry and the government inquiry discovered one of the key reasons, which is that 30% of French workers felt they could never, when they were awake, stop checking their phones or emails. Because at any moment their boss could message them. And if they didn't reply quickly, they'd be in trouble. Right. So I remember when

Starting point is 00:19:30 we were kids, the only people who were on call were the president and doctors and even doctors weren't on call all the time. Right. So we went from almost nobody being on call to almost half the economy being on call. And I can give those people all the lovely self-help advice in the world about all the dozens of things I recommend people do in the book. They can't do them, right? Like you're saying, if your job depends on you being constantly plugged in, you can't do it, right? So the French government, and I stress they only did this because ordinary French people pressured them, introduced a solution. It's a very simple solution that's worked incredibly well. By law, every French worker now has what's called the right to disconnect. It's very simple law, just says your work hours have to be defined in your

Starting point is 00:20:14 contract. And when your work hours are over, you have the legal right to not check your phone or email. So when I went to Paris to research this, while I was there, Rent-A-Kill, the pest control company, just before I went there, was fined 70,000 euros for getting one worker to check his truck, but complaining that one of their workers hadn't checked his email an hour after he finished his legally defined workhouse. Now you can see how the right to disconnect is a big collective thing. You can't demand that on your own, right? I mean, maybe if you're very powerful in your workplace, you can, but most people can't. But together we can fight for it, right? We can demand it. In the corner of my room over here, I have something called a K-safe.

Starting point is 00:20:52 It's a plastic safe. You take off the lid, you put in your phone, you put on the lid, you turn the dial and it will lock your phone away for anything between five minutes and a whole day. I won't sit down to watch a film with my partner unless we both imprison our phones. I won't have my friends around for dinner unless we both put our phones in the phone jail. The pleasures of getting back your focus, it's really difficult at first, but the pleasures of getting back your focus are so much greater than whatever TikTok or Instagram or whatever. When you can think deeply, your life is so much better. It does just seem that the pace of life today with all of the distractions and the gadgets and the gizmos, that it's very easy

Starting point is 00:21:40 to get distracted. And it's just, you know, it's fundamental. It's like just a different way of life than it used to be. One of the heroes of my book is a woman called Lenore Skenazi. Lenore grew up in a suburb of Chicago in the 1960s. And from when she was five years old, she left her home on her own every morning and walked to school. It was 15 minutes away. And she would generally bump into all the other kids because everyone walked to school in the 1960s um and when school ended at three o'clock lenore would leave and she'd wander around the neighborhood with all her friends and do whatever they wanted there were no adults watching over them part of many adults who happened to pass by and they went home when they were hungry right so kids spent enormous amount of their time outside their house playing

Starting point is 00:22:22 freely with other children by By the time Lenore was a mother in the nineties in Queens, that was over. In fact, by 2003, only 10% of American children ever played outside without an adult. And it turns out that childhood we've lost contains a huge number of things that are really important for attention and focus. One of them is exercise. Kids develop more brain connections and compare attention better when they get to run around. But there's even something even more important. When children play freely with other children without adults standing over and enforcing the rules, they learn how to pay attention. They learn what matters to them, which is important for attention. They learn how to persuade other kids to pay attention to what they care about. They learn

Starting point is 00:23:03 how to take turns. They learn how to take risks, which is really important because if you don't learn how to take risks, you'll be anxious and that ruins your attention. So Lenore was looking at all this evidence and she's like, look, this is really bad for our kids. And at first she thought, okay, the solution is kind of obvious. I just need to persuade parents to let their kids play outside. Right. And it's just persuade them as individuals. But she quickly discovered if you're the only parent who lets your kid go out, they get scared. You look nuts. In fact, people often call the cops. So Lenore began to build a much bigger solution. She runs a group called Let Grow. It's letgrow.org. I really recommend parents, grandparents listening, go to this site. So what Let Grow do is they go to whole schools and whole neighbourhoods,

Starting point is 00:23:46 and they persuade everyone to give their kids increasing levels of freedom, building up to playing outdoors. And I think of all the conversations I had for Stolen Focus, probably the most moving was with a 14-year-old boy in Long Island. And until this programme had begun nine months before I met him, he had never been allowed out of his house on his own. This was a big, strong 14 year old boy. It was taller than me and never been allowed out of his house on his own. And I asked him why.

Starting point is 00:24:17 And he said, oh, my parents are scared of all these kidnappings. He said, this is a town in Long Island where the olive oil store is across the street from the French bakery. But then this program began and all the kids in his neighborhood started to play outside. I said to him, what did you do? He said, well, we played ball games. But then he said we went into the woods and he leaned forward and he said very confidentially, our phones don't have signal in the woods. And we still went there. He thought that was like a miracle. And I said, what did you do in the woods? He said, we built a fort. And now me and my friends, we go and sit in the fort and we build other things. It was like watching a child come to life. And I thought about how many kids I know who never get to explore anything except on Fortnite and

Starting point is 00:24:59 World of Warcraft. We can hardly be surprised they've become so obsessed. I would argue every school in the United States should have a Let Grow program. This is the lowest hanging fruit, right? It costs nothing. We can restore human childhood. Well, given the fact that I suspect everybody has had that experience of having trouble concentrating, focusing, paying attention, I think this is an important discussion because as you point out, there are solutions to these things if we make it a priority. I've been talking to Johan Hari. He's

Starting point is 00:25:32 a journalist and best-selling author. The name of the book is Stolen Focus, Why You Can't Pay Attention and How to Think Deeply Again. There's a link to that book in the show notes. Thanks, Johan. Thanks, Mike. Really enjoyed it. Bumble knows it's hard to start conversations. Hey. No, too basic. Hi there. Still no. What about hello, handsome?

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Starting point is 00:26:31 Every episode is a conversation with a fascinating guest. Of course, a lot of podcasts are conversations with guests, but Jordan does it better than most. Recently, he had a fascinating conversation with a British woman who was recruited and radicalized by ISIS and went to prison for three years. She now works to raise awareness on this issue. It's a great conversation. And he spoke with Dr. Sarah Hill

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Starting point is 00:27:29 Walk into any drugstore for any kind of remedy, for any kind of problem, and you will see countless boxes and bottles of potions and lotions and pills. And that's just the over-the-counter medication. So how do you make sense of it all? How do you know what to choose? Here to help you understand it and sort it all out and help you make better choices is Joe Graydon. Joe is a pharmacologist who, well, he's really spent an entire career making drug information understandable to consumers. He wrote a best-selling book called The People's Pharmacy, which led to a syndicated

Starting point is 00:28:06 newspaper column, a public radio show, and a great website. Hi, Joe. Thanks for being here. Nice to be with you. So I want to start with a question I've always had, and that is, there are drugs that used to be prescription medications that you had to go to your doctor to get a prescription to take this medicine that now are over-the-counter you can just walk in and buy them so what happened what what is the process that makes a drug go from prescription to over-the-counter well the drug company requested from the Food and Drug Administration permission to sell it over the counter. And that usually occurs after a prescription drug loses its patent. So let's just take Prilosec as an

Starting point is 00:28:54 example. This is phenomenally successful heartburn medicine, ulcer healer, that doctors prescribed in huge quantities, and then it lost its patent. and Omeprazole became available generically. And the company said, oh, wow, maybe we ought to promote it OTC. And the FDA gave them approval. And now, of course, you can buy it without a doctor's supervision, but it's the same drug. One of the things I've never understood is when you buy a bottle of pills, headache pills, or some medicine over the counter, and you get it home and it's time to take it for the first time, you haven't taken it before, you really have to hunt for the directions. Usually, like how many pills to take is buried somewhere in and amongst all kinds of warnings and things. And you have to really look hard and you may have to get out your magnifying glass and the directions can be confusing. You know, a lot of people think in terms of two, you know, two aspirins for a headache, two Advils for a headache or any other kind of pain.

Starting point is 00:30:09 But Aleve, the over-the-counter version of naproxen, is different. It's quote-unquote more potent. So it might start by saying take one. And then if that doesn't work, maybe you can take another one, but it's not like, oh, you can just pop two every four hours. There's a limit to how much you can take because it's considered quote unquote, a little stronger than the ibuprofen NSAID. You're absolutely right. The directions, the dosing directions should be in large print and right up front and easy to find. If you asked a drug company why it isn't, what would they say? You'd have to ask a drug company because I have no idea.

Starting point is 00:30:57 And there's a lot of information that's not available on the over-the-counter label. So in other words, if you were to look at the prescription information that the doctors get when when they can prescribe these drugs it's a lot it'll talk about drug interactions I mean for example the whole issue of acetaminophen tylenol that everybody thinks is so super safe well there's a lot of concern about alcohol and acetaminophen. When you look at the label, it's a little confusing when it comes to alcohol because it'll say something to the effect of, for example, Tylenol PM.

Starting point is 00:31:36 Three drinks or more could cause severe liver damage and then someplace else it'll say, don't drink alcohol if you're taking acetaminophen, if you're taking Tylenol. So, well, which is it? Can you have two drinks? What about one drink? So, people get very confused. Sometimes the information on the label is more confusing than helpful. Yeah, well, sometimes on the label, it'll say things like extra strength, maximum strength. Do those terms have any real meaning? Well, they're what the drug company wants it to be. So in the case of Tylenol, oftentimes the regular strength is 325 milligrams, but the extra strength is 500 milligrams. So there often will be more in an extra strength something. But does that make it better? Does that make it more effective? Does that make it faster? Not necessarily. So there are several different kinds of pain relievers. There's acetaminophen,

Starting point is 00:32:39 there's naproxen, there's aspirin. Is there any indication, any proof, any evidence that one is better than the other for treating different kinds of pain? Meaning that, oh, if you have a headache, you take this one, but if you have a toothache, you take that one because it works better on a toothache. Anything like that? In a word, no. We've never seen good studies that would say, oh, well, acetaminophen is going to be terrific for your tennis elbow, but ibuprofen is going to be better for your sore knee. Or your headache will respond best to Advil and not as well to aspirin. We just don't have those kinds of studies. So the bottom line seems to be that over-the-counter medications, acetaminophen, NSAIDs like ibuprofen or naproxen, aspirin, they all work about the same. Now, people are different. And so some people may say, wow, you know, when I've got a bad headache, Excedrin really does the job for me. And Excedrin has some caffeine in it, which may be the magic ingredient. themselves working better for one thing versus another not that different i mean we could say

Starting point is 00:34:06 well nseds and aspirin have anti-inflammatory properties so they'll probably be better for arthritis pain and acetaminophen doesn't have as much anti-inflammatory activity so it might be better for your headache and there is a difference when it comes to stomach irritation. So yes, if you have an ulcer or a sensitive stomach, acetaminophen would be the drug of choice versus aspirin or ibuprofen or other NSAIDs. But in terms of effectiveness, they're all roughly the same. Do you have a preference?

Starting point is 00:34:42 You know more about this than most people. So knowing what you know, do you usually reach for this and not that? I'm an old-fashioned kind of guy. And because of the pharmacology of the drugs, I actually like aspirin. And the reason I like aspirin is because it's just as good as the other anti-inflammatories, the non-steroidal anti-inflammatory drugs. It's in that same category. But unlike them, it doesn't raise blood pressure and it doesn't cause blood clots and it doesn't cause heart attacks and strokes. If anything, aspirin lowers the risk of having a heart attack or a stroke, but it shouldn't be used for that purpose anymore unless the doctor recommends it because there is a slight increased risk of bleeding that

Starting point is 00:35:31 counteracts the benefits of the anti-heart attack activity of aspirin. So I just like aspirin and I think it's gotten a bad rap. I don't think it's any worse, any more dangerous than ibuprofen or naproxen. And I'll take acetaminophen if I had heartburn, if I had a sensitive stomach, but I seem to manage to take aspirin without too much trouble. So if it's a choice between Advil or aspirin, I personally would be taking aspirinin what else about over-the-counter drugs and there's so many of them what else are do people maybe not know I find it amusing that there are all of these what I call old-fashioned drugs that have been around for not just decades, in some cases, but almost, you know, 100 years or more. And they're sort of being repurposed. And so there, there are these over the counter

Starting point is 00:36:32 drugs that people are kind of rediscovering. And one of my favorites is Vicks vapor rub. I believe it's over 100 years old. And most people think about for, you know, a cold, you know, chest congestion, and mom would rub your chest with um with vicks and maybe put a dab under your nose but people are starting to use it for toenail fungus putting it on in the morning putting it on in the evening and they say it works and there actually have been some studies to demonstrate that the ingredients and Vicks have antifungal activity. It takes a long time, but that's true for prescription drugs as well, months and months. The one thing that I

Starting point is 00:37:12 really love about Vicks is that we were told on our radio show that, and this was a nurse, she said, if you put a little Vicks on the soles of your feet if you have a cough and you're trying to go to sleep put the vix on put on a pair of warm socks and you will sleep through the night and a lot of people have told us it works like magic that's one example here's another one that's really old-timey and that's listerine the original amber colored version to get rid of lice. And you know, getting rid of lice is a lot harder than most people think because they become resistant to a lot of the over-the-counter lice remedies. And you just massage it into your hair, leave it on for an hour or so, and it just suffocates the lice. One of my favorites of all time is milk of magnesia.

Starting point is 00:38:07 Most people think of it as Phillips milk of magnesia in the familiar blue bottle. Used as an underarm deodorant, it works like magic to prevent body odor. And instead of having aluminum, like all of the over-the-counter antiperspirants, it works with magnesium, which we are usually deficient in. So that's just a few examples. Going back to Vicks VapoRub, my mother, as you said, like many mothers, used to rub it on my chest and a little under my nose. Is there any sense that that's effective?

Starting point is 00:38:44 Absolutely. The ingredients in Vicks are old-fashioned, but very effective. And it probably loosens up congestion, and it probably does help suppress a cough through a neural mechanism that we are only recently learning about called TRP receptors, transient receptor potential channels that are quite important for a number of physiological processes in our body. So a lot of medical students are now just beginning to learn about TRP, but their mentors who've been around for 10 or 20 or 30 years may never have heard of it. So we're learning what the mechanism is, and we're learning that the ingredients in Vicks are really quite helpful.

Starting point is 00:39:37 I don't know if this is a common experience, but my experience is when I have a cough and I go to the drugstore and get over-the-counter cough medicine, it doesn't work very well. It doesn't really prevent me from coughing as compared to, say, going to the doctor and getting cough medicine with codeine in it. And then I sleep right through the night. But the over-the-counter stuff doesn't seem to do much. Is that a common experience? I would have to tell you that the ingredient in most over-the-counter cough remedies, DM, dextromethorphan, is just not that great. Your experience matches mine and a lot of other people as well.

Starting point is 00:40:23 And it doesn't taste very good even when they put that cherry flavor in there and and so I think a lot of people have experienced what you're describing and that is if they have a bad cough the cough remedies that are available OTC are just not that great. You know, some people have told us that time tea, and that's T-H-Y-M-E, is a very effective cough suppressant. And that's been our experience. So next time you have a cough, get out some of your dried thyme, steep it for, you know, a couple of minutes in hot boiling water, and then strain out the thyme, and see if adding a little honey to that thyme tea

Starting point is 00:41:13 doesn't work as well or better than the dextromethorphan you can buy over the counter. And of course, if you can get your doctor to prescribe codeine these days, much harder than it used to be, it too will be an effective cough suppressant. Is there anything on the horizon that seems particularly hopeful or maybe something that is turning out to be disappointing or what? One thing is a drug for

Starting point is 00:41:42 Alzheimer's disease. We do have a new drug. It's been one of the most controversial drugs in the pharmaceutical industry because the FDA approved it even though there was no data to suggest that it might have actual clinical benefit. In other words, keep you from ending up in a nursing home, keep you from developing really severe memory problems this drug is called adjuhelm and it's quite expensive and it just has not lived up to the potential that a lot of people were hoping for so i think one area that will be quite exciting in the future is when we actually have drugs that can work, but we may not be able to afford them because the price will be so significant.

Starting point is 00:42:30 So that's one of the big frontiers that so far the pharmaceutical industry has failed at. I think that we're going to see improved antiviral drugs. I think COVID has changed that ballgame dramatically. And because of drugs like Paxlovid and others that are in the pipeline, we will have better drugs for not just COVID, but hopefully better drugs against influenza and other viral infections. When people go to the doctor and get a prescription for whatever it is that's bothering them, I think most people just take that medicine blindly.

Starting point is 00:43:09 But I'm wondering, knowing what you know, is there a conversation that should be happening between patient and doctor before you just say, oh, okay, and take the medicine? I think that one of the most important things that people need to ask their prescribers, whether it's a physician, a nurse practitioner, physician's associate, is how effective is this medicine for the condition that you are treating that I'm dealing with? And when I say how effective, I mean literally how well will this drug work? And there's a number that we use called the NNT, the number needed to treat. Surprisingly, a lot of medicines are not very effective.

Starting point is 00:44:01 Let's just take statins as a for example if you're taking a statin to prevent a heart attack and you're you're relatively healthy you've never had heart disease you've never had a heart attack you might just have slightly elevated cholesterol and the doctor says well you have you have a risk for heart disease it's your elevated cholesterol how many people would have to take that drug to prevent one heart attack and in many cases it's 70 or 80 and you you know if you had to put 70 pieces of toast in your toaster in order to get one toasted piece of bread, you would probably throw that toaster out and say, what the heck is wrong with it?

Starting point is 00:44:53 Why would I keep a toaster that doesn't work 69 times out of 70? Well, that's the kind of question you need to ask your doctor, whether it's your migraine medicine, whether it's your blood pressure pill you know and it's not just lowering your blood pressure that matters how good is this drug at preventing the things that I care about like a heart attack or a stroke and that's true for your diabetes medicine it's true for your cholesterol medicine it should be true for every pill you take. Doctor, what's the number needed to treat? How many people would have to be treated with this pill for one person to get a benefit?

Starting point is 00:45:33 And when you have that information, you'll be better informed about what medicine you do want to take and which ones you might say, nah, I don't want to take it because the side effects are worse than the benefits. I would imagine the doctor would likely respond to that is, it's not great, but it's all we've got. In some cases, that may be true. But again, what are your betting odds if you say well here's here's a drug it'll work one time out of 80 that means 79 people or a hundred people would have to take this for one person to get a benefit am I the the one you

Starting point is 00:46:21 know we wouldn't accept that in any other part of our lives. If your car would only start once out of every hundred times, you would take it to the dealer and say, this car is a lemon. I want my money back. I want a different car. Fix it. Well, I think by listening to this conversation, people are a little more informed and a little more empowered when they go into the drugstore. So I appreciate you sharing the information. Joe Graydon has been my guest.

Starting point is 00:46:51 He is a pharmacologist. His website is peoplespharmacy.com. The name of his book is The People's Pharmacy. And there's links to both of those things in the show notes. Great. Thanks, Joe. This was fun. Thanks, Mike. It's been a pleasure.

Starting point is 00:47:06 Always nice to talk to you. Most of us have a four-digit PIN that we use. You have to have one because banks use them, phones use them for security. But it's only four digits, so how hard are they for hackers to crack? Well, not that hard. A four-digit pin without a repeating number has only 24 possibilities, assuming you know which four

Starting point is 00:47:34 digits are in there. When choosing a four-digit pin, it's a good idea to repeat one of the digits. That ups the possible combinations from 24 to 36. And if your pin is one of these, change it. These are the most popular and the first that hackers will try. 1-2-3-4,1-2-1-2-1998-2580. 2580 is the center row buttons on your phone. And 5683 spells love. And that is something you should know. If you would like to support this podcast, one of the best ways to do it is simply tell someone you know

Starting point is 00:48:24 that you haven't told before about this podcast, why they should listen to it, and tell them to listen. I'm Mike Carruthers. Thanks for listening today to Something You Should Know. Do you love Disney? Do you love top 10 lists? Then you are going to love our hit podcast, Disney Countdown. I'm Megan, the Magical Millennial. And I'm the Dapper Danielle. On every episode of our fun and family-friendly show, we count down our top 10 lists of all things Disney. The parks, the movies, the music, the food, the lore. There is nothing we

Starting point is 00:48:56 don't cover on our show. We are famous for rabbit holes, Disney themed games, and fun facts you didn't know you needed. I had Danielle and Megan record some answers to seemingly meaningless questions. I asked Danielle, what insect song is typically higher pitched in hotter temperatures and lower pitched in cooler temperatures? You got this. No, I didn't. Don't believe that. About a witch coming true?

Starting point is 00:49:20 Well, I didn't either. Of course, I'm just a cicada. I'm crying. I'm so sorry. You win that one. So if you're looking for a healthy dose of Disney magic, check out Disney Countdown wherever you get your podcasts. Hi, this is Rob Benedict. And I am Richard Spate.

Starting point is 00:49:40 We were both on a little show you might know called Supernatural. It had a pretty good run. 15 seasons, 327 episodes. And though we have seen, of course, every episode many times, we figured, hey, now that we're wrapped, let's watch it all again. And we can't do that alone. So we're inviting the cast and crew that made the show along for the ride. We've got writers, producers, composers, directors, and we'll, of course, have some actors on as well,

Starting point is 00:50:06 including some certain guys that played some certain pretty iconic brothers. It was kind of a little bit of a left field choice in the best way possible. The note from Kripke was, he's great, we love him, but we're looking for like a really intelligent Duchovny type.

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Something You Should Know - What Distractions Do To Your Brain & What You Never Knew About Your Pharmacy

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