Drug prevention

Posted on October 30, 2018  in Medical news

Prevention is broadly related to the avoidance or alleviation of problems related to substance use. Due to this non-strict definition, attempts at prevention can have different goals. For example, the goal of efforts to prevent the use of illegal drugs is to stop incidents of their use. One way or another, an additional goal of such activities may be to minimize the effects of the use of illegal drugs, which is taking place. If so, then the approaches chosen for the implementation of the intended goals may be different. Therefore, when it comes to the prevention of drug use, it is important to clarify what exactly is being prevented: onset of use, repeated use, negative impact on society, health problems, or something else.

Prevention of substance abuse is traditionally divided into three stages. The first is primary prevention, which is the avoidance of drug abuse before an abuse at all has a chance to occur. For example, one of the goals of such prophylaxis would be to prevent the initial use of a substance. Without ever starting a drug use, you will not have any problems with it. At the core of this approach is the principle “Just Say No”, when, especially young people, a drug is offered. Another goal of primary prevention may be to develop a responsible attitude and / or a culture of substance use. The best example of this is a responsible drinking attitude. Numerous advertising posters and television programs should pay more attention to the fact that you can not get behind the wheel while intoxicated or allow drunken friends to get behind the wheel.

Secondary prophylaxis deals with already started abuse. This type of prophylaxis is similar to early treatment, when drug problems only surfaced. Secondary prophylaxis is often used by the legal system responsible for the misuse of substances. For example, a person arrested for drunk driving may be sent to special courses, training on which should prevent a repetition of the situation. In some parts of the United States, this is the case with juvenile offenders detained for drug possession. In both cases, emphasis is placed on the problem nip in the bud. Central to such efforts is the early detection of such problems.

The third form of prevention, which is called tertiary, is the treatment of people who already fully use drugs and are completely dependent on them. Its purpose is to stop drug use and avoid further deterioration in the human body. Tertiary prevention and treatment of drug addiction are the same, but prevention is usually said when the incident happens for the first time, and treatment when relapses occur. In the remainder of this chapter, we focus our attention on primary and secondary prevention.

Problems of abuse of various substances.

Posted on October 26, 2018  in Medical news

The sociocultural aspect of understanding abuse is that social norms directly affect substance use or abuse. This model was mainly used in efforts to prevent the use of alcohol. In this case, the model consists of three main components:
– underlining cultural standards
– the need to include the adoption of alcohol in socially significant activities
– focus on developing a culture of drinking alcohol
The main efforts of this model are aimed at changing attitudes towards taking alcohol within a culture.
One of the most significant defenders of the sociocultural approach. Rupert Wilkinson believes that drinking alcohol can be influenced by well-planned policies. Wilkinson notes that there are examples of alcohol use that are not associated with any problems, and that these examples can be used as guidelines for rooting a similar drinking culture.

During his fruitful work in 1970, Wilkinson identified five proposals for changing the culture of drinking alcohol. The first involves creating a low level of emotionality associated with alcoholic beverages in society, while at the same time bringing clarity to conflicting ideas about alcohol consumption. Emotionality surrounding alcohol, according to Wilkinson, creates pressure on a person, as well as an environment in which discussion and changing the culture of drinking alcohol are simply impossible. A more thoughtful and well-coordinated approach will increase the benefit by clarifying inconsistencies and provide greater clarity about drinking norms.

The second basis of the Wilkinson sociocultural model is that a clear line should be drawn between the normal use of alcoholic beverages and drunkenness. The challenge is to clearly define what is acceptable drinking and what is drinking. Unfortunately, to come to such clarity is far from easy.
Wilkinson’s third principle: after certainty has been reached about where the drunkenness begins, a strict ban must be imposed on it. The fourth, central principle is that alcohol should be integrated into the social context in the broad sense of the word. In other words, the use of alcohol should not be the meaning of life or a single party, but instead should simply be an addition to other activities.
In conclusion, Wilkinson concludes that society can afford to drink alcohol only when it is accompanied by eating food. He believes that when there is a snack, alcohol consumption ceases to be the only meaning of activity. Moreover, food slows down the absorption of alcohol and potentially helps reduce intoxication.
Together, these principles create an idea of ​​acceptable and unacceptable use of alcohol and, thus, form the desired pattern of responsible behavior. Such a pattern must then be rooted in ordinary family life and other social activities. It is noteworthy that the aim of the sociocultural approach is not to stop the use of alcohol in general, but to change the social norms relating to this use. Thus, his strategy is not focused on the prohibition, and many believe that the main mistake of this approach is that it supports the use of alcohol.

The main criticism of this approach is that it cannot be widely applied. In many countries, such as the United States and Canada, there are simultaneously different types of cultures and subcultures, so the customs and values ​​adopted in one of them may not be suitable or rejected by the other. The second direction of criticism is that the sociocultural approach, with an emphasis on moderate consumption, does not take into account how much pleasure is given to excessive drinking. The third doubt is that a change in attitude will lead to the desired change in behavior. In conclusion, they draw attention to the fact that the sociocultural approach does not take into account the physiological problems associated with the use of alcohol (cancer, diseases of the liver and stomach). Therefore, many believe that the introduction of a sociocultural model will cause the predominance of physiological problems, even if social problems are resolved simply due to the widespread use of alcohol.
Contrary to these doubts, the sociocultural model does not lose its influence in the United States.Currently, this is perhaps the most dominant strategy. It applies and has a large scope of activities. Examples of this are advertising and educational approaches to the problem of drunk driving.
The socio-cultural model is mainly used to solve problems related to alcohol abuse, but it is also a cornerstone in preventing many problems associated with the use of other drugs. As noted above, an example of the latter is the campaign “Just Say No”, which calls on everyone, but especially the young, to refuse the offer to try drugs. Another example of this type of advertising campaign is the Drug America Rescue Partnership. This campaign, focused on marijuana, cocaine and crack, is trying to reduce the social acceptability of drug use among young people and warns those who are already using them or are only going to try, about the dangers of using. Mainly this campaign is carried out on television. However, to date, their effectiveness has not been documented. In addition, the effectiveness of this campaign can be reduced due to the fact that it is aimed at young people of middle and upper social classes who are less exposed to this danger. The only main difference in the application of the sociocultural model to drug abuse, as compared to alcohol abuse, is that in the first case an attempt is made to make abuse a norm, and in the second to form reasonable norms of use.

Consumer model

Posted on October 22, 2018  in Medical news

This model is based on a statistical study of alcohol use in various cultures. The first work in this area was the study of the French mathematician Sally Liderman in the 50s. The type of model has changed dramatically over the next several years under the influence of international studies.

There are three main provisions of this model. The first is that the percentage of people who drink heavily from a given population directly depends on the average level of alcohol consumption in a given society. Therefore, the number of alcoholics is growing in a society where alcohol consumption is growing. In connection with this dependence, it can be predicted that a decrease in alcohol consumption in a given culture will be accompanied by a decrease in the number of chronically ill alcoholics.

The second proposition is that the increase in strong alcohol consumption increases the likelihood of associated negative effects in the spiritual, physical and social spheres. Therefore, as soon as the average alcohol consumption in a society increases, the number of alcoholics increases, and, accordingly, an increase in such adverse effects can be expected.

The essence of the third statement is that society should try to reduce the negative effects of alcohol consumption by limiting its accessibility. It is argued that limiting the availability of alcohol, especially by raising the cost of alcoholic beverages, will reduce alcohol consumption, and, accordingly, the associated consequences. Other ways – reducing the working hours of bars and snack bars with alcoholic beverages, control over the retail sale of alcohol, raising the age limit for purchasing alcoholic beverages.

Although this model examines in detail the ways of prevention, it is also criticized. There is an opinion that this model is entirely descriptive and does not reveal the underlying causes – why people drink or how the environment in which a person exists affects his attitude to alcohol. The problem was examined in more detail, and it was noted that the model should be improved by introducing sociocultural variables such as the environment. There is also a criticism that “normal” drinkers in a social group may react differently to efforts to reduce the availability of alcohol than chronic alcoholics. The criticism is again based on the fact that sociocultural and psychological variables are not included in the consumer model. For example, the differences between moderate drinkers and alcoholics can be decisive in trying to predict behavior. Thus, the reaction of alcoholics to an increase in the price of alcohol and other measures aimed at reducing the use of alcohol is less predictable. In this regard, there may be situations in which such measures will be ineffective. If, for example, the price of alcohol grows very strongly, the result of this will immediately manifest itself in the growth of home production and the spill of alcoholic beverages and the mysterious image surrounding alcohol consumption. As can be seen from the above, the task of reducing the average level of alcohol consumption is very difficult.

Takes a moral position in solving the problems of the use of various substances. Its essence is that if there is no use of the substance, then therefore there is no problem itself. If a person uses a substance, it is not seen as a social problem, but a product of some kind of human nature flaw. If so, then the objectives of the prohibiting model are (a) to prohibit accessibility and (b) to abstain from use.
The inhibitory model applies to both alcohol and drugs. The most famous embodiment of this model for alcohol in practice is the Prohibition in the USA in 1921-1932. However, this model is more applicable to drug abuse. For decades, there was a strict ban on the use of drugs, mainly marijuana and heroin, and later cocaine. The prohibiting model in the 30s, 40s in America was very much manifested in films, newspapers, and magazine articles aimed at a mass audience. Sensational stories about the upsurge of crimes caused by marijuana, became known thanks to newspaper publications and films of those years “Crazy marijuana cigarette”, “Killer of youth”, “Marijuana: grass with roots in hell.” Then, as now, the “key” to such companies was that “good” people do not use drugs.

Although the prohibiting model remains popular, it has not made a significant contribution to the prevention of problems associated with drug use. It is well known that the Dry Law did not produce the desired results, and the problems of using other drugs also continue.

Zero Tolerance to Drugs

Posted on October 18, 2018  in Medical news

Among the most recent methods of prohibiting drug abuse is the well-known “zero tolerance” policy used by some states and federal agencies. Its essence lies in the development of zero tolerance to any drug in any quantity, anywhere, at any time. The purpose of this policy is to attack the demand for drugs and thus make drug addicts responsible for their role in drug distribution.
As part of this policy, which was actively covered in the media in the late 80s and early 90s, cars, ships, luxury yachts were withdrawn from private property if they found at least a small dose of the drug. In just one month, the coast guard confiscated 27 vessels. One yacht, the “Royal Ship”, was confiscated when the guards discovered several seeds and a stalk of marijuana in the dressing table and in the garbage can. On another yacht, the Coast Guard inspectors found one twenty-eighth of an ounce of marijuana. These two yachts were returned to their owners after paying fines and the value of the property confiscated. These are just the two most famous cases. Smaller items of property such as cars and luggage were also confiscated, and many of these cases are still found in legal practice.
Some officials believed that the principle of zero tolerance should be extended. Edwin Meese III, the minister of justice in Ronald Reagan’s office, called for all workers in the country to be subjected to a drug test, and positive tests would mean immediate dismissal. According to Miz, the zero tolerance testing policy is an “absolute necessity” in dealing with the problem of drug abuse. Supporters of observance of the rule of law noted that the constitutional issues relating to such testing, especially those proposed by the government, would obviously prevent its wide dissemination.
Officials from the Reagan and Bush administrations thought that such methods could reduce drug abuse. However, many others are not so optimistic. They noticed that if even a small percentage of those who use drugs are arrested, the judicial system will simply get bogged down, even if the majority of them admit their guilt. It is believed that more need to deal with manufacturers and traffickers.
The elaboration of a national policy, for example, a policy of zero tolerance, is, of course, a function of the chief officials of the government, and it would be very interesting to study in greater detail the strategy of the Clinton administration in this matter. Clinton expressed his willingness to devote large resources to combating the demand for drugs with methods of prevention and treatment of drug addiction. The effects of such a policy will be visible very soon.

Frequently asked questions about using Careprost (Bimatoprost)

Posted on October 15, 2018  in Medical news

What is Kareprost?

Kareprost is a solution of bimatoprost, a special drug that can be used to treat eyelashes from hypotrichosis, make them darker, thicker, longer.

What is hypotrichosis?

Hypotrichosis of the eyelashes – inadequate or insufficient growth, deterioration of the type of eyelashes.

How does bimatoprost solution work?

The drug has a beneficial effect on the cyclic phase of growth, known as anagen, hair eyelashes in different directions. First of all, it increases the duration of this phase, and, moreover, increases the amount of hair of the eyelashes during growth.

How to use bimatoprost?

Every evening, the drug should be carefully applied to the upper eyelid only near the base of the eyelashes. The solution bimatoprost can not be used for the lower eyelid and eyes, because it can cause excessive hair growth outside the required area. More information is available on the page.

After how many results will be noticeable?

Users of the drug will see results in 8 weeks (2 months). The maximum result will be noticeable by 12-16 weeks. The growth of beautiful and healthy eyelashes occurs gradually at night.

Is Bimatoprost a replacement for eye mascara?

Not. Bimatoprost cannot work as a mascara, because it is only a special therapeutic solution for their growth. You can use traditional mascara in addition to the drug.

What should I do if I forget to use Kareprost (Bimatoprost) one evening or several days in a row?

If you miss the application, then do not try to catch up. You will only need to continue the treatment the next evening and try to adhere to the established schedule.

What happens if I stop using the drug?

After the end of the use of Kareprost, in the near future (a few weeks – months), the eyelashes will definitely return to the previous look.

What side effects may start due to bimatoprost solution?

The most frequent side effects after using Kareprost (bimatoprost solution) are the appearance of itching in the eyes, as well as redness of the eyes. About 4% of patients reported this. The solution can cause other side effects that are less common, but can appear not only on the eyes, but also on the skin close to the places where the drug is used. These side effects include darkening of the skin, redness of the eyelids, irritation and dry eyes. If your eyes have changed due to injuries or infections, visual acuity has decreased dramatically, an eye surgery has been performed, or some disease, such as conjunctivitis, has begun, then you should immediately consult with your doctor about the further use of this treatment solution.

Are there any special warnings that are associated with the use of the drug?

Bimatoprost is designed for use on the skin of the upper eyelid near the base of the eyelashes, but not on the lower eyelid. If you use drugs such as LUMIGAN with elevated intraocular pressure (PGD), or you have previously had abnormal PGD, bimatoprost is allowed only under strict medical supervision. Due to the use of this drug may begin darkening of the skin of the eyelids, but it will be reversible. Bimatoprost may cause an increase in the brown pigmentation of the colored part of the eye that will be irreversible. There may be an increase in those places that are in contact with Kareprost. If a lot of the solution outside the field of the upper eyelid, then you need to gently soak it with some absorbent material to reduce the risk of spread. In addition, length and thickness, the number and direction of growth, density and pigmentation of eyelashes in different eyes can vary. If the differences are noticeable, they will disappear after the drug is discontinued.

What if I wear contact lenses?

Before Careprost is applied, you need to remove contact lenses. They are allowed to wear only 15 minutes after applying the therapeutic solution.

What if Careprost gets in your eyes?

Bimatoprost solution is a special drug for the eyes. Thus, contact with eyes will not cause any harm and they can not be washed.

Who should not use bimatoprost?

You can not use the drug if you have an allergy to any component.

What components are included in the solution?

Active component used: bimatoprost. Inactive components of the drug: benzalkonium chloride, citric acid, sodium chloride, distilled water, as well as sodium phosphate disubstituted. Sodium hydroxide and hydrochloric acid are added to adjust the pH. The preparation contains 6.8 – 7.8 pH.

Hyperpigmentation of the skin: what is it?

Hyperpigmentation of the skin is a normal harmless condition during which some areas darken. The cause of this phenomenon is an increase in melanin (brown pigment) produced in the skin to ensure normal skin color. Hyperpigmentation of the skin sometimes becomes a side effect of the use of Careprost, but the level of melanin becomes normal after discontinuation of the solution.

Increased intraocular pressure: what is it?

Increased intraocular pressure is a condition during which the pressure inside the eye exceeds the normal level. Due to bimatoprost, PGD levels can be reduced. If you are taking any medications to reduce PGD, you need to talk with your doctor about using bimatoprost solution. If you use Kareprost and other medications to reduce PGD and hypertensive eye disease is noted, you should regularly and closely monitor any changes in intraocular pressure.

Can the eye color change due to bimatoprost?

Brown pigmentation of the iris can be increased if the same composition of the solution is instilled to treat glaucoma or increased intraocular pressure. In clinical trials, iris pigmentation cannot be indicated, but patients should regularly report the risk of an increase in brown pigmentation that may become irreversible.

Why does the manual say that the solution can only be applied to the upper eyelids near the base of the eyelashes?

Clinical trials were conducted on patients who used careprost on the skin of the upper eyelids near the base of the eyelashes, and did not put the drug on the lower eyelids, eyes. There is a potential risk of beginning hair growth in places where the bimatoprost solution contacts the skin. Thus, it is allowed to use the drug only on the upper eyelids at the base of the eyelashes using a special applicator, and the excess – you need to wipe it thoroughly.

What to do if itching is noted in the eyes?

Immediately after starting the medication, itching may start. If you notice that itching persists or other symptoms appear, consult your doctor. If the condition of the eyes was changed due to injury or illness, the vision became less acute, an operation was performed on the eyes, it is important to consult a specialist to resolve all issues regarding the further application of the solution.

Anti-drug movement

Posted on October 14, 2018  in Medical news

Prevention methods are applied in different areas and in this blog some topics and programs in primary and secondary prevention will be described. We begin this section with a list of important trends in the anti-drug movement:
the tendency to include the family (especially parents) in the anti-drug movement;
developing the ability to resist, in particular the development of strategies used to avoid pressure to use the drug;
program development in addition to broader social movements. For example, an anti-drug school curriculum may be complementary to messages disseminated through the media;
identification of social groups prone to alcohol and other drugs and the development of programs specifically for them;
increased attention to drugs, the use of which is a direct way to the use of other drugs. While most programs struggle with illicit drugs, some programs focus their attention on preventing the onset of the use of tobacco, alcohol and, in particular, marijuana. They are regarded as “intermediate” narcotic drugs, from which they shift to the use of “hard” drugs, such as cocaine, heroin and LSD;
increasing attention to programs designed to minimize the risk and negative consequences of already started drug use. These programs do not allow the use of drugs, but seek opportunities to minimize the negative consequences associated with their use, for the person and for society.

Education and influence of the media

Posted on October 10, 2018  in Medical news

The most common anti-drug tools in the United States have become the education and efforts of the media. Traditionally, these programs are designed for adolescents and young people – the two most obvious risk groups. Recently, efforts have been made to extend their influence to children.
The school system is the ideal link for educational work regarding substance use. In fact, many states today require the inclusion of alcohol and other drugs in the school year, although state laws, unfortunately, have not been systematized and translated into accessible instructional programs. Moreover, in the past, the use of such programs has been hampered by the inadequate training of teachers in materials related to alcohol and other drugs. However, in recent years there have been many changes and school programs are becoming increasingly systematized. What happens when courses in alcohol and drugs are introduced? The results are different. The main result is that the general level of knowledge about alcohol and drugs has increased. However, there were no noticeable changes in substance use. In fact, in some cases, it was found that the educational program in the short term increased the use of drugs by students! One way or another, one should be wary of this data until more systematic studies are conducted on the effects of educational programs, especially studies on the long-term aspects of their influence. Although the expansion of knowledge about alcohol and drugs should not be seen only as a way to modify their use.
One of the factors that influences this development of cases is the age at which the study of drugs begins. As a result of data showing that young children have already begun to form their own concepts about intoxication, drinking culture and the consequences of alcoholism, more attention has been paid to educational materials for primary school children. Preparing materials for this level of development is more likely to be more effective than attempts to change more well-established ideas about drugs in high school. As an example of this, consider the attitude to smoking. When scientists wanted to determine the best age for the introduction of anti-smoking programs, they examined 500 students in 6th, 9th, and 12th grades in Massachusetts. The results showed that the greatest effect was in the 6th grades. The researchers had several reasons for this conclusion. The first of them is that only 6.5% of students in the 6th grade described themselves as random or regular smokers, the same was done in the 9th – 21% or in the 12th – 32%. Pupils of the 6th grades also showed less pressure to smoke from their peers than pupils of the 9th and 12th grades, less knowledge about tobacco and the consequences of its use and less awareness about the attitude to tobacco of their parents. In addition to this, many students said they were going to start smoking in the next five years. Thus, training in anti-smoking programs should give the most positive effect in this group of students.
Has to do with the above written and the growing role of parents, who should be models for their children. According to Du Ponto, Director of the National Institute for Combating Drugs: “Interestingly, after a decade of research on the role of parents that we performed, we are rediscovering today that parents, whom we considered ignorant at best and“ problem ”at worst, today They are “a solution to the drug problem.” Although this statement can be considered exaggeration, parents are still an important — and perhaps decisive — element in the prevention of drug use. The decade originates in the premise that the problem of drug use is a family problem. Programs focusing on the contribution of parents try to increase the role of family discussions of alcohol and drug problems so that parents can become a model for children by teaching them not to use narcotic drugs at all or Responsibly approach the use of acceptable drugs, such as alcohol.The meaning of one of these programs, called “The Power of Proper Education”, is to make parents aware of how deep ie the impact of having children on their behavior. Children, especially in the preschool period, directly copy the behavior of their parents when they are looking for a pattern suitable for the situation. The goal of the program is for parents to understand the ways in which they influence their children with regard to drug use and to help parents determine what constitutes “responsible behavior”, for example, in terms of drinking culture.
Educational programs are complemented by the media, i.e. through television, radio, newspapers, magazines, films and specials Printed materials intended for wide distribution, although television and radio are most often used for this purpose. Since media campaigns often consist of repetition of relatively brief messages (for example, 15-second TV spots), the creators of these campaigns usually use a single slogan that combines different material. Examples of the mottos of some modern campaigns are “Just Say No” for drugs and “Know When To Stop Enough”, “Friends Do Not Allow Friends To Drive In Drunk,” for alcohol. Most modern anti-alcohol campaigns are aimed at reducing drunk driving. It is not yet clear how effective such campaigns are, but it is clear that these programs contribute to the dissemination of knowledge about drugs in society. It should be especially noted that the campaigns to prevent drunk driving significantly raised the level of knowledge (for example, knowledge of the legislative definition of intoxication). But just as with other approaches, the attitude changes much less. One way or another, there is no direct evidence that as a result of media campaigns, there have been significant changes in the use of alcohol and drugs. Such an approach may be more successful in affecting specific groups of drug users. The use of education and the media still consumes the main resources for prevention. Their success is manifested mainly in the field of knowledge and to a lesser extent in changing attitudes. Their effectiveness increases as a result of improving the quality of production of advertising appeals, as well as efforts that direct these campaigns to specific social groups. And, of course, more effort needs to be made to increase the likelihood that these approaches will ultimately lead to real changes in drug use.

Sensory-oriented programs.

Posted on October 6, 2018  in Medical news

Many modern programs, especially those that are conducted among young people, contain the so-called emotional component. It involves clarifying values ​​and making decisions. The clarification of values ​​includes self-knowledge, the development of life values ​​and the definition of ways to implement them. These programs reveal to the student a strategy that allows them to make choices in life and apply this technique specifically to situations with alcohol and other drugs. The main objective of the program is that students should be aware of their feelings about drugs and develop their attitude towards them in order to behave in accordance with their individual values ​​in drug-related situations.
The logic of applying an emotional or sensual approach is that thoughts, feelings, attitudes, and values ​​relating to alcohol and other drugs may be as important in a particular situation as knowledge, and may even be the most important. It is still unknown to what extent these programs have a beneficial effect. As in the case of educational programs, no serious research has been done on the effects of such programs. Nevertheless, those studies that were nevertheless carried out showed that the influence of the programs helps to clarify personal views on the use of drugs. Popular in the 1970s and 1980s, these programs are less frequently used today, although some of their elements are incorporated into modern programs in modified form.
Alternative behavior and artwork resist
In recent years, the number of prevention programs that have been focused on developing alternatives to drug use and the ability to recognize and resist pressure forcing them has increased significantly.
The development of alternatives to drug use refers to engaging in various productive activities (for example, sports, various hobby groups, vacations). In theory, this strategy seems reasonable, but in practice it has not shown concrete benefits in relation to substance abuse.
On the other hand, resistance training seems more promising. This training includes a combination of the following informational and behavioral strategies:
Development of the ability to solve problems and make decisions;
Development of the ability to recognize interpersonal and mass (advertising of alcohol and cigarettes) forms of agitation, as well as the ability to resist them;
Increase self-awareness and self-esteem;
Learning the art of coping with anxiety and stress without the use of drugs;
Improving interpersonal qualities, such as the ability to start a conversation;
The development of hardness, ability to express displeasure and anger, as well as the ability to communicate their needs;
Development of an understanding of the effects of drugs on health;Usually in these programs, participants are taught to recognize the social impact that leads to the use of drugs, and also to resist these influences. For example, they are taught to refuse offers to try a drug when it comes from peers. Often programs include the ability to resist the influence of leaders in a group. Analyzing the results of the development of the ability to resist, note positive changes, especially in relation to smoking.
One of the most famous, resistance-oriented programs currently used in America is the DARE Project (Resistance Training in Drug Use). The DARE Project is designed for fifth and sixth graders before they go to high school. The program is based on the premise that schoolchildren need to be taught to recognize the dangers of substance use and to resist indirect and direct coercion to use drugs. In the same way, the program teaches students to recognize and resist peer suggestions and others to experiment with drugs. The program includes from 15 to 20 modules, each of which is conducted by a representative of the official authorities and lasts 45-60 minutes. The modules are devoted to such topics: the art of refusing, risk assessment, decision making, interpersonal skills and the art of communication, critical thinking, alternatives to drug use. The DARE program has achieved positive results in refusing art to schoolchildren, although there are still no data on the long-term impact of these projects on drug use.
Harm reduction social policy
“We are talking about a high degree of risk for young people and families in the United States, but I don’t know of a single continent that would not be in danger of drug and alcohol abuse or a country not affected by them. Young people are at risk around the world, families are at risk all over the world. All communities and institutions of humanity are at risk all over the world, nations in danger. ”
Dr. Benson Bateman, President of the Organization for the Development of Human Resources, The Journal, May 1993
Countries vary greatly in their social policies regarding drug use. Much has been said in this book about the “war against drugs” and the policy of “zero tolerance” in the United States. This policy is opposed to another social strategy called “harm reduction”, used, for example, in England and the Netherlands. The harm reduction policy focuses on minimizing the negative effects of drug use on individuals and society, even if it temporarily supports safe drug use. According to Diana Reli, who heads the Canadian Substance Abuse Center, “Harm reduction builds a hierarchy of goals, outlining the most vital and realistic that should be achieved in the first steps towards safe use or abstinence. This is a pragmatic approach that reveals that abstinence cannot not be a real, not desirable goal for some, especially in the short term. ”
She described two examples of harm reduction policies. The first is Merseyside in England. Pharmacists and police collaborate in Merseyside clinics, who have introduced “a rational approach, including prescribing drugs, providing clean syringes and facilitating, rather than criminalizing, drug addicts.” The advantages of such cooperation include the low incidence of HIV infection among drug addicts, the preservation of jobs for many drug addicts, the reduction of thefts and robberies.
The second example is Amsterdam, where they tried to reduce the harm from drug use by providing medical and social assistance to drug addicts. Part of this strategy was reducing police attention to the possession and use of marijuana and mobile stations distributing methadone. Prison sentences threaten only distributors of “hard” drugs.
So far, this policy has not been adopted in the United States as a whole, but its individual elements are being applied. For example, in the 1960s, supporting methadone programs were introduced throughout the country. They were intended to partially reduce crime among heroin users. Secondly, a syringe exchange program was recently introduced, designed to reduce the risk of the spread of HIV among drug users. However, both of these programs have their violent opponents. Recently, a syringe exchange program has been subjected to fierce attacks, contrary to scientific research, indicating that drug addicts participating in these programs did not use drugs more often, and also that the number of drug addicts did not increase. However, harm reduction approaches are not likely to become more widespread in the near future.

Pain in the abdomen, stomach

How can osteochondrosis and abdominal pain be associated? The fact is that the nerve supply of the organs located in the thoracic and abdominal cavities is provided by nerves connected with the thoracic spine. For this reason, arising from osteochondrosis in the abdomen, stomach, pancreas, liver, lung pain, it is sometimes very difficult to differentiate from the pains accompanying the true pathologies of these organs.

pains in the stomach
Consequences of infringement of spinal roots can be very serious: in the zone of innervation the vessels are affected, there is a spasm, irritation of the nerve or its paralysis. For example, in the stomach often there are drawing pains. They gradually intensify, heartburn develops, digestion of food is disrupted. Such patients are often mistakenly treated for gastritis, while it is necessary to correct the spinal column in the area of ​​5-7 thoracic vertebrae. A prolonged course of the disease can lead to the formation of ulcers.

In osteochondrosis, abdominal pains are often nagging, cutting. They can be shingles, poured or localized in the stomach, pancreas, right hypochondrium, in the lower abdomen (right or left).

If the mid-thoracic roots are affected, the pain in the stomach is intensified when moving in the thoracic spine.
When the pathological process is localized in the 8th and 9th roots, the pain sensations are localized in the area of ​​the duodenum and show a tendency to increase with coughing, sneezing, bends, inclinations, and prolonged sitting.
The defeat of the right 7, 8, 9 of the thoracic roots leads to the development of symptoms of cholecystitis: the pain is felt in the right hypochondrium and also increases with movement.
Thoracic and cervical osteochondrosis can provoke both abdominal pains, and diarrhea, constipation, gas formation, intestinal motility disorders.

Pain in the leg with osteochondrosis

In the late stages of lumbar osteochondrosis, back pain often radiates to different parts of the lower extremities: gluteal region, thigh, and shin. Sensations are of a different nature, often imitating other pathologies of the nervous and vascular systems of the legs.

Pain in the legs with late osteochondrosis
Because of severe pain, patients often stop – so-called intermittent claudication develops. The clinic of this condition resembles the endarteritis of the vessels of the lower extremities. Differential diagnostics using Doppler study of blood vessels allows to determine the true cause of the pathological condition.
With the formed intervertebral hernia in the lumbar region, the calf muscle syndrome manifests itself. It is characterized by the appearance of severe severe pain in calves, sometimes accompanied by tonic convulsions. Pain sensations can also be trailing, aching. In this case, there is a need for differentiation from chronic venous insufficiency. The difference is the absence of swelling of the legs and the severity of the veins in lumbar osteochondrosis.
When the spine L III is injured, patients can feel chill and cold in the area of ​​the foot, shin. When these symptoms appear, differential diagnosis is performed with a spasm of the arteries of the legs of different origin.
Often the pains associated with osteochondrosis extend to the foot, accompanied by paresthesia, weakening of reflexes, partial or total loss of sensitivity. A similar clinic arises with diabetic peripheral polyneuropathy. In the case of osteochondrosis, the infringement of the nerve root leads to paresthesias propagating in one leg innervated by this spine. With polyneuropathy both limbs are affected.