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Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020
The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.

Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.

Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.

The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.

A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.

The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.

The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.

Context and Discussion

The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.

Conclusions and Advice

It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.

The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.

The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.

The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).

For DRC:
- Sustain the political commitment and multisectoral coordination approach to the response.
- Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
- Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
- Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
- Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
- Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
- Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
- Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).
For countries at risk:
- At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
- Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
- Risk communications and community engagement, especially at points of entry, should be maintained.
For all countries:
- As recommended previously, no country should close its borders or place any restrictions on travel and trade.
- The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.

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https://www.who.int/news-room/detail/12-02-2020-statement-on-the-meeting-of-the-international-health-regulations-(2005)-emergency-committee-for-ebola-virus-disease-in-the-democratic-republic-of-the-congo-on-12-february-2020

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February 27, 2020
Assessing national guidelines on responding to violence against children in the Eastern Mediterranean Region

In 2019 WHO published guidelines on the health sector response to child maltreatment which describe the role of frontline healthcare providers in recognizing child abuse and neglect and providing appropriate physical and mental health care to child victims of violence. WHO’s Regional Office for the Eastern Mediterranean is using these guidelines to assess and where needed improve existing national health protocols to ensure that child victims of violence receive appropriate support and treatment.

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https://www.who.int/news-room/detail/18-02-2020-assessing-national-guidelines-on-responding-to-violence-against-children-in-the-eastern-mediterranean-region

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February 27, 2020
WHO Global Initiative for Childhood Cancer: progress on all fronts

Peru shows the way forward and the courage of Ander Martinez

“When Ander was diagnosed, I didn´t have the possibility to cover the cost of the treatment. It was very expensive, and I had nothing,” says Rosalina Tocto, 29 years mother of Ander Martínez Tocto. Ander had just been diagnosed with acute leukemia at the young age of 6 years. From the beginning, the odds were stacked against him. He and his family lived in a rural town, six hours from the nearest city. His parents did not have a formal job, placing the family under financial strain.

Ander and his family were not alone in this situation. “In Peru, nearly 1800 children and adolescents are diagnosed with cancer every year; however, up to 70% will have a late stage, often metastatic due to delays in diagnosis,” says Dr. Juan García, medical chief of the Pediatric Department of in the National Institute of Neoplastic Diseases (INEN) in Lima, Peru. “Most of our patients come from outside Lima and the majority of parents do not have formal employment and therefore do not have any type of insurance.”

Fortunately, Peru has made a strong commitment to Universal Health Coverage. In 2009, a law was passed to improve access to care by introducing a mandatory health insurance system and registering everyone living in extreme poverty under Seguro Integral de Salud (SIS), regardless of age or circumstance.

Dr. Reina Bustamante, Executive Director of the Division of Prevention and Control of Cancer of the MINSA says “UHC is an important step in public health particularly for those who lack public or private insurance like Ander. In this context, we are trying to follow WHO guidance to achieve UHC and ensure all individuals and communities receive the health services they need without suffering financial hardship.”

In 2019, Peru was selected as a focus country for the WHO Global Initiative for Childhood Cancer as the first focus country in the Region. The Global Initiative aims to improve survival for all children with cancer to at least 60% by 2030 while reducing suffering, altogether with the potential to save an additional one million lives.

Four main goals were formulated for the national pediatric cancer plan: (1) improve early diagnosis of childhood cancer, (2) decrease treatment abandonment, (3) implement a national pediatric cancer registry and (4) improve the quality of services in pediatric oncology units.

Dr. Liliana Vasquez, pediatric oncologist who works as an external consultant for the Division of Prevention and Control of Cancer of MINSA said, “Ten working groups have been established to achieve the goals.”

Dr. Vivian Perez, advisor of the Non-Communicable Diseases Office in PAHO-Peru added “the initial focus for the Initiative will be on six cancers selected as tracers for monitoring progress across the health system, alongside engagement of at least six focus countries with a record of strong political commitment and foundational efforts supporting children with cancer.”

For Ander, his health care team, the commitments from the government of Peru and partners and Global Initiative have made it possible to be successfully treated and will now allow him to dream of a healthy future though better access to surveillance monitoring and psycho-oncological support aimed at childhood cancer survivors.

Peru is showing what is possible for all countries. By concerted action and promoting universal health coverage, every child in the world can have access to high-quality care with the greatest likelihood of survival, and every family should be protected from financial hardship. We can do more together.

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https://www.who.int/news-room/detail/14-02-2020-who-global-initiative-for-childhood-cancer-progress-on-all-fronts

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February 27, 2020
Pregnancy and breastfeeding during an Ebola virus outbreak

Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

Improving clinical care and reducing mortality

Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

Obstetric care at an Ebola Treatment Centre

Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

Breastfeeding recommendations in an Ebola outbreak

WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.

The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

Women’s health and rights in a disease outbreak

A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

Accessing the guidelines and further research

These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

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https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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February 27, 2020
WHO and FIND formalize strategic collaboration to drive universal access to essential diagnostics

Geneva, Switzerland – 10 February 2020 – The World Health Organization (WHO) and the Foundation for Innovative New Diagnostics (FIND) announced today that a memorandum of understanding has been signed by the two organizations to formalize a strategic collaboration that will strengthen diagnosis in resource-poor countries by closing major diagnostic gaps at country level and bolstering disease surveillance that will inform public health initiatives and enhance outbreak preparedness and response.

“This collaboration is an inspiring development that will take us a long way towards ensuring access to diagnostics to all who need them,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Global health challenges such as the ongoing novel coronavirus (2019-nCoV) outbreak demonstrates that without these essential elements of health systems, we cannot hope to promote health, keep the world safe, and serve the vulnerable. I look forward to working closely with FIND to determine what countries need and to forge a path to deliver these innovations so that no one is left behind.”

Diagnosis is a driver of patient, financial and health systems impact, and a critical enabler of universal health coverage, but it is also the weakest link in the care cascade. This is especially true in primary healthcare settings in low- and middle-income countries. A unique and unprecedented opportunity exists to expand the role and impact of diagnostics to fully realize their potential to address major health security threats and evolving disease burdens through technological and digital advances.

FIND has been an active partner with WHO since 2008 and a WHO Collaborating Centre since 2014, acting in the areas of laboratory strengthening and diagnostic technology evaluation. This expanded collaboration will put in place the building blocks necessary to enable transformative change in a move toward a country-led diagnostics alliance. Initial workstreams will focus on demand-driven access to essential diagnostics and the development of national Essential Diagnostics Lists, alongside collection of data that assist the scale up of diagnostics to support low- and middle-income countries on their paths to universal health coverage.

“Each and every person has the right to a quality, timely diagnosis,” said Catharina Boehme, CEO of FIND. “Comprehensive diagnostic services underpin functional and efficient health systems not only to manage day-to-day healthcare needs, but also to ensure new disease outbreaks can be spotted and contained quickly. Working closely with WHO as part of a country-led alliance, we will strive to ensure that low- and middle-income countries have what they need to develop their own comprehensive, data-driven diagnostic strategies that enable universal health coverage and empower disease surveillance. Our ambition is that all patients, providers and decision-makers have access to the diagnostic solutions needed for optimal health outcomes.”

The strategic collaboration agreement will initially run for a period of 5 years, until 2025.

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About FIND

FIND is a global non-profit organization that drives innovation in the development and delivery of diagnostics to combat major diseases affecting the world’s poorest populations. Our work bridges R&D to access, overcoming scientific barriers to technology development; generating evidence for regulators and policy-makers; addressing market failures; and enabling accelerated uptake and access to diagnostics in low- and middle-income countries (LMICs). Since 2003, we have been instrumental in the development of 24 new diagnostic tools used in 150 LMICs. Over 50 million FIND-supported products have been provided to our target markets since the start of 2015. A WHO Collaborating Centre, we work with more than 200 academic, industry, governmental, and civil society partners worldwide, on over 70 active projects that cross six priority disease areas. FIND is committed to a future in which diagnostics underpin treatment decisions and provide the foundation for disease surveillance, control and prevention. For more information, please visit www.finddx.org

About WHO

The World Health Organization is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. WHO is committed to the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. WHO’s current global programme of work sets out three interconnected strategic priorities: ensuring healthy lives and well-being for all at all ages; achieving universal health coverage; and addressing health emergencies and promoting healthier populations. These priorities are linked to three ambitious targets, the “triple billion”: one billion more people to benefit from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.

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https://www.who.int/news-room/detail/10-02-2020-who-and-find-formalize-strategic-collaboration-to-drive-universal-access-to-essential-diagnostics

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February 27, 2020
Researchers explore epigenetic influences of chronic pain

Chronic pain is one of the most prevalent, disabling and expensive public health crises in the United States. It affects more than 100 million Americans, with annual costs estimated at $635 billion, says a 2014 report from the American Pain Society.

Despite the enormous societal impact of chronic pain, present treatment options are limited to nonsteroidal anti-inflammatory drugs (NSAIDS), opioids, anticonvulsants and antidepressants, which provide pain relief to only about half of patients. Furthering the problem, prescription opioid overdoses have quadrupled since 1999. There were more than 45,000 painkiller-related deaths in 2014 alone, according to the Centers for Disease Control and Prevention.

Now, researchers at Drexel University College of Medicine are aiming to identify new molecular mechanisms involved in pain. Their latest study, published this month in Epigenetics & Chromatin, shows how one protein – acting as a master controller – can regulate the expression of a large number of genes that modulate pain.

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February 27, 2020
Changes needed to increase access to colorectal cancer screening

Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the procedure, yet current Medicare insurance beneficiaries lacking supplemental insurance may not be able to afford colon cancer screening and treatment. This policy disproportionally puts low-income Americans at risk and adds unnecessary strains on overall health care costs, according to a commentary in the May issue of the journal Gastroenterology.

“Study after study shows that screening saves lives,” said Chyke A. Doubeni, MD, MPH, chair and the Presidential Associate Professor of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania, and lead author of the commentary. “Yet many of those in the group most affected by this deadly disease are unable to afford the screening they critically need. We must renew efforts to ensure equitable access to and use of disease prevention, detection, and treatment services for colorectal cancer.”

For CRC screening, a full colonoscopy is necessary, where the doctor inspects the rectum and entire colon through a flexible lighted tube, and can remove any abnormal growth. The entire colon has to be cleansed before the colonoscopy, for which the patient is usually sedated

There are currently an estimated 55.5 million Medicare beneficiaries in the U.S. A 2010 Kaiser Family Foundation survey found that 14 percent lacked supplemental coverage. Until recently, colon cancer screening has been viewed as a one-time activity, while in practice, screening is a series of clinical activities to identify and test patients and perform diagnostic confirmation when necessary. This series of tests and steps include a diagnostic workup, which can include a biopsy to obtain a tissue sample or polypectomy, in which polyps are removed to prevent them from becoming cancerous.

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February 27, 2020
Cervical Traction: The Best Way to Heal a Sore Neck

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Traction is a centuries old treatment that has been administered by chiropractors for healing conditions like a sore neck or a sore back. Alternately, traction therapy may be used for decompressing any of the ailing joints.

Who Can Use Traction Therapy

Traction may broadly be seen as application of continuous force to stretch the spine. It is also very often used and is highly effective for treatment of musculoskeletal conditions, i.e. injuries that are not externally visible, but involve muscles, ligaments, joints, tendons, nerves, bones or the supporting structures. For muscular disorders, including muscle spasms, dislocation or for fracture, traction therapy can be very useful, and is often applied for arms, legs, back or neck.

Traction Therapy for Neck related Issues

In particular, traction therapy can be greatly effective for neck related problems. While neck traction is very often applied to ensure pain relief, there are various mechanisms by which it heals the neck.

1. When traction is applied on the neck, soft tissues and joints are mobilized in the cervical spine.

2. Alternately, it relieves pressure from the pinched nerve root by applying decompressive forces,

3. And also reduces herniations on the spine.

4. By applying traction, one can align any dislocations in the cervical spine, and this can effectively stabilize an injury in the cervical spine.

5. And for anyone who has a faulty neck posture, such as the forward head posture, home traction therapy can enable the patient to get the curve in the neck again.

6. This also works very well for anyone who suffers from conditions like military neck, wherein the curve of the neck is not bent forward, as it should ideally be. When a patient suffers from military neck, the curve of the neck is either straight or bent backwards, and with cervical traction, the patient benefits in the long term. Cervical traction not just ensures pain relief for the patient, but also increases the cervical range of motion, such that the patient can comfortably return to everyday activities.

If one is able to treat a sore neck at home, it simply speeds up the healing process, and might even suffice in terms of treatment. Home cervical traction is advantageous because while it ensures long term pain relief, it is a non invasive treatment methodology.

When cervical traction is administered, it relieves neck pain by stretching the soft tissue, or the tissues such as tendons, ligaments and fibrous tissue which surround, connect or support the backbone. This in turn works towards separating the spinal joint structures and ensures pain relief.

With constant traction, the muscles are fatigued out, and the strain then rests on the joints. So with traction, the joint spaces are widened, and this induces pain relief as pressure on the cervical nerves is reduced.

Cervical Traction: Is It Painful?

People often wonder if traction therapy or traction devices in particular are painful. But traction therapy has been in prominence for centuries, and has worked very effectively for healing conditions like a stiff neck.

Moreover, nowadays one can find some highly refined cervical traction devices which allow the patient to himself control the pressure. These are air inflated devices which work using a hand operated air pump, and allow the patient to adjust the air pressure to suit his needs and comfort levels.

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Source by Harshad Jethra

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February 10, 2020
Distinguishing Drug Abuse From Drug Addiction
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Though “drug abuse” and “drug addiction” are often used interchangeably, in reality the terms refer to two distinct behavior patterns. An individual can abuse or misuse drugs without being inevitably addicted to them. Abuse or misuse involves the use of drugs defying the culturally acceptable standards or medically prescribed doses to attain a certain effect. The substances abused may be legal, such as alcohol or prescription drugs, or illegal, like heroin and other street drugs which have no medicinal value.

On the other hand, drug addiction, or compulsive drug use, refers to an uncontrollable desire to use a drug in spite of being aware of harmful psychological and physiological effects that they can have on the body. Addiction is often characterized by an insatiable appetite for substances by increasing the dosage, leading to a complete dependence on them.

Since abuse and addiction are two distinct concepts, their causes are unique as well. Abuse is generally considered to be more complicated but it is not necessarily triggered by any motivational factor, unlike addiction which is caused by a powerful motivational force. Therefore, in most of the cases, abuse may not always result in addiction, but addiction can certainly lead to abuse.

Impact of drug abuse and addiction on the brain

It has been observed that both drug abuse and drug addiction have similar effects on mind and body. People often view abuse and addiction as a moral weakness or character flaw. One of the common myths surrounding drug use is that quitting it is directly linked to behavioral changes. In reality, addiction is a disease which alters the brain functions, hijacking the natural motivational control circuits. Thus, quitting is simply not a matter of choice or willpower. Though, the decision to use the drug initially might be voluntary, changes in the brain structure due to repeated drug use can inhibit someone’s self-control and decision-making ability, causing intense cravings.

Experts attribute the inability to refrain from drug use to these changes in the brain. However, modern medical advancements have led to the development of an array of treatment and rehabilitation options to combat the disastrous effects of addiction and help abusers take control of their lives. Studies have shown that a combination of medications and behavioral therapy can boost the recovery process with minimal withdrawal effects.

Possible reasons leading to drug abuse and addiction

For those who are dependent on illegal substances, it can be difficult to know whether they have crossed the limit. Here are some possible reasons that can trigger drug abuse or addiction:
- Connecting socially: A strong desire driven by an urge to fit into a certain group could lead people toward drugs.
- Dealing with problems in life: Continuous drug use can get individuals accustomed to it, and soon it might become the only way to escape from problems and challenges.
- Using drugs to combat other issues: Serious concerns, such as panic attacks or chronic pain, can cause dependence on drugs, until people discover healthier alternative methods to counter such problems.
- Strong influence of any drug: Frequent use of drugs triggers dependence on them. Thus, what started as a voluntary choice may slowly transform into a physical and psychological need.
Leading a drug-free life

Many families and individuals have suffered great losses due to addiction to drugs. Fortunately, there is hope, though the battle to eliminate addiction and regain sobriety is challenging. There are numerous treatment strategies that can go a long way in helping people come out of their addiction-related problems.

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Source by Barbara Odozi

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February 9, 2020
Herbal Cure For Joint Pain

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Joint pain can be stressful and it can also limit the activities you can do comfortably. Severe joint ailments might also restrict mobility. The most common joint ailments that cause excruciating pain include arthritis and osteoarthritis. People are always looking for ways by means of which they can cure or at least relieve the discomfort. Herbal cure is probably one of the best that you can choose for pain relief. This is considering that it revolves around natural herbs which do not have any side effects.

Ayurveda is a natural healing process which offers a holistic approach allowing the patients to attain higher self harmony (atmay), mind (manas) and helps in regaining vital energy from the universe (prana), body and the senses. The Ayurvedic treatment process combines natural herbs and herbal minerals with no side effects. Meditation, yoga and use of massage are also practiced under this treatment to achieve complete wellness besides, getting rid of joint pain.

Arthritis Treatment

This is the most common joint condition people suffer from. It is a systemic, chronic inflammatory disorder which affects organs and tissues, thus leading to pain and ailing. It is a disease that can start with morning stiffness and fatigue extending to muscle ache, weakness and loss of appetite. Those suffering from this condition might use pharmaceutical drugs to relieve the pain, but it is not always a good option. Ayurvedic treatment for arthritis is probably the most effective herbal way of dealing with the pain.

This herbal treatment revolves around internal medicines and external therapies which help in dealing with and eliminating the pain of arthritis. It uses traditional Ayurvedic treatment methods together with classical Ayurvedic medicines to help with pain relief. The treatments are made up of:

Choorna Kizhi:

This is considered to be the most effective of all Ayurvedic treatments when it comes to rheumatoid arthritis, arthritis and osteoarthritis. The treatment uses a mixture of natural herbs which are applied to the body to an extent that the individual sweats profusely. The treatment requires that the patient is kept in different positions including left lateral, right lateral, supine and sitting positions.

Abhyangam:

This treatment uses special massage oil. The oil is applied using a variety of strokes lasting for up to 45 minutes every day for at least two weeks. The treatment is most suitable for osteoarthritis, obesity and body aches among others. The treatment nourishes the body, revitalizes the nervous system, helps overcome stress and fatigue, promotes good sleep, improves physical appearance, and builds self confidence.

Njavarakizhi:

This is another Ayurvedic treatment where the patient suffering from joint pain is rubbed with medicated herbal oils. It is applied all over the body and in different postures, including lying and sitting. The treatment uses cooked Njavara rice and a medicinal decoction used by the therapist for at least 14 days for complete joint pain relief to be enjoyed. Regular use of the Ayurvedic pain treatment methods has a way of offering a permanent cure for arthritis. This is because complete well being is promoted during the treatment.

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Source by Shalini Mittal

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February 9, 2020