Secondhand smoke can be described as any smoke from burning tobacco products, such as cigarettes, cigars, or pipes. It also includes smoke exhaled or breathed out by smokers. Tobacco smoke contains over 7,000 chemical, most of which are either toxic or carcinogenic. Non-smokers exposed to second hand smoke are referred to as involuntary or passive smokers. They inhale nicotine and toxic chemicals from tobacco the same way smokers do.  There is currently no risk-free level of exposure to second hand smoke and it affects every organ in the body. Some individuals may experience severe health problems and physical reactions may occur despite short periods or low levels of exposure. Immediate reactions including heart attack and stroke are not uncommon. Other reactions include increased heart rate, reduced supply of oxygen to the heart and narrowed blood vessels which upsurge blood pressure and cause greater burden or workload for the heart. In pregnant women, second-hand smoke may result in greater risks of miscarriages, premature birth and babies with low birth weight.

Regular exposure to second-hand smoke can cause as much harm as that found in smokers, however, the risk and severity of harm are dependent on the amount and length of exposure.

The long term effects of second-hand smoke include:

• Heart disease
• Stroke
• Nasal sinus cancer
• Lung cancer
• Breathing problems, such as coughing, wheezing, pneumonia and asthma

Secondhand smoke has been associated with cancer even in people who have never smoked. More specifically, it has been linked to certain cancers in adults such as cancers of the larynx, pharynx, brain, breast, bladder and rectum. In children, it has been associated with, lymphoma, leukemia, liver cancer and brain tumors. Additionally, several studies have found a link between second hand smoke and mental or emotional challenges such as depression. More research is however needed to better understand this link. The only way to avoid the effects of second hand smoke is by creating a smoke-free environment: making homes, work places, schools and cars smoke-free. Using air purifiers and ventilation systems will not remove all the toxins and chemicals found in second-hand smoke. These substances remain in rooms for hours, even with open windows and one can still be exposed because the particles are either suspended in air or settled on surfaces such as carpets, curtains, furniture and clothes.

To help reduce second hand smoke, some countries have laws that ban smoking in buildings, as well as public and shared spaces.

Stroke is a medical emergency which occurs when blood flow to the brain is disrupted, denying brain tissues oxygen and nutrients. In this situation, brain cells begin to die in a few minutes. It is important to take immediate action when stroke occurs so as to reduce brain damage and associated possible complications. This is because the longer stroke goes untreated, the greater the potential for brain damage and disability.

Thankfully, stroke is both preventable and treatable. Some symptoms associated with stroke include:
• Slurring of speech, difficulties communicating and comprehending
• Paralysis on one side of the body including face and some body parts
• Blurred vision in one or both eyes
• Sudden severe headache accompanied by vomiting and dizziness
• Loss of balance or coordination.

Causes of stroke include blockage of an artery and leakage or bursting of a blood vessel. In addition, some people experience a temporary disruption of blood flow to the brain which does not cause permanent brain damage.

Types of stroke depend on the causes and they include:
Ischemic stroke: Most strokes- up to 80%, fall into this category. They occur when the arteries to the brain become narrowed or blocked, causing severely reduced blood flow (ischemia). Forms of Ischemic stroke include Thrombotic and Embolic strokes.
Hemorrhagic stroke: This type of stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages result from many conditions that affect the blood vessels including hypertension, blood thinning and aneurysm. Form of hemorrhagic stroke include Intracerebral hemorrhage and Subarachnoid hemorrhage.
Transient ischemic attack (TIA): TIA- sometimes referred to as a mini-stroke, is caused by a brief decrease in blood supply to the brain lasting as short as five minutes. Similar to ischemic stroke, TIA occurs when a clot or debris blocks blood flow to part of the nervous system but there is no permanent tissue damage and no lasting symptoms. Having a TIA increases the risk of having a full-blown stroke, causing permanent damage later.

Risk factors for stroke include:
• Lifestyle factors such as physical inactivity, smoking, obesity, alcohol and drug abuse.
• Medical factors such as hypertension, high cholesterol, diabetes, sleep apnea, heart problems and personal or family history of stroke.
• Other factors such as age, race and gender.

Stroke prevention strategies focus on general, healthy lifestyle recommendations which include:
• Controlling high blood pressure (hypertension)
• Lowering the amount of cholesterol and saturated fat in your diet
• Quitting tobacco use
• Controlling diabetes
• Maintaining a healthy weight
• Eating a diet rich in fruits and vegetables
• Exercising regularly
• Drinking alcohol in moderation, if at all
• Treating obstructive sleep apnea (OSA)
• Avoiding illicit drugs

Preventive medications such as anti-platelets and anti- coagulants may be recommended and prescribed by a doctor to prevent the recurrence of a stroke.

According to World Health Organization, there are about 32.4 million myocardial infarctions and strokes worldwide every year. People who have had a previous episode of myocardial infarction (MI) or stroke are at the highest risk of having another episode. MI survivors are at increased risk of recurrent infarctions and have an annual death rate of 5 percent- 6 times that of people of the same age who do not have a history of MI. In the United States, someone suffers a heart attack every 40 seconds. A total of about 790,000 Americans suffer a heart attack yearly, and of these cases, 580,000 are a first heart attack while up to 210,000 are recurrent.

By definition, Myocardial infarction (MI), also known as heart attack is the irreversible death (necrosis) of heart muscle due to prolonged lack of oxygen supply (ischemia). MI is a medical emergency that occurs when a part of the heart muscle does not receive sufficient blood flow such that the heart muscle is unable to receive oxygen. The more the time that elapses before treatment to restore the blood flow, the greater the damage that will be done to the heart muscle- in severe cases, the affected section of the heart begins to die and this can be fatal. The major cause of heart attack is Coronary artery disease (CAD). Other causes include severe spasm which may be caused by tobacco and illicit drug use or sudden contraction of a coronary artery that can interfere with blood flow to the heart muscle. A heart attack occurs when one or more of the coronary arteries are blocked due to narrowing from the buildup of various substances, including cholesterol in a condition called atherosclerosis.

Risk factors for heart attack are those factors that contribute to atherosclerosis. They may include:

• Age
• Tobacco
• High blood pressure
• Obesity
• Diabetes
• High levels of low-density lipoprotein (LDL) blood cholesterol or triglyceride levels
• Metabolic syndrome
• Family history of heart attack
• Lack of exercise and Stress
• Use of Illicit drugs such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.
• History of preeclampsia or an autoimmune condition

There are two types of heat attack; the first is STEMI (ST-elevation myocardial infarction) where there is a complete obstruction of blood flow in a coronary artery supplying the heart with oxygen-rich blood. This results in damage to the width of the heart wall. The second type of heart attack is the Non-STEMI (Non-ST-elevation myocardial infarction) in which there is a partial obstruction of blood flow in a major coronary artery supplying the heart with oxygen-rich blood. In this case, only part of the heart wall thickness is damaged.

Medications can reduce the risk of a subsequent heart attack and help damaged heart function better. In addition, lifestyle changes such as maintaining a healthy weight, eating heart-healthy foods, quitting smoking, exercising regularly, managing stress and controlling conditions that can lead to heart attack, such as high blood pressure, high cholesterol and diabetes can prevent heart attack or its recurrence.

Arteries are blood vessels that carry blood from the heart, they are lined by a thin layer of cells called endothelium, which keep them smooth and allow blood to flow easily. Arteriosclerosis is a situation where these blood vessels that carry blood-containing oxygen and nutrients, from the heart to other parts of the body thicken and become stiff, causing restrictions in blood flow to body organs and tissues. Usually, the structure of arteries allows them to be flexible and elastic; however, the arterial walls can harden and become narrow in another condition commonly known as Atherosclerosis. In this condition, the arteries become narrowed and hardened due to a buildup of plaque around the artery wall; it is also known as arteriosclerotic vascular disease.

Similar to Atherosclerosis, Arteriosclerosis disrupts blood flow around the body, posing the risk of serious complications. It occurs when the endothelium becomes damaged, allowing harmful cholesterol to build up in walls of the artery. To fight this problem, the body sends white blood cell to flush out the cholesterol, however, these cells may become stuck at the affected site building up plaque. In extreme cases, the plaque may break open, cause blood clots and result in life-threatening complications, such as stroke and heart attack.

Risk factors for arteriosclerosis (Arteriosclerosis is the stiffening or hardening of the artery walls) and Atherosclerosis (narrowing of the artery because of plaque build-up- a specific type of arteriosclerosis) include high blood pressure, high levels of cholesterol, smoking, diabetes, air pollution, genetics,  and high levels of sugar in the blood. Symptoms of these conditions depend on whether it’s the carotid, coronary or renal arteries that are affected. General symptoms include weakness, difficulty breathing, headache, facial numbness, paralysis, vomiting, anxiety, chest pain, coughing, loss of appetite, swelling of the hands and feet and difficulty concentrating

Diagnosis and treatment of atherosclerosis are important to prevent complications. Common methods of diagnosis include:

• Blood tests which measure sugar, fat and protein content in the blood
• Physical exams used to detect plaques, weak pulse, low blood pressure, aneurysm and wounds that don’t heal properly
• Ultrasound scanner can be used to check blood pressure at distinct parts of the body- pressure changes may indicate arteries that have an obstructed blood flow.
• CT scan is used to find arteries that are hardened and narrowed.

Treatment options include lifestyle changes including maintaining a healthy weight, medications that have antiplatelet capacity and surgical interventions such as angioplasty or coronary artery bypass grafting (CABG). However, it is important that atherosclerosis is accurately diagnosed, and on time, to ensure the functions of the arteries are returned to full capability. It is always better to prevent the development of by eating a good diet, frequent exercise and not smoking.

Pruritus, also known as itchy skin, is an uncomfortable, tingling and irritating sensation that stimulates an individual to scratch. Pruritus or itchy skin can be associated with some disorders, including dry skin, skin disease, pregnancy, and rarely, cancer. It is also more common in older adults because the skin has a tendency to become drier with age. Itchy skin may appear normal, red, rough or bumpy depending on the cause or trigger. It may occur on certain small areas, such as on some parts of the arm or leg, or it can occur over the whole body. It can also occur with or without any other noticeable changes on the skin. In some cases, itchiness can last for a long time and can be intense- the more the itchy area is rubbed or scratched, the itchier it gets; And the more it itches, the more it is scratched causing an itch-scratch cycle can be very difficult to discontinue. Continuous itching can result in inflamed or swollen areas on the skin leading to wounds or infection.

Self-care and homemade measures such as moisturizing frequently, use of gentle cleansers and warm water bath can bring temporary relief. Permanent relief requires a diagnosis and treatment of the factor underlying the itchiness. The major characteristic of Pruritus is a continued urge to itch some or most parts of the body. Identified and common symptoms include redness, bumps or blisters, dry cracked skin and scaly skin.

Pruritus can be caused by pruritogens and several factors; however, it is sometimes difficult to determine the exact cause. Skin conditions such as dry skin (xerosis), eczema (dermatitis), psoriasis, scabies, insect bites, atopic dermatitis, urticaria, mastocytosis, dermatitis herpetiformis, pemphigoid and hives result in itchiness. Other factors include:

• Internal diseases: Liver disease, kidney failure, iron deficiency anemia, thyroid problems and certain cancers
• Nerve disorder: Multiple sclerosis, diabetes, pinched nerves and shingles
• Psychiatric problems: Anxiety, obsessive-compulsive disorder and depression
• Irritants and allergies: Poison ivy, parasites, cosmetics, opioids, wool, chemicals and some soap

It is important to see a dermatologist if:

• Itchy skin persists for over two weeks
• Doesn’t improve with self-care measures
• Doesn’t improve despite treatment
• Is severe and distracting
• Starts suddenly without cause
• Causes sleep interruptions
• Affects the whole body
• Is accompanied by signs and symptoms such as extreme tiredness, weight loss, changes in bowel habits, or urinary frequency, fever or redness of the skin

A physical examination and inquiries about a patient’s medical history are essential to diagnosing and treating Pruritus. Blood tests, x-rays, thyroid, liver and kidney function tests are important for diagnosis. Itchy skin treatment focuses on determining the underlying the cause of the itch and treating it. If self-care and homemade remedies don’t ease itchiness, medications may be used as prescribed by a doctor. Some medications include corticosteroid creams; ointments such as tacrolimus, pimecrolimus, capsaicin, doxepin and oral medications such as fluoxetine and sertraline. In addition to medications, light therapy (phototherapy) which involves exposing the skin to a specific type of light at several times may be used to treat Pruritus.

Insomnia is a sleep disorder characterized by difficulty falling and staying asleep, sleep interruptions at night, waking up earlier than necessary and feeling exhausted when awake. According to Centers for Disease Control and Prevention, about 50 to 70 million Americans experience some form of sleep disorder. Insomnia can sometimes lead to depression by influencing the mood and attentiveness of people who it affects. Lack of sleep can also lead to household injuries, car accidents, problems at work, marital issues, social problems, alcohol abuse and poor health. Symptoms of Insomnia include sleepiness during the day, general tiredness, irritability and problems with concentration and memory. Insomnia is caused by several factors and may include one or more of the following:

• Health problems such as pain, sleep apnea and restless legs syndrome
• Lack of sufficient physical activity
• Substance abuse
• Reactions to bad nights of sleep
• Shift work and Jet lag
• Insufficient exposure to sunlight
• Overheating the bedroom
• Emotional conditions such as stress, depression, worry and anxiety
• Poor sleep habits, such as watching TV in bed
• Lack of a regular bedtime schedule or significant physical discomfort
• Changes in sleep habits or surroundings including noise, light, or bed change
• Tobacco, alcohol, drugs, caffeine and certain medicines

There are two major types of insomnia; primary and secondary insomnia. Primary insomnia occurs when a person suffers sleep problems that are not directly associated with any other health condition. On the other hand, secondary insomnia is a situation where a person experiences sleep problems because of an underlying problem such as a health condition or factor.

Insomnia can also be categorized based on how often it occurs and how long it lasts when it occurs; these are acute and chronic Insomnia. Acute Insomnia may or may not occur frequently but lasts for a short time while chronic Insomnia occurs more frequently and lasts for a long time. Additionally, acute insomnia can last from one night to a few weeks; it can also come and go with periods of no sleep problems. Chronic Insomnia, on the other hand lasts at least three nights a week for three months or longer. Treating Insomnia focuses on the reasons and factors underlying one’s inability to sleep well. Certain personal and lifestyle changes may relieve Insomnia. These include:

• Going to bed and waking up at the same time
• Avoiding caffeine, nicotine and alcohol use hours before bedtime
• Exercising regularly
• Avoiding prolonged use of phones or devices that give off light before bed,
• Making the bedroom comfortable
• Avoiding naps at daytime

Prescription drugs and counseling can also be used, however, it is important to note that medication doesn’t work as well over time as lifestyle and behavior changes do.

Anemia is the most common blood condition in the United States, affecting about 5.6% of the population. In Canada, approximately 3% of the population had anemia in 2015. People at higher risk of anemia include those with increased need for red blood cells such as young children, pregnant women and people with chronic diseases as well as people who suffer blood loss from internal bleeding, accident and menstruation. Common symptoms of anemia include fatigue, weakness, dizziness, drowsiness, irregular heartbeats, pale skin, cold and in severe cases, heart failure. There are various types of anemia but the most common types include:

Anemia is a medical condition marked by a lack of, or decrease in the number of red blood cells and hemoglobin. It is a disorder in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet the body’s daily physiologic needs. Red blood cells are produced in the bone marrow and their lifespan is about 120 days. They play an important role in human health by carrying fresh oxygen from the lungs to the rest of the body. Hemoglobin is the protein contained in the red blood cells that makes them red and binds or carries the oxygen. Red blood cells also remove carbon dioxide from the body, transporting it to the lungs for exhalation. When the body has abnormal or insufficient healthy red blood cells or hemoglobin, the cells and organs in the body will not get enough oxygen to function properly.

1. Iron-deficiency anemia: The body does not make sufficient red blood cells when the mineral, iron is lacking. Iron-deficiency anemia is the most common form of anemia and may be caused by low-iron diet, loss of blood, or inability to absorb enough iron from food.
2. Sickle cell anemia: This is an inherited form of anemia where the red blood cells are abnormally shaped. In this disease, the red blood cells are shaped like sickles or half-moons rather than the normal indented circles. This change in shape makes the cells get stuck and unable to move smoothly through blood vessels causing blockage in blood flow. This blockage may cause acute or chronic pain and can also lead to infection or organ damage. These sickle cells also die much faster than normal blood cells- in about 10 to 20 days instead of 120 days, causing a shortage of red blood cells.
3. Normocytic anemia: This type of anemia is caused by insufficient amount of red blood cells to meet the body’s needs. Diseases that cause this type of anemia are usually long-term conditions, like kidney disease, cancer, or rheumatoid arthritis.
4. Hemolytic anemia: This occurs when the red blood cells are destroyed by an abnormal process in the body before their lifespan is over. As a result, the body doesn’t have enough red blood cells to function, and the bone marrow cannot make enough to keep up with the body’s demand.
5. Fanconi anemia: This is a rare inherited disorder in which the bone marrow is unable to make enough of any of the components of blood, including red blood cells. Children born with this disorder often have serious birth defects because of the problems with their blood and may develop leukemia.
6. Aplastic anemia: This form of anemia occurs when there is a significant reduction in the number of stem cells or absence of these cells. Aplastic anemia can either be inherited or occur without any apparent cause. It can also occur when the bone marrow is injured by medications, radiation, chemotherapy, or infection.
7. Thalassemia: This occurs when red blood cells are unable to grow and mature properly. Thalassemia is an inherited condition typically affecting people of Mediterranean, African, Middle Eastern, and Southeast Asian descent. The condition varies in severity from mild to life-threatening, where the most severe form is called Cooley’s anemia.

Unfortunately, the genetic and inherited forms of anemia cannot be treated. However, iron-deficiency anemia, which is the most common type, can be prevented or treatable with high iron diet and iron supplements. The risk of iron-deficiency anemia can be reduced by choosing iron-rich foods such as red meat, pork, poultry, seafood, beans, dark green leafy vegetables, iron-fortified cereals, breads and pastas. Additionally, foods containing vitamin C such as citrus juice are important to enhance iron absorption.

Clinical depression is a global health issue characterized by complex mood disorders which results from various factors such as genetic predisposition, personality, gender, stress level and brain chemistry. Depression is a common but serious medical illness that negatively affects feelings, thoughts and actions. It is not merely a feeling of unhappiness or mood swings that can be gotten over, but a health issue that can be clinically diagnosed. Fortunately, it is also treatable. Depression leads to a lack of interest and loss of fulfillment in activities that an individual once enjoyed. It can also lead to a variety of emotional and physical problems which decrease a person’s ability to function both at work and home. Some forms of depression develop under specific circumstances, examples include:

• Seasonal affective disorder (SAD): This form of depression is caused by the weather and time of the year.
•  Postpartum depression: This occurs in women, following the birth of a child. Over 10 per cent of women will experience this type of depression.
• Persistent depressive disorder (Dysthymia): This is characterized by a constant moodiness with moderate symptoms of depression.

Symptoms of depression can vary from mild to severe and may include:

• Loss of appetite
• Weight gain or loss
• Insomnia
• Fatigue
• Difficulty concentrating or making decisions
• Suicidal thoughts
• Loss of interest in work and hobbies
• Withdrawal from family and friends
• Pessimism
• Low self-esteem
• Irritability
• Hallucinations or delusions

An estimated 6.7% of adults experience depression at some point in their life in any given year. Additionally, one in six people (16.6%) will experience depression at some time in their life. Depression is most common among teens, young adults in their mid-20s and women. Although there is no single cause of depression, some risk factors include:

• Family history of depression
• Psychological vulnerability to depression
• Biological factors such as imbalances in brain chemistry
• Stress level
• Personality and gender

There are no known laboratory tests for depression; however, health care professionals may carry out some tests to rule out conditions with similar symptoms. Questions about feelings, thoughts, behavior, history of mental health problems, physical health problems and routine activities are used determine whether a person may have depression so as to establish or make a diagnosis. Depression is among the most treatable of mental disorders. About 85% of people who suffer from depression eventually respond well to treatment and almost all patients gain some relief from their symptoms. Commonly used treatments are:

• Psychoeducation
• Psychotherapy
• Pharmacotherapy such as antidepressants
• Electroconvulsive therapy (ECT)
• Repetitive transcranial magnetic stimulation (rTMS)
• Magnetic seizure therapy (MST)

These treatments are used either individually or in a combination to increase their effectiveness. Clinical depression needs to be managed over the course of a person’s life to prevent recurrence. It can be effectively managed and controlled by combining a healthy lifestyle with regular treatments.

A healthy diet promotes growth and health at all stages of life- foetus, child, adult and old age. The role of nutrients and vitamins in fetal development and growth cannot be overemphasized. Eating a healthy, balanced diet in pregnancy is particularly helpful in supplying the necessary vitamins and minerals needed for baby formation and nutrition. In addition to a balanced, healthy diet, some vitamins are so important that they have to be supplemented by taking multivitamins to provide adequate amounts for the body. These extra vitamins also help to bridge any nutritional gaps in diet and should be started as early as possible to be effective. Understanding which nutrients are most needed as well as where to find them prepares expecting mothers and helps them optimize the health of their baby.

The first 28 days of foetal development represent one of the most crucial periods as the spine, spinal cord and brain begin to develop. Consequently, the essential prenatal vitamins must be taken in the required dose during this period to aid these developments.

There is actually no special formula for a healthy pregnancy diet; in fact, the basic principles of healthy eating remain binding and constant- fruits, vegetables, whole grains, lean protein and healthy fats. However, some nutrients and vitamins are needed in more doses than even a healthy, balanced diet can supply. In such cases, these vitamins deserve special attention and should be supplemented. They include:

1. Folate and folic acid: Folate is a B vitamin that helps prevent neural tube defects, birth defects, premature birth, serious abnormalities of the brain and spinal cord. Its synthetic form- folic acid is found in supplements and fortified foods. The recommended daily intake is 400 – 800 micrograms before conception and throughout pregnancy. Sources include fortified cereals, leafy green vegetables, citrus fruits and dried beans.
2. Calcium: Calcium is needed for strong bones and teeth. It also helps the circulatory, muscular and nervous systems run normally. Up to 1,000 milligrams are needed daily for pregnant women while pregnant teenagers need up to 1,300 milligrams. Sources include dairy products, fortified fruit juices, broccoli and kale.
3. Vitamin D: Vitamin D, like calcium also helps build foetal bones and teeth. About 600 international units (IU) are needed daily. Sources include fatty fish, such as salmon, and fortified milk and orange juice.
4. Protein: Protein is crucial for foetal growth throughout pregnancy. Recommended intake amount is 71 grams a day. Protein sources include Lean meat, poultry, fish, eggs, beans and peas, nuts, seeds and soy products.
5. Iron: The body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to tissues. Iron is needed to make more blood to supply oxygen to the growing baby. During pregnancy, the need for iron should be doubled because its deficiency causes anaemia, fatigue, premature birth, low birth weight and postpartum depression. About 27 milligrams is needed daily. Sources include lean red meat, poultry, fish, iron-fortified breakfast cereals, beans and vegetables.

Other prenatal vitamins include: Vitamin C, Vitamin E, Vitamin B₁₂, Iodine, Zinc, Niacin, Thiamine, and Riboflavin. It is important to consult a healthcare professional who would recommend the specific vitamins and in what doses they should be taken.

Substance misuse or addiction or drug dependence is a major public health problem worldwide. In 2012, a total of 2.8 million Canadians aged 15 and older reported symptoms consistent with major disorders and dependence on alcohol, cannabis or other drugs. Compared to other drugs (4.0%), Cannabis (6.8%) had the highest number of users in Canada. Addiction or dependence on drugs is a chronic, relapsing disorder that causes significant cost on individuals, families, businesses, communities, and nations. Individuals suffering addiction usually engage in destructive and criminal behavior.

Drug rehabilitation or drug rehab services are a collection of programs and services which involve the processes of medical or psychotherapeutic treatment for drug dependency or addiction. These drugs usually include psychoactive substances such as prescription drugs and street drugs such as cocaine, heroin or amphetamines. The overall aim of these services is to enable patients to confront their dependence on substances and discontinue use in order to improve their health, well being, quality of life and avoid the psychological, legal, financial, social, and physical consequences that result from drug abuse.

Treatment, interventions, programs and services can aid these individuals stop using addictive drugs and reduce the consequences of addictive drug use on the rest of society. They enable patients become abstinent and to improve functioning through sustained recovery by reducing drug use, improving the addict’s ability to function, and minimizing medical consequences. Various methods of treatment are used in drug rehabilitation including medication for depression, expert counseling, spiritual healing, focus groups and experience sharing.

Other treatment options include therapeutic communities, behavioral treatments, medications (e.g., methadone, levo-alph-acetyl-methadol (LAAM), or naltrexone for heroin addiction), outpatient drug free programs, hospitalization, psychiatric programs, twelve-step recovery programs, and treatment that combine two or more of these options. Providing treatment for chronic drug users is both compassionate public policy and a sound investment. For example, Drug Abuse Treatment Outcome Study (DATOS) in the United States found that outpatient methadone treatment reduced heroin use by 70 percent, cocaine use by 48 percent, and criminal activity by 57 percent. It also increased employment by 24 percent.