Over -the Counter Painkillers

I thought people might be interested in this. I do get migraine headaches from time to time and often wondered whether I should just let the headaches run their course . Those who take painkillers know exactly what I am talking about. It's the amount and at the end of the day they all add up. Obviously one can get a variety of over the counter painkiller. Are we drugging ourselves to death?

Over-the-counter (OTC) drugs such as painkillers and cough mixtures can be bought anywhere by anyone. They come in tablet form, in capsule form, in syrup form and in powder form

No questions are asked by anyone and people who are addicted to OTC drugs can buy them in vast quantities from the same pharmacy or supermarket. Painkillers and cough mixtures that contain codeine, and to a lesser extent alcohol, seem to be the most commonly abused OTC medications, along with some of the appetite suppressants which contain stimulants. OTC medicines are usually cheap and this makes them doubly attractive.

Prescription drugs are generally a little more difficult to procure, as addicts need doctor’s prescriptions in order to get these. Some addicts have been known to use two or more doctors and pharmacists to feed their addictions, resorting to the devious behaviour which is characteristic of using drug addicts generally. Prescription drugs come in many different forms – usually tablets or capsules.

They are usually prescribed initially legitimately for existing medical conditions. Very often people overdose on prescribed medication and sometimes continue taking it after the condition for which it was prescribed is cleared. Sometimes the initial condition gets worse as a result of the drug abuse and people use increasingly large doses.

For example, the benzodiazepines (sleeping pills and tranquillisers) have rebound effects and after a while the user will experience the very symptoms of anxiety for which they were originally taken.

The most commonly abused prescription drugs are painkillers, sedatives or sleeping tablets and stimulants. The combination painkillers that contain paracetamol, codeine and caffeine seem to be very popular amongst people who abuse analgesics (painkillers).

Effects of medication abuse
Initially, medication serves a purpose, but it is in its continued or excessive use that problems arise. There are so many different types of medication that get abused that they cannot all be mentioned here.

One of the most famous is the date-rape drug Rohypnol that gets sold on the black market for large sums of money. This is available on prescription as a sleeping tablet, although in some countries its use is being legally restricted. However, there are many similar tranquillisers and sleeping pills that are abused widely, with serious consequences for the abuser and significant others.

Addiction to any substance means that some natural bodily function is suppressed or hampered. For instance, if something is taken which stimulates serotonin production, the body gradually loses its ability to produce serotonin without the stimulus of this drug. If laxatives are taken over a long period of time, the body’s ability to evacuate the bowels decreases without the help of a laxative. With tranquillisers the brain’s ability to produce its own relaxing chemicals becomes retarded.

Long-term addiction to any form of medication, whether over-the-counter or prescription drugs, can lead to liver and kidney damage, and in some cases heart and blood pressure problems. There are many other unpleasant side effects depending on which medication is abused.

Withdrawal symptoms
These can vary tremendously from vague irritability and a slight headache, to withdrawal from prescription medication such as Pethidene (an opiate like heroin and codeine) for which one has to be under medical care. From certain substances, the withdrawal can be every bit as traumatic as withdrawal from street drugs such as heroin. In fact, the withdrawal process from sleeping pills and tranquillisers (the benzodiazepines) is the most difficult out of all the drugs, and must be medically managed.

Anything with codeine in it or a benzodiazepine will have significant physical withdrawal symptoms.

Someone who takes a painkiller at breakfast, in case they might get a headache and two every night in order to sleep, is most probably using the medication to mask other non-physical problems. The denial that their medication abuse is problematic, is typical of all people who have a substance abuse problem, however small.

Most people do not want to admit that there is some underlying psychological cause to their addiction or that they are addicted at all. For them, the term ‘drug addict’ conjures up an image of someone injecting heroin in a public toilet, not of an old lady taking six painkillers a day.

Headaches are the most frequent symptom of withdrawal – even from substances such as caffeine. Ironically, frequent use of painkillers actually causes headaches, although it is not clear why. However, there is a long list of other withdrawal symptoms from analgesics and benzodiazepines, including disorientation, constipation or diarrhoea, hot and cold sweats, irritability and raised blood pressure.

Analgesics with codeine
Analgesics (painkillers) with codeine are often abused because of the pleasant, sleepy feeling that the medications elicit. Like morphine, codeine is derived from opium. People often use analgesics with codeine to relieve symptoms such as depression and anxiety.

When used in accordance with the warnings on the pack and your doctor's instructions, codeine should pose no risk. Taking too much codeine, however, or taking the medication over too long a period, may result in addiction and serious side effects including constipation, nausea, seizures and difficulty breathing.

Taking medications containing codeine along with other medications or alcohol can be very dangerous. If you are taking codeine, please consult with your doctor about what medications can safely be used with it.

Benzodiazepines
Benzodiazepines are a group of drugs acting on the central nervous system and is most often prescribed for the treatment of anxiety and amnesia. Valium may be the best known of the benzodiazepines. Many people become addicted to benzodiazepines.

Taking too large a dose or taking these drugs for too long may result in side effects like amnesia, irritability, confusion and increased aggression.

The danger with this group of drugs is that they are highly addictive and may cause severe withdrawal symptoms. These withdrawal symptoms may include anxiety, breathing difficulties, heart palpitations, memory problems, depression and ringing in the ears.

Appetite suppressants/stimulants
Stimulants are a class of drugs that increase brain activity – leading to an increase in alertness and attention, and mild feelings of euphoria due to increased dopamine or serotonin levels.

Stimulants are prescribed for narcolepsy, depression, ADHD and for short periods as an appetite suppressant. In the past, stimulants were prescribed for a much wider set of conditions, but an increased awareness of side effects and the potential for abuse has lead to stimulants being prescribed much less frequently.

Taking doses that are too high may lead to paranoia, feelings of hostility, seizures and an increase in cardiovascular risk. In addition, there is a risk of both physical and psychological addiction. The most commonly abused illegal stimulants such as crack-cocaine and crystal methamphetamine can cause serious cognitive difficulties and even permanent brain damage.

Check yourself!

Bad Parenting- Culture or Pure evil?

Well before I go ahead I have to put a disclaimer. My comments are based entirely on a survey carried out recently and I have written this unknown world from a friend's request. As a Christian I alos believe God protects us from evil. My friend claims to be having all the misfortunes that everyone could think of and she attributes this to the bad works of her father. The father and the mother are divorced and the father does not like to see the kids doing well for fear they would look after their mother only.(Talk about another Southern African attribute). The father spends all his money going after traditional medicine men  in his quest to bring misfortunes on his children. In a survey carried out in Zimbabwe however 95% of the respondents to the survey agreed they were aware of such forces.Some knew of people whose families were haunted by a jealous uncle or aunt who was then using Juju to make the life of the other family uncomfortable. Can JuJu ever be justified?

What is JuJu?

Juju is a West African magic charm or amulet or gri-gri (see below) used by a shaman, medicine man or witch doctor. Many objects may contain a magical juju spirit. Juju can be the fetish object itself, the magic power inside the object, or juju may be the tutelary spirits who superintend and wield juju, at the behest of the witch doctor.  Whichever way anything that has a potential of making other people suffer is evil. Would we not be better people if we were to live life freely?

 Talk about juju Africa is at the fore front.This might explain why these things -curses and bad spirits are not known in the same light in Europe as much as they are in Africa. Apparently good juju cures diseases of mind and body. Bad juju works to get revenge, to assuage jealous rage, or to bring bad fortune crashing down upon the fate and body of someone who has thwarted you in business, in love or cheated you at the marketplace. Bad juju can be used just to spite and make life miserable for others.That's purely a thing done by evil people.

When I was at University years ago,another friend of mine was always haunted by what she said was a family curse. It was very difficult to understand what she meant at the time.I thought she was deluded. A father doing what exactly? It was said he used his girls for juju. He gets to be rich while his children suffers.They were not to be married. No man will see them as women for as long as the father lived. None of the girls had boyfriends much as they wanted and the eldest was in her thirties.This to African standards in the 90s was abnormal. A woman should be by that time be married or at least in a relationship. They were told by prophets that their father was using them for his business and surely none of them are married. Coincidence or Truth?

For people from a different culture this might sound far fetched but to many African this sounds familiar. As a matter of fact, women have been known to do the same. Make the children suffer by using magic and curses. Who would do such a thing to their own child? Yes they do.

This Juju practice has a tendency of making people sick,misfortunes ad have financial problems only to mention a few. There seem to be a generation of parents who go after juju inorder to better themselves financially. They seem to do this at the expense of the younger generation who have no idea what their adults do behind closed doors.It is a spiritual war that is difficult to understand.

In the west we often associate spells and curses with books and not really a big issue. For Africa and some some parts of the world, these things are real and has led to men and women around the world suffer, some even to the extend of disowning their parents.

There is so many evil practices around the world but one attributed to a parent is the worst. I know of parents who had abused , raped their daughter and some even killing their children. Why should people like that be allowed to have kids in the first palce, one wonders.

Each culture has it's own evil practices but what exactly goes in the mind of a man or woman who harms his own flesh? Is it some pyschological disease or just pure evil?

To friends and anyone who finds this familiar, praying does help.

Fake World,Fake Britain?

My studying of varieties of Literature at the University of Zimbabwe left me very equiped mentally among other things for the world's stupid ways and attitude towards other people. The course was so robust nothing was left out-from African literature,the Carribean literature,African American to English Literature.  It feels so good because I was not restricted to one type of genre.It was our desire to know that kept us on top of the game.We read everything that was there to read - from ''Roots'' to Walter Rodney's ''How Europe underdeveloped Africa''. What I learnt is priceless and has made me the person I am today.

Some of the things I read were really intense and the truth be said, I am not a racist but what you got in Literature had the potential of making anybody angry but I learnt at the time that emotions do not help anybody but could create an undesirable hatred which might lead to racism The world I was brought in was so innocent. Born towards the end of the war of liberation in Zimbabwe, we were a generation that only read of what happens in other countries or watch on television which is different from those form other parts of Africa born in the middle of a war. I heard of Apartheid and because I was young, it did not mean a thing , all I know is it was evil. As read all thes with slave trade and books like ''Scotsboro boys'', ''Roots'', ''Heart of Darkness'' among many others I began to understand  what a piece of work man is. At first I did what everyone does, anger but I realise that whosoever think they are better than others are simply ignorant and selfish people who lack understanding of the true nature of life. Anger is a virus that can destroy so I don't let people who say or think like what  I am about to say anger me.I would not give them the chance to drag me that route. I think therefore I am,so does yellow or white people. I refuse to let anyone see or think of me as less than them.

Recently a very close friend sent this to me,

.....The fact that blacks look like human beings and act like human beings do not necessarily make them sensible human beings. Hedgehogs are not porcupines and lizards are not crocodiles simply because they look alike. If God wanted us to to be equal to the Blacks,he would have created us all of a uniform colour and intellect. But he created us  differently; Whites, Blacks,Yellow, Rulers and the ruled. Intellectually we are superior to the Blacks,that has been proven beyond any reasonable doubt over the years........By now every one of us has seen it practically that the blcks cannot rule themselves. Give them guns they kill each other.They are good in nothing else but making noise,dancing,marrying many wives and indulging in sex. Let us all accept that the black man is the symbol of poverty, mental inferiority , laziness and emotional incomptence

.......And here is a creature ( black man ) that lacks fore sight...

This was a speech made by P.W Botha in 1985. What a speech! Besides being racist which is obvious,  this speech was poisonous and evil. It goes to show you how fake people are. To actually justify apartheid and any form of racism like that is utter stupidity. Unfortunately even in 2012 there are peole who think like Botha but try to hide it by pretending to be politicall correct. Much as they don't say things like that in speeches ,they do say and show it in their actions. I have been in England for seven years and I see it everyday. Those who do it don't say it directly but try to say because they laugh or talk to Black people they there fore are not racist.

Even with dancing and having more wives,is  not there no intelligence in that? Even the athletes like Jessie Owens and Bolt, is there no intelligence in what they do? Was there no intelligence in Muhamad Ali,the great in the fights he won?

Don't get me wrong, racism is both ways but that of some of the white skinned is far more insulting as it inevitably reminds one of slave trade and the segregation of South Africa and even the States.

Call me crazy,I had to say something because this speech reminded me how far we have come and how much far we still have to learn as human beings. John Terry, England, Chelsea player is facing charges for racially insulting another player. His defence -he was provoked. Do you say  racist things when you are provoked or it is something one keeps in the subconcious? Is it not like saying bad things to a friend when you are drunk and then hide by saying it was the drink talking? What has been his attitude to black people all along?
Racism is racism whether one has been provoked or not. Legislation in the UK has not changed anything. People do fake it. In work places minority groups especially blacks and Asians are still not getting enough opportunities. Even in offices you hear comments.

Yet people pretend and will still pretend.

To be continued.....

Epilepsy

Years ago I had a friend who was 20 years older than me. She was a nurse at one of the local hospitals in Botswana . We talked and laughed but I did not know she suffered from seizures.My brother was visiting and my friend promised to drop in to meet my brother. When my brother arrived my friend was so excited she wanted to get into my brother's 4x4 car. All of a sudden she could not move down or up and fell. She started foaming and while my brother and I were trying to see what was happening,she urinated herself. I did not know what to do. I called her several times and she seemed not to know her name.I had no idea she had epilepsy and after a few minutes she finally came to and was all shy. In the end she had to go home. What I realised at the time is there is stigma associtaed with the disease that most people do not want anyone else knowing except close ones. In Africa some people see it as a family curse. And yet it's not. It should not be like that.

What is Epilepsy

Epilepsy is a neurological disorder characterised by seizures, or "electrical storms" in the brain. In different patients these may range from dramatic convulsive seizures, to "absence" seizures that take the form of brief lapses in awarenes

Causes

A seizure is best thought of as an uncontrolled, abnormal burst of electrical and chemical activity that spreads rapidly between nerve cells (millions upon millions of them) in the brain. A seizure may start in one region of the brain (the "focus") and spread to other parts. The first symptoms of a seizure, referred to as the "aura" (often a strange sensation or smell) reflect the function of that part of the brain first affected by the epileptic activity. A seizure that initially causes only twitching of one hand and then goes on to convulsions with loss of consciousness, for example, reflects seizure activity that starts in the front part of one hemisphere and then spreads to involve widespread areas on both sides of the brain.

Seizures are a feature of a variety of states of ill-health, and have many differing causes. Seizures may be the only manifestation of disease, may be caused by a specific brain disorder, or are seen as part of a more generalised bodily illness.

Primary epilepsy refers to seizures, often seen in children and teenagers, where the brain is abnormally prone to seizure activity, probably due to an inherited tendency. Secondary seizures, on the other hand, are typically due to spread from a seizure focus (a scar). Finally, isolated seizures may be related to an underlying transient medical condition, and will stop as soon as the underlying condition is effectively treated; examples would include organ failure (liver or kidney failure), infections such as meningitis, head injury, brain surgery, drug and alcohol abuse.

In all forms of epilepsy, stress, sleep deprivation, a change in diet or medication, alcohol, certain specific activities, and menstruation and pregnancy in women may precipitate individual seizures.

Symptoms and signs

Epileptic seizures are generally brief (usually seconds to minutes), often dramatic episodes that usually alter awareness, and may cause complete loss of consciousness. In such a circumstance, the person experiencing the seizure will have an incomplete recollection, or none at all of the event itself, and onlookers will need to provide a description of what happened to health personnel. The initial symptoms (e.g. sudden loss of consciousness, involuntary twitching of a limb or a strange feeling or sensation) are often the most helpful in categorising a particular seizure.

Furthermore, because awareness can be lost very rapidly, and in some cases without warning, those prone to seizures need to be very circumspect about certain activities. Seizing while driving, swimming, bathing alone or using machinery, for example, has the potential for harm to self or others. Most seizures are self-limited, and not life-threatening in themselves. Occasionally, seizures do not stop, a situation known as status epilepticus. This is a medical emergency, has a high mortality, and requires immediate medical attention. Other possible complications of epilepsy are discussed below.

There are several different types of seizure. Classification is important because different seizures have differing underlying causes, and often respond to specific medications:

Partial (focal) seizures

Partial(focal) seizures involve epileptic activity in a restricted region of the brain and do not cause loss of consciousness, until they spread to other regions of the brain.

A partial seizure that develops into a generalised seizure is referred to as a secondarily generalised seizure, at which point convulsions and loss of consciousness occur.

The most frequent type of partial seizure is the so-called complex-partial seizure. This is often called a temporal lobe seizure, since the temporal lobe is the commonest site for these seizures to arise. However, complex partial seizures can arise from any part of the brain. Patients typically experience a strange feeling or odd smell (the aura) followed soon afterwards by an alteration of consciousness. This causes mental clouding and a "spaced out" manner. In general, patients will not respond to commands and may manifest unusual behaviors such as picking at their clothing, smacking their lips or wandering in a purposeless manner. Unconsciousness, convulsions and collapse do not occur.

A less common type of partial seizure is the simple partial seizure. Here, seizure activity is restricted to a region of the brain that controls movement or receives sensation, producing restricted jerking of a limb (simple motor seizure), or an abnormal feeling. Occasionally, persistent weakness of the limbs may follow such a seizure. The person remains conscious and aware of his or her surroundings, and is able to communicate with others.

Generalised seizures

Generalised seizures are those that cause loss of consciousness, and imply widespread involvement of both hemispheres of the brain. However, the term is confusing: "generalised" refers to the fact that there is a widely distributed change on EEG. Many generalised seizures do not cause loss of consciousness.

Generalised tonic-clonic seizures, previously termed "grand mal" seizures, are the most dramatic and frightening kind of seizure. Sudden collapse with loss of consciousness is followed by muscle spasm ("tonic") and violent jerking ("clonic") of the limbs that builds to a climax and then subsides and stops on its own after several minutes. The involuntary contraction of muscles can cause tongue biting, temporary arrest of breathing, and incontinence. Injury may occur in falling to the ground and as a result of the violent movements of the limbs. Exhaustion, muscle aches and headache are common for several hours after the seizure has settled, in the so-called "post-ictal" period.

Absence seizures ("petit mal") also involve loss of consciousness, and as such are also generalised seizures, but are quite distinct from tonic-clonic convulsions. Seen most frequently in children, absences involve very brief periods (seconds) of "blanking out" that may occur many times a day, and are often put down to daydreaming. These staring spells briefly interrupt whatever the child is doing and may be associated with fidgeting or picking at clothes (automatisms). The child and his or her family may be quite unaware of anything unusual, and absence seizures frequently only come to light when schoolwork suffers.

Other varieties of generalised seizure may involve sudden loss of muscle tone with collapse or large-scale jerks of the whole body, but these are rare.

Diagnosis

Obtaining a clear description of the seizure either from the patient themselves, or more often from reliable eyewitnesses, is the initial and most important step in diagnosing an epileptic seizure. The physician needs to recognise features that suggest a seizure and distinguish it from other kinds of brief neurological events. These include TIAs (transient ischaemic attacks – "mini-strokes"), fainting spells, behavioral problems and a range of involuntary movements. Seizures are characterised by the presence of an aura, rhythmical jerking, alteration or loss of consciousness, and a post-ictal period of recovery. A careful history may also provide clues to finding a cause for seizures, such as a head injury or alcohol or drug addiction.

Usually patients have no signs of epilepsy or ill-health between seizures, and a physical examination may be quite normal. In some patients, signs of neurological disease may point towards a cause for the seizures.

An electroencephalogram (EEG) is a recording of the brain's electrical activity as measured by electrodes placed on the outside of the scalp. A recording made during the normal interval between seizures in an epileptic often reveals a seizure "signature" – spiky waves on the smooth, regular background pattern of normal brain waves – and can provide important information about the type and location of the seizure. A normal EEG does not rule out the diagnosis of epilepsy, however. During a seizure, abnormal activity tends to be clearly evident on the EEG recording. Certain patients may be admitted to an epilepsy unit for long-term monitoring. Here, a video recording of the patient asleep and awake and an EEG tracing are obtained over many hours, and the two can be compared side by side.

Other investigations, including various blood tests, and CT or MRI scans of the brain help to determine a cause, and are often obtained as part of the workup of a first seizure.

Treatment

Many seizures are the direct result of an underlying brain or bodily disorder. In such a case, treatment of the underlying condition will often be sufficient to prevent seizures from recurring, and the seizures themselves will need no specific management. In general, seizures that have only occurred once are not treated unless they recur. Once seizures are recurrent, specific anti-epileptic medication will generally be needed. Some epileptics will only have seizures in certain settings, or find that their seizures are reliably provoked by specific triggers. Alcohol use and sleep deprivation are frequently responsible.

There has recently been an explosion of new drugs for treating epilepsy. These new-generation medications may be better tolerated and are all considerably more expensive than the older medications, which remain the mainstay of treatment. Examples of widely-used established medications are Carbamazepine, Phenytoin, Phenobarbital, Valproic acid and Ethosuximide. Examples of newer medications are Levetiracetam, Lamotrigine, Topiratmate and Gabapentin. All anti-epileptic drugs have side effects, and currently, no particular drug is clearly more effective than another. Choosing the best agent is a complex task best done by a neurologist with a special interest in epilepsy. The choice will rest on the type of seizure, as well as the efficacy of the medication and how well it is tolerated by the individual patient. Most patients are rendered seizure-free with the use of a single medication, or, if necessary, medications in various combinations.

Follow-up should occur at least annually. Monitoring drug levels in the blood is important for continued control of seizures and reduction of side-effects, but is often unnecessary with newer agents. Illness, pregnancy, sleep deprivation, skipping medication doses and using drugs, alcohol or certain medications may cause seizures in someone with previously well-controlled epilepsy. People with epilepsy should wear Medic-Alert bracelets, and family members should be instructed in how to assist during a seizure.

The last decade has seen the development of effective surgery for seizures of certain kinds. In general, surgery is reserved for patients with a seizure focus that can be precisely identified, and who have failed drug therapy. Workup for surgery is complex, but when successful, surgery may render patients seizure-free without having to use medications. Other modalities of treatment, such as the vagal nerve stimulator, are also used in specific cases, although results with vagal nerve stimulators are disappointing.

Emergency first-aid treatment for a convulsive seizure

• Protect the person from injury. Clear the area of furniture or other objects that may cause injury. Cradle the head with a pillow if it is on a hard surface, but don't restrain the person's movements.
• Turn the person onto one side with the head down. This allows drainage of saliva and prevents inhalation of vomit.
• The vast majority of seizures will end spontaneously after a minute or two, and no specific treatment is necessary. When seizures continue, or consciousness is not regained between seizures, status epilepticus is diagnosed and requires urgent management that may be started by the emergency medical service, but is best performed in a hospital.

Outcome

Although epilepsy tends to be a lifelong condition, effective management is available for most, allowing a seizure-free, productive life. Most occupations and recreational activities are open to people with controlled epilepsy, and most countries allow driving after a seizure-free period of 6-12 months (on or off medication).

Complications of seizures can occur in many forms. Although seizures themselves tend to be self-limiting, the consequences of abruptly losing contact with the environment can be dangerous. These include: accidents while driving, bathing, swimming or using machinery; injuries sustained from falling or trauma to flailing limbs; and aspiration of vomit, leading to choking or aspiration pneumonia.

Status epilepticus refers to seizures that do not stop, or are so close together that consciousness is not regained. In this serious circumstance, respiratory and metabolic failure occurs, and mortality is high, even with intensive care treatment.

Even when seizures do not directly threaten life or limb, the condition can be damaging. If absence seizures are not recognized in children, these brief interruptions of attention throughout the day can lead to learning disability. Older children and adults may find the prospect of seizures so socially embarrassing or frightening that they withdraw from the world. Explanation of the condition, the broader education of the public, and contact with other people affected by seizures can do much to alleviate this.

Lastly, all anti-epileptic drugs have side-effects, and in an individual patient this often governs the choice of agent. Most of these side-effects are reversible and simply represent individual intolerance to a particular medication or excessively high dose. Rarely, side-effects can be unpredictable and serious. Pregnant women need especially careful choice of medication, and younger women who may fall pregnant need effective contraceptive advice. All women who are considering falling pregnant should take supplements of folic acid.

Prevention

If seizures occur as the result of an underlying disease of the brain (e.g. a tumour) or the body (e.g. kidney failure), treatment of these primary conditions can prevent seizures from occurring, and anti-epileptic medication may become unnecessary. In other circumstances, drug treatment or surgery for epilepsy can prevent seizures from recurring. Occasionally, drug therapy is prescribed prophylactically – as is the case after brain surgery, where a short course of anti-epileptic medication is often prescribed routinely to all patients, even those with no history of seizures.

In established epilepsy, avoiding changes in routine, disturbed sleep, drugs and alcohol, and (in a minority of patients) certain situations or activities known to promote seizures, are other practical forms of prevention.

People suffering from seizures are still stigmatised and suffer from discrimination which is bad.

Substance Abuse-21st Century Curse?

Substance Abuse

When I was growing people often talked about drug abuse and addicts and I was curious. Luckily none of my family members were into drug/ substance abuse. For me druggies only existed in films until the day I went to University. I was coming from the city with my friend when on our way a group of street kids were lying unconscious with their face dark from the stuff they were inhaling. Most were lying with eyes dilating and others were just still. I had never seen anything like it. If they were dead I thought, what could have killed them. Immediately we called the police and within minutes the ambulance arrived. To quench my curiosity, I asked what had happened. The police informed us the young fools had been sniffing glue and other substances. I could not believe it because as far as I was concerned at the time, glue was glue surely and could never be used for that purpose. I decided at the point to look into what else people were doing to destroy or shorten their lives. Since then in Zimbabwe, Botswana and South Africa where I have been, I have always seen people taking dangerous substances. These substances ranged from marijuana the very cheapest- glue and this does not come without a price to pay. Most of these youngsters stopped going to school, some even got stabbed to death for stepping on other people’s toes or even stealing. I thought I would start looking at the very cheap drugs ones used by the common people.

Inhalants

 Appearance

Inhalants come in many different forms – from glue to petrol to laughing gas and poppers.

Inhalants in Southern Africa
Glue is the most commonly abused inhalant in Southern Africa and glue-sniffing is prevalent amongst many young children, many of whom live on the street. The use of inhalants is common amongst children from disadvantaged backgrounds worldwide.

Many people do not see inhalants as drugs, because they are freely available in the home or workplace and they have other uses. These inhalants are breathable chemical vapors that can cause mind-altering effects.

These inhalants are usually volatile solvents. Inhalants are popular among children because they are cheap, readily available, require no special equipment to use, and they take effect quickly and wear off quickly. If you are living on the streets, you need to have your wits about you and cannot afford to be under the weather for protracted periods of time.

The different categories of inhalants:

·         Solvents – household or industrial, such as paint thinners and different types of glue

• Art or office supply solvents – correction fluids, felt-tip marker fluid.
• Gases – these are used in many products including lighters or refrigeration gases.
• Aerosol propellants – spray paints, hair or deodorant sprays.
• Medical anaesthetic gases – ether chloroform and laughing gas.
• Amyl nitrate –poppers

How they are used
Inhalants are breathed in through the nose or the mouth. Often a paper or plastic bag is attached to the substance being inhaled. This concentrates whatever substance is being inhaled.

·         Its effects
Most inhalants produce a feeling of temporary contentment, pleasure and detachment.

·         But sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death.

·         High concentrations of inhalants also cause death from suffocation by displacing oxygen in the lungs and then in the central nervous system so that breathing ceases.

·         Glue, correction fluids and paint spray inhalation can lead to hearing loss. Glue, gas cylinder and petrol inhalation can result in muscle spasms. Glue and paint sprays can lead to central nervous system and brain damage and petrol inhalation can cause bone marrow damage.

·         Long term effects
These can be very serious and include liver and kidney damage, blood oxygen depletion, suffocation, heart failure and sudden death.

·         It also appears that people who are HIV positive develop Karposi’s sarcoma, the most common cancer amongst AIDS patients, more frequently if they have taken poppers previously.

Withdrawal symptoms

Inhalant users suffer a high rate of relapse, and require thirty to forty days or more of detoxification. Users suffer withdrawal symptoms, including hallucinations, nausea, excessive sweating, hand tremors, muscle cramps, headaches, chills and delirium tremens.

Cheap as they are, inhalants are bad for one’s health and must be avoided. If you are affected seek help before it’s too late. The combination of poverty and substance abuse does nothing but make the situation worse.

Comments On Autism

I thought I would comment on Autism. The reason being,it's often a condition associated with stigma. A friend had an autistic daughter but not knowing what it was led to all sorts of accusations among them witchcraft. To know is to be equiped. There is life after autism.

Autism

Autism is a complex developmental disorder traditionally defined by a core triad of impairments, relating to communication, socialisation and behaviour. Children who are affected have communication and socialization difficulties, as well as restricted and repetitive interests and behaviours. It is important to note that all children with autism also have sensory dysfunction.

Alternative names

• Autistic disorder
• Asperger syndrome
• Pervasive developmental disorders (PDD)
• Unspecified, but collectively referred to as Autism Spectrum Disorders (ASDs)

Definition and causes

Autism is a behaviourally defined developmental disorder which appears to be caused in early development by the impact of the environment on a genetic predisposition. Autism is treatable, and early medical/biomedical and behavioural/therapeutic intervention greatly improves the outcomes of children with ASDs. Usually diagnosed before the age of three, a pattern of initial seemingly normal development, followed by a regression or loss of skills around 18 months, is common.

Very few children with autism have a history of autism in their families. A widely accepted hypothesis is that there is no one particular cause for autism, but rather a genetic predisposition to many things, including depression, alcoholism, OCD, etc. These genes interact with the environment, which may include metals, viruses, antibiotics, toxins and other factors, which result in insult or injury to the gut/brain axis.

Who gets it and who is at risk?

The prevalence of autism is currently one in 86 children. Typically it affects more boys than girls and knows no socio-economic or ethnic boundaries. Twin studies show a concordance of more than 80% in identical twins and a rate of 38% in fraternal twins, similar to that of normal siblings.

At present there is no laboratory test that can detect the presence of autism. It is essentially a diagnosis made through clinical observation by trained professionals, unlike most of the following co-existing disorders.

Autistic Spectrum disorder can co-exist with other well-known disorders such as:

Congenital rubella syndrome: an infectious disease acquired from the mother during pregnancy

Down Syndrome

Neurofibromatosis: a condition in which there are tumours of the nervous tissue

Tuberous sclerosis: an inherited disease of the nervous system and skin

Fragile X syndrome: an abnormality of the X-chromosome that can cause mental deficiency

Phenylketonuria (PKU): an inherited metabolic disorder

ASD can however exist with any disorder. Common eo-morbidity also includes:

Anxiety Disorder

Obsessive Compulsive Disorder and Attention Deficit Disorder

Childhood Disintegrative Disorder: where autistic symptoms develop after the age of three

Rett’s Disorder: presents primarily in girls, can be detected by a blood test and is characterized by a deceleration in head growth and loss of purposeful hand skills and mobility. (The girls however almost always prefer people to objects.)

Checklist for early warning signs of ASD in young children

Early diagnosis and identification of a child at risk is of the utmost importance. To do this, we need to evaluate the emotional and social coordination/regulation in a young child, along with regular developmental assessments done by a paediatrician. In a very young child we need to be aware of behaviours that are NOT present.

Question Test:

• Does the child respond consistently to the calling of his/her name? Call the child by name, without giving any instruction, while he/she is engaged in an activity. Do this twice during the consultation to determine consistency. A response would be indicated if the child looks towards the caller. Note: the calling must be done by a stranger, and not a parent, to ensure that the response is to his/her name and not to the recognition of a familiar voice.
• Does the child show shared attention and read gestures? Point to an object across the room, and observe whether the child follows your gesture, e.g. point to a toy while saying, “Look at that [toy] on the bookshelf.” Ask the child to point to something other than an object they may find desirable, e.g. “Show me your nose”, or “Where’s the light?” The child should be able to do both.
• Does the child show expectation/anticipation during brief pauses in play? Play a peek-a-boo-type game with the child (e.g. hide your face, reappear unexpectedly and then repeat this action). The child should show facial signs of anticipation.
• Does the child reference the parent’s face for reassurance? Pick the child up during the consultation and observe his/her reaction. The child should look at the parent for help/reassurance.
• Does the child exhibit basic imitation skills? Say, “try this” and then perform a basic action, such as clapping your hands or putting your hands on your head. The child should attempt to copy your actions immediately.
• Can the child answer social questions? Ask the child social questions such as “What is your name?” or “How old are you?” The response should not be reliant on verbal ability, but can include a show of fingers or a partial verbal response. If the child is unable to give a positive response to at least five of these questions, further investigation by a professional trained to diagnose ASD, such as a psychologist or psychiatrist, is necessary. Averted gaze, absence of a social smile, resistance to social engagement, sensory problems (which may be indicated by fussy eating, sensitivity to noise, arching of the body and difficulties with potty training), and language delays are further indications of an increased risk of ASD.  

Signs and symptoms

In an older child we become increasingly aware of symptoms, and soon we are able to observe which behaviours ARE present!

Symptoms are varied amongst children and may include:

Social skills

• Seeming lack of attachment to parents or other family members. The child seems to prefer to play alone and has an aloof manner.
• Demonstrates inappropriate social interaction or withdrawal and fails to form normal relationships.
• Apparent lack of awareness of, or indifference to other people’s feelings
• Lack of awareness of boundaries, and often lack of response to being reprimanded (over time)

Language and Communication

• A young child with autism may appear to be deaf and parents often have the child’s hearing tested.
• The child often skips the babbling stage, and starts to speak later than other children of the same age, or doesn’t develop speech at all. A young child will pull one by the hand to get a desired object, instead of using verbal communication.
• The child has no use or understanding of non-verbal communication and gestures, e.g. does not wave ‘bye bye’.
• The child often uses repetitive sounds, and if speech develops, it might be immature or unusual like combining single words into a giant word like “areyouhungry”.
• He/she could lose a previously existing ability to utter words or sentences.
• The child’s rate, pitch, tone or rhythm of speech is abnormal; he/she may use a sing-song or monotonous voice.
• He/she finds it difficult to initiate or maintain a conversation.
• He/she can't understand or imitate speech or gestures.
• He/she responds inappropriately to sounds (covers ears).
• There may be meaningless repetition of words or phrases. The child may echo what someone says, or often scripts from a TV programme, or someone else’s speech (echolalia).
• In a verbal child there might be pronoun reversal.
• The child could present with apraxia (inability to plan words – absence of speech).

Behaviour/Sensory

• Performs bizarre or repetitive movements such as rocking, hand twisting, finger twiddling, head banging, arm flapping, walking on tip-toe, staring.
• Develops specific compulsive routines or rituals.
• Becomes distressed or enraged by minor changes in the environment or in disruption of routines or rituals.
• Engages in self-destructive behaviour, such as head-banging or biting.
• Hyperactivity or lethargy
• Preoccupation with or attachment to objects or one object; may become fascinated by unusual objects or parts of an object, such as the spinning wheels of a toy car.
• Screaming fits
• Unable to engage in fantasy or imaginative play such as role-playing and storytelling
• Resists being held and cuddled; may scream to be put down; may have to be HELD on the hip (back arching off slightly). Over or under-reaction to sensory stimuli.
• He/she might respond inappropriately in situations, e.g. laugh when scolded or hurt.
• Over or under-reaction to sensory stimuli, including avoidance of certain foods, dislike of haircuts or nail cutting, high pain threshold, eat normally non edible substances, etc.

Other commonly noted symptoms:

• Inappropriate laughter (often at night)
• Night time waking
• Slurred articulation
• Unstable gait
• Low muscle tone
• Fixed or averted gaze
• Dilated pupils

It is interesting to note the following things many of these children have in common:

• A love for vehicular toys
• Removing DVD covers from DVD boxes
• Running off in one direction on the beach
• A dislike of shopping centres and the need to be “trolley bound”
• Rewinding favourite parts of their favourite movies for hours and preferring the credits to the actual movie (often resisting a new movie)
• No delay in motor milestones. They are generally quite agile.
• A “very good memory”

Treatment

Autism is treatable by means of a synergistic or multi-disciplinary, child specific approach.

Therapies:

Autism specific therapies might include Applied Behaviour Analysis, Relationship Development Intervention, Floortime (DIR), TEACCH, Son-Rise and others. It is of the utmost importance that a child-specific approach is used and child-specific deficits addressed.

A rehabilitation programme will usually include:

• Occupational Therapy (sensory integration)
• Speech Therapy

Other: Auditory Integration Training, Listening Programmes, Primal Reflex Therapy, HANDLE therapy, Braingym, etc.