Drug addiction is a social evil, which affect more or less all the nations in this world, from richest nation to the poorest nation. Although the degree of the problem of drug addiction may vary from place to place as well as the drug to which individuals are addicted. In some place heroine may be the drug of addiction and in some other place it may be marijuana. But whatever may be the drug of addiction, the effect of drug addiction to the addict and family and society as a whole is mostly similar. Drug addiction disturbs the harmony and peace in any society and more to the family and friends of the addict.

It is essential to treat (de-addict) a drug addict appropriately, with care, so that drug addict can lead a life of dignity after de-addiction. It is important to treat the drug addiction with care as treatment of drug addiction is very different from other common ailments of body or health problems. A drug addict after successful de-addiction may become drug addict again if after treatment care is not taken care of with appropriate vocational rehabilitation and if drug addict is not counseled as required.

Narconon drug rehab is such a drug de-addiction program that provides their skilled drug de-addiction service across the United States as well as in other neighboring countries such as Canada and in Western Europe. You can get Narconon program wherever you are in United States, be it in California or be it in Hawaii. Narconon drug rehab program provide similar quality service in all its Narconon centers, wherever it may be located.

Narconon drug rehab program is a residential drug de-addiction program. The drug de-addiction method used at Narconon is unique and very successful. Although all the Narconon drug rehab centers are independent, the treatment (de-addiction) used for drug de-addiction is same in all the centers.

Narconon is a non profit non Government organization with the aim of eradicating drug addiction and drug abuse. The methods used mainly are educating people about ill effects drug addiction can cause to individual (drug addict) and society, rehabilitation after de-addiction and by prevention.

It is estimated that the number of drug addicts in United States alone is more than 22 millions. It is a huge task to treat (de-addiction) these drug addicts. Narconon has taken the task of drug addiction treatment and doing its job since it was established and will continue to do so.

If diarrhea continues for more than 4 weeks, it is considered as chronic diarrhea. Chronic diarrhea requires evaluation to rule out underlying pathology. Compared to causes of acute diarrhea, most of the causes of chronic diarrhea are noninfectious.

Principle of treatment of chronic diarrhea:

Treatment of chronic diarrhea depends on the specific cause of diarrhea and it is directed towards the cause of diarrhea, which may be curative, suppressive, or empirical. If the cause can be removed or eradicated, the treatment of chronic diarrhea is curative as with resection of a colorectal cancer, antibiotic administration for Whipple’s disease, or discontinuation of a drug (if any drug is the cause of chronic diarrhea).

For many chronic conditions, diarrhea can be controlled by suppression of the underlying mechanism which is causing the chronic diarrhea. Examples are elimination of dietary lactose for lactase deficiency or gluten (gluten free diet) for celiac sprue, use of glucocorticoids or other anti-inflammatory agents for idiopathic IBDs (inflammatory bowel diseases), adsorptive agents such as cholestyramine for ileal bile acid malabsorption etc. Other examples are use of proton pump inhibitors such as omeprazole for the gastric hypersecretion of gastrinomas, somatostatin analogues such as octreotide for malignant carcinoid syndrome, prostaglandin inhibitors such as indomethacin for medullary carcinoma of the thyroid, and pancreatic enzyme replacement if there is any pancreatic insufficiency.

But if the specific cause or mechanism of chronic diarrhea can not be pinpointed, empirical therapy may be beneficial. For example loperamide, is often helpful in mild or moderate watery diarrhea. For those with more severe diarrhea, codeine or tincture of opium may be beneficial. Such antimotility agents should be avoided with IBD, as there may be precipitation of toxic megacolon. Clonidine, an alpha-2 adrenergic agonist, may allow control of diabetic diarrhea.

General measures:

Fluid and electrolyte replacement is an important and essential component of management for all cases of chronic diarrhea. Replacement of fat-soluble vitamins may also be necessary in patients with chronic steatorrhea (lipids can not be absorbed or fat malabsorption).

Diarrhea is loosely defined as passage of abnormally liquid or unformed stools at an increased frequency and with a typical Western diet stool weight of more than 200 grams can be considered as diarrhea. 

Principle of treatment of acute diarrhea:

In acute diarrhea the most important part of treatment is the replacement of lost fluid and electrolytes. Fluid replacement should be gradual and over a period of time. In mild cases of acute diarrhea fluid replacement is all that may be required. Oral sugar-electrolyte solutions used in sports as drinks or designed formulations should be started promptly with severe diarrhea to limit dehydration, as severe ehydration is the major cause of death in severe diarrhea. If dehydration is very severe, especially infants and the elderly, require IV (intravenous) re-hydration for maintaining patients’ health.

If the dehydration is moderate as seen in non-febrile and non-bloody diarrhea, anti-motility and anti-secretory agents such as loperamide can be used. But drugs like loperamide should be avoided if the diarrhea patient is suffering from febrile dysentery, which may cause prolongation of diarrhea.

Role of antibiotics in acute diarrhea:

Use of antibiotics may sometimes reduce the severity and duration of diarrhea in some selected cases. Ciprofloxacin (500 mg twice a day for 3 to 5 days) is used by many doctors’ for treatment of severely ill patients with febrile dysentery empirically without diagnostic evaluation. If the cause of diarrhea is suspected to be due to giardiasis, metronidazole (250 mg 4 times a day for 7 days) can be used successfully. Antibiotic coverage has to be given whether or not a causative organism is discovered in patients who are immune deficient, have mechanical heart valves or recent vascular grafts, or are elderly.

Antibiotic prophylaxis should be given for certain patients traveling to high-risk countries in whom the likelihood or seriousness of acquired diarrhea would be especially high, including those with immunocompromise, IBD (inflammatory bowel disease e.g. ulcerative colitis), hemochromatosis, or gastric achlorhydria (absence of acid in stomach). For prophylaxis the use of trimethoprim/sulfamethoxazole (Bactrim), ciprofloxacin, or rifaximin (rifaximin not be suitable for invasive disease) may reduce bacterial diarrhea in such travelers by 90%. Finally, physicians should be vigilant to identify if an outbreak of diarrheal illness is occurring and to alert the public health authorities promptly, which may reduce the ultimate size of the diarrhea affected population.  

Drug addiction being an international problem which does not spare any nation should be adequately addressed and treated. For a successful drug addiction treatment the best approach is a holistic approach, which covers not only the medical and psychological aspects of the drug addict, but also covers the emotional and spiritual needs of the addict. For successful drug treatment or drug addiction treatment the role of psychiatrist is the most important as well as psychological counseling.  

The drug treatment of the addicts is not an easy task, as the addicts are usually not interested in getting good treatment and lead a drug free life. Many addicts can not even imagine a drug free life and to treat these drug addicts it is a gigantic task, which need coordinated approach of professional doctors, other technical staffs, supporting staffs, family members (of the addict) and friends of the drug addicts. The govt. help in addressing the social evil of drug addiction is very important. The help of former drug addicts is also very important to motivate the addicts and should be sought. Drug addiction is basically a social problem but the first step of management of the problem of drug addiction, is a medical management.

The drug addiction treatment is not complete without the drug rehabilitation. For drug rehabilitation, after successful drug treatment the govt., social workers play the most important role. Without good drug rehabilitation the rate of relapse of drug addiction (after successful treatment of drug addiction) may be very high. To reduce the relapse rate of drug addiction social activists and the govt. should play a major role with cooperation from the drug treatment centers.

Treatment of spasmodic dysmenorrhea can be following:

• Explanation of physiology of menstruation, sex education and reassurance to the patient are important aspects of management of spasmodic dysmenorrhea.
• Proper nutrition with balanced nutritious diet, regular physical activity (spasmodic dysmenorrhea is more common among women with sedentary lifestyle), and proper treatment of constipation and adaptation of healthy lifestyle are very much essential in the treatment of spasmodic dysmenorrhea.
• Initially spasmodic dysmenorrhea should be treated with simple analgesics (pain killers) like aspirin, paracetamol and codeine. Antispasmodics with atropine derivatives, Buscopan (hyoscine bromide), Baralgan etc. are also helpful. With any of the above a tranquillizer is beneficial.
• Prostaglandin synthetase (inhibit the actions of prostaglandins) inhibitors are successful in the treatment of spasmodic dysmenorrhea. Prostaglandin synthetase inhibitors reduce the activity of myometrium of uterus and reduce pain. The drugs are mefanamic acid (500 mg daily), flufenamic acid (200 mg daily), indomethacin (50 mg daily), and naproxen sodium (200 mg daily) etc. The side effects of these drugs are headache, GIT manifestations like vomiting, reduced menstruation, blurring of vision, acute renal problem etc. due to prolonged use.
• Endocrine treatment: oral contraceptive (steroids) pills can be of very good use in treatment of dysmenorrhea especially women who want contraception. The cure rate is very good, but the biggest disadvantage is the need of taking contraceptive pills for 21 days for the pain of few days (2 to 3 days) besides side effects and contraindications of oral pills.
• Danazol a drug which suppress hypothalamic-pituitary-ovarian axis is sometimes helpful in treatment of dysmenorrhea. 
• Surgical dilatation of cervix is also useful in treatment of dysmenorrhea. But the relief may be temporary and excessive and forcible dilatation may lead to complications like premature labor, habitual abortion due to cervical incompetence in subsequent pregnancies. This is therefore not recommended.
• Presacral sympathectomy is a surgical procedure that is reserved for patients for whom all other measures have failed. But this surgery does not guarantee benefits.
• Hysterectomy is reserved for the cases for patients there is also pathology pelvis like fibroids and those who have completed their family and do not want any more children.