Mental Health Pakistan & Disability Justice Pakistan (2026)

25/02/2015

Is Alcohol Abuse in the Workplace Common!!!
Alcoholism in the workplace is more common than you may think. Alcoholics hide their alcohol use well, and their drinking problems in the work place may or may not be obvious. The signs are there, but they may be subtle. Alcoholism in the work place does not benefit anyone and preventing it will increase production and morale.

Alcoholics in the workplace are more likely to get injured on the job than those who are sober. Alcohol decreases awareness and alcoholics in the workplace are dangerous to themselves and their coworkers. In an emergency room study, thirty-five percent of patients with an occupational related injury were alcoholics or at risk of being alcoholics.

Alcoholics are generally problem prone in the workplace as well. Because alcohol clouds judgment, alcoholics will make more mistakes in their work and cause more upsets with clients. Alcoholics are generally not careful and do not pay attention to details when it comes to work.

Alcoholics are known to be late frequently and lazy on the job. Alcohol causes one to pass out and sleep deeply through alarms and morning wake up calls. Hangovers cause one to move slowly and be less aware of what is going on around oneself, causing alcoholics to be less efficient than sober coworkers.

Alcohol also causes people to be more irritable and prone to violence. Employees who are alcoholics have more disciplinary problems and have a higher likelihood of having trouble with coworkers and supervisors. Alcoholics also tend to be high turnover employees who cannot keep a job for a long period of time. This is largely due to their attitudes and performance in the workplace which is subpar because of their alcoholism.

Preventing Alcoholism in the Workplace!!!
Alcohol has become common at work lunches, dinners and parties. Celebrating statistical improvements or financial gains is often commemorated with alcohol. However, it is unprofessional for employees to be intoxicated in the workplace. Mixing alcohol and work can be unprofessional and awkward.

Increasing awareness of the dangers of alcohol in the workplace (and in general) will decrease the number of alcohol related deaths and increase productivity in the workplace. April is Alcohol Awareness Month. It is meant to raise awareness in the workplace and encourage people everywhere to learn more about alcohol abuse and its consequences.

Alcohol and Youngsters!!!
Alcohol is the number one drug of choice for youngsters, and alcohol is more likely to kill people than all illegal drugs combined. Drinking often begins at a young age despite legal restrictions. Every day, an average of seven thousand young people take their first drink under the age of sixteen.

Preventing alcohol abuse in young people could largely prevent alcohol addiction later in life. Children tend to copy their parent’s actions. Parents who drink regularly around their children are more likely to have children who use and abuse alcohol before they are over the age of twenty-one.

Also, more than seventeen hundred college students are killed every year because of alcohol use. That is nearly five college students who die per day because of alcohol. These students are lacking the knowledge and awareness needed to prevent drinking large quantities of alcohol.

Drinking excessively in the workplace often starts in college. Those who graduate and go into the workplace with a drinking problem are likely to slow down productivity. By increasing awareness on alcohol addiction and the risks involved, everyone will be able to live happier and more productive lives.

25/02/2015

Alcohol Leads From Depression To Su***de!!!
There is important news out of Berlin from the European College of Neuropharmacology and it has to do with a concerning but not unexpected link between alcoholism, depression and su***de.

Essentially the research confirms the fact that an underlying mood disorder often leads to suicidal behavior but the su***de attempt – especially when it is unplanned and impulsive – is driven by alcohol.

What the report is saying is that there is a difference between suicidal thoughts and the act. Alcohol dependence has little or no relationship with the ideas but when a person is suffering from severe depression it can lead to a person carrying out the su***de.

17/02/2015

Tuition fee increase has had little effect on students’ mental health!!!
New research has found no evidence of a long term impact on students’ mental health as a result of the rise in tuition fees, introduced in 2011. The study did find students paying the higher fees were less likely to experience an improvement in their state of mind during their first year of university, but that the increase had no longer term impact on their mental well-being.

New research led by the Trust has found no evidence of a long term impact on students’ mental health as a result of the rise in tuition fees, introduced in 2011.

The study did find students paying the higher fees were less likely to experience an improvement in their state of mind during their first year of university, but that the increase had no longer term impact on their mental well-being.

“Previous studies have found a relationship between financial difficulties, levels of debt and poor mental health in students,”

“This study suggests it may be the ability to pay the bills, rather than the size of the student loan itself, that is important to well-being while at university.”

In an unexpected outcome of the study, those paying lower fees showed greater symptoms of alcohol dependence. The authors speculate that this could be due to a higher level of disposable income to spend on alcohol.

Nearly 400 undergraduate students from universities completed surveys to assess levels of stress, depression, anxiety and other mental health issues during their first two years of study.

Three different groups of students took part in the study: those paying Rs. 3,000/= to Rs. 4,000/=, before the introduction of higher fees.

Surveys were completed online on four occasions, three to four months apart, and spanning students’ first and second academic year at university.

The first survey showed no significant differences between the various groups. Differences became apparent at the second time of study, with those charged lower fees showing an improvement in anxiety, depression, stress and general mental health over time, while those charged more showed no improvement.

However by the third and fourth tests, the trend of worse mental health for those charged Rs. 8,000 to Rs. 9,000 had reversed, so there were no longer any differences between the groups based on fees.

Many students charged fees of Rs. 9,000 will be graduating later this year. "At present the tuition fees increase does not appear to have had a major impact on the mental health of undergraduates.

However differences between those charged higher fees may not become apparent for many years and so ongoing monitoring of the prevalence of mental health problems in students and their relationship with debt is needed.”

15/02/2015

Depression: A barrier to communication in couples?
A massive 6.7% of the population are affected by depressive disorders. As well as pessimism, irritability, pain and exhaustion, depression is also proven to affect communication and ability to maintain relationships. A new article explores depression and relational uncertainty within couples and the causal effect on communication behaviors.

Depressed individuals are known to withdraw from negativity or social challenge. Speculated motivations for avoidance include feelings of futility and inhibition; use as an emotional coping strategy; wish to preserve the relationship; and fear of conflict.

This behavior is detrimental to relationships causing lack of problem resolution, missed bonding opportunities, lack of closeness and questions over commitment.

Uncertainty amongst depressed couples as a catalyst to communication barriers. Uncertainty about the future of relationships; the stability and significance to each person is known to cause topic avoidance amongst platonic relationships in friends and family. The authors hypothesise a likely similar effect on romantic couples affected by depression.

Their study examined 126 couples, one or both of whom diagnosed depressed, most married and almost half parents. Subjects completed an online survey measuring depressive symptoms, relational uncertainty and topic avoidance on a point scale. Interestingly the majority of surveys, showed a positive association between relational uncertainty and topic avoidance. Fascinating differences were observed between men vs. women, cohabiting vs. married and depressed vs. partner.

These novel findings show the combination of depression and uncertainty predicts topic avoidance and has ramifications for treatment methods and outcomes in securing the happiness and safety of both partners. The authors quote “Our results also have pragmatic value for suggesting that relational uncertainty may be a site of intervention for helping people with depressive symptoms be more comfortable discussing challenging issues…(and)… as a step toward unravelling the complexities of people’s avoidance behavior in the context of depression.” They urge further research at the junction between depression, uncertainty and communication to identify methods of halting the cycle.

15/02/2015

Higher opioid doses associated with increase in depression!!!
Patients who increased doses of opioid medicines to manage chronic pain were more likely to experience an increase in depression, according to new findings.

Patients who increased doses of opioid medicines to manage chronic pain were more likely to experience an increase in depression.

The study, "Change in opioid dose and change in depression in a longitudinal primary care patient cohort".

Questionnaires from 355 patients from nine practices who reported chronic low back pain initially and at one-year and two-year follow ups. The respondents to the survey were 72.4 percent female, older than 46 (75.2 percent) and mostly of Hispanic or African-American descent (57.5 percent). The patients reported the number of years they had been experience chronic pain.

"Better understanding of temporal relationship b/w opioids and depression and the dose of opioids that places patients at risk for depression may inform prescribing and pain management and improve outcomes for patients with chronic, non-cancer pain".

Previous research had found depression to be linked with patients' opioid use, but this study has identified the association between an increase in opioid use and an increase in depression.
Contributing factors for cases of new-onset depression, according to this study and previous research may include both the amount of daily morphine exposure and the duration of exposure. The study calls for further study to determine whether patients are at-risk due to past episodes of depression or recent depressive symptoms.

We have been conducting on-going additional analysis, with the large VA patient data base to determine if duration of opioid use and dose of opioid interact or have an additive effect on risk of depression. Our results support the conclusion that most of the risk of depression is driven by the duration of use and not the dose.

"Thus, a strong potential explanation of our finding that increasing opioid dose increases risk of depression could be that the patients who increase dose were the longer using patients. This is logical as longer use is associated with tolerance and a need to increase opioids to achieve pain relief."

"We hope to find risk factors such as opioid misuse that could be in the pathway from chronic opioid use to new onset depression this would expand the targets for intervention to limit the risk of depression in patients who need long-term opioid therapy."

15/02/2015

Ma*****na use is associated with excessive daytime sleepiness in adolescents!!!
A new study found 10 percent of adolescents sent to a Sleep Center for evaluation of excessive daytime sleepiness with testing results consistent with narcolepsy had urine drug screens positive for ma*****na.

A study published recently by researchers from Nationwide Children's Hospital, found 10 percent of adolescents sent to a Sleep Center for evaluation of excessive daytime sleepiness with testing results consistent with narcolepsy had urine drug screens positive for ma*****na, confounding the results.

"Our findings highlight and support the important step of obtaining a urine drug screen, in any patients older than 13 years of age, before accepting test findings consistent with narcolepsy, prior to physicians confirming this diagnosis, Urine drug screening is also important in any population studies looking at the prevalence of narcolepsy in adolescents, especially with the recent trend in ma*****na decriminalization and legalization."

Typically, a diagnosis of narcolepsy is made after a clinical evaluation for excessive daytime sleepiness, followed by a standardized multiple sleep latency test (MSLT) consisting of 4-5 scheduled day time nap opportunities in which speed of sleep onset and presence of rapid eye movement sleep (REM) are both calculated.

However, adult studies have shown that a variety of different medications and illicit drugs may affect MSLT results.

This 10-year retrospective study of 383 children is the first to examine the prevalence of positive drug screens in pediatric patients undergoing MSLT. The study, published in Journal of Clinical Sleep Medicine, found that 43 percent of children with urine drug screens positive for ma*****na actually had test results consistent with narcolepsy or abnormal REM sleep patterns. No child younger than 13 years of age had a positive urine drug screen. The data showed that males were more likely to have a positive urine drug screen and MSLT findings consistent with narcolepsy.

"We believe that many of the children who had positive urine drug testing for ma*****na and testing consistent with narcolepsy had improvement of the symptom of excessive day time sleepiness after enrollment in a community drug program, because most didn't come back for repeat diagnostic studies once they were drug-free".

"A key finding of this study is that ma*****na use may be associated with excessive daytime sleepiness in some teenagers, A negative urine drug screen finding is an important part of the clinical evaluation before accepting a diagnosis of narcolepsy and starting treatment in a teenager."

14/02/2015

Sleep Problems and Substance Use Disorders: An Often Overlooked Link!!!
Sleep problems and substance use disorders often go together, according to a specialist who says many people continue to have insomnia even after they are able to successfully stop abusing drugs and alcohol.

Doctors who treat sleep disorders and those who treat substance use disorders need to be aware of the possible connection between the two, particularly when prescribing sleep medications.

Sleep disorders are b/w five to 10 times higher in people with substance use disorders, compared with the general population. Alcohol dependence can lead to insomnia and sleep disruption that can last long after a patient achieves abstinence, he says. Many people who take opiates report difficulty in falling asleep and staying asleep. Sleep problems can be serious enough to reverse the success of drug or alcohol treatment and cause a relapse.

In addition, evidence is increasing that insomnia is a risk factor for developing psychiatric disorders, including substance use disorders. “Many people use alcohol as a sleep aid, Alcohol can also cause or worsen sleep apnea, and can contribute to restless leg syndrome.

Physicians who treat patients with insomnia and other sleep disorders should inquire about their use of drugs or alcohol, and professionals treating substance use disorders should ask about patients’ sleep problems and screen them for sleep disorders.

“Doctors need to screen for abuse and dependence of substances when they prescribe sleep medications if they prescribe a sleep aid, such as a benzodiazepine, they should do it on a short-term basis, maybe a few weeks, so the patient doesn’t become physiologically dependent.”

While sleep medications are generally safe and effective for many patients, they can be prone to abuse by patients with substance use disorders. Some insomnia drugs that are less likely to cause dependence include (but are not limited to) medications like ramelteon, the antidepressant trazodone and the anti-seizure drug gabapentin. Newer drugs are being developed that might be more effective in treating insomnia and less likely to cause dependence.

Doctors need to be better educated about lifestyle changes a person can make to help them sleep, and about the benefits of cognitive behavioral therapy for sleep problems.

Non-drug techniques to help people with insomnia include teaching them to use the bed only for falling asleep, and not for watching television, talking on the phone or worrying about not sleeping while lying in bed. Patients should be advised to avoid caffeine, ni****ne and exercise close to bedtime. Cognitive therapy can be used to identify patients’ beliefs that cause them anxiety about sleep problems, and to replace these beliefs with thoughts that promote healthy sleep behaviors.

12/02/2015

DRUGS, ALCOHOL AND VIOLENCE!!!
The relationship b/w drugs and violence seems apparent – drug abuse leads to violence. However, research shows that there is very little evidence to support this hypothesis, with the exception of alcohol abuse. There is no significant causal link in general between the use of illicit drugs and violent crimes. But there are are two main links between drug use and and violent crimes. Abusers of particular drugs may commit violent crimes, and distribution of drugs can lead to violent crimes.

Individuals who are under the influence of alcohol or other drugs can be involved in the perpetration of violence because of the dis-inhibiting nature of the drugs. This lack of inhibition may lead to a person being involved in activities that are criminal or violent. This is particularly true for people who are affected by alcohol.

Evidence suggests that crimes that are committed by people who are under the influence of drugs are also affected by alcohol.

Alcohol and Violence!
Alcohol and violent behavior are intrinsically linked and alcohol mediated domestic violence, s*xual assaults, homicides, anti-social behavior and property crimes are all too common. Being the victim of physical or verbal abuse committed by a person affected by alcohol is more than twice as likely to occur than for any other drug type.

People under the influence of alcohol can have varied reactions to the drink. They can become aggressive, passive aggressive, angry, depressed, social or happy. Engaging in binge drinking or chronic hazardous drinking increases the risk of exhibiting negative behaviors and losing control of ones behavior. It is when a person is heavily intoxicated that they may be involved in assaults, s*x crimes, property crimes or become the victim of a crime themselves.

Drug Consumers and Violence!!
Research is increasingly showing that drug use and violent crimes are not related, especially concerning ma*****na, psychoactive drugs, opiates and co***ne. These drugs tend to cause individuals to become relaxed, feel euphoric, have empathy and not have the anger, aggression or rage that would be associated with a violent crime. It is suggested that drug users who fall in those categories are more likely to engage in non-violent property crimes.

However, the increased use of methamphetamine and crack co***ne can be linked to an increase in violent behavior. Both methamphetamine and crack are powerful stimulants that produce alertness, paranoia and a variety of other unpredictable and adverse reactions. These drugs specifically can cause people to become irrational, excited, agitated and become unable to control anger or violent impulses.

Tweaking is a term that is used to describe the behavior that methamphetamine and crack users display which includes worsening paranoia, belligerence and chronic, violent drug seeking. When a person is in this state they will become involved in random acts of violence and aggression which can include prostitution, s*xual assaults and in some cases, homicide.

Violent S*x Crimes!!
Methamphetamine and crack co***ne are associated with a condition known as hyper-s*xuality. This condition refers to extreme s*xual urges that are often aggressive and compulsive. Individuals who suffer from this affliction when they are under the influence of drugs will often be engaged in high risk s*x, have desires to engage in violent and abusive s*xual conduct, compulsive ma********on and s*xual behavior. These feelings can lead to committing s*xual assaults and r**e in some cases.

Research suggests that up to 50 percent of all cases of s*xual assault, including r**e, involves alcohol consumption by the perpetrator, victim or both. Alcohol can cause people to become aggressive, s*xually aroused and violent. Individuals under the influence may assault someone who is also drunk, they may take advantage of someone who is intoxicated or they could commit spousal r**e.

Violence and Drug Distribution!!
Violent crimes associated with drug distribution is common. The occurrence of street level violence to enforce organizational discipline or resolve business disputes is high and these disputes are typically over drug purchases and drug paraphernalia. Trading in illicit substances can lead to drug related violence as drug dealers and distributors compete against one another for markets and customers.

Crack co***ne and methamphetamine are often sold and used in areas that are defined by poverty and social disorganization. These are poor neighborhoods with few options for work or leisure activities, existing social problems such as broken families, unemployment and abuse. The rapid growth of crack and methamphetamine use and the emergence of drug-selling organizations in these areas has contributed to an increase in violent crimes. The presence and involvement in organized gangs as part of the drug distribution networks has further established the link between drugs and violence.

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Mental Health Pakistan & Disability Justice Pakistan

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