Drugs are one of the miracles of nature and science. It’s really amazing how use of a drug can relieve a woman of something as painful as childbirth or how a simple pill can relieve one of an unbearable headache. And yes, they are effective in almost anything, from deadly diseases to the simple anxiety you have before going up on stage. This ubiquitous value of drugs has made it an integral part of our lives but one should not be ignorant of their potential side effects or dangers.

Most of the attention has been on drugs of abuse like opiods, alcohol, marijuana, cocaine etc. These drugs of abuse littered everywhere with different names have a common feature of acting on the central nervous system to give various sensations leading to problems with dependence and addiction. However, some drugs like viagra can be abused for purely social reasons. The psychosocial effects of these drugs are so devastating and can even result in death directly from overdose or from risky behaviour induced by them. It would have been great if drugs of abuse were the only problem but nothing could be farther from the truth.

The father of toxicology, Paraclesus once said that any substance is a poison but the dose makes the difference, and drugs are no exception to this. Indeed, drugs (with no exception) are much more toxic than we think. For example, only 7g of the pain medication, acetaminophen (one of the most common drugs in suicide attempts and accidental overdose) can lead to serious liver damage. Drugs use is inevitable; however, they must be used only for the right purpose, at the right time and in the right quantity. Sadly, over the counter drugs which have the potential to be more toxic than the tightly restricted drugs of abuse are overused by individuals especially the elderly. The older age group tend to abuse drugs more because of fear of diseases and ignorance of drug toxicity, chronic conditions and for pain relief. Overuse is not solely from the part of the user but also from the health care giver. It can be due to over-prescription or prescribing to feel like one is doing something. Finally, overdose is an effect of the widespread availability of drugs.

Since all drugs are toxic, why are some drugs, especially the drugs of abuse, firmly regulated? Perhaps, because of their predisposition for addiction and dependence… Okay but what of the legalization of cannabis (marijuana) in Canada, and what does this mean for other leisure drugs? These questions are all connected to the problem of availability and distribution of drugs. After the exclusive use of prohibition control, governments may be slowly tending towards controlled restriction of drugs. The same ideology is behind the provision of safe injection sites for intravenous drug users. It is not to encourage drug use but to control the negative public health impacts of inappropriate use. This form of control provides drugs adequately through registered pharmacies and eliminates illicit drug use which can circulate fare, more harmful drugs. Irrespective of the preceding paragraphs, drugs remain miracles of nature and science… hence; the governments and health professionals must ensure that every individual has proper drug coverage and knowledge respectively.

The war against infectious diseases has stretched the health care systems beyond their limits and ushered in the widespread use of antibiotics and vaccines. It is a fact that infectious diseases kill very swiftly as evidenced by the fact that deaths due to tuberculosis exceed those from both world wars combined. However, most infectious agents are destroyed by antimicrobial drugs or vaccines. On the other hand, NCDs have no antibiotics or vaccine thus leaving preventive medicine and palliative care as the only solutions, at least for now. These diseases collectively known as NCDs not only account for 71% of all global mortality but also contribute to significant morbidity resulting in reduced health adjusted life years. There are many diseases under this umbrella but four of them are most common and significant due to the high prevalence and mortality rate associated with them. They include: Cardiovascular disease, Cancer, Respiratory disease and Diabetes.

NCDs are caused by an interplay of genome and exposome, the exposome is a more ethical and realistic target of control. As a result, these major NCDs share four common risk factors including alcohol abuse, tobacco use, physical inactivity and unhealthy diets. These modifiable risk factors are all lifestyle habits that when addressed can greatly reduce the burden of these diseases. The natural question now follows, how can these risk factors be modified to address the NCD epidemic? Apart from general public health education on the negative impacts of unhealthy lifestyle habits listed above, there needs to be policies to guide and promote individuals towards healthy living such as restricting the availability of alcohol, tobacco and unhealthy diets such as salty and sugary foods. These could involve increased taxation, clear stipulation of negative health warnings and gradual reduction in activities that negatively impact health. One might wonder: why beat about the problem, why not ban every harmful product? Well, things are never that simple or easy. Most governments, very influential individuals and companies invest in, and even own these some of these health deteriorating products. More so, straight prohibitions are not only ineffective to maintain but also gives room for illegal routes of entry which would further increase financial costs on the system. Physical inactivity and unhealthy diet as risk factors for NCDs have resulted in the recent obesity epidemic. Again, policies like building safe and long walk areas to steer the population towards more activity as well as increased accessibility to healthy foods such as fruits and vegetables will go a long way to address the problem.

The chronic nature of these diseases coupled with little hopes of definite treatment has caused serious problems with hospitalization. How do we weigh the scales… the chances of disease complication and then living one’s entire life in the hospital? It seems homecare; self-care and increased utilization of paramedics and preventive measures may help address the problem.

The World Health Organization defines mental health as the condition of well-being in which individuals realize their full potential, deal effectively with normal levels of life stresses, work productively, and contribute to their community. Mental health encompasses emotional, psychological, and social well-being which affects our thoughts, feelings and actions. It also determines how we handle stress, relate to others, and make choices. As a consequence, mental health is important at every stage of life, from childhood and adolescence through adulthood, mental health is influenced by Biological factors such as genes or brain chemistry, Life experiences such as trauma or abuse and Family history of mental health problems. Mental health problems can affect anyone, irrespective of age, gender or social class.

Mental health involves the general mental wellbeing of an individual, not just the absence of mental illness diagnoses. Considering this, its scope involves:

• Chronic disabling physical conditions
• Psychosomatic conditions
• Mental illnesses like depression, schizophrenia, Anxiety eating and sleep disorders
• Neurodegenerative disorders

There are several disturbing issues around mental health problems that require attention such as distribution and poor health coverage, labelling, stigmatization and institutionalization. Firstly, the distribution is quite disproportionate as is evidenced by the fact that people with poor socioeconomic conditions such as low income earners and minority groups tend to have more cases of mental health problems. A lot of psychiatry is about diagnoses but little about treatment with individuals being labelled to a particular group and stigmatized. It is not uncommon for employers to get rid of mentally ill workers; worse still, they find it difficult to get a job even after treatment and may end up abused and neglected.. Most primary health centres are unequipped and unprepared to tackle mental health problems and resolve to institutionalization which worsens the situation. Mental health problems are perhaps the oldest significant public health burden with relatively ineffective solutions that are devised due to the ideologies of time- religion for the old times, institutionalization for the late 19th and 20th centuries, 21st century medicalization of diseases and current holistic approaches.

Generally, good lifestyle habits such as eating healthy diet, physical activity, not only translate into good mental well-being but also give individuals a sense of control over their health. Support groups and other forms of psychotherapy are great ways of dealing with some problems. Also, there is increasing involvement of alternative approaches like musical therapy, expressive arts, yoga and other forms of physical therapy in mental health treatment. Indeed, even little things like taking a walk or meditation in this globalized, busy and fast paced 21st century world punctuated with activities can benefit ones mental well-being.

With the increase in the knowledge and importance of oral health to overall wellbeing, two vital questions come to mind: First, why was oral health omitted from the UN SDGs to improve global health care on September 27, 2018 at Brussels? And, by direct extension, why was dental health omitted from the public health insurance schemes of many developed countries?

Dental Health, according to WHO is freedom from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that hinders or limits one’s capacity to bite, chew, smile and speak. Poor dental health which hinders psychological wellbeing, is an increasingly neglected public health menace that mostly affects low socioeconomic individuals who cannot afford out of pocket visits to the dentist; dependent population including children, seniors and people living with disability; and of course people ignorant of the need for good dental health. There are several benefits of good dental health such as prevention of common dental problems including tooth ache, dental caries, tooth decay, halitosis etc which cause significant discomfort and morbidity. There is also serious correlation between poor dental health and heart disease as well as depression. Further, systemic diseases such as AIDS, diabetes and genetic conditions like oro-facial clefts can impact oral health providing clinicians with diagnostic mirrors. Aside these medical issues, good dental health improves psychosocial wellbeing as your regular teenager with good dental health would laugh more comfortably than one without.

It is important to address some of the issues that affect dental health such as lifestyle practices including sugar and alcohol intake, tobacco chewing, smoking, vaping, use of dental amalgam, dental fluorosis and poor dental coverage.

Excessive consumption of sugary foods has long been known to predispose one to dental caries, decay, infections and abscess if untreated.

Alcohol and tobacco are serious risk factors for oral carcinoma which is the third most prevalent cancer in Asia.

Vaping has been suggested as an alternative to smoking tobacco due to the well-known negative health impacts of smoking; however, there is inconclusive research about whether it is better for oral health.

There have been concerns over the use of the mercury containing dental amalgam to fill cavities due to negative effects of mercury on health- the 2013 Mina Mata convention and phase down on dental amalgam was part of the move from restorative to preventive oral care.

Despite widespread evidence of the reduction of dental caries by fluoridation, there is increasing challenge to this due to fluorosis and other negative health impacts like increased hip fractures.

Finally, and most worrisome is poor dental coverage reflected by the omission of oral health in public health insurance. Can we expect to tackle the oral health problem without coverage? Of course not… The first step to addressing oral health problems is coverage with specific attention to the high risk groups and individuals with conditions like diabetes, pregnancy etc. The government can help to slowly modify lifestyle habits by setting public health policies geared towards good oral health like increased taxation of sugary foods and reduced availability to school canteens, gradual reduction in amount of tobacco in cigarettes. More so, the general public should be educated in regular ways to achieve good oral health such as brushing twice or thrice daily, regular flossing and annual dental check-ups.

The term, Alternative medicine is used to describe a wide range of medical systems or processes, diverse therapeutic practices and health care systems that fall outside the boundaries of conventional biomedicine because they lack biological plausibility (proof). Alternative medicine can also be called complementary medicine, pseudo-medicine, unorthodox medicine, unconventional medicine, holistic medicine or new age medicine.

Alternative medicine has been around for hundreds of centuries with its rise in the west attributed to the counterculture movement of the 1960s. By mid-1970, the expression “alternative medicine” had become a household name and was seen as natural, effective treatments or substitutes to science based medicine. Alternative medicine has since gained popularity and some studies and research agree to its efficacy. Today, a lot of practices, products and therapies which are integral to health can be classified as Alternative or Complementary medicine. They are also beneficial to public health, and include: acupuncture, acupressure, naturopathy, homeopathy, reiki, color therapy, shamanism, reflexo-therapy, Chiropathy, music therapy, regular massages, hot yoga etc. Individuals whose primary profession involves one or more complementary or alternative therapy are known as complementary therapists.

Some alternative treatments such as folk medicine and herbal products have been used for millennia to combat a whole range of ailments. Examples include the use of herbs such as cilantro as folk medicine anticonvulsant; Exercise is used as a fundamental treatment and intervention method within psychiatric patients as it helps them manage and reduce their anger, depression and other symptoms. Studies have shown that compounds from elder berries can directly inhibit viral infection in human cells and help strengthen a person’s immune response to viruses, thus can be used in cases of flu. The American heart association once studied the effect of hot yoga on blood pressure and found out that after 3 months, individuals being studied had lower blood pressure. These examples seem to approve the use of alternative medicine as a substitute to conventional medicine; however, caution should be applied as alternative medicine could also cause harm given its important characteristic of lacking scientific validation, compared to conventional medicine. Significant drug interactions caused by alternative therapies may negatively affect functional treatments by making prescription drugs less effective. In addition, it is difficult to test the efficacy of alternative therapies using clinical trials.

Due to the popularity of alternative medicine, its practices and products should be adequately regulated as it is always painted positive given that many patients are willing to choose the friendly colorful images of herbs and herbal treatments over the more threatening presentation of drugs. Another reason for this preference over conventional medicine is the ease of accessibility in the developing countries where one- third of the population lack access to the essentials of medicine and this becomes the only way. About 80 percent of people consider alternative medicine better than conventional medicine because it is perceived to have less risks and side effects associated with drugs and therapies used in managing diseases. A survey of Americans found out that 88 percent of the population thought that “there are good forms of treatments that medical science did not recognize”. As a consequence, agencies like the FDA Should help create more policies to regulate the practices of alternative medicine and educate the general public on their facts, theories and limitations.