Understanding Drug Abuse and Addiction

According to the National Survey on Drug Use and Health, 21.5 million American adults (aged 12 and older) battled a substance use disorder in 2014. Almost 80% of individuals suffering from a substance use disorder in 2014 struggled with an alcohol use disorder.1Drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to change.2

Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs.

These brain changes can be persistent, which is why drug addiction is considered a “relapsing” disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the person responds.

What happens to the brain when a person takes drugs?

Most drugs affect the brain’s “reward circuit” by flooding it with the chemical messenger dopamine. This reward system controls the body’s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. This overstimulation of the reward circuit causes the intensely pleasurable “high” that can lead people to take a drug again and again.

As a person continues to use drugs, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance.

They might take more of the drug, trying to achieve the same dopamine high. It can also cause them to get less pleasure from other things they once enjoyed, like food or social activities.

Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include:

  • Learning
  • Judgment
  • Decision-making
  • Stress
  • Memory
  • Behavior

Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction.2

Can drug addiction be cured or prevented?

As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isn’t a cure. However, addiction is treatable and can be successfully managed. People who are recovering from an addiction will be at risk for relapse for years and possibly for their whole lives. Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients.

The good news is that drug use and addiction are preventable. Results from National Institute on Drug Abuse (NIDA)-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking.

Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.2

Treatment for Drug Abuse

Drug addiction can be treated, but it’s not simple. It must help the person do the following:

  • Stop using drugs
  • Stay drug-free
  • Be productive at home, at work, and in society

Successful treatment has several steps:

  • Detoxification
  • Behavioral counseling
  • Medication (for opioid, tobacco, or alcohol addiction)
  • Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
  • Long-term follow-up to prevent relapse

Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.3

Behavioral therapies help patients:

  • Modify their attitudes and behaviors related to drug use
  • Increase healthy life skills
  • Persist with other forms of treatment, such as medication

Finding Treatment Services

Visit https://findtreatment.samhsa.gov to find a treatment service near you or call SAMHSA’s National Helpline:

  • 1-800-662-HELP (4357)
  • 1-800-487-4889 (TTY)

Free and confidential information in English and Spanish for individuals and family members facing substance abuse and mental health issues – 24 hours a day, 7 days a week.

Road to Recovery

If you or a family member are recovering from drug addiction, focus on the following to help prevent relapse:

  • Keep going to your treatment sessions.
  • Try mindfulness breathing, yoga or meditation to reduce stress.
  • Avoid triggers such as spending time with the people you used drugs with, places, things, or emotions that can make you want to use drugs again.
  • Take care of your body to help it heal from the harmful effects of drug use and to feel better. Be sure to add daily exercise, and eat healthy foods.
  • Find new activities and goals to replace the ones that involved drug use.
  • Spend more time with family and friends you lost touch with; consider not seeing friends who are still using drugs.


Get Help from Your Doctor

Call for an appointment with your health care provider if you or someone you know is addicted to prescription drugs and needs help stopping or you’re not sure where to start. Reach out to your doctor if you are having withdrawal symptoms that concern you. Your doctor can help you get connected to the care you need.


  1. https://americanaddictioncenters.org/rehab-guide/addiction-statistics/
  2. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
  3. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

Spread Kindness for a Happier You

Kindness can create a virtuous cycle that promotes lasting happiness and altruism. Kindness is contagious. Once you start doing nice things for others, you might not want to stop. This month we’re focusing on kindness toward ourselves and others to close out the year on a positive note, and to make kindness a healthy habit to carry into the new year.

What if we told you kindness makes you happy?

You don’t have to take our word for it. Two studies suggest spending money on others makes us happy, even happier than spending on ourselves!Happiness is a central desire in our lives. Gratitude is an important human strength that contributes to happiness. One study showed that grateful individuals were especially appreciative of the contribution of others to their happiness.

“Compared with unhappy people, happy people report close and satisfying relationships and feel more gratitude in their lives. Whereas gratitude results when people receive kindness from other people, kindness entails enacting kind behavior toward other people.”2

The same study found that happy people reported higher levels of the three kindness components:

  1. The motivation to be kind to others
  2. The recognition of kindness in others, and
  3. The enactment of kind behavior in one’s daily life.

“Kind people experience more happiness and have happier memories. Simply by counting acts of kindness for one week, people appear to have become happier and more grateful. Happy people are more kind in the first place and they can become even happier, kinder and more grateful following a simple intervention.”2

Kindness Increases:
  • The Love Hormone
  • Energy
  • Happiness
  • Lifespan
  • Pleasure
  • Serotonin3
Kindness Decreases:
  • Pain
  • Stress
  • Anxiety
  • Depression
  • Blood Pressure3

Both kindness and gratitude are an important human strength that influences our wellbeing. It’s important to practice these habits frequently, starting with one random act of kindness per week. Then work your way up to one or more random acts of kindness per day. Practice kindness and compassion toward yourself every day. You can’t fill anyone else’s cup unless yours is full. The positive effects of kindness are experienced in the brain of everyone who witnesses the act, improving their mood and making them more likely to extend kindness to others. Build up your compassion muscle by being kind to others and offer care and help.

Tips to Promote Kindness

  • Try seeing your world view as open to improvement by the evidence and experience of others.
  • Remember to put yourself in other people’s shoes. You never know what others are going through.
  • The only person who can affect your mood and thoughts are you! Be introspective and discover your own thoughts and fears that inhibit you from being the kindest possible version of yourself.
  • Write a list of preconceived notions you have about interactions with others, and then break them.
  • Often, we can mask our insecurities by judging and projecting negative thoughts on others. Try to catch yourself thinking a negative thought, and say “STOP” to redirect yourself to a positive thought.
  • Realize that you have to first help yourself before you can help others.
  • Mistakes are okay. Track what you consider to be mistakes, and how you learn from them in your journal.
  • Reflect on past experiences during the week, and how you made decisions every day.
  • Choose being kind over being right and you’ll be right every time.
  • Just about everything is smoother with a smile.
  • Though being kind to our friends and loved ones may come easily, a true test of your kindness is attempting to resolve problems with people scorned or ones you’ve been scorned by in your past.
  • Your words can influence those around you. Remember that the mouth should have three gatekeepers. Is it true? It is kind? And it is necessary? 

Pay It Forward

When someone does a good deed for you, instead of paying them back, “pay it forward” by doing a good deed for someone else. Below are a few ways you can pay it forward.

  • Give a genuine compliment to someone.
  • Perform random acts of kindness (Hold doors open for people, volunteer, share food, etc.)
  • Become a mentor or tutor to a person in need. We all have skills, so share yours with those who need it!
  • Leave post-it notes with encouraging messages in random places (in library books, on car door/windshields, in public places, etc.).
  • Write a positive Yelp! or Google Review for a business you like.
  • Offer to stay late and help clean up at your friend’s party.
  • Visit family members you haven’t seen in a while.
  • When driving, let someone merge into your lane.
  • Drive a friend to the airport.
  • Do two things to protect and preserve the environment for generations to come.

Loving-Kindness Meditation

To cultivate positive emotions, try a Loving-Kindness Meditation. Try this free meditation from UCLA Health website (available in English and Spanish).

  • To download the meditation, right click on “Play” button and then click “Save Link As”


  1. Greater Good Science Center at UC Berkeley: https://greatergood.berkeley.edu/article/item/kindness_makes_you_happy_and_happiness_makes_you_kind
  2. U.S. National Library of Medicine (NIH): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820947/
  3. Random Acts of Kindness Foundation: https://www.randomactsofkindness.org/the-science-of-kindness

Taking Care of Your Mental Health

From childhood to adulthood, mental health is a part of your life every step of the way. It includes our psychological, emotional, and social wellbeing. The state of our mental health determines how we make decisions, feel and act towards others, and how we cope with the hardships in our lives.1


There are factors that may contribute to an individual’s chance of being exposed to having a mental disorder.

  1. Biological factors (Genes, brain chemistry)
  2. Life experiences (Trauma, abuse)
  3. Family history of mental health problems1,2

Early Warning Signs and Triggers

There are many situations in life that can take us on a rollercoaster of emotions such as divorce in the family or tension within friendships. It is important to not only spot warning signs and triggers in other people, but also in yourself. Below is a list of warning signs that are important to recognize when considering your mental health.

  • Finding little or no pleasure in life
  • Feeling worthless or helpless for long periods of time (Remember, this is not the same as feeling “blue” or sad for a while)
  • Crying a lot
  • Experiencing a change in eating or sleeping patterns
  • Distancing yourself from people and everyday activities
  • Feeling numb like nothing matters
  • Arguing and/or fighting with family and friends
  • Losing interest in your favorite hobbies
  • Wanting to harm yourself or someone else1,2

Myths about mental health

  • Myth: People with mental health problems are violent and unpredictable.
  • Fact: People with mental health problems are actually 10 times more likely to be victims of a violent crime.

  • Myth: Therapy and self-help are a waste of time. Why bother when you can just take a pill?
  • Fact: The best treatment for a mental health illness depends on the individual and could include medication, therapy, or both. Many individuals who have mental health issues also work with a support group counselor to help heal and recover.

  • Myth: Prevention doesn’t work. It is impossible to prevent mental illnesses.
  • Fact: Prevention of mental, emotional, and behavior disorders means to address the issue and promote the social and emotional wellbeing of individuals. Some of the benefits of promoting social and emotional wellbeing are:
  • Lower health care costs
  • Improved family life
  • Lower crime rates
  • Increased lifespan
  • Higher productivity1

So How Do We Contribute to Your Mental Health In a Positive Way?

Listed below are activities that you can take to improve your mental health.

  1. Value yourself. It is not only important to value others, but also to value yourself and see yourself as a VIP of your own life. Take care of your mind by treating yourself with kindness and respect. Make time for yourself by doing your favorite hobbies or taking up a dance class. Try broadening your horizons by traveling or becoming fluent in another language.
  2. Take care of your body
    • Eat nutritious meals
    • Avoid cigarettes
    • Drink plenty of water
    • Exercise (Decreases depression and improves mood)
    • Get enough sleep
  3. Surround yourself with supportive people. Make plans with family, friends, or invest in activities that will encourage you to meet new people such as joining clubs. Having a strong supportive network contributes to our mental health.
  4. Give. Volunteering your time is not only self-fulfilling, but you are also helping others in need. Just think about it, you can help people and make new friends at the same time!
  5. Learn how to cope with stress in a healthy manner. Coping with stress is very important, considering that stress is a part of life. Do Tai Chi, exercise, take a nature walk, play with your pet, etc. Whether it is good stress, or bad stress, we must learn coping strategies that will help us lead a healthy life.
  6. Relax your mind. Relaxation exercises such as meditation, mindfulness, and prayer can improve our view on life. Pick one and start practicing today.
  7. Set realistic goals. Aim high but be realistic. We have all gone through that phase of childhood where everyone under the sun asks, “What do you want to be when you grow up?”. Now is the time where you should think more about your answer. What do you want to achieve academically? professionally? personally? Write it down on paper and go through the steps you need to do in order to get to your goal. This will lead to an incredible sense of accomplishment, and more importantly, self-worth.
  8. Be spontaneous. We can sometimes get caught up in the monotony of life. Instead of committing to your daily routine, try something different that will spice things up! Plan a trip to a place you’ve never been, go on a different path when taking a walk, try food that is new to you.
  9. Avoid alcohol and other drugs. For some people, using drugs to “solve” their issues is common. While it will numb you for a little bit, engaging in activities such as excessive drinking and drug use will only intensify your issues, and may even make you feel regretful.
  10. Get help when you need it. The most important fact that people must remember is that there is treatment. If treated properly, people with a mental illness can fully recover.3

It’s all in the attitude

According to National Alliance in Mental Health (NAMI), approximately 1 in 5 adults in the U.S. (43.8 million, or 18.5%) experiences mental illness in a given year.4,5 So why is seeking help still taboo in America? Fear, shame, and embarrassment by family members and peers often influence people to not seek help. Here a few points to remember when in need of help, but reluctant to take action:

  • Mental health problems are real and not something you can just “snap out of”
  • Gender does not matter, it is OK to ask for help because you CAN get it
  • Seeking help is a sign of strength, not weakness3
  • Mental health is just as important as physical health
  • You wouldn’t avoid a physical illness, so why ignore mental illness?
  • There is hope. People recover and ultimately go on to live healthier lives2
1 in 5 adults in the U.S. experiences mental illness
Reference: https://www.nami.org/NAMI/media/NAMI-Media/Infographics/MulticulturalMHFacts10-23-15.pdf

At USPM, there are many health and wellness programs equipped with coaches and nurses that will assist you. If you are interested in having a health coach or nurse case manager help you on your journey to a healthier you, please refer to your Preventive Plan portal.


  1. https://www.mentalhealth.gov/basics/what-is-mental-health/index.html
  2. http://www.apa.org/helpcenter/change.aspx
  3. https://www.uhs.umich.edu/tenthings
  4. http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml
  5. https://www.nami.org/NAMI/media/NAMI-Media/Infographics/MulticulturalMHFacts10-23-15.pdf

Treating the Root Cause of Disease, Not Just the Symptoms

Our country is amid a population health transformation. Healthcare is moving from treating symptoms to finding and treating the root cause of disease.

Control Your Healthcare

With healthcare costs on the rise and 51% of all mortality1 being directly attributable to lifestyle choices, people have more control over their health than they think. For example, 85% of all type 2 diabetes diagnoses (and the side effects associated with the disease) are preventable!1

The ultimate goal is to reduce healthcare utilization and costs by improving the health and wellbeing of individuals and communities. U.S. Preventive Medicine (USPM) has a vision to Empower Communities to Add Life to Their Years and Years to Their Life…One Person at a Time!  We approach population health management as a population of one. It starts with one, it starts with you. It starts with each one of us.

There are three tiers of preventive medicine that when combined, can create sustainable healthy individuals and workplaces:

  • Primary: Wellness/Health Promotion
  • Secondary: Early Detection
  • Tertiary: Early Intervention Care Management

While many wellness companies address primary and secondary prevention, they fail to address disease acuity and risk management. This is where the highest costs can come from. Care management includes treating the chronic conditions with a personalized care plan, care coordination, and treatment plan adherence.

A Multifaceted Solution

Even with an interactive web portal or a convenient wearable device, technology alone is not enough to drive sustainable behavioral change. The personal touch of coaching and care management combined with innovative technology drives a much higher level of engagement. USPM’s coaching philosophy recognizes the unique circumstances, environments, experiences, and social impacts that affect individuals. This recognition helps us view each individual as a complex, multidimensional person who can make decisions for him or herself.

The Preventive Plan® wellbeing program provides a customized roadmap for everyone to follow to better manage their health. The Plan outlines the risks, action items and educational information that are meaningful to an individual, and avoids short duration, high-intensity programs and cookie-cutter approaches that don’t last or deliver high levels of sustainable behavioral change.

A personalized plan can only be created once all the factors are taken into consideration for each individual. Someone who has a medical condition such as asthma, back and neck pain, coronary artery disease (CAD), or depression will have a tailored and unique set of action plans to address health risks.

This is why U.S. Preventive Medicine believes and supports the high-touch model of wellness. Our team of health coaches and care managers provide a supportive, non-judgmental learning experience and help identify barriers, assist with strategies and goal setting, monitor progress, and provide positive feedback to guide individuals toward a better quality of life by reducing risks and achieving and maintaining a healthy lifestyle.

In addition, USPM offers programs to increase member resiliency to everyday stress. We have partnered with the Cleveland Clinic Wellness Institute to evolve traditional wellness into whole-person wellbeing. By integrating precision analytics to include stress and mental health conditions, we address the root-cause of illness.

In one health system over 6 months, our work on reducing and managing participant stress resulted in:

  • 35% decrease in perceived stress
  • 29% decrease in depersonalization
  • 27% decrease in emotional exhaustion

“Higher levels of resilience were found to have beneficial effects on worker’s perceptions of stress, psychological responses to stress, and job-related behaviors related to stress regardless of difficult environments. Faced with especially difficult work environments, workers with higher levels of resilience seem able to avoid absences and be more productive than workers with low resilience.”2

Evolve beyond wellness to comprehensive population health management. Address the root cause of risk and rising health care costs with evidence-based interventions, precision analytics, and a guaranteed quantifiable return on investment.


  1. Mokdad AH, et.al. Actual Causes of Death in the United States, 2000. JAMA. 2004; 291:1238-1245.
  2. “The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments”, Andrew Shatte´, PhD, Adam Perlman, MD, MPH, et al. JOEM: Volume 59, Number 2, February 2017.

Depression Affects More Than We Think

Depression is a common but serious medical condition that can cause severe symptoms affecting how you think, feel, and act. The CDC estimates that more than 1 out of 20 Americans 12 years of age and older reported depression symptoms in 2009 – 2012.

Depression by the Numbers

Major depressive disorder is one of the most common mental disorders in the United States.

  • Each year about 6.7% of U.S. adults experience major depressive disorder.
  • Women are 70% more likely than men to experience depression during their lifetime.

Depression has also been associated with several chronic diseases, making it one of the most common complications of chronic illness. People diagnosed with a chronic medical condition (heart disease, diabetes, cancer, etc.) have a higher risk of depression, and it’s also true that people with depression are at higher risk for cardiovascular disease, diabetes, stroke and Alzheimer’s among others.

Chronic mental health conditions are becoming increasingly widespread across the U.S. and if not addressed could cost up to $3.5 trillion by 2030 – $3.4 trillion in medical costs and another $140.8 billion in societal costs. Like other chronic illnesses, mental health conditions contribute heavily to productivity losses, but can also worsen unemployment, substance abuse, homelessness, and incarceration.

Learn the signs and symptoms of depression and promote the benefits of early identification and intervention. Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy.

Signs and Symptoms Include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

To Help a Friend or a Relative

  • Offer emotional support, understanding, patience, and encouragement.
  • Talk to him or her, and listen carefully.
  • Never dismiss feelings, but point out realities and offer hope.
  • Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.
  • Invite your loved one out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
  • Provide assistance in getting to the doctor’s appointments.
  • Remind your loved one that with time and treatment, the depression will lift.

If you have depression, you may feel exhausted, helpless, and hopeless. It may be extremely difficult to take any action to help yourself. But as you begin to recognize your depression and begin treatment, you will start to feel better.

To Help Yourself, Keep Busy

There is a lot to do in life. There is a lot to do every day! Staying busy can help direct your thoughts away from what may be troubling you. Try to focus on important daily routines:

  • Work and hobbies
  • Household projects
  • Social and family gatherings
  • Volunteering in the community

If you get overwhelmed, consider delaying tasks, setting priorities and breaking up projects into manageable bits.

Exercise Regularly

Some people find that regular aerobic exercise improves their symptoms as much as antidepressant medication. Others find that their mood improves by getting out in the sun more often. You might combine the benefits of both by increasing your activity outdoors.

People new to regular exercise should increase their activity level gradually. A good place to start is to add steps to your daily commute, errands, and chores.

Get Enough Sleep

Deep sleep helps the body’s cells grow and repair themselves from such factors as stress. So, getting enough sleep may improve your ability to function while awake. To improve the quality of your sleep, be sure to eat healthy foods, exercise at least moderately on most days, and create a sleep-friendly environment:

  • Avoid caffeine and other stimulants during the day.
  • Block out light and noise.
  • Establish a bedtime routine: Go to bed at the same time each night and do something relaxing before getting into bed (take a warm bath, listen to pleasant music).
  • Reduce screen time before bed

Talk to a Friend, Have Some Fun

Don’t try and deal with what you are going through alone. Talk to someone on a regular basis. And while you are at it, put some fun into your life!

In case of an emergency, call:
  • Your doctor.
  • 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
  • The toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.
For more information, call:
  • Depression and Bipolar Support Alliance: 800.826.3632
  • National Alliance on Mental Illness (NAMI): 800.950.6264
  • National Institute of Mental Health (NIMH): 866.615.6464


Transforming Health Care Holistically

Transforming Healthcare - Blog Feature Graphic

What’s the difference between wellness and wellbeing? While wellness refers to the physical health of an individual, wellbeing is the holistic view of the individual’s health. Illness and chronic disease don’t just affect physical health, but also the mental and emotional state. And if one suffers, so will the other.

Whole-Person Health & Wellbeing

Your Wellbeing

Wellbeing includes wellness of the whole individual which includes not only the physical health, but also the psychological (mental and emotional health), occupational, social and financial health.

“Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity.”

– World Health Organization

Each part of wellbeing influences and is influenced by the other parts. In order to maintain a balance of health, all five elements of wellbeing have to perform at their peak:

  1. Physical: Physical health and vitality, disease risk and injury
  2. Psychological: Overall mental and emotional health, behaviors, beliefs and resiliency
  3. Occupational: Work environment, safe and healthy working conditions
  4. Social: Interaction with family, friends, coworkers and other people
  5. Financial: Budget, income, savings, expenses

“Today, we accept that there is a powerful mind-body connection through which emotional, mental, social, spiritual, and behavioral factors can directly affect our health.”

– National Institutes of Health (NIH) MedlinePlus 1

It’s no doubt what the power of prevention can do for an individual’s wellbeing. At USPM, we have seen individuals lose weight, come off their medications, lower numerous health risks, and some even reverse their chronic conditions. Treating the individual’s wellbeing holistically is the key in transforming healthcare. While technology solutions are critical to drive engagement and usability, technology alone is not enough to create sustainable behavioral change.

Whole Person Approach

USPM strongly believes that human interaction is important to drive behavioral change that results in positive outcomes. USPM employs health coaches and registered nurse care managers to engage and empower individuals to succeed on their journey of health and wellbeing. Our passion for better health and mission of More Good Years® is what drives us to collaborate together to ensure we address the whole person and their health needs by taking into account the physical, mental and emotional, social, occupational and financial concerns.


1. https://medlineplus.gov/magazine/issues/winter08/articles/winter08pg4.html