Drug abuse is a serious problem, which is capable of not only causing death to the one using it, but create a havoc in the lives of those who are associated with that person too. There have been plenty cases, whether it is Matthew Perry or the recent death of Liam Payne, which is in trial currently.

It is also a problem in the US and is emerging as one of the health concerns that could destroy families and society. One of the most alarming aspects of drug abuse is also its impact on public safety as well as increased crime rates. Drugs also take a heavy toll on healthcare systems as emergency departments frequently encounter cases of drug overdoses, which puts the burden on medical professional who have the strain the limited resources available.

There are also long-term health impact due to drug abuse, which includes organ damage, infectious disease, mental health disorders and rise in healthcare cost.

Are there any specific drugs which are most abused in US?

Yes. There are commonly used drugs, which also includes prescribed painkillers like oxycodone, hydrocodone, and fentanyl, as well as illicit substances like heroin. As per recent data, opioid abuse has also reached alarming levels which has affected millions of Americans.

Here are the most abused drugs in the US:

Stimulants

They are used to increase alertness, attention, and energy. They also have a high potential for abuse due to the euphoric and performance enhancing effects. Cocaine and methamphetamine are notable stimulants frequently abused in the US. As per 2019 data, 10.3 million people reported to misuse stimulants in the previous year.

Depressants

These substances are used to slow down brain activity and induce relaxation. Benzodiazepines is one of the commonly prescribed medicine. Around 4.8 million individuals in the US have misused this drug.

Other misused drugs and its affects on the health:

Opioids:

It could lead to slow breathing and heart rate. It can also increase the risk of overdose and respiratory failure, constipation and a weakened immune system.

Stimulants:

It can elevate heart rate and blood pressure. It could also increase body temperate and lead to an irregular heartbeat. Furthermore, one can experience loss of appetite and weight loss.

Cannabis:

This can alter perception and coordination. People who consume it often have red eyes and a dry mouth. This can increase appetite, sometimes the "munchies" can reach to a point of no return and it could impair memory and cognitive function.

Benzodiazepines:

It could lead to sedation and drowsiness and an impaired coordination and balance. There also could be memory problems and confusion, along with respiratory depression, when combined with other depressant substance.

Alcohol:

This could lead to slurred speech, impaired condition, poor judgment and decision-making, liver damage and cirrhosis and an increased risk of accidents and injuries, which is the 3rd most leading cause of death in the US.

Additional Negative Impact: Social and psychological

Substance abuse impairs job performance and reliability, leading to frequent absenteeism, reduced productivity, and even job loss. This further leads to financial instability, strained relationships, and a cycle of dependency.

There is a conversation that comes up in almost every consultation, and it is rarely the one the patient came prepared for. After graft numbers, hairline design, cost and downtime have been discussed, the question of smoking and drinking inevitably follows — and the answer is usually a shrug: occasionally, socially, nothing serious.

Yet of all the variable that determines what a patient sees in the mirror eighteen months later, these two are among the very few fully within their control, and among the most underestimated.

What Smoking and Alcohol Do to the Scalp

The hair follicle is one of the most metabolically demanding structures in the body, dividing faster than almost any other cell population and depending entirely on a dense network of microscopic vessels feeding its base. Nicotine constricts those vessels; over years, repeated narrowing combined with low-grade inflammation contributes to perifollicular fibrosis — scarring that gradually chokes the follicle.

Alcohol takes a different route, depleting the zinc, iron, folate, B12 and protein hair is built from, while fragmenting sleep and raising cortisol — both of which push follicles prematurely into their resting phase. For a transplant candidate, this matters twice over: it reflects donor-area quality, and it signals the kind of healing environment the grafts are about to enter.

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Why the First Week After Surgery Is So Critical

For the first few days after surgery, a transplanted follicle is essentially cut off from its blood supply, surviving on nutrients diffusing in from surrounding tissue.

New capillaries begin connecting around day four or five, with full revascularisation taking seven to ten days — the most vulnerable window in the graft's life. Smoking attacks it from two directions: nicotine causes sustained vasoconstriction after every cigarette, while carbon monoxide binds haemoglobin more readily than oxygen, so the reduced blood reaching the scalp also carries less oxygen.

The result is rarely dramatic — just poorer graft survival, patchier density, and a final outcome thinner than the graft count promised. Patients often read this as bad luck; it usually isn't. Notably, this applies equally to vaping, hookah and smokeless tobacco like gutkha or khaini — the delivery method changes, but the nicotine doesn't.

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Alcohol's More Immediate Risk

Alcohol's damage is more mechanical. It causes vasodilation and impairs clotting, meaning patients who've been drinking beforehand bleed more during surgery — which makes graft placement less precise and can dislodge grafts already sited.

Afterward, the same vasodilation worsens normal post-op swelling, its diuretic effect fights the hydration healing tissue needs, and its immune-suppressing effect arrives just as the scalp carries thousands of small open wounds. There's a medication risk too: alcohol combined with post-op antibiotics, anti-inflammatories or steroids raises the chance of gastric irritation or a genuinely unpleasant systemic reaction.

Recommended Windows

For smoking: stop at least two weeks before surgery (four is better), and stay off it for two weeks to a month afterwards — the long lead-in accounts for how slowly small-vessel and immune function normalise, and the long tail covers graft revascularisation.

For alcohol: stop five to seven days before, and avoid it for ten to fourteen days after, or as long as medication continues, since its effects reverse faster. One caveat worth repeating: patients often say they've "stopped" when they've merely cut back. A single cigarette produces measurable scalp vasoconstriction — in this window, occasional isn't the same as fine.

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The Myth That Lifestyle Stops Mattering

A costly misconception is that once surgery is done, lifestyle no longer matters. It's a half-truth: transplanted follicles, taken from the DHT-resistant back and sides of the scalp, are permanent and won't miniaturise. But a transplant only redistributes existing hair — every native follicle remains susceptible to ongoing loss.

If that native hair keeps thinning, overall density falls even though every graft survives, and patients often mistake this for transplant failure. In reality, the surroundings have receded, accelerated by smoking, poor sleep, chronic stress and poor nutrition. Surgery buys a foundation; lifestyle determines how long the picture around it holds.

Practical Guidance

Honesty at consultation matters — knowing a patient smokes heavily changes the surgical plan toward more conservative density and staging, which protects the result. The pre- and post-op window should be treated as non-negotiable, even if permanent quitting feels distant; a defined four-week commitment is far more achievable than an open-ended one.

Switching to vaping or nicotine gum isn't automatically safe — it removes carbon monoxide and tar, but nicotine, the actual vasoconstrictor, remains, so replacement therapy should be discussed with the surgeon. Fundamentals also help: adequate protein, iron and vitamin D, seven to eight hours of sleep, hydration, and gentle movement once cleared.

Turning Surgery into Leverage

Finally, surgery itself can be motivating. Patients who've just invested significant money and recovery time in their appearance are often more driven to quit than at any other point in

By Dr. Harikiran Chekuri, Hair Transplant Surgeon, Founder and Chief Plastic Surgeon, Redefine Hair Transplant & Plastic Surgery Center

It is difficult to determine emotions because of the neurological differences, the surrounding in childhood, the psychological ways of survival, and absence of emotional training.

Alexithymia or "emotional blindness" is the neuropsychological trait associated with severe problems with identification, recognition, and description of the person's emotions. Alexithymia is not a psychiatric disease but a personality trait.

It is characterized by the inability to identify and distinguish emotions and body sensations, difficulty of finding the words to express feelings, inability to understand facial expression and body language of another person and emotional detachment during stressful situations.

It is diagnosed in people with autism spectrum disorder, depressive disorder, generalized anxiety disorder and after traumatic brain injuries. It can be inherited or acquired as a result of childhood trauma, abuse or neurological damage.

The Brain Science Behind Alexithymia

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The cause of alexithymia is the brain wiring and neurological differences. Therefore, there is impaired interception, which is the inability of the brain to recognize its own physical sensations. Also, an unusual structure of the brain regions like amygdala and insula, that regulate emotions, makes difficult to decode emotional signals.

Early childhood environment and emotional competence must be developed in childhood, because, without that, there can be emotional neglect and emotional vocabulary deficiency. Due to the inability to interpret emotional data, the person misses the compass that directs decisions and self-calming. This leads to emotional outburst, panic, hyperarousal, social and psychological consequences.

How Alexithymia Differs From Emotional Numbness

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Emotional numbness is the transient psychological state caused by acute trauma, deep grief or burnout.

The lack of emotional intelligence is the lack of social and emotional competence, when the person feels his emotions correctly, but he cannot control temper, lacks empathy, makes inappropriate social decisions or do not know what kind of effect his behaviour causes on the room.

But alexithymia is different since it is long-term personality trait and the person is unaware of the particular emotion.

In terms of neurodevelopment, the insular cortex and the anterior cingulate cortex (ACC) are the structural core of the brain's salience network. They work as a translator, transforming chaotic physical sensations into recognizable emotional experience.

Although there isn't any cure for alexithymia, one can improve his emotional awareness through certain measures. Interoceptive training where individuals are taught how to associate physical body sensations (such as tightness in the chest) with particular emotions (such as stress).

The use of emotion wheel or list of emotional words to bridge the link between vague physical sensation and precise description. Mindfulness, which involves observing oneself without judgment or without trying to suppress those internal feelings right away. And it is always good to seek professional help from a psychologist or a counselor.

By Dr. Arun Shah, Director - Neurosciences, Sir H.N. Reliance Foundation Hospital

Urine leakage after pregnancy is a common occurrence in many women. It is considered a normal part of motherhood. However, it doesn't have to be. Urine leakage can occur after childbirth, but persistent symptoms should not be ignored or tolerated just because you feel that it is not a big deal. It will be imperative for women to consult a pelvic health physiotherapist to examine the pelvic floor and guide women with the help of personalised rehabilitation for improving bladder control and recovering quickly.

Pregnancy and childbirth lead to changes in a woman's body. However, there can also be an impact on the muscles and tissues that support the bladder, uterus, and bowel. Hence, many women can experience urine leakage while coughing, sneezing, laughing, exercising, or lifting their baby after delivery. Vaginal delivery, prolonged labour, multiple pregnancies, a larger baby, excess weight, and chronic constipation can also cause pressure on the pelvic floor. So, the pelvic floor is a group of muscles that supports the pelvic organs and also contributes to bladder and bowel control.

During pregnancy, these muscles carry load, and childbirth can further stretch or affect their strength and even coordination. Hence, stress urinary incontinence is seen in women post-pregnancy, wherein the urine leaks during activities that increase pressure inside the abdomen. Some women may experience urinary urgency, difficulty controlling urine, pelvic heaviness, or discomfort during physical activity. Even signs such as vaginal pressure and heaviness, urinary leakage during exercise, or difficulty controlling gas can also indicate pelvic floor dysfunction.

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Why Pelvic Floor Recovery Is More Than Just Kegel Exercises

Pelvic floor recovery is more than just doing Kegel exercises: Pelvic floor muscle exercises, commonly known as Kegels, will help to enhance muscle strength and bladder control if done as recommended by the expert. However, not everyone will need the same type or intensity of pelvic floor exercise. Some women tend to have weak pelvic floor muscles, while others may have muscles that are poorly coordinated. So, a pelvic health physiotherapist will help to assess pelvic floor strength, relaxation, coordination, breathing patterns, posture, and abdominal muscle function.

The expert will also help women to understand how the pelvic floor responds to activities such as coughing, lifting, or exercise. The aim will be to have a stronger pelvic floor contract and relax muscles when the body needs it. Breathing and pressure management within the abdomen will also be crucial for women during exercise and doing daily activities. Women may need guidance before returning to running, jumping, gym workouts, or other high-impact activities. Recovery should also be gradual.

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What Women Can Do To Support Pelvic Floor Health

What women should know: It will be important for women to maintain an optimum weight, exercise daily, quit smoking, avoid constipation by having fiber in the diet and staying hydrated. Quit smoking, use appropriate lifting techniques to reduce unnecessary strain on the pelvic floor, and don’t hold urine for a long time. Women who opted for a Caesarean section should also ensure they prevent pelvic problems.

Pregnancy itself causes pressure on the pelvic floor, so pelvic floor rehabilitation can be recommended for women with a C-section. Motherhood should not mean silently living with bladder problems. So, pelvic floor rehabilitation can improve bladder control and confidence in women.