Nutrition for Mental Health of Students

(Excerpt from my research paper titled Bhagavad Gita and Nutrition for Mental Health of Students presented at the World Suicide Prevention Day's UGC Sponsored National Conference on "Educational Reforms and its Impact on Suicidal Ideation of Students organized by Smt. Binzani Mahila Mahavidyalaya, Nagpur, on Sept. 10-11, 2014)

The human body is a society of cells, composed of some hundred trillion cells. And today we know that, “All living cells that we know of on this planet are DNA software driven biological machines comprised of hundreds to thousands of protein robots coded for by the DNA software. The protein robots carry out precise biochemical functions developed by billions of years of evolutionary software changes.”[i]

 

An individual gets his life because of the cells living in his body. And the primary tasks of the cells are performed by their protein robots. If the nutrient molecules required to form these proteins are not available in the calls, the proteins cannot be formed, and the cells sicken or die. And if the cells sicken or die, the individual also sickens or dies. 

Proteins are all chains of amino acids linked together, and so can be formed only from the 20 amino acids found in nature, nine of which are the essential amino acids. So in order to prevent diseases and disorders – including mental disorders – it is important to ensure the formation of the proteins by including adequate amounts of at least the nine essential amino acids in our diet every day; a balanced diet must ensure the correct balance of the essential amino acids.

As most people are ignorant about the amino acids, educational institutions can begin conducting classes to educate students, especially those in Home Science Colleges, about the importance of amino acids – their exact daily requirements, their deficiency symptoms, and the foods in which the amino acids are found. 

The Amino Revolution by Robert Erdmann can serve as a good primer on amino acids. Gopalan’s Nutritive value of Indian foods, published by the National Institute of Nutrition, Hyderabad, gives us the amino acid contents of all Indian foods, but it is no longer in print. Educational institutions ought to make this book available to their students.

Nutrition for Mental Health

The ability to think clearly is vital for students. Clarity of perception and thoughts depends on us having normal or healthy states of consciousness like the wakeful and drowsy states. And when we cannot think clearly, our behavior also tends to become dysfunctional. So it is very important to ensure that our brain maintains the normal states of consciousness if we are to avoid behavioral problems and mental disorders – that is, psychiatric illnesses.

 Vander’s Human Physiology textbook says, “The components of the RAS (reticular activating system) that release norepinephrine, serotonin and acetylcholine are most involved in controlling the various states of consciousness.”[ii] When the nutrients needed to form these three neurotransmitters get depleted in the brain, the RAS cannot form and release these neurotransmitters, and we can develop altered states of consciousness. And Vander’s says, “These altered states are also characteristic of psychiatric illnesses.”[iii] So it is important that everyone knows the nutrients needed to form norepinephrine, serotonin and acetylcholine.

“Acetylcholine (ACh) is synthesized from choline… Some ACh receptors respond not only to acetylcholine but to the drug nicotine, and have therefore come to be known as nicotinic receptors… one cholinergic system that employs nicotinic receptors plays a major role in attention, learning, and memory.

“Dopamine, norepinephrine, and epinephrine (also known as adrenaline) all contain a catechol ring and an amine group; thus they are called catecholamines. The catecholamines are formed from the amino acid tyrosine… These neurotransmitters play essential roles in states of consciousness, mood, motivation, directed attention, movement, blood-pressure regulation, and hormone release.

“Serotonin is an important biogenic amine. It is produced from tryptophan, an essential amino acid… In addition to their contributions to motor activity and sleep, serotonergic pathways also function in the regulation of food intake, reproductive behavior, and emotional states such as mood and anxiety. Serotonin reuptake blockers are thought to aid in the treatment of depression.”[iv]

The essential nutrients choline, tyrosine and tryptophan are extremely important not only for ensuring healthy states of consciousness, but also for other vital needs of students. When choline gets depleted, acetylcholine cannot be formed in the body and the student’s attention, learning and memory suffer. And tryptophan deficiency can cause symptoms of raging emotions, anxiety and depression, – which is the primary cause of people attempting suicide – and also insomnia and overeating or obesity. 

Tyrosine’s deficiency symptoms are more disturbing, primarily because the catecholamines that it forms play an essential role in movement – our bodily activities, including behavior. And also because adrenaline, which is formed from tyrosine, gets secreted in the blood-stream during stress – for the activation of the body’s fight-or-flight stress response – and can quickly cause the depletion of tyrosine during chronic stress.

A person whose body is deficient in tyrosine can develop symptoms of blood pressure problems, attention deficits, loss of motivation, or pep, and disturbing moods. All these symptoms can be very agonizing and so, students often seek relief from their agony by experimenting with alcohol or psychoactive substances, often getting addicted to them. A few students seek relief from psychiatrists who often end up prescribing psychoactive substances as medication. 

But Vander’s says, “Virtually all psychoactive substances exert their actions either directly or indirectly by altering neurotransmitter-receptor interactions in the biogenic amine—particularly dopamine—pathways.”[vi] And once the drugs make the alterations in a person’s brain, the person is unable to lead a normal life without the use of drugs, leading to drug-dependence – addiction. 

I had been one of the toppers when I entered IIT Bombay in 1968. However, after taking the psychiatric drug dextroamphetamine for just a week or so during one of the IIT exams, I had got severely addicted to the drug, and remained a drug-addict until 1990. Today the same drug, dextroamphetamine (Dexedrine/Aderall), is being prescribed by doctors to children suffering from attention deficit (ADD/ADHD). 

To overcome the anxiety caused by stress, students often consume alcohol. But alcohol is a form of sugar/carbohydrate that requires niacin for its metabolism. And so in drinkers, niacin often gets depleted, causing tryptophan to get converted to niacin and get depleted. Thus consuming alcohol can also lead to depression. So, it is good idea to take Niacin – vitamin B₃ – when drinking.

 

Bill W., the founder of Alcoholics Anonymous (AA), started suffering from severe depression in 1944 for over a decade. Bill finally found freedom from depression by taking large doses of niacin. And in 1968, Bill W wrote a paper giving the result of the clinical studies on niacin, showing that niacin is highly effective in treating Alcoholism, Schizophrenia, Heart Diseases and other problems. Orthomolecular Psychiatry professionals recommend taking niacin for the prevention of depression.

Indiscriminate prescribing of psychoactive medication by medical professionals must also be addressed. Medical professionals began prescribing opioid analgesics – painkillers – ever since Bayer started marketing Heroin in 1898 and psychiatrists, psychoactive substances since the 1950s. But the drugs they have been prescribing are so addictive that today America is facing a prescription-drug overdoses epidemic: “Since 2003, more overdose deaths have involved opioid analgesics than heroin and cocaine combined.”

 

“We can no longer pretend that we are not aware. Regardless of what the disease is called, its root cause is still deficiency and toxicity. The typical convention methods of cut (surgery), burn (radiation), and poison (medication) have little effect as they do not address these issues.” – A.P.J. Abdul Kalam, The Family and the Nation (2008)

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[i] What is Life? A 21^st Century Perspective, Lecture by J Craig Venter: http://www.edge.org/conversation/what-is-life

[ii] Vander’s Human Physiology: Mechanism of Body Function, Eleventh Edition, McGraw-Hill 2008, page 236

[iii] Ibid., page 242

[iv] Ibid., page 167-168

[vi] Ibid., page 244

THE GREAT IDEA TO CHANGE THE WORLD

(The following idea had been submitted in 2009 for the IIT Bombay's 50 Anniversary celebration's competition: Great Ideas to Change the World in 50 Years)

Title of your Idea:

REBP: A New Way To Learn

Scientific and/or Technical Area of Your Idea:

Neuro-Cognitive Science, Psychotherapy and Physiology

What is unique and novel about your idea (50 Words):

The novelty of my idea is that it offers us a way to learn by observing experiences with our sense of touch.

It is the only effective therapy for drug addiction and alcoholism.

It is the only simple way to teach children how not to get angry.

 How will this idea impact the world (50 Words):

This idea will help people control their anger and hatred and thus prevent conflicts, wars and terrorism.

It will help in bridging the gap between the rich and the poor.

It will help avert the environmental crisis.

Brief description of the idea and how it can be realized in practice (1000 Words):

Man has so far been unable to be scientific about his inner life. Mainly because the apparatuses we had been using to observe it—our eyes and ears—were inappropriate. My idea is to use the apparatus of our sense of touch to observe our body to learn from it and understand ourselves. I have used Vipassana or dhamma, the scientific teaching of Gautama Buddha, to observe and understand the subtler realities occurring within ourselves, or our body, by using our sense of touch. This technique, or Body Awareness Exercise, helps us to overcome emotional suffering. By observing and understanding our own suffering, we begin to understand the suffering that others must be going through and start having compassion for other beings; we become more reasonable and considerate, and lead a moral life. By diligent practice, this technique even makes it possible for us to experience the laws of physics, such as the law of relativity, within our own body. Now that we are in a quandary as to which path to choose to understand the one universal law or the ‘law of everything’, this technique might well be our best option.

Conflicts about our personal problems and thoughts about our anger and hatred distract our awareness when we start to look within ourselves. This is one of the biggest obstacles in doing the exercise, and why people stop or give up doing it. In order to overcome this obstacle, I have added a psychoanalytical process, which involves a simple inventory of our anger and hatred, in my idea that I have named REBP or the REB Program. The inventory is a part of the original Alcoholics Anonymous program and is very effective in removing one’s anger and resentments. By doing the inventory and sharing it with another person, before starting the Body Awareness Exercise, most of our anger and hatred get removed and stop distracting us too much, and we are able to do the awareness exercise regularly and benefit from it. The inventory sharing also helps us to sort out our problems or come to terms with them and enables us to make the necessary restitutions to restore our relationships with others. 

In times of stress, and poverty is the greatest stressor, the brain is overworked in transmitting excessive messages, and neurotransmitters get depleted. Unless the store of neurotransmitters in the brain is replenished, we experience anxiety, depression and other emotional problems. This also is an obstacle in doing the awareness exercise. Neurotransmitters are produced from the nutrients we consume as food and nutrition supplements. Misinformation by health care providers has made us believe that the proteins we eat are nutrients for the cells of the body. They are not. The nutrients for our body cells are the twenty amino acids that the body extracts from the proteins we eat by the process of digestion. Different combinations of these twenty make up practically everything in our body. When any one of the amino acid is deficient in our diet, the health of the part or system of our body that requires it for its growth or functioning suffers, and we become prone to illness and diseases. Taking the particular amino acid as nutritional supplement can restore out health.

Most of the neurotransmitters in the brain are produced from amino acids, serotonin from tryptophan, dopamine and epinephrine, as well as adrenaline and thyroxin, from tyrosine or phenylalanine. GABA, which relieves anxiety, is itself a neurotransmitter, but also produced from glutamine. Pfeiffer's Law states, "For every drug that benefits a patient, there is a natural substance that can achieve the same effect." People need to be educated about this amino acid aspect of nutrition, for then they would be able to take care of their physical, as well as emotional, health by taking the necessary amino acid as nutrientional supplements rather than unnecessarily poisoning their bodies with drugs, unless absolutely necessary. 

So my idea is to educate people about the Body Awareness Exercise, inventory and nutrition and to tech them how to do the exercise and the inventory.

To awaken is to see and understand! Once people see this idea and understand it, we wouldn’t have to do much more to implement the idea. They would want to practice and implement it themselves. Everybody wants to control their anger. Everybody wants to overcome their fear and emotional suffering. But science has failed us. This idea makes it possible. All that this idea needs to get implemented is for the scientific community to accept the idea as a scientific idea. Once this is done, it would be implemented worldwide through the efforts of universities, schools and affiliates. I have written a book giving a scientific explanation of the processes of both the inventory and the awareness exercise and detailed instructions on doing the inventory. The inventory teaches us to take care of our anger, and with it parents and teachers will now finally have a way to teach children how not to get angry. The inventory alone would be highly beneficial to the all people. It also makes us more compassionate and considerate towards our environment and its people. Along with amino acid supplements to replenish neurotransmitters, it is a highly effective therapy for drug addiction and alcoholism.

People can learn the simple Body Awareness Exercise from the book Sadhana by Anthoney de Mello, and practice it at home. Centers for teaching this exercise along scientific lines would also have to be set up, as the continuity in its practice is more beneficial. Even young children can learn this exercise to start taking care of their emotions from an early age itself. 

Vipassana is known to help executives remain calm in times of stress, increasing their efficiency and productivity. When more executives of commerce and industry and leaders of nations start doing the awareness exercise and inventory, it will go a long way in averting the environmental crisis.

Authority rarely brings about a change; change comes only from within.

Any general comments:

Please note: I will send you a copy of my book and related material, for more information about my idea, by post. 

The inspiration for my idea:  “Over Great areas of the world it still survives; it is possible that in contact with western science, and inspired by the spirit of history, the original teaching of Gautama, revived and purified, may yet play a large part in the direction of human destiny.” - H. G. Wells (The Outline of History)

Quantam and Particle Physics Con Game

Quantum physics is not a science of nature or natural science. What these theoretical scientists using quantum physics call "particles" are only "sparks of energy", which is not an observable (empirical) material reality.

Energy is the essence of material substances that gives the substance its mass. Energy is generally understood to be the capacity to do work; one needs energy to do work. But the scientists have not yet given us a proper definition of energy. If they had defined energy, people would have known what exactly energy is. And if people knew what energy was, the physicists would not have been able to take people for a ride in the name of "energy" -- just like Religious Priests, Mullahs and Pundits are taking people for a ride in the name of "God".

So let us first define energy before we go any further. The best definition that I have found for energy is the one given by Aristotle, who is considered to be the founding father of physics and the natural sciences. Aristotle defines energy as the "source of every thing's being and function". Physics, for Aristotle, is the "science of natures and natural changes". And the natural changes concerns energy.

Mass, length and time are properties, or concepts, that we use to *measure* (Sanskrit, 'maya') material substances and phenomena. In order to understand physical phenomena, natural philosophers -- called "physicists" after the 2nd half of the 19th century -- use the properties of Mass, Length and Time. Newton was the first philosopher to use these properties to define the Laws of Motion, given in his treatise the "Mathematical Principles of Natural Philosophy". But there was a dispute between him and Leibniz on whether L (the living energy) = mv or mv2 (squared). And finally, after over 200 years of experimentation, in his 1905 paper, Einstein, using Maxwell's equations, proved that L = mv2 -- Einstein did not prove that e = mc2. It was only after Rutherford gave the atomic model in 1910, stating that atoms are sparks of energy, that Einstein, after 1912, started calling his equation e = mc2 (whether this is what is called "fudging", or not, you can decide for yourself).

In order to develop advanced technologies, scientists developed quantum physics, wherein they say that length and time can change, but not the mass. This is absurd, because if properties of length and time change, so will mass. That's why they have the Heisenberg Uncertainty Principle -- we can never ever know the exact position and momentum of a particle, both at the same time. So what the modern theoretical physicists call particles is not some empirical observable reality, but is only a statistical equivalent.  This is why quantum physics cannot be used to explain nature or to understand natural reality. If we do, we get results like the famous Schrodinger's Cat, where we can show that a cat can be alive and dead at the same time, until one observes the cat.

And today the physicists, most of whom themselves don't understand quantum physics,  are fooling people about the beginning of the universe, the big bang theory, black holes, god-particle and what not, telling us that quantum physics can prove that. But this is all nothing but unsubstantiated hypotheses -- in short, bull shit.

Of course, quantum physics is a technological aid to develop advanced technologies. But then, just look at what the quantum technologies have developed -- atomic bombs and nuclear arsenal that can now destroy our planet and annihilate life on earth, or the Information Technology that has given USA and NSA the capability to infringe on our privacy and to snoop on whatever we say, write and declare. Seeing the technologies that these quantum physicists have developed, one begins to wonder if it is sane to allow these physicists to waste trillions of dollars worth of our earth's precious resources on their CERN type experiments, only to develop such technologies that enslave and degrade the common man!

Of course, the physicists will definitely tell us that it is necessary to spend the trillions, because if we don't, the physicists will lose their multimillion dollar incomes. Too bad, but Physics has now become a huge game for the Western powers. Are you, I ask, going to allow them to continue spending the trillions, which rightfully ought to be spent of feeding and clothing all the people on this planet?

Right now we are powerless against the tyranny of the Western Powers and their physicists. The only way out for us that I have realized is to develop the soul-power that's within each of us. Once each of us develops the soul-power that is inherent in each of us, the Western Powers will have no power left to control and dominate the common man. And we shall be finally free.

If you'd like to know about the Yoga to develop our soul-power, you can see my YouTube on Bhagavad Gita and also read these two articles on "Yogic science can Transform Education" from the embedded links.

Be Happy

Controlling Anger and Violence

Incidents of mania and rage are on the rise, leading to a lot of violence and sex violence nowadays. Anxiety, depression and suicides amongst our people are also steadily increasing. Although all these problems are mood or behavioral problems, most people have now started believing that they are all mental health problems. But actually, they are merely problems caused by our inability to control our passions. 

Reason is often completely in thrall to passion. And so, rational and cognitive techniques in education and in therapies are often quite ineffective. When our passions or emotions, anger and fear, get enraged, the clarity of our thinking suffers, and we tend to make mistakes and commit blunders – some people become aggressive and violent while others surrender meekly when threatened, unable to voice or do the needful . All the violence, sexual violence, crime and corruption that we are seeing around us today can, directly or indirectly, be attributed to our inability to control our passions. Anger and violence, including sexual violence, can diminish only when people learn the skill to control their passions and emotions.

Maslow’s 1943 paper A Theory of Human Motivation, which is being used quite successfully by management and human resource trainers to improve behavior of their workforce, is a general dynamic theory for controlling one’s passions and, for achieving self-actualization – realizing one’s own ability and potential. 

Passions are strong emotions that compel us to act. Passions arise in us to motivate and instigate us to satisfy our needs – the physiological needs and the psychological needs, namely the Safety needs, the Love and Belonging needs, and the Esteem needs. All our activities and behavior are motivated for the satisfaction these basic needs of ours.

And when any of these basic needs gets thwarted or threatened, we get angry or afraid, and tend to act irrationally, harming others or ourselves. This is what disturbs peaceful coexistence. Maslow’s brief needs gratification therapy gives us a way to become conscious of our psychological needs, which are very often largely unconscious, thus giving us the opportunity to control our passions.

The physiological needs, however, are the most powerful of all our needs and Maslow asks us to consider homeostasis, and correct our nutritional deficiencies, in order to satisfy these needs. Educators, unfortunately, do not teach us the way to satisfy our physiological needs. Leaving our physiological needs unsatisfied in times of stress can often lead to mood and behavioral problems, as you would understand by watching this short video and interview of mine: http://www.youtube.com/watch?v=tUORK9RkTIQ

 

We have published two books on Maslow’s needs gratification therapy. One of them, The Lost Path, has been praised by Jeremy Hunter, professor of self-management at the Drucker Graduate School of Management in Claremont, California. The presentation I had given to the scientists of the Defense Institute of Psychological Research, DRDO Delhi, has also been well appreciated. I have also presented papers on the technique at various psychology conferences. You can check these out on our website: www.karmayog.org/ngo/behappy

As the incidents of anger and violence in the nation are on the rise, we have decided to give seminars and presentation at educational institution on the technique to control one’s passions and emotions. Another thing that must be noted is that, counselling and psychotherapy is often ineffective when the basic needs of the counselor remain unfulfilled. So your staff, counselors and trainers, would find Maslow’s humanistic needs gratification technique highly beneficial, not only for themselves but also in helping students and others to be in charge of their emotional responses and to avoid dysfunctional behavior.

Addiction: A Problem Created by Doctors for Monitory Gains

The ancient goal of medicine carved on a statue honoring physician E. L. Trudeau’s work at Saranac Lake is: “To cure sometimes, To help, often, To console, always.”[1] Pharmaceutical companies and drug manufacturers have not yet developed medicines that can cure most of our common diseases such as the common cold, cancer, heart diseases, diabetes, hypertension, mental disorders and so on. Hence physicians, who depend on pharmaceutical drugs for treating illnesses, are unable to cure most diseases, and are left with no alternative but to adopt palliative treatments – treatments that relieve pain and ease the symptoms without curing the disease.

Narcotic drugs and psychoactive substances are excellent painkillers and are also capable of giving instant relief, and opium has been prescribed by physicians to console patient since ancient times. After the discovery of the cocoa plant, physicians also began prescribing cocaine in the late nineteenth.[2] In 1898, the German pharmaceutical company Bayer started marketing a highly potent opioid painkiller – morphine diacetate or diacetylmorphine – under the trade name of Heroin.[3] So by the beginning of the twentieth century physicians had started prescribing the narcotic drugs and psychoactive substances such as heroin and cocaine.

Today we know that, “Virtually all the psychoactive substances exert their actions either directly or indirectly by altering neurotransmitter-receptor interactions in the biogenic amine—particularly dopamine—pathways. … most psychoactive substances act on the mesolimbic dopamine pathway. … the mesolimbic dopamine pathway allows a person to experience pleasure in response to pleasurable events or in response to certain substances.”[4] And, as “the major neurotransmitter implicated in addiction is dopamine,”[5] most psychoactive drugs, or substances, lead to addiction – drug dependence and tolerance. 

A hundred years back, when physicians began prescribing heroin and cocaine, they might not have known about the addictive nature of these drugs, but they must have soon realized it. Because, once a person starts taking these drugs, he soon becomes addicted to the drugs and requires a larger dose, or a more potent drug, to give him the same affects that earlier required a smaller dose. Soon, laws were put in place, in most countries, making the use of narcotic drugs and psychoactive substances illegal, unless prescribed and monitored by a registered medical practitioner.

But once a person gets addicted to these psychoactive drugs, the physiological urge to take more drugs that he develops is so overpowering that the anti-drug laws have not helped us much in curbing illegal drug usage. And as the physicians and psychiatrists continued prescribing the psychoactive drugs to their patients, the tolerance to the drugs developed by the patients made them seek out for more potent drugs. The pharmaceutical companies have given them the highly potent narcotic analgesics and psychoactive drugs for them to prescribe. 

However, now, after prescribing narcotic drugs and psychotropic substances to the nation for over a century, America has woken up to face the worst addiction crisis in its history – the prescription drugs abuse crisis.[6] And the number of people dying due to prescription drugs has skyrocketed: “Since 2003, more overdose deaths have involved opioid analgesics than heroin and cocaine combined” according to the January 13, 2012 report of the US Centers for Disease Control and Prevention (CDC).[7]

Addiction costs the US governments almost half a trillion dollars each year, $200 billion of which is spent on healthcare costs.[8] When healthcare institutions and their affiliates – physicians/psychiatrists, clinical psychologists and pharmaceutical companies – make hundreds of billion dollars each year that they would lose if the addiction problem vanished, it would be unrealistic to expect psychiatrists, psychologists and physicians to tell everyone about the simple existing solution to the addiction problem. So let us now examine the solution. 

In 1943 Abram Maslow gave us a definitive theory of motivation in his paper A Theory of Human Motivation.[9] The theory, Maslow says, is based on his clinical observations. Every human organism has the need to attain self-actualization – that is, to attain one’s full potential, which Maslow calls ‘self-fulfillment’ and ‘becoming what one is capable of being’. 

In order to attain self-actualization, Maslow’s theory states, one has to first satisfy his deficiency needs – the physiological needs and the three psychological needs, namely the Safety needs, the Love and Belonging needs, and the Esteem and Achievement needs. These psychological needs are the same as the needs/drives contained in the inventory analysis (psychodynamics) that had been described in the 1939 book Alcoholics Anonymous (Big Book). The inventory technique/path as followed by the AA founders had helped AA grow a thousand-fold in the 1940s, from 100 members in 1939 to 100,000 members in 1949. Maslow’s paper explains the psychology of the technique. 

The inventory analysis has been explained in details in the book “12 Steps in aDay” and can be used by anyone to help addicts and alcoholics to recover. It has also been reviewed by the professor of Self-management at the Drucker’s Collage of Graduate Management. 

HAPPY DIWALI & A FULFILLING NEW YEAR

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[1] Randolph Nesse and George C. Williams, Why We Get Sick, Vintage Books (1996), page 11

[2] http://en.wikipedia.org/wiki/Cocaine#Medicalization

[3] http://en.wikipedia.org/wiki/Heroin#History

[4] Vander et al, Human Physiology: The Mechanism of Body Function, 9^th Edition(2004), Chapter 8 Consciousness, The Brain, and Behavior, pages 258-259

[5] Ibid., page 259

[6] http://www.drugfree.org/join-together/prescription-drugs/prescription-drug-abuse-america%E2%80%99s-problem?utm_source=Join+Together+Weekly&utm_campaign=779a11174d-JT_Weekly_News_Prescription_Drug_Abuse and http://www.thefix.com/content/america%E2%80%99s-newest-   and  http://www.nytimes.com/2005/07/31/education/edlife/jacobs31.html?pagewanted=all&_r=0

[7] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm?s_cid=mm6101a3_w

[8] http://www.drugfree.org/join-together/addiction/new-casa-report-finds

[9] http://psychclassics.yorku.ca/Maslow/motivation.htm