Abuse is a complex psychosocial problem that affects large numbers of adults as well as children throughout the world.

It is listed in the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV-TR) under the heading of Other Conditions That May Be a Focus of Clinical Attention. Although abuse was first defined with regard to children when it first received sustained attention in the 1950s, clinicians and researchers now recognize that adults can suffer abuse in a number of different circumstances. Abuse refers to harmful or injurious tlude not only the direct costs of immediate medical and psychiatric treatment of abused people but also the indirect costs of learning difficulties, interrupted education, workplace absenteeism, and long-term health problems of abuse survivors. Types of abuse Physical The Abnormal Involuntary Movement Scale (AIMS) is a rating scale that was designed in the 1970s to measure involuntary movements known as tardive dyskinesia (TD). TD is a disorder that sometimes develops as a side effect of long-term treatment with neuroleptic (antipsychotic) medications. Purpose Tardive dyskinesia is a syndrome characterized by abnormal involuntary movements of the patient s face, mouth, trunk, or limbs, which affects 20% 30% of patients who have been treated for months or years with neuroleptic medications. Patients who are older, are heavy smokers, or have diabetes mellitus are at higher risk of developing TD. The movements of the patient s limbs and trunk are sometimes called choreathetoid, which means a dance-like movement that repeats itself and has no rhythm. The AIMS test is used not only to detect tardive dyskinesia but also to follow the severity of a patient s TD over time. It is a valuable tool for clinicians who are monitoring the effects of long-term treatment with neuroleptic medications and also for researchers studying the effects of these drugs. The AIMS test is given every three to six months to monitor the patient for the development of TD. For most patients, TD develops three months after the initiation of neuroleptic therapy; in elderly patients, however, TD can develop after as little as one month. Precautions The AIMS test was originally developed for administration by trained clinicians. People who are not health care professionals, however, can also be taught to administer the test by completing a training seminar. Description The entire test can be completed in about 10 minutes. The AIMS test has a total of twelve items rating involuntary movements of various areas of the patient s body. These items are rated on a five-point scale of severity from 0 4. The scale is rated from 0 (none), 1 (minimal), 2 (mild), 3 (moderate), 4 (severe). Two of the 12 items refer to dental care. The patient must be calm and sitting in a firm chair that doesn t have arms, and the patient cannot have anything in his or her mouth. The clinician

asks the patient about the condition of his or her teeth and dentures, or if he or she is having any pain or . Again the rater observes the patient s face and legs for any abnormal movements. After the face and hands have been tested, the patient is then asked to flex (bend) and extend one arm at a time. The patient is then asked to stand up so that the rater can observe the entire body for movements. Next, the patient is asked to extend both arms in front of the body with the palms facing downward. The trunk, legs and mouth are again observed for signs of TD. The patient then walks a few paces, while his or her gait and hands are observed 54. Mantra Raj 55. Kuvichka Tantra 56. Vigyan Lalitka Tantra 57. Lingagam Tantra 58. Kalotarr Tantra 59. Brahm Yamal Tantra 60. Aadi Yamal Tantra 61. Rudra Yamal Tantra 62. Brihdhamal Tantra 63. Siddh Yamal Tantra 64. Kalp Sutrah Tantra (sometimes called a bong ) and smoked. An alternative method of using marijuana involves adding it to foods and eating it, such as baking it into brownies. It can also be brewed as a tea. Marijuana has appeared in the form of blunts cigarettes emptied of their tobacco content and filled with a combination of marijuana and another drug such as crack cocaine. Between 1840 and 1900, European and American medical journals published numerous articles on the therapeutic uses of marijuana. It was recommended as an appetite stimulant, muscle relaxant, painkiller, sedative, and anticonvulsant. As late as 1913, Sir William Osler recommended it highly for treatment of migraine. Public opinion changed, however, in the early 1900s, as alternative medications such as aspirin, opiates, and barbiturates became available. In 1937, the United States passed the Marijuana Tax Act, which made the drug essentially impossible to obtain for medical purposes. By the year 2000, the debate over the use of marijuana as a medicine continued. THC is known to successfully treat nausea caused by cancer treatment drugs, stimulate the appetites of persons diagnosed with acquired immune deficiency syndrome (AIDS), and possibly assist in the treatment of glaucoma. Its use as a medicinal agent is still, however, highly controversial. Even although the states of Arizona and California passed laws in 1996 making it legal for physicians to prescribe marijuana in the form of cigarettes for treatment of the diseases listed above, governmental agencies continue to oppose strongly its use as a medicine, and doctors who do prescribe it may find their licenses at risk. Cannabis-related disorders reflect the problematic use of cannabis products to varying degrees. These disorders include: Cannabis dependence: The compulsive need to use the drug, coupled with problems associated with chronic

drug use. Cannabis abuse: Periodic use that may cause legal problems, problems at work, home, or school, or danger when driving. Cannabis intoxication: The direct effects of acute cannabis use and reactions that accompany it such as feeling high, euphoria, sleepiness, lethargy, impairment in short-term memory, stimulated appetite, impaired judgment, distorted sensory perceptions, impaired motor performance, and other symptoms.