Distinguishing needs from wants: Before credit cards were invented, consumers could only purchase what they could afford to pay and had to prioritize their purchases by distinguishing "needs" from "wants". With access to credit, consumers can now purchase pretty much anything their credit limit will allow them, so long as they can make their minimum payments.
Lack of Income: Families that fall below basic family budget levels often lack the income needed to support a safe and decent living standard. Therefore, such families supplement their income by using credit to purchase basic necessities such as food, clothing and shelter. Eventually, debt accumulates to such a level that families cannot afford to make minimum payments against their debt and may have to file bankruptcy.
Job Loss or Illness: A common reason for financial hardship is an unexpected job loss or the inability to work due to a prolonged period of illness or disability. People today are saving less, and often have no savings to draw upon during the period of unemployment or illness. The resultant effect is a significant reduction in income such that living expenses cannot be maintained without going into debt. If the non-working period is prolonged, the debt may have accumulated to such a level that debt payments can no longer be maintained, even after finding employment.
Unrealistic expectations or beliefs - Internal stress factor
A common source of stress is unrealistic expectations. People often become upset about something, not because it is stressful, but because it does not concur with what they expected. This can affect our personal relationships, work, and health. Often our ideas about how life should be do not match reality. We may idealize life. Unrealistic attitudes promote unnecessary disappointment, and resentment when life doesn't doesn’t happen the way we want. Unrealistic expectations can have a negative effect on your social life as you may find yourself isolated by the fact that you expect too much of yourself and are expected to match up to others expectations of how you should be. Personal life may also be tough due to having an unrealistic view of how you should be living your life, in regards to how much money you should have or how happy you think you should be. Unrealistic expectations are common in the workplace, especially during the time of corporate reorganizations due to the current economic crisis, which sometimes puts unhealthy and unreasonable pressures on the employee; this can be a massive source of stress and trouble. Increased workload, extremely long work hours and intense pressure to perform at peak levels all the time for the same pay, can actually leave an employee’s physically and emotionally drained. Unrealistic expectations can come from within or from others high expectations of you; these goals that are set far too high can leave you feeling dissatisfied and frustrated when they are not achieved, the constant frustration and the feeling of failure can lead you to using alcohol or drugs as an escape.
Perfectionism - Internal stress factor
Perfectionism comes in 2 forms:
Normal Perfectionism – A type perfectionism that isn’t necessarily a bad thing, this type can help you set high standards that are possible of reaching and even be a main factor in the way you were able to achieve it, by providing the motivation to persevere in the face of difficulty.
Neurotic Perfectionism – This type of perfectionism is very unhealthy, it can make you very critical of your life and mistakes you make, which inturn make your stress levels rise as your under the constant pressure of trying to be perfect. Neurotic perfectionism can lead to anxiety, depression and make you want to turn to things as alcohol and drugs.
Perfectionism is made up of many characteristics
- The belief that you and/or your environment must be perfect, the striving to be the best, to reach the ideal and to never make a mistake.
- An attitude that whatever you attempt in life must be done perfect with no mistakes, slip-ups or inconsistencies.
- A habit developed from youth that keeps you constantly alert to the imperfections, failings, and weakness in yourself and others.
- The fear of failure and fear of rejection, i.e., if I am not perfect I will fail and I will be rejected by others.
- A reason why you may be fearful of success, i.e., if I achieve my goal, will I be able to continue, maintain that level of achievement
- A moralistic outlook that does not allow for humanism or imperfection
- The belief that no matter what you attempt it is never good enough to meet your own or others' expectations.
Examples of the negative consequences of perfectionism include:
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Low self-esteem. Because a perfectionist never feels good enough about personal performance, feelings of being a failure or a loser will lower self-confidence and self-esteem will be lower as a result.
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Guilt. Because a perfectionist never feels good about the way their responsibility has been dealt with in life, a sense of shame and guilt may result.
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Pessimism. Since a perfectionist is convinced that it will be extremely difficult to achieve an ideal goal, they can easily become discouraged, disheartened and pessimistic about future efforts to reach a goal.
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Depression. Needing always to be perfect, yet recognizing that it is impossible to achieve this goal, a perfectionist runs the risk of feeling depressed which may lead to taking drugs or excessive amounts of alcohol.
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Obsessiveness. Being in need of an excessive amount of order, pattern or structure in life can lead a perfectionist to become picky and obsessive in an effort to maintain a certain order.
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Compulsive behaviour. Over-indulgence or the compulsive use of alcohol, drugs, gambling, food, shopping, sex, smoking, risk-taking or novelty, is often used to medicate a perfectionist who feels like a failure or loser for never being able to be good enough in life.
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Lack of motivation. Believing that the goal of change will never be able to be ideally or perfectly achieved can often give a perfectionist a lack of motivation to attempt change in the first place, or to persevere if change has already begun.
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Lack of belief in self. Knowing that one will never be able to achieve an idyllic goal can lead a perfectionist to lose the belief that he will ever be able to improve his life significantly.
http://www.livestrong.com/article/14702-overcoming-perfectionism/
Low self esteem - Internal stress factor
Having low self esteem means you are not comfortable with yourself, you do not consider yourself worthy of happiness, and are always unfairly criticizing yourself .
You can also be afraid to enter into meaningful relationships with other people, and are too scared to take risks in life. The result is that you do not get as meaningful relationships, and do not achieve as much success as you deserve, therefore further lowering your self image.
Overly Critical of Self and Others: With low self esteem, you are always criticizing yourself, and are never satisfied with your accomplishments. You give more importance to other peoples' negative judgments about you than the love and appreciation shown by those who really love and admire you. Here, we may differentiate between confidence and self esteem. Confidence is something that is related to some area of activity. You might be very good in your chosen area of activity, and yet suffer from low self esteem. There have so been many famous people who were great achievers, but suffered from low self esteem- you get to know about them ever so often when they indulge in self destructive behaviours.
- The self deprecating attitude becomes a major cause of stress and anxiety and a lot of distress in your life. You are never satisfied with who you are and what you have.
- This is also reflected in your attitude towards family: you remain irritable and angry with family members and may sabotage your relationships with your spouse and children. This unhappiness results from a feeling of inadequacy and dissatisfaction which is perpetual and persistent.
Approval Seeker and Indecisive: Low self esteem compels you to always seek approval and acceptance from others. Since you are never sure of yourself you are always looking at others for cues and hints. Being in a perpetual state of self doubt, you become indecisive and unable to take any action on your own. This indecisiveness becomes a great cause of stress in your lives. You may become overly dependent on someone, or may become addicted to smoking, eating, drugs or something else.
Since you are so unsure and insecure, you never enter into close relationships with others. You avoid going to social gatherings, and hide your inadequacy with criticism or self denial – 'They are not my kind of people, had it been some other group, then maybe…', 'I am not in the mood to attend any function right now, may be later on…' Since, since you avoid exposing yourself to social situations, you do not develop adequate social skills and become shy and introvert.
Anxiety, Fear and Panic: Anxiety and Fear are the constant companions of a person suffering from low self esteem. Being unsure of yourself, you are continuously watching each and every action of your own and of other people around you. You become overly sensitive to any remarks or comments made by the others – or rather you are on the lookout for snide remarks made on you, which becomes a major cause of stress in your relationships with other people!
This hyper-vigilant state makes you get angry over insignificant matters, and you may become prone to loosing temper at the slightest provocation. The pressure of living in a state of constant anxiety and stress reaches a point where you start suffering from panic attacks. This can lead to depression and you may take solace in withdrawing from all social contacts. Your social isolation further aggravates the situation and becomes another cause of stress and anxiety, thus trapping you in a vicious circle.
Self Confidence vs. Achievements: As a low self esteem person you are never ever convinced of your own capabilities. You are unsure of taking any action and the consequences of actions that you take. You may carry on being in a job where you feel that you are trapped: your lack of confidence in your capabilities stops you from taking any action. You don't have faith in your ability to deal with new situations that will appear in the new work place. You keep on cursing the job and still put up with your under-achiever status. This is the cause of stress at many workplaces and any steps taken by the management will prove ineffective to alleviate the tensions caused by under-achiever employees.
On the other hand, you may gravitate towards becoming an over-achiever. To prove to yourself and to others about your worth – which is a never ending process – you push yourself to the limits and achieve one success after the other. You may become a typical workaholic who is always busy and has no time for self, spouse, children or other family members.
Depression – Psychological
Depression is actually an illness that can have many different causes. These vary from person to person, and it can sometimes be that what causes one person’s depression is nothing like the cause for another’s. Multiple causes can go hand in hand with each other, or there may well be only one cause.
One common cause of depression is a psychological reaction to a stressful situation in life you may be experiencing or have previously experienced. These causes can include; Bereavement, illness, job or money concerns of stress, divorce, redundancy, disability, childhood experiences etc. These events or stressors can cause the lowering in mood, as well as other symptoms of depression such as anxiety, low self-esteem and self-confidence. In these cases it’s usually easy to notice exactly what’s causing the issue.
Depression can also be caused by chemical or hormonal changes in the brain. Hormonal changes can have a powerful effect on mood. These changes can be particularly apparent in women during pregnancy, the menstrual cycle, or during menopause, and helps to explain why women are more likely than men to suffer from depression.
Depression can often be caused by drugs such as cannabis and other recreational drugs, and also excessive amounts of alcohol. Drugs and alcohol are depressors therefore dependence on these can lead to an unhealthy cycle of taking them to cope with depression, while they are actually a factor causing it.
As previously mentioned, there is often not a single cause to depression, and many of life’s factors may coincide with each to cause the start of depression.
Depression can also play a big part in affecting your personal and social life, at home the depressed individual will lack interest in their family and will be unable to enjoy their company and share in activities, and to participate in family life. They will be unable to show affection for their loved ones and uninterested in love-making with their partner. They will also tend to avoid friends and social gatherings, and be unable to derive enjoy such things as their hobbies and general interests.
Depression can also influence your work life and cause you to be at risk of losing your job through such things as;
Decreased Productivity
Decreased productivity is usually the first impact depression has on work. It usually starts with minor problems such as forgetting little details of a project. As feelings of depression and associated impairment increase, so do problems with concentration, decreased interest and attention span. Left unchecked, the problems can increase to the point that one finds it difficult to get anything completed. Problems with sleep and decreased appetite can also decrease energy, which has a negative impact on productivity. Decreased productivity then increases the depressed person's feeling of despair, which leads to further problems with being productive. The process can develop into a cycle that feels impossible to get out of.
Decreased Reliability
Procrastination often comes with reduced motivation, and a pattern of putting off things that one does not feel like doing. Decreases in reliability often start small, with arriving a few minutes late for work, but escalate into a pattern of frequent sick days, arriving late and leaving early.
Increased Accidents
Depressed individuals are also a safety risk. Delayed reaction times, impaired eye-hand coordination and preoccupation with the distressing emotional state can lead to a lack of attentiveness. When safety depends upon being alert and focused, depression can create a very dangerous situation.
Increased Interpersonal Problems
Irritability is a common sign of depression. Co-workers are frequently dealing with this problem. As depression and irritability increase, others become intolerant of the constant complaining, blaming and lack of cooperation. Depressed people frequently experience an urge to isolate or withdraw from social interactions with others, which could further increase tension through misunderstandings. Also, other workers often find themselves working to compensate for the depressed person's reduced productivity. When these factors are combined, the work environment can begin to experience morale problems, leading to increased troubles and a general decrease in productivity.
Phobias – Psychological
A phobia is an . It is an extreme or irrational fear of an animal, object, place, or situation. Phobias are more than normal fears. They develop when a person begins to live their life around avoiding the things they are afraid of. Living with a phobia can be difficult. Even if the feared object or situation does not regularly appear in their daily life, the individual may find that a lot of their time is spent worrying that it may appear or figuring out how to avoid it. Depending on what your phobia is, you might find it a real struggle to do everyday activities, go out with friends or even make it to work every day.
These limitations can make them feel isolated. They may wonder why they are not like everybody else. They may have trouble keeping friends. They may become reclusive and depressed. Phobias can cause awkward and embarrassing situations. can be especially difficult to manage, because the underlying fear is of humiliation. Having a can feel humiliating, continuing the fear and making the phobia more difficult to manage. Perhaps the worst emotional components of a phobia are the out of control & helplessness feelings you suffer when dealing with the phobia.
Whether a phobia affects your work life depends largely on the exact that you have and the severity of your . With certain phobias affected by the work place, approaching or being at the workplace, or even when intensively thinking of the workplace, anxiety can arise. This goes along with increased physiological arousal, typically with symptoms of accelerated heartbeat, sweating, trembling, hot flushed, chest pain, which might even result in a leaving the person unable to do their work and may lead to them taking a high amount of sick days or in the worst case unable to work outside the home leaving them isolated and unable to be apart of a team.
Digestive diseases - Physiological
Stresses of all kinds, physical, emotional and mental, are primary causes of poor digestion. All unconscious activity in the human body, including both our reactions to stress and digestion, are controlled by the autonomic nervous system. When people experience stress, as a survival mechanism, the body diverts energy, blood, enzymes and oxygen from the digestive organs to other areas of the body and increases acid production. When a person suffers from stress and tension they tend to develop a range of bad coping techniques such as developing a poor diet by in taking large amounts of junk, processed and non low fiber foods due to comfort eating, they can also develop bad posture by having constant tense muscles due to stress.
Digestive problems can be initiated and further aggravated by the presence of stress. As the stress response lingers, immunity is compromised. Stress levels can make the digestive tract the perfect host for infection, disease and inflammation. Peptic ulcers, irritable bowel syndrome and reflux are all examples of such disorders that may be caused by stress. Dealing with a chronic illness such as a digestive disease can be a major stress on your life and when people are stressed, they are more likely to feel anxious or depressed. When a person is diagnosed with a digestive disease or when such a disease flares up, it puts the individual at a higher risk for depression and anxiety. However, some individuals may still have feelings of depression or anxiety even while in remission from a digestive disease. Depression specifically has been found to have a negative effect on the disease course, with a greater chance of a more frequent relapse of their condition. In addition, individuals who have Inflammatory Bowel Disease and a psychological condition such as depression or anxiety combined, they are more likely to have a lesser quality of life and have a poorer adherence to treating themselves. Being diagnosed with a chronic illness is a major life changing event, especially a chronic illness that involves your digestive system. These are illnesses that can be embarrassing to talk about and they are illnesses that not a lot of people know about. They affect so many different aspects of your life such as:
Work – where the constant feeling of illness affects your productivity, ability to focus or work in a team, with the constant thought of the illness or your feelings regarding it.
Social life – the uncontrollable aspect of having a digestive disease can stop you wanting to go out and socialize, you may feel embarrassed or scared that you cant control the illness while in the company of others, therefore leading you to become isolated and spend more of your time at home by yourself.
Self-image – when you are sick you never feel happy or confident in yourself, you always feel like people are looking or talking about you and that you don’t look good. Poor self image is known to result in feelings of loneliness, helplessness, fear, anger, and a whole host of other emotions.
Irritable Bowel Syndrome
IBS (irritable bowel syndrome) is a common condition of the digestive system and can cause bouts of stomach cramps, bloating, diarrhoea and constipation.
Personal
The effort to cope with pain related to irritable bowel syndrome (IBS) leads to stress-related symptoms, fatigue, sleep difficulties and problems with appetite and weight control. Relationships with friends, coworkers and family often suffer. Fear, anxiety, physical tension and depression are common in IBS and can actually increase abdominal pain and discomfort. A vicious cycle begins as your pain leads to psychological distress, which leads back to more pain and increased sensitivity to pain.
Social
Irritable bowel syndrome can even affect your social life. The frustration and embarrassment of dealing with symptoms while you're away from home may prevent you from scheduling activities.
Work life
Irritable bowel syndrome can be not only uncomfortable, but it can affect the quality of your life in other ways. Your professional life may be affected by the amount of missed workdays that are caused by irritable bowel syndrome. In fact, people who have irritable bowel syndrome have three times as many workplace absences as those without the disorder
Heartburn
A valve at the top of the stomach prevents acid from leaving the stomach. If this valve isn't functioning properly, or the pressure on the stomach is too great, acid is forced up into the gullet - reflux - and irritates its sensitive lining.
Personal
Heart burn can play a big part in affecting your personal life, as there are effects of finding it hard to sleep due to heartburn. And the after-effects the next day of getting less sleep than you needed from the night before such as being frustrated and angry, like the physical symptoms of heartburn, these effects can be just as discomforting to you, not to mention the people who care about you.
Social
Going out and enjoying a nice meal or a drink can become a big deal to a sufferer of heart burn due to the fact they know what will come next, wether it be a long night filled with pain and discomfort or a sudden attack forcing you to go home, heart burn can greatly affect your social life.
Work life
Frequent heartburn may affect your ability to focus at work. And then there's the stress factor of heartburn that can make you seem ill-tempered or moody which may lead to work place tension.
Ulcers
A peptic ulcer is an open sore that develops on the inside lining of the stomach (a gastric ulcer), which causes a burning or gnawing pain in the centre of the abdomen.
Ulcers have very similar effets on your life as IBS and Heartburn, it can be caused by certain foods or substances and can greatly affect all aspects of your life as you do not want to social due to the discomfort of the ulcer, it may even affect your daily mood towards friends and colleagues alike causing tension and arguments.
Substance use/abuse – Physiological
The presence of stress can be a decisive factor in leading you to seek a crutch such as alcohol, drugs and tobacco.
Physiological effects of drug abuse vary by the type of drug. Stimulants, such as amphetamines, can delay sleep and elevate a person's mood, but high amounts can cause nervousness and anxiety in the user. Depressants, by contrast, impair mental and physical functions, and slow neural activity in the brain. With some drugs, especially narcotics such as opium or heroin, the body can build a tolerance in which it adjusts to the drug's presence. Over time, the body requires higher doses to maintain the same effect. When an abuser stops taking the drug, the body experiences withdrawal symptoms, such as feeling weak or sick. Withdrawal symptoms are the body's reaction to the absence of the drug to which it had become adjusted.
Alcohol is very similar with its addictiveness, some if its physiological effects include such serious consequences as depression, anxiety disorders and even alcohol induced psychosis. Many individuals afflicted with alcoholism can also end up suicidal.
Substance abuse can also lead to things such as;
Isolation is the most common social effect of drug and alcohol abuse. The substance abuser eventually maintains a connection only with his drug of choice. Depending upon the substance of choice, the financial strain can be devastating. Buying drugs and alcohol becomes more important to the addict than daily responsibilities. Close connections to the substance abuser are affected. Relationships become dysfunctional, as the co-dependent recognizes the effects of the substance which can lead to arguments and spouse or child abuse. Social effects on the family can be felt long after the addiction. The family can be dissolved, children can develop emotional issues and trust can be shattered.
After-effects of substance use (hangover, withdrawal) affecting job performance and the ability to get to work as you cant drive. Absenteeism, illness, and reduced productivity.
Preoccupation with obtaining and using substances while at work, interfering with attention and concentration.
Illegal activities at work, including selling illicit drugs to other employees.
Psychological or stress-related effects due to substance abuse by a family member, friend or co-worker that affects another person's job performance.
Tobacco is also a drug commonly abused to deal with stress. Most tobacco users believe that tobacco reduces their stress and helps them manage unpleasant moods, tobacco users feel normal after using nicotine, but stress levels rise in between smoke or chew breaks. Thus, the tobacco user is kept constantly bouncing back and forth between feeling normal immediately after using and feeling increasingly stressed as the hours since their last intake of nicotine go by.
Tobacco effects your entire environment. Not only does it worsen your appearance by yellowing and wrinkling your skin, and darkening your teeth, it also makes you smell like smoke and that can cause some people around to become nauseous or you may be smoking and getting others sick with second hand smoke.
Also, it affects the people you become friends with. You are more likely to loose friends because of your smell or because they don't want to be involved with cigarettes. Then, the new friends you make are most likely going to be smokers as well because smoking will be something you will have in common. Having friends who smoke may make it hard to quit unless they encourage you to quit as well.
Smoking causes you to get addicted to it. This means that you depend on smoking to lead a normal life
When you do not smoke, you will get nervous and tense, or agitated. You might also suffer a loss of concentration until you get your dose of nicotine.
When trying to quit, not only will you suffer withdrawal symptoms, you will feel left out and depressed. The harmful effects of smoking will also make you more anxious.
Smoking greatly decreases your brain's performance, making you less effective in your work and also causing you to be unsociable with work colleagues.
Anxiety – Psychological
Anxiety affects everyday life in many aspects like relationships, profession and other personal interests. This disorder can dampen the spirit and reduce the potential and performance of the individual in a huge way. Causes of this disorder can be a wide range or build up of things such as financial, work or personal pressures. It can show itself through a variety of symptoms such as causing the individual to get headaches, tense muscles, dizziness, dry mouth, stomach problems and sleeping problems. Anxiety may lead the individual to feeling uncomfortable in social situations ending up in a anxiety attack, therefore forcing them to become isolated and lose contact with friends and family. Stress in general can be one of the major causes of anxiety attacks, especially when stress in different areas of people's lives come together. Anxiety attacks are strongly linked to low self esteem and stress from home life where the individual is constantly stressed as people may look to avoid them such as spouses or children as they are too tense and unhappy. Soon they can't cope with the stress and it is so overwhelming they have an anxiety attack.
Workplace
The right amount of anxiety can improve work performance through an adrenaline rush, such as when an athlete is about to perform. But if people's anxiety levels become too high, anxiety can interfere with people's ability to work effectively as there performance will start to decline, it may also cause absenteeism due to being unable to face the pressures of work which may cause the individual to lose their job. Anxiety may also cause increased work tension due to the sufferer being unsociable and moody.
Anxiety typically arises when people feel that they are about to become victims of situations over which they have no control. Workplaces are particularly fertile grounds for generating such situations. Most jobs no longer come with long-term guarantees and companies can implode in a few weeks resulting in huge layoffs, making people feel there jobs are at risk with every decision they make.
Anxiety can also elicit strong emotional reactions. When people are anxious, they are more likely to lose their temper or become impatient with their fellow workers which can lead to conflicts in the place of work therefore leading to a decrease in productivity and also a hostile work environment.
Interrupted sleep patterns – Physiological
According to Dr Jeni Worden, there's little evidence that lack of sleep, or sleep deprivation as it's known, causes any immediate physiological damage to the body. But it certainly affects how you feel and how your brain works, and it can interfere with work and home life.
If it goes on for a long time, there may be some risk that it can cause some health problems, such as aggravating existing . Interrupted sleep patterns can be caused by other problems affecting your work life and once you got to bed you are unable to switch off, instead you lay there thinking about your troubles and running through the many outcomes that may happen.
http://www.bbc.co.uk/health/physical_health/conditions/sleepdeprivation.shtml
Symptoms
Fatigue can make you grumpy, irritable and unable to function properly. Chronic tiredness can increase vulnerability to depression and accentuate other mood problems such as anxiety.
Sleep deprivation can also affect your performance by reducing cognitive ability - your ability to think and use your brain. Combined with drowsiness, this can greatly increase the risk of accidents because you're less able or quick at thinking your way fast out of a dangerous problem.
Along with the delays and errors in doing mental tasks, there's a slowing down of mental and logical reasoning. Memory is affected by sleep deprivation, with reduced immediate recall, although information acquired before sleep deprivation is normal.
Personal
Lack of sleep can severely affect your personal life, you may not be able to function properly on a daily basis, you make be overly grumpy towards family leading to arguments and may also affect you sex life with your partner as you don’t physically feel up to doing anything after a long sleep deprived day.
Social
Social life is affected by interrupted sleep patterns due to being too tired to socialise with your friends and enjoy things that involve physical activity or just being out the house in general.
Workplace
Lack of sleep and/or untreated sleep disorders have serious consequences for productivity, safety, health, and quality of life. Despite this, sleep needs tend to be ignored by popular culture in general and corporate culture in particular. Poor sleep costs businesses directly through lost productivity, compromised physical or emotional health, impaired cognition, accident rates and absences, and indirectly through such factors as poor morale, poor social relationships, and depression.
Outline of current legislation governing workplace stress
HSE has created some straight forward guidance on stress management standards –
Management standards for work related stress started in November 2004. It promotes organisations to take preventative measures through a risk assessment and includes a guide for employers and a template stress policy. The 6 management standards cover the main sources of stress in the workplace – demands, control, support, relationships, role and change. Standards aren’t law but HSE have indicated that they will be used as evidence against employers who continually ignore their responsibilities in managing stress under the Health and Safety at Work Act 1974.
HSE are pursuing a 3 year preventative plan that will take place between 2005 and 2008. The objectives include:
- Implementing a national stress programme
- Reducing the incidence of stress by 8% nationally
- Reducing the number of people first reporting awareness of work related stress by the end of 2007/2008
- Focussing on 5 key sectors that report the highest incidence of work stress related ill health – health, education, central government, local government and the financial services.
References:
Unit DP2M35 Managing Stress through Exercise and Therapy Class notes
http://www.ehow.com/about_5387147_physiological-economic-effects-drug-abuse.html
