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If your pet experiences any of these symptoms cheap 10mg female cialis amex menstruation every 20 days, stop the drug and contact your veterinarian immediately female cialis 20mg amex women's health center jacksonville fl. Termed an inodilator generic female cialis 20mg without prescription womens health diet pill, pimobendan combines the effects of increasing heart muscle pump strength and acts as a vasodilator to decrease the workload the heart is pumping against. This drug is intended to be used in complement to the traditional heart failure treatment. Also known as blood thinners, these drugs are most commonly used in cats with severe heart disease at risk for stroke formation. Due to their metabolism, cats cannot take aspirin daily, and are usually put on an every 2 – 3 day regimen. Side effects include inappetance, vomiting (especially any coffee ground like material) or discolored (dark, tarry) stool. If any of these occur while your pet is taking aspirin, it is best to discontinue the drug and notify your veterinarian. Do not combine with a steroid (such as prednisone, prednisolone) as serious gastrointestinal ulceration may result. Clopridogrel inhibits platelet aggregation, which leads to the formation of a clot. Side effects are typically milder that those seen with aspirin, but may include inappetance, vomiting and some blood cell dyscrasias. If any of these occur while your pet is taking clopridogrel, it is best to discontinue the drug and notify your veterinarian. There are four general classes of antiarrhythmic drugs, however some have crossover class action. Class I antiarrhythmics are sodium-channel blockers, and include procainamide and mexilitine. Most antiarrhythmics help control the heart rate, and may be prescribed to patients with rapid heart rates (tachycardia). In general, these drugs are very well tolerated with low risk for side effects, which may include gastrointestinal upset and neurologic dysfunction in rare cases. Reducing the heart rate and strength of heart muscle contraction can be beneficial for cats with the condition called hypertrophic cardiomyopathy, especially when the heart contracts so vigorously it obstructs the path of blood. Carvedilol also has alpha-blocking activity, which helps to cause relaxation of the arteries, helping to reduce high blood pressure. Beta-blockers may cause some animals to become weak due to a slow heart rate or low blood pressure. If your pet collapses while receiving a beta-blocker, contact a veterinarian immediately. The goal is to block the ability to generate a heart rate greater than 160 bpm even under stressful conditions. Sotalol may cause some animals to become weak due to a slow heart rate or lower blood pressure. It can depress heart muscle function and heart rate to the point of reducing cardiac output. If your pet collapses while receiving sotalol, contact a veterinarian immediately. There is a risk for changing the electrical conduction in a manner that is less stable than the current abnormality. The primary use of diltiazem is for treatment (and sometimes prevention) of cardiac arrhythmias, including atrial fibrillation, atrial flutter and supraventricular tachycardia. Diltiazem may relax blood vessels or depress the heart contraction or rate to such a degree that some animals become weak due to low blood pressure. These drugs typically contain an opiod, and as such, they are often controlled substances. Some over-the-counter formulations are available, and typically include the drug dextromethorphan. These include tracheobronchitis (kennel cough), chronic bronchitis, tracheal collapse and bronchial compression. In many instances, the only effective therapy for these major airway irritations is a cough suppressant or antitussive drug. These drugs suppress the cough reflex within the brain and also can cause sedation. They should not be used in the setting of an active bacterial infection of the lungs since a cough is an essential reflex to rid the lung of infection. Cough suppressants should be avoided in animals with significant heart or lung disease, unless supervised by a veterinarian. Certain nutritional deficiencies have been associated with heart disease, and supplementation may improve cardiovascular function in certain situations. The following substances are not classified as drugs (pharmaceuticals) and may be known as neutraceuticals. Fortunately, despite the lack of documented efficacy of many nutritional supplements, side effects are generally minimal. The possibility of a drug interaction also increases with the number of drugs a patient is taking, and most dogs and cats are placed on multiple drugs for the treatment of congestive heart failure. Congestive heart failure can be associated with a number of electrolyte (blood salt) imbalances, and many common veterinary medications may worsen the symptoms of heart failure. Vitamin E supplementation may increase the risk of congestive heart failure, and vitamin C supplementation may worsen muscle function in humans suffering from congestive heart failure. Congestive heart failure is a very serious and potentially life-threatening condition. The following supplements are therefore not intended to be used in place of, but rather in addition to conventional drug therapy. Taurine: Taurine (2-aminoethanesulfonic acid) is an amino acid normally found in high concentrations in tissues including the heart and retina, and is used in the liver for detoxification and excretion through the bile. Though taurine is not an essential amino acid in the dog, severe dietary restriction in certain situations may predispose dogs to deficiency. Cats are predisposed to taurine deficiency if dietary taurine is restricted because taurine is an essential amino acid in cats, and they have a limited natural ability to make taurine. A completely carnivorous (all-meat) diet supplies abundant taurine to dogs and cats. Diets that are all-cereal and grain-based (vegetarian or vegan) predispose to taurine deficiency. Retinal degeneration, infertility and dilated cardiomyopathy have been associated with taurine deficiency. While incompletely understood, taurine may act in the heart to promote cellular osmoregulation, calcium modulation, free radical inactivation (antioxidant properties), as well as other functions. A plasma taurine level (a blood test) is required to document taurine deficiency in dogs and cats. If we suspect a taurine-deficiency to be implicated in your pet’s heart disease, we may recommend testing and supplementation (often along with L-carnitine and coenzyme Q10). Taurine may be found at most supplement sections in pharmacies, Publix®, Whole Foods® or other places like the General Nutrition Center®. L-Carnitine: L-carnitine is a quaternary amine normally found in high concentrations in heart and muscle tissue.

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In the surgical group buy female cialis in india menstrual relief hormone balance, eighpatients had a second opera- Pharmacological TreatmenReferences tion: six on adjacenlevel cheap female cialis generic womens health vitamins, one infection and one 1 order female cialis online from canada women's health clinic vienna austria. Eleven patients in the surgery and injection therapies for mechanical neck disorders. Surgery reduced the pain fasr, buno diference was seen Tis clinical guideline should nobe construed as including all proper methods of care or excluding other acceptable methods of care reasonably direcd to obtaining the same results. In patients with high pain inn- for future studies which would genera meaning- sity, low function, high depression and anxiety were ful evidence to assisin further defning the role of seen. In gener- ercise in the managemenof cervical radiculopathy al, coping stragies changed. Active coping (cogni- from degenerative disorders should include an un- tive reappraisal and problem solving) was common tread control group when ethically possible. Coping with pain Recommendation #2: was changed in general into a more passive/escape Future outcome studies including patients with focused stragy. Iappeared thawith inrvention, cervical radiculopathy from degenerative disorders especially surgery, healthy active coping stragies tread only with physical therapy/exercise should nded to be replaced by passive coping stragies include subgroup analysis for this patienpopula- as patients allowed themselves to become more de- tion. Function was signifcantly relad in patients with cervical radiculopathy from degen- to pain innsity. Afr 12 months, 20% suf- Physical Therapy/Exercise References fered from depression. Resolution of pronounced painless weakness arising from radiculopathy and disk cognitive and behavioral therapy is importanto extrusion. Is treatmenin exnsion contrain- masked to treatmengroup, the sample size was dicad in the presence of cervical spinal cord compres- small and duration of follow-up was short. A nonsurgi- cal approach to the managemenof patients with cervical Tis clinical guideline should nobe construed as including all proper methods of care or excluding other acceptable methods of care reasonably direcd to obtaining the same results. Pain, coping, emotional sta and lead to worsened symptoms or signifcancom- physical function in patients with chronic radicular neck pain. A comparison between patients tread with surgery, plications when considering this therapy. Pre- physiotherapy or neck collar--a blinded, prospective ran- manipulation imaging may reduce the risk of domized study. Nonoperative managemenof e work group identifed the following suggestions herniad cervical inrverbral disc with radiculopathy. Diagnosis and treatmenof cervical radicu- manipulation/chiropractics in the managemenof lopathy using a clinical prediction rule and a multimodal inrvention approach: a case series. Recommendation #1: Future studies of the efects of manipulation/chiro- Whais the role of manipulation/ practics in the managemenof cervical radiculopa- chiropractics in the treatmenof thy from degenerative disorders should include an untread control group when ethically possible. Recommendation #2: Future outcome studies including patients with A sysmatic review of the lirature yielded no stud- cervical radiculopathy from degenerative disor- ies to adequaly address the role of manipulation/ ders tread only with manipulation/chiropractics chiropractics in the managemenof cervical radicu- should include subgroup analysis for this patienlopathy from degenerative disorders. Chiropractic treatmenof cer- vical radiculopathy caused by a herniad cervical disc. Foraminal snosis with radiculop- athy from a cervical disc herniation in a 33-year-old man nipulation in the treatmenof cervical radicu- tread with fexion distraction decompression manipula- lopathy from degenerative disorders is un- tion. Herniad cervical inrverbral discs of cervical radiculopathy from with radiculopathy: an outcome study of conserva- tively or surgically tread patients. Use of cervical spine manipulation under anes- thesia for managemenof cervical disk herniation, cer- A sysmatic review of the lirature revealed limid vical radiculopathy, and associad cervicogenic head- high quality studies to address this question. Rotary of patients, and abou25% of patients referred with manipulation for cervical radiculopathy: observations on the importance of the direction of the thrust. Complications of cervical spine manipulation therapy: 5-year retrospec- weeks post-injection. Cervical myelopathy: a case reporgarding the safety or efcacy of inrlaminar epi- of a �near-miss� complication to cervical manipulation. Is treatmenin exnsion contrain- dicad in the presence of cervical spinal cord compres- lirature search yielded a number of publica- sion withoumyelopathy? Nonvascular com- sroid injections are nowithourisk and the po- plications following spinal manipulation. Nonoperative managemenof a medical/inrventional treatmenplan for pa- herniad cervical inrverbral disc with radiculopathy. Due consideration should be disc afr spinal manipulation therapy: reporof two cas- given to the pontial complications. Of these patients, follow-up 60% of patients obtained good or excel- 65% (45/70) repord good or excellenresults with lenpain relief. In critique of this study, this is a regard to pain relief and 63% (44/70) opd noto nonrandomized, nonconsecutive case series with have surgery. In critique of this study, no validad a small sample size and fairly shorrm follow-up. In thareceived transforaminal epidural sroid in- critique of this study, iis retrospective and excluded jections and a control group thareceived transfo- any patients with neurologic defcits. Athree week ing the relevance of this study is the small sample follow-up, 40% (8/20) of the patients in the sroid size and relatively shorrm follow-up. In critique of this study, no validad outcome mea- sures were used and the sample size was very small. Patients were fol- dural injections provides no additional therapeutic lowed for four months with approximaly 25% opt- benefathree weeks post-injection. In critique of this study, the sample size is Future Directions for Research small. Iis difculto make any outcome staments e work group identifed the following suggestions regarding these patients other than they opd oufor future studies which would genera meaningful of surgery afour months following this treatment. Future studies of the efects of epidural sroid in- jections in the managemenof cervical radiculopa- Lin eal17 described a retrospective case series of 70 thy from degenerative disorders should include an patients considered pontial surgical candidas for untread control group when ethically possible. Patients underwencervical Tis clinical guideline should nobe construed as including all proper methods of care or excluding other acceptable methods of care reasonably direcd to obtaining the same results. Herniad cervical inrverbral discs jections in the managemenof cervical radiculopa- with radiculopathy: an outcome study of conserva- thy from degenerative disorders should include data tively or surgically tread patients. A of oxygen-ozone gas mixture for the treatmenof cervical prospective outcome study. Cervical Transforaminal sroid injections for the treatmenof cer- epidural sroid injections for symptomatic disc hernia- vical radiculopathy: a prospective and randomised study. Nonoperative managemenof sroids in the managemenof chronic spinal pain and ra- herniad cervical inrverbral disc with radiculopathy. Adverse cen- injection with and withoumorphine in chronic cervical tral nervous sysm sequelae afr selective transforam- radicular pain. In critique, this case ments such as bracing, traction, series did noutilize any validad outcome mea- electrical stimulation, acupunc- sures and had a very shorfollow-up period. Of the 26 patients who compled cations, physical therapy, injections and traction the program, 24 were available for follow-up athree have been associad with improvements in pa- months, with 89% (22/24) of patients reporting a tienrepord pain in uncontrolled case series.

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Voriconazole treatment for less-common buy female cialis 10mg overnight delivery breast cancer 3 day walk michigan, emerging purchase 10mg female cialis with mastercard menopause help, or refractory fungal infections generic female cialis 10mg line menstrual uterine lining. Activity of posaconazole in the treatment of central nervous system fungal infections. Management of elevated intracranial pressure in patients with Cryptococcal meningitis. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology: Official Publication of the International Retrovirology Association. A randomized, double-blind, placebo-controlled trial of acetazolamide for the treatment of elevated intracranial pressure in cryptococcal meningitis. Paucity of initial cerebrospinal fluid inflammation in cryptococcal meningitis is associated with subsequent immune reconstitution inflammatory syndrome. Clinical and mycological predictors of cryptococcosis-associated immune reconstitution inflammatory syndrome. Cryptococcal lymphadenitis and immune reconstitution inflammatory syndrome: current considerations. Trends in antifungal drug susceptibility of Cryptococcus neoformans isolates in the United States: 1992 to 1994 and 1996 to 1998. Cryptococcosis in Australasia and the treatment of cryptococcal and other fungal infections with liposomal amphotericin B. Discontinuation of secondary prophylaxis for cryptococcal meningitis in human immunodeficiency virus-infected patients treated with highly active antiretroviral therapy: a prospective, multicenter, randomized study. Maternal use of fluconazole and risk of congenital malformations: a Danish population-based cohort study. Prospective assessment of pregnancy outcomes after first-trimester exposure to fluconazole. Infection is endemic to the central and south-central United States and is especially common in the Ohio and Mississippi River Valleys. Asymptomatic dissemination of infection beyond the lungs is common, and cellular immunity is critical in controlling infection. When cellular immunity wanes, reactivation of a silent focus of infection that was acquired years earlier can occur, and it is the presumed mechanism for disease occurrence in nonendemic areas. Diagnosis Detection of Histoplasma antigen in blood or urine is a sensitive method for rapid diagnosis of disseminated histoplasmosis and acute pulmonary histoplasmosis8 but is insensitive for chronic forms of pulmonary infection. Histopathological examination of biopsy material from involved tissues demonstrates the characteristic 2 to 4 µm budding yeast and can provide a rapid diagnosis. These include creating dust when working with surface soil; cleaning chicken coops that are contaminated with droppings; disturbing areas contaminated with bird or bat droppings; cleaning, remodeling, or demolishing old buildings; and exploring caves. In patients with less severe disseminated histoplasmosis, oral itraconazole, 200 mg 3 times daily for 3 days followed by 200 mg twice daily, is appropriate initial therapy (All). Because absorption of itraconazole can be erratic, a random serum itraconazole level should be obtained after 2 weeks of therapy if there is concern about adherence or if medications with potentially adverse interactions are added to the drug regimen. Fluconazole is less effective than itraconazole for this purpose but has some efficacy at 400 mg daily. No relapses were evident in 32 subjects who were followed for a median of 24 months. At delivery, infants born to women treated with amphotericin B should be evaluated for renal dysfunction and hypokalemia. Congenital malformations similar to those observed in animals, including craniofacial and limb abnormalities, have been reported in infants born to mothers who received fluconazole at doses of 400 mg/day or more through or beyond the first trimester of pregnancy. Random serum concentrations (itraconazole + hydroxyitraconazole) should be >1 µg/mL. Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of the literature. Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature. Gastrointestinal histoplasmosis in the acquired immunodeficiency syndrome: report of 18 cases and literature review. Disseminated histoplasmosis: a comparative study between patients with acquired immunodeficiency syndrome and non-human immunodeficiency virus-infected individuals. Itraconazole prophylaxis for fungal infections in patients with advanced human immunodeficiency virus infection: randomized, placebo-controlled, double-blind study. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Itraconazole treatment of disseminated histoplasmosis in patients with the acquired immunodeficiency syndrome. Histoplasmosis in solid organ transplant recipients at a large Midwestern university transplant center. Transplant infectious disease: an official journal of the Transplantation Society. A 43-year-old woman with acquired immunodeficiency syndrome and fever of undetermined origin. Treatment of histoplasmosis with fluconazole in patients with acquired immunodeficiency syndrome. National Institute of Allergy and Infectious Diseases Acquired Immunodeficiency Syndrome Clinical Trials Group and Mycoses Study Group. Increased incidence of disseminated histoplasmosis following highly active antiretroviral therapy initiation. Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. Pregnancy outcome after in utero exposure to itraconazole: a prospective cohort study. These have presumably been the result of reactivation of a previously acquired infection. This diagnosis can be difficult to distinguish from a bacterial community-acquired pneumonia; patients present with symptoms that include cough, fever, and pleuritic chest pain. The syndromes other than focal pneumonia usually occur in more immunosuppressed patients. Diffuse pulmonary disease presents with fever and dyspnea and can be difficult to clinically distinguish from Pneumocystis pneumonia. Routine bacterial cultures from pulmonary secretions frequently reveal Coccidioides after an incubation time of less than one week. Blood cultures are positive in a minority of patients, usually those with diffuse pulmonary disease. Unlike other endemic mycoses, Coccidioides grows relatively rapidly at 37°C on routine bacterial media, especially blood agar. Growth of a non-pigmented mould may be observed in as few as 3 days and can be confirmed as Coccidioides by gene probe.

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Nonetheless discount female cialis 10mg without a prescription women's health issues endometriosis, cannabis is the towards North America purchase genuine female cialis on line zinc menstrual cramps, either directly to Mexico and most widely consumed illicit substance in the region discount female cialis uk womens health 97th and western. The prevalence of cocaine use in South America, Central America and the Caribbean is clearly above the global Cannabis trafficking flows are mainly intra-regional. In % of global 2005 2006 2007 2008 2009 total in 2009 Cannabis herb 509,265 1,065,673 1,009,470 857,534 619,786 10% Coca leaf 3,195,757 3,318,645 4,698,820 4,883,732 3,517,918 100% Cocaine 429,740 400,266 427,685 523,040 541,070 74% Amphetamines 140 87 519 41 189 0. Cocaine continues to be • In East Europe, notably in the Russian Federation the main problem drug in South America, Central and Ukraine, there is domestic production of opium America and the Caribbean, accounting for some 50% or poppy straw for local consumption purposes of all drug-related treatment demand in the region. Overall opioid use is far more Most cannabis seizures are related to cannabis resin in prevalent (some 0. The most prevalent prescriptions drugs in the region Cannabis resin found on the European market origi- seem to be prescription opioids. While cannabis resin sei- non-medical use of prescription opioids has been reported zures declined over the 2005-2009 period, those of by Costa Rica, Brazil and Chile. High levels of con- Despite the increasing importance of cannabis herb, sumption have been reported for 2009, in particular overall cannabis seizures declined by 19% between 2005 from Argentina, Brazil and, to a lesser extent, Chile. Cocaine is trafficked to Europe mainly by sea, though in Drug-related deaths terms of reported seizure cases, deliveries by air are Countries in South America, including the Caribbean higher. Countries consistently strong increases in trafficking over the 1998-2006 period rank cocaine first as the primary cause of death, which – cocaine seizures declined massively over this period is in accordance with high prevalence of cocaine use and (-53%). This partially reflects improved cooperation the dominance of cocaine in treatment demand. The countries of West Illicit drug production in Europe is mainly linked to and Central Europe accounted for 97% of all European cannabis, amphetamines and ecstasy. In addition to direct shipments from South America, shipments via Africa, notably West • Cannabis production in Europe is believed to be increasing, mostly in indoor settings. Twenty-nine Africa, gained strongly in importance over the 2004- European countries reported domestic cultivation of 2007 period, before decreasing over the 2007-2009 cannabis herb in 2008. Though the Iberian peninsula, followed by the Netherlands and Belgium, continue to be main entry • In the past, ecstasy-group substances used to be points for cocaine shipments into Europe, there have manufactured predominantly in West Europe. Te also been reports of shipping cocaine to the Balkan Netherlands and Belgium are still the main sources for ecstasy in Europe. However, manufacture has shifted region (by container or air freight) for final destinations away from the region and only a few laboratories were in the European Union. Heroin seizures made in Europe accounted for 38% of • Most amphetamine seized in Europe is manufactured, the world total in 2009. Heroin seizures are mostly con- in order of importance, in the Netherlands, Poland centrated in South-East Europe (63% of all heroin sei- and Belgium. While Methamphetamine production and consumption are, heroin seizures in West and Central Europe remained however, still the exception in Europe. Europe’s share in global ecstasy seizures Cocaine use is still concentrated in West and Central declined from 90% in 1996 to 18% in 2009. Cocaine prevalence rates in West and Central Europe accounted for 24% of global amphetamine sei- Europe doubled between 1998 and 2006 but remained zures in 2009. More than 80% of all European amphetamine seizures in 2009 took place in The next most prevalent substance is ecstasy (0. Methamphetamine use is ecstasy’ and as a ‘date rape drug,’ increased four-fold in mainly limited to the Czech Republic, though some Europe over the 2005-2009 period. European seizures consumption also occurs in neighbouring Slovakia, some accounted for almost 80% of the world total. Illicit drug use In contrast to other regions, non-medical use of pre- scription drugs has not been regarded as a major prob- The most prevalent drug in Europe is cannabis, showing 32 lem in Europe so far. Around 18% of the total canna- non-medical use of prescription opioids than heroin. Following years of The highest levels of non-medical use of prescription significant increases, cannabis use appears to have stabi- opioids so far have been reported from Northern Ireland lized in Europe. Other countries in Europe reporting a substantial Cocaine is the second most prevalent drug (0. In % of global 2005 2006 2007 2008 2009 total in 2009 Cannabis resin 907,423 618,448 853,654 937,027 623,369 49% Cannabis herb 105,577 132,558 144,310 178,345 198,841 3% Cocaine 106,587 121,065 79,864 62,737 56,736 8% Amphetamines-group 9,906 11,434 11,216 9,771 9,077 14% of which amphetamine 8,039 6,019 8,791 9,438 8,117 24% Ecstasy 4,709 5,649 5,839 1,763 995 18% Heroin 22,165 22,171 26,394 29,206 28,762 38% Opium 2,059 1,292 1,445 1,324 1,379 0. Khat is not under international control, though a drug users all across Europe, including substitution number of countries – including countries in Africa – treatment clients. Studies show that between 11% and 33 have introduced national legislation to prohibit its cul- 70% of clients report current use of benzodiazepines. Drug-related deaths Trafficking For Europe, the best estimates suggest that there are Most of the cannabis trafficking is for shipments across between 25,000 and 27,000 drug-related deaths annu- African countries. Only smaller amounts are destined ally, with a rate between 46 and 48 deaths per one mil- for overseas markets, mainly in Europe. Most of the can- lion people aged 15-64, though some estimates give nabis resin production in North Africa is for final con- substantially higher figures (about twice these numbers). The largest seizures were reported Drug-related deaths due to overdose amounted to some for cannabis herb, followed by cannabis resin. Africa’s 7,000 in the countries of the European Union in recent 34 share of global cannabis herb seizures amounts to 11% years, down from around 8,000 in 2000. Opioids, – and is thus below its share of the global population mainly heroin, are predominantly ranked as the primary (15%), while its share in global cannabis resin seizures cause of death, followed – at much lower levels – by – mostly carried out by countries in North Africa – is cocaine. Combined, these five countries Africa has been affected by significant shipments of account for some 80% of all reported drug-related cocaine from South America to Europe in recent years. In terms of mortality rates, Ukraine, The amounts trafficked via Africa to Europe, however, Iceland, Ireland and Luxembourg seem to experience seem to have decreased in 2008 and 2009, and only some of the highest levels in Europe, with over 100 partly resumed in 2010. Estimates for 2009 suggest that drug-related deaths per one million inhabitants aged some 35 mt of cocaine may have left South America for 15-64. Illicit drug production in Africa is mainly focused on In addition, African countries are increasingly being used cannabis. While cannabis resin is mainly produced in by traffickers to ship Afghan heroin to final destinations Morocco, cannabis herb is produced all over Africa. Though East Africa is Small-scale opium production is limited to countries in reportedly the main intermediate target for these traf- North Africa, notably Egypt, which regularly reports the ficking activities, African heroin seizures were highest in largest eradication of opium poppy among all countries Southern Africa and North Africa. For some time, methamphetamine and Methamphetamine seizures have been reported from methcathinone production has been taking place in Nigeria and South Africa. The paucity of the data does not allow for a reliable characterization for the continent In contrast, recent reports of shipments of metham- as a whole. In % of global 2005 2006 2007 2008 2009 total in 2009 Cannabis herb 865,974 1,220,578 694,177 936,084 639,769 11% Cannabis resin 121,576 132,784 140,544 165,455 320,600 25% Khat* 1,522 5,691 2,490 6,219 23,442 12% Cocaine 2,575 851 5,535 2,551 956 0. The available information that drug-related death in Africa is close to the global suggests that cannabis use is widespread, and that other average. Estimates could of course change substantially drugs are used as well, notably in urban areas.