drug abuse : an overview. -2- drug / psychoactive substance any substance that when taken by a...
TRANSCRIPT
Drug Abuse : An Overview
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Drug / Psychoactive Substance
• Any substance that when taken by a person modifies perception, mood, cognition, behaviour or motor functions.
• This definition includes legal and illegal substances, that can lead to dependence
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Part 1: Types of drugs
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Classification
• Alcohol
Alcoholic beverages
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• Alcohol is a brain depressant. In small amounts it relieves anxiety. it may also give a sense of strength
and result in boisterous behaviour It heightens the mood prior to intake,
be it sadness or happiness. Impairs judgement and performance
Alcohol: Psychological effects
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Classification
• Alcohol• Opioids
Opium
Heroin (Smack)
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Opioids: Psychological effects
• The effects differ widely between new and dependent users
New users
• Who is not in pain an unpleasant reaction.
• Who has pain or anxiety some relief
Dependent users
• Short lived in-tense experience – “rush”.
• A state of profound euphoria.
• A dreamlike state lasting longer
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Classification
• Alcohol• Opioids • Cannabis
Cannabis (Bhang, Charas, Ganja, Hashish)
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Cannabis products
• Bhang (leaves)• Ganja (dried flowering stem
of the plant)• Charas / Hashish (extracted
from the resin covering the plant)
• Hashish Oil (extracting THC using chemical methods)
Oral
Smoked
Smoked
Smoked
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Cannabis: Psychological effects
• A dreamy state with an increased tendency to fantasize State of euphoria, well being and
enjoyment. Generally followed by a period of
drowsiness.• Perceptual and sensory distortions.
Can prolong reaction time and impair coordination
Sounds and colours may become more intense
• Restlessness, fear and even panic may spoil the experience (“bad trip”).
• There may be driven activity (subject knows that one’s activities are meaningless, yet is unable to control them).
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Classification
• Alcohol• Opioids • Cannabis • Sedative – hypnotics
Valium, Avil, Cough Syrups
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Sedative – hypnotics & other pharmaceuticals
Medications for: • Sleep (Diazepam)• Allergy (Promethazine, pheniramine)• Pain (Pentazocine, Propoxyphene)• Cough (Codiene)• Diarrhea (Diphenoxalate)• Anesthesia (Ketamine)
General brain depressants
Opioid like actions
Hallucinogen
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Classification
• Alcohol• Opioids • Cannabis • Sedative – hypnotics • Cocaine and other stimulants
Coca leaf and cocaine powder
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Amphetamine Type Stimulants (ATS)
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Stimulants: Psychological effects
• Immediately after smoking the drug or injecting it- extremely pleasurable ‘rush’ or ‘flash’. Enhanced mood and body movement,
euphoria Increased respiration Increased heart rate, blood pressure Insomnia Reduced appetite
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Classification
• Alcohol• Opioids • Cannabis • Sedative – hypnotics • Cocaine and other stimulants• Hallucinogens
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Classification
• Alcohol• Opioids • Cannabis • Sedative – hypnotics • Cocaine and other stimulants• Hallucinogens • Tobacco
Tobacco
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Classification
• Alcohol• Opioids • Cannabis • Sedative – hypnotics • Cocaine and other stimulants• Hallucinogens • Tobacco • Volatile solvents
Volatile solvents (Inhalants)
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Classification
Stimulants• Cocaine • Amphetamine Type
Stimulants• Tobacco• Cannabis
Depressants• Alcohol• Opioids • Sedative –
hypnotics • Volatile solvents • Cannabis
Hallucinogens• LSD• Cannabis
Types of drugs
Legal (licit):• Medicine• Tobacco• Alcohol• Caffeine/tea • Bhang
Illegal (illicit):• Opium• Heroin• Cocaine• ATS,• Charas/Ganja
The Extent, Pattern and Trends of Drug Abuse in India:National Survey
1. National Household Survey (NHS)2. Drug Abuse Monitoring System (DAMS)3. Rapid Assessment Survey (RAS)4. Focused Thematic Studies (FTS)
Drug abuse and women in India Burden on women through abusing family
members Drug abuse in rural population Drug consumption in border areas Drug abuse in prisons
Components of the survey
Sample Size: 40,697 males (12-60 yrs)
Prevalence of ‘current’ use (i.e., during last month)
• Alcohol: 21%• Cannabis: 3%• Opiates: 0.7%
(heroin: 0.2%)• Any illicit drug: 3.6% (excl. tobacco and
alcohol)• IDUs (‘ever’): 0.1%• Poly-drug users: 22.3%
1. DATA HIGHLIGHTS – NHS
62.5 m8.7 m2 m
ALCOHOL 62.5 m 16.8% 10.5 m
CANNABIS 8.7 m 25.7% 2.3 m
OPIATES 2.0 m 22.3% 0.5 m
Current use Dependency ‘Volume of Work’
1. DATA HIGHLIGHTS – NHS
Part 2: Why Do People Take Drugs?
Why Do People Take Drugs?
To feel good
To have novel:feelings
sensationsexperiences
ANDto share them
To feel betterTo lessen:anxietyworriesfearsdepressionhopelessness
Why do some people become addicted while others do not?
Vulnerability
DRUG ADDICTION IS A COMPLEX ILLNESS
www.drugabuse.gov
www.drugabuse.gov
www.drugabuse.gov
There’s aBig Biological / Genetic
Contribution to Drug Abuse and Addiction…
….Overlapping with Environmental Influences that Help Make
Addiction a Complex Disease.
Biology/genes
Environment
Biology/EnvironmentInteractions
Environmental factors
• Drug related• Individual related• Society – community related
Drug related factors
• Availability – Legal and policy environment– Socio-cultural norms and attitudes
• Abuse liability– Reward or reinforcement– Non-toxic– route, duration of action
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Drugs: The vicious cycle
Presence makes you feel good… (euphoria)
Absence makes you feel miserable… (withdrawal)
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Taking drugs…
NOT Taking drugs…
..makes you feel good… (euphoria)
likely that you will continue..
..makes you feel miserable… (withdrawal)
..to avoid which you will continue..
Drugs: The vicious cycle
Individual related factors• Self-medication theory
– Co-morbid mental illnesses very common– Co-morbid symptoms even commoner
• Personality factors– ‘novelty seeking’
Society related factors
• Family influence• Peer influence • Cultural and religious sanction &
proscription• Legal & policy environment• The setting
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Part 3: Concept of Abuse
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Terminology
• Use• Misuse / harmful use• Abuse • Dependence • Addiction - older term, still used
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Terminology
• Use The ingestion of alcohol or other drugs
without the experience of any negative consequences.
If a student had drank a beer at a party and his parents had not found out we could say he had USED alcohol.
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Terminology
• Misuse When a person experiences negative
consequence from the use of alcohol or other drugs it is clearly misuse.
A 40-year old man uses alcohol occasionally, his boss throws a party and the man drinks more than usual and on the way home he is arrested by police.
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Terminology
• Abuse / harmful use Maladaptive pattern of use resulting in
physical, social, legal harm Continued use in spite of negative
consequences
The same 40-year old man continues drinking alcohol after the incident.
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Terminology • Dependence
Drug taken in larger amounts or over longer period Persistent desire or unsuccessful efforts to cut
down A great deal of time is spent in:
• obtaining the drug • using the drug • recovering from its effects
Important social, occupational, or recreational activities given up or reduced
Continued use despite harm Tolerance Withdrawal
• Addiction - older term, still used
Withdrawal symptoms
• Usually opposite of acute effects– Depressants: withdrawal-excitation– Stimulants: withdrawal-lethargy/’crash’
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Alcohol withdrawal: mild
• Anxiety• Restlessness • Insomnia• Tremors • Craving• Palpitation • Sweating • Breathlessness
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Alcohol withdrawal: severe
Severe Alcohol Withdrawal: “Delirium Tremens”
• All features of mild withdrawal• Disorientation (unawareness of self and
surroundings – time, place and person)• Hallucinations • Seizures (fits – ‘rum fits’)• Can be fatal
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Opioid withdrawal
Very distressing, but never fatal !• Opening of all holes !
Watering from eyes, nose Vomiting Loose motions
• Bodyache / pain• Anxiety, restlessness, insomnia• Premature ejaculation
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Cannabis withdrawal
Non specific• General discomfort• Intense craving• Anxiety, restlessness
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The usual drug-use ‘career’
Experimentation
• Depends upon Availability Peer pressure Socio-cultural norms Psychological factors
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Experimentation
Occasional / Irregular use
• Depends upon Initial
experiences Peer pressure
The usual drug-use ‘career’
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Experimentation
Occasional / Irregular use
Regular use
• May be ‘Abuse’ or ‘Misuse’
• Symptoms of harm start appearing
The usual drug-use ‘career’
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Experimentation
Occasional / Irregular use
Regular use
Dependence / Addiction
The usual drug-use ‘career’
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Alcohol / Tobacco
Charas / Ganja
Heroin / Smack
Injection Tidigesic
From ‘softer’ to ‘harder’ drugs…
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Terminology
Use Abuse Dependence
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TerminologyPurpose of
intervention
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