DRUG ABUSE Dr. S. I. AHMED CHAIRMAN AIDS PREVENTION SOCIETY

DRUG ABUSE Dr. S. I. AHMED CHAIRMAN AIDS PREVENTION SOCIETY & President, NORTH EAST INDIA HARM REDUCTION NETWORK ( NEIHRN)

DRUGS OF ABUSE – CLASSIFICATION AND EFFECTS Drug and Drug use A pharmaceutical preparation or a naturally occurring substance used primarily to bring about a change in the existing process or state (physiological, psychological or biochemical) can be called a ‘drug’ When drugs are used to treat an illness, prevent a disease and improve health condition, it is termed drug use.

Drug abuse and Addiction Intake of drugs for reasons other than medical in a manner that affects physical or mental functioning is termed drug abuse. Any abuse can lead to addiction. Tolerance refers to a condition where the user needs more and more of the drug to experience the same effect. Smaller quantities, which were sufficient earlier, are no longer effective and the user is forced to increase the amount of drug intake. Dependence – This can be physical and psychological . The person becomes dependent and starts feeling uncomfortable in the absence of the drug.

Dependence This can be physical and psychological . The person becomes dependent and starts feeling uncomfortable in the absence of the drug.

Withdrawal symptoms When the drug intake is stopped, withdrawal symptoms are experienced. Physical dependence gives rise to withdrawals such as tremors and vomiting. Psychological dependence causes withdrawal symptoms like restlessness or depression. The intensity of withdrawal symptoms depends on the physical condition of the user, type of drug abused, the amount of drug intake and the duration of abuse.

Classification of Addictive Drugs Narcotic Analgesics Stimulants Depressants Hallucinogens Cannabis Volatile Solvents Other drugs of abuse

NARCOTIC ANALGESICS Pain killing or pain relieving drugs with opium like effects Natural sources – Opium – Morphine, Codeine Semi synthetic : Heroin (brown sugar) Synthetic : Buprenorphine (tidigesic), Methadone, Pentazocine

Mode of intake Opium – oral, inhalation Morphine – injection Codeine – oral (tablets and cough syrups) Heroin – injection, inhalation, chasing Buprenorphine – oral, injection

Short – term effects Euphoria Thought process impairment, drowsiness, apathy Feelings of hunger and pain are not felt Overdose of heroin can cause convulsions, coma and death

Long – term effects Mood instability Reduced libido Constipation Respiratory impairments Physical deterioration Infections like serum hepatitis and HIV can occur among IV users due to use of unsterile needles. In female abusers, menstrual irregularity and fetal addiction / abnormality can occur

Tolerance and dependence develop Withdrawal symptoms Feeling of unpleasantness Aches and pains all over the body Diarrhoea Dilation of pupils Insomnia

STIMULANTS Drugs which excite or speed up the central nervous system Type and mode of intake Amphetamines – oral Cocaine – snorted

Short – term effects A heightened feeling of well being, euphoria A sense of super-abundant energy Increased motor and speech activity Suppression of appetite Increased wakefulness

Long-term effects Chronic sleep problem Poor appetite Rapid and irregular heart beat Mood swings Amphetamine psychosis’ may occur

Tolerance and dependence develop Withdrawal symptoms – No major physiological disruptions Extreme fatigue Disturbed sleep Voracious appetite Moderate to severe depression

DEPRESSANTS Drugs which depress or slow down the functions of the central nervous system Type and mode of intake Sedative-hypnotics – Barbiturates, Benzodiazepines (oral tablets) Alcohol Short – term effects Relief from anxiety and tension Euphoria Lowering of inhibitions Poor motor coordination Impaired concentration and judgement Slurred speech and blurred vision Sedation, sleep with larger doses

Long – term effects Depression Chronic fatigue Respiratory impairments Impaired sexual function Decreased attention span Poor memory and judgement Chronic sleep problems

Tolerance and dependence Tolerance does not develop uniformly Cross tolerance can develop Physical and psychological dependence develop Withdrawal symptoms Tremors Insomnia Irritability and restlessness Hallucinations Convulsions Delirium tremens

HALLUCINOGENS Hallucinogens are drugs which affect perception, emotions and mental processes Type and mode of intake LSD -Lysergic acid diethylamide (oral tablets) PCP –Phencyclidine (snorted / smoked) Mescaline (oral tablets) Psilocybin (smoked)

HALLUCINOGENS Short – term effects Alterations of mood Distortion of the sense of direction, distance and time ‘Pseudo’ hallucinations Synesthesia – melding of two sensory modalities Feelings of depersonalization Long-term effects Flash back or spontaneous recurrence of on LSD experience can occur Amotivational syndrome LSD precipitated psychosis Tolerance and dependence Tolerance develops rapidly Withdrawal symptoms are not reported

CANNABIS Drugs from cannabis plant come under this category Ganja / Marijuana Hashish / Charas Hashish oil Bhang Mode of intake : Smoking

Short – term effects Mild euphoria Lowering of inhibitions Reddening of eyes Sense of smell, touch and taste are often enhanced Altered sense of time perception Impaired short-term memory Impairment of ability to perform complex motor tasks Long-term effects Decreased cognitive ability Amotivational syndrome Psychosis Respiratory problems Sterility / impotence In women abusers, fetal damage can occur

Tolerance and psychological dependence develop Withdrawal symptoms Sleep disturbances Loss of appetite, irritability Tremors Depression or psychotic symptoms may become prominent

OTHER DRUGS OF ABUSE Medically used drugs that do not fall into any of the above categories. Muscle relaxants Painkillers Anti-histamines, prescribed for allergies Anti-emetics Anti-depressants / anti-psychotics These drugs are taken orally as tablets or used in the form of injections. The effects and subsequent dependence and withdrawal symptoms vary.

VOLATILE SOLVENTS Drugs under this category are volatile hydrocarbons, Petroleum derivatives Type and mode of intake Glue and solvents like varnish and eraser fluids and petrol through sniffing. Short – term effects Euphoria Clouded thinking Slurred speech Staggering gait Hallucinations Sudden death Long – term effects Psychosis Permanent brain damage Liver, kidney and heart damage

Damage due to Addiction Irrespective of the drug abused, addiction leads to Physical deterioration Psychiatric problems Intellectual impairment Personality deterioration Increased risk of accidents and higher susceptibility to high risk behaviour in the form of unprotected sex or use of unsterile needles Legal risks Even death

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