Drug Addiction

A drug is any substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via inhalation, injection, smoking, ingestion, absorption via a patch on the skin, or dissolution under the tongue.

In pharmacology, a drug is a chemical substance, typically of known structure, which, when administered to a living organism, produces a biological effect. A pharmaceutical drug, also called a medication or medicine, is a chemical substance used to treat, cure, prevent, or diagnose a disease or to promote well-being. Traditionally drugs were obtained through extraction from medicinal plants, but more recently also by organic synthesis. Pharmaceutical drugs may be used for a limited duration, or on a regular basis for chronic disorders.

Pharmaceutical drugs are often classified into drug classes groups of related drugs that have similar chemical structures, the same mechanism of action (binding to the same biological target), a related mode of action, and that are used to treat the same disease. The Anatomical Therapeutic Chemical Classification System (ATC), the most widely used drug classification system, assigns drugs a unique ATC code, which is an alphanumeric code that assigns it to specific drug classes within the ATC system. Another major classification system is the Biopharmaceutics Classification System. This classifies drugs according to their solubility and permeability or absorption properties.

Psychoactive drugs are chemical substances that affect the function of the central nervous system, altering perception, mood or consciousness. These drugs are divided into different groups like: stimulants, depressants, antidepressants, anxiolytics, antipsychotics, and hallucinogens. These psychoactive drugs have been proven useful in treating wide range of medical conditions including mental disorders around the world. The most widely used drugs in the world include caffeine, nicotine and alcohol, which are also considered recreational drugs, since they are used for pleasure rather than medicinal purposes. Abuse of several psychoactive drugs can cause psychological or physical addiction it’s worth noting that all drugs can have potential side effects. Excessive use of stimulants can promote stimulant psychosis. Many recreational drugs are illicit and international treaties such as the Single Convention on Narcotic Drugs exist for the purpose of their prohibition.

Alcohol, Alcoholism and Alcoholic:

Alcoholism as a concept has undergone a myriad of changes throughout the history of man's relationship to alcohol. Modern research conceptions relating to alcoholism include the following: Id pscombe et al (1974) noted that \ alcohol is a drug of the depressant/tranquilizer variety rather than a magical substance inhibited by God, Satan, Truth etc. "Alcoholism" is a form of drug abuse rather than a manifestation of possession by the devil, moral insufficiency, mental illness, etc; the term "alcoholism" refers to chronic process rather than to any single discrete evil or behavior.

One of the most persistent, discouraging and confusing inferences in the early research attempts to study alcoholism and the alcoholic was the lack of agreement regarding the definitions of the terms being used and studied. In persuit of a realistic and productive conception of alcoholism, science has had to assault the popular reification of the term and accept the fact that alcoholism and alcoholic are merely impressive sounding, arbitrarily defined and applied labels rather than fixed existent, and observable realities.

It was soon later realized that the terms used were ambiguous, obscure and unproductive. Some early definitions were

1. Alcoholism is a complex disease having physiological, psychological and sociological implications (National Council on Alcoholism)
2. Alcoholism represents the abnormal survival in adulthood of a need for the infantile normal experience of unitary pleasure of body and mind ( a psychoanalyst).
3. Alcoholism is reached when certain individuals stop s bragging about how much they drink and begin to lie about how much they are drinking (American Medical Association, Archieves of industrial Health).
4. One becomes alcoholic when he begins to be concerned about how activities might interfere with his drinking instead of how drinking might interfere with his activities (W.H.Q).

Causes of alcohol abuse

A grave social evil like alcoholism is not due to any one single factor. It is the result of the operation of multifarious factors. In analyzing the causes of alcoholism, the important factor to keep in mind is that, of those who use alcohol, about 90 percent do not become alcoholics. The key to alcoholism is in the motive for repeating the drinking. Therefore, explaining alcoholism only in terms of factors like personality structure will be inadequate. Alcoholic addiction is a complex phenomenon that research indicates is likely to be caused by a variety of factors rather than a single one. It was earlier believed that people who were of a certain type, viz. deviant were more likely to become addicted. There is no fixed type of personality which is addiction prone. Some factors may however, create a favourable environment or the development of addiction, while some factors may make it more difficult to give up addition.

These are looked at in the following sub-sections.

Physiological causes:

It has been found that if both parents of a child are addicted, the child has greater chances of developing addiction. While this does not mean that children of all addicts will become addicts, it suggests a greater possibility. Alcoholism tends to run in the family, suggesting that the predisposition to be an addict may be inherited. Some physiological factors which are believed to contribute towards the development of addiction of alcoholism are nutritional deficiency, dysfunction of different body system, e.g. endocrine system, etc. However none of these have been conclusively proved.

Individual or Psychological Causes:

According to some scholars, there seems to be a definite connection between alcoholism and personality maladjustment. Initially, a person drinks to seek refuge for his problems of life or to find a temporary respite from his troubles. Gradually he starts drinking more and more frequently until he becomes utterly dependent on it. However, psychologist maintain that only those people take to frequent drinking who are emotionally immature, emotional deprivation, lack self Confidence, a high level of anxiety in interpersonal relationships ambivalence towards authority, low frustration tolerance, low self-esteem, and feeling of isolation and guilt.

Socio-Cultural causes:

The sociological reasons for taking alcohol are essentially the same for taking drugs. Several theories are offered today which claim that addiction has socio-cultural origins. People in societies that view that consumption of drugs and/or alcohol a acceptable, and where drugs are easily and cheaply available are likely to have high consumption of drugs/alcohol. In some tribal societies, the consumption of alcohol is a part of religious rituals and ceremonies. Such regular consumption may cause some people to become addicted. This does not mean that only availability and acceptance encourages addiction. In societies where this consumption is not accepted, some people turn to drugs/ alcohol because they suffer normlessness.

Youth often take drugs as a rebellion against adult norms and values. The cultural defiance theory thus, indicates that drug addiction develops because of these emotional and social ties, with a nonconventional group. To add to this is the factor of social acceptance of alcohol and milder forms of drugs in certain sections of society. In India, tradition has accepted the use of alcohol, bhang, ganja on certain religious and social occasions like marriage, death, celebrations, etc. and more so among certain socio-cultural groups. Today, the social consumption of alcohol in particular has risen in all socio-cultural groups and it is considered to be a sign of social prestige to drink.

In certain Western countries, taking alcohol is socially the norm and taking pills to reduce pain or improve performance, in the regular practice. The legal status of the addicting substance is also an important factor in determining the incidence of addiction.

Whether a culture accepts the consumption of a drug/alcohol or punishes it, is also believed to be closely related to the extent of addiction in that culture. Thus, both legal and cultural approval of drugs/alcohol is believed to increase rates of addiction. However, if milder forms of drugs/alcohol are 1egally permitted, the number of persons addicted to “hard” drugs/alcohol will reduce. Such persons hold that classifying all drugs/alcohol into one broad category has had a negative impact on attempts at preventing addiction. Among young people, growing up is a stage of proving oneself to one's peer i.e. those in the same age group, who help to shape one's sense of identity. Since ability to tolerate alcohol is equated with one's manhood, boys often begin to consume alcohol and at times drugs at a young age, due to peer pressure. As in the case of age and cultural background, occupation too has been found to be related to addiction. Persons in jobs that create stress, physical and/or mental are known to become addicted.

Those prone to addiction thus include:

1. Persons in conservancy jobs, morticians and morgue workers, ragpickers, etc. whose job is associated with unpleasant activities,
2. Those performing excessively exhausting, monotonous, laborious work e.g. load-carriers and porters, drivers, etc.
3. Persons in competitive target-oriented jobs, where many deals may be struck around alcohol, like marketing and sales, etc. Family influence is believed to be another important environmental factor in addiction.

Imitation may occur if the family has an adult addict. Other factors that operate are:

1. The aggravating of stress by the family at periods of transition, e.g. adolescence,
2. The absence of reasonable parental control.
3. A disunited and dysfunctional family.

Peer group influence in initiating drug abuse and encouraging it to the point of addiction is even more decisive, as mentioned earlier. Socialization determines the extent to which people choose to conform to the larger social norms or to break the social bonds and choose deviance, living a life of addiction. Different cultures provide diverse means to their members of gaining satisfaction and of handling tensions. If a culture provides many healthy ways of reducing tensions, and of gaining pleasure, e.g. sports, creative arts, rituals and ceremonies, etc., especially to young people and those under physical or mental stress, they are less likely to turn to alcohol or other drugs and thus be less prone to addiction. Sociological theorists offer other explanations as well. The theory of strain holds that people turn to drugs and alcohol because social conditions in their environment do not provide them adequate opportunity for achievement. This is particularly so for lower socio-economic groups and other socially disadvantaged groups. It is also believed that people, because of their consumption of alcohol and other drugs and life-style become labeled as “deviants”, tend to become dependent on drugs and/or alcohol, as these become the most important aspects of their lives.

Consequences of Alcoholism

Drinking large quantities of alcohol during a short period of time, binge drinking, or drinking excessively on a regular basis can bring about severe health consequences. Overdosing on alcohol can lead to:

1. Unintentional falls or burns.
2. Accidents, including motor vehicle accidents, accidental shootings, and drowning.
3. Unprotected or risky sex.
4. Pregnancy and pregnancy-related disorders, including miscarriages.
5. Liver disease.
6. Cancers of the mouth, pharynx, larynx, and colon.
7. Cardiovascular and neurological problems.
8. Unconsciousness, coma, or death.

Excessive alcohol consumption can lead to a number of social problems as well. These consequences include:

1. Domestic violence.
2. Child abuse and neglect.
3. Sexual assault.
4. Unemployment.
5. Divorce.
6. Family issues.
7. Financial problems.
8. Criminal or civil legal problems.

Smoking Addiction

Smoking, the act of inhaling and exhaling the fumes of burning plant material. A variety of plant materials are smoked, including marijuana and hashish, but the act is most commonly associated with tobacco as smoked in a cigarette, cigar, or pipe. Tobacco contains nicotine, an alkaloid that is addictive and can have both stimulating and tranquilizing psychoactive effects. Smoking soon spread to other areas and today is widely practiced around the world despite medical, social, and religious arguments against it.

Nicotine is the addictive drug in tobacco smoke that causes people who smoke to continue to smoke.

Along with nicotine, people who smoke inhale about 7,000 other chemicals in cigarette smoke. Many of these chemicals come from burning tobacco leaf. Some of these compounds are chemically active and trigger profound and damaging changes in the body.

Tobacco smoke contains over 70 known cancer-causing chemicals. Smoking harms nearly every organ in the body, causing many diseases and reducing health in general.

Dangerous chemicals in tobacco smoke

Effects of smoking tobacco on the body

Effects of smoking on the respiratory system

Effects of smoking on the circulatory system

Effects of smoking on the immune system

Effects of smoking on the musculoskeletal system

Effects of smoking on the sexual organs

Other effects of smoking on the body

Effects of smoking on babies

Diseases caused by long-term smoking

Steps to Manage Quit Day

Stick to Your Plan

2. Get Support

3. Stay Busy

4. Avoid Smoking Triggers

5. Stay Positive

Diagnosis

Treatment

Medications

Counseling

Medications help you cope by reducing withdrawal symptoms and cravings, while behavioral treatments help you develop the skills you need to give up tobacco for good. The more time you spend with a counselor, the better your treatment results will be.

During individual or group counseling, you learn techniques you can use to help you stop smoking. Many hospitals, health care plans, health care providers and employers offer treatment programs. Some medical centers provide residential treatment programs — the most intensive treatment available.

All tobacco control measures require political commitment. Because the tobacco industry is far better funded and more politically powerful than those who advocate to protect children and non-smokers from tobacco and to help tobacco users quit, much more needs to be done by every country to reverse the tobacco epidemic. By taking action to implement the MPOWER policies, governments and civil society can create the enabling environment necessary to help people quit tobacco use. WHO, with the help of its global partners, stands ready to support Member States as they face the challenges ahead.

Mental Depression

Depression is a state of mental illness. It is characterized by deep, longlasting feelings of sadness or despair. Depression can change an individual’s thinking/feelings and also affects his/her social behaviour and sense of physical well-being. It can affect people of any age group, including young children and teens. It can run in families and usually starts between the ages of 15 and 30 years.

Women and elderly people are more commonly affected than men. There are several types of depression such as major depression it is a change in mood that lasts for weeks or months. It is one of the most severe types of depression.

Dysthymia (chronic depression) is a less severe form of depression but usually lasts for several years.

Psychotic depression a severe form of depression associated with hallucinations and delusions (feelings that are untrue or unsupported). Seasonal depression, occuring only at certain time of the year usually winter, also known as ‘winter blues’.

Causes:

Depression is thought to be caused by an imbalance of certain brain chemicals called ‘neurotransmitters’ that carries signals in brain which the body uses to control mood. Some of the common factors that may cause depression are genetics (hereditary), trauma and high levels of stress, mental illnesses such as schizophrenia and substance abuse, postpartum depression (women may develop depression after the birth of the baby), serious medical conditions such as heart disease, cancer and HIV, use of certain medications, alcohol and drug abuse, individuals with low self-esteem, trauma and high levels of stress due to financial problems, breakup of a relationship or loss of a loved one.

Signs and Symptoms:

The signs and symptoms of depression include feeling of sadness and loneliness, loss of interest in activities once found enjoyable, feeling of hopelessness, worthlessness or excessive guilt, fatigue or loss of energy, sleeping too little or too much, loss of appetite, restlessness and being easily annoyed.

Diagnosis:

The doctor may diagnose depression based on the detailed history and sign and symptoms of the individual. Many a times the individual is asked a series of questions to help screen/check for depression symptoms. Specific examinations include physical examination of the individual such as height and weight measurement. Examination of the vital signs such as blood pressure, heart rate and temperature. Laboratory tests such as blood tests to screen for alcohol/drugs in blood. Psychological evaluation of the individual’s thoughts, feelings and behavior patterns.

Treatment:

The most common treatments of depression are –

1. Counselling & Psychotherapy.
2. Medication.
3. Electroconvulsive therapy.

Counseling allows individuals to understand and accept the initial cause of depression. It can help address low self-esteem or relationship issues or persistent negative thinking.

Psychotherapy - For mild to moderate depression, psychotherapy may be the best treatment option. There are two main types of psychotherapy commonly used to treat depression. Cognitive-behavioural therapy (CBT) helps change negative ways of thinking and behaving. Interpersonal therapy (IPT) helps people understand and work through troubled personal relationships that may cause depression. Medications such as anti-depressants are given to help balance chemicals in the brain known as ‘neurotransmitters’.

Electroconvulsive therapy (ECT) is carried out in case the treatment with other therapies such as medications has failed. ECT is a procedure during which controlled amount of electricity is introduced into the brain in conjunction with anesthesia and muscle relaxant medications. It helps restore the balance of neurotransmitters by causing the brain to produce a mild generalized seizure (lasting for about 30 seconds).

Complication:

If left untreated, depression can lead to some severe complications such as emotional, behavioural, health and even legal/financial problems, relationship difficulties, social isolation and even suicide.

Prevention:

Preventive measures include regular exercise, healthy diet and stable relationships. They are helpful in keeping stress low and thereby reduce the chances of feeling depressed again. The outcome of depression is usually favourable. With prompt treatment, a depressed person can return to a happier lifestyle and more balanced outlook on life.