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Drug Abuse : An Overview. -2- Drug / Psychoactive Substance Any substance that when taken by a person modifies perception, mood, cognition, behaviour.

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Presentation on theme: "Drug Abuse : An Overview. -2- Drug / Psychoactive Substance Any substance that when taken by a person modifies perception, mood, cognition, behaviour."— Presentation transcript:

1 Drug Abuse : An Overview

2 -2- 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

3 -3- Part 1: Types of drugs

4 -4- Classification Alcohol

5 Alcoholic beverages

6 -6- 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

7 -7- Classification Alcohol Opioids

8 Opium

9 Heroin (Smack)

10 -10- 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

11 -11- Classification Alcohol Opioids Cannabis

12 Cannabis (Bhang, Charas, Ganja, Hashish)

13 -13- 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

14 -14- 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).

15 -15- Classification Alcohol Opioids Cannabis Sedative – hypnotics

16 Valium, Avil, Cough Syrups

17 -17- 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

18 -18- Classification Alcohol Opioids Cannabis Sedative – hypnotics Cocaine and other stimulants

19 Coca leaf and cocaine powder

20 -20- Amphetamine Type Stimulants (ATS)

21 -21- 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

22 -22- Classification Alcohol Opioids Cannabis Sedative – hypnotics Cocaine and other stimulants Hallucinogens

23 LSD

24 -24- Classification Alcohol Opioids Cannabis Sedative – hypnotics Cocaine and other stimulants Hallucinogens Tobacco

25

26 -26- Classification Alcohol Opioids Cannabis Sedative – hypnotics Cocaine and other stimulants Hallucinogens Tobacco Volatile solvents

27 Volatile solvents (Inhalants)

28 -28- Classification Stimulants Cocaine Amphetamine Type Stimulants Tobacco Cannabis Depressants Alcohol Opioids Sedative – hypnotics Volatile solvents Cannabis Hallucinogens LSD Cannabis

29 Types of drugs Legal (licit): Medicine Tobacco Alcohol Caffeine/tea Bhang Illegal (illicit): Opium Heroin Cocaine ATS, Charas/Ganja

30 The Extent, Pattern and Trends of Drug Abuse in India: National Survey

31 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

32 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 m 8.7 m 2 m

33 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

34 Part 2: Why Do People Take Drugs?

35 Why Do People Take Drugs? To feel good To have novel: feelings sensations experiences AND to share them To feel better To lessen: anxiety worries fears depression hopelessness

36 Why do some people become addicted while others do not? Vulnerability

37 DRUG ADDICTION IS A COMPLEX ILLNESS

38

39

40 There’s a Big Contribution to Big Biological / Genetic Contribution to Drug Abuse and Addiction… Drug Abuse and Addiction… ….Overlapping with Influences that Help Make Addiction a Complex Disease. ….Overlapping with Environmental Influences that Help Make Addiction a Complex Disease.

41 Biology/genes Environment Biology/ Environment Interactions

42 Environmental factors Drug related Individual related Society – community related

43 Drug related factors Availability –Legal and policy environment –Socio-cultural norms and attitudes Abuse liability –Reward or reinforcement –Non-toxic –route, duration of action

44 -44- Drugs: The vicious cycle Presence makes you feel good… (euphoria) Absence makes you feel miserable… (withdrawal)

45 -45- 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

46 Individual related factors Self-medication theory –Co-morbid mental illnesses very common –Co-morbid symptoms even commoner Personality factors –‘novelty seeking’

47 Society related factors Family influence Peer influence Cultural and religious sanction & proscription Legal & policy environment The setting

48 -48- Part 3: Concept of Abuse

49 -49- Terminology Use Misuse / harmful use Abuse Dependence Addiction - older term, still used

50 -50- 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.

51 -51- 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.

52 -52- 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.

53 -53- 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

54 Withdrawal symptoms Usually opposite of acute effects –Depressants: withdrawal-excitation –Stimulants: withdrawal-lethargy/’crash’

55 -55- Alcohol withdrawal: mild Anxiety Restlessness Insomnia Tremors Craving Palpitation Sweating Breathlessness

56 -56- 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

57 -57- 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

58 -58- Cannabis withdrawal Non specific General discomfort Intense craving Anxiety, restlessness

59 -59- The usual drug-use ‘career’ Experimentation Depends upon  Availability  Peer pressure  Socio-cultural norms  Psychological factors

60 -60- Experimentation Occasional / Irregular use Depends upon  Initial experiences  Peer pressure The usual drug-use ‘career’

61 -61- Experimentation Occasional / Irregular use Regular use May be ‘Abuse’ or ‘Misuse’ Symptoms of harm start appearing The usual drug-use ‘career’

62 -62- Experimentation Occasional / Irregular use Regular use Dependence / Addiction The usual drug-use ‘career’

63 -63- Alcohol / Tobacco Charas / GanjaHeroin / SmackInjection Tidigesic From ‘softer’ to ‘harder’ drugs…

64 -64- Terminology Use Abuse Dependence

65 -65- Terminology Purpose of intervention

66 Thank You


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