Drug Addiction and Drug Abuse

Drug Addiction & Drug Abuse
Definition
• The word "drug" is defined as "any substance that, when taken into the living organism, may modify one or
more of its functions" (WHO).
• "Drug abuse" is defined as self administration of a drug for non-medical reasons, in quantities and
frequencies which may impair an individual’s ability to function effectively, and which may result in social,
physical, or emotional harm.
• "Drug dependence" is described as "a state, psychic and sometimes also physical, resulting from the
interaction between a living organism and a drug, characterized by behavioural and other responses that
always include a compulsion to take the drug on a continuous or periodic basis in order to experience its
psychic effects, and sometimes to avoid the discomfort of its absence.
• A person may be dependent upon more than one drug.

Drug addiction
• Drug addiction is defined as a state of periodic or chronic intoxication detrimental
to the individual and society produced by the repeated intake of habit-forming
drugs .
• Drug abuse has reached an alarming proportion in recent years. "Drug culture" is
fast making inroads into the lives of young people from all walks of life.
• To call a person a drug addict, the following criteria must be satisfied :
• (1) Psychological dependance there is an overpowering desire (compulsion) to

take the drug and obtain it by any means.
• (2) Physical dependance : when the drug is withdrawn, the patient shows
"withdrawal symptoms" such as irrational and violent behaviour, nausea,
diarrhoea, watering of eyes and nose, etc.
• (3) Development of tolerance : there is a tendency to increase the dose.

Reasons for drug dependence
1. Curiosity and natural tendency to experiment withdrugs.
2. Disturbed home environment : children from broken homes, indifferent

parents, lack of communication between parents and children.
3. An escape phenomenon from tensions and frustrations in life, e.g. ,

unemployment, failure inexaminations.
4. Impact of disco culture, mobile, TV, internet etc.
5. Ignorance regarding the habit-forming nature of the drugs.

Agent factors
Dependence-producing drug
• A dependence-producing drug is one that has the capacity to produce dependence, as described above.
• The specific characteristics of dependence varies with the type of drug involved. ICD-10 recognizes the following
psychoactive drugs, or drug classes, the self administration of which may produce mental and behavioural disorders,
including dependence :
• 1. Alcohol
• 2. Opioids
• 3. Cannabinoids
• 4. Sedatives or hypnotics
• 5 . Cocaine
• 6. Other stimulants including caffeine
• 7. Hallucinogens
• 8. Tobacco
• 9. Volatile solvents
• 10. Other psychoactive substances, and drugs from different classes used in combination.
Symptoms of drug addiction
1. Loss of interest in sports and daily routine
2. Loss of appetite and body weight;
3. Unsteady gait, clumpsy movements, tremors
4. Reddening and puffiness of eyes, unclear vision
5. Slurring of speech
6. Fresh, numerous injection marks on body and blood stains on clothe
7. Nausea, vomiting and body pain
8. Drowsiness or sleeplessness, lethargy and passivity
9. Acute anxiety, depression, profuse sweating
10. Changing mood, temper, tantrums
11. Depersonalization and emotional detachment
12. Impaired memory and concentration
13. Presence of needles, syringes and strange packets at home.
Environmental factors
• Among the environmental factors attributed to drug dependence are rapid technological
developments with associated need for extended periods of education, along with the
in-applicability of old solutions to novel problems.
• Television , world travel, affluence, freedom to speculate and experiment have

encouraged youngsters to question and often reject the values and goals of their
parents.
• Established social values are perceived as irrelevant, all to be stripped away, partly
through the use of drugs in order to reveal the real person, the real humanity, and the
real goals of mankind.
• Studies confirm that those who take drugs usually form part of a small antisocial and
often criminal subculture.
Factors associated with a high risk for drug abuse
• Unemployment
• Living away from home
• Migration to cities
• Relaxed parental control
• Alienation from family
• Early exposure to drugs
• Leaving school early
• Broken homes; one parent families
• Large urban environments
• Areas where drugs are sold, traded, or produced
• Certain occupations (tourism, drug production or sale)
• Areas with high rates of crime or vice
• Areas where there are drug - using gangs
• Areas where delinquency is common
Prevention
Preventive measures include education of target groups and the general public through TV,
radio, leaflets, and posters to create awareness of the problem.
The Government have promulgated an Act called the "Narcotic Drugs and Psychotropic
Substances Act" which came into force in 1985 to combat this problem.
1. Legal approach
• The legal control on the distribution of drugs, when effectively applied has been
and remains an important approach in the prevention of drug abuse.
• Controls may be designed to impose partial restriction or to make a drug

completely unavailable. Legislation may be directed at controlling the
manufacture, distribution, prescription, price, time of sale, or consumption of a
substance.
• Legislation restricting or prohibiting advertisements that directly or indirectly

promote use of tobacco and alcohol has been increasingly common in recent
years.
Antismoking measures
• (a) prohibition of the sale of tobacco products to minors
• (b) restriction on the sale of cigarettes from automatic vending machines
• (c) prohibition of smoking in schools and other places frequented by young
people
• (d) prohibition of smoking in public
• (e) prohibition of cigarette advertising at times, and in places and ways,
calculated to ensure its maximum impact on adolescents
• (f) establishment of mandatory public health education on health consequences
of smoking
• (g) insisting on the placing of mandatory health warning on cigarette packets.
• The minimum age at which minors may legally have access to alcoholic
beverages, has been raised in some countries.
• There is also legislation controlling the distribution of alcohol in some countries.
• Mandatory jail sentences for drunken driving have not been very effective.
2. Educational approach
• Educational approaches to the prevention of drug use and drug-related problems
have been used in many countries.
• Common approaches have included educational programmes for school children

and public information campaigns on electronic media.
• General principles of communication can be applied to increase the effectiveness

of educational approach.
• The message should be clear and unambiguous to the intended audience, and
come from credible source of information.
• The message should also provide specific advice, rather than general, and as far
as possible the information should be new to the audience and should be capable
of provoking discussion or action.
• Educational approach should not be planned and carried out as isolated activity.
• To be effective, such approaches should be regarded as a part of integrated plan

of action involving other strategies.
3. Community approach
• The non-medical use of the drugs individually as well as in its mass appearance involves a
complex interaction of drug, man, and his environment, including social, economic, cultural,
political and other elements of varying character and strength.
• The rapid changes taking place at the present time in relations between individuals, groups and
nations are also reflected in a rapidly changing pattern of drug abuse in many parts of the world.
• There should be a strong emphasis on action at the community level to prevent drug abuse.
• Initiating preventive interventions in the community brings preventive action to the level of
people's every day lives and actions, and contributes to emphasis on strengthening primary
healthcare.
• Action at the community level is also important since communities often bear the main
burden of dealing with the harmful use of drugs and drug related problems.
• A popular approach to the prevention of drug abuse is provision of alternative activities

which may help to prevent drug abuse - e.g. , teen centres providing activities attractive
to the adolescents who might otherwise drift in to drug taking subculture.
• Such activities include the establishment of groups or organizations interested in

athletics, sports, music, public policy, religion, artistic activities of various kinds, and
improvement of the environment through the prevention of pollution.
• Non-governmental organizations play a crucial role in the development of such activities

and are likely to become important.
Treatment
• Treatment cannot take place unless the individual attends for treatment.
• He must come to terms with the possibility of a life without drug taking.
• Unfortunately, drug takers, as a rule, have little or no motivation to undergo treatment.
• Alcoholics tend to deny that their consumption is abnormal; others openly defend their
habits.
• Long term treatment is not only a medical problem, but needs the cooperation of
psychologists and sociologists.
• There is a high relapse rate with all treatment methods

• Though drug addiction may be considered as a social problem, the first step in its
management is medical care , which includes :
• a. identification of drug addicts and their motivation for drug detoxification;
• b. detoxification (requires hospitalization) ;
• c. Post-detoxification counselling and follow-up (based on clinic and home visits);

and
• d. rehabilitation .
• Simultaneously with medical treatment, changes in environment (home, school,
college, social circle) are important.
• The patient must effect a complete break with his group, otherwise the chances
of relapse are 100 per cent.
• Psychotherapy has a valuable place in the management of the addict.

Rehabilitation
• The rehabilitation of former drug user, regardless of age, is in most cases a long and difficult
process.
• Relapses are very frequent. Success of the treatment necessitates the adoption of mature and
realistic attitude by the local community and the avoidance of panic, moralcondemnation and
discrimination.
• Facilities for vocational training and sometimes the provision of sheltered work opportunities are
useful in rehabilitation and help to prevent relapse.
• Generally speaking, facilities for the registration, diagnosis, treatment, after-care, etc., of drug-
dependent individuals and groups should be regarded as indispensable integrated parts of the
health and social services structure of any community in which drug-dependence exists.

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Drug Addiction & Drug Abuse

• A person may be dependent upon more than one drug.

• (1) Psychological dependance there is an overpowering desire (compulsion) to

• (3) Development of tolerance : there is a tendency to increase the dose.

2. Disturbed home environment : children from broken homes, indifferent

3. An escape phenomenon from tensions and frustrations in life, e.g. ,

4. Impact of disco culture, mobile, TV, internet etc.

5. Ignorance regarding the habit-forming nature of the drugs.

• Television , world travel, affluence, freedom to speculate and experiment have

• Controls may be designed to impose partial restriction or to make a drug

• Legislation restricting or prohibiting advertisements that directly or indirectly

• There is also legislation controlling the distribution of alcohol in some countries.

• Common approaches have included educational programmes for school children

• General principles of communication can be applied to increase the effectiveness

• To be effective, such approaches should be regarded as a part of integrated plan

• A popular approach to the prevention of drug abuse is provision of alternative activities

• Such activities include the establishment of groups or organizations interested in

• Non-governmental organizations play a crucial role in the development of such activities

• Unfortunately, drug takers, as a rule, have little or no motivation to undergo treatment.

• There is a high relapse rate with all treatment methods

• a. identification of drug addicts and their motivation for drug detoxification;

• b. detoxification (requires hospitalization) ;

• c. Post-detoxification counselling and follow-up (based on clinic and home visits);

• Psychotherapy has a valuable place in the management of the addict.

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