Transcript Drug Abuse

DR. MUNIR A. BADAR
DEPARTMENT OF
COMMUNITY MEDICINE
SH. ZAYED MEDICAL COLLEGE,
RAHIM YAR KHAN
DRUG ABUSE
AND
DRUG DEPENDENCE
Drug:
Any substance when taken into the living organisms may
modify one or more of its functions
Drug abuse:
Self administration of drug for non-medical reasons which
impair individual’s ability to function, resulting in social,
physical or emotional harm
Long term drug use may damage the heart liver and brain.
Drug Dependence:
A state of interaction between a living tissue and a drug,
characterised by Behavioural and other responses which
include a compulsion to take the drug periodically or on
continuous basis, in order to experience its psychic effects
and to avoid the discomfort of its absence.
Drug Addiction
A state of periodic or chronic intoxication
determined to the individuals and society produced
by the repeated intake of habit – forming drugs.
To call a person ----- a drug addict, following
criteria is to be considered.
1. Psychological Dependence:
An over powering desire to take the drug
and obtain it by all means
2. Physiological Dependence:
“Show of withdrawal symptoms,” --Irritation, Violent behaviour, Nausea, Diarrhoea,
watering of eyes and nose.
3. Development of Tolerance:
A tendency to increase the dose.
Phases of Addiction:
 Tolerance – diminished effect of the
same dose of a drug or the need to
increase the size of dose to get an effect
to the earliest ones.
 Habitation – the emotional and
psychological need felt for a drug.
 Physical dependence: Body’s need to
get the drug.
Agent factors
 Alcohol
 Opioids
 Cannabinoids
 Cocaine
 sedatives or hypnotics
 Caffeine
 Hallucinogens
 Tobacco
 Volatile solvents
 Amphetamine
 LSD (Lysergic acid diethylamide)
Symptoms of Drug Addiction:
 Loss of Appetite and Body weight
 Unsteady gait, Clumpsy movements, Tremors
 Reddening and puffiness of eyes, unclear vision
 Slurred speech
 Nausea, Vomiting and Body pains
 Fresh, numerous injection marks on body and Blood
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stains on cloths
Drowsiness/Sleeplessness, Lethargy.
Anxiety, Depression, Profuse Sweating
Changing mood, Temper,
The personalisation and Emotional detachment
Impaired memory and concentration
Presence of Needles, Syringes and strange packets at
home
Loss of interest in daily activities
ALCOHOL & ALOCOHOLISM
Alcoholism: Ch. Diseases marked by a craving for alcohol.
Alcoholics : Develop a craving or a strong urge to drink despite the
awareness that drinking is creating problems in their lives.
One drink of alcohol is defined as consuming:
12 oz of beer,
5 oz of wine,
1.5 oz of 90-proof liquor
Ethyl Alcohol (Ethanol) ----- In beers and wines, and in distilled
liquid (Whiskey, Gin & Rum)
Alcoholic beverages contain:
Beer (5-6 % of alcohol), Rum, Gin & Brandi (40-45 % alcohol)
Moderate Drinking: One or less than two drinks a day
Heavy Drinking:
More than 14 drinks per week or
4-5 drinks at one sitting
ALCOHOL
 A symbol of prestige and social status
 Alcoholism is world wide social and medical problem
 Used as Sedative, Tranquillizer, Hypnotic or Anaesthetic
 Drinking by adults serves as a role model for the young
 Rapidly absorbed from the stomach and small intestine
 Can be detected in blood within 2-3 minutes after
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consumption.
Food in the stomach inhabits its absorption.
Supplies about 7 kcal / gm.
A marked effect on CNS (not a stimulant but produces
depression)
Produces psychotic dependence of mild to strong but
physiological dependence develops slowly.
Physical Effects
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Tension
Fatigue
Increase appetite
Painful Numbness
Depression
Lose of self confidence
Anxiety
Guilt
Loud and Slurred speech
Impaired Judgment
Affected Muscular coordination & physical reflexes
Loss of physical control - --- ending in Stupor and
Death
CAUSES
1. Physiological Causes:
 Large quantities of alcohol drink produces and
enhances tolerance for alcohol
 Alcoholic are 6 times more likely than nonalcoholic to have blood relatives (who are
alcoholic dependence)
 A genetic factor plays a role in alcoholic
dependence
Many genes are involved in increasing and
individual’s risk for developing alcoholic
dependence.
CAUSES
Environmental Causes:
Indirect
Direct
 Unemployment
 Personal Behavioral skills
 Ignorance /Neglect
 Peer influences early in life
 Gang culture
 Parenteral behaviour
 Tourism
 Society and cultural
 Sex workers
attitudes towards alcohol
 Rapid urbanization
use.
 Urban migration
 Life stress
 Family tensions
 Availability of alcoholic
beverages
 Delinquency (Crime)
CAUSES
3. Psychological Causes:
Many drinkers develop a psychological condition
known as DENIAL, (in which they are unable to
acknowledge that alcohol use lies at the root of many of
their problems)
Cultural Factors:
 Upper class society use expensive drugs and lower
class people use illegally manufactured drugs e.g.
charas, bhang, tan, ganja etc.
 Drug addiction is more among beggars, mujawars of
argahs, malangs and darveshes inhabiting takyas
and shrines of saints.
Major alcohol related Problems
 Crime (e.g.: Rape, Assault, Homicides)
 Loss of self confidence and will to work
 Physical health and sexual energy weaken
 Traffic Accidents or injuries
 Absenteeism
 Family disorganization
 Loss of productivity
 Foetal growth retardation and mental retarded babies
Medical Complications:
 Liver damage (Fatty liver → hepatitis, liver cirrhosis)
 Cardiomyopathy (Enlarged both ventricles, Flabby,
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Reduced heart pumping efficiency →
Reduces blood flow through the kindness
resulting in salt retention and water loss
from the blood.
Arrhythmias (Heartbeat irregularities)
Hypertension → stroke
Delirium tremens → confusion, sleeplessness, depression and
hallucinations.
Gastritis & Pancreatitis
Ca. mouth, pharynx, Larynx and oesophagus
Peripheral Neuropathy
Psychosis
Foetal alcoholic syndrome (Intra-uterine growth retardation &
Mental disorders, craniofacial abnorm. & limb dislocations)
Why do the Addicts use the
drugs?
 To allay anxiety or fatigue
 To forget economic problems, social
difficulties and worries
 To enhance sexual capacity
 To meditate and attain mystical state
Treatment of addiction
 Drug takers 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 Sociologist.
 Drug addiction may be considered as the social problem
so its management is medical care as
Identification of drug addicts and their
motivation for detoxification
Detoxification (requires hospitalization for
therapeutic treatment)
Post detoxification counselling and follow up
(based on clinic and home visits)
Prevention
 Cultivation of drug plants should be licenced
 Manufacture, Profession, Sale and Transport of all
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intoxication drugs should be checked and brought under
control for appropriate use.
The Law prohibits use of alcohol but the majority of
population abstains from the use of alcohol.
Legislation for dealing the offenders and smugglers
Pharmacological solutions (Antidepressants &
antipsychotic drugs)
Prohibition of advertisements that promote use of
tobacco and alcohol
Public education and discussion.
Rehabilitation of Ex-drug dependant persons
Unemployment problem should be solved by increasing
job opportunities