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  • 1. Int J Cur Biomed Phar Res. 2011; 1(3): 130 -133 Contents lists available at CurrentSciDirect Publications International Journal of Current Biomedical and Pharmaceutical Research CurrentSciDirect Journal homepage: PublicationShort ReportAddiction in Adolescents ---- A Current TrendDr.Anil Batta*Dept of Medical Biochemistry, Baba Farid Univ. of Health Sciences, INDIAARTICLE INFO ABSTRACTKeywords:Opium Addiction is a condition that results when a person regularly consumes substances likeAbstinence alcohol, opioids or tranquilizers or engages in an activity like womanizing ,using internet,Tranquilizers watching television & gambling which give him pleasure in increasingly high quantity so thatAlcohol finally it becomes an imperative compulsion and deviates him from carrying out normal dutiesRelapse User is not aware of this fact that continuity in increasing amount is creating problem to himself and to society. For all practical purposes it is uniinhibitng outcome of all these factors. . Its consequences are social, emotional and psychological. Pattern of substances of use is notorious as it can change from time to time. But this is for sure that the substances of abuse whether legal or illegal can cause havoc at national and even international levels. The nature of these though may be significant but the regional variation can vary from time to time. Substance of use among adolescents & children are a cause of deep concern. Keeping in view this thing in mind a study in northern belt was carried 85 patients of age group of 14 to 19 years in age.Resuts were devastating and unimaginable. Important point is that this menace has to be tackled at social level. c Copyright 2011. CurrentSciDirect Publications. IJCBPR - All rights reserved.1. Introduction A lot many factors are available which contribute to this High Emotions: Emotional disorders such as anxiety,avoidable adventure. Out of these few which are highly relevant depression, bipolar disorder or post-traumatic stress disorderhave been lineated as follows. often increase the risk of substance abuse. In them the insecurity feeling flares up the urge to use to drugs. Familial : This could be an important cause as individuals fromfamilies with a history of any kind of addiction are more likely to Action of drug: Certain substances are more addictive thandevelop addiction.. The family scenario is again a driving force e.g. others, and risk of full-blown addiction is higher for drugs such ashistory of alcoholism in the parents may become an important opioids, alcohol & tranquilizer because of their ability to createcause. dependence after just a quick time. Surroundings: Again as the Children are brought up by Low Frustration Tolerance: One common factor foundalcoholic or drug addicted parents gets family environment amongst addicts of all types is a low frustration tolerance. Addictsbecomes a causative factor. Individuals from countries where use are highly susceptible to the negative effects of stress, having a lowof a certain substance is not imposed as an illegal sanction have threshold of facing the disturbances. They become easily upsethigher role to play as the causative factor. over everyday stress factors, creating a need for escape. They find this escape in their addiction. Exploitation: Individuals who experienced sexual,psychological, emotional or physical exploitation are more likely to Absentism at school: Frequently missing classes or missingbecome addicts. The addiction becomes a coping mechanism in school, a sudden disinterest in school or school activities, and athem. drop in grades may be indicators of drug use. * Corresponding Author : Dr.Anil BATTA Weak All of a Sudden : Lack of energy and motivation may Dept of Medical Biochemistry indicate that child is using certain drugs. Baba Farid Univ. of Health Sciences INDIA Listless appearance: Adolescents are generally concerned E.mail: c Copyright 2011. CurrentSciDirect Publications. IJCBPR - All rights reserved. about how they look. A lack of interest in clothing, grooming or looks may be a warning sign of drug use.
  • 2. Anil Batta / Int J Cur Biomed Phar Res. 2011; 1(3): 130 -133 131 Changes in behavior : Teenagers enjoy privacy, but substance intake. Lapses were defined as using the substance lessexaggerated efforts to bar family members from entering their than that for relapse. Relapse was defined as re-mergence ofrooms or knowing where they go with their friends might indicate substance dependence as per the ICD- 9 or 10. Duration of follow-drug use. Also, drastic changes in behavior and in relationships up was calculated in number of months from first visit to the lastwith family and friends may be linked to drug use. visit to the hospital. Sudden Expenditure: Sudden requests for money without a 3.Resultsreasonable explanation for its use may be a sign of drug use. Youmay also discover money stolen from previously safe places at Adolescents from nuclear families were 63.8%.out of thesehome. Items may disappear from your home all of a sudden. Most 76.9& were from urban population. School absentees comprised >of these are costly items which are not of frequent daily use but 50%. In general they presented or were forced to present bydisappear suddenly. parents at the age of 15—18 years. Opioids were used by > 75% and the commonest used opioid was morphine. Nicotine was also2.Material and Methods found to be common by more than 52.9%. More than 76% used these for curiosity for the first time. More than 20% were found to Keeping all the things in mind a study was conducted in be indulged in all types of multiple sex users. Nearly half of theadolescent subjects presenting to a Drug de-addiction OPD of subjects had positive family history of either drug dependenceDept of Psychiatry PGIMER, CHD. Data on demographic and (40.2%) or psychiatric disorder (5.5%). Alcohol, tobacco andclinical features were made available in adolescent patients who tranquillizers along with analgesics are the common substances ofpresented to the centre during 1978-1992. abuse. The study was conducted at the Drug De-addiction and The mean age at first use of the primary substance was 14Treatment Centre of PGIMER CHD, with incident area in north years (range 5-17.5 yr), while the mean age at clinic presentationIndia. Most patients either came of their own or were referred by was 17 years . Almost all the subjects were single (96.4%) atbig Hospitals The De addiction services include outpatient, presentation; majority of them belonged to Hindu nuclear familiesinpatient, laboratory, aftercare, various agencies and self-help (63.5%).Out of these 83.5% were from urban background (Moregroups. The cohort for this study consisted of all child and than half of the subjects were school dropouts and nearly one thirdadolescent patients (age less than or equal to 18 yr at the time of (35%) of the subjects were going irregularly to school at the timeregistration) registered at the DDTC between September 1978 of presentation. Most of the subjects, who were not studying, wereand December 1992. Substance dependence was diagnosed as per unemployed (32.9%). An interesting finding was that nearlyICD-9. by a consultant psychiatrist after direct interview with the three-fourth (72%) of the subjects who presented to our clinic hadpatient and her relatives. Following detailed evaluation, the studied, or had been studying, in government schools. It was alsotreatment consisted of detoxification, symptomatic treatment, observed that, two third (65.9%) of subjects were brought to thetreatment of medical complications, if any, and psychotherapy of OPD by a relative and only one fifth (21.2%) sought help on theirpatients and their families. Monthly follow-ups were done by a own and rest were referred by physician/surgeons. Most of thepsychiatrist when patients drug use profile, social and subjects (97.6%) had good social support.occupational functioning and physical and psychologicalproblems were monitored. The study was therefore limited to 3.1.Clinical profilethese 85 subjects as that number was available. The mean duration of dependence on the primary substance2.1.Socio-demographic profile till clinic attendance was 20 years. The average duration to develop dependence (from first use) was 6 month. Almost all A semi-structured proforma was used to record sex, age, (97.6%) the subjects were dependent on at least one substance atmarital status, educational level, occupation, income, family type, the time of presentation.religion and locality. The commonest used primary class of substance was opioids2.2.Clinical and substance use profile (76.2%) and the commonest used opioid was morphine (36.5%). This included type of predominantly used substance, More than half of the subjects (54.2%) were also tranquilizersduration of dependence, relapses, treatments and hospitalizations dependent at the time of the past (before the index treatment episode), detailed physical Most of the subjects started using the substance either out ofand psychiatric co morbidity, and other substances being used. curiosity (78.8%) or under peer pressure (16.5%). Nearly half ofThe information about the physical and psychiatric co morbidity the subjects had positive family history of either drug dependencewas inferred from the history, and clinical and laboratory (40.2%) or psychiatric disorder (5.5%). About one-fifth (21.2%)evaluation and monitoring of the patient throughout the contact of the subjects indulged in high-risk behavior such as havingperiod. Abstinence, lapse, or relapse was considered as the sexual intercourse with multiple sexual partners. Only a fewprimary outcome measures. Abstinence was defined as no subjects (9%) reported physical co morbidity in the form of
  • 3. Anil Batta / Int J Cur Biomed Phar Res. 2011; 1(3): 130 -133132seizure disorder (4.7%), thyrotoxicosis (1.2%) and pancreatitis reported starting of substance on experimental basis and later on(2.4%). A substantial minority (25.6%) of the subjects had co becoming dependent on it. Co morbidity was reported in very fewmorbid psychiatric disorder, most common being conduct disorder. subjects and could be attributable to the selection procedure.More than half (57.6%) of the subjects were treated on outpatient Nearly half of the subjects had positive family history of either drugbasis and about one third of the subjects (32.9%) were admitted dependence or psychiatric disorder, which is in similar lines withonce only, during the period of contact. At the time of first contact, other studies, which have implicated environmental and geneticmore than two-third (68.2%) of the subjects had poor to superficial factors in development of drug dependence.motivation for treatment (0-1 as rated on a 0-4 scale), most being Within the limits of generalizability, this study provides abrought by parents (65.9%). glimpse into the profile of clinic-attending adolescent substance After the initial detoxification, 37.6% agreed to take abusers. The major strength of the study derives from the fact that itpharmacoprophylaxis with naltrexone. Only one fifth of the has collected data from clinic-attending patients over a span of asubjects, however, continued to take pharmacoprophylaxis beyond quarter of a century. Patients came from nuclear urban set-up andone month, with mean duration of prophylaxis being 156 month were predominantly opioid-dependent. There was evidence for(range 2-730; SD 181.14). Among the 28 subjects who were both genetic as well as socio-environmental factors as correlates ofprescribed naltrexone, 20 were noted to be abstinent at the last drug use. Efforts should be made to collect similar data from otherfollow-up. addiction clinics in the country so that a more composite picture of The mean duration of follow-up was 11.2 month (SD 21.90, the clinical situation can emerge nationwide.range 0-122). The mean number of follow-up at hospital visits was 5. Conclusion6.62 (SD 5.42, range 1-31). While 51.8% subjects reportedabstinence at the last follow up, 36 subjects (42.4%) were noted to The results suggest that the development of substancebe continuing substance use or had relapsed after an initial period dependence in children and adolescents is a combination of familialof abstinence. and social vulnerability factors, including the drug culture of the social milieu. A rise in opiate use was reported in school children.4. Discussion Indian data on the profile of young population with substance abuse The current study was a retrospective chart review with the in organized form is lacking. For planning effectively and to provideaim of studying the sociodemographic and clinical profile of efficient services catering to the special needs of this sensitive andadolescents presenting to a de-addiction centre of a tertiary care vulnerable population, there is a need to understand the substancehospital. The profile of treatment seekers can help the treatment use profile, associated problems, as well as the special needs ofagencies to prepare themselves in managing such cases. More than adolescents. Hence, the current study was designed to be familiarhalf of the subjects were school dropouts and nearly one third of the with the socio-demographic and clinical profile of the adolescentsubjects were going irregularly to school at the time of presentation. population seeking treatment for de-addiction.. All the probableThis probably reflects the effect of drug use on the educational causes of the abuse should be nullified to bring a feeling offunctioning of the subjects. Mean age at first use of the primary responsibility in the young ones who will decide the future of thesubstance was nearly 15 year, which suggests that various drugs are country. If adolescents are themselves the victims then anyeasily available. The mean duration required to develop unpleasant thing is on cards. Multiple addiction is the ultimate thatdependence was nearly 6 months. This was probably highly can be expected.influenced by the predominant substance of dependence, i.e., 6. Referencesopioids, which are known for their high drug dependence potential.Almost all the subjects were dependent on at least one substance at [1] Patel DR, Greydanes DE. Substance abuse: A pediatric concern.the time of presentation. This was probably due to more frequent Indian J Pediatr. 1999; 66 : 557-567.use of high dependence potential drugs. The commonest used [2] Johnston LD, OMalley PM, Bachman JG. Overview of keyprimary class of substance was opioids and the commonest used findings monitoring the future: National results on adolescentopioid was morphine. This finding is different from studies drug use. NIDA, US DHHS, 2001.conducted among school students from other centers in the country, [3] Schwartz RH. Adolescent heroin use: a review. Pediatrics.where alcohol & tranquilizer is the commonest drug of use, followed 1992; 102: tobacco. This probably reflects the availability of substancesacross various regions of the country. Also, a tertiary-care centre [4] SAMHSA. The relationship between mental health andsuch as ours is likely to attract more dependents on harder drugs substance abuse among adolescents. Highlights: Office oflike heroin. Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), USDHHS, 2001. More than half of the subjects (54.2%) were also nicotinedependent at the time of presentation. This probably suggests that [5] Jaffe S. The substance abusing youth. In Parmelle DX, ed. Childnicotine use/dependence acts as a gateway for starting other hard and Adolescent Psychiatry . St. Louis; Mosby Year Book Inc.,drugs. Most of the subjects started using the substance either out of 1996; 237-224.curiosity or under peer pressure. Previous studies have also [6] Centre on Addiction and Substance Abuse. National Survey of American Attitudes on Su bstance Abuse VII: Teens, Parents and Siblings, CASA , 2002.
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