Alcohol & Drug Abuse

Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D. Consultant in Cardiac & Diabetic Care H2, Turnbulls Road , 1st Cross street, On Chamiers road (Next to Canara Bank) Nandanam, Chennai – 600 035 Phone : Clinic 24355368 Residence 42112244 Mobile 9381047102 Alcohol and Drug Abuse

Alcohol Alcoholic drinks have been prepared and drunk for thousands of years, and the problems that can accompany excess alcohol intake have undoubtedly been around just as long.
Alcohol (Arabic al-kuhul ), term applied to members of a group of chemical
compounds and, in popular usage, to the specific compound ethyl alcohol,
or ethanol.
The Arabic word denotes kohl, a fine powder of antimony used as an eye makeup.
The word alcohol originally denoted any fine powder; the alchemists of medieval
Europe later applied it to essences obtained by distillation, and this led to the current usage.

Types of Alcohol Uses Manufacture Kind Solvent for nitrocellulose, ethyl cellulose, lacquer, urea-formaldehyde, urea-melamine plastics. Diluent of hydraulic fluids, extractant of drugs. By fermentation of starch or sugar. Also by synthesis, using ethyl alcohol or acetylene. Butyl (n-butanol) Solvent for lacquers, resins, coatings, films, waxes. Also as brake fluid, in manufacture of propionic acid, plasticizers. As a coproduct of air oxidation of propane and butane mixtures. Normal propyl Solvent for oils, gums, alkaloids, resins. Making acetone, soap, antiseptic solutions. By hydration of propylene from cracked gases. Also as by-product of certain fermentation processes. Isopropyl (isopropanol) Solvent for products such as lacquers, paints, varnishes, glues, pharmaceuticals, explosives. Also as 'building block' in making high-molecular-weight chemicals. By fermentation of sugar, starch, or waste sulfite liquor. Synthesis from ethylene or acetylene. Direct hydration of ethylene. Ethyl (grain alcohol, ethanol) Solvent for fats, oils, resins, nitrocellulose. Manufacture of dyes, formaldehyde, antifreeze solutions, special fuels, plastics. By destructive distillation of wood. Also by synthesis from hydrogen and carbon monoxide under high pressure. Methyl (wood alcohol, methanol)

Principally in perfumes. By synthesis from benzene and ethylene oxide. Phenylethyl Intermediate in making chemicals used in nylon manufacture. Stabilizer and homogenizer of soaps, synthetic detergents. Solvent. By catalytic hydrogenation of phenol. By catalytic air oxidation of cyclohexane. Cyclohexanol In foods, pharmaceuticals, in chemical manufacture. Conditioning agent in paper, textiles, glue, cosmetics. Source of alcohol in resin manufacture. By reduction of sugar, usually corn sugar, with hydrogen. Sorbitol In synthetic resins. As tetranitrate in explosives. Also as drug for treatment of heart disease. By condensation of acetaldehyde and formaldehyde. Pentaerythritol In alkyd resins, explosives, cellophane. Tobacco humectant. From treatment of fats in soapmaking. Synthetically, from propylene. By fermentation. Glycerol (glycerin; 1-, 2-, 3-propanetriol) Air disinfectant and dehumidifier. Production of resins, plasticizers. Coproduct in manufacture of ethylene glycol. Triethylene glycol Solvent for dyes, resins. Antileak agent. In gas drying. Softening agent in adhesive printing inks. As coproduct in manufacture of ethylene glycol. Diethylene glycol Deicing fluid, antifreeze, brake fluid. In production of explosives. Solvent for stains, oils, resins, enamels, inks, dyes. By oxidation of ethylene to glycol. Also by hydrogenation of methyl glycolate made from formaldehyde and methanol. Ethylene glycol Solvent for many natural and synthetic resins. Diluting brake fluids, printing inks, lacquers. In medicinal products. By fractional distillation of fusel oil, a coproduct of ethyl alcohol manufacture by fermentation. Amyl (pentyl) In perfume making. As wetting agent in detergents. Solvent for drugs and cleaning compounds. By hydration of isobutylene, derived from petroleum cracking. Tertiary butyl In making other chemicals such as methyl ethyl ketone. Solvent in nitrocellulose lacquers. Production of brake fluids, special greases. By hydration of 1-butane, formed in petroleum cracking. Secondary butyl Solvent for castor-oil-base brake fluids. Substitute for n-butyl alcohol in making urea resins. By synthesis from carbon monoxide and hydrogen at high pressure, then distillation from products formed. Isobutyl

Friend or Foe?
High levels of alcohol consumption can lead to physical illness and
psychological and social distress.
Small, regular amounts of alcohol also seem to have a positive effect
on the heart and circulation.
But too much alcohol is often a recipe for disaster.
The increasing use of alcohol, along with other drugs of abuse, is a serious public health problem across all age ranges, but especially so in the young.

Brief description of alcoholic beverages Wines are made from a variety of fruits, such as grapes, peaches, plums or apricots. The most common wines are produced from grapes. The soil in which the grapes are grown and the weather conditions in the growing season determine the quality and taste of the grapes which in turn affects the taste and quality of wines. When ripe, the grapes are crushed and fermented in large vats to produce wine. Beer is also made by the process of fermentation. A liquid mix, called wort, is prepared by combining yeast and malted cereal, such as corn, rye, wheat or barely. Fermentation of this liquid mix produces alcohol and carbon dioxide. The process of fermentation is stopped before it is completed to limit the alcohol content. The alcohol so produced is called beer. It contains 4 to 8 per cent of alcohol.

Brief description of alcoholic beverages Whisky is made by distilling the fermented juice of cereal grains such as corn, rye or barley. Scotch whisky was originally made in Scotland. The word "Scotch" has become almost synonymous with whisky of good quality. Rum is a distilled beverage made from fermented molasses or sugarcane juice and is aged for at least three years. Caramel is sometimes used for colouring. Brandy is distilled from fermented fruit juices. Brandy is usually aged in oak casks. The colour of brandy comes either from the casks or from caramel that is added. Gin is a distilled beverage. It is a combination of alcohol, water and various flavours. Gin does not improve with age, so it is not stored in wooden casks. Liqueurs are made by adding sugar and flavouring such as fruits, herbs or flowers to brandy or to a combination of alcohol and water. Most liqueurs contain 20-65 per cent alcohol. They are usually consumed in small quantities after dinner.

Types of alcoholic beverages

Common local brews in the South-East Asia Region Arrack is a distilled beverage, obtained from paddy or wheat. Jaggery, sugar or sugarcane is added to either of these two cereals and boiled with water. This is allowed to ferment, after which it is distilled. This beverage contains about 50- 60 per cent of alcohol. Toddy is obtained from the flowers of a coconut or palm tree. A white liquid, with a sweetish taste, oozes out of these flowers. When consumed fresh, this juice has no intoxicating effect. This liquid is collected and allowed to ferment. At times, yeast is added to hasten the process. The fermented juice has an alcohol content of approximately 5-10 per cent.

Equivalence of different beverages
The volume-by-volume strength of alcoholic beverages varies considerably.
The equivalence of different beverages is measured in terms of 'units' of alcohol.
One unit is equal to approximately 10 grams of absolute alcohol, often considered as one
drink, since it is available from 30 ml (1 fluid ounce or small peg) of spirits like whisky, rum
or brandy.
The same amount of alcohol, one unit, is also available from a glass of wine, which is generally
120 ml or half a pint or 285 ml of beer.

Alcoholism (Dependence on Alcohol) Alcoholism, or alcohol dependence is a medical term with a deliberately more precise Meaning than the problems that can occur, sometimes as one-offs, through an uncharacteristic binge. In alcohol dependence a number of features come together in the behavior of the person affected.
Drinking begins to take priority over other activities.
It becomes a compulsion.
Tolerance develops, it takes more alcohol to produce drunkenness.
Withdrawal symptoms such as anxiety and tremor develop after a
short period without a drink, and are reduced by taking more alcohol.
Often alcohol dependence remains undetected for years.

Signs of Alcoholism As alcohol levels increase with more drinking, there is poor control of muscles, poor coordination, double vision, flushing of the face, bloodshot eyes, and vomiting. Behavior varies greatly. It is hard to predict what an intoxicated person will do next. He/she may cry bitterly, show unexplained happiness, change moods rapidly, or just pass out. NOTE: “Passing out” or “falling asleep” can be a warning sign that the person is actually in a dangerous alcohol coma. Shipmates may assume the person is safely asleep, when he/she may actually be in a life-threatening coma. Take care to monitor a shipmate’s condition and make certain he is breathing and responsive. Get immediate help if you suspect alcoholic coma. This could save a life. Serious intoxication results when a large amount of an alcoholic beverage is taken over a relatively short period of time (or for a longer period of time, when alcohol intake exceeds alcohol excretion). Memory is commonly lost for the events while intoxicated. Symptoms are drowsiness that can progress rapidly to coma; slow snoring breathing; blueness of the face, lips, and fingernail beds; involuntary passage of urine or feces; dilated pupils; and rapid weak pulse. A suspected alcoholic stupor or coma represents a medical emergency. Obtain immediate help via radio

Alcohol Withdrawal Alcohol withdrawal occurs when a physiologically dependent person abruptly stops using alcohol. Physiologic dependence can develop after prolonged and heavy drinking. For example, consider a crew member who drinks alcohol regularly while in home port. When this crew member goes to sea and suddenly stops drinking, he/she may experience withdrawal within a day or two. Thus, withdrawal is most common early in a voyage. Alcohol withdrawal can be a life-threatening emergency. Symptoms include increased sweating and pulse (greater than 100/min), hand tremor, insomnia, nausea or vomiting, hallucinations or illusions, agitation, anxiety, and grand mal seizures. The patient is distressed by the symptoms. Alcohol withdrawal is diagnosed when the symptoms are due to the cessation of alcohol and not due to another medical or psychiatric disorder. Alcohol withdrawal can advance to withdrawal delirium, called delirium tremens or “DTs”. DT’s include a disturbance of consciousness and a change in cognition. DT’s usually occur within 24 to 72 hours of stopping alcohol intake; however they may occur as much as a week after.

CAGE Questionnaire The ‘ CAGE ’ questionnaire is a short list of questions that can indicate if alcohol dependence is a possibility. Two or more positive answers to these questions suggests dependence. Have you ever:
Thought you should C ut down on your drinking?
Felt A nnoyed by others criticizing your drinking?
Felt bad or G uilty about your drinking?
Had a drink first thing in the morning to steady your
nerves or get rid of a hangover? ( E ye-opener.)

What problems are caused by too much alcohol? Excess alcohol can lead to health problems including:
Depression Liver cirrhosis Heart failure Damage to the brain and nervous system.
Along the way there is often damage to relationships, finances and jobs and problems with the law.

Alcohol in the Body Unlike other foods that require slow digestion, alcohol is absorbed directly into the bloodstream through the walls of the stomach and the small intestine. The blood carries it to all body tissues, including the brain, where it has an immediate depressant effect.
The liver slowly metabolizes the alcohol. Lesser amounts are excreted through the lungs, skin, and kidneys.
If alcohol is consumed faster than the body can dispose of it, the blood concentration increases.
Alcohol “numbing” of the judgment center of the brain, which controls inhibitions and restraints, makes one feel buoyant and exhilarated.
Continued drinking on a given occasion increases the concentration of alcohol in the bloodstream.
This causes depression of various areas of the brain that affect judgment, emotions, behavior, and physical well-being.
Reflex time is markedly reduced.
Operating marine vessels under the influence of any amount of alcohol is unsafe.

Alcohol in the Body
Alcohol ingestion causes absorption and nutritional deficiencies.
The combination of malnutrition and tissue injury may contribute to brain damage, heart disease,
diabetes, ulcers, cirrhosis of the liver, and muscle weakness.
The Wernicke-Korsakoff syndrome, with irreversible and potentially fatal brain and nervous system
damage, is due to severe acute and chronic thiamine deficiency.
Treatment of serious alcohol disorders should include injected and oral thiamine, as well as other
vitamins and nutrients.
Alcohol can also act a a direct poison to body tissues.
Liver damage, including irreversible cirrhosis, can result from chronic drinking.
The brain and other tissues can also be irreversibly damaged.

Alcohol in the Body
Sudden death may occur:
When the individual has ingested so much alcohol that the brain center which controls breathing and heart action is fatally depressed.
(2) When other depressant drugs (such as “sleeping pills”) are taken along with alcohol, magnifying the depressant effects.
(3) During an accident (one-half of all fatal traffic accidents involve the use of alcohol); or (4) as a result of suicide or murder (many self-inflicted deaths as well as homicides involve the use of alcohol.)

Mental health and alcoholism
Mental health problems are common with alcoholism.
Each can lead to or reinforce the other.
Depression is a common cause of alcoholism as the depressed person seeks a way out of their
problems or a relief from insomnia.
Unfortunately, alcohol is itself a depressant, so the problem is only compounded.
Anxiety can be temporarily relieved by alcohol, but this may lead to repeated intake and dependence.
Without adequate attention to the mental health needs of a person with alcohol dependence,
little progress will be made.
Often alcoholism remains unsuspected even by the doctor, and it may come to light only when
medical tests are done for other reasons.

Treatment
Alcohol dependence and abuse are difficult to manage and treat aboard ship.
Chapters of Alcoholics Anonymous are found world-wide.
For someone who has the determination to quit drinking, attending meetings in the various ports-of-call can be helpful.
However, management of the crew member who does not want to change problem drinking behaviors is challenging.
Referral for formal evaluation and treatment in the homeport are appropriate.
Most importantly, alcohol use must be prevented from interfering with the safe operation and management of the ship.
PREVENTION Prevention of alcohol incidents requires senior leadership and education of the entire crew. It also requires effective management of any problems as they occur. The ship’s culture should expect (and demand) responsible alcohol behavior.

Social effects of alcoholism - I
Excessive and inappropriate alcohol consumption at work leads to accidents, absenteeism
and lost revenue .
25% people who die in road accidents have blood alcohol levels greater than 80mg per 100 mls.
40% of casualty patients had consumed alcohol before attending and 32% had a blood alcohol
concentration over the legal driving limits.
30% of pedestrians sustaining injuries have blood alcohol levels of over 80mg per 100mls.
In young people one third of deaths from drowning are alcohol related.
It is well known that aggressive and criminal behaviour and the consumption of alcohol are linked.
Offenders have been found to be intoxicated in 30% of sexual offences, 33% of burglaries,
50% of street crime and 85% of crime in pubs and clubs.
The precise nature of the link is complex and in many cases alcohol is not itself a directly
causative factor but merely part of the circumstances or environment within which the criminal
behaviour occurs.

Social effects of alcoholism - II
Measures to reduce alcohol-related crime could include creating an environment that inhibits
the escalation of violence (for example public space controls, an integrated public transport
initiative etc) or contains it if it breaks out (making it a requirement for drinks to be served in
toughened glass for example).
Minimising binge drinking by banning drinks promotions and 'happy hours' has also been suggested.
The social cost of drinkers consuming over 50 units a week in terms of drink driving and drunkenness
offences alone is estimated to be 175 Crores.
The IMA estimate that either the offender or victim has been drinking in 65% of homicides,
75% of stabbings, 70% of beatings and 50% of fights or domestic assaults. 58% of remand and
63% of male sentenced prisoners have severe alcohol problems in the year before being sent to
prison and alcohol abuse is strongly implicated in re-offending, particularly amongst women.
30% of divorces, 40% of domestic violence and 20% of child abuse cases are associated with
alcohol misuse. Alcohol plays a significant part in teenage sexual activity.
After drinking alcohol one in seven 16-24 year olds have had unsafe sex, one in five had sex they
later regretted and one in ten couldn't remember if they had had sex the night before.
Therefore alcohol can play a significant role in both the spread of sexually transmitted disease and
unwanted pregnancy.

Personal effects of alcoholism
Alcoholics and heavy drinkers are especially susceptible to the development of other diseases,
not specifically alcoholic, and are then less able to withstand the vicissitudes of ill health.
For example, although worldwide far more people die from the complications of smoking and high
blood pressure than from alcoholism, the disability-adjusted life years (a technical measure for
computing the loss of healthy life as the result of disability) resulting from alcohol abuse nearly
equals that from high blood pressure and smoking combined.
Alcoholics and problem drinkers also undoubtedly contribute to the deterioration of the mental health
of other members of their families through verbal, physical, and sexual abuse.
Indeed, alcoholism may be the greatest single cause of the breakdown of family life.
Finally, a great portion of the work of police departments and the costs of local courts and jails is
attributable to arrests, prosecutions, and brief incarcerations for public intoxication and other incidents
in which alcohol is involved.

Drug Abuse

What is Medicine ? Medicine (Latin medicus, “physician”), the science and art of diagnosing, treating,and preventing disease and injury. Its goals are to help people live longer, happier, more active lives with less suffering and disability. Medicine goes beyond the bedside of patients. Medical scientists engage in a constant search for new drugs, effective treatments, and more advanced technology. In addition, medicine is a business. It is part of the health care industry, one of the largest industries in India, and among the leading employers in most communities.

What is a Drug ?
A drug is any chemical or biological substance, synthetic or non-synthetic, that when taken
into the organism's body, will in some way alter the functions of that organism.
This broad definition can be taken to include such substances as food.
However more strict applications of the word prevail in everyday life.
In these cases the word "drug" is usually used to refer specifically to medicine, vitamins,
entheogenic sacraments, consciousness expanding or recreational drugs.
Many natural substances such as beers, wines, and some mushrooms, blur the line between
food and drugs, as when ingested they affect the functioning of both mind and body.
The word "drug" is etymologically derived from the Dutch/Low German word " droog ",
which means " dry ", since in the past, most drugs were dried plant parts.
Drugs are usually distinguished from endogenous biochemicals by being introduced from
outside the organism.
For example, insulin is a hormone that is synthesized in the body;
it is called a hormone when it is synthesized by the pancreas inside the body,
but if it is introduced into the body from outside, it is called a drug.

Drug abuse Drug abuse has a wide range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect . Some of the most commonly abused drugs include alcohol, amphetamines, barbiturates, cocaine, methaqualone, opium alkaloids, and minor tranquilizers. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.
The use of chemicals to alter the way we feel and see things is one of the oldest activities
of the human race.
But a person's use of a drug such as tobacco, alcohol, cannabis or heroin can become
uncontrolled, or start to control them.
Even when the use of drugs leads to serious physical and mental problems, the person
using may still not want to stop.
If they do decide to give up, they may then find it's much harder than they thought.

Types of Drugs Drugs can be categorized in many ways, hard or soft, uppers or downers, addictive or non-addictive, most harmful or least harmful, legal or illegal. However, we think a useful way of categorizing drugs is by dividing them into three categories based on the effect they achieve: STIMULANTS... They increase the activity of the central nervous system ( examples include Alkyl Nitrites, Amphetamines, Anabolic Steroids, Cocaine & Crack, Caffeine, Ecstasy and Tobacco ). DEPRESSANTS... They reduce the activity of the central nervous system ( examples include Alcohol, Barbiturates, Benzodiazepines, Heroin and Solvents ). HALLUCINOGENS... They alter perceptions of reality and may result in hallucinations ( examples include LSD, Cannabis and Magic Mushrooms ).

Cannabis
All forms of cannabis have negative physical and mental effects.
Several regularly observed physical effects of cannabis are a substantial increase in the heart rate,
bloodshot eyes, a dry mouth and throat, and increased appetite.
Use of cannabis may impair or reduce short-term memory and comprehension, alter sense of time,
and reduce ability to perform tasks requiring concentration and coordination, such as driving a car.
Motivation and cognition may be altered, making the acquisition of new information difficult.
Marijuana can also produce paranoia and psychosis.
Because users often inhale the unfiltered smoke deeply and then hold it in their lungs as long as possible,
marijuana is damaging to the lungs and pulmonary system. Marijuana smoke contains more
cancer-causing agents than tobacco smoke. Long-term users of cannabis may develop psychological
dependence and require more of the drug to get the same effect.

Cannabis Smoked - mixed with tobacco Concentrated syrupy liquid varying in color from clear to black Hash Oil Hashish Oil Smoked or eaten Brown or black cakes or balls Hash Hashish Taken orally Soft gelatin capsules THC Tetrahydrocannabinol Smoked or eaten Like dried parsley, with stems and/or seeds; rolled into cigarettes Pot, Reefer, Grass, Weed, Dope, Ganja, Mary Jane, or Sinsemilla Marijuana How is it used? What does it look like? What is it called? Type

Inhalants
The immediate negative effects of inhalants include nausea, sneezing, coughing, nosebleeds, fatigue,
lack of coordination, and loss of appetite.
Solvents and aerosol sprays also decrease the heart and respiratory rates and impair judgment.
Amyl and butyl nitrite cause rapid pulse, headaches, and involuntary passing of urine and feces.
Long-term use may result in hepatitis or brain damage.
Deeply inhaling the vapors, or using large amounts over a short time, may result in disorientation,
violent behavior, unconsciousness, or death.
High concentrations of inhalants can cause suffocation by displacing the oxygen in the lungs or by
depressing the central nervous system to the point that breathing stops.
Long-term use can cause weight loss, fatigue, electrolyte imbalance, and muscle fatigue.
Repeated sniffing of concentrated vapors over time can permanently damage the nervous system.

Inhalants Vapors inhaled Cans of aerosol propellants, gasoline, glue, paint thinner Solvents Hydrocarbons Vapors inhaled Aerosol paint cans Aerosol sprays or cleaning fluids Chloro hydrocarbons Vapors inhaled In small bottles Rush, Bolt, Bullet, Locker Room, and Climax Butyl Nitrite Vapors inhaled Clear yellowish liquid in Poppers or Snappers Amyl Nitrite Vapors inhaled Small 8-gram metal cylinder sold with a balloon or pipe propellant for whipped cream in aerosol spray can Laughing gas or Whippets Nitrous Oxide How is it used? What does it look like? What is it called? Type

Cocaine
Cocaine stimulates the central nervous system.
Its immediate effects include dilated pupils and elevated blood pressure, heart rate, respiratory rate,
and body temperature. Occasional use can cause a stuffy or runny nose, while chronic use can ulcerate
the mucous membrane of the nose. Injecting cocaine with contaminated equipment can cause AIDS,
hepatitis, and other diseases.
Preparation of freebase, which involves the use of volatile solvents, can result in death or injury from
fire or explosion.
Crack or freebase rock is extremely addictive, and its effects are felt within 10 seconds.
The physical effects include dilated pupils, increased pulse rate, elevated blood pressure, insomnia,
loss of appetite, tactile hallucinations, paranoia, and seizure. The use of cocaine can cause death by
cardiac arrest or respiratory failure.

Cocaine Smoked White to tan pellets or crystalline rocks that look like soap Crack, rock, freebase Crack cocaine Inhaled, injected White crystalline powder Coke, Snow, Nose Candy, Flake, Blow, Big C, Lady, White, and Snowbirds Cocaine How is it used? What does it look like? What is it called? Type

Other Stimulants
Stimulants can cause increased heart and respiratory rates, elevated blood pressure, dilated pupils,
and decreased appetite.
In addition, users may experience sweating, headache, blurred vision, dizziness, sleeplessness,
and anxiety.
Extremely high doses can cause a rapid or irregular heartbeat, tremors, loss of coordination,
and even physical collapse.
An amphetamine injection creates a sudden increase in blood pressure that can result in stroke,
very high fever, or heart failure.
In addition to the physical effects, users report feeling restless, anxious, and moody.
Higher doses intensify the effects. Persons who use larger amounts of amphetamines over a long
period of time can develop an amphetamine psychosis that includes hallucinations, delusions,
and paranoia.
These symptoms usually disappear when drug use ceases.

Other Stimulants Taken orally, injected Pills or capsules Ritalin, Cylert, Preludin, Didrex, Pre-State, Voranil, Sandrex, and Plegine Additional Stimulants Taken orally, injected, inhaled White powder, pills, rock that resembles a block of paraffin Crank, Crystal meth, Crystal methadrine, and Speed Methamphetamines Taken orally, injected, inhaled Capsules, pills, tablets Speed, Uppers, Ups, Black beauties, Pep pills, Copilots, Bumblebees, Hearts, Benzedrine, Dexedrine, Footballs, and Biphetamine Amphetamines How is it used? What does it look like? What is it called? Type

Depressants
The effects of depressants are in many ways similar to the effects of alcohol.
Small amounts can produce calmness and very relaxed muscles, but larger doses can cause slurred
speech, staggering gait, and altered perception. Very large doses can cause respiratory depression,
coma, and death.
The combination of depressants and alcohol can multiply the effects of the drugs, increasing the risks.
Regular use of depressants over time can result in physical and psychological addiction.
People who suddenly stop taking large doses can experience withdrawal symptoms, including anxiety,
insomnia, tremors, delirium, convulsions, and death.
Babies born to mothers who abuse depressants may also be physically dependent on the drugs and
show withdrawal symptoms shortly after they are born.
Birth defects and behavioral problems also may result.

Depressants Taken orally Tablets or capsules Valium, Librium, Miltown, Serax, Equanil, Miltown, and Tranxene Tranquilizers Taken orally Tablets Qualudes, Ludes, Sopors Metha qualone Taken orally Red, yellow, blue, or red and blue capsules Downers, Barbs, Blue Devils, Red Devils, Yellow Jacket, Yellows, Nembutal, Tuinals, Seconal, and Amytal Barbiturates How is it used? What does it look like? What is it called? Type

Hallucinogen
Phencyclidine (PCP) interrupts the functions of the neocortex, the section of the brain that controls
the intellect and keeps instincts in check.
Because the drug blocks pain receptors, violent PCP episodes may result in self-inflicted injuries.
The effects of PCP vary, but users frequently report a sense of distance and estrangement.
Time and body movements are slowed down. Muscular coordination worsens and senses are dulled.
Speech is blocked and incoherent. In later stages of chronic use, users often exhibit paranoid and
violent behavior and experience hallucinations.
Large doses may produce convulsions and coma, as well as heart and lung failure.
Lysergic acid (LSD), mescaline, and psilocybin cause illusions and hallucinations.
The physical effects may include dilated pupils, elevated body temperature, increased heart rate and
blood pressure, loss of appetite, sleeplessness, and tremors.
The user may experience panic, confusion, suspicion, anxiety, and loss of control.

Hallucinogen Chewed or swallowed Fresh or dried mushrooms Magic Mushrooms, 'shrooms Psilocybin Discs - chewed, swallowed, or smoked or Tablets and capsules - taken orally Hard brown discs, tablets, capsules Mesc, Buttons, and Cactus Mescaline and Peyote Taken orally, licked off paper, gelatin, and liquid can be put in the eyes. Colored tablets, blotter paper, clear liquid, thin squares of gelatin LSD, Acid, Microdot, White lightning, Blue heaven, and Sugar Cubes Lysergic acid diethylamide Taken orally, injected, smoked (sprayed on joints or cigarettes) What does it look like - Liquid, white crystalline powder, pills, capsules PCP, Hog, Angel Dust, Loveboat, Lovely, Killer Weed Phencyclidine How is it used? What does it look like? What is it called? Type

Narcotics
Narcotics initially produce a feeling of euphoria that often is followed by drowsiness, nausea,
and vomiting.
Users may also experience constricted pupils, watery eyes, and itching. An overdose may produce
slow and shallow breathing, clammy skin, convulsions, coma, and possible death.
Tolerance to narcotics develops rapidly and dependence is likely.
The use of contaminated syringes may result in disease such as AIDS, endocarditic, and hepatitis.
Addiction in pregnant women can lead to premature, stillborn, or addicted infants who experience
severe withdrawal symptoms.

Narcotics Taken orally, injected Tablets or capsules Percocet, Percodan, Tussionex, Fentanyl, Darvon, Talwin, and Lomotil Others Taken orally, injected White powder, solution, tablets Pethidine, Demerol, Mepergan Meperidine Smoked, eaten, or injected Dark brown chunks, powder Paregoric, Dover's Powder, Parepectolin Opium Taken orally, injected, or smoked White crystals, hypodermic tablets, or inject able solutions Pectoral syrup Morphine Taken orally, injected Dark liquid varying in thickness, capsules, tablets Empirin compound with codeine, Tylenol with codeine, Codeine in cough medicine Codeine Injected, smoked, or inhaled White to dark-brown powder or tar-like substance Smack, Horse, Mud, Brown sugar, Junk, Black tar, and Big H Heroin How is it used? What does it look like? What is it called? Type

Designer Drugs
Illegal drugs are defined in the terms of their chemical formulas.
To circumvent these legal restrictions, underground chemists modify the molecular structure of
certain illegal drugs to produce analogs known as designer drugs.
These drugs can be several hundred times stronger than the drugs they are designed to imitate.
The narcotic analogs can cause symptoms such as those seen in Parkinson's disease:
uncontrollable tremors, drooling, impaired speech, paralysis, and irreversible brain damage.
Analogs of amphetamines and methamphetamines cause nausea, blurred vision, chills or sweating,
and faintness.
Psychological effects include anxiety, depression, and paranoia.
As little as one dose can cause brain damage.
The analogs of phencyclidine cause illusions, hallucinations, and impaired perception.

Designer Drugs Taken orally, injected, or smoked White powder PCPy, PCE Analog of Phencyclidine (PCP) Taken orally, injected, or inhaled White powder, tablets, or capsules MDMA (Ecstasy, XTC, Adam, Essence), MDM, STP, PMA, 2, 5-DMA, TMA, DOM, DOB, EVE Analog of Amphetamines or Methamphetamines (Hallucinogens) Inhaled, injected White powder MPTP (New heroin), MPPP, synthetic heroin Analog of Meperidine (Narcotic) Inhaled, injected White powder Synthetic heroin, China white Analog of Fentanyl (Narcotic) How is it used? What does it look like? What is it called? Type

Anabolic Steroids
Anabolic steroids are a group of powerful compounds closely related to the male sex hormone testosterone.
Developed in the 1930's, steroids are seldom prescribed by physicians today.
Current legitimate medical uses are limited to certain kinds of anemia, severe burns, and some types
of breast cancer.
Taken in combination with a program of muscle-building exercise and diet, steroids may contribute to
increases in body weight and muscular strength.
Steroid users subject themselves to more than 70 side effects ranging in severity from liver cancer to
acne and including psychological as well as physical reactions.
The liver and cardiovascular systems are most seriously affected by steroid use.
In males, use can cause withered testicles, sterility, and impotence.
In females, irreversible masculine traits can develop along with breast reduction and sterility.
Psychological effects in both sexes include very aggressive behavior known as "roid rage" and depression.
While some side effects appear quickly, others, such as heart attacks and strokes, may not show up for years.
Signs of steroid use include quick weight and muscle gains (when used in a weight training program);
aggressiveness and combativeness; jaundice; purple or red spots on the body; swelling of feet and lower
legs; trembling; unexplained darkening of the skin; and persistent unpleasant breath odor.

Alcohol
Alcohol consumption causes a number of changes in behavior.
Even low doses significantly impair the judgment and coordination required to drive a car safely.
Low to moderate doses of alcohol can increase the incidence of a variety of aggressive acts,
including spouse and child abuse.
Moderate to high doses of alcohol cause marked impairments in higher mental functions, severely
altering a person's ability to learn and remember information.
Very high doses cause respiratory depression and death.
Continued use of alcohol can lead to dependence. Sudden cessation of alcohol intake is likely to
produce withdrawal symptoms, including severe anxiety, tremors, hallucinations, and convulsions.
Long-term effects of consuming large quantities of alcohol, especially when combined with poor nutrition,
can lead to permanent damage to vital organs such as the brain and the liver.
In addition, mothers who drink alcohol during pregnancy may give birth to infants with fetal alcohol
syndrome.
These infants may suffer from mental retardation and other irreversible physical abnormalities.
In addition, research indicates that children of alcoholic parents are at greater risk than other children
of becoming alcoholics.

Tobacco
The smoking of tobacco products is the chief avoidable cause of death in our society.
Smokers are more likely than nonsmokers to contract heart disease - some 170,000 die each year
from smoking-related coronary heart disease.
Lung, larynx, esophageal, bladder, pancreatic, and kidney cancers also strike smokers at
increased rates.
Some 30 percent of cancer deaths (130,000 per year) are linked to smoking.
Chronic, obstructive lung diseases such as emphysema and chronic bronchitis are 10 times more likely
to occur among smokers than among nonsmokers.
Smoking during pregnancy also poses serious risks.
Spontaneous abortion, pre-term birth, low birth weights, and fetal and infant deaths are all more likely to
occur when the pregnant woman is a smoker.
Cigarette smoke contains some 4,000 chemicals, several of which are known carcinogens.
Perhaps the most dangerous substance in tobacco smoke is nicotine.
Nicotine is the substance that reinforces and strengthens the desire to smoke.
Because nicotine is highly addictive, addicts find it very difficult to stop smoking.
Of 1,000 typical smokers, fewer than 20 percent succeed in stopping on the first try.

What are the symptoms? There are a lot of bewildering different words used to describe drug use and addiction problems. Not every expert will agree with the definitions here, but being consistent about the terms used helps to reduce the confusion and anxiety everyone feels when faced with this problem.
Each drug has different patterns of:
use
intoxication
overdose
hangover
For each different drug, the term 'substance abuse' can cover different levels of
use, including:
experimenting with use
bingeing
using large amounts without appearing intoxicated
using large amounts to get intoxicated

Drug use & abuse
People can use a substance for more than one of the above reasons, and may also use
several drugs for different reasons.
Untangling the 'how' and 'why' of a person's drug use is rarely an easy task, but most people use a
drug because they enjoy the effects. This may seem like a simplistic or insensitive statement, but
it's a fact that's easily forgotten by the people around the drug user, who are concerned and trying to
understand why they're using drugs.
Worried parents often ask for tell-tale signs of drug use, but the simple answer is that it's very hard
to spot.
Many users who have contact with mental health services manage to conceal their use from mental
health professionals, so it's obviously difficult to identify.
Parents usually know their children better than anyone else, and maintaining an open atmosphere
in which communication is kept up is often the best way to find out what's going on.
This is not always easy with teenagers, as they might view the methods parents use to find out if they
are using drugs as intrusive and controlling. And angry confrontations with teenagers might push
them further into a cycle of resentment and refusal to communicate.

Dependence (or psychological addiction)
The media's portrayal of a person giving up drugs usually focuses on the immediate effects of
withdrawing from heroin.
It's important to remember that there's often more to an addiction than the physical withdrawal symptoms.
In fact, for some drugs such as cannabis, there's a debate about whether there are actually any physical
symptoms of withdrawal.
People who use cannabis regularly over a long period may find there are certain situations in which they
come to rely on the drug. If they stop using it they may feel very disabled.
This is a situation that can develop for almost any substance that affects the mind and this aspect of
addiction can be harder to overcome than the physical symptoms.
Mental symptoms can include:
anxiety
depression
disrupted sleep and rest
controlling mood
relearning different coping skills
reduced wellbeing

Dependence (or psychological addiction)
The pattern of these symptoms will depend on the drug being used, the psychological
make-up of the person using it and the circumstances under which they are attempting
to remain drug free.
The term 'craving ' is often used when talking about addiction.
If a person is experiencing any of the symptoms listed and they know that by using the
drug all these problem will go away, it's not surprising that they develop an overwhelming
desire to use and that this dominates their thoughts.

Physical addiction
It's ironic that through films, quite a lot of people feel that they understand the physical
effects of withdrawal from heroin.
They rightly see it as an unpleasant and difficult experience - and a good reason not to
experiment with it.
The irony is that alcohol has much worse and more dangerous withdrawal effects.
It's possible, but very rare, for someone experiencing heroin withdrawal to need to be admitted to
hospital, while someone who is physically addicted to alcohol should not attempt to stop using it
without consulting a doctor.
Again, as with psychological dependence, the length and severity of withdrawal differs according
to the drug, how much has been taken and for how long.
For most addicts, their problem is a mixture of both physical and psychological aspects.
There are some instances when it's difficult to distinguish between the two.
The stimulants cocaine and amphetamine are classic examples of this - people coming down after
using these drugs feel very low and lack energy. When they take cocaine, they feel very high and
use up lots of energy. Their feelings afterwards could be partly because of feeling tired and adjusting
to a normal mood again, but there are other theories that suggest these feelings are because the
body is re-establishing its chemical balance.

Two Reasons for Addiction
The two major causes for drug and alcohol addiction have been identified.
They are thoroughly addressed and treated 100% successfully on the Narconon
Drug Rehabilitation Program.
These two major reasons are:
Mental and physical cravings caused by drug residues which remain in the body even
long after a person quits using the drug.
The "Biochemical Personality" -- the "way of thinking" that is caused by drug addiction
and the lifestyle an addict adopts to get drugs and live with a drug habit.
These two situations are intricately linked, the one feeding the other, and both must be
recognized and dealt with before a person can fully free himself or herself from the addiction.

What can I do to help myself?
The saying that admitting you have a problem is half of solving the problem is very applicable.
The next step is to get support.
If you're physically addicted, it may be dangerous just to stop - especially if you're using
alcohol or tranquilizers.
Even if it isn't dangerous to stop abruptly, a doctor may be able to prescribe medication to
help you through the first phase of withdrawal.
Not all family doctors are happy to help with this problem, so if yours isn't it's probably best
to approach your local drug dependence unit (DDU). It's also vital to get other forms of
support and counseling

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Alcohol & Drug Abuse

by Ravindranath Dr.

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