This document discusses alcohol and substance abuse. It defines substance abuse and different types of substances that are abused, including legal and illegal drugs. It describes the effects of substance abuse on individuals and communities. It also outlines preventive and control measures for substance abuse, including education, treatment, public policy, and law enforcement strategies aimed at both reducing demand and supply of drugs. Management of substance abuse involves evidenced-based interventions from behavioral psychology like behavioral therapy, motivational interviewing, and contingency management. Prevention requires a coordinated effort through education, legal measures, community involvement, and political support.

1. ALCOHOL AND SUBSTANCE ABUSE

2.  At the end of the session participants will
be able to:
 Explain alcohol and substance abuse
 Mention different types of substance abuse
 Describe the effects of substance abuse
 State the preventive and control measures to be
undertaken for substance abuse

3.  Use, misuse, and abuse of mind-altering
substances predates recorded history
 Chronic alcohol and other drug abuse or
dependence is regarded as destructive behavior in
most cultures
 Affects individuals and the surrounding
community
 Abuse of alcohol, tobacco, and other drugs is a
community concern

4. ‘Psychoactive substance abuse' is defined as a
'maladaptive pattern of use indicated by ... continued use
despite knowledge of having a persistent or recurrent
social, occupational, psychological or physical problem
that is caused or exacerbated by the use [or by] recurrent
use in situations in which it is physically hazardous‘. -WHO
Drug Dependence means- 'persistent or sporadic
excessive drug use inconsistent with or unrelated to
acceptable medical practice'. -WHO Expert Committee (1969)

5. Contd
Substance abuse, also known as drug abuse, is a
patterned use of a substance (drug) in which the user
consumes the substance in amounts or with methods
which are harmful to themselves or others. -Wikipedia
Public health have attempted to look at substance
abuse from a broader perspective than the individual,
emphasizing the role of society.

6.  Brain’s own Opiate – Endorphins
 Brain’s own Cannabis – Anandamide
 Cocaine/ Amphetamine – Dopamine
 Tobacco – Acetyl Choline

8.  Legal drugs/Substances
 Nicotine, alcohol, nonprescription
(over-the-counter) drugs,
prescription drugs
 Illegal (illicit) drugs and
controlled substances
 Marijuana, narcotics, cocaine and
crack cocaine, hallucinogens,
stimulants, depressants, club
drugs and designer drugs, anabolic
drugs, inhalants

9. Type of
Substance/Drug
Product Remarks
Nicotine
Chewable tobacco,
Cigarette, Bidi etc
Legal
Alcohol Beer, Wine etc Controlled
Sedatives
Diazepam, Nirazepam,
Clonazepam etc Prescription
drug
Depressants
Barbiturates,
Benzodiazapines etc
Inhalants
Paint solvents, motor fuels,
cleaners, glues, aerosol
sprays
Legal
Stimulants
Amphitamine,
Methamphitamine (Yaba)
Prescription
drug

10. Type of
Substance/Drug
Product Remarks
Codeine based
cough suppressant
Phensidyl Illegal drug
Marijuana Marijuana or cannabis
Illegal
drugs
Narcotics
Opium & its derivatives,
morphine and heroin
Cocain
Cocaine and Crack
Cocaine
Hallucinogens
LSD, mescaline, peyote,
mushrooms
Injectable analgesic Pathedine, Buprenorphine
Prescription
drug
Anabolic Drugs
Testosterone,androgenic
steroids, GH
Contd

11. Comparison
Drug Mean Pleasure
Psychological
dependence
Physical
dependence
Heroin 3.00 3.0 3.0 3.0
Cocaine 2.37 3.0 2.8 1.3
Alcohol 1.93 2.3 1.9 1.6
Barbiturates 2.01 2.0 2.2 1.8
Benzodiazepines 1.83 1.7 2.1 1.8
Amphetamine 1.67 2.0 1.9 1.1
Cannabis 1.51 1.9 1.7 0.8
Ecstasy 1.13 1.5 1.2 0.7
LSD 0.90 1.3 1.1 0.3

13. EPIDEMIOLOGICALASPECTS
AGENT FACTORS:
Availability, Entrance, Injudicious prescription
HOST FACTORS: excitement, Fashion,
Relaxation, Curiosity, Escape from problem,
Bored situation
ENVIORNMENTAL FACTORS:
Broken parenthood, slum area, Psycho-social
instability

14.  There is big business with illegal drugs
 Majority of drug abusers are young people
aged between 18-30 years
 Males are about two times more
vulnerable than female to drug abuse

15. A study shows:

17.  Requires knowledge of:
 Causes of drug-taking behavior
 Sources of illicit drugs
 Drug laws
 Treatment programs
 Community organizing skills
 Persistent cooperation between various
individuals and agencies
 A well coordinated effort of Govt agencies, NGOs,
educators and community leaders

18. Primary prevention aimed at those who have
never used drugs
Secondary prevention aimed at those who have
used, but are not chronic abusers
Tertiary prevention aimed at drug abuse
treatment and aftercare, including relapse
prevention

19.  Education
 Treatment
 Public policy
 Law enforcement
 Education and treatment aims at:
 Reducing demand for drugs
 Public policy and law enforcement aims at:
 Reducing supply and availability of drugs

20. Management
From the applied behavior analysis literature,
behavioral psychology, and from randomized clinical
trials, several evidenced based interventions have
emerged:
 Behavioral marital therapy, motivational
interviewing,
 Community reinforcement approach,
 Exposure therapy,
 Contingency management

21. PREVENTION
Political commitment & policy implementation
Detection of risk group
Education
Mass awareness
Legal support
Identify source & destruction
Strict vigilance
Community participation etc.