Definitions.1. It is also known as drug abuse or substance use for reasons other than medical in a manner that affects physical or mental function. Any abuse can lead to addiction. [Alcohol, nicotine, cocaine, inhalants (including compounds found in gasoline, glue, and paint thinners), opioids (including morphine, heroin, codeine), sedative, hypn otic substances, sleeping medication.]
2. A maladaptive pattern of substance use lading to clinically significant impairment or distress, as manifested by one or more of the following occurring within a 12- month period. [DSM-4]3.Substance abuse refers to the taking of a psychoactive substance in a manner that violates current medical, legal, religious or social practices.
Division of substances or drugs. A).Legal drugs or licit drugs.• Such as coffee, tea, cocoa, alcohol, tobacco. B).Illegal drugs or illicit drugs.• Such as marijuana, cocaine, and lysergic acid diethylamide.• The popular use of legal drugs , particularly alcohol and tobacco has caused for more deaths, sickness, violent, crimes, economic loss and other social problems than the use of all illegal drugs combined.
Gateway drugs.• The word gateway suggests a path leading to something else. Alcohol, tobacco, and marijuana are the most commonly used drugs. Almost all abusers of more powerfully addictive drugs have first experimented with these 3 substances.
Major problems of substance abuse.• Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home. Repeated absence or poor work performance related to substance abuse, suspensions or expulsions from school, neglect of children or house hold.• Recurrent substance use in which it is physically hazardous, like driving an automobile or operating a machine when impaired by substance use.
Cont…• Recurrent substance- related legal problems like, arrest for substance related disorderly conduct.• Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. Arguments with spouse about consequences of intoxication, physical fights.
Common sign and symptoms of substance abuse.• You’ve built up a drug tolerance. You need to use more of the drug to experience the same effects you used to with smaller amounts.• You take drugs to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweat ing, shaking, and anxiety.• You’ve lost control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.
Cont…• Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.• You’ve abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.• You continue to use drugs, despite knowing it’s hurting you. It’s causing major problems in your life—blackouts, infections, mood swings, depression.
Alcohol.• Alcohol is an organic solvent especially for its use for human consumption. The type of alcohol that is found in alcohol beverages is ethanol. Ethanol is a colourless volatile and pungent liquid resulting from fermented grains, berries, and other fruits. Most common alcohol beverages are beer, wine, and spirits. Alcohol is a depressant that mainly affects the gastro intestinal system.
• Alcohol abuse:- uncontrollable drinking that leads to alcohol craving, loss of control and physical dependence.• Alcoholism:- a state of physical and psychological addiction to ethanol a psychoactive substance.• Binge drinking:- consume five or more drinks on one occasion.• Heavy drinkers:-five or more drinks on one occasion on five or more days during a given 30 days period.
Major components of alcoholism1. Craving.• An overwhelming compulsion to drink even when not feasible, such as at work, driving vehicle etc..2. Very impaired or loss of control.• An inability to limit one’s dinking once drinking has began, for example• one drink only before going to bed is impossible to control.3. Physical dependence.• Presence of withdrawal symptoms when attempting to abstain from usage. Such symptoms as nausea, sweating, shakiness and anxiety about the availability of alcohol consumed to maintain its effects.•
Effects of alcohol.The excessive amounts of alcohol often cause a progression in the loss of inhibitions, flushing and dizziness, loss of coordination, impaired motor skills, blurred vision, slurred speech, sudden mood swings, irregular pulse and memory impairment. Chronic heavy use may lead to high blood pressure, arrhythmia(irregular heart beat) and cirrhosis (severe liver deterioration). High rates of many types of cancer are seen in alcoholic persons, especially cancers of the head, neck, esophagus and stomach.
Among alcoholics liver disorder are responsible for 10% to 15% of deaths.• Relapsing syndrome:- returning to the use of alcohol after quitting.• Alcohol withdrawal syndrome:- symptoms that occur when an individual who is addicted to alcohol does not maintain his usual blood alcohol level.• Psychiatric disorders:- depression, schizophrenia, chronic use leading to permanently compromised mental function and memory.
Nicotine.• It is considered a gateway drug. It is an addictive, colourless, highly volatile liquid alkaloid found in all tobacco products such as cigarettes, chewing tobacco, pipe tobacco, cigars and bidi. Because nicotine is highly addictive and tobacco use is still socially acceptable under certain circumstances. Smokers often start young and have a vary difficult time quitting. Long term use of tobacco products can lead to several different chronic respiratory ailments and cancers.
• In 1828 nicotine was discovered to be one component of tobacco. It is one of more than 4000 chemicals found in the smoke from tobacco products such as cigarettes (NIDA1998). When smoked, nicotine enters the lungs and is then absorbed in to the blood stream.• Tobacco chewing:- the absorption of nicotine through the mucous lining of the mouth.• Snuff dipping:- placing a pinch of tobacco between the gums and the cheek.
Tobacco products.• Rolles of tobacco which are smoked[ bidi, cigarette, cigare, pipes, huka]• Oral preparation for chewing and holding in the mouth or placing in the nose.[snuff, snus, betel quid, paan masala, gutkha].Environmental tobacco smoke.• Mainstream smoke;- smoke drawn directly through the mouthpiece of a cigerette.• Side stream smoke:- smoke released in to the air from a lighted cigarette.• Passive smoking:- non smokers inhalation of tobacco smoke.
Health effects of tobacco.Tobacco consumption continues to be the leading preventable cause of deaths in the world. When you smoke tobacco you inhale up to 4000 chemicals. Tobacco use contributes to cataracts, pneumonia, abdominal aeortic aneurysm, stomach cancer, kidney cancer and other diseases. The diseases join the familiar list of tobacco related disease including cancer of the lung, vesicle, esophagus, larynx, mouth, and throat
Cont…chronic pulmonary disease, emphysema and bronchitis, stroke, heart attacks and other cardio vesicular disease.• Studies shows that in india half the male tuberculosis deaths in that caused by smoking. Kicking the habit of tobacco use.• Acupuncture, self-help with behavioral modification, nicotine patches, nicotine gum, hypnosis.
Cannabinoids• Hashish, Marijuana• How Consumed: swallowed, smoked• Effects: euphoria, slowed thinking and reaction time, confusion, impaired balance and coordination• Consequences: cough, frequent respiratory infections, impaired memory and learning, increased heart rate, anxiety, panic attacks.
Drug abuse prevention.• Three level prevention programs are their,1). Primary substance abuse prevention program.• Refers to the very broad range of activities aimed at reducing the risk of drug use among non users and assuring continued non use.• Primary prevention includes affective education, personal and social skill development, values, and clarification.
2). Secondary substance abuse prevention program.• Targeting at risk groups, experimenters, and early abuse population, to reverse the progression of abusive behaviors, similar to early intervention. It includes, teacher, counselor, parent team approach.3). Territory substance abuse prevention program.• Intervention at an advanced state of drug abuse, basically the same as drug abuse treatment. It includes assessment and diagnosis, referral in to treatment. Comprehensive prevention programs involving the community, school and family are more effective than single unit programs.
Support is essential to addiction recovery• Don’t try to go it alone; it’s all too easy to get discouraged and rationalize “just one more” hit or pill.• Recovering from drug addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance.Support can come from:• family members• close friends• therapists or counselors
Thankyou By,Abilittin James BenittoMsC. Psychiatric Nsg.