This document discusses drug abuse among military personnel and recommendations for addressing the problem. It defines key terms, examines epidemiology and common drugs abused. Predisposing factors include combat stress, PTSD, and military culture where drinking is accepted. Effects of drug abuse negatively impact duties, family, finances, and health. Treatment involves counseling, rehabilitation, and random drug testing. Prevention prioritizes early mental health support and avoiding lengthy deployments.
Substance Abuse
outlines
Definition
Factsheet
Risk factors
ICD classification
Sign and Symptom
The harmful effect of substance abuse on health and behaviour
Prevention and Rehabilitation for substance abusers
References
Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.
Symptoms: Compulsive behavior
Obsessive-compulsive disorder is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours.
OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.
Treatment includes talk therapy, medication or both.
Consult a doctor for medical advice.
Substance Abuse
outlines
Definition
Factsheet
Risk factors
ICD classification
Sign and Symptom
The harmful effect of substance abuse on health and behaviour
Prevention and Rehabilitation for substance abusers
References
Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.
Symptoms: Compulsive behavior
Obsessive-compulsive disorder is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviours.
OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.
Treatment includes talk therapy, medication or both.
Consult a doctor for medical advice.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Seminar on mental retardation for Nursing students. Its definition, causes, risk factors, sign and symptoms its management and training program available for the children.
Overview of substance abuse/addiction prevention principles including risk and protective factors. NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
This presentation was done on the 'First Qilu Doctoral Forum on Health Economy and Policy' Conference on 15th May 2019 at Shandong University, Jinan, China
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Seminar on mental retardation for Nursing students. Its definition, causes, risk factors, sign and symptoms its management and training program available for the children.
Overview of substance abuse/addiction prevention principles including risk and protective factors. NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
This presentation was done on the 'First Qilu Doctoral Forum on Health Economy and Policy' Conference on 15th May 2019 at Shandong University, Jinan, China
Drug abuse represents a complex and multifaceted issue prevalent across societies globally. It involves the misuse of legal or illegal substances that alter the functioning of the brain, leading to detrimental effects on an individual's physical health, mental well-being, and social relationships. From the casual misuse of substances to the severe grip of addiction, drug abuse encompasses a wide spectrum of behaviors and consequences that profoundly impact individuals and communities.
Types and Categories of Drugs:
Drug abuse spans a broad array of substances, including but not limited to alcohol, cannabis, opioids, stimulants, hallucinogens, and prescription medications. Each category of drugs affects the brain and body in distinct ways, contributing to varying levels of dependence and health risks. Alcohol, for instance, is legal in many societies but is also one of the most commonly abused substances, leading to addiction and a myriad of health problems when consumed excessively. On the other hand, opioids like heroin or prescription painkillers can quickly lead to physical dependence and overdose fatalities.
Causes and Risk Factors:
The reasons behind drug abuse are multifaceted and can involve a combination of genetic, environmental, and psychological factors. Genetic predispositions, family history of substance abuse, trauma, stress, peer pressure, mental health disorders, and socioeconomic factors can all contribute to an individual's susceptibility to drug abuse. Additionally, availability and societal attitudes toward drugs play a significant role in influencing patterns of abuse.
Effects of Drug Abuse:
The effects of drug abuse extend far beyond the individual consuming the substance. Physically, drug abuse can lead to a range of health issues, including cardiovascular problems, liver damage, respiratory complications, infectious diseases from needle sharing, and neurological impairments. Mentally, drug abuse can exacerbate or trigger mental health disorders such as depression, anxiety, psychosis, and cognitive impairments. Socially and behaviorally, it can strain relationships, cause legal issues, financial strain, and impair an individual's ability to function at work or in academic settings.
Impact on Society:
Drug abuse poses significant challenges at a societal level. It contributes to crime rates, strains healthcare systems, leads to lost productivity, and imposes substantial economic burdens. Moreover, the societal stigma associated with drug abuse often hinders individuals from seeking help, exacerbating the problem further.
Prevention and Treatment:
Preventing drug abuse involves a multifaceted approach, including education, early intervention, addressing risk factors, and promoting healthy coping mechanisms. Treatment strategies vary and often include behavioral therapies, counseling, support groups, and, in some cases, medication-assisted therapies. The goal of treatment is not only to help individuals overcome their dep
ANTI-DRUG CAMPAIGN (TYPES/EFFECTS/HOW TO OVERCOME DRUGS)czarinaCervo
this is all about drugs and on how to avoid or stop drug abuse, through this slideshow, viewers can be aware about the effects and the negative things that drugs can do to our body.
Drug addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.
Brain changes that occur over time with drug use challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. This is why drug addiction is also a relapsing disease.
Relapse is the return to drug use after an attempt to stop. Relapse indicates the need for more or different treatment.
Most drugs affect the brain's reward circuit by flooding it with the chemical messenger dopamine. This overstimulation of the reward circuit causes the intensely pleasurable "high" that leads people to take a drug again and again.
Introduction to Drugs and SocietyChapter 1.docxmariuse18nolet
Introduction to
Drugs and Society
Chapter 1
Key ConcernsWhat constitutes a drug?What are the most commonly abused drugs?What are designer drugs?How widespread is drug use?What is the extent and frequency of drug use in our society?What are the current statistics and trends in drug use?
Key Concerns (continued)What types of drug users exist?How does the media influence drug use?What attracts people to drug use?When does drug use lead to drug dependence?When does drug addiction occur?What are the costs of drug addiction to society?What can be gained by learning about the complexity of drug use and abuse?
Drug Use Causes Three
Major Simultaneous Changes in the User
1. The social and psychological rewards from the effects of the
drug “high” results in the illusion of temporary satisfaction and
postponement of social pressures and anxieties leading to a superficial belief that problems and/or concerns are nonproblematic.
2. Pharmacologically, the nonmedical use of most drugs alters body chemistry largely by interfering with (affecting) its proper (homeostatic) functioning. Drugs enhance, slow down, speed-up, or distort the reception and transmission of reality.
3. Using a particular drug may satisfy an inborn or genetically programmed need or desire.
Drug UseDrug users are found in all occupations and professions, at all income and social class levels, and in all age groups. No one is immune to drug use, (that often leads to drug dependence). Drug use is an equal-opportunity affliction.
Four Principle Factors That Affect Drug Use Biological, Genetic, and Pharmacological Factors: Substance abuse and addiction involve biological and genetic
factors. The pharmacology of drug use focuses on how the
ingredients of a particular drug affect the body and the nervous
system, and in turn, a person’s experience with a particular drug.Cultural Factors: How do societal views, determined by custom
and tradition, affect our initial approach to and use of a drug?Social Factors: What are the specific reasons why a drug is taken (e.g., curing an illness, self-medicating, escape from reality, peer pressure, family upbringing, membership in drug-abusing subcultures)?Contextual Factors: How do physical surroundings (music concerts, bars, nightclubs, or fraternity and sorority parties) affect the amount of drug use?
The Dimensions of Drug Abuse
Q: What is a drug?
A: Any substance that modifies (enhances, inhibits, or distorts) mind and/or body functioning.
Q: What are psychoactive drugs?
A: Drug compounds (substances) that affect
the central nervous system and/or alter
consciousness and/or perceptions.
Psychoactive DrugsPsychoactive drugs are classified as either: Licit (Legal): Examples may include coffee, tea, alcohol, tobacco, and over-the-counter drugs. Illicit (Illegal): Examples may include marijuana, cocaine, and LSD.
Major Typ.
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1. DRUG ABUSE AMONGST MILITARY PERSONNEL
THE WAY FORWARD
SURG SLT LO MAJOLAGBE
MEDICAL OFFICER
NIGERIAN NAVY REFERENCE HOSPITAL OJO
1
2. OUTLINE
Introduction
Definitions of Terms
Epidemiology
Common Drug Abused
Predisposing Factors of Drug Abuse Amongst Personnel
Effects/Symptoms of Drug Abuse
Investigations
Management
Way forward
Recommendations
2
3. INTRODUCTION
It’s important to understand that drug abuse is an extreme
desire to obtain, and use, increasing amounts of one or more
substances.
In the military, certain substance types tend to be abused
more often than others.
Reasons for drug abuse in military personnel differ from the
civilians.
Alcohol and prescription drugs (including sedatives and
opioid painkillers) are more commonly abused than illicit
drugs among armed forces.
3
4. DEFINITION OF TERMS (1)
Drugs: Any substance that enters the human body and can
change either the function or structure of the human
organism.
Psychoactive drugs: are substances that, when taken in or
administered into one's system, affect mental processes, e.g.
perception, consciousness, cognition or mood and
emotions. [W.H.O]
4
5. DEFINITION OF TERMS (2)
Drug abuse: Drug abuse is the deliberate or unintentional
continuous use of mind-changing chemical substances
(usually for reasons other than legitimate medical purposes)
that results in any degree of physical, mental, emotional, or
social impairment of the user, the user's family, or society
in general.
5
6. DEFINITION OF TERMS (3)
It is simply the use of a drug in amounts or by methods
which are harmful to the individual or others.
It is also known as substance abuse [ICD. DSM]
Controversial.
Illegal or Legal
6
7. DEFINITION OF TERMS (4)
Drug addiction is the inability to stop using the drug in
spite of numerous attempts to stop despite substantial harm
and adverse consequences.
One can abuse drugs without necessarily being addicted to
drugs.
Addictive drug – psychoactive substances that with
repeated use are associated with significantly higher rates of
substance use disorders.
7
8. DEFINITION OF TERMS (5)
Withdrawal syndrome: is the group of symptoms that
occur upon the abrupt discontinuation or decrease in the
intake of medicational or recreational drugs.
Drug dependence: is an adaptive state that develops from
repeated drug administration, and which results
in withdrawal upon cessation of drug use.
8
9. DEFINITION OF TERMS (6)
• Physical dependence – dependence that involves persistent
physical–somatic withdrawal symptoms (e.g., fatigue
and delirium tremens).
• Psychological dependence – dependence that involves
emotional–motivational withdrawal symptoms
(e.g., dysphoria and anhedonia).
9
10. Tolerance – the diminishing effect of a drug resulting from
repeated administration at a given dose.
Drug misuse: Use of a substance for a purpose not
consistent with legal or medical guidelines, as in the non-
medical use of prescription medications. [W.H.O] e.g.
Tramal
10
DEFINITION OF TERMS (7)
12. EPIDEMIOLOGY (1)
W.H.O World drug report (2019)
About 270 million people (or about 5.5% of global
population aged 15-64) had used psychoactive drugs in the
previous year.
12
13. EPIDEMIOLOGY (2)
It is estimated that about 0.5 million death annually are
attributable to drug use with about 350,000 male and
150,000 female deaths
It is estimated that worldwide there are almost 11 million
people who inject drugs, of whom 1.4 million live with HIV
and 5.6 million - with hepatitis C.
13
14. EPIDEMIOLOGY (3)
Cannabis (marijuana) is the most widely abused drugs in
the world.
Around 141 million people worldwide consume cannabis.
While among armed forces, alcohol and marijuana take the
lead.
320,000 young people between the age 15 and 29 years die
of alcohol related deaths resulting in about 9% of death in
that age group.
14
15. EPIDEMIOLOGY (4)
Kareem and Abdukarim (2014)
investigated relationship between depression, paranoid
ideation and substance abuse among Nigerian military
personnel deployed for peace support operation.
Using a 211 item structured self-report questionnaire, the
research has found that depression and paranoid ideation were
significantly and positively associated with substance abuse.
(Kareem &Abdulkarim. 2014).
15
16. EPIDEMIOLOGY (5)
Alcohol Use Among Military and Paramilitary Personnel
by GE Abikoye 2016; 18.5% of Nigerian
Army personnel abuse one of alcohol, cannabis and
tobacco; and 8.5% abuse at least two of alcohol. cannabis
and tobacco.
16
17. DRUG CATEGORY (1)
• Depressants: These cause depression of the brain's
faculties and examples include sleeping pills (barbiturates)
and heroin.
• Hallucinogens: These cause hallucinations and an "out of
this world" feeling of dissociation from oneself.
Hallucinogens may cause distorted sensory perception,
delusion, paranoia and even depression. Examples include
ecstasy, mescaline and LSD.
17
18. DRUG CATEGORY (2)
• Stimulants: These cause stimulation of the brain, giving
rise to alertness and increased bursts of activity. A rapid
heart rate, dilated pupils, raised blood pressure, nausea or
vomiting and behavioral changes such as agitation, and
impaired judgment may also result. Examples are cocaine
and amphetamines.
• Alcohol, Tobacco, Opioids, and Marijuana.
• Narcotics, Rubber, Gutter, Gum, Cigarette.
18
19. MOST COMMON DRUGS USED BY MILITARY
PERSONNEL
Marijuana. Easily the most used drug in the military.
Marijuana is a relatively easy for soldiers to obtain. The
drug is used to temporarily escape the stressors provided by
the wartime environment.
Cocaine and other stimulants. Long stretches of duty lead
many soldiers to turn to stimulants such as amphetamines
or cocaine to stay alert throughout the course of the day.
19
20. MOST COMMON DRUGS USED
Opiates. Vicodin and OxyContin are becoming more
widespread in the military because of the euphoric effects
they provides. Many will have these drugs shipped in from
home, or brought over with incoming military personnel.
They provide escape and self-medication against the horrors
of war.
Alcohol: military culture.
20
21. Oral
Injection
subcutaneous
intramuscular
intravenous reaches brain in ~10 secs
quick response thus dangerous, HIV, Hepatitis Risk
Inhalation - reaches brain in ~8 secs
Dermal – absorbed through the skin
Buccal or nasal membranes
ROUTES OF ADMINISTRATION
21
22. PREDISPOSING FACTORS
Combat exercise: active deployment in a combat zone.
Those who have multiple deployments may be at an
even higher risk of developing substance abuse issues,
due to cumulative effect in terms of the related stress
and trauma.
22
23. PREDISPOSING FACTORS
Post traumatic stress disorder: vivid flashbacks, intrusive
images, thoughts, nightmares seen in PTSD contribute to
increased substance use as well as depression, and
traumatic brain injury.
Unfortunately, substance use is a maladaptive coping
method that some turn to in the face of untreated mental
health issues and psychological distress.
23
24. PREDISPOSING FACTORS
Culture of military: For many, drinking is an accepted part
of military culture. Turning to alcohol to unwind or
otherwise cope with the challenges of military life is
common. Alcohol is widely available in some military
bases at a discounted rate, and service members have many
opportunities to partake in established drinking rituals. It
serves as anti-emetics for sailors.
Examples are regimental dinners nights, mess functions etc.
24
25. PREDISPOSING FACTORS
Increased risk for injury: there is an increased risk of
physical injury.
Treatment for injuries often involves prescription
opioids, painkilling medications with a high potential
for misuse and abuse. Misuse of prescribed pain
medication may lead to an opioid use disorder
25
26. EFFECTS OF DRUG ABUSE
MILITARY DUTIES
FAMILY / SOCIAL
FINANCIAL PROBLEMS
26
27. EFFECTS OF DRUG ABUSE
The subsequent “crash” after using these drugs is
dangerous because it leaves soldiers in a weakened state
during what could be times of emergency.
Creating the wrong kind of environment. A military unit
functions on order and the chain of command. If conflict
arises, or chaos ensues as a result of drug use, the entire unit
will cease to function properly.
27
28. EFFECTS OF DRUG ABUSE
Putting their comrades in jeopardy. In the military, all
you have to rely on at the end of the day are your comrades
in arms. If an individual’s judgment is impaired because of
drug use, it puts the man or woman next to them in peril as
well.
Risking one’s own personal safety. Drugs can slow
reaction times, which on the battlefield can mean the
difference between life and death. Taking drugs puts the
soldier at greater risk for being wounded or separated from
their fellow soldiers during battle or troop movements.
28
29. EFFECTS OF DRUG ABUSE
Emotional burden (frustration, worry, depression, shame
and guilt).
Increased financial burden (financial embarrassment, loss
of job, reliance on others).
Family instability (tension, conflicts, abuse, violence and
break up).
29
30. SIGNS AND SYMPTOMS OF SUBSTANCE ABUSE
Anxiety
Blackouts, dizziness
Depression
Disorientation
Mood swings
Falls, bruises, burns
Family/Social problems
Financial problems
Headaches
Incontinence
Increased tolerance
Aggressive / violent
behavior
Memory loss
New problems in decision
making
Poor hygiene
Seizures, idiopathic
Sleep problems
Social isolation
Unusual response to
medications
30
31. ALCOHOL INTOXICATION
Drunkenness / Alcohol poisoning
Mainly absorbed in the stomach, small amount in the small
intestine.
Alcohol is primarily metabolized by the liver (90%).
Alcohol has lethal effects on all organs of the body.
Legally, alcohol intoxication is often defined as a blood
alcohol concentration (BAC) of greater than 5.4–
17.4 mmol/L (25–80 mg/dL).
31
33. BREATHALYZER TEST
A breathalyzer or breathalyser is a device for estimating
blood alcohol content from a breath sample.
The name is a genericized trademark of the Breathalyzer
brand name of instruments developed by inventor Robert
Frank Borkenstein in the 1950s.
33
39. INVESTIGATIONS OF DRUG ADDICTS
Random screening e.g. annual medical screening, pre-
enlistment screening.
Monitor someone with a history of substance abuse.
To monitor compliance with prescribed medications e.g.
pain medications or addictive drugs.
To detect and evaluate drug intoxication or overdose for
legal or forensic reasons.
39
40. INVESTIGATIONS OF DRUG ADDICTS
Sample Required:
Random urine; detects drug use from few days to 1 week
Venous blood; hormones and steroids
Hair; 2 to 3 months
Saliva; last 24 hours
Sweat; collected on an absorbent patch worn for several
days to weeks
40
41. INVESTIGATIONS OF DRUG ADDICTS
Urine Drug Tests
• amphetamines.
• methamphetamines.
• benzodiazepines.
• barbiturates.
• marijuana.
• cocaine.
• PCP.
• methadone.
41
42. INVESTIGATIONS OF DRUG ADDICTS
Test Preparation Needed
Some prescription and over-the-counter drugs may give a
positive screening result; prior to testing, indicate any
medications that you have taken and/or for which you have
prescriptions.
Vicks nasal spray can test positive for amphetamines;
poppy seeds can produce a false-positive for opiates.
42
43. MANAGEMENT OF SUBSTANCE ABUSE
Seek help: free counseling to service members who are
concerned about their substance use or are dealing with
overwhelming stress, depression, or other concerns, can
access this resource.
Psychotherapy: Psychiatrists, psychologist and the
counselors.
Rehabilitation.
43
44. MANAGEMENT OF SUBSTANCE ABUSE (CONT)
Disciplinary committee: While disciplinary action may
result, it’s important to remember that without intervention,
it is likely that the substance abuse issue will continue to
worsen and may end in devastating consequences.
Random drug test: positive member can go for in-patient
or out-patient detox program.
44
45. MANAGEMENT OF SUBSTANCE ABUSE (CONT)
Focus of treatment: Treatment programs for military
personnel with substance abuse should ideally include a
focus on addressing trauma, include treatment for other
psychiatric disorders, and work to lessen the stigma
associated with substance abuse or mental health disorders
among military members.
45
46. First need to treat acute withdrawal
With benzodiazepines (diazepam)
Then follow up with more long-term strategies
Pharmacotherapies e.g. Disulfiram, Acamprosate
Join groups like Alcoholics Anonymous
TREATING ALCOHOL DEPENDENCE
46
48. Opioid based drugs
heroin, morphine, oxycodone, methadone, etc.
Treatment often uses substitution therapy
methadone
buprenorphine
TREATMENT OF OTHER DRUGS
48
49. WAY FORWARD - PREVENTION
Continuous mandatory random drug testing that would
discourage drug use.
Avoid lengthy deployments which put service members
under unusual work stress, which may further contribute
to substance abuse issues.
PTSD: early diagnosis and prompt treatment before they
start using drugs as coping mechanism.
49
50. WAY OF PREVENTION (CONT)
Avoid using drugs with addictive tendencies: Treatment
for injuries often involves prescription opioids, painkilling
medications with a high potential for misuse and
abuse. Misuse of prescribed pain medication may lead to an
opioid use disorder.
50
51. DISCIPLINARY ACTION IN MILITARY
Armed Forces Act Chapter A20 Laws of the Federation of
Nigeria 2004:
64. Drunkenness.
65. Drugs: wrongful use, possession, etc., of controlled
substances.
51
52. CONCLUSION
Cannabis and opiates use in military personnel have
increased in recent years.
Alcohol (and pain killers) remains the most commonly
drug abused among military men due to military alcohol
culture (and work related stressful conditions).
Work stress and PTSD are the leading predisposing
factors in drug abuse amongst personnel.
Prevention, early detection and prompt treatment
(psychological counselling) are key in moving away
from substance abuse in the military and in the society
at large.
52
53. RECOMMENDATIONS
Compulsory drug testing and psychological counselling for
every personnel that just returned from combat deployment.
Provide other means of alleviating boredom, like sport,
religious activities as opposed to ritualized drinking and
using alcohol as a way to handle stress, boredom,
loneliness, and other negative feelings.
53
54. RECOMMENDATIONS
Reduction in the availability or increase in price of alcohol
at the military bases.
A study on substance use abuse amongst Naval personnel in
Nigeria can be done.
54
55. REFERENCES
National Institute on Drug Abuse; National Institutes of Health; U.S.
Department of Health and Human Services.
Michael’s House residential drug treatment facility
Serious Mental Illness Treatment Research & Evaluation Center
Department of Veterans Affairs
Sharbafchi, M. R., & Heydari, M. (2017). Management of Substance Use
Disorder in Military Services: A Comprehensive Approach. Advanced
biomedical research, 6, 122.
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