Drug and Substance Abuse

Drug abuse or substance abuse has various definitions. It can be defined as a drug used in the constant order in which the user consumes the substance in harmful amounts, via different methods which can cause harm to themselves and also others. It’s a form of the substance-related disorder.

The definitions of substance abuse differ in contexts such as public health, criminal justice and also medical contexts.  For instance, in criminal justice, substance abuse can influence the user’s social behavior as it long-term alters the user’s personality causing criminal penalties to occur. So this anti-social behavior caused by the user under the influence of the substance attracts penalties depending on one’s jurisdiction. Some drugs are considered legal in some states.

In medical contexts, substance abuse can be termed as prescription misuse or the intentional use of the prescribed drugs to achieve sedative, analgesic or stimulant properties. Public health practitioners broadly term drug abuse as any substance that alters not only the users’ personality, but his role in the society and the shortcomings contributed by the individual under the influence of drugs.

When an individual persists in the use of personality-altering substances for a long time, it is termed as substance dependence. It can be physical or psychological dependence and at times both. Compulsive or repetitive use of drugs may result to tolerance to the drug and the user may need to use more than one drug or switch to a stronger drug.  Tolerance to the drug may be in form of the underachievement of the intended effects or cause withdrawal symptoms when reduced or stopped. The severity of the withdrawal symptoms varies with the substance in question. Constant use of these substances fatally affects the society as it contributes to the rise of death cases among the users due to overdose or suicide sparked unstable mental health status.

Age groups abusing drugs and reasons for drug abuse

Substance abuse is not limited to a specific age and reasons for abuse vary with individuals regardless of age, financial and socio-economic status. Drug misuse is no longer tied to adolescents only under peer pressure. Drug dependence is a menace to the society as it is a common problem even among the senior citizens and does not matter your age or role in the society.

• Under the category of adolescents abusing drugs, street children are also adversely affected as through this abuse, they dull their senses against the hardships of street life. It can also provide a support system where they relate streetwise as they share life experiences. They link to form street families comprising of users of the same peer groups, children, and older people. Older people tend to misuse prescription drugs by self –administration of the drugs and particularly in large doses. Sleeping pills are an example. The intent of using abusing prescription sleeping pills is to achieve an intentional intoxicating effect like sleep.
• Musicians too are not spared as they feel the need to use these substances to cope with the pressure of delivering high-quality performances. The inability to cope with stress resulting from over expectation from their fans, drive them to use stronger stimulants which cause irreversible neurological effects. It makes them delusional and as a result feels like they own the stage when under the influence.
• Veterans’ physical and mental health is also under attack consequently causing a rift between family members. Homelessness is also a part of the result of drug abuse as it brings down their financial stability. Most veterans abuse drugs to cope with or run away from depression and (Post Traumatic Stress Disorder –PTSD) resulting from their first-hand experience during their service on the battlefield. The trauma they undergo when in training and also at work need to be addressed through a strong support group therapy or else substance cause becomes an option as they intend to bury the overwhelming feelings and experiences they went through during their service.

Legal Classification of Drug Abuse

Drug abuse is classified chemically depending on how it affects the brain and body. Additionally, they are legally classified based on their medical use, potential abuse, and dependence on the said drugs. In the world of medicine and pharmacology, in regards to addiction and treatments; drugs are classified into five categories or schedules regulated by the Controlled Substances Act.

• Schedule I includes the drugs that have a higher promise of abuse and are illegal. They also have severe safety concerns and no medical use. Drugs such as cannabis, heroin, ecstasy, LSD, mescaline, GHB, and methaqualone are included in Schedule I.
• Schedule II includes drugs that have a high promise for abuse, have currently accepted medical use in treatment in and that the abuse of may lead to severe psychological or physical dependence. Abused substances such as amphetamine, cocaine, hydromorphone oxycodone, fentanyl, and hydrocodone are included in Schedule II.
• Schedule III includes drugs that have a lower latent for abuse, accepted medical use and that the abuse of may lead to moderate or low physical dependence. Drugs such as anabolic steroids, and Hydrocodone-based opioids.
• Schedule IV includes drugs that have a reduced number of addicts compared relative substances in schedule III category. They are presently accepted medical treatment in the United States, and that the abuse of may lead to limited addiction. Drugs such as benzodiazepines and sedatives are included in Schedule IV.
• Schedule V includes drugs that have an unpromising potential for abuse relative to the drugs or other substances in schedule IV, accepted for medical use and that the abuse of may lead to very limited addiction potential. Drugs such as narcotics or stimulant drugs for diarrhea, cough, and pain are included in this schedule.

They are further broken down into smaller psychoactive drug categories which consist of:

• Depressants
• Stimulants
• Hallucinogens

Depressants

These are drugs that slow or suppress the brain by directly affecting the nervous system to create a calming or sedating effect. They come in form of tablets, capsules and also liquid form. This category includes alcohol, barbiturates, tranquilizers benzodiazepines, and inhalants. Depressants are taken to relieve anxiety, promote sleep and manage seizures.

Different types of Depressants

• Alcohol

Alcohol abuse may lead to health problems like liver cirrhosis, engaging in unprotected sex, social problems, physical dependence and psychological addiction. Criminal offenses such as domestic violence, rapes, burglaries, child abuse and assaults are directly connected to alcohol abusers. Alcohol causes physiological distortion of brain chemistry causing slurred speech, delayed reflexes and clumsiness. Large consumption of beer, wine, and hard liquor significantly impairs coordination and judgment. Withdrawal symptoms of alcohol can be potentially fatal. They include shaking, sweating, vomiting, nausea and seizures. Permanent psychiatric disorders can occur even after detoxification.

• Barbiturates

Barbiturates fall under a group of sedative-hypnotic drugs. They produce effects of mild sedation to total sedation when taken in pill form thus creating sleep-inducing and anxiety-decreasing effects. They can also be injected into veins or muscles. They are mostly used to treat insomnia, anxiety, and seizures. Adverse effects of long-term abuse of barbiturates comprise of hypoventilation, addiction, lowered blood pressure, confusion, fatigue, fever, overexcitement, irritability, dizziness, inhibited concentration, sedation, impaired judgment, and coordination. In severe cases, the respiratory arrest occurs which may lead to death. Abusers report that a barbiturate high gives feelings of relaxed contentment and euphoria.

• Benzodiazepine

Benzodiazepine, commonly known as “benzo”, are mostly used in treating insomnia and anxiety. The five most common benzos are Xanax, Klonopin, Ativan, Valium, and Restoril. Benzodiazepines are used to fabricate sedation effects, induce sleep, mitigate anxiety and to prevent muscle convulsions and seizures. In general, they act as hypnotics in higher doses, anxiolytics in moderate doses, and sedatives in lower doses.

• Opiates and Opioids

Morphine, codeine, thebaine, and papaverine are some of the major active opiates constituted in opium. Semi-synthetic extractions such as oxycodone, hydrocodone, and heroin are derived from their natural forms. Opiates can be smoked, injected or snorted. The short-term effect of opiate abuse consists of bliss outbursts combined with a warm flushing of the skin, dry mouth, and heavy extremities. Users tend to interchange between an insomniac and drowsy conditions. Mental functioning becomes inactive due to the depression of the central nervous system.

• Tranquilizers

Tranquilizers or antipsychotics are used to treat anxiety or insomnia. They are the most commonly prescribed psychiatric medications as they are supposed to reduce the symptoms of mental illness. Just like alcohol, they produce a relaxing and anxiety-reducing effect. Minor tranquilizers have direct depressant effects on brain areas that regulate vigilance and alert fullness by stimulating receptors in the nervous system Major tranquilizers primarily affect specific receptors in the brain that reduce psychotic thoughts, perceptions and agitation.

General side effects may include: Sedation, memory impairment, anesthesia, lowered blood pressure, feelings of euphoria and respiratory depression. Muscle relaxation and anticonvulsant effects are experienced.

• Inhalants

These substances are easily abused as they exist in vapor form and can be consumed mainly by sniffing, bagging, inhaling, spraying or huffing. They produce mind-altering effects by producing chemical vapors which cross through the lungs into the bloodstream. They are found in many household products and medical aesthetics. Such household products are glues, spray paints and cleaning detergents.

The distinctions of abused inhalants are categorized by their chemical structure and are divided into five categories. Aliphatic Hydrocarbons contain chemical compounds like gasoline, kerosene, propane, and butane found in petroleum products. Toluene and xylene solvents are aromatic hydrocarbons found in products such as paint thinner. Like acetone, Ketones are key constitutes of many household items like nail polish remover. Haloalkanes are chemicals that constitute aerosols and propellants products. Nitrites are used medically for treatment as well as abused.  Dental sedatives like nitrous oxide and anesthetic which contain alkyl or amyl nitrite have acquired a street name known as ‘poppers’ and are used as recreational inhalants in some places.

Inhalants have a high potential for abuse because of their availability mostly among the young people. Inhalant users utilize plastic bags or bottles placed over their mouths to inhale vapors or aerosol propellants, some can be inhaled from an open container that the product was packed in. These substances have some the most dangerous and harmful short-term effects of any drug that is abused. Users have died from a lack of oxygen, pneumonia, cardiac arrest or failure or the inhalation of vomit. Some people have suffered from ‘sudden sniffing death’ dying immediately or soon after inhaling the chemical vapors.

An irreversible effect such as severe brain damage is common in chronic inhalant users. Inhalant abuse can also distort the normal functions of the central nervous system and can cause similar indications to those who suffer from multiple sclerosis. Prolonged abuse can also affect thinking, locomotion, vision impairment and hearing loss as well.

Most of the substances abused as inhalants are not addictive to users, but some become psychologically dependent on the feeling of inhalant insobriety. For those who are already addicted to inhalants, rehabilitation centers can be a great treatment strategy for drug disorders. Even though withdrawal symptoms from inhalant abuse may not be severe, but addicts will crave for the ‘high’ hence elevating the chances of relapse.

Depressants surpass the brain via the brain chemical neurotransmitters namely gamma-aminobutyric acid (GABA). They affect the brain communication between cells by decreasing brain cells activity. So, due to depressants ability to increase GABA activity, a calming effect or drowsy effect is achieved.

With continued use of depressants, the body will most likely develop a tolerance for the drugs, requiring larger doses to achieve the initial effects. Sudden termination of abuse from these drugs, can cause severe brain injury such as convulsions mostly leading to permanent epileptic conditions.

Stimulants 

These are drugs when taken accelerate the nervous system activity. They contribute the user to feel angry, paranoid or edgy. They can make you feel energetic, alert and focused.

Illegal stimulant drugs include cocaine, amphetamine, methamphetamine and crack cocaine. A recently publish World Drug Report, showed that amphetamine-derived stimulants like ecstasy are mostly abused after marijuana which were used to treat obesity and fatigue in the early 1930s.

Legal stimulants like caffeine, nicotine (found in tobacco products), weight loss pills and energy drinks are very popular and addictive too.

Their prolonged use cause rapid moods swings, anxiety, restlessness and hyperactivity. Moreover, increased blood pressure, sex drive, insomnia, dizziness and blurred vision may be exhibited. Loss of appetite is also a side effect under the influence of stimulants.

Hallucinogens  

These drugs also known as psychedelics, act on the central nervous system. They alter the brains’ perception of time, space and reality. The user can hear imaginary things or see things which are unreal. They include cannabis, dimethyltryptamine (DMT), psilocybin (found in magic mushrooms), lysergic acid diethylamide (LSD), and peyote. Cannabis can be smoked, chewed, or drunk in tea. Cannabis consumption mostly involve breathing in the vapors from cannabinoids from glass pipes, stoning bongs, rolled joints, or tobacco-leaf-wrapped blunts. Fresh cannabis may also be consumed chewed. In an attempt to hide from the law, stoners consume foods cooked with the drug. Cannabis baked cakes, brownies and sauces are most popular as it not easily detectable compared to normal forms of consumption. Even cannabis tea is most preferable. Due to more people consuming this drug under devious ways, it has gained popularity and is ranked among the Schedule 1 of drug categories. Additionally, it is a criminal offence to be found in possession of this drug, while the sale of the same attracts serious criminal charges under the federal law. Cannabis can either fit in the stimulant category, but its primary active component makes it more of a hallucinogenic. This plant-based drug contains tetrahydrocannabinol (THC) as its main ingredient and its long-term abuse exhibit symptoms similar to effects of magic mushrooms. Various studies have suggested that other cannabinoids like cannabinol (CBD) may also contribute to its psychoactive effects. Cannabis has crazy and anatomical effects when consumed. Cannabis can cause rapid mood swings, increased heart rate, lowered blood pressure; equilibrium coordination and concentration. Users also experience heightened sexual arousal, mood elevation, anxiety and relaxation. Extreme hunger, paranoia, body temperature fluctuations, seeing imaginary things, sudden weight gain and psychosis are some of the substance abuse. Permanent cases of mental illness are also seen among the users because most of them detest even taking a shower so as to maintain the high.

LSD is a powerful drug that causes users talk to imaginary people, as they tend to see, hear or unreal things. They also tend to stare blankly into space and are amused by imaginary light patterns and flashing of colors. They feel as they are re-born again as they meditate on memory flashes of past unreal situations and consequently leading to depression. LSD side effects can include paranoia and insomnia. In rare cases, the hallucinations that some people experience under the influence of LSD have led them to take their own life.

New psychoactive substances or in short form (NPS) are drugs which in their synthetic nature are considered legal such as plant-based khat and kratom. Khat chewers exhibit manic behaviors, hyperactivity and they tend to be talkative under the influence. It deprives them of food appetite and discoloration of teeth if used for a long time. Such drugs in their synthetic forms like cannabinoids, cathinones, piperazines, ketamine, are examples of psychoactive substances.

Is there a cure for drug addiction?

Many people wonder if there is a viable cure for this chronic disease or prevention of relapse. The answer is, it is possible to be cured of drug addiction and treatment vary from individual and the substances abused. There are no standard criteria used in the treatment of drug addiction.

Signs of addiction

People addicted to drugs tend to care on how to access the substance rather than how to take care of themselves, how their actions affect others and tending to other responsibilities. The mental and physical health of an addict is mostly affected. Inability to maintain employment resulting from financial constraints to support the habits is also manifested in the addict’s life. Inability to cope well with others socially and consequent legal issues arise as a result of actions done under the influence.

Before commencement of addiction treatment, the user has to acknowledge and admit that they are addicts and identify it is a problem and needs to be handled. Most addicts relapse after treatment because they are either still in denial or blame their addiction on others.

Ways of treatment

Rehabilitation centers offer the most effective cure for addiction. In these centers, treatments such as detox, sober living, and constant therapy are applied to cure or prevent relapse of addicts. In some cases, several treatments can be attended concurrently for an effective cure for drug problems.

Detox

This method of treatment is always the first step of treating addiction after acceptance. The body is allowed to process and remove the abused substances from the system under medical supervision. At times, medication may be offered to maintain and manage adverse withdrawal symptoms.

12 step Inpatient or Outpatient Program

This program allows an addict to realize full recovery from drug addiction by attending inpatient or outpatient treatment facilities through a follow-up process of meetings and group support. Full recovery is realized for addicts with mental illness such as personality disorder, depression and anxiety disorders and lack a good support system at home.

The cost of either inpatient or outpatient varies by location, duration, and the luxury level of the facility. Inpatient programs will provide a mixture of individual or group therapy where addicts will learn ways on how to overcome their addictions and conquer their drug addiction. Motivational speakers are also invited to educate the addicts intending to reform on ways to curb relapse cycles. These treatment centers offer reform support and therapeutic treatments for about 6-12 months duration. Although outpatient treatment is most likely to be less expensive where cognitive behavioral therapy is effective in treatment of substance abuse as addicts are able to control their negative thoughts by learning how to think positively. Cure from addiction is achievable with adherence to such treatment measures.