DRUG ABUSE &

DRUG ADDICTION

BY RUCHIT PATEL

DRUG ABUSE & DRUG ADDICTION

• Drug abuse or drug addiction, chronic or habitual use of any chemical substance to alter states of body and mind for other than medically warranted purposes.

- Dependence - Withdrawal

BASIC TERMINOLOGIES

• DRUG ABUSE – Refers to the use of a drug by SELF MEDICATION in a manner and amount that deviates from the approved medical and social patterns in a given culture at a given time.

For regulatory agencies, drug abuse refers to use of an ILICIT DRUG. The two major patterns of drug abuse are :

a. CONTINUOUS USE : The drug is taken regularly, the subject wishes to continuously remain under the influence of the drug. e.g. opioids, alcohol, sedatives.

b. OCCASIONAL USE : The drug is taken off and on to obtain pleasure or high, recreation ( as in rave parties) or enhancement of sexual experience. e.g. cocaine, amphetamines, psychedelics, binge drinking ( alcohol) , cannabis, etc.

• DRUG ADDICTION It is a pattern of comprehensive drug use characterized by overwhelming

invovlement with the use of a drug. Procuring the drug and using it takes precedence

over other activities. Even after withdrawl most addicts tend to relapse. PHYSICAL DEPENDENCE though a strong impetus for continued drug use is not a essential factor for addiction. Amphetamines, cocaine, cannabis, LSD are drugs that produce addicition but little/no physical dependence. Nalorphine produce physical dependence without imparting

addiction in a sense that there is little drug seeking behaviour.

• DRUG HABITUATION - It denotes less intensive involvement of the drug, so that its withdrawl produces only mild discomfort.

• DRUG DEPENDENCE - It is a state in which use of drugs for personal satisfaction is accorded a higher priority than other basic needs, often in the face of known risks to health. Drug dependence occurs due to increase in levels of DOPAMINE in certain areas of the brain.

Two types :

a. PSYCHOLOGICAL DEPENDENCE b. PHYSIOLOGICAL DEPENDENCE

PSYCHOLOGICAL DEPENDENCE

• It is said to have developed when the individual believes that optimal state of wellbeing is achieved only through the actions of the drug.

• The subject feels emotionally distressed if the drug is not taken.

• It may start as liking for the drug effects and may progress to compulsive drug use in some individuals who then lose control over the use of the drug.

PHYSICAL DEPENDENCE

• It is an altered physiological state produced by repeated administration of a drug which necessitates the continued presence of the drug to maintain physiological equilibrium.

• Discontinuation of the drug results in a characteristic withdrawal (abstinence) syndrome.

• Since the essence of the process is adaptation of the nervous system to function normally in the presence of the drug, it has been called NEUROADAPTATION.

• Examples – Opioid, barbiturates, alcohol, benzodiazepines.

TYPES OF SUBTANCES ABUSED

• LEGAL SUBSTANCES - Legal substances, approved by law for sale

over the counter or by doctor’s prescription include caffeine, alcoholic beverages, nicotine and inhalants

- Prescription drugs such as tranquilizers, amphetamines, barbiturates, benzodiazepines, steroids and analgesics can also be used for improper purposes.

TYPES OF SUBSTANCES ABUSED

• ILLEGAL SUBSTANCES - Prescription drugs are considered illegal

when diverted from normal use. - Others include cocaine, crack, marijuana,

hashish, heroine, LSD, Phencycline or “ ANGEL DUST” party drugs like GHB (gamma hydroxybutyrate) designer drugs like MDMA (ecstacy)