Tuesday 22nd Jan 2019
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DRUG ADDICTION A Growing Menace; An Academician Perspective

Cover Story

, by DR. ABDUL AZIZ KHAN

Drug addiction, in recent decades, has become a matter of concern for every individual, community and nation. Mankind no doubt has been using and abusing drugs right from the very beginning, but in the present century drug addiction has emerged as a cancer and has brought within its fold almost all the segments of society. The technological revolution has brought about sweeping changes throughout the world and has reduced the entire world to a global village. Knowledge explosion and technological revolution on one hand has brought an overall development and bestowed on humanity all the comforts, but on the other hand it has engulfed mankind in confusion and chaos and has made the youth to resort to drugs.

Drug addiction has markedly increased during past three decades all over the world, including India, and has assumed epidemic proportions, according to WHO. The highest incidence of the epidemic is found in slum areas. An idea of its prevalence can be had from the fact that at an annual global turnover of more than 800 billion dollars, the narcotics industry is second only to defence industry. According to a recent estimate, it may well become the largest organised industry in the world if the present rate of growth continues. Over 50 million people in the world are addicted to hard drugs and narcotics. The number in India is 3-5 million, 2 lakh of which are in Delhi alone. In India, there are one million heroin addicts, 2 million opium addicts and several million cannabis addicts. It may be mentioned that the ratio of drug abusers to alcoholics having serious alcohol abuse problem is 1: 30.

A Drug is any substance (other than food) that produces changes in physical or mental functioning of an individual, and the Drug Use is taking a drug for medical purpose like treating an illness, protecting the body against the disease or to relieve pain or tension. On the other hand, Drug Abuse is taking a drug for other than medical reasons in amount, strength, frequency and manner that damages the physical and mental functions. Drug Addiction is defined as a state of periodic or chronic intoxication detrimental to the individual and society produced by repeated intake of habit forming drugs. It produces both drug dependence and tolerance.

Drug abuse has revealed an alarming proportion in recent years. “DRUG CULTURE” is fast making inroads into the lives of the young people from all walks of life. A person may have more than one reason to start using drugs. People who start using drugs for one reason (curiosity, pleasure, social pressure or medical reason) may continue using it for quite another (such as psychological dependence or group pressure). The reason given for Drug Dependence include following:

Curiosity and natural tendency to experiment with drugs: Young people are especially tempted to experiment to drugs.

Emotional pressure: Some people use psychoactive drugs (those which affect mind or behaviour) to relieve various emotional problems such as anxiety, nervousness or depression. Others use drugs simply because they are bored. Insecure people may take drugs to boost their self-confidence. Some young people may use drug as an expression of alienation or rebellion. An escape from tensions and frustrations in life e.g. unemployment, failure in examination, etc. is also a phenomenon.

Disturbed home environment: Children from broken homes, indifferent parents, lack of communication between parents and children.

Social pressure: The social pressure for using drugs can be very strong. Young people may be influenced by popular songs glorifying the effects of drugs or by famous singers, musicians or athletes who are known to use drugs. Children are especially influenced by their parents whose casual use of alcohol, nicotine (cigarettes) and other drugs may make drug-taking seem normal or safe or even justifiable.

Group pressure: In some groups, drug-taking is the fashionable thing to do. It is the badge of belonging and the key to social acceptance. Abstainers are excluded. An impact of Disco culture.

Availability: Drugs, both legal and illegal, are now more easily available. More people than ever before are directly or indirectly exposed to them.

Previous drug use: For most people, trying a drug for the first time is a major step. A single experiment does not mean a person will become a regular drug user, but it may remove some of the barriers against trying drugs again. It is also true that people who are regular users of one drug are more likely to use other drugs as well.

Dependence: some people use drug because they have become physically or psychologically dependant on them. It does not matter whether the drug is legal or illegal, mild or strong or whether it was first used for medical or non-medical purposes. When people continue using a certain drug because they don’t feel right without it, they can said to be drug dependant.

 

HABIT FORMING NATURE OF DRUG

To call a person drug addict, the following criteria must be satisfied:

Psychological Dependence: There is an empowering desire (compulsion) to take the drug and obtain it by any means. It occurs when a drug is so central to a person’s thought, emotions and activities that it is extremely difficult to stop using it, or even stop thinking about it. Psychological dependence is marked by intense craving and an abnormal obsession for the drug and its effects.

Physical Dependence: When the drug is withdrawn, the patient shows “withdrawal symptoms” such as irrational and violent behaviour, nausea, diarrhoea, watering of eyes and nose, etc. It occurs when a drug user’s body becomes so addicted to a particular drug that it requires the drug in order to function normally.

Development of tolerance: There is a tendency to increase the dose. It means requiring more and more of a drug to get the same effect. Tolerance increases physical health hazards of any drug, simply because of the amount taken increases over time.

 

ADDICTION AS A DISEASE

In the year 1956, addiction was declared as a disease by the American Medical Association which can be treated and arrested. The characteristic features of the disease are primary, progressive, terminal and permanent.

Addiction as such is a disease and not a symptom of a psychological disorder. It can cause mental emotional and physical problems. The associated problems cannot be treated effectively unless addiction is treated first.

The disease progresses from bad to worse. Sometimes, there may be intermittent periods of improvement. However, the disease invariably follows a course of serious deterioration over a period of time.

An addict may die due to any complication, but the factor which includes the complication itself is the abuse of the drug which is also the real agent behind the death.

The disease cannot be cured but can be successfully arrested by totally abstaining from the drug. Even if an addict has remained sober (drug free) for many years, he should not take even small doses of the drug.

Hence, addiction is considered to be a permanent disease.

 

TYPES OF DRUG ABUSE

Any drug can be used intentionally in the following ways:

Too much: Taking too much of any drug at one time or taking small doses too frequently cause problems ranging from fatal overdose to addiction. For example, taking an overdose of sleeping pills can result in death.

Too long:  A drug can be abused if it is taken regularly for a long period of time. Some medicines, such as pain killers (e.g., pethidine), can cause serious problems if they are taken after they are no longer needed.

Wrong use: A drug can be abused if it is taken for wrong reasons or taken without following instructions. For example, taking phenobarbitone, an anti-epileptic drug, for reasons other than prescribed reasons.

Wrong combination: A drug can be abused if it is taken in combination with certain other drugs knowingly or unknowingly. Some combinations can prove to be fatal. For example, phenobarbitone with alcohol can cause death.

Wrong drug: With some drugs like brown sugar, potential damages are extremely high and there are no legitimate uses. These drugs can cause serious problems, no matter how or when they are taken. With such drugs, there is no difference between use and abuse. To use them is to abuse them.

 

HOW TO IDENTIFY DRUG ABUSERS?

Some probable signs are:

Academic changes Poor attendance at school or college Decline in academic performance Physical changes Slurring of speech Sweating at night Loss of appetite Reddening of eyes Unsteady gait Fresh injection sites Temper tantrums Puffiness under eyes Withdrawal symptoms Other changes Blood stains on clothes Disappearance of articles from home. Addicts often sell articles to obtain money for the purchase of drug. Odour on breath and clothing Presence of needles, syringes, strange packets, etc. at home Presence of solitude, especially spending long hours in the toilet

 

HOW TO CONTROL

The control of drug addiction essentially involves a two-pronged strategy – diminishing the supply of narcotics and diminishing the demand for them. The former is essentially to be tackled by the government, using various strategies such as stricter enforcement of Narcotic Drugs and Psychotropic Substances Act. The latter strategy is primarily the responsibility of voluntary organisations.

 

HOW TO MANAGE

Though drug addiction may be considered a social problem, the first step in its management is medical care which includes:

Identification of drug addicts and their motivation for drug detoxification

Detoxification (requires hospitalisation)

Post detoxification counselling and follow-up (based on clinics and home visits), and

Rehabilitation.

Simultaneously, with medical treatment, changes in the environment (home, school, college, social circle) are also important. The patient must effect a complete break with his group, otherwise the chances of relapse are 100 per cent. Psychotherapy has a value place in the management of the addict.

Preventive measures include education of target groups and the general public through TV, Radio, Leaflet, and Posters to create awareness of the problem.

[DR. ABDUL AZIZ KHAN is a Lecturer in the Dept. of Tahaffuzi wa Samaji Tib (Preventive & Social Medicine), Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, India. abdulaziznium@gmail.com]



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