Drug abuse and dependence

Drug abuse is the use of a drug to the degree that it produces impairment in social adjustment or physical and psychological health. Moreover, drug addiction is the habitual use of drugs, with psychological and physical dependence. The psychoactive drugs those are associated with abuse and dependence, aside from alcohol, such as, (a) narcotics-opium and its derivatives; (b) sedatives-barbiturates; (c) stimulants-cocaine and amphetamines; (d) antianxiety drugs-meprobamates; and (e) hallucinogens-LSD and related drugs, appear to be addictive. Drug abuse and dependence may occur at any age but adolescence and young adulthood are most common age-groups in various countries. Clinical features vary, depending on the type, amount, and length of time of drug usage, the physiological and psychological make up of the individual and social setting, in which, the drug experience attained.
Some of the drugs that are more commonly associated with abuse and dependence:

Opium and its derivatives (narcotics). Opium and its derivatives are in use for over 5000 years. Galen mentioned several conditions, in that, theriaca,  whose principal ingredient was opium, to be a veritable panacea. Opium contains eighteen alkaloids, alkaloid if present in the largest amount, 10 to 15 percent, proved to be a powerful sedative and pain reliever; it was named morphine. Thereafter, it was discovered that if morphine were treated by an inexpensive and readily available chemical called acetic anhydride, it could be converted into another powerful  analgesic called heroin. It proved to be an even more dangerous drug than morphine, acting more rapidly and more intensely. It was removed from use in medical practice. Opium and its derivatives-including codeine due to Acts became a federal offense because of unauthorized sale and dispensation in U.S.A.

Effects of morphine and heroin. The euphoric spasm ( the rush ) lasting sixty seconds due to immediate effects of heroin, sometimes, compared to orgasm followed by a “high” , in which, pleasant feelings of relaxation, euphoria, and reverie tend to dominate. The use of opium derivatives results in a physiological craving for the drug. Larger amounts are needed to achieve the desired effects. Withdrawal symptoms in opiate addict start after eight hours. Withdrawal from heroin is not always dangerous or even very painful. In some instances, it is agonizing and perilous. Withdrawal symptoms decline by the third or fourth day, and by the seventh or eighth day disappear. Wester Meyer concludes that, in South-east Asia, long-term opium use has very clear dangers in terms of one’s health and the social and economic deprivation it can bring to the entire family of the user. On the other hand, narcotics users with financial means may maintain their drug dependence over many years without any complication or resorting to criminal behaviour.

Causal factors in opiate abuse and dependence. It is pleasure, curiosity, and peer pressure, besides, life stress, personal maladjustment, and sociocultural conditions that play a part. These are (1) neural bases for physiological addiction; (2) addiction associated with the relief of pain; (3) addiction associated with psychopathology; and (4) addiction associated with sociocultural factors. Receptor sites for narcotic drugs in the brain are specific nerve cells which produce the effects of these drugs. Some investigators suspect that the endorphins, opium-like substances produced by human body in the brain and pituitary gland, may play a role in drug addiction. Immaturity, low frustration tolerance, and the ability to distort and evade reality in the lime-light of drug-induced fantasy pave the way for narcotic drugs addiction. Psychopathic traits are depression, tension, insecurity, and feelings of inadequacy, and difficulty in forming warm and lasting interpersonal relationships. Narcotics subcultures, in which, addicts can obtain drugs and protect themselves, exist in socities.

Amphetamines and cocaine ( stimulants). The most commonly used stimulants are caffeine, nicotine, the amphetamines and cocaine. Amphetamines and cocaine stimulate or speed up the action of the central nervous system. The amphetamines have been employed medically in the treatment of narcolepsy, depression and obesity, in addition to the, hyperkinetic (extremely overactive) children. The amphetamines cause increased alertness, loss of appetite, insomnia and, sometimes, euphoria. Chronic usage may cause irritability, loss of weight, agitation, paranoid reactions, and depression upon withdrawal. Cocaine, like opium, is a plant product discovered and used in ancient times. And like the opiates, euphoric state of four to six hours duration, in that, the user experiences feelings of peace and contentment. It may be preceded by headache, diziness, and restlessness. If it is chronically abused, acute toxic psychotic symptoms may occur. Because of its anesthetic qualities, cocaine is used as a substitute for morphine. It stimulates the cortex of the brain, inducing sleeplessness and excitement, as well as stimulating and accentuating sexual processes. Neither the amphetamines nor cocaine produce physical dependence with chronic usage, but many result in psychological dependence.

Barbiturates (sedatives).Barbiturates are poerful sedatives and extremely dangerous drugs associated with both physiological and psychological dependence as well as with lethal overdoses. Barbiturates are widely used by physicians to calm patients and/or induce sleep. Sedatives are used to induce relaxation or sleep, relieve anxiety, and alleviate muscular spasm or tension. As depressants, barbiturates slow down the action of the central nervous systems. Long-acting barbiturates (phenobarbital) are not subject to abuse because of failure to produce quick results. Amphetamines and barbiturates in fixed-ratio combinations are also commonly used with alcohol.

LSD and related drugs (hallucinogens). The hallucinogens or psychedelic drugs include LSD ( lysergic acid diethylamide),mescaline, psilocybin, hashish and marijuana. The hallucinogens arouse or enhance visual imagery, cause increased sensory awareness,anxiety, impaired coordination, and feelings of expanded consciousness in some instances. There is some potential for increased tolerance with the hallucinogens, especially LSD. There is no serious physical dependence, but strong psychological dependence may occur.

Tranquilizers. The tranquilizers  include chlorpromazine, reserpine, and lithium salts, all of which are anti-psychotic agents.                           *         *         *         *         *        *    


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