Understanding Drug Use

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Drug / Psychoactive SubstanceAny substance that when taken by a

person modifies :PerceptionMoodCognitionBehaviour Motor functions

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Types of Drugs Used

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Sedative – hypnotics

Depressants

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Cocaine Tobacco

ATS Cannabis

Stimulants

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L S D Cannabis

Hallucinogens

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Classification of Drugs

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Legal (Licit):MedicineTobaccoAlcoholCaffeine/Tea

Illegal (Illicit):OpiumHeroinCocaineATSMarijuana

Modes of Drug UseDrinkingSwallowingInjectingSnortingSmoking

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Why is Injecting Route preferred?Faster action (High/rush)More economicalWhen availability is poor

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Drugs Injected

Depressants Stimulants Hallucinogens

HeroinDiazepamBuprenorphinePentazocineSpasmoproxyvo

n

CocaineAmphetamine 

Ketamine

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Why do People Take Drugs?

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To feel good

To have novel:

feelingssensations

experiencesAND

to share them

To feel betterTo lessen:anxietyworriesfearsdepressionhopelessness

www.drugabuse.gov12

www.drugabuse.gov13

Why do some people become dependent (addicted) while others do not?

Vulnerability

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Biology/genes

Environment

Biology/EnvironmentInteractions

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Environmental Factors Drug relatedIndividual relatedSociety/community related

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Drug-related FactorsAvailability

Legal and policy environmentSocio-cultural norms and attitudes

Abuse liabilityReward or reinforcementNon-toxicRoute; duration of action

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Drugs: The Vicious Cycle

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Presence makes you feel good… (euphoria)

Absence makes you feel miserable… (withdrawal)

Contd…

Taking drugs…

NOT Taking drugs…

..makes onefeel good… (euphoria)

likely that one will continue..

..makes onefeel miserable… (withdrawal)

..to avoid which one will continue..

Drugs: The Vicious Cycle

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Individual Related FactorsSelf-medication theory

Co-morbid mental illnesses very commonCo-morbid symptoms more common

Personality factors‘Novelty seeking’

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Society Related FactorsFamily influencePeer influence Cultural and religious sanction &

proscriptionLegal & policy environmentThe setting

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Terminology UseMisuse/harmful useAbuse Dependence Addiction – older term, still used

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Use The ingestion of alcohol or other drugs

without experiencing any negative consequences

ExampleIf a student had drunk a beer at a party and his parents had not found out we could say he had USED alcohol

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Misuse

When a person experiences negative consequences from the use of alcohol or other drugs it is clearly misuse

Example A 40-year old man uses alcohol occasionally, his boss throws a party and the man drinks more than usual and on the way home he is arrested by the police

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Abuse/Harmful Use

Maladaptive pattern of use resulting in physical, social, legal harm

Continued use in spite of negative consequences The same 40-year old man continues drinking alcohol

after the incident

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DependenceA cluster of physiological, behavioural and

cognitive phenomena in which use of a substance or class of substances takes on a much higher priority for an individual than other behaviours

Three or more of the following criteria to be present for some time in a one-year period:

Increasing tolerance WithdrawalImpaired controlPreoccupationContinued use despite harm Craving 26

ToleranceNeed for increasing the amount of

substance consumed to achieve intoxication or the desired effect

Markedly diminished effect with continued use of the same amount of substanceExample A person ‘X’ started with one line of heroin smoking to get intoxicated; with time, he had to increase the dose to 1 pudiya per day to get the same amount of intoxication

A person ‘Y’ started with 1 peg of whisky and got high; with continued use, has to now consume 3 pegs of whisky to get the same high

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WithdrawalSet of symptoms experienced on

stopping or reducing the amount of the substance after prolonged use

Every class of substance (e.g. alcohol, opioids, etc.) has its own unique set of withdrawal symptoms

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Early symptoms Anxiety Restlessness Yawning Nausea Sweating Runny nose Watery eyes Dilated pupils Abdominal

cramps

Delayed symptoms Restlessness Diarrhoea Vomiting Goose bumps Muscular spasm,

pain Chills Increased heart rate,

B.P. Increased

temperature

Opioid Withdrawal

29 Opening of all holes in the body!!

Impaired control of behaviour associated with substance use in terms of its starting the use of the substance, stopping the use of the substance, or controlling the level of use

ExampleA person ‘X’ had thought that he would consume only 1 peg of alcohol on a given day, but he is not able to stop after 1 peg; continues to take more than 1 peg: loss of controlA person ‘Y’ planned to stop his drug use, but is unable to do so: loss of control

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Impaired Control

PreoccupationPreoccupation with the use of substance manifested as:

Great amount of time spent in using the substance/procuring the substance/recovering from the effect of the substance

Other activities which were pleasurable are given up as a result of the substance use

Other interests/hobbies given up due to indulgence in substance use

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Continuing use of the particular substance despite harmful consequences of the substance on the individual

Strong desire to use the substance: CravingCraving can be spontaneous or in reaction to

certain stimulus (e.g. place where the individual takes drugs, drug using friends, shop where the individual purchases drugs/alcohol, etc.). The craving in reaction to stimulus is called as ‘cue induced’ craving 32

Continued Use & Craving

Drug Dependence is :• a chronic relapsing disorder• a brain disorder, in which biological, psychological and social factors operate

www.drugabuse.gov33

Drugs and HIV risksDue to :

Drug effects:• Lowering of risk perception• Mood changes- risk taking increases• High risk behaviour – sharing of N/S• Cognition impaired – may not remember

to take precautions• Motor functions – may not be able to take

the precautions Mode of use :

• If injected: chances of sharing N/S and paraphernalia

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Thank You

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