Dr. Francis SANWO

Substance abuse, also known as drug abuse, is use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder.

People abuse substances such as alcohol, tobacco, and other drugs for varied and complicated reasons, but it is clear that our society pays a significant cost. Studies have made it clear that drug education and prevention aimed at children and adolescents offers the best chance to curb drug abuse nationally.

Nearly all drugs abuse can also produce a phenomenon known as tolerance, in which one must use a larger amount of the drug to produce the same level of intoxication.

Substance abuse without treatment takes a heavy toll on a person's health, family, and society.

Effect of Substance Abuse.

Crime: More than half of the economic cost of alcohol and other drugs is due to crime. A substance abuser is 18 times more likely to be involved in illegal activity than someone who does not abuse alcohol or other drugs. Many violent crimes have been linked to the mind-altering effects of drugs. Substance abusers often commit thefts to support their drug habits. Drugs and alcohol have been linked to domestic violence and sexual assault.

Disease: Most abused substances have harmful health effects. For some substances, such as tobacco, effects are caused by long-term use. For other drugs, a single use can cause death, disability, or significant disease.

Behavior: In addition to their direct effects on health, drugs produce other indirect effects. Many drugs lessen inhibitions and increase the likelihood that a person will participate in risky behavior. Studies show that the use of alcohol and drugs among teenagers increases chances for teen pregnancy and contracting HIV/AIDS or other sexually transmitted diseases. Any injected drug is associated with contracting HIV/AIDS and hepatitis B and C.

Trauma: Up to 75% of injured people treated at emergency departments test positive for illicit or prescription drugs. Alcohol is strongly associated with both intentional and unintentional injury. Drug use also puts people at risk of violence. Nearly half of assault victims are cocaine users.

What Are Commonly Abused Drugs?

Prescription and Over-the-Counter (OTC) Medicine

These can be just as dangerous and addictive as illegal drugs. After marijuana, tobacco, and alcohol, prescription medications are the substances most commonly abused by teens. You can abuse medicine if you: take medicine prescribed for someone else, take extra doses or use a drug other than the way it’s supposed to be taken and take the drug for a non-medical reason.

Types of prescription drugs that are most often abused include: Opioid pain relievers, anxiety and sleep medicines. The most commonly abused OTC drugs are cough and cold medicine that have dextromethorphan, which in high doses can make you feel drunk or intoxicated.

Inhalants: This group of substances includes solvents that emit vapors, causing intoxication when breathed in. Individuals who abuse inhalants intentionally breathe in the vapors, either directly from a container, from a bag in which such a substance is in, or from a rag soaked with the substance and then placed over the mouth or nose. Inhalant intoxication happens quickly and doesn't last long. Teens sometimes inhale chemical fumes from paint, gas, cleaning liquids, or glue to get high. Symptoms of inhalant intoxication are very similar to those seen with intoxication with alcohol, including dizziness, clumsiness, slurred speech, elation, tiredness, slowed reflexes, thinking and movement, shaking, blurred vision, stupor or coma, and/or weakness. It can also result in chemical and temperature burns, as well as withdrawal symptoms, chronic mental illness, and even sudden death.

Long-term damage associated with inhalant use includes brain and nerve damage as well as heart, liver, or kidney failure.

Tobacco: People cite many reasons for using tobacco, including pleasure, improved performance and vigilance, relief of depression, curbing hunger, and weight control.

The primary addicting substance in cigarettes is nicotine. But cigarette smoke contains thousands of other chemicals that also damage health both to the smoker and to those around them. Hazards include heart disease, lung cancer and emphysema, peptic ulcer disease, and stroke. Withdrawal symptoms of smoking include anxiety, hunger, sleep disturbances, and depression.

Smoking is responsible for nearly a half million deaths each year.

Alcohol: Although many people have a drink as a "pick me up," alcohol actually depresses the brain. Alcohol lessens your inhibitions, slurs speech, and decreases muscle control and coordination, and prolonged use may lead to alcoholism.

Withdrawal from alcohol can cause anxiety, irregular heartbeat, tremor, seizures, and hallucinations. The drug can cause heart enlargement and cancer of the esophagus, pancreas, and stomach.

In addition to its direct health effects, officials associate alcohol abuse with nearly half of all fatal motor-vehicle accidents.

Marijuana (also known as grass, pot, weed, herb):  Its smoke irritates the lungs more and contains more cancer-causing chemicals than tobacco smoke. Common effects of marijuana use include pleasure, relaxation, and impaired coordination and memory.

Often the first illegal drug people use, marijuana is associated with increased risk of progressing to the use of more powerful and dangerous drugs such as cocaine and heroin. The risk for progressing to cocaine use is 104 times higher if you have smoked marijuana at least once than if you never smoked marijuana.

Cocaine (also known as crack, coke, snow):  The intensity and duration of the drug's effects depend on how it is taken. Desired effects include pleasure and increased alertness. Short-term effects also include paranoia, constriction of blood vessels leading to heart damage or stroke, irregular heartbeat, and death. Severe depression and reduced energy often accompany withdrawal. Both short- and long-term use of cocaine have been associated with damage to the heart, the brain, the lung, and the kidneys.

Heroin (also known as dope).Effects of heroin intoxication include drowsiness, pleasure, and slowed breathing. Withdrawal can be intense and can include vomiting, abdominal cramps, diarrhea, confusion, aches, and sweating. Overdose may result in decreased breathing to the point of stopped breathing and death. Because heroin is usually injected, often with dirty needles, use of the drug can trigger other health complications including destruction of your heart valves, tetanus, and botulism, and infections like HIV/AIDS or hepatitis.

Methamphetamines (also known as meth, crank). It shares many of the same toxic effects as cocaine -- heart attacks, dangerously high blood pressure, and stroke.

Withdrawal often causes depression, abdominal cramps, and increased appetite. Other long-term effects include paranoia, hallucinations, weight loss, destruction of teeth, and heart damage.

Anabolic steroids: This group of drugs includes testosterone, which is the natural male hormone. It also includes a number of other synthetic forms of testosterone. Steroids are often abused by bodybuilders or other athletes to increase muscle mass or improve performance.

These types of substances seem to be associated with a number of mental-health effects, like dependence on the substance, mood problems, and developing other kinds of drug abuse.

Club drugs: The club scene and rave parties have popularized an assortment of other drugs. Many young people believe these drugs are harmless or even healthy. The following are the most popular club drugs:

Ecstasy (also called MDMA, E, X, E pills, Adam, STP): This is a stimulant and hallucinogen used to improve mood and to maintain energy, often for all-night dance parties. Even onetime use can cause high fevers to the point of inducing a seizure. Long-term use may cause damage to the brain's ability to regulate sleep, pain, memory, and emotions.

Rohypnol (also called roofies, roche): This is another sedative that has been used as a date-rape drug. Effects include low blood pressure, dizziness, abdominal cramps, confusion, and impaired memory.

What Are the Causes and Risk Factors of Substance Abuse?

Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the teen years. Certain risk factors may increase someone's likelihood of abusing substances.

Family history factors that influence a child's early development have been shown to be related to an increased risk of drug abuse, such as, chaotic home environment, ineffective parenting, lack of nurturing and parental attachment  and parental drug use or addiction.

Other risk factors for substance abuse are related to the substance abuse sufferer him- or herself, like male gender, childhood attention deficit hyperactivity disorder (ADHD), history of anxiety or other mood disorders and  conduct disorder or antisocial personality disorder.

Factors related to a child's socialization outside the family may also increase the risk of drug abuse, including

inappropriately aggressive or shy behavior in the classroom, poor social coping skills, poor school performance and  association with a deviant peer group or isolating oneself from peers altogether.

 

What Are the Symptoms and Signs of Substance Abuse?

Friends and family may be among the first to recognize the signs of substance abuse. Early recognition increases the chances for successful treatment. Signs to watch for include the following: Giving up past activities such as sports, homework, or hanging out with new friends, declining grades, aggressiveness and irritability, a  significant change in mood or behavior, forgetfulness, disappearing money or valuables ,feeling rundown, hopeless, depressed, or even suicidal, sounding selfish and not caring about others.

Others are: physical problems with unclear cause (for example, red eyes and slurred speech), getting drunk or high on drugs on a regular basis, avoiding friends or family in order to get drunk or high, planning drinking in advance, hiding alcohol, and drinking or using other drugs alone, having to drink more to get the same high, believing that in order to have fun you need to drink or use other drugs, frequent hangovers and pressuring others to drink or use other drugs

Taking risks, including sexual risks, constantly talking about drinking or using other drugs, getting in trouble with the law, drinking and driving are also signs.

 Any of the following symptoms warrant a call to the doctor: Mild tremors or an alcohol withdrawal seizure not accompanied by hallucinations or confusion, Jaundice (yellow skin and eyes), Increasing abdominal girth, Leg swelling, cough, congestion, or sniffles that won't go away and continuing feelings of sadness or depression. Others include but not limited to: thoughts of harming yourself or others, chest pain, rapid heartbeat, difficulty breathing, or lightheadedness, confusion or ongoing hallucinations and severe tremors or recurrent seizures .

What Is the Treatment for Substance Abuse?

Most substance abusers believe they can stop using drugs on their own, but the majority who try do not succeed. Before treatment for the addictive behavior can be directly addressed, the substance abuse sufferer might need help in lessening physical withdrawal from alcohol or other drugs they have been using. That initial phase of treatment is called detoxification or "detox." It often requires inpatient hospital treatment.

 

How Can Substance Abuse be prevented?

Substance abuse may start in childhood or adolescence. Abuse prevention efforts in schools and community settings now focus on school-age groups. Programs seek to increase communication between parents and their children, to teach resistance skills, and to provide information in order to correct children's misperceptions about cigarettes, alcohol, and drugs and the consequences of their use. Most importantly, officials seek to develop, through education and the media, an environment of social disapproval of drug use from children's peers and families.