Understanding Drug Use

1. Understanding Drug Use

2. Drug / Psychoactive Substance • Any substance that when taken by a person modifies : • Perception • Mood • Cognition • Behaviour • Motor functions

3. Types of Drugs Used

4. Depressants Sedative – hypnotics

5. Stimulants Cocaine Tobacco • ATS Cannabis

6. Hallucinogens L S D Cannabis

7. Classification of Drugs Legal (Licit): Medicine Tobacco Alcohol Caffeine/Tea Illegal (Illicit): Opium Heroin Cocaine ATS Marijuana

8. Modes of Drug Use • Drinking • Swallowing • Injecting • Snorting • Smoking

9. Why is Injecting Route preferred? • Faster action (High/rush) • More economical • When availability is poor

10. Drugs Injected

11. Why do People Take Drugs? To feel better To lessen: anxiety worries fears depression hopelessness To feel good To have novel: feelings sensations experiences AND to share them

12. www.drugabuse.gov

13. www.drugabuse.gov

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

15. Biology/ Environment Interactions Environment Biology/genes

16. Environmental Factors • Drug related • Individual related • Society/community related

17. Drug-related Factors • Availability • Legal and policy environment • Socio-cultural norms and attitudes • Abuse liability • Reward or reinforcement • Non-toxic • Route; duration of action

18. Drugs: The Vicious Cycle Presence makes you feel good… (euphoria) Absence makes you feel miserable… (withdrawal) Contd…

19. likely that one will continue.. ..makes one feel good… (euphoria) ..makes one feel miserable… (withdrawal) ..to avoid which one will continue.. Drugs: The Vicious Cycle Taking drugs… NOT Taking drugs…

20. Individual Related Factors • Self-medication theory • Co-morbid mental illnesses very common • Co-morbid symptoms more common • Personality factors • ‘Novelty seeking’

21. Society Related Factors • Family influence • Peer influence • Cultural and religious sanction & proscription • Legal & policy environment • The setting

22. Terminology • Use • Misuse/harmful use • Abuse • Dependence • Addiction – older term, still used

23. Use • The ingestion of alcohol or other drugs without experiencing any negative consequences Example If a student had drunk a beer at a party and his parents had not found out we could say he had USED alcohol

24. 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

25. 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

26. Dependence • A cluster of physiological, behaviouraland 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 • Withdrawal • Impaired control • Preoccupation • Continued use despite harm • Craving

27. Tolerance • Need 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 substance Example 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

28. Withdrawal • Set 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

29. Opioid Withdrawal • 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 Opening of all holes in the body!!

30. Impaired Control 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 Example A 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 control A person ‘Y’ planned to stop his drug use, but is unable to do so: loss of control

31. Preoccupation Preoccupation 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

32. Continued Use & Craving • Continuing use of the particular substance despite harmful consequences of the substance on the individual • Strong desire to use the substance: Craving • Craving 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

33. Drug Dependence is : • a chronic relapsing disorder • a brain disorder, in which biological, psychological • and social factors operate www.drugabuse.gov

34. Drugs and HIV risks Due 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

35. Thank You