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Drug & Alcohol Abuse
Dr Neeta Gupta
Practitioner Of CBT,REBT & EFT
Associate Professor
Department of Psychology
DAV (PG) College
Dehradun
Behavioural Risk Factorsinclude many
things. Such as
1. Drug and Alcohol Use
2. Smoking Tobacco
3. Unsafe Sex Behaviour
Drug/Substance Abuse:
The use of illegal drugs or the use of
prescription or over-the-counter drugs for
purposes other than those for which they
are meant to be used, or in excessive amounts.
Drug abuse and addiction, now both grouped
as substance or drug use disorder is a
condition characterized by a self-destructive
pattern of using a substance that leads to
significant problems and distress, which may
include tolerance to or withdrawal from the
substance.
DREs (Drug recognition Experts/Evaluators) classify
drugs in one of seven categories:
1.Central nervous system (CNS) depressants
2.CNS stimulants
3.Hallucinogens
4.Dissociative anesthetics
5.Narcotic analgesics
6.Inhalants
7.Cannabis
Drugs from each of these categories can affect a
person's central nervous system and impair a
person's normal faculties, including a person's ability
to safely operate a motor vehicle.
1) Central Nervous System (CNS) Depressants
CNS depressants slow down the operations of the
brain and the body. Examples of CNS depressants
include alcohol, barbiturates, anti-anxiety
tranquilizers (e.g., Valium, Librium, Xanax, Prozac,
and Thorazine), GHB.
2) CNS Stimulants
CNS stimulants accelerate the heart rate and elevate
the blood pressure and "speed-up," or over-
stimulate, the body. Examples of CNS stimulants
include cocaine, "crack" cocaine, amphetamines
3) Hallucinogens:
Hallucinogens cause the user to perceive
things differently than they actually are.
Examples include LSD, peyote, psilocybin and
MDMA (Ecstasy).
4) Dissociative Anesthetics
Dissociative anesthetics include drugs that
inhibit pain by cutting off or dissociating the
brain's perception of the pain. PCP, its analogs,
and dextromethoraphan are examples of
dissociative anesthetics.
5) Narcotic Analgesics:
Narcotic analgesics relieve pain, induce euphoria,
and create mood changes in the user. Examples of
narcotic analgesics include opium, codeine, heroin,
demerol, morphine, methadone, and oxycontin.
6) Inhalants:
Inhalants include a wide variety of breathable
substances that produce mind-altering results and
effects. Examples of inhalants include Toluene,
plastic cement, paint, gasoline, paint thinners, hair
sprays, and various anesthetic gases.
7) Cannabis:
Cannabis is the scientific name for marijuana.
The active ingredient in cannabis is delta-9
tetrahydrocannabinol, or THC. This category
includes cannabinoids and synthetics like
Dronabinol.
Symptoms of a drug problem:
It may include:
1. recurrent drug use that results in legal problems,
2. occurs in potentially dangerous situations.
3. interfere with important obligations,
4. results in social or relationship problems,
5.tolerance,
6.withdrawal symptoms,
7.using a lot of the drug or for a long period of
time,
8.persistent desire to use the drug, unsuccessful
efforts to stop using the drug,
9. neglecting other aspects of life because of
their drug use, and
10.spending inordinate amounts of time or
energy getting, using, or recovering from the
effects of the drug.
While the specific effects of drugs on
the brain can somewhat vary
depending on the drug that is being
used, virtually every substance that is
abused has an effect on the executive-
functioning areas of the brain. Drugs
particularly affect the brain's ability to
inhibit actions that the person would
otherwise delay or prevent.
Addiction is a disease that affects our brain and behaviour.
When someone is addicted to drugs, he can’t resist the urge
to use them, no matter how much harm the drugs may cause.
The earlier one gets treatment for drug addiction, the more
likely he is likely to avoid some of the more dire consequences
of the disease.
Drug addiction isn’t about just heroin, cocaine, or other illegal
drugs. One can get addicted to alcohol, nicotine, sleep and
anti-anxiety medications, and other legal substances as well.
Addiction is when a person can’t stop. Not when
it puts his health in danger. Not when it causes
financial, emotional, and other problems for him
or his loved ones. That urge to get and use drugs
can fill up every minute of the day, even if he
wants to quit.
Addiction also is different from physical
dependence or tolerance. In cases of physical
dependence, withdrawal symptoms happen when
you suddenly stop a substance. Tolerance
happens when a dose of a substance becomes
less effective over time.
Drug abuse is an intense desire to
obtain increasing amounts of a
particular substance. Drug
dependence is the body’s physical
need, or addiction, to a specific
agent. Over the long term, this
dependence results in physical
harm which causes tolerance. Thus
it creates a vicious cycle.
DRUG
Drug
Dependence Drug Abuse
Psychological-Dependence: is a state in which
individuals feel a computation to use a substance for
the pleasant effect it produces, without necessarily
being physically dependent on it. They rely heavily on
it-often to help them adjust to life and feel good-and
they centre many activities on obtaining and using it.
Physical dependence is a state in which
the body has adjusted to a substance and
incorporated it into the “normal”
functioning of the body’s tissues. This state
has two characteristics:
a)Tolerance: is the process by which the
body increasingly adapts to a substance
and requires larger and larger doses of it to
achieve the same effect. At some point,
this increases reach a plateau.
b) Withdrawal: refers to unpleasant physical and
psychological symptoms people experience when
they discontinue using a substance on which the body
has become physically dependent. The symptoms
experienced depend on the particular substance
used,and can include anxiety, irritability, intense
cravings for the substance, hallucinations, nausea,
headache, and tremors.
Addiction vs. Abuse and Tolerance
Drug abuse is when one uses legal or illegal
substances in ways one shouldn’t. One might take
more than the regular dose of pills or use someone
else’s prescription. One may abuse drugs to feel good,
ease stress, or avoid reality. But usually, one is able to
change one’s unhealthy habits or stop using
altogether.
People learn to depend on substances through
repeated use. Individuals who become addicted first
become psychologically dependent later they become
physically dependent as their bodies develop a
tolerance for it. The potential for producing
Psychological dependence differs from one substance
to another-it seems to be high for heroine and
cocaine and low for LSD.
Substance abuse is diagnosed on the basis of two criteria-
1. A person shows a clear and persistent pattern of pathological
use, such as heavy daily use and an inability to stop or decrease
using a substance.
2. The abuse has produced at least one of the following problems.
a. Failing to fulfil important obligations such as in repeatedly
neglecting a child or being absent from work.
b. Putting oneself or others at risk for physical injury for
instance by driving while intoxicated
c.Having legal difficulties such as being arrested
for disorderly conduct
d.Having serious social or interpersonal
problems for instance repeated arguments
with family or co-workers.
Effect of Drug Abuse:
1.Loss of appetite
2.Rapid Breathing and heartbeat
3.High BP
4.Dilated pupil
5.Fever,sweating, headache
6. Blurred vision and dizziness
7.Flushing,Tremors
8.Loss of Coordination
Prevalence of Drug Abuse in India:
In the last three decades (following the inception of the NDPS), the
Ministry of Social Justice and Empowerment has conducted two
nation-wide drug surveys, published in 2004 and 201918,19. The
results of these surveys suggest that drug use in India continues to
grow unabated. Opioid use has increased from 0.7 per cent in the
previous report to a little >2 per cent in the present one - in terms
of magnitude from two million to more than 22 million. More
disturbingly, heroin has replaced the natural opioids (opium and
poppy husk) as the most commonly abused opioids.
Ganja is the most widely used drug in India, has
been the first ever-abused drug for most of drug
abusers, also known as Marijuana followed
by Charas known as Hashish form of Cannabis
which is hand made in Indian subcontinent and
Jamaica.
Alcohol Use and Abuse:
Alcohol affects people in different ways. Some people
can enjoy a glass of wine with food and drink
moderate amounts of alcohol in social settings
without any problems. Having one or fewer drinks per
day for women and two or fewer drinks per day for
men is considered moderate drinking, according to
the Centres for Disease Control and Prevention.
The symptoms of alcohol abuse include:
1.Drinking to relax
2.Driving under the influence of alcohol
problems with family and friends because of
drinking
3.Neglecting responsibilities
4.Having legal problems because of alcohol
People who abuse alcohol may deny a
problem, but there are ways to recognize
alcohol abuse in others. People who abuse
alcohol may drink often and experience family,
work, or school problems because of drinking.
People who abuse alcohol may deny a
problem, but there are ways to
recognize alcohol abuse in others.
People who abuse alcohol may drink
often and experience family, work, or
school problems because of drinking.
People who experience the following are also more likely to
deal with their problems with alcohol:
1.Depression
2.Loneliness
3.Emotional stress
4.Boredom
This is dangerous because alcohol abuse can lead to
alcoholism. This is because alcohol tolerance levels can
gradually increase. Some people start to drink more and more
with each passing day.
Alcohol Abuse and Alcoholism:
The terms “alcohol abuse” and “alcoholism” are often used
interchangeably. Both connote a problem with drinking and
negative impacts on day-to-day life from alcohol
consumption. But there are subtle yet important distinctions
between these two terms.
According to the American Psychological
Association (APA), alcohol abuse is a
pattern of drinking that results in
“significant and recurrent adverse
consequences.” People who abuse alcohol
may have repeated problems with the law,
difficulty maintaining relationships, or
trouble holding down a job because of
their habitual drinking. Yet they continue to
drink despite these consequences.
Alcoholism.
Alcoholism is a chronic disease characterized by
a physical and psychological dependence on
alcohol. People with an alcohol addiction need
to drink in order to function. Signs that you may
be struggling with alcohol dependence include:
1. Tolerance
You find yourself needing to drink larger
quantities of alcohol to get the same mind-
altering effects.
2.Alcohol withdrawal
Someone with alcohol dependence
who stops drinking may have
withdrawal symptoms.
Withdrawal symptoms include:
1.Nausea
2.Shaking
3.Sweating
4.Irritability
5.Anxiety
Alcohol withdrawal can be a medical
emergency. Seek medical help right away if
someone experiences:
1.seizures
2.severe vomiting
3.hallucinations
4.fevers
If you have alcoholism and a history of
withdrawal symptoms, see a doctor before
quitting. You should also see a doctor before
quitting alcohol if you have other health
conditions.
3.Compulsion
You experience intense cravings to
drink alcohol, and find yourself
unable to stop drinking even when
you want to.
Long-term alcoholism can result in
life-threatening conditions, such as
heart disease, cancer, and cirrhosis.
WHO DRINKS
Age and Gender affect people’s experience
with drinking Alcoholic beverages in most
societies. One reason for Gender
Differences in drinking is that female on
average experience more intoxication than
males from the same amount of alcohol.
This is because, even when body size is the
same, females metabolize alcohol less
quickly than males.
How alcohol affects your health
Alcohol is used to make wine, beer,
spirits and liqueurs. It is a legal,
sedative drug that can cause addiction
or dependency for people who drink
too much. Alcohol can change
behaviour. Alcohol abuse harms your
health and damages relationships and
society through violence, crime,
accidents and drink driving.
1.Binge drinking
Binge drinking means drinking too much alcohol in a short time. For a
man, drinking more than eight units of alcohol on one occasion is a
binge. For a woman, it’s more than six units on one occasion.
If you binge drink, you could develop long-term or permanent health
problems. Binge drinking can cause: blackouts, memory loss, anxiety,
irregular heartbeat.
2.Hangover
A hangover follows a bout of heavy drinking. When
you have hangover, you’re dehydrated and
experiencing alcohol poisoning. You also: have a
headache, feel sick ,feel tired, become irritable.
Alcohol and Health:
1.Brain damage: Alcohol can damage your brain.
Brain damage affects your:
Behaviour, memory, ability to learn.
Alcohol is very harmful to young people because their
brains are still developing.
If you’re a regular heavy drinker, you risk: permanent
brain damage, mental health problems and
alcoholism.
2.Cancer
Alcohol is the second biggest risk for cancer
after smoking. If you regularly drink above the
weekly alcohol limits, you're at greater risk of
developing: mouth cancer, throat cancer (upper
throat),oesophageal cancer (food pipe), colon
cancer, breast cancer, bowel cancer, liver cancer.
3.Heart and circulation
Alcohol can cause high blood pressure, which
increases your risk of having a heart attack or stroke.
6.Excess drinking alcohol can make a person more
prone to lung infections such as pneumonia. One
could also suffer a collapsed lung. When a person
vomits due to drinking alcohol, they could choke if
vomit gets into their lungs.
4.Pancreas-Inflamation:
Heavy or long-term drinking can cause
inflammation of the pancreas. It is a very
painful condition where a drinker
experiences: vomiting, fever, weight loss.
5. Alcohol-Abuse and Fertility:
Long-term drinking can cause infertility in men and women.
Men can also become impotent.
Drinking alcohol when pregnant can damage your unborn
baby's development.
6.Alcohol-Abuse and Bones:
Alcohol interferes with your body's ability to absorb calcium.
If you lack calcium, your bones become weak and thin.
Why people use and abuse alcohol:
1.Socio cultural Factors: The main reasons
for starting to drink involves social and cultural
factors particularly the expectancies that form from
watching other individuals enjoying themselves
while drinking. For example: The more teens see
alcohol see in movies and on TV the more they are
likely to drink in the future.
2. Reinforcement: With continued drinking
the strength of behaviour through positive
and negative reinforcement and substance
related cue develop.
a. Positive Reinforcement: Individual may
receive positive reinforcement for drinking
if they like the taste of a drink or the
feeling they get from it or if they think they
succeeded in business dells or social
relationships as a consequence of drinking
b. Negative Reinforcement : In case
of negative reinforcement-that is,
the reduction of an unpleasant
situation- we have seen that people
often use alcohol to reduce stress
and unpleasant emotions. They
may drink to suppress their
negative thoughts or feelings of
anxiety in social situations .
3.Developmental and Biological
Factors
a.Heredity: It plays a much stronger
role when the abuse begins before
age 25 than after.
b.People with a family history of
alcoholism appear to develop a
tolerance to alcohol, drink increasing
amount to feel the same affect.
c. People with a specific
gene pattern experience
stronger cravings for
alcohol after having a
drink than other
individuals do.
d. People with high genetic risk for
alcohol dependence find alcohol
rewarding each time they drink but low
risk people do not.
4. Avoiding Withdrawal:
Because withdrawal symptoms
are very unpleasant so people
want to avoid it so they drink.
5.Expectancies: People develop
expectancies or ideas about the
outcomes of their behaviour from their
own experiences and from watching
other people. Some expectancies are
positive for example we may decide by
watching others that drinking alcohol is
fun. Other expectancies are negative
that drinking can lead to hangover.
Types of Treatment of Alcohol Abuse
Behavioural Treatments
Behavioural treatments are aimed at changing
drinking behaviour through counselling. They are led
by health professionals and supported by studies
showing they can be beneficial.
Medications:Three medications are currently
approved in the United States to help people stop or
reduce their drinking and prevent relapse. They are
prescribed by a primary care physician or other health
professional and may be used alone or in combination
with counseling.
The U.S. Food and Drug Administration (FDA) has
approved three medications for treating alcohol
dependence, and others are being tested to
determine if they are effective.
Naltrexone can help people reduce heavy drinking.
Acamprosate makes it easier to maintain
abstinence.
Disulfiram blocks the breakdown (metabolism) of
alcohol by the body, causing unpleasant symptoms
such as nausea and flushing of the skin. Those
unpleasant effects can help some people avoid
drinking while taking disulfiram.
Self-Care Groups
Alcoholics Anonymous (AA) and other 12-step
programs provide peer support for people
quitting or cutting back on their drinking.
Combined with treatment led by health
professionals, Self-care groups can offer a
valuable added layer of support.
Types of Behavioural Treatments
1.Cognitive–Behavioural Therapy The goal is to
change the thought processes that lead to
excessive drinking and to develop the skills
necessary to cope with everyday situations that
might trigger problem drinking.
2.Motivational Enhancement Therapy The
therapy focuses on identifying the pros and
cons of seeking treatment, forming a plan for
making changes in one’s drinking, building
confidence, and developing the skills needed to
stick to the plan.
3.Marital and Family Counselling strong family
support through family therapy increases the
chances of maintaining abstinence (stopping
drinking), compared with patients undergoing
individual counselling.
4.Brief Interventions are short, one-on-one or small-
group counselling sessions that are time limited. The
counsellor provides information about the individual’s
drinking pattern and potential risks. After receiving
personalized feedback, the counsellor will work with
the client to set goals and provide ideas for helping to
make a change.
REFERENCES:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755770/
https://www.theiacp.org/7-drug-categories
https://www.webmd.com/mental-health/addiction/drug-abuse-addiction#1
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https://i.pinimg.com/originals/ba/ef/8e/baef8e5f6283097711f5449f73025c31.gif
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a.akamaihd.net/ugc/922544977934826187/86DB4F3166EBDCA103DDD4357B61E0EB58935CC7
/?imw=512&imh=288&ima=fit&impolicy=Letterbox&imcolor=%23000000&letterbox=true
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Drug and Alcohol Abuse