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Drug addiction
Drug addiction
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Drug abuse

  2. 2. General introduction What is drug ? • Any substance, when taken into living body may modify one or more of its function. • In other word, a pharmaceutical preparation or a naturally occurring substance used primarily to bring about any change in existing process or state (physiological, psychological or biochemical) is called – DRUG • An overdose of any drug may lead to death.
  3. 3. Termrelated to drug • Hard drug (lead to severe physical addiction / dependence) :  Drug that is generally considered to be more dangerous, with higher risk of dependence that soft drugs. Eg. Heroin, cocaine, methamphetamine etc. • Soft drug (Do not cause physical addiction / dependence) :  While they do not cause physical addiction, some of them may still lead to psychological dependency. Eg. Cannabis, lysergic acid diethylamide (LSD) etc.
  4. 4. • Dependence: A Drug dependence is the situation or condition that a person find himself in which he uses or abuse a drug to the point that the drug become the main focus of his life. There are two types of dependence - Psychological dependence - is the subjective feeling that the user needs the drug to maintain a feeling of well-being. Physical dependence - is characterized by tolerance( the need for increasingly larger doses in order to achieve the initial effect) and withdrawal symptoms when the user is abstinent.
  5. 5. Use vs abuse • USE :  Intake of drugs – 1. To treat an illness 2. To prevent a disease 3. To improve health condition • ABUSE :  Intake of drugs, for reason other than medical in such a manner that the drug affects the physical or mental functioning of the person.  In short : • Drug abuse is intentional chronic and excessive use of drugs. OR • Drug abuse is the non permissive consumption of certain substance that may lead to physical and psychological dependence. And it is also called as SUBSTANCE ABUSE.
  6. 6. Reason why do people abuse drugs ? Curiosity Low- self esteem Peer - pressure Adult modelling Boredom Relief of discomfort Depression, anxiety, stress Family dysfunction Unemployment Mental conditions Life events Family and social environment disturbance Poverty Neglected children Lack of education
  9. 9. • Stage 1 : Experimentation 1. Here Curiosity is the motivator. 2. Experimentation is defined as the voluntary use of drugs without experiencing any negative social or legal consequences. 3. For many , experimentation may occur once or several times as a way to “ HAVE FUN” OR may occur without any desire to continue using the drug. 4. But for other, it can start to become a problem when it moves into the next stage. • Stage 2 : Regular use 1. Here user is thinking more about drugs and always carves for drugs. 2. The problem with regular use is that the risk for drug abuse greatly increases during this stage. 3. It also increase risky behaviours such as driving under the influence, unexplained violence and symptoms of depression and anxiety.
  10. 10. • Stage 3 : Risky use / abuse 1. The line between regular and risky use/abuse is very thin one, but is usually defined as continued use of drugs in spite of severe social and legal consequences 2. This is the stage where the warning sign of addiction will begin to appear like craving, irritability , fatigue etc if the drug is not used. • Stage 4 : Drug dependence 1. Here drugs become the centre of their life. 2. Characteristics of dependence include withdrawal symptoms and compulsive use of the drug along with severe negative consequences to his or her relationships, physical and mental health, personal finance etc.
  11. 11. Illegal drug usage
  12. 12. Illegal drug usage : • All over the world : 230 million people have used an illegal drug in all over the world. Cocaine-dependent people number about 27 million. 0.6% of world adult population. Global illegal drug use is expected to rise by 25% over the next few decades. • In india : An NGO survey revealed that 63.6% of population are involved and out of them 13.1% are at young age of 20 yrs. And on an average – everyday 10 -12 suicide are happened due to drug abuse.
  13. 13. • In Punjab :  Around 2.7lakh people addicted to drugs. Out of them :  89% of drug addict are educated and literate.  99% are male  Half of Punjab’s drug abuser are from village.  Mostly involve age group –are 18- 35 yrs The most common drug consumed is heroin (chitta)
  14. 14.  On an average – Rs 1400 is spent on heroin by drug abuser everyday in Punjab ; Opium user spend Rs 340 per day and pharmaceutical opioid user spend Rs 265 per day. Some fact regarding children of age group 12- 13yrs : 1. Around 10,000 children are into alcohol consumption. 2. 7000 children are consuming inhalants. 3. 5600 children are in the habit of taking cannabis.
  15. 15. Knowledge regarding druds
  16. 16. Commonly abuseddrugs • Marijuana • Cocaine • Heroine • Alcohol • Lysergic acid diethylamide (LSD) • Inhalants • Methylene-di oxy-methamphetamine (MDMA) • Barbiturates • Tobacco • Opium • Prescription drugs such as tranquilizers, steroids, analgesics etc
  17. 17. Classificationof abuse drugs • Stimulant • Depressant • Cannabinoids • Hallucinogen • Inhalants • Narcotics
  18. 18. Stimulants • Stimulants are the drugs which excite or speed up/ stimulate the central nervous system. • DRUGS – I. Cocaine II. Amphetamine III. Methamphetamine • EFFECTS – I. Restlessness II. Headache III. Increased energy IV. Sense of power V. Give rise to alertness VI. Blurred vision VII. Confusion and impaired judgment VIII. Reduced appetite IX. Increased appetite X. Elevated BP with dilated pupil XI. Very rapid or irregular heart rate XII. Collapse XIII. Even death COCAINE
  19. 19. 2. Alcohol Depressant • Depressant are the drugs which depress or slow down the functions of central nervous system. • DRUGS – I. Barbiturates II. Benzodiazepine III. Tranquilizer IV. Alcohol • EFFECT- I. Highly addictive, impaired co-ordination, balance and judgment. II. Produce sedation, hypnosis, anxiety and dizziness III. Tremors , hypertension, seizures IV. If taken by pregnant mother – cause permanent damage to the developing fetus V. Coma followed by death can occur in some cases. • LONG TERM EFFECT- I. Chronic fatigue and sleep problem II. Depression , confusion III. Impaired sexual function IV. Poor memory and personality change 1. Barbiturates
  20. 20. Cannabinoids • Cannabinoids produce a strong psychological dependence with mild withdrawal syndrome. • Most common modes of intake is – smoking. • DRUGS : I. Marijuana II. Charas III. Ganja and bhang • EFFECTS : I. Strong dependency II. Increased heart rate III. Dry mouth IV. Reddening of eye V. Muscle relaxation VI. Lung infection VII. Lethargy VIII. Bodyache IX. Drug craving • LONG TERM EFFECT – I. Decreased cognitive ability Cannabis ( bhang ) II. Psychosis III. Sterility/ impotence
  21. 21. Hallucinogens • Hallucinogens are the drugs which affect perceptions, emotions and mental processes. • Also cause feeling of dissociation from oneself. • DRUGS – I. Lysergic acid diethylamide (LSD) II. Phencyclidine (PCP) III. Mushrooms IV. Methylene – dioxy – methamphetamine (MDMA) • EFFECTS – I. Rapid breathing 1. Mushrooms II. Dizziness III. Dilated pupils IV. Hyperactive reflexes V. Raised BP VI. Delusion VII. Distorted sensory perception VIII. Even depression IX. Panic attack 2. LSD . 3. PCP X. Increased emotional energy
  22. 22. Inhalation • Inhalation drugs are the volatile substance that produce chemical vapours that can be inhaled to induce a psychoactive or mind altering effects. • They are commonly abused because of their easily availability, rapid action and low cost. • There are three major classes of inhalants are : I. Solvents : - paint thinner, glues , dry cleaning fluids etc. II. Gasses :- propane tanker, spray paints, deo , chloroform etc. III. Nitrites :- butyl nitrite and amyl nitrite . • EFFECTS – I. Slurred speech II. Lack of co-ordination III. Euphoria IV. Lightheadedness V. Tremors VI. Suffocation VII. Limbs spasms • LONG TERM EFFECTS : I. Severe CNS , KIDNEY , LIVER damage II. Behavioral disturbances Inhalants
  23. 23. Narcotic drugs • Also called as pain killing or relieving drugs. • DRUGS – I. Heroin II. Codeine III. Opium IV. Morphine and Methadone 1. Morphine • EFFECT – I. Watery eyes II. Cramps III. Anorexia IV. Sweating V. Mood instability 2. Heroine VI. Reduced libido VII. Constricted pupil VIII. Constipation IX. Physical deterioration X. Respiratory impairment 3. Codeine 4. Opium • In female abuser – menstrual irregularity and fetal addiction/ abnormality.
  24. 24. Commonwithdrawal symptoms of drugs 1. Sleep disturbances 2. Loss of appetite 3. Irritability 4. Depression or psychotic symptoms may become prominent 5. Tremors 6. Insomnia or hypersomnia 7. Seizure 8. Blackout 9. Nausea and vomiting 10. Abdominal pain 11. Suicidal tendency
  25. 25. Different routeof administrationand their effect: • Route of drug administration is a method in which a drug is taken into body. It can split into three categories : 1. Oral route 2. Parental route 3. Inhalation route Oral route :  In form of pills or drinks.  Is one of the simplest way.  It allow the drug to move onto the stomach through mouth where they are absorbed by stomach lining and then enter the blood steam.  May cause ulcers in mouth and stomach, dental decay and malnutrition.
  26. 26.  Parental route :  It includes various types of injection like subcutaneous, intravenous and intramuscular.  Here drugs being injected directly into the blood stream.  The peripheral vein in arm, hands, legs and sometimes abdomen , groin or neck are damaged.  It may produce thrombosis, phlebitis , gangrene, cellulitis, skin abscess, septicaemia and pulmonary embolism.  Shared syringe and needles can transmit hepatitis B and C, HIV , syphilis and malaria.  Inhalation or nasal route :  It include inhalation where drugs are inhaled in form of smoke where drug get absorbed through mucus membrane in nose and enter into blood stream.  It may cause asthma or bronchitis, pneumothorax and vomiting.
  27. 27. Impact of drug abuse
  28. 28. Impactof drugabuse • To one’s self : Drug abuse lead to – 1. Loss of co-ordination 2. Poor judgment and personality deterioration 3. Slowed reflexes 4. Distorted vision 5. Memory loss 6. Blackout 7. Frequent mood swings 8. Sudden change in appearance 9. Carelessness 10. Coma – Confusion – Convulsion 11. Numbness 12. Nausea 13. Vomiting 14. Loss of appetite 15. Constipation 16. Depression , anxiety , fatigue 17. Even death
  29. 29. • To the family : Drug abuse may lead to – 1. Loss of money 2. Increased incidents of abusing and domestic violence 3. Marital problem 4. Intense feeling of humiliation and guilt are felt by family members 5. Financial issues 6. Bad influence • To the children : Drug abuse may lead to – 1. Lack of care and warmth 2. Lack of a role model 3. Birth defects 4. Living in constant fear and anxiety 5. Emotional disturbance
  30. 30. • To the society : Drug abuse may lead to – 1. Crimes like rape , robbery , kidnapping 2. Violence 3. No role in nation’s construction. 4. Limited movement of people, specially at night. 5. Downfall of social values of country.
  31. 31. Sign of drug abuse
  32. 32. Sign of drug abuse  Physical warning : Bloodshot eyes Pupils larger or smaller than usual Changes in appetite or sleep patterns Sudden weight loss or weight gain Deterioration of physical appearance Unusual smells on breath Impaired coordination Cold/bluish fingers Needle marks on his arms Puffy eyelids Sleeping problems Excessive sweating and increased heart rate Suicide attempt
  33. 33.  Behavioural warning :  Poor work Decline in performance Financial problems Secretive or offensive behaviour Lack of motivation Unexplained anxiety  Impulsiveness Aggressiveness Mood swings
  34. 34. Drug testing
  35. 35. Drug testing • There are different types of drug test like : 1. Blood sample testing 2. Urine sample testing 3. Saliva testing 4. However, drug may be test using stomach content that are obtained through gastric lavage or after vomiting. • URINE DRUG TESTING : Is most common method of all above Here the urine is use to detect the trace of drug. Drug concentrations are higher in urine than in blood – so it is easier to detect. Detection periods typically 1-3 days
  36. 36. • SALIVA TESTING :  Is less invasive Detection period from hours to 1-2 days One study reports that saliva testing can only detect cannabinoids when subjects have smoked cannabis only 4-10 hrs beforehand. • BLOOD TESTING : Is most expensive and invasive testing methods It actually detects right at the time of testing the presence of substance and its metabolites in the blood. The actual amount of drugs in the blood at the time of test can also be measured by a blood drug test. However , its cost make it used less frequently. Detection period: 0-2 days for most drugs.
  37. 37. • How long after usage of drug can be detected ?  It depend on following factors : 1. Substance or drug itself 2. Dosage 3. Frequency of abuse 4. Individual rate of drug metabolism and excretion. 5. Sensitivity of the particular test carried out.
  38. 38. Prevention and control
  39. 39. drug abuse prevention and control • Also called substance abuse prevention. • It is a process that attempt to prevent the onset of drug use or to limit the development of problem associated with using drugs. • Here are the following ways to prevent drug abuse: UNDERSTAND the reasons behind children or adults using drugs and alcohol. AVOID BAD COMPANY and TEMPTING SITUATION – • It is the biggest reason for teen to start using drugs. • In these cases, all what need is to either found a better groups of friends that won’t pressurize for doing anything harmful. • or find a good excuse to say NO , just to keep getting away from such a tempting situations.
  40. 40. PROVIDE SUPPORT- A good bond and support between you and the abuser help to prevent from using drugs. PROVIDE GUIDANCE AND CLEAR RULES ABOUT NOT USING DRUGS AVOID UNDUE PEER PRESSURE – • Every child has his or her own choice and personality which should be kept in mind. • So a child should not be pressed unduly to do beyond his or her capacities because this may lead them to use drugs. GIVE PROPER COUNSELLING to the teens and adults , which are very important to face problem, stress, disappointment and failure in life. GIVE EDUCATION to children or teen regarding risk or consequences of drugs use. LOOK FOR THE DANGER SIGN , so that an appropriate measures would be taken. TRY TO GET INVOLVE OWNSELF OR OTHER INTO THE WORTHWHILE ACTIVITIES, just to distract. PRACTICE HEALTHIER LIVING HABBIT – Exercise, eating well, yoga, meditation and getting good sleep are excellent way to avoid using drug and alcohol. This will help to resist the temptations to use drugs or alcohol.
  41. 41. ORGANISING YOUTH CENTRE – • Drug addiction may be caused due to feeling of isolation, loneliness, anxiety etc. • Hence , social service organization and NGO should establish youth centre to over come such feelings. ROLE OF GOVERNMENT – • The government can play vital part in this regard by – 1. By reducing the scale of unemployment. 2. By controlling the production and availability of these drugs. 3. By spreading knowledge about harmful effect of abused drugs through campaign.
  42. 42. Management
  43. 43. Management • PRINCIPLES : 1. Addiction is complex but also treatable. 2. No single treatment is appropriate for everyone. 3. Counselling and other behavioural therapies are most commonly used. 4. Medication are an important elements of treatment for many patient, especially when combined with counselling and other behavioural therapies. • METHODS OF MANAGEMENT : 1. Pharmacotherapy 2. Behaviour therapy 3. Family therapy 4. Group therapy 5. Psychotherapy 6. Motivational enhancement therapy (MET)
  44. 44.  Pharmacotherapy : • GOAL: 1. To prevent withdrawal symptoms 2. To reduce drug cravings 3. To normalize any physiological functions disrupted by drug abuse • Alcohol :-  Drug of choice are BENZODIAZEPINE 1. Chlordiazepoxide – 80-200 mg/day 2. Diazepam – 40-80 mg/day  Vit B complex is also added  For craving – naltrexone are used. • Opioids : -  Here drug which are use for detoxification are – 1. Methadone – 25-50mg BD daily 2. Clonidine – 0.3 – 1.2 mg daily along with NALTREXONE • Cocaine : -  Bromocriptine and amantadine are use for reducing craving.
  45. 45. • Other drugs : 1. Mood stabilising drug – Lithium, valproate and carbamazepine. 2. Antidepressant drug - amitriptyline and imipramine 3. Antipsychotic drug – chlorpromazine and clozapine 4. And for other symptoms – give symptomatic treatment Behavioural therapy:  It is based on theories of learning and aims at changing maladaptive behaviour and substituting it with adaptive behaviours.  Family therapy :  This is not an individual based therapy but is a family based approach in which family act as a unit. It include – Problem solving Training in communication skill Home assignment etc
  46. 46. Psychotherapy : This therapy help to remove, modify or retard existing symptom. And promote positive personality growth and development. And also help in correcting the disturbed pattern of behaviour. Group therapy : It is a type of psychotherapy in which a group of 8- 10 person can be treated at one time. It provide the patient and their relative a platform to share problem with other which are very similar in nature and to make them realise that they are not alone in their suffering.
  47. 47. Motivational enhancement therapy : It is a counselling approach that help the individual to resolve their ambivalence about engaging in treatment and stopping their drug use. This approach has been used successfully with people addicted to alcohol to both improve their engagement in treatment and reduce their drinking problem. MET has also been used successfully with marijuana dependent adult when combined with cognitive behavioural therapy, constituting a more comprehensive treatment approach.
  48. 48. Thank you !!