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What is Substance Abuse?

In 1972, the American Psychiatric Association created a definition that used legality, social acceptability, and even cultural familiarity as qualifying factors:

a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien.

Substance abuse refers to the overindulgence in and dependence on a psychoactive leading to effects that are detrimental to the individual's physical health or mental health, or the welfare of others. The disorder is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin, that results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems. There are on-going debates as to the exact distinctions between substance abuse and substance dependence, but current practice standard distinguishes between the two by defining substance dependence in terms of physiological and behavioural symptoms of substance use, and substance abuse in terms of the social consequences of substance use.

Substance abuse may lead to addiction or substance dependence. Medically, physiological dependence requires the development of tolerance leading to withdrawal symptoms. Both abuse and dependence are distinct from addiction which involves a compulsion to continue using the substance despite the negative consequences, and may or may not involve chemical dependency. Dependence almost always implies abuse, but abuse frequently occurs without dependence, particularly when an individual first begins to abuse a substance. Dependence involves physiological processes while substance abuse reflects a complex interaction between the individual, the abused substance and society.

Drug Abuse Substance abuse is sometimes used as a synonym for drug abuse, drug addiction, and chemical dependency, but actually refers to the use of substances in a manner outside socio-cultural conventions. All use of illicit drugs and all use of illicit drugs in a manner not dictated by convention (e.g. according to physician's orders or societal norms) is abuse according to this definition, however there is no universally accepted definition of an abused substance.

Activity

Drugs and Substance Abuse What do do you understand by the term "Drug"? Jim was an alcoholic who had become dependent on alcohol. He was not addicted to alcohol but could not function without a couple drinks each day. Explain the difference between "dependence" and "addiction" to a drug? Do you think that a legal over the counter drug like aspirin could be abused? Explain.

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Feedback: You may now check the answers for the Activity on Drugs and Substance Abuse in the checklist below.

Checklists of Performance Task

Classification of Drugs

The diagram below shows the different groups of drugs.These include stimulants,hallucinogens,depressants and narcotics.

The Classification of Drugs

Depressants

Alcohol

Alcohol Abuse

Alcohol is a socially accepted drug in most countries. It is therefore one of the most frequently abused drugs. Alcohol is a depressant. It is important for you to know that alcohol depresseses the activities of the Central Nervous System. This increases your reaction time and impedes your judgment. As a result the abuse of alcohol may lead to traumatic death or injury e.g. though car crashes. Prolonged drinking may also lead to liver disease ( cirrhosis of the Liver), acute alcohol poisoning ( alcohol toxity) and foetal alcohol syndrome (damage to the foetus in utero).

Solvents: Glue Snifffing

Solvent abuse involves the use of any kind of volatile substance (that is, one that gives off fumes at room temperature) to get a high. A common form of solvent abuse is 'glue sniffing'. However, many different everyday products, can also be abused. The inhalation or 'sniffing' of vapurs through the mouth or nose can also be as solvent abuse.

Sniffing is a very dangerous practise. Death may occur very suddendly and even during your first sniffing session. Are you aware that more teen agers die from sniffing household products than from all the illegal drugs. Can you suggest why?

Stimulants

Crack Cocaine

Cocaine "coke" is obtained from the Coca Plant. Cocaine can be inhaled or it can be made into a solution and directly injected into the vein. It can also be converted into a flammable compound know as "crack" and smoked. After smoking or injecting cocaine you may feel euphoric and very energetic.However, the detrimental health effects on the body include heart attacks, respiratory failure, strokes, and seizures. Taken in large amounts cocaine may also cause strange and vioent behaviour patterns and, in rare occasions, even death .

Nicotine

This is another socially accepted drug in the Western Hemisphere. Nicotine is the drup component found in Tobacco Leaves. The drug enters the body through the smoking, chewing or sniffing of tobacco.

Nicotine is similar in shape to the natural brain neuro-transmitter acetycholine. It acts by binding to acetycholine receptors in the brain, resulting in increased heart and respiratory rates and mobilisation of blood glucose. This is the reason why smokers feel alert after smoking a cigarette. <p>Nicotine also has detrimental effects on the cardio-vascular system. It causes platelets to stick together making the smoker more at risk to strokes and other diseases of the brain and cardio-vascular system.

Hallucinogens

Cannabis sativa (Marijuana)

the Cannabis Plant

Marijuana is a mixture of the dried and shredded leaves, stems, seeds, and flowers of the hemp plant. The mixture can be green, brown, or gray. Hemp's scientific name is Cannabis sativa.

A bunch of leaves seems harmless, right? But think again. The main active compound in Marijuana is a chemical known as tetrahydrocannabinol (THC). Marijuana contains many other chemicals some of which can cause lung cancer.

Narcotics:The Opiates

the Opium Poppy

Opium and its derivatives are drugs derived from the poppy plant. Morphine and Codeine are examples of opiates which are used medicinally. Opiates are analgesics (pain killers) and may produce the following effects: sedation, raspy speech, slowed reflexes, sluggish movements, slowed breathing, cold skin, and maybe vomiting.

Heroin

Heroin

This is a commonly abused opiate. It is a white or brown powder, derived from the opiate, morphine. Heroin is usually injected into the veins. Short-term effects of heroin use may be a surge in euphoria followed by aklternate drowsy and wakeful moments. Tolerance to the drug develops, that is you will need more and more of the drug to experience the same degree of euphoria. However, the fatal dose remains the same. In addition, sharing of needles introduce the risk of contraction of hepatitis and HIV AIDS.

Case Study

Susan was a heroin user. After using the drug for a while she found that she had to take more and more of the drug to experience the same high. So her drug intake increased until she was taking 4.5 mg of the drug. One day Susan took 5 mg. of heroin. She overdosed and died. Explain why Susan had to increase her dose of Heroin to experience "the same high"? Why did Susan die when she increased her drug dose to 5 mg?

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Feedback:

1. I explained that Susan had developed Tolerance (link to definitions) to Heroin. Very Well ; OK, Not so Good.
2. I explained that eventhough Susan had grown tolerant to Heroin the lethal dose remained the same. Very Well ; OK, Not so Good.

Activity

The table below gives statements on Substance Abuse. Circle the Correct Answer.

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Feedback: The correct answers for the above True/False statements are given in the table below