Essay on Drug Addiction

Any chemical (psychoactive) substance that alters a person's physical, mental, emotional, or behavioural state is referred to as a drug. Drug addiction, also known as substance use disorder, is a condition that affects a user's brain and behaviour and causes them to lose control over whether or not they take drugs or medications, whether they are legal or not. Alcohol, marijuana, and nicotine are examples of substances that are regarded as drugs. If one gets hooked, they might continue consuming the drug even when it is harmful.

Drug addiction is a persistent, relapsing brain condition marked by obsessive drug seeking and usage, even when doing so has negative effects (National Institute on Drug Abuse, 2014) while drug abuse refers to a pattern of drug usage in which the addict consumes the substance (or substances), in quantities or ways that are detrimental.

The following list of characteristics best describes the trend of substance use and accompanying syndrome:

• A fresh consumption of an addictive substance causes the reversible, substance-specific condition known as substance intoxication. Confusion, poor judgement, lack of attention, and poor motor and spatial skills are common indicators of intoxication.
• When a drug is consumed frequently, the body becomes physically accustomed to it, and greater doses are required to get the same effect. This state of bodily habituation to a substance refers to tolerance. The individual may raise their drug use to a level that is fatal to non-users.
• A range of psychological, behavioural, and cognitive symptoms are associated with dependence. A person is said to be dependent on a drug when their drug usage takes precedence over other activities that they once valued more. The symptoms of dependence syndrome include a strong desire or sensation of urge towards using drugs, difficulties in limiting drug use conduct, withdrawal, tolerance, disregard for alternative pleasures, and continued drug use in spite of abundant evidence of its negative effects.
• A group of symptoms termed as withdrawal syndrome, sometimes known as abstinence syndrome, appear when a dependent individual abruptly ceases consuming a specific substance after heavy, extended use. Anxiety, agitation, and body aches are a few frequent withdrawal symptoms, whereas other withdrawal symptoms are drug-specific. As a result, withdrawal symptoms differ depending on the substance.

Drug addiction might begin as social experimentation with a recreational drug, and for certain people, the drug consumption progresses to more routine usage. Others get drug addiction after being exposed to prescribed pharmaceuticals or after acquiring medicines from a family member or friend who has been prescribed the medication, especially with opioids.

Each substance has a different level of potential for addiction and pace of addiction development. The risk and speed of addiction are higher with some medicines than others, like opioid painkillers. As time goes on, one might require higher drug doses to feel euphoric. They might eventually require the substance just to feel fine. They might find that it gets harder to abstain as their drug consumption escalates. When trying to stop using drugs, individuals could experience strong desires and physical sickness (withdrawal symptoms).

In order to overcome drug addiction and maintain a drug-free lifestyle, users might need assistance from their doctor, family, friends, support groups, or an organised treatment programme.

Types of Drugs

Drugs can be generically categorised as stimulants, depressants, narcotics, and hallucinogens.

1. Depressants

Depressants are drugs that can lower brain activity. They are often referred to as sedatives and tranquillizers. Alcohol, hypnotics that induce sleep, anxiolytics that lessen anxiety, sedatives that promote relaxation, and anticonvulsants like barbiturates are some of these. The most frequently administered depressant is alcohol. Just 21% of men and about 2% of women in India are alcohol drinkers, according to official statistics. However, up to a fifth of this group-roughly 14 million people who are dependent alcoholics in need of "assistance". Studies conducted in Kerala by the Alcohol and Drugs Information Centre India show that the percentage of people drinking who are under 21 years old has climbed from 2% to more than 14% during the previous 15 years (NGO). Worryingly, the survey discovered that over the previous 20 years, the "average age of commencement" had decreased from 19 to 13 years.

2. Barbiturates

Barbiturates, which include amobarbital, pentobarbital, phenobarbital, and secobarbital, are sedatives or depressants. These medicines have a variety of medicinal applications, such as reducing stress and anxiety, numbing pain, and managing epilepsy and hypertension. Anesthesiologists, doctors of emergency medicine, family practitioners, psychiatrists, and nurses are among those most susceptible to prescription drug misuse. One aspect that raises the likelihood that these professionals may abuse prescription medicines is their easy availability and frequent exposure to them. Stress, anxiety, and depression-all of which are frequently linked to the lengthy workweeks and high levels of stress experienced by healthcare workers-are additional contributing factors to prescription medication misuse.

3. Narcotics

Drugs known as narcotics or opioids are prescribed by doctors to treat pain, but they also have a high potential for addiction. Opioids provide users a rush or strong pleasurable feelings, which is the main factor in their appeal as street narcotics. Additionally, they make one less aware of their own issues, which is appealing to those looking for a mental break from stress. Their pleasant outcomes result from their capacity to directly engage the brain's pleasure circuits, which are the same brain regions in charge of emotions of sexual or gastronomic delight.

4. Stimulants (Uppers)

Stimulants work on the central nervous system by reducing hunger and exhaustion while boosting energy and alertness. Cocaine, amphetamines, methamphetamine, MDMA, caffeine, nicotine, and amphetamine-like substances are among them. Some stimulants may alter the way the brain functions over time, making it difficult to organically experience pleasure. For instance, long-term consumption of amphetamines (including cocaine) may cause the nucleus accumbens to temporarily lose 20% of its dopamine receptors, at least for four months after the last exposure.

5. Amphetamines

A central nervous system (CNS) stimulant, amphetamine is derived from alpha-methylphenethylamine. High doses of amphetamines are utilised for their ecstatic surge. They are frequently smoked in a comparatively natural form known as "ice" or "crystal meth," or consumed as pills. Additionally, amphetamines are used therapeutically to treat conditions like obesity, narcolepsy, and attention deficit and hyperactivity disorder (ADHD). Physical effects at therapeutic levels include faster reaction times, greater resilience to tiredness, and stronger muscles. Amphetamine in higher amounts can have negative effects on the brain and muscles.

6. Ecstasy

Designer drugs like ecstasy, also known as MDMA (3,4-methylenedioxymethamphetamine), are chemically identical to amphetamine. It causes mild euphoria and hallucinations, and has grown particularly well-liked in clubs and "dance parties" in numerous cities, as well as on university campuses.

7. Cocaine

Cocaine is a naturally occurring stimulant that is made from the coca plant's leaves. Cocaine is typically smoked as crack or inhaled as a powder. 5.3 million Indians over the age of 12 who were surveyed in 2008 reported abusing cocaine in any form, and 1.1 million reported abusing crack minimum once the year before the study.

8. Nicotine

Smokeless tobacco, cigars, and other tobacco products all contain nicotine. Tobacco can be consumed by chewing, sucking, putting to the teeth and gums, and smoking. Smoking products (including bidis, cigarettes, hookahs, and other forms) and smokeless tobacco are widely available in India (e.g., gutkha, khaini, zarda). According to WHO estimations, 1 billion people smoke worldwide, and more than 3 million people pass away each year due to conditions associated to smoking.

With a big population who adopt a variety of smoking methods and a wide range of smokeless tobacco products, India has a very complicated tobacco issue. The majority of these items are produced in cottage and small-scale companies employing a wide range of manufacturing techniques and combinations.

In Goa, the Indian state known as the "party capital," the highest prevalence of stimulant injection was found. Although there have been no studies in the scholarly literature, findings in the mainstream media have suggested that Goa has grown to be a major centre for drug business and abuse in India, possibly as a result of its largely ungrounded coastline.

9. Hallucinogens

Psychedelics, often known as hallucinogens, are a family of chemicals that cause hallucinations or sensory aberrations, including significant changes in hearing and colour perception. Additionally, hallucinogens may have other effects like exhilaration, relaxation, and in certain instances anxiety. LSD, psilocybin, and mescaline are a few examples of hallucinogens. The most popular hallucinogens include PCP, marijuana, LSD, and PCP.

10. Marijuana/Cannabis

The Cannabis sativa plant is the source of marijuana. Since it might create moderate hallucinations or cognitive aberrations, it is typically categorised as a hallucinogen. Additionally, it goes by a number of street names, including bhaang, gaanja, charas, hashish, weed, pot, and marijuana. Cannabis use can result in feelings of anxiety, paranoia, and depersonalization. It's the most widely used illegal substance globally. Roughly 40% of Americans aged 12 or older have used cannabis at some point, and about 10% have done so in the past year.

11. PCP (Phencyclidine)

In the 1950s, phencyclidine was produced as an anaesthetic but was later abandoned due to its hallucinogenic side effects. The usage of this drug results in hallucinations, increases blood pressure and pulse rate, and induces perspiration, flushing, and tingling. PCP is categorised as a deliriant, a substance that can cause delirious behaviors. Additionally, it has dissociative effects, making users feel as though there is some type of invisible wall separating them from their surroundings. Another name for it is "angel dust." Since then, its appeal has decreased considerably as a result of its unexpected results.

Causes

Drug addiction can develop for a variety of reasons, just like many other mental health issues. The primary elements are:

Environment. Early drug usage appears to be influenced by environmental factors, such as one's family's values and attitudes and interaction with a peer group that supports drug use.

Genetics. Once a person begins taking drugs, inherited (genetic) attributes may have an impact on how quickly the condition progresses or how slowly it does so.

Risk Factors

Drug addiction can happen to people of all age groups, sex, or socioeconomic background. The chance and rate of development of an addiction can be influenced by a number of factors, including:

Addiction in the family history. Drug abuse is more prevalent in some households and is probably associated with a higher risk due to genetics. One is more susceptible to having a drug addiction if they have a blood family who already has one, such as a parent or sibling.

Mental health ailment. One is more prone to develop a drug addiction if they have a mental health issue like depression, attention-deficit/hyperactivity disorder (ADHD), or post-traumatic stress disorder. Drug use can become a coping mechanism for unpleasant emotions like anxiety, despair, and alienation and can exacerbate these issues.

Peer influence. Peer pressure has a significant role in young individuals beginning to try and abuse drugs.

Minimal Family participation. Addiction risk can be increased by challenging family dynamics, a lack of closeness to parents or siblings, and lack of parental monitoring.

Early encounter with drugs. Early drug usage can alter the brain's development and raise the probability of developing drug dependency later in life.

Consuming a substance that is very addictive. Substances like amphetamine, cocaine, or opiate medicines may cause dependence to develop more quickly than other drugs.

Assessing the scale of the issue

Several aspects of physical, psychological, and social economic competence are all impaired by drug addiction. The world over, drug addiction is an increasing issue. Millions of deaths and infections of HIV are caused by the global epidemic of addiction and drug usage.

Global Scenario

• The United Nations Office on Drugs and Crime (UNODC), in its 2016 World Drug Report, states:
• For the first time in six years, a disproportionately higher number of people have been identified as having drug use disorders. As opposed to the former figure of 27 million, the current number is 29 million.
• Injecting drug users make up over half of the estimated 27 million problem drug users (PWID). In 2013, there were 1.65 million injecting drug users who were HIV positive.
• 207,000 drug-related deaths were reported in 2014; this is an unacceptable proportion of deaths that might be avoided with the right measures.
• Over the past two years, there seems to have been a significant increase in both heroin use and overdose mortality. Among important medications, opioids continue to have the greatest risk to human health and potential for harm.
• At the global level, cannabis continues to be the most widely used drug, with 183 million users reported in 2014. The study's analysis of trends over a number of years reveals that as social standards around cannabis have changed, its usage has increased along with public acceptance of the drug.
• Drug abuse is prevalent in jail, especially the usage of opiates and injectable drugs.
• According to the study, men are three times as likely as women to use marijuana, cocaine, or amphetamines, whereas women are more likely to use opioids and tranquillizers for non-medical purposes.
• Despite the fact that more men than women take drugs, the effects of drug use are more severe in women because they frequently lack access to treatment for drug dependency. The likelihood of female partners and children of drug users becoming victims of drug-related violence increases inside the family setting.
• Drug trafficking is typically believed to thrive in areas with a weak state presence, unequally administered laws, and corruption opportunities.
• It has been demonstrated that offering drug-using offenders evidence-based treatment and care services as an alternative to jail significantly increases recovery and lowers recidivism.
• Every year, the global issue of addiction and drug usage results in 5 million fatalities and 42 million new infections of HIV (Soltani et al, 2013).

Indian Scenario

• The National Survey on Extent, Pattern and Trends of Drug Abuse in India (2000), which had a sample size of 40,697 males, was one of the earliest studies on drug use in India (12-60 yrs).
• These are the study's main observations:
• Alcohol was the most commonly used substance (21%) and was followed by cannabis (3%) and opiates (0.7%). 22.3 percent of people used multiple drugs.
• Most people who started using drugs did so in their early 20s or early 30s (46%).
• The majority of the population (53%) have used drugs continuously for more than five years.
• 27% of those surveyed had already received treatment.
• The prevalence of alcohol usage varied significantly across Indian states. Present use varied from a low of 7% in Gujarat, a western state that is ostensibly under prohibition, to 75% in Arunachal Pradesh, a northern state.
• Males were more likely than females to smoke tobacco, with a prevalence of 55.8%, with use peaking in the 41-50 age range.
• 179 women with drug-using family members were interviewed (in 8 locations), and the results revealed a number of physical, psychological, and financial/workplace issues.
• The cost of treatment adds another stress. Other effects include violence and a disturbed home environment.

The following were the main findings of the 2000 National Survey on the Incidence, Pattern, and Trends of Drug Abuse in India:

• In India, the three most commonly abused substances are alcohol, cannabis, and opioids.
• Male drug misuse is significantly more common than female abuse in the general population.
• There is drug misuse among females. Drug misuse poses serious risks to women and places a heavy load on them.
• It is noteworthy how many dependent users are "not in treatment."
• Both urban and rural areas have high rates of injectable drug use (IDU) and other risky behaviour.
• There is a substantial gap in the provision of services.

Management of Drug Addiction

Both prevention and treatment are involved in managing drug addiction. According to scientific data, frequent exposure to drugs together with biological and environmental elements interact in a complex multi-factorial manner to cause drug use disorders and dependency. Pharmacotherapy, behavioural therapy, and social support are three common elements of efficient treatment, each of which targets a different aspect of the condition and is tailored to the needs and challenges of the individual patient.

Pharmacological Treatment

Opioid addiction can be treated with drugs like methadone, buprenorphine, and naltrexone, whereas tobacco addiction can be treated with nicotine preparations including patches, gum, lozenges, and nasal spray, as well as drugs like varenicline and bupropion. Medication for alcohol dependence includes naltrexone, acamprosate, and disulfiram.

Psychological Treatment

1. Motivational Enhancement Therapy

The trans-theoretical model of behaviour change, which holds that behaviour change occurs in phases, is the foundation of motivational enhancement therapy (MET). By guiding patients through the stages of change (pre-contemplation, contemplation, determination, and action) for generating change in substance use behaviours, MET helps patients become more treatment-ready. The therapist asks the patient about the benefits and drawbacks of particular behaviours, explores the patient's goals and any accompanying ambivalence about achieving those goals, and then listens thoughtfully to the patient's response. This compassionate approach is what distinguishes MET.

The acronym FRAMES stands for the major components of MET that are thought to be the intervention's active ingredients.

1. FEEDBACK of personal risk or impairment
2. Emphasis on personal RESPONSIBILITY for change
3. Clear ADVICE to change
4. A MENU of alternative change options
5. Therapist EMPATHY
6. Facilitation of client SELF-EFFICACY or optimism

2. Behavioral Therapies

Following the principles of learning, behavioral therapies transform the target behavior of compulsive excessive substance use by methodical environmental alterations that differ greatly depending on the particular substance use behavior.

A form of contingent management called contingency contracting uses planned positive or negative outcomes to encourage abstinence from drugs or to punish and thereby discourage drug-related conduct. One of the negative effects of substance usage is that judges, employers, or family members may be informed.

The goal of cue exposure therapy is to expose a patient to cues that cause cravings while preventing real substance use and the subsequent experience of reward from substances. To help with the eradication of classically conditioned need, cue exposure can also be used in conjunction with relaxation exercises and drug-refusal training.

The goal of aversion therapy is to make drug use associated with an awful experience, such as a minor electric shock, pharmacologically triggered vomiting, or the drug's exacerbated side effects. By punishing substance use habits, this treatment aims to eradicate them.

3. Cognitive-Behavioral Therapies

• As a component of CBT, social skills training acknowledges that alcohol and drug dependency frequently causes both the disruption of previously taught social skills and the worsening of newly acquired social skills due to drug-seeking and drug-using behaviors. Training in social skills focuses on a person's ability to communicate effectively and meaningfully, including nonverbal communication, listening, thinking from others' perspectives, adapting to various situations, maintaining relationships, and being firm.
• Relapse prevention is a therapeutic strategy that employs CBT to assist patients in gaining more self-control in order to prevent relapse. Recognizing emotional and environmental triggers of urges and substance use, continuing to develop and evaluating specific coping mechanisms for dealing with internal or external stress factors, examining the decision-making process that results in resuming substance use, and developing effective early intervention techniques are just a few examples of specific relapse preventative measures.

4. Group Therapy

For several patients with a substance use disorder, group therapy is seen as a crucial and important component of their treatment plan. A population receives treatment using a variety of therapies in a group setting, including CBT, IPT, behavioral marital, interactive, rational emotive, Gestalt, and psychodrama therapies.

Given the social stigma that surrounds substance use problems, being with other group members who recognise they have a similar issue can be consoling. Additionally, group members who have made progress in their rehabilitation can serve as role models and offer inspiration.

5. Family Therapies

Poor short- and long-term treatment outcomes for individuals with substance use disorders are related with dysfunctional households, which are characterized by reduced interaction and a failure of family members to set reasonable boundaries or uphold standards of behaviour. Details about the patient and the factors that lead to substance abuse is one of the objectives of family therapy. Included in these are the patient's views about substance use, treatment compliance, social and occupational adjustment, engagement with peers who use substances, and extent of abstention. Sustaining marriage and family connections, as well as abstinence, is supported with the help of the family. Even a limited family member participation in the therapy process can increase patient involvement and retention. Controlled studies have demonstrated favourable results when non-drinking family members participate in the rehabilitation of an alcoholic.

6. Prevention with adolescents

Adolescence is the time when substance use typically starts and progresses. This has prompted the creation of numerous preventative programmes for kids and teenagers. Most adults who struggle with substance misuse began consuming drugs while they were teenagers. These treatments are intended to help adolescents become more aware of the numerous social factors that encourage substance use and to provide them the practical knowledge and skills they need to successfully oppose peer and media encouragement to smoke, drink, and try drugs.

• Social Resistance Skills: Adolescents learn how to spot circumstances where they could feel peer pressure to smoke, drink, or consume narcotic substances through resistance skills training programmes. Individuals are educated that they can respond to significant pressure to use drugs or alcohol in an appropriate manner by being prepared with what to say (i.e., the precise content of a rejection communication) and how they should say it. These programmes also feature material to raise students' knowledge of the strategies utilised by marketers to advertise the sale of alcohol or tobacco goods.
• Normative Education: Normative education strategies include materials and exercises to dispel false assumptions about the widespread use of drugs. Many teenagers exaggerate how common smoking, drinking, and using specific drugs are, giving the impression that substance abuse is standard behaviour.
  Youth impressions of the societal acceptance of drug use can be lowered by enlightening them about actual drug usage rates, which are nearly always lesser than assumed usage rates. The prevalence of drug usage in the population is also supported by the fact that many adolescents think using drugs is okay and not unusually risky. Training for social resistance frequently contain elements from normative education.
• Competence-Enhancement: The significance of social instructional strategies in the emergence of drug use in teenagers is acknowledged by competency-enhancement programmes. Youth who lack social and personal competencies are more vulnerable to peer pressure to use drugs. Additionally, these young people can be more driven to take drugs as a substitute for healthier coping mechanisms.
• A variety of skills are typically taught as part of competence enhancement strategies, including general problem-solving and decision-making, cognitive skills for fending off social or media pressure, skill sets for boosting self-control and conscience, adaptive coping techniques, social skills, and assertiveness.

Conclusion

According to published findings on substance usage around the globe, majority of people suffer from drug use disorders. Death caused by drugs is a serious issue. While drug addiction can be treated psychologically and with drugs, deterrence is a primary objective for programmes like those that offer appropriate education and skill development to teenagers. People who are battling with addiction frequently reject that they have this condition and put off getting help. An intervention might inspire somebody to seek or receive support by giving them an organised chance to make adjustments before circumstances worsen.

An intervention must be meticulously planned. Family and friends may carry it out under the supervision of a healthcare specialist or mental health expert, such as a certified alcohol and drug counsellor, or they may carry it out on their own. It comprises the person's family, friends, and occasionally colleagues, clergy, or other concerned parties. These individuals come together during the intervention to speak candidly and personally with the addict about the negative effects of substance abuse. Next, they ask the patient to commit to therapy.