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Substance abuse

Doctor Sun 114

What is substance abuse?

Substance abuse is a patterned use of harmful, hazardous or psycho-active substances, in which the user consumes the substance in amounts, or with methods which are harmful to themselves or others. It is the long-term, pathological use of substances characterised by daily intoxication, inability to reduce consumption and impairment of social interaction.

What are the reasons for substance abuse?

1) Social Conformity – If the use of a substance is accepted in a peer-group to which a person belongs, or which he identifies with, he will feel a need to use the substance to show that he belongs to the group.

2)Pleasure – One of the main reasons, substances are taken, is to induce pleasant feelings – ranging from well being and relaxation to mystic euphoria.

3) Escape from psychic stress – In a society which increasingly see substance abuse as the answer to all their social or physical problems, the use of substances to escape one’s psychological, and societal problems inevitably seem appropriate.

4) Alienation – This may underline substance abuse. In social alienation, especially within the peer-group, where the societal norms are rejected and considered oppressive. Substance use may seem a valid symbol of opposition to constituted authority. In psychic-alienation where the Subject has rejected all alternatives, including himself and his goals – the resulting feelings of meaninglessness, isolation, and inadequacy, will predispose him to chronic substance abuse.

5) Availability – Illegal use is highest where there is a ready supply(University towns), or where the market has attracted a ready supply. Legal drug use also increases with availability, example alcoholism is common in the liquor trade if bars are located within accessible environment.

6) Curiosity – Curiosity about the substance and why people take them, can often start off substance abuse.

7) Affluence & Leisure – These can produce boredom and loss of interest in pursuit of gainful activity and meaningful activity. Substance can then supply easy answer to the desire for stimulation and escape.

8) Theological reasons – Some Theological reasons account for some substance abuse. The practice of certain traditional, religions or church norms, and the personal search for self-identity and the reason for existence.

Example religious believers consume excess red-wine with the erroneous belief that it is the same wine used by Jesus Christ during the festival of Passover.

What are the classification of substances abused?
These fall into (4) major categories, according to their effects.
1) Depressants( downers).

• These reduce nervous activity, they include alcohol, barbiturates and opiates(opium, codeine, morphine heroine).
• Taken in small doses, they have a sedative effect: in larger doses they bring on sleep.
• An over dose can kill – nervous activity is so reduced that vital functions such as respiration and breathing are impaired and may cease.
• Tranquillisers are a special category of depressants.

2) Stimulants.
• These include – caffeine, nicotine, amphetamines and cocaine They increase nervous activity, especially in the sympathetic nervous system, which mobilises the body for action.
• So these drugs help prolong activity and take away the desire to sleep.
• Locally things like glue, lizard excreta, suck-away fume, tramadol etc etc, are also abused.

3) Hallucinogens.
• These include mescaline, psilocybin and Ly- Sergic acid Diethylamide. They produce bizarre states of consciousness.
• The interpretation of incoming sense-stimuli is radically affected, and this produces hallucinations, delusions, and extraordinary reactions to normal reactions and events.

How do we treat substance abuse?
1) Substance abuse is a complex but treatable disease, that affects brain function and behaviour. Let the parents consult a doctor who will counsel them and give them proper referral.
2) Bear in mind that no single treatment is right for everyone. Others may result to spirituality.
3) Relatives or friends, must be very observant and quickly notify any medical personnel of suspected cases.
4) Effective treatment addresses all of the patients needs, not just his or her substance abuse.
5) Patient must be advised to endure, because staying long in the treatment is very critical.
6) Counseling and other behavioural therapies are the most commonly used forms of treatment.
7) Medications are often an important part of treatment especially when combined with behavioural therapies.
8) Treatment should address other possible mental disorders and the reason ab nitio for the abuse.
9) Medically assisted detoxification is only first stage of treatment.
10) Treatment of substance abuse does not necessarily have to be voluntary to be effective. The person could be compelled, persuaded or forced.
11) Drug use during substance abuse treatment, must be strictly monitored, before we commit the error of elimination by substitution.
12) Treatment programmes should test patients for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases. As well as teach them steps they can take to reduce risk of these illnesses. Be medically guided.
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