Lesson Five

DRUGS AND SUBSTANCE ABUSE

BUCU 1103
Dr. Mwaniki Taiti
Definition of concepts
 Drug
 Substance
 Drug abuse
 A drug is any substance that causes a change in an
organism's physiology or /and psychological
state when consumed.
 It is any substance or product that affects the way
people feel, think, see, taste, smell, hear, or behave.
 The World Health Organization (WHO) defines “a drug”
as “any substance, solid, liquid or gas that changes the
function or structure of the body in some way”.
 The term “substance use” is preferred, so that all things
that affect the way a person feels, thinks, sees, tastes,
smells, hears and behaves are included. Thus, glue is a
substance used by many street children
Sometimes the phrase “psychoactive substance" is
used for drugs to emphasize the fact that the substance
produces a change in mental processes.
A drug can be a medicine, such as morphine, or it can
be an industrial product, such as glue.
 Some drugs are legally available, while others are
illegal, such as heroin and cocaine.
 The use of drugs may have a little or a large effect on
a person's life and health.
 The extent of the effect depends on the person, the
type of substance, the amount used, the method of
using it, and the general situation of the person.
 In pharmacology, a drug is a chemical substance,
typically of known structure, which, when
administered to a living organism, produces a
biological effect.
 A pharmaceutical drug, also called a medication or
medicine, is a chemical substance used to treat, cure or
prevent in order to promote an organisms well being.
 Traditionally drugs were obtained through extraction
from medicinal plants, but more recently also by
organic synthesis.
 Pharmaceutical drugs may be used for a limited
duration, or on a regular basis for chronic disorders.
 Psychoactive drugs are chemical substances that affect
the function of the central nervous system, altering
perception, mood or consciousness
 These drugs are divided into different groups like;
 Stimulants
 Depressants
 Antidepressants
 Anxiolytics
 Antipsychotics
 Hallucinogens
 Most psychoactive drugs have been useful in treating
a wide range of medical conditions including mental
disorders.
The most widely used drugs in the world include
caffeine, nicotine and alcohol.
They are considered as recreational drugs, since they
are used for pleasure rather than for medicinal
purposes.
Abuse of several psychoactive drugs can cause
psychological or physical addiction.
 Excessive use of stimulants can promote stimulant
psychosis.
 Many recreational drugs are illicit and international
treaties such as the Single Convention on Narcotic
Drugs exist for the purpose of their prohibition.
Substance Abuse
According to WHO, Substance abuse refers to the harmful
or hazardous use of psychoactive substances, including
alcohol and illicit drugs.
Psychoactive substance use can lead to dependence
syndrome (Addiction)
Addiction is a cluster of behavioral, cognitive, and
physiological phenomena of variable intensity, in which
the use of a psychoactive drug (or drugs) takes on high
priority, more than other behaviours that once had
value.
 Addiction is characterized by;-
1. A strong desire or sense of compulsion to take the drug
2. Difficulties in controlling its use
3. Persisting in its use despite harmful consequences
4. A higher priority is given to the drug use rather than to
other activities and obligations
5. Increased tolerance and a physical withdrawal from
other people..
Drug use may be influenced by a number of factors;
1. The individual:
 Adolescence is a time of immense physical and
emotional change.
 Young people may feel caught between conformity and
the urge to be different or the urge to fit in with the peer
group.
Often, young people do not have the skills necessary
to deal with the stress and pressures of life, and drugs
may be seen as a way of dealing with them.
2. Family and friends:
Often, children living in families where smoking,
drinking alcohol and taking prescription drugs, or any
other stimulant is considered as part of life, end up
believing that drugs are normal.
They also believe that drugs are helpful in releasing
stress or worries.
3. Environmental factors:
 These include laws that control the supply and
availability of drugs
 Advertisements and promotions of alcohol and other
drugs
Examples of why people use drugs
Reason for Taking the Drug Effects
Drug
Hunger Lessens hunger pangs
Boredom Creates sense of excitement
Fear Generates a feeling of bravery
Feelings of shame, depression, Helps to forget
and hopelessness
Lack of medicine and medical Self-medication
care
Difficulty falling asleep Produces drowsiness or overcrowding
Reason for Taking the Drug Effects
Drug
Need to stay awake for job Help user to stay awake
protection
No recreational facilities Offers entertainment
Social isolation Provides a sense of connection
with other drug users
Physical pain Relieves physical pain
Loneliness Promotes socializing
Major patterns of drug use among the youth
Patterns of drug use vary greatly among youth, and may
change over time.
Some develop a regular pattern of use while others may be
quite haphazard and opportunistic.
This variability of drug use by the youth can be useful to
help classify their use according to the level of use and
risks or problems experienced.
There are 5 major patterns in drug use:
1. Experimental use:
 Young people go through a period of development that
involves experimentation, exploration, curiosity and
identity search.
 They are curious about drugs and want to experience new
feelings and sensations.
2. Functional use
For the majority of young people, drug use is not
mindless or pathological, but functional.
Drugs have a specific purpose in their lives, such as
recreation, providing relief from anxiety or boredom, to
keep awake or to get to sleep, to relieve hunger and pain
among other reasons.
Such use is often controlled and limited to specific
circumstances and situations where the experienced user
knows what, when and how to use specified drug.
If their drug use is not causing serious problems for
them, there is little motivation for these functional users
to stop using these drugs.
3. Dysfunctional use
Dysfunctional drug use leads to impaired psychological
or social functioning.
As a result of their use, young people become involved
in fights or arguments with others or family members.
It interferes with important survival tasks, such as
finding adequate food and avoiding violence.
This behavior causes alienation, including rejection by
other members of the peer group or family.
There may be some motivation to think about quitting
drugs because of these increasing difficulties.
However, the benefits they perceive in using drugs
may make it difficult for them to break the habit.
4. Harmful use:
In harmful use, drugs cause damage to physical or mental
health.
These harms include traumatic injuries from accidents and
violence, overdose and poisoning, suffocation, burns and
seizures.
Injecting drugs is particularly dangerous because of the risk of
hepatitis, HIV and other infections from contaminated needles
and syringes, along with collapsed veins.
Smoking drugs can result in disorders of the
respiratory system and burns.
Such drugs include leaded petrol, benzene and coca
paste.
 Disorders such as alcohol-related liver diseases or
smoking- related lung cancer tend to occur later in life.
5. Dependent use
Drug dependence is the name given to the most intensive
type of drug use.
Users who are dependent on drugs often have poor
control over their intake and continues to use the drugs
despite their very serious consequences
In addition, they may spend more and more of their days in
activities related with drugs; earning money or trading sex for
them, purchasing them, using them, recovering from them, and
planning to get more of them.
Dependent users may develop a tolerance for certain drugs, that
is, their bodies may adjust to the drugs so that the same amount
of the drugs no longer produces the same effect and require more
of the drug to get the effect previously experienced.
The three main types of drugs, classified by their effects
on the central nervous system are:
1.Depressants.
2.Hallucinogens.
3.Stimulants.
1.Depressants
They slow down (depress) the central nervous system
affecting coordination, concentration and judgment.
They do not necessarily make the user feel depressed.
Examples include:
Alcohol
Opiates and opioids including heroin, morphine, codeine,
methadone, and pethidine
 Cannabis including marijuana, hashish and hash oil
Tranquillizers and hypnotics, including Rohypnol, Valium,
Serepax,
Solvents and inhalants including petrol, glue, paint thinners among
others
In moderate doses, depressants can make users feel
relaxed. Some depressants cause euphoria and a sense
of calm and well-being.
They are mostly used to wind down or to reduce
anxiety, stress or inhibition.
In larger doses, depressants can cause unconsciousness
by reducing breathing and heart rate.
Speech may become slurred and movements sluggish or
uncoordinated.
Other effects of larger doses include nausea, vomiting
and, in extreme cases, death.
When taken in combination, depressants increase their
effects and the danger of overdose.
2. Hallucinogens
 They distort perceptions of reality.
 Examples include:
- LSD (lysergic acid diethyl amide); trips, acid, microdots
- Magic mushrooms (psilocybin): gold tops, mushies
- Mescaline (peyote cactus)
- Ecstasy (MDMA/methylenedioxymethamphetamine)
The main physical effects of hallucinogenic drugs are
dilation of pupils, loss of appetite, talking or laughing
excessively, jaw clenching, sweating and sometimes,
stomach cramps and nausea.
Drug effects can include a sense of emotional and
psychological euphoria, visual, auditory and tactile
hallucinations may occur, causing users to see or hear
things that do not actually exist.
The person may behave in ways that appear irrational
or bizarre and often depend on the mood of the user and
the context of use.
Paranoia and loss of contact with reality.
In extreme cases, this can result in dangerous
behaviours like walking into traffic or jumping off a
roof.
3. Stimulants
They are used by millions of people every day. Coffee,
tea and cola drinks contain caffeine, offering some mild
stimulation.
The nicotine in tobacco is also a stimulant, despite many
smokers using it to relax.
Other stimulant drugs, such as ephedrine, are used in
medicines for bronchitis hay fever and asthma.
Amphetamines and other ATSs (Amphetamine-type
Stimulants, such as, forms of methamphetaime known
as “ice”, “shabu”, and “ya ba”) and cocaine are illegal in
most countries.
The use of ATS is becoming a major problem in most
countries and has begun to overshadow heroin use.
Stimulants speed up or stimulate the central nervous
system and can make the user feel more awake, alert or
confident.
 They increase heart rate, body temperature and blood
pressure, reduce appetite, dilate pupils, users become
talkativeness, agitation and sleep disturbance.
Mental health difficulties
Higher doses of stimulants can over stimulate the user,
causing anxiety, panic, seizures, headaches, stomach
cramps, aggression and paranoia.
Strong stimulants can mask the effects of depressant
drugs, such as alcohol. This can increase the potential
for aggression and poses an obvious hazard if the person
is driving.
Symptoms that identify a person who may be using
drugs
1. Marked personality change:
 A placid, soft-spoken person suddenly becomes noisy
and abusive.
 Sometimes, this may occur the other way around i.e.,
an outgoing and talkative person may turn silent and
withdrawn.
2. Mood swings:
 Mood may swing from high to low and back again,
seemingly, without reason.
3. Change in physical appearance or well-being:
A change in weight, sleep patterns, slurred speech,
staggering gait, sluggish reactions, pinpoint or dilated
pupils, sweating, talkativeness, euphoria, nausea and
vomiting.
4. Change in school or work performance:
 For students a significant deterioration in performance,
especially when the student has been diligent.
5. An increase in cryptic communication:
 This is often observed on cryptic telephone calls, crypted
sign language.
6. Intuition: Based on the awareness you have of a person
you know well. You can tell when all is not well
7. An excessive need for money:
Buying drugs costs money, and the more drug
dependent the person becomes, the greater their need for
money to finance their “habit”.
Money, however, is not the only transferable commodity
for young people. For example, baseball caps, sport
shoes and sex are commonly traded for alcohol and other
drugs.
How life skills training help in reducing drug/substance
use
Life skills are abilities for adaptive and positive behaviours
that enable individuals to deal effectively with the demands
and challenges of everyday life (WHO 1994).
Life skills are a promising approach to strengthen
protective factors in treatment and aftercare, including
relapse prevention.
 Life skills applied to drug/substance use prevention
are supposed to facilitate the practice and
reinforcement of psychosocial skills that contribute
to the promotion of personal and social
development.
They include:
1. Self-awareness
2. Empathy
3. Communication skills
4. Interpersonal skills
5. Creative thinking
6. Critical thinking
7. Coping with emotions and coping with stress .