Substance Abuse

Source: Adapted from Family Medical Adviser, Reader’s Digest

What is substance abuse?

Drug misuse is the taking of drugs that can harm health, make it hard to function socially, or are simply illegal. Substance abuse can lead to physical or psychological dependency on the drug, and may be a sign of other behavioural problems.

Not all drugs are addictive. Those that are will lead to a psychological – and sometimes physical – state which is characterized by a compulsion to take the drug. This is known as drug dependence. Addiction is a severe form of drug dependence. It is an actual physical need for the drug and results from changes in the body that have been caused by regularly taking that drug. Addiction is preceded by tolerance. Tolerance can develop to any drug if it is taken regularly. What it means in physical terms is that more of the drug is needed in order to achieve the same effects.

Some drugs, when used repeatedly, can cause withdrawal symptoms if suddenly stopped. In the case of opiates, withdrawal involves nausea, diarrhea, pain and ‘goose-flesh’, though symptoms vary with the type of drug.

Psychological dependence is regarded as the compulsion to take a drug purely for the mind-altering effects, even in the absence of physical withdrawal symptoms. Drugs producing major psychological and physical dependence include the opiates, nicotine, alcohol, benzodiazepines and barbiturates.

Commonly misused drugs

Most drugs that can be described as being misued are taken to alter the user’s state of mind. Some cause a depression or a calming of brain function, while others act as stimulants, elevating mood and reducing appetite and the need for sleep. Others have powerful hallucinogenic properties.

Relaxants and stimulants

The opiates, such as heroin, are some of the most powerful and popular relaxants. Initially they produce a state of euphoria, a general numbing of feeling and alleviation of pain. At higher doses, they bring drowsiness and sleep. A brown or white powder, heroin is often diluted with other substances and injected, sniffed or smoked.

Cannabis is also a relaxant, probably the most widely used. Although it causes some stimulation, giddiness and euphoria at first, this is quickly followed by a feeling of calm and and an increased perception of the senses. Sedative-hypnotics such as benzodiazepines and the barbiturates, are also used to depress alertness, producing symptoms similar to those caused by large amounts of alcohol.

Nitrates, nicknamed ‘poppers’, are commonly used for an almost immediate, though short-lived, feeling of light-headedness, followed by a sense of relaxation and well-being. Some users also claim they have an aphrodisiac effect. But continued sniffing of such drugs can damage the circulatory system and the blood’s capacity to carry oxygen, as well as causing skin problems around the mouth and nose. They are particularly harmful for people with anaemia, glaucoma, or breathing or heart problems, and may be fatal if swallowed.

There is also a range of powerful stimulants that act on the central and peripheral nervous systems to heighten alertness, creating a feeling of euphoria and of having boundless energy. These include cocaine, ecstasy and amphetamines (‘speed’) and their derivatives. Nicotine from smoking is also a stimulant, reducing the appetite and raising blood pressure.

Hallucinogenic drugs

Some drugs are used to produce changes in perception. A good example is LSD – a psychoactive drug with extremely powerful hallucinogenic properties. Mescaline, from the Mexican peyote cactus, and magic mushrooms have similar effects but are less potent. Some other drugs, such as cannabis, opiates and ecstasy, can promote vivid dreams and experiences, but are not regarded primarily as hallucinogens.

Who is at risk for substance abuse?

Substance abuse occurs in all sectors of society, particularly the taking of illegal drugs amongst younger people. Drug traffickers are known to target this age group providing easy access to cannabis, stimulants such as ecstacy, as well as a range of the more addictive drugs.

Treatment for substance abuse

There are often no definite signs that a person is misusing drugs. If you suspect that someone in your care has a drug problem, try not to be too alarmed; if you can, attempt to air your worries with them. Listen to what they have to say. Discuss the legal and health implications of drug taking – including alcohol and tobacco – and try to suggest ways of avoiding harm or preventing an escalation of the substance abuse.

If the person has a serious substance abuse problem, it may help to discuss it with a health professional, perhaps your doctor, in the first instance, or to phone one of the dedicated organizations that can offer advice and support.