How Drug Addiction Follow Dependency; its Symptoms and Treatment
A drug is any substance, other than those required for the maintenance of normal health, that when taken into the living organism may modify one or more of its functions (WHO).
Drug misuse (substance abuse) is defined as "a state psychic and sometimes also physical, resulting from the interaction between a living organism and a drug characterized by a behavioral and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects and sometimes to avoid discomfort of its absence.
Tolerance may or may not be present" (WHO). For drug dependence to exist psychological dependence must be present but physical dependence may not necessarily occur. Tolerance occurs when increased doses are required to produce the same effect and will only be maintained if the drug is taken regularly and in sufficient doses.
Drug addiction is a state of periodic or chronic intoxication, produced by the repeated consumption of a drug, which is harmful to the individual and to the society. Alcohol, cannabis and heroin are the most commonly abused substances. The most important drugs of addiction are opium and its derivatives, pethidine, heroin, alcohol, barbiturates, cocaine, cannabis, LSD, benzodiazepines, methaqualone, buprenorphine, dextropropoxyphene, and amphetamine. Other drugs are chloral hydrate and bromides. Heroin is the most dangerous.
Drug habituation is a condition resulting from the repeated consumption of a drug, in which there is psychological or emotional dependency on the drug.Caffeine and nicotine are habit-forming drugs. Drug dependence includes both the terms 'addiction and 'habituation'.
Cocaine, LSD, and cannabis do not cause tolerance or physical dependence but cause strong habituation. Non narcotic drugs of abuse are: (1) Hypnotics. (2) Stimulants, e.g. amphetamines, cocaine. (3) Non narcotic analgesics, (4) Tranquillizers. (5) Hallucinogens.
Addiction consists of physical dependence and psychological dependence. Physical dependence is a biological phenomenon which depends on the type, dose and duration of drug use irrespective of personality factors. If the drug is abruptly withdrawn, a withdrawal syndrome will occur in a physically dependent person.
The withdrawal symptoms are usually opposite to the effects of the drug itself. Psychological dependence is a compulsive need for a drug in order to maintain a state of well-being, and it can occur in the absence of physical dependence.
Pharmacologically, addiction evolves through the following stages: (1) Habituation. (2) Physical dependence, wherein an altered physiological state exists because of the frequent exposure to the drug. Withdrawal of the drug causes physical and emotional illness, known as the abstinence or withdrawal syndrome. (3) Tolerance to many of the pharmacological effects of the drug.
Drug abuse is a major medical problem with extensive legal, social, moral, ethical and even political problems. A person made tolerant to a large dose of one narcotic is also cross-tolerant to many of the effects of another narcotic.
Most persons use drugs of dependence with a certain discrimination, and in such cases little harm results. Indiscriminate use of any of these drugs becomes dangerous, and produces a gradual mental, physical, and moral deterioration of the individual, and sometimes also sexual perversions or crime. To obtain the money for the drug the addict often turns to prostitution or crime. The majority of drug victims are neurotic individuals who are mentally unbalanced.
A normal person has no tendency to become a drug addict and is most unlikely to become one, even when all the facilities are available. Hereditary factors, abnormal mental correlations, frustrations in life, anxiety, chronic tensions, physical inability to do a job, curiosity, etc. are some of the causes of drug addiction.
Addicts fall in two groups. (1) Those who originally used the drug for some disease and thus have acquired the habit, and (2) those who use the drug for its narcotic effect alone. The first group are more easily cured than the second. The inability to discontinue the use of drug may be due either to a desire for satisfaction, or an anxiety to avoid the discomfort of withdrawal symptoms, or both. Most drug users appear normal.
Symptoms of Drug Dependency :
Loss of appetite and weight; clumsy movements, unsteady gait, tremors; reddening and puffiness of eyes, unclear vision; slurring of speech; loss of interest, sleeplessness, lethargy and passivity; acute anxiety, depression, profuse sweating; mood changes, temper tantrums; depersonalization and emotional detachment; impaired memory and concentration; preference for solitude, especially spending long hours in the toilet. Acute intravenous narcotism is characterized by the appearance of fulminant pulmonary edema and immediate collapse and death.
Withdrawal Symptoms : They may begin within six to eight hours following stoppage of the drug or they may be delayed for twenty-four to forty-eight hours, depending upon the particular drug being used. The length of period of withdrawal symptoms also varies and can last up to ten days.
The intensity of the symptoms depends on the dose and type of the drug used, the duration of addiction and the suddenness of withdrawal of the drug. Early symptoms are chilliness, sensation of cold, uneasiness, anxiety, sweating, cramps, yawning and rhinorrhoea. Later, respirations become labored, sharp and very rapid. Goose skin; lacrimation, gross tremors and dilated pupils are seen. Anorexia is present in all the stages. The third stage is one of sleep lasting from eight to sixteen hours. Upon awakening, all the previous symptoms become intense. In addition, there is tachyapnoea, fever, hypertension, pain and cramps in the legs and abdomen, perspiration, vomiting and diarrhea.
Newborns of addicted mothers may show withdrawal symptoms from one to fifty-six hours after birth and require treatment. The symptoms are hyperactivity, twitching and convulsions.
Narcotic addicts may be murdered by a 'hot shot'. This is a dose of narcotic with poison, such as strychnine in it. In such cases, only signs of anorexia and cerebral depression are present. Another method of accidental or homicidal death is by the use of a purer drug than the addict has been using.Cocaine, LSD, and depressants and anti psychotic do not product physical dependence.
- The person should be removed to an institution, so as to remove him from the association with which the addiction started.
- Constant supervision to prevent addict from obtaining secret supplies of the drug.
- Detoxification: This consists of reduction in dosage of drug over a period of one to 3 weeks.
- Administration of drugs, such as sedatives, Benzedrine, hyocine.
- Diverting the mind by engaging him physically and mentally in some occupation.
- Psychotherapy (group, family or individual).
- Improving general health.
- Symptomatic. The treatment is successful only in 10 to 25% of cases.
- Rehabilitation : Rehabilitation is a continuous process of "weaning away the victims of drug dependency. It requires strong family support and follow-up to prevent relapse. Social rehabilitation and training for gainful employment are the most important components after weaning addicts away from drug dependency to prevent relapse.