Drug Alcohol Abuse

8.21 Drugs and Alcohol Abuse

Surveys show that drug and alcohol use is rising among the youth — a serious public health concern. Proper education, counselling and family support can help young people safeguard themselves against these dangerous behaviour patterns.

The drugs most commonly abused are opioids, cannabinoids and coca alkaloids. Most are obtained from flowering plants; some from fungi.

8.22 Opioids

Opioids bind to specific opioid receptors in the central nervous system and gastrointestinal tract.

Heroin — commonly called smack — is chemically diacetylmorphine. It is a white, odourless, bitter crystalline compound, obtained by acetylation of morphine.

Morphine is extracted from the latex of the poppy plant Papaver somniferum. Morphine is a very effective sedative and painkiller — extremely useful in patients who have undergone surgery. Improper use, however, leads to dangerous addiction.

Routes: Heroin is generally taken by snorting and injection. Effect: depressant — slows down body functions.

8.23 Cannabinoids

Cannabinoids interact with cannabinoid receptors located principally in the brain. Natural cannabinoids are obtained from the inflorescences of the plant Cannabis sativa.

The flower tops, leaves and resin of the cannabis plant are used in various combinations to produce marijuana, hashish, charas and ganja.

Routes: Inhalation and oral ingestion.
Effects: Known for effects on the cardiovascular system.
Note: Cannabinoids are increasingly abused by some sportspersons.

8.24 Cocaine (Coca Alkaloid)

Cocaine is obtained from the coca plant Erythroxylum coca, native to South America. It interferes with the transport of the neurotransmitter dopamine.

Common names: Coke, crack.
Route: Usually snorted.
Effects: Potent stimulating action on the central nervous system; produces a sense of euphoria and increased energy.
Excessive dose: Hallucinations.

Other plants with hallucinogenic properties: Atropa belladonna and Datura.

8.25 Other Abused Drugs

Drugs like barbiturates, amphetamines, benzodiazepines — normally prescribed for depression and insomnia — are often abused. Hallucinogenic plant, fruit and seed preparations have been used for centuries in folk medicine and religious rituals.

8.26 Tobacco and Smoking

Tobacco has been used by humans for more than 400 years. It is smoked, chewed or used as snuff. Tobacco contains nicotine, an alkaloid, among many other chemicals.

Nicotine stimulates the adrenal gland to release adrenaline and nor-adrenaline, both of which:

• Raise blood pressure.
• Increase heart rate.

Health effects of smoking:

• Increased incidence of cancer (lung, urinary bladder, throat).
• Bronchitis.
• Emphysema.
• Coronary heart disease.
• Gastric ulcer.
• Increased carbon monoxide (CO) in blood — reduces haemoglobin-bound oxygen → oxygen deficiency.

Tobacco chewing is linked to cancer of the oral cavity. Statutory warnings appear on cigarette packets — yet smoking remains widespread.

8.27 Drug Categories — A Summary

8.28 Adolescence & Drug/Alcohol Abuse

Adolescence (ages 12–18) is the bridge between childhood and adulthood. It is accompanied by major biological and behavioural changes and is a vulnerable phase for mental and psychological development.

Common motivators that push youngsters toward drugs/alcohol:

• Curiosity, need for adventure and experimentation.
• Perceived "benefits" (e.g., temporary stress relief).
• Academic and competitive stress.
• Perception that drug/alcohol use is "cool" — promoted by TV, films, social media.
• Unstable or unsupportive family.
• Peer pressure.

8.29 Addiction and Dependence

Addiction is a psychological attachment to the effects of drugs and alcohol — euphoria, temporary well-being — that drives people to take them even when not needed, or even when use becomes self-destructive.

With repeated use, tolerance of the receptors increases — so larger doses are needed to produce the same effect, leading to escalating intake and ever-deeper addiction. Even a single use of certain drugs can be a forerunner to addiction.

Dependence is the body's tendency to manifest a characteristic withdrawal syndrome if the drug is abruptly stopped. Symptoms include anxiety, shakiness, nausea, sweating — relieved when use is resumed. In severe cases, withdrawal can be life-threatening and requires medical supervision.

8.30 Effects of Drug/Alcohol Abuse

Immediate Adverse Effects

• Reckless behaviour, vandalism, violence.
• Excessive doses → coma and death due to respiratory failure, heart failure or cerebral hemorrhage.
• Combinations of drugs (or drugs + alcohol) cause overdose and death.

Warning Signs in Youth

• Drop in academic performance; unexplained school/college absence.
• Lack of interest in personal hygiene.
• Withdrawal, isolation, depression, fatigue.
• Aggressive and rebellious behaviour.
• Deteriorating relationships with family and friends.
• Loss of interest in hobbies.
• Changes in sleep, eating, weight.

Long-term Effects

• Intravenous drug abuse — sharing needles spreads AIDS and Hepatitis B; both are chronic and ultimately fatal.
• Long-term alcohol use damages the liver (cirrhosis) and nervous system.
• Alcohol/drugs during pregnancy adversely affect the foetus.
• Financial ruin — addicts may turn to stealing.
• Affects family and friends, not just the abuser.

Anabolic Steroid Misuse in Sports

Some athletes misuse narcotic analgesics, anabolic steroids, diuretics and certain hormones to increase muscle bulk and aggressiveness. Side effects:

• In females: Masculinisation, increased aggressiveness, mood swings, depression, abnormal menstrual cycles, excessive hair growth on face/body, enlargement of clitoris, deepening of voice.
• In males: Acne, aggressiveness, mood swings, depression, reduction in testicle size, decreased sperm production, kidney/liver dysfunction, breast enlargement, premature baldness, prostate enlargement.
• In adolescents (both sexes): Severe facial/body acne and premature closure of long-bone growth centres → stunted growth.

8.31 Prevention and Control

The old saying "prevention is better than cure" applies here. Habits like smoking, drug or alcohol use are most often picked up in adolescence — making early intervention crucial.

Worked Examples