Chapter I

HISTORICAL PERSPECTIVE OF DRUG ABUSE

Overview
This chapter presents the historical perspective of drug abuse, the common methods of
administration of drugs how it works in our body, and the underlying causes/influences
of drug abuse.

HISTORY OF DRUG ABUSE

The Holy Bible is a very reliable source for tracing the early use and abuse of narcotics. The
Book of Judges of the Old Testament revealed that the mighty Samson was put to sleep by
Delilah by means of a drug-laced wine before cutting his hair, the source of his strength, and
subsequently gouged his eyes before the feasting Philistines already “high spirited” with
narcotics mixed with intoxicants. There are also many allusions to drug abuse in the old cities of
Sodom and Gomorrah, which might have led to widespread adultery, bestiality, and incest(Sotto,1994).

Ancient Greek and Roman literature likewise are replete with stories alluding to drug abuse, as
in the lamentable and tragic romance of Mark Anthony and Cleopatra. Cleopatra, in desperation
over her disprized love, drank a narcotic-laden wine before allowing herself to be bitten to death
by a poisonous asp from the River Nile. Even the practice of miracles and black magic during
the Roman ancient times was believed to be accomplished by “narcotics"(Sotto,1994).
Historians credited that marijuana (Cannabis Sativa)is the world's oldest cultivated plant started
by the Incas of Peru. Peruvian and Mexican Incas have also the common practice of using coca
leaves during religious offering ceremonies. It was also known that marijuana was a “sacred
tree" in the belief of the Assyrians being used during religious rituals-some 9,000 years B.C.The
use of marijuana is also deeply ingrained in the cultures of many countries such as India,
Jamaica, Morocco, Nepal, Mexico, and Peru (Sotto,1994). The first reference of introduction
was in Northern Iron as an intoxicant. From there it spread throughout India by the Hindus used
for religious rituals in the belief that it is a source of happiness and a “laughter provoker". The
word “hashis” (resin) of the Marijuana plant was derived from the name Hasan or Hashasin, the
Muslim cult leader who fed his disciples a preparation made from the resin of the female hemp
plant as a reward for their successful activities in assassinations.
American Indians too are believed to use not only the stimulant tobacco but also opium in their
peace pipes order to “narcotize" an oppositionist to their common objectives (Sotto,1994).
Knowledge of the opium poppy plant (PapaverSomniferum) goes back about 7000 years B.C
cultivated and prepared by the Sumerians. Even the ancient Greek physician Hippocrates, the
Father of Medicine, prescribed the juice of the white poppy plant as early as 5,000 B.C in the
belief that it could cure many illnesses both in internal and external use. The plant was first
harvested in Mesopotamia and its use spread throughout the neighboring Mediterranean areas,
then to Asia. From there, it was introduced to Persia, India, and China by the Arab caravans
(Dungo,1988).
Opium use in China stemmed from India and became widespread in the 19th Century. In the
Middle East, the plant was cultivated in India, Pakistan, and Afghanistan. Five centuries later,
An. Opium trade between China and Portuguese merchants became a lucrative business. The
British took over the trade from the Portuguese and established the Opium Trade Monopoly
through the British East Indies Company.

In an attempt to stop the extremely high rate of opium addiction in China, Emperor Yung
Chen prohibited the smoking of opium and attempted to close ports for its importation. This
triggered the "opium war" of 1840 which induced China to accept the British-sponsored
opium trade and forced it to sign a treaty permitting the importation of opium into China after
her defeat.
It was in 1806 that a German pharmacist in the name of Friedrich W. Serturner discovered
Morphine, the first derivative of opium. He called this new drug "Morphium" and later
changed to Morphine after the Greek god of dreams, Morpheus. This was the first attempt
to cure opium addiction. But morphine's addictive properties came to prominence during the
American Civil War vast numbers of Americans so much so that soldiers became addicted
to the drug morphine addiction became known as "soldier disease".

The second attempt of treating opium and morphine addiction started in 1896 when Heroin
(Diacetylmorphine), synthesized from the drug morphine, was discovered by a British chemist in the
name of Alder Wright. It was called the "miracle drug" because it is believed that it can cure both opium
and morphine addiction. It was named after the word "hero" due to its impressive power. So physicians
began to use heroin but it became a substitution of one addiction to another. It turns out later that
heroin is the most addictive of all drugs.

Meanwhile, codeine, the third derivative of opium was discovered in France while in the process of
discovering other drugs that could cure opium, morphine and heroin addiction but it also ended in the
same tragic result. Today, it is widely used as an ingredient in most cough syrup.

There are of course other historical events that would reveal drug abuse in the history of man, the
greatest influence of the modern medical practice today. In fact, physicians all over the world still
consider narcotics as the most effective pain reliever (Sotto, 1994).

HISTORY OF DRUG ABUSE AND ADDICTION IN THE PHILIPPINES

Very little known about drugs in the Philippines during the pre- Spanish era. The intoxicants and
stimulants used by the early Filipinos were fermented alcoholic beverages and the masticatory
preparations known as "nga-nga" in vernacular. Narcotics, including marijuana, were not in the list of
vices in the country at that time. The opium poppy plant and the coca bush were absent in the
Philippine vegetation prior to 1521.

During the Spanish era, drug control laws prohibited the use of opium by the native Filipinos and other
people except the Chinese. Chinese residents in the Philippines particularly in Manila and of the more
distant Chinese pariahs (ghettos) started smoking opium in 1780. As a vice, it was not widespread and
was particularly accepted and tolerated by the authorities. In 1844, The Spanish colonial government
laid down an opium monopoly, which entitled the importation by the Spanish government and its sale
to Chinese users. At this period, opium smoking became widespread among Chinese as its use was
forbidden to Indians, Mestizos and the Filipinos. This compromise policy lasted up to 1896, a period of
revolt and insurrection.

The Americans took over the rule of the country, and after establishing a civil government in 1901, a
systematic survey was conducted and it was found out that there were 190 joints where the Chinese
smoke opium. It was observed that the habit had not yet gained foothold among Filipinos. In 1906,
partial legislation allowed Chinese addicts to obtain a license to use opium in their homes for a fee of
P5.00. The opium sale was under the government control and the quality was limited.

In 1908, the total ban of opium was effected. The campaign continued until the Japanese occupation in
1946, at which point all supplies of opium were cut of from the country and during that period the
number of opium addicts was probably the lowest in Asia.

In 1953, Republic Act No. 953 was enacted which provided for the registration of collection, and the
imposition of fixed and special taxes upon all persons who produce, import, manufacture, compound,
deal-in, dispense, sell, distribute, or give away opium, marijuana, opium poppies, or coca leaves or any
synthetic drugs which may declared as habit forming. The law also declared as a matter of national
policy, the prohibition of the cultivation of marijuana and opium poppy.
 Sometime in 1955, the marijuana plant was introduced in Pasay City by foreigners for purpose of
producing "reefers". These were sold in taverns in Pasay City and introduced into elite schools in the
same area. The PC Criminal Investigation on January 8, 1959 conducted the first marijuana raid in Pasay
City when several potted marijuana plants were seized.

The Philippines has been relatively heroin-free until the early 60's when small heroin laboratories
opened in Manila. In 1963, new trends appear. There was a waning of opium addiction among the
Chinese but a concurrent increase among the Filipinos, just the latter contributed 63 percent of the
total arrests from drug offenses.
Recognizing the deleterious effect of drug abuse on the health and well-being of the Filipino youth
and the threat that it poses to national security, then President Ferdinand Marcos signed into law
Republic Act No. 6425 known as the "Dangerous Drug Act of 1972" on March 30, 1972. This law
which was amended by Presidential Decree No. 44, dated November 9, 1972 placed under control
not only narcotics by also psychotropic substances. On November 14, 1972, the Dangerous Drug
Board was organized to provide leadership, direction and coordination in the effective
implementation of R.A. 6425. By early 1974, addiction to opiates and barbiturates had almost
disappeared among the native population.
During the period 1975-1980 the cultivation of marijuana increased and became geographically
widespread, thus the pattern of drug taking involved marijuana, abuse of pharmaceutical products
(especially cough syrup) and the inhalation of solvents. There was very little trafficking of heroin,
cocaine and LSD and the non-availability of narcotic drugs made the prices sour beyond the reach of
Filipino drug abusers.

Definition of Terms
Drug- is a chemical substance used as medicine or in the making of medicines, which affects the
body and mind and have potential for abuse.
Chemical - is any substance taken into the body that alters the way and the mind and the body work.
Chemical Abuse is an instance when the use of chemical has produced negative or harmful
consequences.
Narcotic Drug - refers to illegally used drugs or dangerous drugs, which are either prohibited or
regulated drugs. It also refers to drugs that produces sleep or stupor and relieves pain due to its
depressant effect on the CNS. The term Narcotic comes from the Greek word "narcotikos". It is
sometimes known as "opiates".

Drug Abuse - is the illegal, wrongful or improper use of any drug.

Drug Addiction - refers to the state of periodic or chronic intoxication produced by the repeated
consumption of a drug.

Drug Dependence- refers to the state of psychic or physical dependence or both on dangerous drugs
following the administration or use of that drug. WHO defines it as the periodic, continuous, repeated
administration of a drug.
Physical Dependence - an adaptive state caused by repeated drug use that reveals it self by
development of intense physical symptoms when the drug is stopped (withdrawal syndrome).

Psychological Dependence - an attachment to drug use that arises from a drug ability to satisfy some
emotional or personality needs of an individual.

Tolerance- is the increasing dosage of drugs to maintain the same effect in the body.

Pusher- any person who sell, administer, deliver or give away to another, distribute, transport any
dangerous drug.

Use- the act of injecting, consuming, any dangerous drugs. The means of introducing the dangerous
drug into the physiological system of the body.

Administer- the act of introducing any dangerous drug into the body of any person with or without his
knowledge.

Manufacture the production, preparation, compounding or processing a dangerous drug either directly
or indirectly or by extraction from substances of natural origin or by chemical synthesis.

Drug Experimenter - one who illegally, wrongfully, or improperly uses any narcotic substances for
reasons of curiosity, peer pressure, or other similar reasons.

Drug Syndicate- It is a network of illegal operations operated and manned carefully by groups of
criminals who knowingly traffic through nefarious trade for personal or group profit.

Drug Abuse Jargons

"Opiate" – Narcotic

"On-the-Nod/ "Nodding"- the state produced by opiates like being suspended on the edge of sleep.

"Mainline'/ "to shoot"

"A Hit"- the street slang for injection of drugs

"Work"- an apparatus for injecting a drug

"A Fix" - one injection of opiate

"Juni" – heroin

"Junkie" an opiate addict

"Skin popping" injecting a drug into the vein to inject a drug under the skin

"A Bag" - a pocket of drug "Cold Turkey" - the withdrawal effect that occurs after a repeated opiate
use

"Track" - scars on the skin left from the repeated injection of opiate
"Overdose" - death occurs because the part of the brain that controls breathing becomes paralyzed.

"Speed" - amphetamines

"Speed Freaks" - amphetamine addicts

"Uppers" street slang for amphetamines

"Rush"- the beginning of a high

"High" - under the influence of drugs

"Coke"- street slang for cocaine

"Flashback" - user can be thrown back into the drug experience months after the original use of drug.

"Acid" - slang term for LSD "Acid Head" - LSD user

"Drop" - taking drug orally "Joint" - an MJ Cigar

"Roach" - butt end of a joint

"Stoned" - the intoxicating effect of a drug

"Trip" - the name for the reaction that is caused by drugs

"Head" - drug user

"Downer" - street slang for depressant

WHAT ARE DRUGS?

A drug, as defined, is a chemical substance used as medicine or in making medicines, which affects the
body and mind and have potential for abuse. Without an advice or prescription from a physician, drugs
can be harmful.

Hundreds of pure chemicals have been developed plants and put into pills, capsules or liquid medicines.
There are also two forms of drugs, natural and synthetic/ artificial. The natural drugs include natural
plant leaves, flowering tops, resin, hashish, opium, and marijuana, while the synthetic drugs are
produced by clandestine laboratories which include those drugs that are controlled by law because they
are used in the medical practice. Physicians prescribe them and are purchased in the legitimate outlets
like drugstores.

Drugs also help a person's body and mind function better during an illness. But drugs have to be taken
correctly in order to do these things. The wrong drug or the wrong amount of the right one can make an
illness, worse, destroy blood cells, damage the body and many cause death. For this reason, most drugs
can be legally purchased only with doctor's written order called prescription. Only a medical doctor can
prescribe medicinal drugs. These drugs could be dangerous and must be used with care, according to
the doctor's prescription. He gives direction on how much medicine to take and how often.

The practice of taking drugs without proper medicinal supervision is called the non-medical use of drugs
or drug abuse.

T A. THE PRESCRIPTIVE DRUGS

these are drugs requiring written authorization from a doctor to allow a purchase. They are prescribed
according to the individual's age, weight and height and should not be taken by anyone else. It is a
personal requirement and self- medication that should be strictly avoided. The pharmacist should never
allow the consumer to request them knowingly without first consulting a doctor.

Once again strict emphasis of following directions needs to be stated. In addition to dosage, the
physician indicates both when and for how long the medicine should be taken. Theses directions are
intended to safeguard the patient from needlessly treating himself after his illness has been brought
under control or from prematurely stopping a drug because he thinks he is well. Since the chemistry of
the body is subtle and variable, only a physician should have the responsibility of prescribing and
directing the use of drugs in the treatment of illnesses.

B. THE OVER THE COUNTER DRUGS (OTC)

These are non-prescription medicines, which may be purchased from any pharmacy or drugstore
without written authorization from a doctor. They are use to treat minor and short term illnesses and
any persistent condition should be immediately referred to a physician. It should be strongly
emphasized that "directions" be closely followed and all precautions necessarily taken to avoid
complications.

OTC drugs are used for the prevention and symptomatic relief of minor ailments. The precautions that
must be observed when dispensing OTCs are the following:

1. the correct drug with the correct drug content is given to the correct patient in the correct dosage
form;

2. the pharmacist must counsel the patient to make sure that he/she takes the drugs correctly; and

3. the pharmacist must be aware of and know about the possible toxicity's possessed by the OTC drugs
to avoid food/drug incompatibilities and overdoses.

OTCS must be used discriminately:

1. To avoid the dispensing of OTC to known identified habitual drug users.

2. To avoid complications, this is done by inquiring from the buyer of the drugs as to the identity of the
patient, the patient's age and other information such as pregnancy, hypertension, etc.
3. Counseling the patient so as to avoid the "self- medication" syndrome by inquiring about the buyer's
source of information about the drug.

C. The "Self-Medication Syndrome"

The "self-medication" syndrome is found in users and would be users of drugs whose sources of
information are people or literature other than doctors, pharmacists and health workers. These could be
members of the family, relatives, and/or neighbors, all of whom may have previously used the drug for
their specific disease or disorder. Self- medication may work against the good of the user because it can
lead to intoxication and other adverse reactions.

Possible outcomes of self-medication are:

1. Adverse reaction towards the drug, such as allergies that may be mild or severe.

2. Possible non-response of the patient to the drug effectively due to incorrect drug usage.

. 3. Possible drug toxicities, through over dosage which may lead to severe reactions such as nausea,
vomiting, rashes, etc.

4. Possible habit-forming characteristics due to periodic use of the drugs even when such are no longer
needed.

HOW DRUGS WORK?

Most drugs act within a cell, rather than on the surface of a cell or in the extracellular fluids of the body.
Similar to normal body chemicals, a drug enters a cell and participates in a few steps of the normal
sequence of a cellular process. Thus, drugs may later, interfere with or replace chemicals of normal
cellular life, hopefully for the betterment of the person. The actual action of a particular drug depends
on its chemical make-up.

When two drugs are taken together or within a few hours of each other they may interact with
unexpected the names of all drugs one is using. A dose of a drug is the results. This is one reason a
physician should always know extremely important part of drug abuse. The amount of drug amount
taken at one time. The doses taken become an in a dose can be described as:

1. Minimal dose - amount needed to treat or heal, that is, the smallest amount of a drug that will
produce a therapeutic effect.

2. Maximal dose - largest amount of a drug that will produce a desired therapeutic effect, without any
accompanying symptoms of toxicity.

3. Toxic dose - amount of d rug that produces untoward effects or symptoms of poisoning

4. Abusive dose_- amount needed to produce the side effects and action desired by an individual who
improperly uses it

5. Lethal dose - amount of drug that will cause death

HOW DRUGS ARE ADMINISTERED?

The common methods of administration are the following:

1. Oral -this is the safest most convenient and economical route whenever possible. There are however,
drugs, which cannot be administered this way because they are readily destroyed by the digestive juices
or because they irritate the mucous lining of the gastro-intestinal tract and induce vomiting.

2. Injection - this form of drug administration offers a faster response than the oral method. It makes
use of a needle or other device to deliver the drugs directly into the body tissue and blood circulation.

3. Inhalation - this route makes use of gaseous and volatile drugs, which are inhaled and absorbed
rapidly through the mucous of the respiratory tract.

4. Topical - this refers to the application of drugs directly to a body site such as the skin and the mucous
membrane.

5. Iontophoresis - the introduction of drugs into the deeper layers of the skin by the use of special type
of electric current for local effect.

THE CONCEPT OF TOXICOLOGY

A drug may cause effects because of any of the following:

1. Overdose - when too much of a drug is taken, there may be an over extension of its effects.

2. Allergy - some drugs cause the release of histamine giving rise to allergic symptoms such as
dermatitis, swelling, fall in blood pressure, suffocation and death.

3. Idiosyncrasy - for unexplained reasons, morphine, which sedates all men, stimulates and renders
some women some maniacal. Perhaps the phrase "catty woman" has pharmacological basis since most
mammals are sedated by morphine but some cats become extremely excited by it.

4. General Protoplasmic Poison Property - drugs are chemicals and some of them have the property of
being general protoplasmic poisons.

5. Side Effects - some drugs are not receptors for one organ but receptors of other organs as well. The
effect in the other organ may constitute a side effect, which is unwanted.

THE MEDICAL USE OF DRUGS

The best use of medicine depends upon the physician, the user or patient, and lastly, the pharmacist.
This idea was subscribed to by both Metro Manila Physicians (PNC Health Education Survey, 1983) and
the Pharmaceutical Manufacturer's Association of Washington, D.C. (U.P., MEC, DDB 1979). Their
common agreements on the intelligent use of drugs are presented below.

1. Take medicines on doctor's advice. In prescribing medicine, the doctor considers factors like age and
weight, prevalent signs and symptoms, severity of the administration tolerated by patient, and presence
of disease, results of laboratory examinations, route of impairment in the organ or system. The
physician has always a reason for his orders.

2. When taking prescribed medicines, remember carefully the dosage, manner of administration,
frequency and time when to take it. Patient must not trust his memory when taking medicine. The label
of the medicine should be read three times - once when medicine id remove from cabinet, again before
medicine is taken and a third time after it is taken. Medicine should not be taken in the dark even if
patient knows its location.

3. If patient goes to more than one doctor, each one of them must know about all the drugs being
taken.

4. Avoid self-medication. Patient should not try to guess what is wrong with him or to select his own
medicines even if his symptoms seem to be familiar to those of his neighbor.

5. Report any untoward effects of medicine to the physician. After taking medicine, tell the doctor if any
symptoms develop.

6. Patient should not take additional drugs without asking his physician.

7. See whether the medicine has expired or not.

8. Be sure that the label stays on a prescription container until all is used.

9. Store medicine in a safe, cool and dry place and out of reach of children.

10. Some people just purchase and use common drugs without knowing their functions and
contradictions. Thus, instead of being relieved of some symptoms, their conditions are aggravated.
Physicians share the same opinion that the following drugs are better used under medical supervision to
avoid harmful consequences and habit formation.

11. Analgesics relieve pain. However, they may produce the opposite effects on somebody who suffers
form peptic ulcer or gastric irritation.

12. Antibiotics combat or control infectious organisms. Ingesting the same antibiotics for a long time can
result in allergic reactions and cause resistance to the drug.

13. Antipyretics can lower body temperature or fever due to infection.

14. Antihistamines control or combat allergic reactions. People who on antihistamine therapy must not
operate or drive vehicles since these drugs can cause drowsiness.

15. Contraceptives prevent the meeting of the egg cell and sperm cell or prevent the ovary from
releasing egg cells. Pregnant women must not take birth control pills to avoid congenital abnormalities.
This advice also applies to women suffering from heart disease, varicose veins, breast limps, goiter and
anemia. The effectiveness of oral contraceptives may be reduced when taken with antibiotic.
16. Decongestants relieve congestion of the nasal passages. Prolonged used of these decongestants
might include nasal congestion upon withdrawal.

17. Expectorants ease the expulsion of mucus and phlegm from the lungs and the throat. They are not
drugs of choice for the newborn that does not know to cough the phlegm out.

18. Laxatives stimulate defecation and encourage bowel movement. They should not be given to
pregnant women and those suffering from intestinal obstruction. Taking purgatives (stronger than
laxatives) unnecessarily might result in rupture of the intestines or appendix if there is an obstruction.
Constant use might make the intestines sluggish.

19. Sedatives and tranquilizers calm and quiet the nerves and relieve anxiety without causing
depression and clouding of the mind. Precautions must be taken in the use of tranquilizers since they
can cause impairment of judgement and dexterity.

20. Vitamins are food substances necessary for normal growth and development and proper
functioning of the body. A person who eats a balanced diet does vitamin preparations should be taken
with meals, not need supplements. If they are found necessary, Vitamins should be treated as drugs
since the body does not manufacture them. Excessive dosage of vitamins A and D can be dangerous and
harmful to health. Excess of vitamin D can lead to nausea, diarrhea, and weight loss, calcification and
heart and kidney troubles. Too much vitamin A might result in symptoms of a disease of the liver.

THE INFLUENCES OF DRUG ABUSE

Concept of Drug Abuse

The term Drug Abuse most often refers to the use of a drug with such frequency that it causes physical
or mental harm to the user or impairs social functioning. Although the term seems to imply that users
abuse the drugs they take, in fact, it is themselves or others they abuse by using drugs.

Traditionally, the term drug abuse referred to the use of any drug prohibited by law, regardless of
whether it was actually harmful or not. This meant that any use of Marijuana, for example, even if it
occurred only once in a while, would constitute abuse, while the same level of alcohol consumption
would not.

The term drug is commonly associated with substances that may be purchased legally with prescription
for medical use. Other substances that may be purchased legally without prescription and are commonly
abused include alcohol and the nicotine contained in tobacco cigarettes (Groiler, 1995).

Concept of Drug Dependence

Drug abuse must be distinguished from drug dependence. Drug dependence, which is sometimes called
drug addiction, is defined by basic three characteristics (Groiler, 1995).

The users continue to take a drug over an extended period of time. Just the long this period is
dependent on the drug and the user. seem The users find it difficult to stop using the drug. They
powerless to quit the drug use. Users take extraordinary and often harmful measures to continue using
the drug. They will drop out of school, steal, leave their families, go to jail and lose their job to keep
using drug.

The users stop taking their drug - only if their supply of the drug is cut off, or if they are forced to quit for
any reason they will undergo painful physical or mental distress. The experience of withdrawal distress,
called the withdrawal syndrome, is a sure sign that a drug is dependency-producing and that the user is
dependent on the drug. Drug dependence may lead to drug abuse - especially the illegal drugs

Concept of Drug Addiction

Drug addiction is a state of mind in which a person has lost the power of self-control in respect of a
drug. He consumes the drug repeatedly leaving aside all values of life. In other words a drug addict will
resort to crime even, to satisfy his repeated craving for the drug. The effects of addiction are mainly
deteriorative personality Changes. They include insomnia, instability, lack of self-confidence especially
when not under the influence of drug. The addict can not concentrate on any work. He avoids social
contacts. Slowly, mentally, physically, and morally he becomes from bad to worse and a burden to the
society.

One or more of the following attributes characterizes drug addiction:

1. Compulsion/ Uncontrollable Craving the addict feels a compulsive craving to take drug repeatedly
and tries to procure the same by any means.

2. Tolerance - it is the tendency to increase the dose of the drug to produce the same effect as to that
of the original effect.

3. Addiction - the addict is powerless to quit drug use.

4. Physical Dependence the addict's physiological functioning is altered. The body becomes sick,
inactive and incapable of carrying out useful activity in the absence of the drug. The withdrawal
syndromes will occur once the drug use is stopped.

5. Psychological Dependence - Emotional and mental discomfort exist to the individual. The drug addict
if he does not take the drug his mental processes are feels he can not do without the drug, consequently
affected. He can not carry out his work efficiently.

6. Withdrawal Syndrome - The addict becomes nervous and restless when he does not get the drug.
After increasingly about 12 hours, he starts sweating. His nose and eyes becomes watery and continue
doing so for another twelve hours. It is followed by vomiting, diarrhea, loss of appetite and sleep.
Respiration, blood pressure and body temperature also rises. This will continue up to three days. After
which, the trouble starts subsiding and most of it is gone in about a week's time. Complete recovery
takes place in three to six months.

UNDELYING CAUSES/INFLUENCES OF DRUG ABUSE

The drug addict or abuser is generally an emotionally unstable person before he acquires the habit. He
can not face painful situations without help, he has less will power and self control. He has not adjusted
himself to his emotional reaction. Due to this, drug addicts have low capacities for dealing with
frustrations, anxieties and stress. Drug abuse is a multi-faceted problem exits in our locality and
countryside, there is usually more than one reason why this problem exists. Any of the following factors
may influence people to abuse drugs.

A. Biological Factors

There are some reasons or pre-existing induced biological abnormalities of chemicals, physiological or
structural in nature that induced a person to take drugs. The following are some to consider:

1. Individual's general health - there are several diseases that easily make a person become a drug abuser.

Examples are fatigue, chronic cough, insomnia, and discomfort.

2. It is believe that drug has the special power to prevent or to increase sexual capacity.

3. One specific genetic theory proposes that there is an inherited defect in the production of endorphin,
similar to morphine. A deficiency of the substance leads to bodily discomfort. With the use of the
morphine, this feeling is induced. According to theory, a person who uses morphine has the physiological
abnormality where endorphin production is less. The drugs when we use the body cells work actively.

B. Common Causation of Drug Abuse

1. Children of broken home easily join peer groups as substitutes to their lost family solidarity.

2. To strike and over protectiveness of parents.

3. For curiosity - eagerness to know what they have not experienced.

4. To assert their independence.

5. To rebel from parental authority.

6. To prove their guts.

7. To escape problems.

8. Peer pressure and for the sake of PAKIKISAMA.

9. They believe that drug can give deeper insights.

10. The belief that medicines can magically solve problems.

11. The easy access to drug or various sort in an affluent society.

12. The enjoyment of euphoria or excitement induced by drugs.

13. The search for sharpened perception and high perception and creativity, which some people believe
they obtained from drugs.

14. The belief that they are just taking it like alcohol.

15. The dissatisfaction or disillusion of lost of faith in the prevailing system.

16. The tendency of persons with psychological problems to seed easily solution with chemicals.
17. The statement of proselytizers who proclaim the goodness of drugs.
18. Slum condition the most critical is that the slum dweller are often deprived of emotional support.

C. Factors in Youthful Drug Abuse

(Psychological, mental health, family conditions)
1. Motives and Attitudes
Psychologically speaking, in terms of motives and function of drug use, some of which may not be
recognized by users themselves. The more a drug is used, the more it tends to satisfy more than one
motive or need.
Recent surveys of college drug use have induces the students reasons for drug use. In one study
smaller or larger groups mentioned all of the following motives;
1. To feel more courageous.
2. To find out more about oneself
. 3. To have a religious experience to come close to God.
4. To satisfy a strong craving or compulsion.
5. To increase or reduce appetite.
6. To feel less dull or sluggish, improve sex.
7. To reduce sexual desire and keep from being panicked or crazy.
8. To improve intelligence or learning, prepare stress.
9. To feel less depress of sad, relieve tension or nervousness
10.To make good moral mood last longer, relieve anger or irritation

2. Personality and Pathology

This psychology has been described as follows:

1. Chronic, low-grade depression.

2. Smoldering, tense and restlessness.

3. A sense of not being taken seriously.

4. Narcissism or egocentricity.

5. Preoccupation with issues or identity, autonomy, and freedom of expression.

6. Repeated dwelling on drug taking and its effects.

7. Difficulty in interpersonal relations.

3. Family Background

The kinds of personality disturbances found in some young addicts and heads cannot, in the current
state of knowledge, be identified as brain damage or schizophrenia. It is more in the manner of
character disorder. And the behavior may be the result of inadequate socialization, condition of child
rearing and family interaction. The few available facts about families of young abuser lend credence to
this idea.

In one broad study of New York's high addiction areas, the families of adolescent narcotics users
showed the following characteristics:

1. Absent or weak father

2. Overprotective, overindulgent and domineering mother

3. Inconsistent standards of behavior, lack of definition of limits

4. Hostility or conflict between parents

5. Unrealistic aspiration for children

D. The Psycho-Social Factors

1. Personality Disorder - Drug abuse is a manifestation of an underlying character of personality

disorder. Thus majority of the drug users are fundamentally immature, emotionally childish, insecure or
suffering from problems of adolescence.

2. Social Disorder - A sign or symptom of family problem involving parent - child relationship, peer
pressures, unethical values.

Drugs use does not also occur in isolation of other environmental factors but rather, is greatly
influenced by these factors. Some of the sociological factors also influenced drug use is as high toll.

a. Availability of over-the counter and prescription drugs variety of drugs available for different ailments.

b. Influence of media-advertisement message that all ailment can be cured through the use of chemical
substances toward messages and help to create the acceptance of drugs.

c. Impact of affluent lifestyle or of high employment.

d. Effect of increased travel and exposure to different culture and social values

e. Modeling, if parents or key influence are drug users, young persons often tend to model the behavior
they are at home.

f. Social pressures exerted by peers

g. Collapse of religious values

h. Alienation and enemies feeling of powerless

i. Lower value on academic achievement

E. Other Factors

1. Ignorance, curiosity
2. Laxity of government and other authorities

3. Mass media influence

4. Nature of society resulting in the increased violent behavior for youth.

F. The 7 Deadly Sins - Primary Causes of Drug Abuse

1. Pride excessive feeling of self-worth or self-esteem, sense of self-importance.

2. Anger unexpressed, deep-seated anger against himself, his family, his friends or the society in general.

3. Lust burning sexual desire can distort the human mind to drug abuse.

4. Gluttony - "food trip" in the lingo of junkies

5. Greed wealth, fame, recognition as exemplified by people under pressure in their work of art, such as
musicians, actors, athletes who indulge in drug abuse.

6. Envy- to get attention from someone: as a sign of protest envy is a major cause of drug abuse.

7. Laziness -" I can't syndrome", incapacity to achieve - the breeding ground of drug abuse. Boredom
coupled with poor self-image.

How Addiction is acquired?

People have generally different motivation in life. The young ones are very much adventurous and
some of them have strong attraction in drug-taking, because these "Space are era belongs to them so to
speak, thus, the "IN" thing these days are drugs. To see drug abusers around seemed to be of a common
sight.

The drug habit is acquired in three ways:

1. association

2. Experimentation

3. Inexperienced doctors

Likewise, addiction may be acquired through:

1. Habituation closely related to euphoric effect, and the relief of pain or emotional discomfort.

2. Toleration the necessity to increase the dose to obtain an effect equivalent to the original dose.

3. Dependence the altered physiological state brought which necessitates the continued use of the drug
to about by the repeated administration of the drug, avoid withdrawal syndrome.
What are the Group Classifications of Drug Abusers?
1. Situational Users - those who use drugs to keep them awake or for additional energy to perform an
important work. Such individual may or may not exhibit psychological dependence.

2. Spree Users - school age users who take drugs for "kicks', an adventurous daring experience, or as a
means of fun. There may be some degree of psychological dependence but little physical dependence
due to the mixed pattern of use.

3. Hard Core Addicts those, whose activities revolve almost entirely around the drug experience and
securing supplies. They show strong psychological dependence on the drug.

4. Hippies - those who are addicted to drugs believing that drug is an integral part of life.

DETECTION OF DRUG ABUSERS

Detecting a drug user is not an easy task. The signs and symptoms of drug abuse, especially in the
beginning stages can be identical to those produced by conditions having nothing whatsoever to do with
drugs.

It is always necessary to exercise certain prudence before drawing conclusions. Some judgments may
only hurt the individual; if he is innocent and one may lose his love and trust. Only after observing
calmly and patiently his behavior, appearance and associations, may one pass judgment and act.

To detect a drug abuser one should observe the following:

1. neglect of personal appearance

2. diminished drive, lack of ambition

3. reduced attention span

4. poor quality of school work

5. impaired communication skills

6. less care for the feeling of others, lessening of accustomed family warmth

7. pale face, red eyes, dilation or constricted pupils, wearing sunglasses at wrong places

8. change from active to passive and withdrawn behavior

9. secretive about money, disappearance of money and other valuables from the house

10.friends refusing to identify themselves or hang up when you answer the phone

11. over reaction to mild conditions

12.smell of marijuana, sweetish odor, like a burned rope in the clothes or room, etc.

13. symptoms of nausea, vomiting, diarrhea, tremors, muscular aches, insomnia and convulsions, etc.
14.presence of:

a. butt from marijuana joint

b. holders (i.e. pipe clips) for the joint

C. presence of leaves, seeds in pockets or lining

d. rolling paper, pipes, "bong" in closet or pocket

e. cough syrup bottles, capsules, syringes, etc.

f. visines or Eye-Mo bottles to treat red eyes

g. devices for hiding drugs like trash cans, soft drinks bottles

h. presence of other pills like valium, artane, other tranquilizers

i. presence of physician's prescription pad in blank form

IDENTIFICATION OF DRUG ABUSER

The following markers can help in identifying them:

1. Change in interest - they lose interest in their studies and in their work. They fail in school, shift from
one course to another, transfer of school of lower standard until eventually drop out.

2. Frequent shifting of mood - they are euphoric, elated and sometimes even ecstatic when under the
influence of drugs. They would be indifferent, irritable and even hostile when the effect of drug is
waning from the system.

3. Changes in behavior - they usually spend a lot. They are usually in the company of known drug users
in the community. They come home late; they become disrespectful and would sell personal or family
valuables.

4. Changes in physical appearance - if they can be seen while still under the influence of drugs the
following can be noted:

The following can also help in identifying drug abusers.

a. They know the lingo of the abusers, i.e. OMAD. Chongki, Bitin, etc.

b. Presence of linear scar in the arms, forearms and abdomen.

c. Lobule of left ear punctured and some of the males even wear earrings.

PROCESS OF DETECTING DRUG ABUSERS

The detection of drug abuse involves five processes namely:

a. Observation

b. History taking

c. Laboratory examination

d. Psychological examination

e. Psychiatric evaluation

1. OBSERVATION
Observations of the signs and symptoms of drug abuse may take relatively a long period of time. Good
sensory equipment and a high degree of objectivity are two requirements for a good observer. To be an
effective observer, the observer should not let his own personal judgements and reactions affect his
observations. He should exercise care in his observation such that the suspected drug abuser is not
made aware of being observed.

2. HISTORY TAKING
A. Collateral Information (Interview with information)

The best information is from the patient himself, but collateral information is necessary. Ideally, a
parent or close relative or a close friend should be present to furnish useful details as to the different
changes observed in the patient that made them suspect the subject is abusing drugs. These changes
may be in his appearance, behavior, mood, or interest.

Added information

1. If subject's "barkadas" are also known drug abusers in the community.

2. He knows the language of drug dependents.

3. Seeing in his room, books or in his belongings or in his possession empty bottles of cough syrups,
empty medicine foils, MJ sticks or rolling paper.

B. Interview with patient

Inquire regarding the drugs being abused, onset of his drug taking activity, reason for abusing drugs,
how he supports his vice, etc.

3. LABORATORY EXAMINATION
Accurate laboratory examinations cannot be performed requires sophisticated equipment and
apparatus, special by any ordinary chemist since detection of dangerous drugs chemical reagents and
most of all, the specialized technical know-how.

4. PSYCHOLOGICAL EXAMINATION
This phase of drug detection requires the expertise of trained psychologists. Teachers therefore are not
in a position to administer psychological examinations among their students. Psychological examination
findings will correspond to the general findings of a drug prone individual:

- drowsy or lethargic appearance accompanied by scratching and without alcoholic breath, tendency to
giggle excessively at things which others don't consider funny, and over-active and over-talkative

5. PSYCHOLOGICAL TESTS
a. Intelligence Test - the test is designed to cover a wide variety of mental functions with special
emphasis on adjustment comprehension and reasoning.

b. Personality Test - this type of test is used to evaluate the character and personality traits of an
individual such as his emotional adjustment, interpersonal relation, motivation and attitude.

c. Aptitude Test - this test is to measure the readiness with which the individual increases his
knowledge and improves skills when given the necessary opportunity and training.

d. Interest Test - this is designed to reveal the field of interest that a client will be interested in.

e. Psychiatric Evaluation - it is a process whereby a team of professionals composed of psychiatrists,

psychologists, psychiatric social workers conduct an examination to determine whether or not a patient
is suffering from psychiatric disorder.

Practical Ways of Recognizing the Drug Addict

A drug abuser will do everything possible to conceal his habit. To be able to recognize the outward signs
and symptoms, it is equally important to realize that the drug problems are so complex. Even expert
advice not to judge abruptly an individual taking narcotics drug as it could lead to falsely accusing an
innocent person.

It should also be remembered that a person might have a legitimate reason for possessing a tablets,
syringe and needle (may be a diabetic) having capsules (they may prescribe by doctor). Having the
sniffles and running eyes may due to head cold or an allergy. Unusual or add behavior may not be
connected in any way with drug use.
Based on the lecture of U.S experts doctor of medicine, Forensic chemist at the London International
Police academy usually detect drugs abusers without too much trouble by means of the following:

1. Presence of drug on the person - which he may try to conceal.

2. Presence of equipment for smoking, drinking or injection of drugs.

3. Presence of hypodermic needle marks or tracks on arms and on various parts of the body.

4. Drug test on blood and Urinalysis

5. Drug intoxication in the absence of alcoholic smell. It is indicated by:

a. dilation or contraction of the pupils

b. unsteady gait and incoherent speech

c. loose mental processes, drowsiness and itching

d. tendency to laugh at trivial

e. Withdrawal symptoms

6. Nalline test indicates an opiate addict.

- A small dose (3 mg.) of nalline is injected into the body of the suspect. The size of the pupil of the
suspect is measured before and after the injection. An addict will show appreciable dilation of the pupil.
The drug has practically no effect on non- addicts.
Actual Outward Physical Signs/ Symptoms of Drug Abusers:

The actual profile of an abuser of narcotic drugs may show some of the following manifestations.

1. Admission of the addict himself.

2. Consistently wear long-sleeved shirt or blouses, dark eyeglasses unlikely times to hide dilated or
constricted pupils of eyes.

3. Blood spots around elbow areas of blouses shirt or pajamas.

4. Walk, talk and act as if under alcoholic influence.

5. Prolonged period of sleep or lethargy, abnormal sleepless, nervous, jumpy and talkative.

6. School works deteriorates (grades and homeworks)

7. Work habits, become slip-shod, too many emotional explosions, loss body weight., abnormal bowel
habits, blood-shot eyes.

8. Sloppy in dress and careless in bodily hygiene, inordinate desire for consumption of sweets. Unusual
odor in the house or room (marijuana, hash, or incense)

9. Develop defiant or contemptuous attitudes towards authority (Parents, Teachers, Police, Etc.)
constant demand for ever-increasing amount of money.

10. Takes money from everyone and fails to repay, steel and sells all possible items of value from home
or elsewhere when opportunity comes.

11. Receives or makes numerous phone calls to people who are unknown in the house. Associates only
with people who have the reputation for playing with using drugs.

12. Persistently lies when asked to explain in expected knock on the door.

13. Unrealistic attitudes, having difficult of concentration.

The Personality Profile of a Filipino Drug Abuser

1. They are of average or above average intelligence

2. They are witty and manipulative

3. They have negative attitudes, they demonstrate hostile feelings to the world or to anybody who does
not want to conform to what they want.
4. They are emotionally immature, selfish and demanding.

5. They want immediate gratification of needs and desires.

6. They have low frustration tolerance.

7. Their interest and aptitude are persuasive and musical field in that order. on dramatics,

8. They are depressed and excessively dependent.

9. They are rebellious and have impulsive behavior.

10. They are pleasure seeker and pathologically liars

11. They like to join anti social groups/ delinquent groups.

12. They have difficulty in solving problems.

END OF CHAPTER 1