Chapter 9 Drug Abuse

Intended Learning Outcomes: At the end of this chapter, the students are expected to:

1. analyze the types of drug abuse;

2. examine the causes and effects of drug abuse;
3. use effective solutions to control and prevent drug abuse; and
4. compare drug abuse and drug addiction.

9.1 Drug Use and Drug Addiction

Drug use (or misuse) includes the following

1. Using illegal substances, such as anabolic steroids, club drugs, cocaine, heroin,
inhalants, marijuana, and methamphetamines.
2. Misusing prescription medicines, including opioids. This means taking the
medicines in a different way than the health care provider prescribed. This
includes:
- Taking a medicine that was prescribed for someone else.
- Taking a larger dose than you are supposed to.
- Using the medicine in a different way than you are supposed to. For
example, instead of swallowing your tablets, you might crush and then
snort or inject them.
- Using the medicine for another purpose, such as getting high
3. Misusing over-the-counter medicines, including using them for another purpose
and using them in a different way than you are supposed to.
Drug use is dangerous. It can harm your brain and body, sometimes permanently. It
can hurt the people around you, including friends, families, kids, and unborn babies.
Drug use can also lead to addiction (National Library of Medicine [NLM], 2021).
Drug addiction, also called drug ause, substance
abuse and substance use disorder, is a chronic disease
that affects a person's brain and behavior and leads to
an inability to control the use of a legal or illegal drug or
medication. Substances such as alcohol, marijuana and
nicotine are also considered drugs. When a person is
addicted, s/he may continue using the drug despite the
harm it causes. Repeated drug use can change the brain
and lead to addiction. The brain changes from addiction can be lasting, so drug addiction
is considered a "relapsing" disease. This means that people in recovery are at risk for
taking drugs again, even after years of not taking them (NLM, 2021).
Drug addiction can start with experimental use of a recreational drug in social
situations, and, for some people, the drug use becomes more frequent. For others,
particularly with opioids, drug addiction begins with exposure to prescribed
medications, or receiving medications from a friend or relative who has been prescribed
the medication.
 Not everyone who uses drugs becomes addicted. Everyone's bodies and brains
are different, so their reactions to drugs can also be different. Some people may
become addicted quickly, or it may happen over time. Other people never become
addicted. Whether or not someone becomes addicted depends on many factors. They
include genetic, environmental, and developmental factors (NLM, 2021).
Moreover, the risk of addiction and how fast you
become addicted varies by drug. Some drugs, such as
opioid painkillers, have a higher risk and cause addiction
more quickly than others. As time passes, a person may
need larger doses of the drug to get high. Soon s/he may
need the drug just to feel good. As his/her drug use
increases, s/he may find that it's increasingly difficult to
go without the drug. Attempts to stop drug use may
cause intense cravings and make the person feel
physically ill (withdrawal symptoms).

❖ Symptoms of Drug Addiction

Drug addiction symptoms or behaviors include, among others:
• Feeling that you have to use the drug regularly —
daily or even several times a day
• Having intense urges for the drug that block out
any other thoughts
• Over time, needing more of the drug to get the
same effect
• Taking larger amounts of the drug over a longer
period of time than you intended
• Making certain that you maintain a supply of the drug
• Spending money on the drug, even though you can't afford it
• Not meeting obligations and work responsibilities, or cutting back on social or
recreational activities because of drug use
• Continuing to use the drug, even though you know it's causing problems in your
life or causing you physical or psychological harm
• Doing things to get the drug that you normally wouldn't do, such as stealing
• Driving or doing other risky activities when
you're under the influence of the drug
• Spending a good deal of time getting the drug,
using the drug or recovering from the effects of
the drug
• Failing in your attempts to stop using the drug
• Experiencing withdrawal symptoms when you
attempt to stop taking the drug.

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9.2 Types of Drug Abuse

According to the National Institute on Drug Abuse (2012), the following are
commonly abused substances:

CATEGORY AND NAME DESCRIPTION

1. Tobacco (Nicotine) Nicotine is a highly addictive chemical found in cigarettes,
chewing tobacco and vaping products. Nicotine is the main
reason why it is so hard to quit smoking. After nicotine is
absorbed into the bloodstream, it makes its way to the
brain. Within seconds of inhaling cigarette smoke or vape
mist, or using chewing tobacco, nicotine causes the release
of dopamine in the brain, which gives people a good feeling
(Government of Northwest Territories, n.d.).
2. Alcohol Alcohol is addictive for these reasons:
• Physical factor: Drinking alcohol stimulates the
release of dopamine and endorphins within the
brain. These are the chemicals that produce feelings
of pleasure and satisfaction and act as a natural
painkiller.
• Psychological factors like not believing in treatment
of alcoholism, developmental maturity, stress
(Recovery Center of America, n.d.)
3. Cannabinoids People use cannabinoids by smoking, eating or inhaling a
(Marijuana, Hashish) vaporized form of the drug. Cannabis often precedes or is
used along with other substances, such as alcohol or illegal
drugs, and is often the first drug tried.
4. Opioids Opioids are a class of drugs that derive from, or mimic,
(Heroin, Opium) natural substances found in the opium poppy plant.
Opioids work in the brain to produce a variety of effects,
including pain relief. Examples of opioids include morphine,
heroin, codeine, oxycodone, hydrocodone and fentanyl
(John Hopkins Medicine, n.d.).
5. Stimulants (Cocaine, They are often used and misused in search of a "high," or to
Amphetamine, boost energy, to improve performance at work or school,
Methamphetamine) or to lose weight or control appetite.
6. Club drugs These are commonly used at clubs, concerts and parties.
Examples include ecstasy or molly, gamma-hydroxybutyric
acid (GHB), flunitrazepam (also called roofie) and ketamine.
These drugs are not all in the same category, but they share
some similar effects and dangers, including long-term
harmful effects.
Because GHB and flunitrazepam can cause sedation,
muscle relaxation, confusion and memory loss, the
potential for sexual misconduct or sexual assault is
associated with the use of these drugs.
7. Dissociative drugs Dissociatives (also referred to as 'dissociative anaesthetics')
are a class of psychedelic drug. This class of drug causes
people to feel separated or detached from their body or
physical environment. Dissociatives can also cause
hallucinations and other changes in thoughts, emotions
and consciousness (Alcohol and Drug Foundation, n.d.).
8. Hallucinogens
9. Prescription
Medications
10. Other Compounds
Use of hallucinogens can produce different signs and
symptoms, depending on the drug. The most common
hallucinogens are lysergic acid diethylamide (LSD) and
phencyclidine (PCP) which may cause:
• Hallucinations
• Greatly reduced perception of reality, for example,
interpreting input from one of your senses as
another, such as hearing colors
• Impulsive behavior
• Rapid shifts in emotions
• Permanent mental changes in perception
• Rapid heart rate and high blood pressure
• Tremors
• Flashbacks, a re-experience of the hallucinations —
even years later
Prescription medications include central nervous system
(CNS) depressants (e.g. sedatives, hypnotics like sleeping
medications), stimulants, opioid pain relievers. They're
often used and misused in search for a sense of relaxation
or a desire to "switch off" or forget stress-related thoughts
or feelings.
These include anabolic steroids and inhalants (e.g. solvents,
gases, nitrites, laughing gas, etc.).

9.3 Causes and Effects of Drug Abuse

❖ Causes
The cause of drug abuse is not known, nor is it understood why some people
can abuse drugs briefly and stop without difficulty, whereas others continue using
drugs despite undesirable consequences. Biological factors, such as genetics and the
presence of other psychiatric disorders, may play a role, as may environmental
factors, such as peer pressure, history of abuse, and stress, and developmental
factors, such as the timing of drug exposure (“Drug Abuse,” n.d.).
Sometimes it is difficult to distinguish normal teenage moodiness or angst
from signs of drug use. Possible indications that a teenager or other family member
is using drugs include:

1. Problems at school or work — frequently missing school or work, a sudden

disinterest in school activities or work, or a drop in grades or work
performance
2. Physical health issues — lack of energy and motivation, weight loss or gain,
or red eyes
3. Neglected appearance — lack of interest in clothing, grooming or looks
4. Changes in behavior — exaggerated efforts to bar family members from
entering his or her room or being secretive about where he or she goes with
friends; or drastic changes in behavior and in relationships with family and
friends

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 5. Money issues — sudden requests for money without a reasonable
explanation; or your discovery that money is missing or has been stolen or
that items have disappeared from your home, indicating maybe they're being
sold to support drug use

❖ Effects
According to Eske (2020), abusing a drug, or misusing a prescription medication,
can produce other short-term effects, such as:
- changes in appetite
- sleeplessness or insomnia
- increased heart rate
- slurred speech
- changes in cognitive ability
- a temporary sense of euphoria
- loss of coordination

Drug abuse can affect aspects of a person’s life beyond their physical health.
People with substance use disorder, for example, may experience:
- an inability to cease using a drug
- relationship problems
- poor work or academic performance
- difficulty maintaining personal hygiene
- noticeable changes in appearance, such as extreme weight loss
- increased impulsivity and risk-taking behaviors
- loss of interest in formerly enjoyable activities

Drug abuse, especially over an extended period, can have numerous long-term
health effects. Chronic drug use can alter a person’s brain structure and function,
resulting in long-term psychological effects, such as:
- depression
- anxiety
- panic disorders
- increased aggression
- paranoia
- hallucinations
Long-term drug use can also affect a person’s memory, learning, and concentration. The
long-term physical effects of drug use vary depending on the type of drug and the
duration of use. However, experts have linked chronic drug use with the following
health conditions:
1. Cardiovascular disease
Stimulants, such as cocaine and methamphetamines, can damage the
heart and blood vessels. The long-term use of these drugs can lead to coronary
artery disease, arrhythmia, and heart attack.

2. Respiratory problems

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 Drugs that people smoke or inhale can damage the respiratory system
and lead to chronic respiratory infections and diseases. Opioids slow a person’s
breathing by binding to specific receptors in the central nervous system that
regulate respiration. By depressing a person’s respiration, these drugs can lead
to slow breathing or heavy snoring. A person may stop breathing entirely if they
take a large dose of an opioid or take it alongside other drugs, such as sleep aids
or alcohol.

3. Kidney damage
The kidneys filter excess minerals and waste products from the blood.
Heroin, ketamine, and synthetic cannabinoids can cause kidney damage or
kidney failure.

4. Liver disease
Chronic drug and alcohol use can damage the liver cells, leading to
inflammation, scarring, and even liver failure.

5. Overdose
Taking too much of a drug or taking multiple drugs together can result in
an overdose. According to the Centers for Disease Control and Prevention (CDC),
drug overdose caused 67,367 deaths in the United States in 2018. Opioids
contributed to nearly 70% of these deaths.

9.3 Measures to Prevent and Control Drug Abuse

The following are measures to prevent and control drug abuse.

❖ Prevention
The following are prevention tips cited by Prairie View A&M University (n.d.):
1. Understand how substance abuse develops. Substance abuse starts by:
- Using addictive drugs (illicit or prescribed) for recreational purposes
- Seeking out intoxication every time you use
- Abusing prescription medication

2. Avoid Temptation and Peer Pressure. Develop healthy friendships and

relationships by avoiding friends or family members who pressure you to use
substances. It’s often said “we become most like those we surround ourselves
by,” meaning if you surround yourself with people who abuse drugs and alcohol
you are more likely to as well. Peer pressure is a major part of life for teens and
adults. If you are looking to stay drug free develop a good way to just say no,
prepare a good excuse or plan ahead of time to keep from giving into peer
pressure.

3. Seek help for mental illness. Mental illness and substance abuse often go hand
in hand. If you are dealing with a mental illness such as anxiety, depression or
post-traumatic stress disorder you should seek professional help from a licensed
therapist or counselor. A professional will provide you with healthy coping skills
to alleviate your symptoms without turning to drugs and alcohol.

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 4. Examine the risk factors. Look at your family history of mental illness and
addiction, several studies have shown that this disease tends to run in the family,
but can be prevented. The more you are aware of your biological, environmental
and physical risk factors the more likely you are to overcome them.

5. Keep a well-balanced life. People often turn to drugs and alcohol when
something in their life is missing or not working. Practicing stress management
skills can help you overcome these life stressors and will help you live a balanced
and healthy life. Develop goals and dreams for your future. These will help you
focus on what you want and help you realize that drugs and alcohol will simply
get in the way and hinder you from achieving your goals.

❖ Treatment
Anyone providing drug addiction treatment should tailor it to suit a person’s
individual needs to ensure that it is effective. Treatment may involve some of the
following components:
1. Behavioral therapy, which helps people build positive coping strategies and
develop problem-solving skills.
2. Group therapy, which gives people the chance to acknowledge, share, and work
through the psychological aspects of recovery with a group of peers under
professional guidance.
3. Medications to help minimize withdrawal symptoms.
4. Additional medical care, which may include vocational training and other
resources that address problems associated with chronic drug abuse, such as
mental health conditions, unemployment, and medical conditions.

Treatment of drug abuse is often an extended process involving multiple

components including:
✓ Cognitive behavioral therapy to work on thought patterns and behavior
✓ Family therapy to help the family understand the problem and to avoid
enabling drug use
✓ Identification and treatment of coexisting conditions
✓ Medications to decrease cravings, block withdrawal symptoms, counteract
drug effects, or to cause unpleasant side effects if a drug is used
✓ Motivational incentives to reinforce abstinence
✓ Motivational interviewing to utilize a person’s readiness to change behaviors
✓ Rehabilitation to assist those with severe addiction or coexisting mental
illness through the initial stages of quitting
✓ Supervised withdrawal (detoxification) to prevent, recognize and treat
physical symptoms of withdrawal
✓ Support groups

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