Professional Documents
Culture Documents
PRESENTED BY DR .SHEFALI
RANA
MD 1ST YEAR
DRAVYAGUNA DEPTT.
RGPGGAC, PAPROLA
General introduction
What is drug ?
• Any substance, when taken into living
body may modify one or more of its
function.
• In other word, a pharmaceutical
preparation or a naturally occurring
substance used primarily to bring
about any change in existing process
or state (physiological, psychological
or biochemical) is called – DRUG
• An overdose of any drug may lead to
death.
Term related to drug
• Hard drug (lead to severe physical
addiction / dependence) :
Drug that is generally considered to be
more dangerous, with higher risk of
dependence that soft drugs.
Eg. Heroin, cocaine, methamphetamine etc.
Curiosity
Low- self esteem
Peer - pressure
Adult modelling
Boredom
Relief of discomfort
Depression, anxiety, stress
Family dysfunction
Unemployment
Mental conditions
Life events
Family and social environment disturbance
Poverty
Neglected children
Lack of education
STAGES OF DRUG ABUSE / DEPENDENCE
STAGES OF DRUG ABUSE / DEPENDENCE:
• Stage 1 : Experimentation
1. Here Curiosity is the motivator.
2. Experimentation is defined as the voluntary use of drugs without experiencing any
negative social or legal consequences.
3. For many , experimentation may occur once or several times as a way to “ HAVE
FUN” OR may occur without any desire to continue using the drug.
4. But for other, it can start to become a problem when it moves into the next stage.
• Stimulant
• Depressant
• Cannabinoids
• Hallucinogen
• Inhalants
• Narcotics
Stimulants
• Stimulants are the drugs which excite or speed up/ stimulate the central nervous system.
• DRUGS –
I. Cocaine
II. Amphetamine
III. Methamphetamine
• EFFECTS –
I. Restlessness
II. Headache
III. Increased energy
IV. Sense of power
V. Give rise to alertness
VI. Blurred vision
VII. Confusion and impaired judgment
VIII. Reduced appetite
IX. Increased appetite
X. Elevated BP with dilated pupil
XI. Very rapid or irregular heart rate
XII. Collapse
XIII. Even death COCAINE
Depressant
• Depressant are the drugs which depress or slow down the functions
of central nervous system.
• DRUGS –
I. Barbiturates
II. Benzodiazepine
III. Tranquilizer
IV. Alcohol
• EFFECT- 1. Barbiturates
• Route of drug administration is a method in which a drug is taken into body. It can split into
three categories :
1. Oral route
2. Parental route
3. Inhalation route
Oral route :
In form of pills or drinks.
Is one of the simplest way.
It allow the drug to move onto the stomach through mouth where they are absorbed by
stomach lining and then enter the blood steam.
May cause ulcers in mouth and stomach, dental decay and malnutrition.
Parental route :
It includes various types of injection like subcutaneous,
intravenous and intramuscular.
Here drugs being injected directly into the blood stream.
The peripheral vein in arm, hands, legs and sometimes
abdomen , groin or neck are damaged.
It may produce thrombosis, phlebitis , gangrene,
cellulitis, skin abscess, septicaemia and pulmonary
embolism.
Shared syringe and needles can transmit hepatitis B and
C, HIV , syphilis and malaria.
Physical warning :
Bloodshot eyes
Pupils larger or smaller than usual
Changes in appetite or sleep patterns
Sudden weight loss or weight gain
Deterioration of physical appearance
Unusual smells on breath
Impaired coordination
Cold/bluish fingers
Needle marks on his arms
Puffy eyelids
Sleeping problems
Excessive sweating and increased heart rate
Suicide attempt
Behavioural warning :
Poor work
Decline in performance
Financial problems
Secretive or offensive behaviour
Lack of motivation
Unexplained anxiety
Impulsiveness
Aggressiveness
Mood swings
Drug testing
Drug testing
• There are different types of drug test like :
1. Blood sample testing
2. Urine sample testing
3. Saliva testing
4. However, drug may be test using stomach
content that are obtained through gastric
lavage or after vomiting.
• URINE DRUG TESTING :
Is most common method of all above
Here the urine is use to detect the trace of
drug.
Drug concentrations are higher in urine than in
blood – so it is easier to detect.
Detection periods typically 1-3 days
• SALIVA TESTING :
Is less invasive
Detection period from hours to 1-2 days
One study reports that saliva testing can only detect cannabinoids when subjects
have smoked cannabis only 4-10 hrs beforehand.
• BLOOD TESTING :
Is most expensive and invasive testing methods
It actually detects right at the time of testing the presence of substance and its
metabolites in the blood.
The actual amount of drugs in the blood at the time of test can also be measured
by a blood drug test.
However , its cost make it used less frequently.
Detection period: 0-2 days for most drugs.
• How long after usage of drug can be detected ?
• METHODS OF MANAGEMENT :
1. Pharmacotherapy
2. Behaviour therapy
3. Family therapy
4. Group therapy
5. Psychotherapy
6. Motivational enhancement therapy (MET)
Pharmacotherapy :
• GOAL:
1. To prevent withdrawal symptoms
2. To reduce drug cravings
3. To normalize any physiological functions disrupted by drug abuse
• Alcohol :-
Drug of choice are BENZODIAZEPINE
1. Chlordiazepoxide – 80-200 mg/day
2. Diazepam – 40-80 mg/day
Vit B complex is also added
For craving – naltrexone are used.
• Opioids : -
Here drug which are use for detoxification are –
1. Methadone – 25-50mg BD daily
2. Clonidine – 0.3 – 1.2 mg daily along with NALTREXONE
• Cocaine : -
Bromocriptine and amantadine are use for reducing craving.
• Other drugs :
1. Mood stabilising drug – Lithium, valproate and carbamazepine.
2. Antidepressant drug - amitriptyline and imipramine
3. Antipsychotic drug – chlorpromazine and clozapine
4. And for other symptoms – give symptomatic treatment
Behavioural therapy:
It is based on theories of learning and aims at changing
maladaptive behaviour and substituting it with adaptive behaviours.
Family therapy :
This is not an individual based therapy but is a family based
approach in which family act as a unit.
It include –
Problem solving
Training in communication skill
Home assignment etc
Psychotherapy :
This therapy help to remove, modify or retard existing
symptom.
And promote positive personality growth and
development.
And also help in correcting the disturbed pattern of
behaviour.
Group therapy :
It is a type of psychotherapy in which a group of 8-10
person can be treated at one time.
It provide the patient and their relative a platform to
share problem with other which are very similar in
nature and to make them realise that they are not
alone in their suffering.
Motivational enhancement therapy :
It is a counselling approach that help the individual to resolve their ambivalence
about engaging in treatment and stopping their drug use.
This approach has been used successfully with people addicted to alcohol to both
improve their engagement in treatment and reduce their drinking problem.
MET has also been used successfully with marijuana dependent adult when
combined with cognitive behavioural therapy, constituting a more comprehensive
treatment approach.
Thank you !!