CHAPTER 6

DRUG DEPENDENCE

ST. JOSEPH COLLEGE OLONGAPO CITY INC.

MS. KATHRYN JOY G MIRANDA
Introduction

 Drug dependence is an adaptive state that develops from repeated

drug administration, and which results in withdrawal upon
cessation of drug use. Drug addiction is a distinct concept from
substance dependence, and it is classified as compulsive, out-of-
control drug use, despite negative consequences.
Introduction

 This is due to the addictive drug as a drug which is both rewarding

and reinforcing. FosB or Delta FosB, a gene transcription factor, is
now known to be a critical component and common factor in the
development of virtually all forms of behavioral addiction and drug
addictions, but not dependence.
What is Drug?

Drug is any chemical substance which by virtue of its

chemical nature, alters the structure and functioning of
a living organism or in its broadest term, is a chemical
substance that has known biological effects on
humans or other animals.
History of Drug Abuse

 The use of chemical substance that alters physiological and psychological functioning
dates back to the Old Stone Age. Egyptian relics from 3500 BC depicted the use of
opium in religious rituals. By 1600 BC, an Egyptian reference work listed opium as an
analgesic, or painkiller. The Incas of South America were known to have used cocaine
for at least 5000 years ago. Cannabis, the hemp plant from which marijuana and hashish
are derived, also has a 5000-year history.
 Since antiquity, people have cultivated a variety of drugs for religious, medicinal, and
social purposes. By the nineteenth century, the two components of opium, which derived
from the sap of opium poppy, were identified and given names as , “morphine” and
“codeine”.
History of Drug Abuse

 Ignorant of the addictive properties of these drugs, physicians used them to treat a
wide variety of human illness. So great was their popularity that they found their
way into almost all patent medicines used for pain relief and were even
incorporated in soothing syrup for infants and young children.

 During World Wars I & II, the use of injectable morphine to ease the pain of
battle casualties was so extensive; thus causing addiction among veterans, and
came to be known as “the soldier’s disease.” By that time, the medical
professional and the public recognized how addictive morphine was, and its use
had reached epidemic proportions.
History of Drug Abuse

 Then in 1898, the Bayer Drug Company in Germany introduced a new opiate,
supposedly a non-addictive substitute for morphine and codeine. It came out
under the trade name heroin, yet it provided to be even more addictive than
morphine.
 When cocaine, which was isolated from the coca leaf in 1869, appeared on the
international drug scene, it too was used for medicinal purposes. Its popularity
spread and soon it was used in other products, a variety of gin tonics, and the
most famous all, Coca-Cola, was made with coca until 1903.
History of Drug Abuse

 Abuse of marijuana use began to arouse public concern during the 1930s in other
foreign countries. Because marijuana use was associated with groups outside the
social mainstream, such as petty criminals, jazz musicians, bohemians, and
members of the disadvantaged sector of the society, a public outcry for its strict
regulation arose.
 Despite the legislation of the law, the popularity of marijuana continued. As the
drugs that were being abused proliferated to include glue, tranquilizers, such as
Valium and Librium, LSD, amphetamines, and many others, the public became
increasingly aware of the dangers of drug abuse.
Are All Drugs Harmful?

 Any drug may be harmful when abused. The fact that many drugs will produce
beneficial results has led some people to feel that it will solve all problems. Drugs
that affect the mind can have subtle or obvious side effects which can be
immediate or may only become evident after long continuous use.
 Drugs are dangerous and can seriously damage the health or kill the use. Drug
abuse can damage the person’s ability to live a normal life. However, if someone
is taking dangerous drugs, do not think that there is no help available; it is best
for them to talk to a parent, teacher or guidance counselor who will be able to
help.
Are All Drugs Harmful?

 There are drugs that are taken as medicines but certain drugs are taken
not as medicine but to satisfy a craving or a strong desire and taking
dangerous drugs becomes an ingrained habit. These habit-forming
dangerous drugs have brought misery to millions of people in all parts
of the globe.
Seven Categories of Drugs

1. Herbal Drugs
2. Over-the-Counter Drugs
3. Prescription Drugs
4. Unrecognized Drugs
5. Illicit Drugs
6. Tobacco
7. Alcohol
Seven Categories of Drugs

The seven categories of drugs are as follows:

1. Herbal Drugs. These are plant substances that have drug effects and
whose use is not generally regulated by law. These substances generally
require little processing after the plants are gathered or harvested, usually
washing and boiling. Although they may be processed or sold
commercially, it is possible for the consumer to prepare the drug for use it
can be grown locally.
Seven Categories of Drugs

2. Over-the-Counter Drugs. These are commercially produced drugs that may be

purchased legally without prescription. These drugs are also known as propriety
drugs. They are safe and effective when you follow the directions on the label and
as directed by the health care professionals.
3. Prescription Drugs. These are commercially produces drugs that can be legally
sold or dispensed only by a physician or on a physician’s order. They are like over-
the-counter drugs for they are manufactured by pharmaceutical companies, but they
differ, because the decision to use drugs is legally vested in a licensed physician, not
in the patients or drug user.
Seven Categories of Drugs

4. Unrecognized Drugs. These are commercial products that have psychoactive

drugs effects but are not usually considered drugs. These substances are not
generally regulated by law except insofar as standards of sanitation.
5. Illicit Drugs. These are drugs whose sale, purchase or use is generally
prohibited by the comprehensive dangerous drugs law. Criminal penalties
usually apply to violators of these laws. They include narcotic drugs, such as
cocaine, amphetamines, heroin, and hallucinogens.
Seven Categories of Drugs

6. Tobacco. It is not generally considered a drug and thus can be classed as

unrecognized drug. However, tobacco holds a distinct position in terms of usage
patterns, economic importance and health consequences that it merits a category
to itself.
7. Alcohol. Is also seemed to merit its own category, although it too could be
included in the unrecognized drugs. Alcohol, in form, such as beer, wine, and
distilled liquor, is one of the most widely used drugs in our society. It is regarded
by many experts as the most commonly abused drug in our society.
Pharmacological Types of Drugs

1. Stimulants
2. Depressants
3. Narcotics
4. Hallucinogens
Pharmacological Types of Drugs

1. Stimulants. These are drugs which increase alertness,

reduce hunger and provide a feeling of well-being. Cocaine
and amphetamines are the most common stimulants.
2. Depressants. They are drugs which decrease body functions
and nerves activities, and they include sedatives, hypnotics
and tranquilizers. They are referred to as “downers” as they
lower the level of arousal when taken.
Pharmacological Types of Drugs

3. Narcotics. They are drugs which produce insensitivity, stupor,

melancholy or dullness of mind with delusions. Opium, heroin,
codein, and morphine are the most popular of narcotics.
4. Hallucinogens. They are drugs capable of provoking sensation,
thinking, self-awareness and emotions, and alteration of time and
space perception, illusions, hallucinations and delusions. They may
be minimal or overwhelming depending on the doses. LSD,
marijuana and mescaline are the most popular hallucinogens.
Routes of Drug Administration

1. Oral Ingestion
2. Inhalation
3. Injection
a. Subcutaneous (SC)
b. Intramuscular (IM)
c. Intravenous (IV)
4. Snorting
5. Buccal
6. Suppositories
Routes of Drug Administration

1. Oral Ingestion. The drugs are taken by mouth and must pass
through the stomach before being absorbed into the bloodstream.
This is one of the most common ways of taking a drug.
2. Inhalation. Drug in gaseous form enter the lungs and is quickly
absorbed by the rich capillary system. It is probably the second most
commonly used route of drug administration.
Routes of Drug Administration

3. Injection. The drug can be administered into the body by the use of syringe and
hypodermic needle in the following ways.
a. Subcutaneous (SC). Drug is administered by injecting it just below the surface of the skin. This
is sometimes called “skin popping”. It is highly effective in administering vaccines and
medications.
b. Intramuscular (IM). Administration involves the injection of a drug into a large muscle mass
that has a good blood supply, such as the gluteus maximus, quadriceps, or triceps.
c. Intravenous (IV). This is the most efficient means of administration which involves depositing
drug directly into the bloodstream. This is also the most rapid method of drug administration.
Routes of Drug Administration

4. Snorting. This is inhalation through the nose of drugs not in gaseous form. It is
sometimes inhaling a powder of liquid drug into the nose coats of the mucous
membrane.
5. Buccal. The drug is administered by placing it in the buccal cavity just under
the lips and the active ingredients of the drug will be absorbed into the
bloodstream through the soft tissues lining of the mouth.
6. Suppositories. The drug is administered through the vagina or rectum in
suppository form and absorbed into the bloodstream.
Motivating Factors of Drug Use

1. Increased Enjoyment of Activities

2. Attain some degree of euphoria
3. As means of social lubricant
Motivating Factors of Drug Use

1. Increased Enjoyment of Activities. Enjoyment is a word

for the pleasure that comes from enjoyable activities.
However; some people get enjoyment from using dangerous
drugs without their knowing that they bring no enjoyment
in their lives; instead they bring miseries as consequences
of the concomitant effect to their persons, mentally and
physically.
Motivating Factors of Drug Use

2. Attain Some Degree of Euphoria. Technically, euphoria is a psychological effect and

the term is often colloquially used to define emotion and an intense state of transcendent
happiness combined with an overwhelming sense of contentment. It has also been
defined as an “affective state of exaggerated well-being or elation,” or an emotional and
mental state defined as a sense of great happiness and well being.
3. As Means of Social Lubricant. A social lubricant is any food, beverage, drug or
activity that helps people feel more comfortable on social occasions. Different cultures
use different social lubricants for this purpose. Some common social lubricants are
alcoholic beverages, coffee, tea, tobacco, and the worst is the use of dangerous drugs.
Varied Levels of Drug Taking

1. Drug Use. When the effects of a drug sought can be realized with minimal
hazard, whether or not used therapeutically, legally or as prescribed by a
physician.
2. Drug Misuse. It occurs when a drug is taken or administered under certain
circumstances and a dose that significantly increases the hazard to the individual
or to others.
3. Drug Abuse. It occurs when the drug is taken under certain circumstances and at
a dose that significantly increases their hazard or potential, whether or not used
therapeutically.
General Patterns of Drug Taking

1. Social-Recreational Use
2. Circumstantial-Situational Use
3. Experimental Use
4. Intensified Use
5. Compulsive Use
General Patterns of Drug Taking

1. Social-Recreational Use. Very similar to experimental use, the taking of drugs occurs
within social settings and is motivated by a desire to share pleasurable experiences
among friends. Although this type of drug-taking tends to escalate to other patterns of
uses, it is more patterned on experimental use.
2. Circumstantial-Situational Use. It is drug taking on a short-term basis as a way of
coping with some immediate distress or pressure. The use is using the drug based on the
circumstance or situation that will take place in his or her life.
General Patterns of Drug Taking

3. Experimental Use. It implies a short-term use at one or a variety of drugs, either singly
or in a combination, curiosity desire to experience something new, or peer group
pressure are the major motivations for experimental drug use.
4. Intensified Use. This implies the regular and long-tern consumption of a drug or series
of drugs by an individual to achieve relief from persistent problem or stressful situation
on his desire to maintain a certain self-prescribed level of performance.
5. Compulsive Use. It is characterized by diminished social integration and functioning, it
has escalated to the point where a reduction in the intensity or frequency will be
accompanied by increasing discomfort on the part of the individual.
Social Factors in Drug Taking

1. Ideology
2. Information
3. Opportunity
4. Example
Social Factors in Drug Taking

1. Ideology. Participation in drug-using groups provides

supporting ideologies that neutralize some of the negative
opinions and attitudes surrounding illicit drug use and
provides positive reinforcement and justification for drug
taking behavior.
2. Information. Friends or relatives, or even the various forms
of media may offer information on situations in which
certain substances may be used for specific purpose.
Social Factors in Drug Taking

3. Opportunity. The more people there are in the environment who use
drugs on a regular basis, the more likely that opportunity to use them
will arise at times when individual may not otherwise have thought
of consuming a drug and that they will discover more sources of
illicit drugs.
4. Example. The occasional user may learn by watching the behavior
of peers, what situation is appropriate for certain kinds of drug use
and what level of use can be deemed excessive.
What is the Term Dependence?

Originally, the tern used popularly to described dependence on drug was

“drug addiction”. This term has been replaced by the World Health
Organization (WHO) with the term drug dependence.
Drug dependence is an adaptive state that develops from repeated drug
administration, and which results in withdrawal upon cessation of drug use.
Drug addiction is a distinct concept from substance dependence, and it is
classified as compulsive, out-of-control drug use, despite negative
consequences.
What is Drug Dependence?

Drug dependence is a state of psychic or physical dependence

or both on a drug arising in a person following the
administration of drug on a periodic or continuous basis. Over
the long term, this dependence results in physical harm,
behavior problems, and association with people who also abuse
drugs.
What is Physical Dependence?

Physical dependence is a result when a drug has been used for a long
period of time, and is only identified when a characteristic withdrawal or
abstinence syndrome occurs after its use is discontinued, and where
negative physical symptoms of withdrawal result from abrupt
discontinuation or dosage reduction.
What is Psychological Dependence?

Psychological dependence refers to a state in which an individual has a

compulsion to take a drug, but one in which there may not be a physical
dependence. It is a form of drug dependence that involves emotional-
motivational withdrawal symptoms upon cessation of drug use or
engagement in certain deviant behaviors.
What is Drug Habituation?

Drug habituation is a condition resulting from the repeated

consumption of a drug. It is also defined as a process that decreases a
behavioral response to a recurring stimulus, and there is an additional
connotation to the term habituation which applies to drugs and habits.
Drug Habituation

The characteristics of drug habituation are as follows:

1. A desire but not compulsive to continue taking the drug for the sense of
improved well-being it engenders;
2. Some degree of psychic dependence on the effect of drug but absence of
physical dependence and hence, of abstinence syndrome;
3. Little or no tendency to increase dose; and
4. Detrimental effect if any, primarily on the individual.
What is Drug Addiction?

Drug addiction is a state of periodic or chronic intoxication produces by

the repeated consumption of a drug, natural or synthetic. It is also
defined as a chronic, relapsing brain disease that is characterized by
compulsive drug seeking and use, despite harmful consequences.
Drug Addiction

The characteristics of drug addiction are as follows:

1. An overpowering desire or need, a compulsion to continue taking the drug and obtain it
by any means;
2. A psychic or psychological and generally a physical dependence on drug;
3. A tendency to increase dose or tolerance; and
4. Usually, a detrimental effect on the individual and on the society.
Other Definitions of Drug Abuse

(1) the use of medically useful drugs which have the capacity to alter mood and
behavior without the benefit of prescription;
(2) the use of a medically useful mood-altering drug for a purpose different from
the one for which that has been prescribed;
(3) the use of drugs and substances having no legitimate medical application for
purposes other than the research;
(4) the recurrent use of dangerous drugs; and
(5) the misuse of prescription or over-the-counter drugs with negative
consequences.
Reasons Why People Turn to Drugs

1. Poverty
2. Ignorance
3. Loss of Family Values and Solidarity
4. Various Factors
Reasons Why People Turn to Drugs

1. Poverty. This is the most prevalent factor that prompts pushers and abusers alike
to indulge in dangerous drugs. Pushers are forced by the circumstances to the
retailing of prohibited drugs as a means or source of livelihood. Many abusers
use dangerous drugs are a vehicle to escape the realities of poverty and its
concomitant problems resulting from strain or anomie.
Reasons Why People Turn to Drugs

2. Ignorance. Lack of knowledge and information about how dangerous drugs

look like, their bad effects, legal ramifications or consequences and other aspects
of prohibited drugs, drug addiction, drug pushing, drug syndicates and many
others, aggravated by multi-faceted problems of the society, force the young
people to abuse drugs.
3. Loss of Family Values and Solidarity. Parents being busy bodies, their children
are being neglected. Western influence through tri-media erodes the values of
praying and eating together. The loss of family values and solidarity have been
very much influenced by the industrialization and urbanization, accompanies by
the emergence of technology, computerization, and globalization.
Reasons Why People Turn to Drugs

4. Various Factors. Curiosity, peer-pressure, environmental influence, boredom,

frustration, and weak desire to escape reality are some other factors to be
considered why people turn to drugs. The various factors to drug use are
developed through the concept of differential association and differential
opportunity in each of the person, individually and collectively.
Contributory Factors to Drug Abuse

1. Family Aspect
2. School Aspect
3. Community Aspect
4. Tri-Media and Social Media Aspects
5. Biological Aspect
6. Psychological Aspect
7. Parental Neglect Aspect
8. Sociological Aspect
Contributory Factors to Drug Abuse

Some of the identified contributory factors to drug abuse are as follows:

1. Family Aspect. As regards family aspect, the following elements tend to contribute
in the development of the drug using behavior of the youth, such as escape from the
strict and over-domineering parents; lack of communications between the parents
and the children; parents are frequently quarreling in the children’s presence; parents
are busy in their work, making children feel rejected, and children prefer to be with
their peer group because they feel nobody wants them at home.
Contributory Factors to Drug Abuse

2. School Aspect. The school, despite its efforts of molding the youth also tends to contribute in
the drug abuse problems in the society, because of the following reasons, such as, no basic drug
education on the proper use of drug in the school; the teachers are not sensitive to the various
needs and problems of their students; teachers are oftentimes concerned only on the academic
achievements of the students; and teachers are not aware of the psychological and emotional
conflicts encountered by their students.
3. Community Aspect. The most influential aspect to the upbringing of the youth is the influence
that the environment can do to them. By this, the drug taking behavior can be influenced by the
prevailing environmental condition, because of the following reasons, i.e., availability of drugs;
increasing number of users and pushers; unavailability of sports and recreational facilities; no
vocational or skills training for out of school youth; and indifference and apathy of the
community members.
Contributory Factors to Drug Abuse

4. Tri-Media and Social-Media Aspect. Some of the media, if not all, also play an important role
in influencing and corrupting the mind of the youth towards drug using behavior, by the
following reasons; over-sensationalized effort of the tri-media on the drug abuse problem, and
too much advertisement on curative and therapeutic effects of drug. The tri-media and even the
social media are powerful vehicles of communication invariably that have far-reaching
responsibilities in influencing the mind-set of people.
5. Biological Aspect. Biological factor in one way or another also contributed to an individual to
use drugs. Some individual health conditions such as fatigue, chronic cough, insomnia, physical
distress and mental disorders are usually relieved with the use of drugs. With the improper use, it
will lead to drug abuse. With the use of drugs, the body works actively, but the continued
improper use will result to drug dependency.
Contributory Factors to Drug Abuse

6. Psychological Aspect. Psychological conflicts from among the youth also affect their positive
behavior toward the maintenance of clean living. The psychological conflicts serve as
contributing factors for the youth to be hooked on drugs, such as low self-esteem and poor self-
image contributes easily to drug abuse; needed for acceptance and belonging can lead to drug
abuse; feeling for more freedom and autonomy from parents; attention getting, mental problems,
and escape from reality.
7. Parental Neglect Aspect. By the influence brought about by advanced technology in the
behavior and attitude of the youth, not to set aside the fast pace global modernizations, the
following are contributory factors in developing drug using-behavior: or over-domineering
parents; lack of parent’s concern and closeness; parental permissiveness, rejection by the
parents; abuse by the parents; family instability and disorganization; and psychological effects to
the children having separated parents.
Contributory Factors to Drug Abuse

8. Sociological Aspect. Sociological factors are the combinations of the preceding contributory
reasons which influence the people to use drugs, because of the following reasons, namely:
availability of over-the-counter and prescription drugs; influence made by the media; modeling
of parents or key influencers; feeling of powerlessness; lower value on academic achievements,
and involvement in graft and corruption of some of the public officials, especially the members
of the criminal justice system.
Symptoms of Drug Dependence

 It is common to speak of a drug having certain effects, and these effects alone, always resulted
from taking that drug. In fact, the same drug may have different effects on different people or
even on the same persons on different occasions. Ritalin, for instance, produces a state of
excitability with increased activity and talkativeness in most individuals; however, the same drug
is used for its tranquilizing effect on hyperkinetic or hyperactive children.
 Similarly, drinking the same amount of alcohol will make some drinkers happy and others
melancholy, still others become aggressive; some simply become unconscious. The effects that
will result from taking a drug depend on the nature of the drug, the dose, and the manner in which
it was taken. Often of equal importance, however, are there factors known as set and setting.
Setting includes interpersonal and environmental factors surrounding the drug experience.
Symptoms of Drug Dependence

 In terms of interpersonal factors, different effects may be experienced, depending on whether the drug
is taken with friends, with strangers, or while alone. Environmental variables have a similar impact.
The effects of a drug taken at a rock concert may differ from the effects of the same drug taken in
research laboratory. A traumatic event, such has an accident, argument, arrest, or the unexpected arrival
of drug user’s parents, can drastically alter, or even terminate, the drug experience.
 Set refers to the internal state of the drug taker. It encompasses physiological and psychological factors.
Perhaps the most important psychological factor in determining drug effects is the user’s expectation.
Other psychological set factors of importance include mood, attitude, and general personality
orientation. If the drug taker is depressed or anxious, his or her experience may be quite different
effects from that a cheerful individual. A confider user may experience different effects from a different
and uncertain user.
Symptoms of Drug Dependence

 Moreover, a rigid or otherwise poorly adjusted personalities are more likely to

experience adverse effects from psychoactive drugs than healthy individual or
personalities. Psychological dependence results from reliance on narcotic’s
tranquilizing or drive-reducing effects, while physical dependence develops
because the body has adjusted to operating on the depressed state caused by the
narcotic drugs and cannot operate normally in the absence of the drugs. Finally,
some people will become paranoid or hostile as a result of taking drug.
Perspective on Drug Dependence

 Drug dependence, is an adaptive state that develops from repeated drug administration,
and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct
concept from substance dependence, is defined as compulsive, out-of-control drug use,
despite the negative consequences. An addictive drug is a drug which is both rewarding
and reinforcing. It was described accordingly, that “whenever an individual persists in
use of alcohol or drugs despite problems related to use and abuse of dangerous drugs,
dependence of the individual person may be diagnosed.”
Perspective on Drug Dependence

 Compulsive and repetitive use may result in tolerance to the effect of the drug and
withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse
are considered Substance Use Disorders. In the DSM-5, substance abuse or drug
dependence has been merged into the category of substance use disorders and they no
longer exist as individual diagnosis. However, it is still unclear if all drugs with similar
physical effects are used for similar purposes, or if other subtle social or psychological
dimensions to use dangerous drugs are influential to an individual person, or groups of
persons.