As today is "International Day Against Drug Abuse and Illicit Trafficking", let me present few facts about Drug abuse and dependance. * Substance Dependence Arises out of maladaptive pattern of cluster use , leading to a cluster of behavioural, cognitive and physiological phenomenon that develop after repeated intake. It includes:-        1. Strong desire to take the drug        2. Difficulties in controlling its use        3. Persisting in its use despite harmful consequences        4. Higher priority to drug use than other activities & obligations        5. Increased tolerance        6. Physical withdrawal state *Substance Abuse. Persistent or sporadic excessive drug use, inconsistent with or unrelated to acceptable medical practice arising from maladaptive pattern of substance use, manifested by recurrent and significant adverse consequences related to repeated intake of the substance. * Substance Intoxication Refers to unwanted physiological or psychological effects that cause maladaptive behaviour. It must produce disturbance in the level of consciousness , cognition , perception , effect of behaviour that are clinically significant. * Substance Withdrawal It should be restricted to major symptoms resulting from the cessation of substance abuse, accompanied by a maladaptive behaviour change. * Physical Dependence It is defined as the alteration in neural systems which is manifested by tolerance and the appearance of withdrawal phenomena when a chronically administered drug is discontinued or displaced from its receptor. ADDICTION Chronic disorder characterized by compulsive use of drugs resulting in physical , psychological and social harm, and continued use despite evidence of that harm. * Drugs of Abuse   - Alcohol - Tobacco - Barbiturates and Benzodiazepines - Opiates : Heroin , Morphine , Codeine , Pethidine etc. - Cocain - Cannabis - Amphetamines and Designer drugs - Hallucinogens : LSD, Phencyclidine , Ketamine , Marijuana etc. - Inhalants : Freons , Ethers , Ketones , etc. - Miscellaneous : Caffeine , Datura seeds , Analgesics , Anabolic steroids , etc.. * Drug Addiction State of periodic or chronic intoxication , produced by the repeated consumption of a drug and is harmful to the individual and to the society.         Most important drugs of addiction are opium and its derivatives esp. Heroin, Cocaine , Cannabis , LSD , Benzodiazepines , Barbiturates , etc.. * Drug Habituation Condition resulting from the repeated consumption of a drug , in which there is psychological or emotional dependency on the drug. Caffeine and Nicotine are habit forming drugs. * Drug Dependence Includes both the terms ‘addiction’ and ‘habituation’, For existence , it requires psychological dependence but nonecessarily physical dependence. Drug Addiction vs Drug Habituation * Drug Addiction 1. Psychological and physical dependence necessarily occurs. 2. Compulsion is present. 3. Tendency to increase drug dosage is seen. 4. Characteristic withdrawal symptoms present. 5. Harm both to the individual and society. * Drug Habituation 1. Some degree of psychological but not physical dependence occurs 2. Desire is present but no compulsion 3. No tendency to increase drug dosage 4. Withdrawal symptoms are mild or are absent 5. If any harm done , it’s primarily due to the individual. Addiction consists of physical dependence and psychological dependence.      Physical dependence is a biological phenomenon which depends on the type, dose and duration of drug use irrespective of personality factors.      Psychological dependence is a compulsive need for a drug in order to maintain a state of well-being, and it can occur in absence of physical dependence.      Indiscriminate use of any of these drugs becomes dangerous and produces a gradual mental, physical and moral worsening of the individual and sometimes also sexual perversions or crime.   * Causes of Drug Addiction        -- Hereditary factor        -- Abnormal mental conditions        -- Physical inability to do a job    -- Curiosity        -- Anxiety , Chronic tensions, etc.     SYMPTOMS OF DRUG DEPENDENCY 1. Loss of appetite & weight 2. Unsteady gait & tremors 3. Eye changes 4. Anxiety,depression,mood changes 5. Impaired memory & concentration 6. Preference of solitude 7. Acute intravenous narcotism 8. Pulmonary oedema 9. Immediate collapse 10. Death. WITHDRAWAL SYMPTOMS (ABSTINENCE SYNDROME) * Onset      :  6 – 8 hrs * Duration   :  Delayed for 24 to 48 * Early symptoms (1st stage) Chillness   Cold sensation   Yawning & rhinorrhoea * Later symptoms (2nd stage)   Laboured & rapid respiration   Goose skin, lacrimation, gross tremors   Dilatation of pupil * 3rd stage Sleep (8 – 16 hrs) Anorexia in all stages. OTHER SYMPTOMS Tachyapnoea  Fever  Hypertension  Pain & cramps in legs and abdomen Perspiration  Vomiting  Diarrhoea. TREATMENT 1. Constant supervision 2. Detoxification 3. Sedatives,benzidrine,hyoscine 4. Diverting the mind 5. Psychotherapy 6. General health 7. Symptomatic treatment. THANK YOU....



Thanks again dear Anandu, You have posted another line extension article like Clinical features and definitions and Treatment too. Nice to learn the terms Substance abuse Substance intoxication Substance withdrawal Physical dependence Addiction Drug abuse Drug addiction Drug Habituation. Signs and symptoms including treatment. Fabulous Anandu.

My pleasure Krishna mohan sir. Thanks a lot for your appreciation and constant support.

ALCOHOL * Alcoholism and Alcohol abuse are 2 different forms of problem drinking. Alcoholism is when a person has signs of physical addiction to alcohol and continues to drink despite problems with physical health, mental health , social, family or job responsibilities. Alcohol abuse is when ones drinking leads to problems, but not physical addiction. * Causes peer pressure , depressed people , relationship problems, easy access to alcohol , low self esteem , etc. People of alcoholism and alcohol abuse often: --Continue drinking alone even when health , work , family is being harmed. --Become hostile when asked about drinking. Need to use alcohol on most days to get through drinking. --Reduced food intake, personal hygiene. -- Difficult to control alcohol intake. -- Marked withdrawal symptoms if stopped for a day. * Complications- Wernicke-Korsakoff Syndrome, c.a oesophagus, Delirium Tremens , Dementia , Pancreatitis, Nerve Damage etc. * Medicolegal Importance -- Public nuisance and pose as threat. -- Suicide , Homicide -- Road Traffic Accident Efforts taken to prohibition of alcohol isnt successful in India due to : -- Chances of alcohol being prepared illegally. -- Loss of the major source of revenue in many states of India.

CAGE is simple four questions to start treatment of an C for "have you ever think to Cut short alcohol.A for "have you ever Annoyed by criticism of your alcoholic behavior.G for "have you ever felt guilty about drinking" last E for "have you ever think that the first thing to start a day is drinking(Eye opener),If any alcoholic score two or more treatment should be start as soon as possible.

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TOBACCO Smoking tobacco in the form of cigarettes is the commonest source of nicotine poisoning. Particulate phase of cigarette smoke Nicotine and Tar. Usual nicotine content of a regular cigarette varies between 13 & 20 mg. When a cigarette is smoked , a large fraction remains in the butt and filter , and only 0.5 2 mg of nicotine is delivered to the smoker. This amount depends on nicotine content of the cigarette and on individuals smoking technique. In India , beedis are very popular and more harmful than cigarettes and produce higher levels of CO , nicotine and tar. In beedis, crushed and dried tobacco is wrapped in tendu leaves and rolled into beedi. Other forms Cigars , Chillum , Hookah Cigar roll of tobacco wrapped in leaf tobacco. Chillum tobacco smoked in a clay pipe Hookah Involves device that heats tobacco and passes it through water before its inhaled. Next common source of nicotine toxicity results from smokeless tobacco. Two of its kinds Snuff and Chewing tobacco. Snuff is usually available as finely cut tobacco powder which is packaged dry or moist. It contains approx. 14mg of nicotine per gram tobacco. Chewing tobacco is generally packaged as twists or plugs. Others Gutkha , Paan masala , Mawa , Mishri, Gudakhu. Gutkha Areca nut pieces coated with powdered tobacco, flavouring agents and other secret ingredients that increase addiction potential. Mawa - Combination areca nut pieces, scented tobacco , slaked lime mixed on the spot. Mishri Roasted tobacco powder Gudakhu Paste of tobacco and sugar molasses. Quid portion of tobacco that is placed in the mouth each time for chewing. A typical bite size quid contains 1.5 2.5 g tobacco. A smokeless tobacco user who takes 8 - 10 quids/day gets a nicotine = 30 40 cigarettes/day. Environmental tobacco smoke (ETS) consists of mainstream smoke, sidestream smoke and vapour phase components that diffuse through cigarette paper into the environment. * Complications -- Circulatory failure -- Stroke -- carcinoma of mouth , larynx , lung.

Dr.Anandu really good info.Thanks.If u also mention some Drug Deaddiction remedies/Medicines (for Alcohol, Tobacco chewing n Smoking addiction preferably) I would be very greatful .

You are most welcome Dr. Deepak sir. I will surely mention about alcohol and tobacco addiction in detail.

once again nice post.congratulations Dr Anandu.I personally think future of next generation.Being a psychiatrist many pt's come to me and everyone wants shortcut method. most of them start talking treatment from quack or powder available which is available even online.One or two of them sold at TV program NAPTOL.It's a height of our national television.Morning news paper is packed with "BINA BATAYE NASHA CHUDAO"like advertisement.Drug paddlers have deep roots.If any addict wants anything anywhere in northindia he get in just15 min after dialing to his paddler.This is a fact that divorce cases are more here.

Thanks a lot Dr. Dharmendra Jyani sir...what you mentioned is very true sir. Most of the patients are running behind quacks for treatment. Very pathetic situation...Thanks again for sharing your views sir.

Nice Post Dr. Anandu sir.....

Thank you so much Dr. Hemant sir.

A very good post Dr Anandu sir

Thank you so much Dr. Arnab sir.

very nice Dr Anandu

Thank you sir

wondeful post....dr anandu

Thanks a lot Dr. Melvin.

Helpful share. Thankyou Dr

You are most welcome Karishma.
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