Drug addiction and community

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Drug addiction and community


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By


Beni Maya Ghalley


Class XII (Sci.) ‘A’


Gyalposhing Higher Secondary School


Monggar Bhutan


Introduction


What is a drug?


History of drug


Drug cult 5


Sports Drug use 6


What is Drug abuse? 6


Types of drug abuse 6


Some commonly abused drugs


What is Drug dependence/addiction? 10


Why people abuse drugs? 10


Effects of drug use 11


Treatment of drug abuse 1


Adolescents and drug use 1


Combating drug abuse 1


Role of World Health Organisation 14


Drug problem in Bhutan 15


Conclusion 16


References 17





1. Introduction


In a community, there are both individual and social problems. When individual problems affect a large number of people, they become social problems. One of the present day social problems is drug addiction. Drug addiction is defined as a state of periodic or chronic intoxication detrimental to the individual and society produced by the repeated intake of habit-forming drugs.


Drug abuse has reached an alarming proportion in recent years. “Drug culture” is fast making inroads into the lives of young people from all walks of life.


To call a person drug addict, the following criteria must be satisfied


1. Psychological dependence There is as overpowering desire (compulsion) to take the drug and obtain it by any means.


. Physical dependence when the drug is withdrawn, the person shows “withdrawal symptoms” such as irrational and violent behaviour, nausea, diarrhoea, watering from the eyes and nose, etc.


. Development of tolerance there is a tendency to increase the dose.


The term “Drug abuse” is the excessive, maladaptive, or addictive use of drugs for non-medical purposes despite social, psychological, and physical problems that may arise from such use. Abused substances include such agents as anabolic steroids, which are used by some athletes to accelerate muscular development and increase strength and which can cause heart disease, liver damage, and other physical problems; and psychotropic agents, substances that affect the users mental state and are used to produce changes in mood, feeling, and perception. The latter category, which has a much longer history of abuse, includes opium (and such derivatives as heroin), hallucinogens, barbiturates, cocaine, amphetamines, tranquillisers, the several forms of cannabis, and alcohol.


The history of non-medical drug consumption is ancient. The discovery of the mood-altering qualities of fermented fruits and substances such as opium has led to their use and, often, acceptance into society. Just as alcohol has a recognized social place in the West as well as in Bhutan, so many other psychotropic substances have been accepted in different societies.


. What is a drug?


World Health Organisation defines drug as any substance, with the exception of food and water, which when taken into the body, alters its function physically and/or psychologically.


Scientifically or biologically drugs are substances used to treat diseases or relieve symptoms. Some drugs are used to replace a missing substance essential for normal health, like vitamins. Some drugs are used to combat against germ-causing infection. While a third category of drugs include those substances which work on the nervous systems and act either as STIMULANTS to excite it or as DEPRESSANT which slows down the activity of the brain. Some may act as SEDATIVE and other causing ‘hallucination’.


. History of drug


The narcotic and sleep-producing qualities of the poppy have been known to humankind throughout recorded history. Sumerian records from the time of Mesopotamia (5000 to 4000 BC) refer to the poppy, and medicinal reference to opium is contained in Assyrian medical tablets. Homers writings indicate Greek usage of the substance at least by 00 BC; Hippocrates (c. 400 BC) made extensive use of medicinal herbs including opium. The Romans probably learned of opium during their conquest of the eastern Mediterranean; Galen (AD 10�00) was an enthusiastic advocate of the virtues of opium, and his books became the supreme authority on the subject for hundreds of years. The art of medicinals was preserved by the Islamic civilization following the decline of the Roman Empire; opium was introduced by the Arabs to Persia, China, and India. Paracelsus (14�1541), professor at the University of Basel, introduced laudanum, the modern tincture of opium. Le Mort, a professor of chemistry at the University of Leyden (170�18), discovered paregoric, useful for the control of diarrhoea, by combining camphor with tincture of opium.


There is no adequate comprehensive history of the addictive aspects of opium use in spite of the fact that it has been known since antiquity. Because there were few alternative therapeutics or painkillers until the 1th century, opium was somewhat of a medical magic potion. Thus, although at least one account in 1701, by a London physician named Jones, spoke of an excessive use of opium, there appears to have been no real history of concern until recent times, and opiates were easily available in the West in the 1th century, for instance, in a variety of patent medicines. Physicians prescribed them freely, they were easy to obtain without prescription, and they were used by all social classes. At one time, the extensive use of these medicines for various gynaecological difficulties probably accounted for the high addiction rate among women (three times the rate among men). Today, in the United States, only one addict out of six is a woman. The invention of the hypodermic needle in the mid-1th century, and its subsequent use to administer opiates during wartime produced large numbers of addicted soldiers (about 400,000 during the U.S. Civil War alone); it was thought mistakenly that if opiates were administered by vein, no hunger or addiction would develop, since the narcotic did not reach the stomach. Toward the end of the 1th century, various “undesirables” such as gamblers and prostitutes began to be associated with the use of opiates, and narcotics became identified more with the so-called criminal element than with medical therapy. By the turn of the 0th century, narcotic use had become a worldwide problem, and various national and international regulatory bodies sought to control traffic in opium from the Near and Far East.


In the 0th century, until recently, narcotic use was largely associated with metropolitan slums, principally among poor and culturally deprived. Currently, narcotic use has begun to spread to middle class youth, and, interestingly, there is evidence that the middle class is now beginning to look at narcotic addiction as a mental health problem. When it was confined to the slums, it was considered a police problem.





Figure 1 Poppy plant from which Opium is extracted.


4. Drug cult


Drug cult is group using drugs to achieve religious or spiritual revelation and for ritualistic purposes.


Though the idea may be strange to most modern worshippers, drugs have played an important role in the history of religions. The ceremonial use of wine and incense in contemporary ritual is probably a relic of a time when the psychological effects of these substances were designed to bring the worshipper into closer touch with supernatural forces. Modern studies of the hallucinogenic drugs have indicated that such drugs, in certain persons under certain conditions, release or bring about what those persons claim to be profound mystical and transcendental experiences, involving an immediate, subjective experience of ultimate reality, or the divine, resulting from the stirring of deeply buried unconscious and largely non-rational reactions. Modern students of pharmacological cults who have participated in cultic drug ceremonies and used the drugs themselves have been astonished at the depth of such experiences. R. Gordon Wasson has suggested that the religious impulse itself may have had its origin in the amazement felt by primitives on accidentally finding and ingesting plants with hallucinogenic properties while foraging for food; this view is not held by most scholars of religion.


Whatever the psychological origins of such reactions, they are viewed as religious in nature and have been structured and channelled through cultic forms. Through cultic leaders�such as shamans, witch doctors, and medicine men�as well as through tradition, pharmacological cults have specified not only how the cultic drugs should be assimilated but also how they should be gathered and prepared; generally also there are specifications for participants behaviour outside the ceremonies, in the practical affairs of living. Western observers of primitive cultures, such as missionaries, colonial administrators, and travellers, have often regarded such practices as demonstrating superstition and folly. Anthropologists and other scientific observers who have attempted to participate sympathetically in tribal rituals, however, not only have reported the useful aspects of such practices in primitive society but also have collected information that is of use to science, medicine, religion, and social theory.


Drugs usually encountered in cultic ceremonies are generally classifiable as narcotic. Few of these are true narcotics, however, in the sense of being numbing or producing sleep. They are called hallucinogens when they produce changes in perception. A hallucinogenic drug may lead to experiences that resemble psychoses, in which case it is called psychotomimetic; under other circumstances it may cause a quasi-mystical, or psychedelic, experience. Most psychedelic drugs tend to stimulate rather than numb the mind, whereas some true narcotics, such as alcohol and opium, in turn stimulate and stupefy the mind at different stages of their physical effect. Most cultic drugs come from plants, though Western cults more recently formed have made use of the active principles of natural drugs in synthetic form and of synthetic analogues of naturally occurring compounds.


5. Sports Drug use


Drug abuse must be considered among the other unfortunate aspects of modern sports. The misuse of amphetamines, anabolic steroids, and other drugs has become a central problem of modern sports. One of the touted values of sports is that they better ones health. Pursued in moderation, they certainly do improve muscle tone, increase cardiovascular efficiency, and retard skeletal decalcification. When sports become an obsession, however, they tend ironically to have the opposite effect. The human body is thought of not as a part of the self but as the selfs instrument, something to be used and abused. In pursuit of the absolute maximum achievement, 1th-century cyclists began to drug themselves with caffeine and strychnine; some died from the effects of the drugs. Modern chemistry has greatly enlarged the possibilities of artificial stimulation. In the late 0th century came widespread use of amphetamines and anabolic steroids. The former permits athletes to draw upon their physical reserves and continue despite the extremes of exhaustion until they collapse and, occasionally, die. Steroids are thought to increase muscle mass and muscular strength, but the side effects include damage to various organs and, in the case of women, masculinization (e.g., facial hair, deeper voices). Efforts of the International Olympic Committee to limit drug abuse have often been frustrated by national Olympic committees determined upon sports victories at any cost. Efforts to control drug abuse in professional sports and in intercollegiate athletics have frequently been countered by the athletes concerns regarding personal privacy. Nevertheless, in the United States, codes of varying strictness have been imposed in different sports, part of which includes the requirement of periodic testing for drug use. Olympic athletes now undergo testing prior to participation.


6. What is Drug abuse?


Drug abuse is the non-medical use of a drug that interferes with a healthy and productive life. Drug abuse occurs at all economic levels of society, from the wealthy to the impoverished, and among young people as well as adults. Any drug may be abused, including alcohol and medications prescribed by a doctor.


7. Types of drug abuse


Abuse of legal drugs


Some of the most commonly abused drugs can be purchased legally. They include (1) alcoholic beverages, () tobacco, () inhalants, and (4) prescription drugs.


Alcoholic beverages are made chiefly from grains or fruit and contain ethyl alcohol, one of the most commonly abused drugs in the world. Alcohol is a depressant--that is, it lowers the activity of the central nervous system. It also interferes with thinking, concentration, and movement. Heavy use of alcohol can lead to death. Even a single episode of excessive drinking can cause coma and death. Some people develop a physical dependence on alcohol, and overcoming that dependence may be extremely difficult.





Figure 4 Examples of commonly abused legal drugs.


Tobacco is a plant native to North and South America, whose leaves are made into smoking tobacco, chewing tobacco, and snuff. Tobacco contains a substance called nicotine. Nicotine is a stimulant, a drug that raises activity of the central nervous system. In addition to nicotine, tobacco smoke contains carbon monoxide and substances called tars. The chemicals that make up the tars can cause lung cancer. Tobacco use contributes to heart disease and other health problems. It can become a habit that many users have difficulty breaking.


Inhalants are substances that give off fumes inhaled for their intoxicating effects. They include certain glues, nail polish, petrol, and aerosol sprays. In some instances, the effect of these substances results from their fumes taking the place of oxygen in the lungs. The reduced flow of oxygen to the brain creates an intoxicating effect. Inhalants can make the user relaxed, restless, uncoordinated, and sometimes delirious. Some fumes result in lung damage, brain damage, and coma. Some also can cause death when they coat the lungs surface and prevent the absorption of oxygen.


Prescription drugs can be obtained legally only with a doctors prescription. Commonly abused prescription drugs include tranquillizers, barbiturates, stimulants called amphetamines, and analgesics (pain relievers). Many prescription drugs are powerful, and some create physical dependence. Some examples of commonly abused prescription drugs in Bhutan are Diazepam (Valium, Calmpose), relipin, nitrazepam (N-10), proxyvon, codeine (Phensedyl), pethidine, fortwin (Pentazocine), etc.


Steroids are a special type of prescription drug used medically for a variety of purposes. Some athletes take anabolic steroids because, in certain cases, the drugs help increase muscle size and strength. Some doctors believe anabolic steroids may cause aggressive behaviour and lead to liver damage.


Abuse of illegal drugs


Many abused drugs are illegal--that is, their possession and sale are forbidden by law. Illegal drugs include (1) cocaine, () marijuana, () heroin and other opiates, (4) hallucinogens, and (5) designer drugs. In some countries, some of these drugs can be obtained legally with a prescription.


Cocaine is a powerful stimulant made from the leaves of the coca shrub, a plant native to the Andean region of South America. Most users eat or snort (sniff) a powdered form of the drug, or inject a solution of cocaine and water. Some people also smoke a form of cocaine called crack. People easily develop a compulsive desire for cocaine, and many have great difficulty stopping the use of this drug.


Crack is a form of cocaine usually smoked in a potent crystal form. It produces stronger, briefer effects than other forms of cocaine because the body absorbs it faster. Crack cocaine is considered to be highly addictive.





Figure 5 Examples of illegal drugs.


Ecstasy, or MDMA, is classed as a hallucinogenic drug manufactured in laboratories. It produces some of the effects of amphetamines combined with LSD-like hallucinogenic experiences. Ecstasy users swallow the drug in tablet or capsule form. Research suggests that it can permanently damage brain cells.


Marijuana is the common name for hemp, a tall plant that grows easily in most parts of the world and which is abundant all over Bhutan. It contains a potent drug called tetrahydrocannabinol (THC). People usually smoke the dried leaves and flowers of the plant in cigarettes or pipes. Some may mix marijuana with food and beverages. The thick, sticky resin of the plant, called hashish, can be eaten or smoked.


Heroin and other opiates are made from the sap of the opium poppy. Opium, the dried sap of the poppys seed pods, contains a potent narcotic called morphine. Some people smoke or eat opium, seeking pleasant effects from morphine. Doctors use morphine to relieve severe pain in patients. Codeine, a less potent opiate, relieves coughs and mild pain. Heroin is a highly addictive drug made from morphine. People use heroin by eating or snorting it, or by injecting it.


Hallucinogens include such naturally occurring drugs as mescaline, produced within the peyote cactus and such substances as LSD (lysergic acid diethylamide), manufactured in laboratories. Hallucinogens affect the senses, emotions, and reasoning, often producing delusions or visions. The hallucinogen PCP (phencyclidine) may cause violent outbursts.


Designer drugs, created in laboratories, are variations on existing illegal drugs. Originally, they were designed to vary slightly in chemical composition from the definition of existing illegal drugs so that they could be considered legal substances. Many designer drugs are of poor quality, and they sometimes contain dangerous chemicals.


8. Some commonly abused drugs





Name What they do Possible immediate health effects Possible long-term effects


Stimulants


Amphetamines (Dexedrine, Benzedrine) Speed up physical and mental processes, boost energy, create sense of excitement. Appetite loss, blurred vision, dizziness, sweating, sleeplessness, trembling, anxiety, hallucinations. Malnutrition, depression, memory impairment, mental illness, stroke, heart failure.


Cocaine and Crack Speed up physical and mental processes, create sense of heightened energy and confidence. Rapid heartbeat, depression, sleeplessness, muscle spasms, convulsions, loss of sexual desire, impaired judgment, extreme suspiciousness, violence. Damage to nasal lining, heart attack, stroke, hepatitis or AIDS (if injected). Risk of fatal overdose. If used in pregnancy, danger of miscarriage and risk of birth defects.


Tobacco Products Speed up physical and mental processes, decrease appetite, lessen fatigue. Nausea, throat irritation, shortness of breath, vomiting, increased blood pressure and heartbeat. Bronchitis, emphysema, lung cancer, heart attack, stroke. If used in pregnancy, can cause miscarriage, or birth defects.


Depressants


Alcoholic Beverages Slow down central nervous system, produce intoxication and drowsiness. Mental confusion, slurred speech, impaired judgment, poor coordination, violence. Physical dependence, memory impairment, hallucinations, violent trembling, liver damage, paralysis, death. If used in pregnancy, increased risk of birth defects.


Barbiturates (Nembutal, Seconal) Produce mild intoxication, drowsiness and lethargy. Decrease alertness. Drowsiness, poor coordination, slurred speech, slowed breathing, weak and rapid heartbeat, impaired judgment, confusion, irritability. Physical dependence, coma. Risk of fatal overdose. If used in pregnancy, can cause birth defects. Sudden withdrawal can cause death.


Tranquilizers (Valium, Xanax) Slow down the central nervous system and relax muscles. Decrease alertness. Slurred speech, drowsiness, stupor. Impaired judgment. Physical and psychological dependence.


Marijuana and Hashish


Marijuana and Hashish Relax the mind and body, distort perceptions, alter mood, impair coordination. Faster heartbeat and pulse, impaired perception and reactions, possible hallucinations, panic attacks, decreased motivation. Impaired memory and coordination, bronchitis. If used in pregnancy, babies may have lower birth weight and slower growth rate.





Name What they do Possible immediate health effects Possible long-term effects


Heroin, Morphine, and Codeine


Heroin, Morphine, and Codeine Relax central nervous system, relieve pain, produce sense of well-being. Restlessness, nausea, vomiting, slowed breathing, lethargy, mood swings, sweating. Physical dependence, malnutrition, lower immunity, infections of the heart lining and valves, liver disease, hepatitis or AIDS (from contaminated needles), and fatal overdoses.


Hallucinogens


LSD, PCP, and Mescaline Alter perceptions and produce hallucinations, which may be frightening or pleasurable. Increased heart rate, nausea, sweating and trembling on LSD. PCP can produce stupor and delusions of great strength and invulnerability. Mescaline can produce vomiting, fever, increased blood pressure and heart rate. LSD may trigger disturbing flashbacks. PCP can cause coma, convulsions, heart and lung failure. Effects of mescaline unknown.


. What is Drug dependence/addiction?


After continued use of certain drugs, some people develop a condition called drug dependence. Drug dependence can be psychological, physical, or both. A person with a psychological dependence craves a drug for the feeling of well-being it might provide. A person with a physical dependence continues drug use chiefly to avoid the physical illness that results when drug use stops. The need for a drug may become so overpowering that nothing matters except getting more.


Many people begin and continue to use drugs because they want a pleasurable change in their state of mind. Unfortunately, drugs only change the brains perception of difficulties and problems. When a drug wears off, the users real problems nearly always remain.


10. Why people abuse drugs?


Young people begin using drugs for various reasons. Some experiment with drugs because their friends use them. Many young people find it difficult to resist peer pressure (the influence of people their own age). Also, young people often have a sense of invulnerability--that is, that death or other severe consequences of drug use will not affect them personally. Users of tobacco and alcohol may be attempting to appear grown-up by imitating their parents or other adults who smoke or drink.


Adults may begin using drugs for some of the same reasons as young people. In addition, the stress of life, job, and family pressures may lead people to seek relief in drugs. People also may use drugs for a surge of energy or to help them relax. Others may use drugs out of curiosity, for a thrill, or to rebel. Regardless of why drug use begins, many people continue the practice because they become dependent on the drug.


11. Effects of drug use


Effects on the individual


Both legal and illegal drugs have a range of potentially harmful effects. For example, alcohol can damage the liver, brain, and heart. Cocaine can cause high blood pressure, leading to a burst blood vessel in the brain and a stroke. Injecting drugs into the body with contaminated needles can lead to blood poisoning, which may destroy the heart valves and result in death. Sharing needles and syringes with a person who has hepatitis or AIDS can give a user those diseases. Constant drug use also causes malnutrition, particularly in heavy drinkers, who tend to miss meals and suffer from lack of vitamins. Use of illegal drugs may lead to overdose or death because their strength is unknown, and some contain toxic impurities.


Frequent drug users may turn to crime to meet the increasing expense of their habit. Continued drug use may cause personality changes. The user may become hyperactive or withdrawn. Some users lose interest in school, work, or family life.


Associated with many drugs are two effects known as tolerance and withdrawal that often contribute to continued drug use. Tolerance is a state of resistance to the effects of a drug. A person who develops a tolerance must take more and more of a drug to achieve its original effect. In this way, occasional drug users can become frequent users. Withdrawal is the reaction of the body when regular drug use is stopped. The symptoms of withdrawal can range from headaches and muscle cramps lasting a few days to death, depending on the drug and the extent of use. Some people continue to use drugs only to prevent withdrawal symptoms.


The warning signs of drug abuse are varied. Most abused drugs strongly influence a persons behaviour. For example, excessive use of alcohol or sleeping pills causes slurred speech and drowsiness. People who use cocaine become restless and talkative. Parents may notice money and household items disappearing as their children seek money to buy drugs. Employers might find workers functioning poorly.


Effects on family, friends, and work


Some users spend so much time under the influence of drugs or thinking about getting drugs that they neglect their family, friends, and work. In some cases, their actions harm the people closest to them. Pregnant women who take drugs can cause harm to their unborn children. All drug users risk injury or death to themselves and others if they drive a vehicle under the influence of a drug.


Some people help conceal and make up for a users destructive actions. They pay a users debts, supply money that can be used for drugs, and in other ways make it possible for drug use to continue. These people are called co-dependents. Some co-dependents do not realize they are supporting the habit. Others may say they oppose drug use, but they find themselves unable to stop assisting the users drug habit. Some co-dependents fear losing the users affections. Others may fear the legal consequences of refusing the user. For example, if rent goes unpaid, a user might be evicted.


Effects on society


Drug users may resort to theft, prostitution, or selling drugs to pay for their drug habits. Drug users in the transportation industry, such as bus drivers and air traffic controllers, risk endangering the public. Factory and office workers using drugs perform inefficiently and make mistakes. These inefficiencies and errors result in higher costs for products.


1. Treatment of drug abuse


Some doctors use medication to treat drug dependence. Such medication relieves craving or blocks the effect of habit-forming drugs. Doctors often use methadone, a drug with effects similar to opiates, to relieve an addicts craving for heroin during withdrawal. Although methadone is addictive, many doctors believe its use in the treatment of opiate addicts can be beneficial. Disulfiram, also known as Antabuse, is a drug used to treat alcoholism. It makes the user suffer flulike symptoms for several hours whenever alcohol is consumed. Nicotine skin patches can relieve a smokers craving for cigarettes.


Many professionals who treat drug dependence believe that users can profit from treatment in groups of drug users. In such groups, drug abusers share experiences and learn from one another. One organization that uses such treatment, Alcoholics Anonymous (A.A.), has helped many people dependent on alcohol. Other counselling methods include individual psychotherapy and treatment communities, where members must follow strict rules of conduct.


Detoxification is a treatment used to eliminate a persons physical dependence on a drug by eliminating the drug from the body. One method involves decreasing the daily dose of a drug gradually over a period of weeks to reduce the severity of withdrawal illness. Effective detoxification methods include counselling and other support to help users fight craving and solve the problems that first led them to drugs.


Treatment for drug abuse is not always successful. Some people must fight strong cravings for years after they stop using drugs. The success of the treatment often depends on the persons desire for cure. Pressure from the family and employer often motivates the user to seek treatment and stay off drugs.


1. Adolescents and drug use


The use of drugs


In some countries drug abuse among adolescents causes great concern. Surveys in the United States have shown that the majority of teenagers in that country have at least experimented with such drugs as alcohol, barbiturates, cocaine, LSD, or marijuana. Some have experimented with heroin, morphine, or other narcotic drugs. Many of these drugs are physically harmful if taken regularly. A single overdose of some drugs, such as heroin or a barbiturate, can result in a coma or death.


In societies where drug-taking is a problem, nearly all the drugs that teenagers take cannot be obtained or used legally without a doctors prescription. Alcohol is the major exception. It is the most widely used drug among both adults and teenagers. Teenage drinking is a serious problem in some countries, despite restrictions on the sale of alcohol to adolescents.


Adolescents experiment with drugs for various reasons, including peer group pressure, the example of parents, and curiosity. Most teenagers pass through the experimentation stage without developing a drug abuse problem. Others are not so fortunate.


The causes of teenage drug abuse are not well understood. Some teenagers may be led into it by boredom or by an unconscious desire to escape mental or emotional pressure. Teenagers who feel genuinely useful are perhaps least likely to develop the problem of drug abuse.


Delinquency


In most societies offenders under 18 are tried as juveniles rather than as adults. Many juvenile offences are relatively minor. They include certain offences, such as running away from home, that apply only to juveniles. However, adolescents may also be arrested and charged with more serious crimes such as stealing and driving away cars, burglary, shoplifting, and violent behaviour, often aggravated by drunkenness. Rowdiness and vandalism are other offences particularly associated with adolescents. In many cases, hooliganism in cities and at sports events involves adolescent participants. Teenage boys may belong to street gangs. On average, only 0 per cent of teenagers charged with serious offences are female.


In general, the juvenile delinquency rate is highest in deprived inner-city areas with few employment and recreational opportunities for youth. Many juvenile delinquents, but by no means all of them, come from low-income families. In numerous cases, juvenile delinquency results mainly from faulty parent-child relations and poor parental example, not from economic hardship. However, delinquency also has other causes. Pressure from the peer group may be a principal cause in many cases. Some juvenile offenders have strong antisocial feelings or other deep-seated psychological problems.


14. Combating drug abuse


Reducing supply


In the developed countries, the vast profits from the drug market attract drug suppliers from many parts of the world. To discourage drug smuggling and dealing, known as drug trafficking, most countries set severe punishment for anyone convicted of those crimes.


Countries also attempt to block the supply of drugs at their borders. Coast guards patrol national shores to prevent illegal shipments of cocaine and narcotics from entering the countries. The police in many countries cooperate to arrest those who distribute, finance, and process illegal drugs.


Despite efforts to reduce the supply of drugs, large quantities still enter the market from Latin America and Asia.


The legalization debate


The problem of drug abuse has persisted worldwide despite vast sums spent each year trying to stop the trade. In addition, drug traffickers have continued to commit violent crimes and make large profits. Because efforts to reduce drug abuse and drug-related crime have not shown dramatic results, some people have suggested that drugs be legalized.


Supporters of legalization believe laws against making and selling drugs should be overturned. They argue that if drugs were legally available at low prices, drug dealers would go out of business and much drug-related crime would end. In addition, the money spent on law enforcement could be devoted to educating and persuading people how to avoid the misuse of drugs, and to treat those who are dependent on drugs.


Instead of legalization, some people suggest changing the laws so that possession of small amounts of drugs would not be treated as a criminal offence. Such changes, called decriminalisation, would make personal use of drugs legal or subject only to a small fine. The greatest efforts to arrest drug traffickers would continue, however.


People against legali-sation fear that the low price and availability of legal drugs would encourage the use of dangerous substances. They also fear that the alternative, setting a high price on drugs to discourage people from using them, would sustain an illegal market of lower-priced drugs.


15. Role of World Health Organisation


Since it’s founding in 148, WHO has played a leading role in supporting countries to prevent and reduce the problems due to psychoactive substance use and in recommending which psychoactive substances should be regulated. In 000, the Department on Substance Abuse was merged with the Department of Mental Health to form the Department of Mental Health and Substance Dependence, reflecting the many common approaches of management of mental health disorders and substance dependence.


WHO is the only agency which is dealing with all psychoactive substances, regardless of their legal status. WHOs mandate in the area of substance abuse include


1. Prevent and reduce the negative health and social consequences of psychoactive substance use;


. Reduce the demand for non-medical use of psychoactive substances;


. Assess psychoactive substances so as to advise the United Nations with regard to their regulatory control


Various groups in the Organization deal with substance use issues, such as the Tobacco Free Initiative (all issues related to tobacco use), the Task Force on Alcohol Policy (on a global alcohol policy), Mental Health Determinants and Populations (issues related to primary prevention of substance use) and the Department of Essential Drugs and Medicines Policy.


The programme on Management of Substance Dependence is concerned with the management of problems related to the use of all psychoactive substances, regardless their legal status. It is concerned with the epidemiology of alcohol and drug use, neuroscience related to alcohol, tobacco and other psychoactive substances, brief interventions for alcohol and drug problems, drug use and HIV/AIDS (including injecting drug use), responses to the problems related to amphetamine-type stimulants, evaluation of treatment and other interventions for drug/alcohol users and capacity building in the area of research and treatment. It seeks an integrated approach to all substance use problems within the health care system, in particular primary care.


16. Drug problem in Bhutan


As with all cultures Bhutan too has our own list of socially accepted drugs that are used commonly in most households. Some use it in moderation while others may abuse them. Substances other than the ones that are socially accepted have reached the Bhutanese society along with modern development. Occasionally, over the past few years, Kuensel has reported incidences of smuggling cough syrup or other drugs across the border and a few cases of suspected overdose deaths. To date no national studies have been conducted to assess the problem, but we can hope that the problem is still small. Therefore, while the problem is still small and easy to curb, it is the duty of everyone to stop the problem from growing bigger. Parents, teachers, police, health workers and policy makers alike have a responsibility towards our children to prevent substance abuse from becoming a problem in our society.


Socially acceptable drugs


Alcohol and “doma” have important standing in the Bhutanese culture. Offering “doma” is a gesture of friendship and offering “ara” is commonly practiced sign of welcome. Both of these substances also have a role in our religious and ceremonial rituals.


Smoking, chewing tobacco and use of snuff has long been practiced in our society. In the recent years with strong anti-tobacco campaigns supported by the World Health Organisation, many dzongkhags have been declared tobacco free zones. Anti-tobacco campaign is greatly facilitated by our Buddhist teaching that shun the use of tobacco. Although no studies have been carried out, one can assume that tobacco use is not as extensive as alcohol. Alcohol is extensively used in many parts of Bhutan. It is common to see many patients in hospitals suffering from alcohol related diseases.


Over the counter drugs and solvents


Drugs such as codeine, cough syrups and solvents like thinner, dendrite and petrol have made their appearance in Bhutan only in the recent years with modern development. As is the case in other countries, in Bhutan too, the people most prone to abusing these substances are youths. No formal research has been done to assess this problem.


Illegal drugs


There are no studies carried out to assess the problem of abuse of illegal drugs such as LSD, heroin, marijuana etc. in Bhutan. Although there have been several reported cases of death due to overdose mainly in the border towns like Phuentsholing, it is assumed that drug abuse and trafficking has not yet become a visible problem. In order to prevent the problem from escalating, the Royal Government of Bhutan has accorded high priority to the task of suppression of illicit trafficking and abuse of drugs. In 188, Bhutan passed the Narcotic Drugs and Psychotropic Substances Notification after becoming a signatory to the United Nations Conventions against Illicit traffic in Narcotic Drugs and Psychotropic substances.


Treatment


Currently, there are no rehabilitation centres established specifically for drug addicts. However, the national referral hospital in Thimphu has a Psychiatry Unit with a qualified national Psychiatrist who offers counselling and treatment for detoxification. People with the problem are referred to this unit from all the other parts of Bhutan.


Actions to prevent drug abuse


Today, with rising living standards and emergence of strains of undesirable behaviour and attitudes in some of the urban settings, the Royal Government, through Ministry of Health and Education have put in tremendous effort to educate the population against the harmful effects of drug abuse.


17. Conclusion


“Prevention is the best cure”, getting in early interventions to prevent drug use is the best that any family or community can do. Refusing to take action, believing that drug abuse is a problem that happens in other families or communities and not in your own is being short sighted. As said earlier, drug abuse cuts across income, social class and age groups.


Poor family relationships and feeling of alienation often are factors that influence drug abuse in adolescents. Parents who are informed and knowledgeable about drugs are in much better position to prevent their children from drug abuse. Parents who use non-judgemental approach and express concern and care rather than anger can avert adolescents from developing drug dependency even if they experiment with drugs as part of adolescent development process. Most of all parents should establish family policy or rule about drug use and be good example and role models for their children.


Drug abuse is a preventable behaviour. Drug addiction is a treatable disease.


Partnership for a Drug-Free America


18. Bibliography


1. Text book of Biology


. World Book Millennium 000


. 14-00 Encyclopædia Britannica, Inc.


4. Kuensel July 1, 00


5. News letter The Youth Development Fund.


6. OPD record, Psychiatry Unit, JDW NR Hospital Thimphu Bhutan.


7. http//www.who.int/


8. Parents’ Orientation on adolescent and youth issues, A guide to Facilitators � YGCD, Department of Education, Thimphu Bhutan.


. http//www.avert.org/druguse.htm


10. http//www.marijuana.com/


11. http//www.well.com/user/woa/


1. http//www.alcoholanddrugabuse.com/





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