What is Drug?
When a pharmaceutical preparation or naturally occurring substance is used primarily to bring about a change in some existing process or state (Psychological, Physiological or Biochemical) it can be called a Drug.

In Simpler terms any chemical that alters the physical or mental functioning of an individual is a Drug.

Difference between drug use and drug abuse
When drugs are used to cure an illness, prevent a disease or improve the health condition, it is termed “Drug use”.

When drugs are taken for the reason other than medical, in an amount, strength, frequency or manner that damages the physical or mental functioning of an individual, it becomes drug “Abuse.”

Drug abuse of medical drugs
Drugs with medical use can be abused in the following ways.
Too much
Taking an increased doses without medical advice.
Too often
Taking small doses frequently
Too long
Taking an drug for an extended period of time – longer than the prescribed period.

Wrong use
Taking a drug for reason other than medical, for which it is intended or taking a drug without medical advice. Wrong combination

Taking a drug in combination with certain other drugs.

Illegal drugs like Brown–Sugar and opium have no medical use at all, With these drugs there is no drug use, to use them is to abuse them.

Drug abuse and drug addiction

• Tolerance
• Psychological dependence
• Physical dependence
• Withdrawal symptoms

Classification of addictive drugs
Addictive drugs can be classified into five major categories according to their effects on the user.

• Narcotic analgesics
• Stimulants
• Depressants
• Hallucinogens
• Cannabis

Narcotic Analgesics

• In Greek prefix ‘Narco’ means to ‘Deaden’ or ‘benumb’.
• Analgesics means pain killer or pain relieving.
• The term Narcotic medically refers to opium and opium derivatives or synthetic substitutes that produce opium–like effects.

Drugs belonging to this category can be studied under three broad categories

 

Narcotic of natural origin

• Opium comes from Poppy plant, Botanical called ‘Papaver Somniferum’.
• Opium is collected from unripe fruit of the Poppy plant. Opium is dark greyish or brownish tar like substance.
• Opium is smoked , Chewed and absorbed through the mucuous membrane of the mouth. It is also boiled with water and drunk.

Morphine
Morphine is principal alkaloid that is extracted from opium about 10 to 15 % of opium contains morphine. It is one of the most effective drugs for relief of pain.

Routes of administration

• Injected – Subcutaneously, Intra muscularly or intravenously.
• Most morphine addict use intravenous route.

Codeine
Codeine is another alkaloid found in opium, 1 to 2 %. Codeine is used in cough – suppressant drugs and anti diarrhoeal preparations.

Route of administration

• Injected – subcutaneously or intramuscularly.
• Oral – medical preparation of codeine are made in combination with other chemicals and are available in the form of tablets and syrups.
• Codeine is very rarely abused as its analgesic effects are mild and severe side effects ( Eg. Convulsions) are often experienced.

Semi synthetic narcotics

• Heroine/Brown Sugar
• Heroine( Di – acetyl morphine ) is a semi synthetic derivative of drug morphine.
• Brown sugar is adulterated form of heroine.
• Brown Sugar is ‘Smoked’ of ‘Chased’.

Synthetic Narcotics

• Synthetic narcotics are produced only in laboratory.
• These drugs imitate the effects of opiates but are not prepared from opium.
• Pethidine and methadone are most widely available synthetic drugs.

Routes of administration

• Oral– Meperidine (Pethidine) can be administered orally in the form of tablets.
• Injected – Subcutaneously, intramuscularly or intravenously.
• Pethidine addicts almost always inject the drug intravenously.
• Methadone is effective when administered orally, so Methadone is usually taken in the form of tablets.

 

Short term effects of narcotic analgesics
When injected, the effects are immediate and pronounced. The main effects include

• Short lived state of euphoria during which feelings of hunger and pain are not felt.
• Mental clouding– impairment of intellectual processes.
• Drowsiness, apathy, decreased physical activity.
• Reduced heart rate and blood pressure.
• Constipation.
• Constriction of pupils.
• A few adverse reaction may also appear.
• Nausea, vomiting.
• Dysphoria (A feeling of unpleasantness).
• Increase sensitivity to pain after the initial effects wears off.
• Itchy skin.

Narcotic Analgesics – Long term effect

• Severe constipation
• Contracted pupils
• Moodiness
• Abscesses (pus formation)
• Liver damage
• Tetanous
• Brain damage
• Infection can be caused by unsterile needles
• Chronic uses may develop lung problems due to its effect on respiratory system.

Withdrawal symptoms

• The withdrawal symptoms of narcotic analgesics are more painful and severe.
• The severity of withdrawals will depend on the type of narcotic used, the amount, the duration of use and the general health condition of the person.
• Initial phase symptoms resemble those of moderately severe bout of influenza.

Symptoms after 8–12 hours after the last dose

• Watery discharge from eyes and nose, yawning and perspiration.
• Restlessness, Irritability, loss of appetite, tremors, pupilary dilation, yawning and severe sneezing also occur.

Symptoms after 48–72 hours after the last dose

Withdrawal symptoms intensify and reach their peak, the patient becomes weak and depressed.

• Nausea vomiting.
• Stomach cramps and diarrhoea are common.
• Heart rate and blood pressure are elevated.
• Pain in the bones and muscles.
• Chills alternating with flushing and excessive sweating are also characteristic symptoms.
• At this time the individual may develop suicidal tendencies.

 

Route of administration

• Oral–the leaves of coca plant are sometimes chewed and is absorbed through mucuous membranes of the mouth.
• Snorted – cocaine is usually snorted or taken through nasal passages.

Short term effects of stimulants
The main effects include

• A feeling of well being, Euphoria.
• Sense of super abundant energy, increased self – confidence.
• An increased motor and speedy activity.
• A suppression of appetite (which is why it is used in diet pills).
• An increased falls feeling of masking fatigue.
• Pupilary dilation, dryness of mouth increased respiration, heart rate and blood pressure reduced a gastro intestinal activity and urinary retention.
• With larger doses, very rapid heart beats, hyper tension, head ache profuse sweating, severe agitation and tremors.

Stimulants

• Stimulants are drugs which excite or speed up central nervous system.
• The most prevalent stimulant are nicotine (Tobacco products) and caffeine (Tea and Coffee).
• The more potent stimulant drugs are amphetamines and cocaine.

Amphetamines
Amphetamines are synthetic drugs.
Amphetamines are white, odorless, crystalline powder with bitter taste they are supplied loose or in the form of capsule or tablets.

Amphetamines are used abused by

• Students, to ward off sleep, enabling them to study late night
• Athletes, to mask feelings of fatigue and increase their endurance
• Busy executives use stimulants to increase their activity during the day and the depressant to calm down the sleep during night.

Route of administration
Oral–generally taken in the form of tablets and capsules

Cocaine
Cocaine, g class="subtitle">Long term effects of stimulants

• Chronic sleep problems.
• Poor appetite.
• Rapid and irregular heart beats.
• Impotence.
• Mood swing.
• Anxiety and tension states are the long term effects of stimulant abuse.
• Acts of violence, Homicide and suicide rates among the stimulant abuser are high.
• Chronic use may produce ‘Amphetamines psychosis’.

Withdrawal symptoms of stimulant

• Extreme fatigue
• Prolonged but disturbed sleep
• Voracious Appetite
• Irritability and moderate to severe depression are the common withdrawals.

 

Depressants
Depressants are drugs which depress or slow down the functions of central nervous system.

The drugs include

• Sedative– hypnotics
• Alcohol

Sedative– hypnotics
Sedative – hypnotics are non–narcotic depressant drug, Barbiturates and Benzodiazipines are two main drugs that fall into this category

Barbiturates
Barbiturates are medically prescribed for sedation and to induce sleep.

Routes of administrative
Orally in the form of tablets and capsules.

Benzodiazipines

• Benzodiazipines are white or pale yellow crystalline powders.
• They are clinically used to reduce anxiety induce sleep and muscle relaxation.

Routes of administration
Oral in the form of capsules and tablets

Generic name	Trade name
Dizapham	Valium, Calmpose
Chlordizapoxide	Librium
Alprazolam	Alprex,Trika
Iorazapam	Ativan

Short term effects of Depressants
Sedative hypnotics produce similar effects to that of alcohols. The Main effect includes

• Relief from anxiety and tension
• Euphoria
• Mild release from inhibitions
• Sedation, Sleep with larger doses
• Poor motor coordination
• Impaired concentration and judgment
• Slurred speech and blurred vision

Long term effect of Depressants

• Depression
• Chronic fatigue
• Impaired Sexual function
• Decreased attention span poor memory and judgment
• Respiratory impairments, Reduced sleep

Withdrawals symptoms of Depressants

• Mild withdrawal symptoms like anxiety insomnia, weakness, nausea are usually noticed
• With high and chronic uses of drugs
  • Agitation
  • High body temperature
  • Hallucinations and convulsions
  • Tremors

 

Hallucinogens
Hallucinogens are drugs which dramatically affects perception, emotions and mental processes.

As they distort the perception of the objective reality and produce hallucinations, these are known as hallucinogens. Hallucinogens are also referred to as ‘Psychedelic’ (Mild altering) drugs

The common hallucinogens are

• LSD (Lysergic acid Di ethylamide)
• PCP (Phencyclidine)
• Mescalime

LSD (Lysergic acid Di ethylamide)
LSD is a semi synthetic drug and the most powerful hallucinogen. It is produced from lysergic acid. LSD is white odorless, crystalline material, which is soluble in water.

Route of administration

• It is easily absorbed orally and usually taken in the form of tablets.
• LSD blotter paper are also common.

PCP (Phencyclidine)
PCP is commonly called angel’s dust. PCP in its purest form is a white crystalline powder, which easily dissolve in water.

Route of administration
It is snorted, smoked, eaten and rarely taken intravenously.

Short term effects of hallucinogen
The main effects include

• Alteration of moods – usually euphoric but some time severely depressive.
• Distortion of the sense of direction, distance and time.
• Intensification of sense of visions
• ‘Psuedo’ hallucinations
• Synesthesia (User may feel that he can see music and can hear colors)
• Feeling of depersonalisation, loss of body image and loss of sense of reality (user may feel that his body is shrinking or becoming weightless)
• Sense of past, present and future may be jumbled
• Vague idea and extreme pre occupation with philosophical issues are common.

Long term effect of hallucinogen

Flash backs or spontaneous recurrences of an LSD experience can occur without warning for upto one year after LSD use.

Amotivational syndrome– the user becomes very apathetic, is very passive and shows no interest in life.

LSD Precipitated psychosis– acute panic reaction which can occur may lead the user into a stage of drug induced psychosis.

The psychotic episode normally lasts for several hours but in some cases it may last for years.

Cannabis

• Cannabis drugs are made from Indian Hemp Plant–Canabis Sativa
• Cannabis drugs do not have any medical drug use. More than 60 constituents, known as Cannabinoids, occur naturaly in Cannabis plant.
• Chief Psycho active substance delta–9–tetra hydrocannabinol (THS).

Main drugs under this category

• Ganja/Marijuana–Prepared from dried leaves and flowering tops of the plant.
• Hashish/Charas– THC 5 to 15%.
• Hashish Oil– THC 20 to 60%.
• Bhang–Dried parts of the plants leaves and stem.
• Route of administration–Smook.

Short term Effects

• Dreamy state of relaxation.
• Lower inhibitions.
• Increase auditory and visual acuity.
• Sence of smell and test are often enhance.
• Altered sense of time perception.
• Impaired short term memory.
• Impaired ability to perform complex motor task.

Long Term Effects

• Pronounce Psychological dependence.
• Psychosis–Typical acute psychotic episodes– Confusion, Delusion, Hallucinations, Disorientation etc.
• Bronchitis, Asthma, Sinusitis or chronic redness of the eyes.
• Sterility: reduced sperm count & decreased sperm morality.
• Reduces immunity.