1. HAZARDS OF DRUG ABUSE Dr Aslesh OP, MBBS,MD Assistant professor, Community Medicine

2. Definition - WHO  Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs

3. Substance abuse in India  Tobacco  Alcohol  Cannabis  Narcotics-opium, morphine, codeine, Heroin  Stimulants- amphetamine, cocaine  Medicines like cough syrup, Propoxyphene,  Inhalants like gums, whiteners, paint, clearing fluid

4. NumberMedian age Number of times per week Smoking12 (3.4)152 Hookah22 (6.2)131 Alcohol99 (28.2)121 Glue-sniffing71 (20.2)113 Cannabis2 (0.6)111 Cocaine3 (0.9)122 Substance Abuse in Urban School Going Adolescents in India: A Growing Challenge. Indian Pediatr 2013;50: 799-800

5. Socio cultural factors of drug abuse  Parental influence  Family structure  Peer influence  Role model  Advertisements  Socio economic factors  Knowledge attitude and beliefs

6. Developmental pressures leading to substance abuse  Deliberate violation of social norms  Testing whether able to behave like adult  Excessive and ritualized behavior to test ones limit  Lack of self control  Age related life style for peer group interaction  Emergency reaction to age related stress – coping stratergy

7. HARMFUL EFFECTS OF MEDICATION, ALCOHOL, DRUGS, AND ADDICTION

8. Tobacco

9. Why do some people smoke?  Lose weight  You feel happy  Feeling relaxed  Amuse your friends by blowing smoke rings  You will look cool and modern

10. Disadvantage  Bad breath  Yellow teeth  Blackened lips  Smelly cloths  Difficult keeping up with friends playing sports  Empty wallet

11. CIGARETTES -  More than 4,000 chemicals  At least 43 known carcinogens  NICOTINE  TAR-

12. DANGERS OF SMOKING

15. C.O.P.D. Chronic Obstructive Pulmonary Disease  Chronic bronchitis  Emphysema

16.  Lung Cancer

17. Effects of Smoking Circulatory System  Decreased circulation  Increased plaque build up in the vessels  Increased risk of myocardial infraction  Increased blood pressure  Increased risk of stroke  Damages the heart muscle

18. SMOKING AND PREGNANCY  effects fetal growth and low birth weight  Increased chance of miscarriage and stillbirths  Growth and development during childhood  Nicotine-transfers during breast feeding  Affects children

19. Pipe and Cigar Smokers  More likely to develop lip, mouth, and throat cancer

20. What about smokeless tobacco?  DANGERS:  Addictive  Leukoplakia  Bad breath, discolored teeth  Decreased smell and taste senses  Oral Cancer

21. QUITTING TOBACCO USE  WITHDRAWAL-nervous, moody, difficulty sleeping

22. QUITTING TOBACCO USE  Suggestions for quitting:  Change routine  Avoiding people/situations that increase your chances of smoking  Chew gum/snack on candy  Drink plenty of water, avoid alcohol, coffee, tea, and cokes

23. QUITTING TOBACCO USE  Suggestions for quitting:  Set a date  Plan rewards  Positive reinforcement for non-smoking friends  In relapse, quit again

25. REASONS TEENAGERS DRINK To have fun To relax To feel more self confident To fit in—peer pressure To get away with something

26. EFFECTS OF ALCOHOL  Brain  Liver  Blood vessels  Kidneys  Stomach  Tolerance  Dependence  Withdrawal

27. disadvantage  Increase risk in cancer of liver, pancreases, breast.  Increase blood pressure  Increase risk of renal failure  Liver diseases- cirrhosis  Anxiety, depression, insomia

28. NEGATIVE SOCIAL CONSEQUENCES Difficulties with: family friends school police

29. ALCOHOL AND PREGNANCY FAS-Fetal Alcohol Syndrome  Shorter, smaller babies, slow body growth  Facial abnormalities  Poor coordination  Heart defects  Poor attention spans, nervousness, hyperactivity

30. DRINKING AND DRIVING  #1 cause of death among teenagers  Decreases ability to judge distances, speeds, and turns  Increases risk taking  Slows reflexes  Decreases ability to concentrate

31. 3 STAGES OF ALCOHOLISM

32. STAGE 1  Physiological and psychological dependence  Drinks regularly  May have blackouts

33. STAGE 2  Cannot stop drinking  Defensive  In denial  Tolerance  Performance at school or work declines

34. STAGE 3  Drinking is visible  Drinking is uncontrollable

36. Illegal Drugs Dangerous and illegal substances

37. Dangers of drug use  Addiction  Physiological dependence  Psychological dependence  Tolerance  Body systems damage  Death

38. Social Consequences  Poor school and work performance  Problems with family and friends  Police, court, jail

39. DRUGS Categories, Classes, and Effects

40. STIMULANTS  Increase central nervous system activity  Irregular heart beat, heart failure  Increased blood pressure, stroke  Anxiety, paranoia  Physical collapse, death

41. COCAINE Can be snorted, injected Rapid acting, powerful stimulant Increases heart rate, blood pressure, respiration Physiological dependence Paranoia, hallucinations, psychological dependence Increases risk of heart attack, heart rhythm irregularities, cardiac arrest Increased risk of HIV with use of shared needles for injecting

42. CRACK  Smokeable form of cocaine  Danger of injury/death from explosion or fire  Dilates pupils, increases pulse, blood pressure, insomnia, hallucinations, paranoia, seizures  Lung damage  Extremely addictive

43. AMPHETAMINES  Increase heart rate and breathing  Anxiety, sleeplessness  Tolerance, dependence  Methamphetamines (crack, speed, ice) cause paranoia and may increase violent tendencies

44. DEPRESSANTS  Slow down the central nervous system  Relax muscles, relieve tension  Physically and psychological dependence

45. SEDATIVES-HYPNOTICS  Induce sleep, reduce anxiety  Decreases heart rate and respiratory rate  Physiological and psychological dependence  Barbiturates – mood changes, coma, death

46. NARCOTICS  Drowsiness  Dependence  Sleep-Coma-Death

47. HEROIN  Depresses central nervous system  Coma/death with large doses  Tolerance  Withdrawal from drug is difficult and painful  Increased risk of HIV infection from contaminated needles

48. HALLUCINAGENICS  Alter mood, thought, and the senses  PCP-Phencyclidine, angel dust  LSD-Lysergic acid diethylamide  Inhalants

49. Hazards of hallucinogens  Altered sensory perception  Misinterpretation of depth, distance,speed  Lead to accidents  Recurrent flash backs  Experience fear or panic

50. Cannabis-MARIJUANA  Hashish-dark brown resin from the tops of cannabis plant  Acts as hallucinogen, depressant, and has stimulant effects

51. EFFECTS OF MARIJUANA USE  Sensory perception changes  Decreased body temperature, increased heart rate and blood pressure  Stimulates appetite  Decreases self control  Mood changes  Personality problems  Psychological dependence

52. EFFECTS OF MARIJUANA USE  Memory deficits  Concentration and coordination  Decreased immune system function  Decreased testosterone, decreased sperm production  Use during pregnancy causes condition in baby similar to FAS

53. CLUB DRUGS-ECSTASY-MDMA  Tablet, powder, capsule  Usually consumed orally  Effects can last from 3-24 hours  Causes euphoria and intoxication  Depression, paranoia, violent and irrational behavior  Physical reactions-vomiting, blurred vision, convulsions, and more

54. CLUB DRUGS-ROHYPNOL- Sedative 10x stronger than Valium  Taken orally  Causes intoxication  Can cause deep sedation, respiratory distress, blackouts  Can last up to 24 hours  Short term amnesia  Causes aggression  “Date Rape” drug

55. CLUB DRUGS-GHB  Capsule/white-sandy colored powder dissolved in water or alcohol  Sold as slightly salty, clear liquid in small bottles  Effects last up to 3 hours  Causes nausea, vomiting, delusions, depression, vertigo, seizures, and more

56. CLUB DRUGS-KETAMINE  White powder that is snorted or smoked with marijuana  Causes hallucinations, delirium, amnesia, impaired motor skills, depression, high blood pressure, recurrent flashbacks, respiratory failure

57. ANABOLIC STEROIDS Used illegally to increase athletic performance  Increases aggressiveness and strength, BUT…

58. *Increased blood pressure, acne, liver damage, heart disease, and stroke *MALES: baldness, decrease testicular size, increase in breast growth, and body and facial hair *FEMALES: breast shrinkage, growth of facial hair, baldness *Mood swings *Increase risk of HIV infection with shared needles

59. Social and cultural consequences  Road traffic accidents  School related problems- declining grades, absenteeism, dropping out  Risky sexual practices  Delinquent behaviors  Juvenile crimes  Developmental problems  Psychological and social

60. Social and cultural consequences  Physical and mental consequences  Violent behaviors- towards family  suicides  Infection- HIV, Hepatitis  Future use disorder  Drug trafficking

61. Symptoms and signs of substance abuse  Sudden change in personality without another known cause  Loss of interest in once favorite hobbies, sports etc  Sudden decline in performance or attendance at school  Change in friends or reluctance to talk about new friends  Deterioration of personal grooming habits

62. Symptoms and signs of substance abuse  Difficulty in paying attention, forgetfulness  Sudden aggressive behavior, irritability, nervousness or giddiness  Increased secretiveness, heightened sensitivity to inquiry  Physical changes- red eye, reduced reaction time, dilated/constricted pupil

64. Thank you

66. ADDICTION  Tolerance  Physiological dependence  Psychological dependence  Withdrawal  Intervention  Recovery  Family Disease

67. Tobacco

68. Hazards of

69. Why do some people smoke?  Lose weight  You feel happy  Feeling relaxed  Amuse your friends by blowing smoke righs  You will look cool and modern

70. disadvantage  Bad brath  Yellow teath  Blackend lips  Smelly cloths  Difficult keeping up with friends playing sports  Empty wallet

71. Disadvantage on inner body  Bronchitis  Lung cancer  Heart disease  Lip cancer  Mouth cancer  Throat cancer  Skin damage  Reproductive system

72. Why do some people drink alcohol  Source of energy  Improve mood  Increase relaxation  To forget problems  Like the taste  To relieve stress  For good company

73. disadvantage  Increase risk in cancer of liver, pancreases, breast.  Increase blood pressure  Increase risk of renal failure  Liver diseases- chirrosis  Anxiety, depression, insomia