The morbidity from drug abuse can be due to direct physical or mental pharmacological effects, consequences of the methods used, and the effects of dependence and abstinence. Those addicted to drugs have a compulsion to take the drug on a continuous or periodic basis to experience its psychic effects (psychic dependence) and sometimes to avoid the discomfort of its absence (physical dependence).
There are many addictive or dependence producing drugs. They include, Alcohol and barbiturate type drugs Amphetamine, methamphetamine (Ecstasy) and anti-obesity drugs Cannabis Cocaine Hallucinogens (LSD, certain mushrooms) Khat type (from the plant Catha edulis) Opiates (heroin)
Volatile solvents Benzodiazepines, methaqualone and similar drugs New psychoactive substances Tobacco products Substances can be taken into the body in several ways. Oral ingestion (swallowing), inhalation (breathing in) or smoking, injection into the veins (shooting up) , and depositing onto the mucosa (moist skin) of the mouth or nose (snorting) are the methods used by drug addicts.
People abuse drugs for a number of different reasons. The most common reason is to “get high”. Adolescents can become involved in experimentation with drugs. Fortunately, only a small percentage of people who experiment with drugs become drug abusers. The desire to “get high” can be for many reasons. Pressures of coping with school, work, or family tensions and underlying disease such as depression can lead to addiction.
It is estimated that Sri Lanka has about 200,000 cannabis addicts and 50,000 heroin addicts. Can a person addicted to drugs rehabilitated? Yes, but it is difficult. There are nearly 25 centres for rehabilitation of addicts in Sri Lanka. Five are government owned. Others are run by various private organizations. Residential treatment is much more effective to get an addict out of drugs habits. The support of the family is essential for the recovery of an addicted person. Cannabis is the only drug that grows in Sri Lanka. It is grown illicitly, mostly in the dry zones of the country (in the Eastern and Southern provinces). The estimated land area under cannabis cultivation is nearly 500 hectares. Residential treatment is much more effective to get an addict out of drugs habits Cannabis without the narcotic content is used in the manufacture of Ayurveda (indigenous) medical preparations. Cannabis causes euphoria, “high” feeling, pleasurable state of relaxation, enhancement of sensory experiences, increased appetite, impaired performance, sleepiness, confusion and hallucinations.
Opiates derived from the plant Papaver somniferum or poppy plant, have many alkaloids including morphine. Heroin is a substance synthesized from morphine. Opium is used in the Ayurveda (indigenous) medical pharmacopeia and the government makes it available to Ayurveda Medical Practitioners through Government Hospitals.
Among the heroin users in Sri Lanka, inhalation (“chase the dragon”) is the preferred mode of administration. This is much less harmful than intravenous injection. Intravenous drug addicts are more prone to get infections. Diazepam, lactose, sucrose, acetaminophen and caffeine are the commonly used adulterants of heroin.
Heroin causes a sense of wellbeing, euphoria, contentment, detachment from emotional/physical distress and pain relief. It can cause drowsiness, lack of concentration, respiratory depression and even death. Addiction to heroin causes serious withdrawal symptoms when heroin is not present in blood. Addicts experience anxiety, restlessness, sweating, yawning, runny nose, watering of the eyes, diarrhoea, incontinence of urine, abdominal pains and delusions. Heroin users die prematurely from acute heroin overdose, inhalation of vomit, acute ulcerative endocarditis, bronchopneumonia and hepatitis. They are more likely meet with accidents and commit suicide.
Amphetamines have medical uses for attention deficit disorders, narcolepsy and appetite suppressant (slimming pills). Its abuse can cause feeling of wellbeing, euphoria, increased alertness and energy, increased heart rate and blood pressure and bizarre, erratic and violent behaviour. 3,4-methylene - dioxymethamphetamine (MDMA), also known as ‘Ecstasy’ or ‘Disco drug’, increases all pleasurable sensations. Users have feeling of emotional closeness, increased physical and emotional energy, restlessness, anxiety and hallucinations.
Its serious health effects are increased heart rate and blood pressure, brain damage and liver damage. Ecstasy is popular among participants of discos in night clubs and users have died suddenly in night clubs. Heroin’s synthetic cousin, ‘Fentanyl’, is one of the deadliest drugs in the world.
Dealers are lacing cocaine and heroin with fentanyl, and young adults are dying in significant numbers. While there has been a downward trend in deaths from prescription opioids alone, overdose deaths from fentanyl have risen dramatically, up 540 percent in three years.
Fentanyl is a synthetic opioid painkiller, prescribed to treat severe pain. It is a cousin to heroin, but much deadlier because it is much stronger—50 times more potent than heroin. Fentanyl owes its potency over heroin to differences in chemical structure. Both chemicals bind to the “mu opioid receptor” in the brain. But fentanyl gets there faster than heroin because it more easily passes through the fat in the brain. It also grabs onto the receptor so tightly that it does not take much to trigger the opioid effects in the body.
As fentanyl is a fine powder, it is easy to mix into other drugs. It looks identical to heroin, so users, injecting heroin laced with fentanyl, do not know they’re injecting a lethal dose until it is too late.Drug abuse is common among poor families, while a drug abuser in a family makes them poore
The impact of drug abuse on the individual, his family and on the society is very significant. The family and the community can be the origin of drug problems, but they can also be a potent force for treatment. The disrupted family life can lead to drug problems, while drug problems can lead to disruption of family life. Drug abuse is common among poor families, while a drug abuser in a family makes them poorer. Drug abuse impairs family life, results in unproductive employment and reduces the quality of life. Impaired performance at work can lead to poor productivity and reduced income. Absence from work and intoxication at work can lead to disciplinary problems, accidents at work and excess medical claims
It is very unfortunate that young drug addicts face premature death. The cost to the health services and the economy of the country as a result of drug dependence can be significant. While illicit cultivation, production, distribution and possession of drugs are crimes, drug abusers commit crimes for money and after influence of drugs. Drug trade is involved with money laundering. Drug trafficking leads to all types of crime, violence and gun use, as seen in Sri Lanka. Monetary costs from theft and other crimes by abusers to support their drug habits, and money spent for law enforcement agencies and the judiciary can be significant.
Many recommendations are made to prevent and treat drug abuse. Return to old family values in the society is one. There should be adjustment to accept the return of a family member who was a drug abuser. Families counselling for change, informing and educating parents and support and strengthen religious values are also recommended.
As Kofi Annan, a former UN Secretary-General said, “Illicit drugs destroy innumerable individual lives and undermine our societies. Confronting the illicit trade in drugs and its effects remains a major challenge for the international community