WHAT IS A DRUG?

A drug is any kind of medicine or chemical that changes how your body or brain functions.
A drug is any substance (other than food that provides nutritional support) that, when inhaled,
injected, smoked, consumed, absorbed via a patch on the skin, or dissolved under the tongue causes
a physiological change in the body. There are legal drugs, which can be bought over the counter or
get from a health professional, and illegal (or ‘street’) drugs.

MEDICAL DRUGS:
Some medical drugs have side effects that make them appealing to people who don’t have a
medical reason to take them. They include drugs such as:

1. benzodiazepines (Xanax, Valium, Ambien)

2. amphetamines (Dextroamphetamine, Ritalin)
3. opiate painkillers (Vicodin, Oxycodone, Codeine).

Even though these drugs are prescribed for medical purposes, they can be extremely
dangerous. They are often very addictive, and if taken improperly or with alcohol or other drugs,
they can cause death.

WHAT ARE THE FIVE MAIN TYPES OF DRUGS?

In regards to addiction treatment and rehabilitation, the drug classifications used most often
are the following five classes regulated by the Controlled Substances Act:

1. Narcotics or Opioids.
2. Depressants.
3. Stimulants.
4. Hallucinogens.
5. Anabolic steroids
1. NARCOTICS or OPIOIDS:
Opioids or Narcotics attach to proteins called opioid receptors on nerve cells in the brain,
spinal cord, gut, and other parts of the body. When this happens, the Opioids block pain messages
sent from the body through the spinal cord to the brain. While they can effectively relieve pain,
Opioids carry some risks and can be highly addictive. The risk of addiction is especially high when
Opioids are used to manage chronic pain over a long period of time.

Examples- Codeine, Meperidine, Morphine, Oxycodone and naloxone.

Side effects of opioids include:

Sleepiness, Constipation, Nausea etc.

Addiction is also possible. Opioids can make your brain and body believe the drug is
necessary for survival. As you learn to tolerate the dose you’ve been prescribed, you may find that
you need even more medication to relieve the pain — sometimes resulting in addiction. More than 2
million Americans misuse Opioids, according to the National Institute on Drug Abuse, and every
day more than 90 Americans die by Opioids overdose."

2. DEPRESSANTS:
These drugs slow down (the central nervous system) the messages sent to and from your
brain. For this reason, they’re often called ‘downers’. They make people feel relaxed, less tense, and
less aware of events around them.
Examples of depressants are:

1. Alcohol , opiates (such as heroin and morphine), Inhalants, cannabis, Sleeping Pills,
Ketamine, sedatives (such as Valium) and
2. Prescription Pain Killers
3. Opioids, Oxycontin: Straight talk

Large amounts of depressants can: make you pass out, stop your breathing, make you feel
nauseous, make you vomit

3. STIMULANTS:
These drugs speed up the central nervous system. Stimulants, or ‘uppers’, speed up the
messages sent to and from your brain. They help people feel more alert and they increase the user’s
physical energy. Stimulants are taken to make people feel happy and to decrease appetite.
Examples of stimulants are: Tobacco, Cocaine/Crack, Amphetamines, Methamphetamine,
caffeine, nicotine, ecstasy etc.

Stimulants can put a strain on your heart, increase your body temperature, make you paranoid,
anxious or psychotic. Using different stimulants together, or in combination with depressants, puts
an extra strain on your heart and can cause major health problems.
4. HALLUCINOGENS:
These drugs are sometimes called “mind-altering” or “mind-expanding” drugs.
Hallucinogens change your perception of reality. They can increase a person’s awareness of sight,
touch, taste, feeling and hearing. Objects may take on different shapes and sizes, sounds may be
heard louder or softer. Hallucinogens can also alter a person’s mood. Examples of hallucinogens
are:

Marijuana (Cannabis or Weed), Ecstasy, LSD (lysergic acid diethylamide), mescaline,

magic mushrooms.

People who take hallucinogens often have 'trips', which is when they hear and see things that
aren’t really there. How your 'trip' goes depends on your mood, state of mind and the setting. You
can't predict whether a ‘trip’ will be good or bad, or how strong it will be.

Hallucinogens can make you: feel panicky, anxious or paranoid, take risks you wouldn't
normally take, lose touch with reality (psychosis).

5. ANABOLIC STEROIDS:
Anabolic steroids work by imitating the properties of naturally occurring hormones. They
have a similar chemical composition to testosterone and are therefore able to activate testosterone
receptors. Once the receptors are stimulated, a domino effect of metabolic reactions takes place as
the drug instructs the body to increase muscle tissue production.

Examples- Nandrolone, oxandrolone, oxymetholone, stanozolol and trenbolone acetate.

Anabolic steroids affects everyone differently. The following may be experienced-

Aggression and violence, Sleeping difficulties, Liver damage, Kidney or prostrate cancer,
High blood pressure, Depression, Cardiovascular complications etc.

WHAT ARE THE DIFFERENT CATEGORIES OF DRUGS?

Types of drugs include:
1. Opiods: Codeine, Oxycodone, Morphine.
2. Central nervous system depressants: barbiturates, benzodiazepines.
3. Stimulants: dextroamphetamine, methylphenidate.
WHAT IS DRUG ADDICTION?
Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or
difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for
most people, but repeated drug use can lead to brain changes that challenge an addicted person’s
self-control and interfere with their ability to resist intense urges to take drugs. These brain changes
can be persistent, which is why drug addiction is considered a "relapsing" disease—people in
recovery from drug use disorders are at increased risk for returning to drug use even after years of
not taking the drug. These brain changes can be long-lasting, and can lead to the harmful behaviors
seen in people who abuse drugs.

WHAT HAPPENS TO THE BRAIN WHEN A PERSON TAKES DRUGS?

Most drugs affect the brain's "reward circuit" by flooding it with the chemical messenger
dopamine. This reward system controls the body's ability to feel pleasure and motivates a person
to repeat behaviors needed to thrive, such as eating and spending time with loved ones. This
overstimulation of the reward circuit causes the intensely pleasurable "high" that can lead people to
take a drug again and again.

As a person continues to use drugs, the brain adjusts to the excess dopamine by making less
of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high
that the person feels compared to the high they felt when first taking the drug—an effect known as
tolerance. They might take more of the drug, trying to achieve the same dopamine high. It can also
cause them to get less pleasure from other things they once enjoyed, like food or social activities.

Long-term use also causes changes in other brain chemical systems and circuits as well, affecting
functions that include: Learning, judgment, decision-making, stress, memory, behaviours.

Despite being aware of these harmful outcomes, many people who use drugs continue to take them,
which is the nature of addiction.

WHY DO SOME PEOPLE BECOME ADDICTED TO DRUGS WHILE

OTHERS DON'T?
No one factor can predict if a person will become addicted to drugs. A combination of factors
influences risk for addiction. The more risk factors a person has, the greater the chance that taking
drugs can lead to addiction. For example:

1. Biology:
The genes that people are born with account for about half of a person's risk for
addiction. Gender, ethnicity, and the presence of other mental disorders may also influence
risk for drug use and addiction.
 2. Environment:
A person’s environment includes many different influences, from family and friends
to economic status and general quality of life. Factors such as peer pressure, physical and
sexual abuse, early exposure to drugs, stress, and parental guidance can greatly affect a
person’s likelihood of drug use and addiction.

3. Development:
Genetic and environmental factors interact with critical developmental stages in a
person’s life to affect addiction risk. Although taking drugs at any age can lead to addiction,
the earlier that drug use begins, the more likely it will progress to addiction. This is
particularly problematic for teens. Because areas in their brains that control decision-making,
judgment, and self-control are still developing, teens may be especially prone to risky
behaviors, including trying drugs.

WHY DO PEOPLE TAKE DRUGS?

In general, people begin taking drugs for a variety of reasons:

1. To feel good:
Most abused drugs produce intense feelings of pleasure. This initial sensation of
euphoria is followed by other effects, which differ with the type of drug used. For example,
with stimulants such as cocaine, the “high” is followed by feelings of power, self-
confidence, and increased energy. In contrast, the euphoria caused by opiates such as heroin
is followed by feelings of relaxation and satisfaction.

2. To feel better:
Some people who suffer from social anxiety, stress-related disorders, and
depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a
major role in beginning of drug use, continuing drug abuse, or relapse in patients recovering
from addiction.

3. To do better:
Some people feel pressure to chemically enhance or improve their cognitive or
athletic performance, which can play a role in initial experimentation and continued abuse
of drugs such as prescription stimulants or anabolic/androgenic steroids.

4. Curiosity and "because others are doing it.":

In this respect adolescents are particularly vulnerable because of the strong influence
of peer pressure. Teens are more likely than adults to engage in risky or daring behaviors to
impress their friends and express their independence from parental and social rules.
 5. Lifestyle Appeal:
Sometimes individuals find the lifestyle of the substance abuser to be appealing,
perhaps even glamorous. Observers will notice the way a community of substance abusers
dress, the music they listen to, what they do for fun, their attitude toward structure and
responsibility, and find this lifestyle appealing.

6. Relief from Stress:

Another common reason people overindulge is for the sense of relief from the stresses
of daily life. Have you ever heard someone say that their drug of choice is “an outlet” or
their means of temporarily “escaping reality”? This typical, yet harmful, justification of
frequent intoxication is common and frequently a precursor to full-blown addiction.

7. Sense of Community:
The primary contributor—by a large margin—for use of narcotics such as cocaine and
heroin are peer group characteristics, followed distantly by adverse familiar conditions and
individual social circumstances (such as homelessness). Another social factor that contributes
to addiction is the tendency for drug and alcohol abuse to promote group solidarity and
feelings of community and belonging. In particular, the primary contributor—by a large
margin—for use of narcotics such as cocaine and heroin are peer group characteristics,
followed distantly by adverse familiar conditions and individual social circumstances (such
as homelessness).

8. The Allure of Rebelling:

The abuse of alcohol and drugs, by nature, creates the sense that one is rebelling
against the norms and expectations of society. Adolescents in particular will turn to substance
abuse as a way to “act out” against authority and the limitations imposed on them both at
school and at home.

IF TAKING DRUGS MAKES PEOPLE FEEL GOOD OR BETTER, WHAT'S

THE PROBLEM?
When they first use a drug, people may perceive what seem to be positive effects; they also
may believe that they can control their use. However, drugs can quickly take over a person’s life.
Over time, if drug use continues, other pleasurable activities become less pleasurable, and taking the
drug becomes necessary for the user just to feel “normal.” They may then compulsively seek and
take drugs even though it causes tremendous problems for themselves and their loved ones. Some
people may start to feel the need to take higher or more frequent doses, even in the early stages of
their drug use. These are the telltale signs of an addiction.

Even relatively moderate drug use poses dangers. Consider how a social drinker can become
intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that
affects many lives.
IS CONTINUED DRUG ABUSE A VOLUNTARY BEHAVIOR?
The initial decision to take drugs is typically voluntary. However, with continued use, a
person’s ability to exert self-control can become seriously impaired; this impairment in self-control
is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes
in areas of the brain that are critical to judgment, decision making, learning and memory, and
behavior control. Scientists believe that these changes alter the way the brain works and may help
explain the compulsive and destructive behaviors of addiction. No single factor determines
whether a person will become addicted to drugs.

WHY DO SOME PEOPLE BECOME ADDICTED TO DRUGS, WHILE

OTHERS DO NOT?
As with any other disease, vulnerability to addiction differs from person to person, and no
single factor determines whether a person will become addicted to drugs. In general, the more risk
factors a person has, the greater the chance that taking drugs will lead to abuse and addiction.
Protective factors, on the other hand, reduce a person’s risk of developing addiction. Risk and
protective factors may be either environmental (such as conditions at home, at school, and in the
neighbourhood) or biological (for instance, a person’s genes, their stage of development, and even
their gender or ethnicity).

SOCIAL AND CULTURAL ASPECTS OF DRUG ABUSE IN ADOLESCENTS:

There are many factors that play a part in initiation and maintenance of drug abuse in
adolescents. The social and cultural factors influencing the initiation of tobacco use vary from
country to country, from developed world to developing nations, region to region and culture to
culture.

1. Parental Influence:
Parents have a tremendous influence on their children and the children of smoker parents are
twice likely to become smokers. Parental disapproval of smoking makes an adolescent less likely to
initiate smoking. Female adolescents are more likely to be smokers if both parents are smokers.
There is a strong correlation between mother smoking and the female youth becoming a smoker.
Parents who smoke may also give easy access to cigarettes and less likely to oppose their children’s
smoking. Cannabis, a traditional drug in Indian society is ritualized in social and religious
gatherings. It is a socially sanctioned behaviour in certain cultural groups to use Bhang and Charas
by adolescents and has parental approval for that. Parental attitude towards alcohol plays an
important role in initiating the adolescent to drink alcohol.
2. Family Structure:
Higher levels of parental education and socioeconomic variables have inverse relationship
with tobacco use and use of other psycho-active substances among adolescents. Prevalence of
smoking is more common in families which are with low socio-economic educational status of the
society. Children using inhalants generally hail from low socio-economic status, engaged in menial
work with unstable family income. Marital discord, divorce among parents, single parenting, is
associated with drug abuse among adolescents. Parents having poor monitoring of their children are
likely to have their children abusing drugs.

3. Peer Influence:
Friends have the greatest influence on the young smokers. The initiation of tobacco smoker
generally occurs in the company of a friend who is a smoker. Female adolescents with a best friend
who is a smoker are nine times more at risk to become smokers. Smoking is a shared activity with
important socializing functions for female youth. Cannabis abuse in school going population has
been associated with poor scholastic performance, school drop-out and reinforcement of conduct
symptoms These adolescents form their own peer group.

4. Role Model:
Film and TV stars, pop stars and fashion models make smoking seem attractive and the
adolescents imitate them to smoke their style. They leave tremendous impact on adolescent mind.

5. Advertising and Promotion:

Advertising is an effective weapon to influence the decision of young to initiate smoking.
Advertising bans have been found to be very effective in reducing cigarette smoking prevalence in
youth. Indian Government has banned advertisement of cigarettes and other tobacco products
through an Act.

6. Socio-economic Factors:
Higher drug-abuse rates are observed in lower income groups. Adolescents from low
socioeconomic background are more likely to become smokers than the middle-class counterparts.
This difference in smoking pattern may reflect divergent beliefs about tobacco use based on socio-
economic status. In India, beedi smoking is more common in adolescents for the reasons of easy
availability, low in price and convenient to use. Adolescents from low income families tend to use
cheap and spurious country-made liquor prepared illegally. Use of inhalants is also common in the
adolescents from poor families.

7. Availability:
Availability and accessibility are important factors in initiation and maintenance of drug
abuse among adolescents. An adolescent who has an easy access to drugs or alcohol because his
parents or elder sibling is using, is more likely to use these drugs than those whose parents or any
one else is not using these in the family. Similarly peer group members making the product
available are likely to recruit new adolescents in the drug use behaviour.
8. Knowledge, Attitude and Beliefs:
Knowledge about the detrimental health effects has preventive effect on drug use. Some
believe that moderate alcohol consumption does not have adverse effects, tobacco cessation could
lead to weight gain and cannabis is a social and religious blessing of gods. These beliefs permit the
adolescents to use drugs without hesitation or guilt. Positive attitude towards the drugs is likely to
initiate drug use among the adolescents.

SOCIAL AND CULTURAL CONSEQUENCES OF ADOLESCENT

SUBSTANCE ABUSE
Drug abuse has led to a detrimental impact on the society. Apart from affecting the financial
stability, addiction increases conflicts and causes untold emotional pain for every member of the
family. With most drug users being in the formative age group, the loss in terms of human potential
is incalculable. The damage to the physical, psychological, moral and intellectual growth of the
youth is very high. Adolescent drug abuse is one of the major areas of concern in adolescent and
young people’s behavior. The use of substances may compromise an adolescent’s mental and
emotional development by interfering with how young people approach and experience interactions.
In addition, adolescents are at serious risk for a number of direct and indirect consequences,
including the following:

1. Traffic Accidents:
Nearly half (45%) of all deaths from traffic accidents are related to alcohol
intoxication or influence of other drugs, and an estimated 18% of drivers age 16 to 20 (or 2.5
million adolescents) drive under the influence of alcohol.

2. School-Related Problems:
Adolescent substance abuse is associated with declining grades, absenteeism from
school, and dropping out of school. Cognitive and behavioral problems experienced by teens
abusing substances may interfere with their academic performance.

3. Risky Sexual Practices:

Adolescents who use drugs and alcohol are more likely than non-using teens to have
sex, initiate sex at a younger age, and have multiple sex partners, placing them at greater risk
for unplanned pregnancies and HIV/ AIDS, hepatitis C, and other sexually transmitted
diseases.

4. Delinquent Behavior:
Adolescents who use marijuana weekly are six times more likely than nonusers to
report they run away from home, five times more likely to say they steal from places other
than home, and four times more likely to report they physically attack people.
5. Juvenile Crime:
Adolescent drug use has led to increase in the crime rate. Addicts resort to crime to
pay for their drugs. Drugs remove inhibition and impair judgment egging one on to commit
offences. Incidence of eve-teasing, group clashes, assault and impulsive murders increase
with drug abuse. Adolescents age 12 to 16 who have ever used marijuana are more likely at
some point to have sold marijuana (24 percent vs. less than 1 percent), carried a handgun
(21 percent vs. 7 percent), or been in a gang (14 percent vs. 2 percent) than youth who have
never used marijuana.

6. Developmental Problems:
Substance abuse can compromise an adolescent’s psychological and social
development in areas such as the formation of a strong self-identity, emotional and
intellectual growth, establishment of a career, and the development of rewarding personal
relationships.

7. Physical and Mental Consequences:

Smoking marijuana can have negative effects on the user’s mind and body. It can
impair short-term memory and comprehension, alter one’s sense of time, and reduce the
ability to perform tasks that require concentration and coordination, such as driving a car.
Evidence also suggests that the long-term effects of using marijuana may include increased
risk of lung cancer and other chronic lung disorders, head and neck cancer, sterility in
men, and infertility in women.

8. Infections:
Increase in incidences of HIV, hepatitis B and C and tuberculosis due to addiction
adds the reservoir of infection in the community burdening the health care system further.
Women in India face greater problems from drug abuse. The consequences include domestic
violence and infection with HIV, as well as the financial burden.

9. Violence:
87% of adolescent addicts being treated in a de-addiction center run by the Delhi
police acknowledged being violent with family members. Most of the domestic violence is
directed against women and occurs in the context of demands for money to buy drugs. At the
national level, drug abuse is intrinsically linked with racketeering, conspiracy, corruption,
illegal money transfers, terrorism and violence threatening the very stability of governments.
Drug abuse and suicide have strong association.

10. Future Use Disorders:

The earlier the age at which a person first drinks alcohol, the more likely that person is
to develop an alcohol use disorder. A person who starts drinking alcohol at age 13 is four
times more likely to develop alcohol dependence at some time in his or her life than someone
who starts drinking at age 20.
DRUG TRAFFICKING AND LEGISLATION:
India has braced itself to face the menace of drug trafficking both at the national and
international levels. Several measures involving innovative changes in enforcement, legal and
judicial systems have been brought into effect. The introduction of death penalty for drug related
offences has been a major deterrent. The Narcotic Drugs and Psychotropic Substances Act, 1985,
were enacted with stringent provisions to curb this menace. The Act envisages a minimum term of
10 years imprisonment extendable to 20 years and fine of Rs. 1 lakh extendable up to Rs. 2 lakhs for
the offenders. The Act has been further amended by making provisions for the forfeiture of
properties derived from illicit drugs trafficking. Comprehensive strategy involving specific
programmes to bring about an overall reduction in use of drugs has been evolved by the various
government agencies and NGOs and is further supplemented by measures like education,
counseling, treatment and rehabilitation programmes. India has bilateral agreements on drug
trafficking with 13 countries, including Pakistan and Burma. Prior to 1999, extradition between
India and the United States occurred under the auspices of a 1931 treaty signed by the United States
and the United Kingdom, which was made applicable to India in 1942. However, a new extradition
treaty between India and the United States entered into force in July 1999. A Mutual Legal
Assistance Treaty was signed by India and the United States in October 2001.

SIGNS AND SYMPTOMS OF SUBSTANCE ABUSE:

People who interact with adolescents in the home or community need to be alert to changes
in an adolescent’s behavior and appearance that may signal substance abuse. By recognizing the
potential warning signs and symptoms of substance use, you may be able to get help for a teenager
in need of treatment. The following behavior changes, when extreme or lasting for more than a few
days, may indicate alcohol-related or drug-related problems and the need for further screening by a
professional.

1. Sudden changes in personality without another known cause.

2. Loss of interest in once favourite hobbies, sports, or other activities.

3. Sudden decline in performance or attendance at school or work.

4. Changes in friends and reluctance to talk about new friends.

5. Deterioration of personal grooming habits.

6. Difficulty in paying attention, forgetfulness.

7. Sudden aggressive behavior, irritability, nervousness, or giddiness.

8. Increased secretiveness, heightened sensitivity to inquiry