Medical complications of

drug taking
 TYPES OF COMPLICATIONS:

There are two types of complications

General complications
Socio-economic complications
 1) General complications:

Mortality Rate:
It is Increase in number of deaths in a population per unit
time.
Mortality rate of injecting drug user was estimated in 12 studies
from several developed countries, carried out between 1968 –
1993 as 13.2%. This means that mortality rate observed among
injecting drug users in about 13 times higher than expected
with those having no history of injecting drug use.
When HIV enters the drug injecting population, HIV related
medical complications dominate the clinical picture and the
mortality increases within a few years and death from HIV or
AIDS then became more common than death from drug
overdose.
 General complications:

Morbidity Rate:
“The disease rate in the society of community is known as
Morbidity rate”
 Most of the complications are due to hazardous
consumptions of both legal and illegal drugs like alcohol,
amphetamine, cigarette, BZD, barbiturates and cocaine.
Illicit drug use is associated with the factors, which
include common complaints, skin diseases,
respiratory diseases, gynecological diseases,
hepatitis, poor living conditions, high rates of
unemployment, high rates of incarceration
(imprisonment)
 SPECIFIC/ GENERAL HEALTH PROBLEMS

Specific or general health problems that arise due to drug

complications are
i)Drug Overdose:
It is the major cause of death in world where prevalence of HIV
infection is low and second major cause of death where HIV is
prevalent among injecting drug users.
Experience of non-fatal drug overdose is very common. Most
injecting drug users have witnessed a non-fatal or even a fatal
drug overdose.
Drug overdose occurs following ingestion of multiple
substances e.g. heroine, alcohol, BZD.
Number of deaths due to overdose has increased globally in
recent years, due to increased number of illicit drug users.
 SPECIFIC/ GENERAL HEALTH PROBLEMS

ii) Hepatitis:
HIV, HBV and HCV are spread by blood-blood contact
while HIV, HBV are also transmitted by sexual contact.
One case control study showed a nine folded elevated
increased risk hepatitis ‘A” among injecting drug use is a
relatively important mechanism for spread of HBV and HCV
iii) Sexually transmitted infections and Gynecological
complaints:
Sexually transmissible infections are very common among
injecting drug users. This may result in an increased risk of
sexually transmissible infections and pelvic
inflammatory disease.
 SPECIFIC/ GENERAL HEALTH PROBLEMS

iv) Bacterial infections:

Bacterial complications of injecting drugs including
infections with the agents which cause tetanus. More
recently, outbreaks of tetanus serious disease causing
muscle paralysis and possibly death, which has been
directly linked with the use of heroine.
v) Violence:
Injecting drug users are often injured or killed by violent
means. Some injuries and deaths result from territorial
disputes between drug trafficking gangs.
Illicit drug use appears to contribute little to read crash
injuries and fatalities.
SPECIFIC/ GENERAL HEALTH PROBLEMS

vi) Fungal Infections:

Candidiasis and other fungal infections occur among
injecting drug users eg. Aspergillus has been linked to
contamination of lemon juice containers used to acidify
street heroines.
vii) Tuberculosis:
After several decades of declining incidence and
prevalence, TB is once again emerging as an
international problem. TB is more common in HIV
infected injecting drug users.
 SPECIFIC/ GENERAL HEALTH PROBLEMS

Viii) Parasitic infections:

Malarial outbreaks linked to infecting drug users and
sharing of injecting equipments or apparatus have been
detected
ix) Venous and Arterial problems:
Damage to veins occurs from repeated vein puncture often
with blunt previously used needles. Chemical phlebitis results
from adulterants commonly found in street heroine samples
such as talc used to dilute street heroine.
Some injecting drug users also grind up and inject tablets
including BZD and other opioids.
Arterial spasm damage to arterial wall results in the use of
heroine injections.
 SPECIFIC/ GENERAL HEALTH PROBLEMS

x) Dental Problems:
Dental decay is common among injecting drug users. Opioid drugs
like heroine and methadone decrease the salivary flow and
increase the rate of dental caries
xi) Respiratory Disease:
Respiratory symptoms are common among drug injectors and are
usually due to tobacco smoking. Acute pulmonary edema occurs due
to heroin overdose.
xii) Cardiovascular Problems:
Arrhythmias, MI, hypertension are known complications of cocaine
use.
xiii) Mental Illness:
A high prevalence of variety of mental illness has been repeatedly
found in studies of injecting drug users
 2. SOCIO ECONOMIC COMPLICATIONS

These are the implications of drug taking without any

guideline of health care professional or pharmacist.
Socioeconomic complications include
Frustration
Isometric and social violence
Suicidal attempts
Terrorism
Unemployment
Imprisonment
Mental Retardation
 SOCIO-ECONOMIC FACTORS:

SOCIAL FACTORS
i) Unemployment:
very common among injecting users
Direct effect of health leading to social problems
ii) Incarceration (imprisonment)
Very common among injecting drug users
Increased ratio of HIV infection has been repeated in
long term incarcerated individual
Increased ratio of HCV and HBV are also common
Involved in purchasing street drugs
 SOCIO-ECONOMIC FACTORS:

iii) Living condition:

Poor living condition
Homelessness
Lack of basic necessities
Usually occupy temporary accommodation
iv) Crime:
Criminal record is magnificently clear and very common in
injecting drug users
Mobile snatching
Property crimes
Street crimes
Black marketing of street drugs
 SOCIO-ECONOMIC FACTORS:

ECONOMIC FACTORS
 Most illicit drug users are substantially in dept for
the majority of their drug using career.
Expenditures on drugs of Rs 100,000 is very
common among illicit drug users
A life of chronic poverty has an independent impact
on health which leads to costly/ expensive
treatments
All factors ultimately resulting in committing various
crimes to get illicit drugs
 IMPROVING THE HEALTH OF INJECTING DRUG
USERS

Improving drug policy in worldwide countries.

Pharmacological treatment e.g. methadone,
maintenance
Provision of quality primary healthcare
HBV vaccination must be provided to injecting drug
users
Harm reduction strategies must be adopted
Peer-based education (visible)
Counseling and awareness programs should be
conducted
CONCLUSION:

More effective policies are required in response to

illicit drug use to diminish the complications faced
by individual and community
Role pharmacist in drug abuse
Role pharmacist in drug abuse
Role pharmacist in drug abuse