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DRUGS AND DRUG ABUSE

Author: Aanchal Gupta, II year of B.B.A.,LL.B. from Gitarattan International Business School, New Delhi


ABSTRACT

Drug addiction affects both the brain and behaviour. It has multifaceted impacts on the patients’ body, mind, and nervous system. Drugs that are psychologically active are used to induce consciousness. This can be modifying the perceptions, feelings, and emotions of the user. When a psychological active drug intake to the body, induces an intoxicating effect. Some of the persons may use recreational and medical practitioner suggested drugs without becoming addicted, many persons who start using drugs converted to physically and emotionally dependent on them. So, Drug abuse causes vary greatly, depending on everyone and the extent of his or her addiction. Initially, many people start using drugs to cope with stress or pain. An effect of drug addiction is the creation of a cycle where anytime the user encounters stress or pain, they feel the need to use the drug. This is one of the psychological effects of drug addiction involved in the "craving" of the drug. Various Medicinal Plants used for Addiction Treatment. Many drugs of abuse, including cannabinoids, opioids, alcohol and nicotine, can alter the levels of endocannabinoids in the brain. Recent studies show that the release of endocannabinoids in the ventral tegmental area can modulate the reward-related effects of dopamine and might therefore be an important neurobiological mechanism underlying drug addiction. There is strong evidence that the endocannabinoid system is involved in drug-seeking behaviour (especially behaviour that is reinforced by drug-related cues), as well as in the mechanisms that underlie relapse to drug use. The cannabinoid CB1 antagonist/inverse agonist rimonabant has been shown to reduce the behavioural effects of stimuli associated with drugs of abuse, including nicotine, alcohol, cocaine, and marijuana. Drug abuse addiction is a chronic illness with relapse rates like those of hypertension, diabetes, and asthma. And it refers to the use of certain chemicals to create pleasurable effects on the brain. There are over 190 million drug users around the world and the problem has been increasing at alarming rates, especially among young adults under the age of 30. Drug addiction is a preventable disease. Through scientific advances, we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives. Most countries have legislation designed to criminalize some drugs. To decrease the prevalence of this problem in our setting; increase awareness, promote additional research on abused and addictive drugs, and exact implementation of existing laws are strongly recommended. We should also deserve renewed attention on prescription drug abuse. Drugs of abuse are usually psychoactive drugs that are used by people for various reasons which may include curiosity and peer pressure, especially among school children and young adults.

KEYWORDS: drug, drug abuse, psychological illness, peer groups etc.


INTRODUCTION

Drug addiction affects both the brain and behaviour. It has multifaceted impacts on the patients’ body, mind, and nervous system. Drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, hallucinogens, methaqualone, and opioids. The exact cause of substance abuse is not clear, but there are two predominant theories: either a genetic disposition that is learned from others or a habit which, if addiction develops, manifests itself as a chronic debilitating disease.


Addiction is most simply defined as the continued use of drugs despite adverse consequences. Clinicians using the Diagnostic and Statistical Manual of Mental Disorders (DSM) often distinguish between substance abuse, which is simply the addictive pattern over a year or more, and substance dependence, which is the addictive pattern over a year with the additional feature of significant tolerance and withdrawal (as seen especially with opiates and alcohol). Most patients, and many professionals, believe that addictions are a form of self-medication for deeper underlying disorders, such as anxiety, depression, or stress. This hypothesis has been largely discredited by the prospective studies of George Vaillant and others. This means that addictions require treatment in their own right, separate from psychiatric disorders. It is known, for example, that 40–60% of the risk for alcoholism is inherited, but there is far less certainty about the heritability of addiction to cocaine or opiates. Thus, it is known that addictions have genetic underpinnings, activate increasingly well-understood reward centres in the brain, and their expression is influenced by cultural/environmental factors.


Drug abuse is considered a great challenge to social and public health in the world. To date, 185 million addicts are there around the world. According to the statistics, with 1,200,000 permanent drug abusers and 600,000 occasional abusers, herbal medicine has a long history in the treatment of diseases and the majority of people tend to use such medications. The abuse of drugs and alcohol is a major problem worldwide, costing 250 billion dollars annually due to premature deaths, healthcare expenditures, reduction of productivity, lost earnings and drug-related crime in the United States alone (estimated by U.S. National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism). Drug addiction is considered to be a chronic, relapsing disorder characterized by compulsive drug-seeking, by continued use despite serious negative socio-economic and health consequences, and by loss of control over drug use (Cami and Fare 2003). The World Health Organization and the American Psychiatric Association use the term “substance dependence” rather than “drug addiction”. Both terms are used interchangeably in the literature, but the latter term is less likely to be confused with physical dependence and emphasizes the behavioural component of the process. According to the DSM-IV (American Psychiatric Association 1994), three or more of the following must be present to diagnose substance dependence: a) symptoms of tolerance, b) symptoms of withdrawal, c) large amounts of drug taken, d) unsuccessful attempts or desire to control use, e) considerable time spent obtaining the substance, f) reduction of social and occupational activities due to abuse, g) continued use of a substance despite physical or psychological problems.


Drug abuse, also known as substance abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.


Definitions of drug abuse and addiction are subjective and infused with the political and moral values of society or culture. For example, the stimulant caffeine in coffee and tea is a drug used by millions of people, but because of its relatively mild stimulatory effects and because caffeine does not generally trigger antisocial behaviour in users, the drinking of coffee and tea, even though caffeine is physically addictive, is not generally considered drug abuse. Even narcotics addiction is seen only as drug abuse in certain social contexts. In India opium has been used for centuries without becoming unduly corrosive to the social fabric. The United States has the highest substance abuse rate of any industrialized nation. Government statistics (1997) show that 36% of the United States population has tried marijuana, cocaine, or other illicit drugs. By comparison, 71% of the population has smoked cigarettes and 82% has tried alcoholic beverages. [1]Marijuana is the most used illicit drug.

Types of Abused Substances

There are many levels of substance abuse and many kinds of drugs, some of them readily accepted by society.


Legal Substances

Legal substances, approved by law for sale over the counter or by doctor's prescription, include caffeine, alcoholic beverages (see alcoholism), nicotine (see smoking), and inhalants (nail polish, glue, inhalers, gasoline). Prescription drugs such as tranquillizers, amphetamines, benzodiazepines, barbiturates, steroids, and analgesics can be knowingly or unknowingly overprescribed or otherwise used improperly. In many cases, new drugs prescribed in good conscience by physicians turn out to be a problem later. For example, diazepam (Valium) was widely prescribed in the 1960s and 70s before its potential for serious addiction was realized. In the 1990s, sales of fluoxetine (Prozac) helped create a $3 billion antidepressant market in the United States, leading many people to criticize what they saw as the creation of a legal drug culture that discouraged people from learning other ways to deal with their problems. At the same time, readily available but largely unregulated herbal medicines have grown in popularity; many of these are psychoactive to some degree, raising questions of quality and safety. Prescription drugs are regulated by the Food and Drug Administration and the Drug Enforcement Administration.


Illegal Substances

Prescription drugs are considered illegal when diverted from proper use. Some people shop until they find a doctor who freely writes prescriptions; supplies are sometimes stolen from laboratories, clinics, or hospitals. Morphine, a strictly controlled opiate, and synthetic opiates, such as fentanyl, are most often abused by people in the medical professions, who have easier access to these drugs. Other illegal substances include cocaine and crack, marijuana and hashish, heroin, hallucinogenic drugs such as LSD, PCP (phencyclidine or "angel dust" ), "designer drugs" such as MDMA (Ecstasy), and "party drugs" such as GHB (gamma hydroxybutyrate).


Motivations for Drug Use

People take drugs for many reasons: peer pressure, relief of stress, increased energy, to relax, to relieve pain, to escape reality, to feel more self-esteem, and for recreation. They may take stimulants to keep alert, or cocaine for the feeling of excitement it produces. Athletes and bodybuilders may take anabolic steroids to increase muscle mass.


Signs of Drug Addiction

You keep taking a drug after it's no longer needed for a health problem. You need more and more of a substance to get the same effects (called "tolerance"), and you can take more before you feel an effect. You feel strange when the drug wears off. You may be shaky, depressed, and sick to your stomach, sweat, or have headaches. You may also be tired or not hungry. In severe cases, you could even be confused, have seizures, or run a fever. You can't stop yourself from using the drug, even if you want to. You are still using it even though it's making bad things happen in your life, like trouble with friends, family, work, or the law. You spend a lot of your time thinking about the drug: how to get more when you'll take it, how good you feel, or how bad you feel afterwards. You have a hard time giving yourself limits. You might say you will only use "so much" but then can't stop and end up using twice that amount.


What causes drug abuse?

While some people can use recreational and prescription drugs without becoming addicted, many individuals who start using drugs become physically and emotionally dependent on them. Drug abuse causes vary greatly, depending on everyone and the extent of his or her addiction. The extent of a person’s vulnerability to his or her addiction depends on their social environment, their mental and physical health, and genes. Countless other factors contribute to drug addiction as well. Once a person is addicted to drugs, he or she generally needs professional help and support to overcome their addiction. Understanding the underlying causes of an addiction can help an addicted person deal with the issues that lead to their drug abuse. For some individuals, the cause of their drug abuse is solely due to peer pressure. For many others, however, the reason for their excessive drug use is much more complicated.


Effects of drug addiction (physical and psychological)

Psychological effects of drug addiction

The psychological effects of drug addiction come from the reason the user is addicted to drugs, as well as the changes that take place in the brain once a person becomes a drug addict. Initially, many people start using drugs to cope with stress or pain. An effect of drug addiction is the creation of a cycle where anytime the user encounters stress or pain, they feel the need to use the drug. This is one of the psychological effects of drug addiction involved in the "craving" of the drug. Craving is an effect of drug addiction whereby the addict is obsessed with obtaining and using the drug, to the exclusion of all else. One of the psychological effects of addiction involved in craving is the belief the addict cannot function or handle life without the use of the drug. Other psychological effects of drug addiction include Wild mood swings, depression, anxiety, paranoia, violence, decrease in pleasure in everyday life, Complication of mental illness, Hallucinations, Confusion, Psychological tolerance to the drug's effects creating a desire to do ever-increasing amounts of the drug, Desire to engage in risky behaviour.


Physical effects of drug addiction

Physical effects of drug addiction vary by drug but are typically seen in all systems of the body. Some of the primary physical effects of drug addiction take place in the brain. Drug addiction changes the way the brain functions and impacts how the body perceives pleasure. These effects of drug addiction are because the drug repeatedly floods the brain with the chemical dopamine and serotonin during drug use. The brain adapts and comes to expect, and depend on, these drug-induced highs. Physical effects of drug addiction are also seen in babies of drug abusers as well as in mortality statistics. One effect of drug addiction is: children born to drug-using mothers can be cognitively affected throughout life. Regarding mortality, one-in-four deaths are because of drug addiction. Other physical effects of drug addiction include Contraction of HIV, hepatitis and other illnesses, Heart rate irregularities, heart attack, respiratory problems such as lung cancer, emphysema and breathing problems, Abdominal pain, vomiting, constipation, diarrhoea, Kidney and liver damage, Seizures, stroke, brain damage, Changes in appetite, body temperature and sleeping patterns.


Effects of Substance Abuse

The effects of substance abuse can be felt on many levels: on the individual, on friends and family, and society.


On the Individual

People who use drugs experience a wide array of physical effects other than those expected. The excitement of a cocaine high, for instance, is followed by a "crash": a period of anxiety, fatigue, depression, and an acute desire for more cocaine to alleviate the feelings of the crash. Marijuana and alcohol interfere with motor control and are factors in many automobile accidents. Users of marijuana and hallucinogenic drugs may experience flashbacks, unwanted recurrences of the drug's effects weeks or months after use. Sudden abstinence from certain drugs results in withdrawal symptoms. For example, heroin withdrawal can cause vomiting, muscle cramps, convulsions, and delirium. With the continued use of a physically addictive drug, tolerance develops, i.e., constantly increasing amounts of the drug are needed to duplicate the initial effect. Sharing hypodermic needles used to inject some drugs dramatically increases the risk of contracting AIDS and some types of hepatitis. In addition, increased sexual activity among drug users, both in prostitution and from the disinhibiting effect of some drugs, also puts them at a higher risk of AIDS and other sexually transmitted diseases. Because the purity and dosage of illegal drugs are uncontrolled, drug overdose is a constant risk. There are over 10,000 deaths directly attributable to drug use in the United States every year; the substances most frequently involved are cocaine, heroin, and morphine, often combined with alcohol or other drugs. Many drug users engage in criminal activity, such as burglary and prostitution, to raise the money to buy drugs, and some drugs, especially alcohol, are associated with violent behaviour.


Effects on the Family

The user's preoccupation with the substance, plus its effects on mood and performance, can lead to marital problems and poor work performance or dismissal. Drug use can disrupt family life and create destructive patterns of codependency, that is, the spouse or whole family, out of love or fear of consequences, inadvertently enables the user to continue using drugs by covering up, supplying money, or denying there is a problem. Pregnant drug users, because of the drugs themselves or poor self-care in general, bear a much higher rate of low birth-weight babies than the average. Many drugs (e.g., crack and heroin) cross the placental barrier, resulting in addicted babies who go through withdrawal soon after birth, and fatal can affect children of mothers who consume alcohol during pregnancy. Pregnant women who acquire the AIDS virus through intravenous drug use pass the virus to their infants.

Effects on Society

Drug abuse affects society in many ways. In the workplace, it is costly in terms of lost work time and inefficiency. Drug users are more likely than nonusers to have occupational accidents, endangering themselves and those around them. Over half of the highway deaths in the United States involve alcohol. Drug-related crime can disrupt neighbourhoods due to violence among drug dealers, threats to residents, and the crimes of the addicts themselves. In some neighbourhoods, younger children are recruited as lookouts and helpers because of the lighter sentences given to juvenile offenders, and guns have become commonplace among children and adolescents. The great majority of homeless people have either a drug or alcohol problem or a mental illness—many have all three.The federal government budgeted $17.9 billion on drug control in 1999 for interdiction, prosecution, international law enforcement, prisons, treatment, prevention, and related items. [2]In 1998, drug-related health care costs in the United States came to more than $9.9 billion.


Treatment

Treatment of substance abusers depends upon the severity and nature of the addiction, motivation, and the availability of services. Some users may come into treatment voluntarily and have the support of family, friends, and the workplace; others may be sent to treatment by the courts against their will and have virtually no support system. Most people in drug treatment have a history of criminal behaviour; approximately one third are sent by the criminal justice system.

Both pharmacological and behavioural treatments are used, often augmented by educational and vocational services. Treatment may include detoxification, therapy, and support groups, such as the 12-step groups Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous. Non-residential programs serve the largest number of patients. Residential facilities include hospitals, group homes, halfway houses, and therapeutic communities, such as Phoenix House and Day top Village; most of the daily activities are treatment-related. Programs such as Al-Anon, Cannon, and A lateen, 12-step programs for family and friends of substance abusers, help them to break out of co-dependent cycles.


Some treatment programs use medicines that neutralize the effects of the drug. Antabuse is a medicine used in the treatment of alcoholism. It causes a severe and sudden reaction (nausea, vomiting, headache) when alcohol is present. Naltrexone, to treat alcohol and heroin abuse, and acamprosate, used to treat alcoholism, both reduce cravings. Other programs use stabilizing medications, e.g., methadone or buprenorphine maintenance programs for heroin addiction. Acupuncture has been successful in treating the cravings that accompany cocaine withdrawal and is being used with pregnant substance abusers to improve the health of their babies.


For every person in drug treatment, there are an estimated three or four people who need it. Many who attempt to get treatment, especially from public facilities, are discouraged by waits of over a month to get in. Evaluating the effectiveness of treatment is difficult because of the chronic nature of drug abuse and alcoholism and the fact that the disease is usually complicated by personal, social, and health factors.


Fighting Substance Abuse

Efforts at fighting substance abuse are dictated by the attitudes of the public and their perceptions of a substance's dangers. These attitudes may be framed by personal experience, media portrayals, news events, or drug education. Most drug enforcement is local, but the international and interstate nature of the drug trade has gradually resulted in more federal involvement. The Drug Enforcement Administration (DEA), created in 1973, is responsible for enforcing federal laws and policies and coordinates information sharing between agencies. Approaches to combating the drug problem have traditionally focused on reducing both supply and demand.


Supply Reduction

The policy of supply reduction aims to decrease the available amount of a drug and make its cost prohibitively high due to the short supply. One strategy for supply reduction is the passage and enforcement of strict laws that govern the prescribing of narcotic drugs. Other strategies are aimed at disrupting drug trafficking. In general, heroin and other opiates come into the United States from SW and SE Asia, Central America, and Colombia, cocaine from South America, marijuana from domestic sources, Mexico, Colombia, and Jamaica, and designer drugs from domestic clandestine laboratories. The Bureau of Immigration and Customs Enforcement is charged with interdicting smuggled drugs that come in across land borders, the U.S. Coast Guard with interdiction on the seas.


Other attempts to disrupt the flow of drugs involve the seizure of clandestine labs, arrest and conviction of drug dealers and middlemen, and international efforts to break up drug cartels and organized crime distribution networks. Asset seizure is a controversial but effective strategy that allows authorities to confiscate any profits derived from or property used in drug trafficking, including cars, houses, and legal fees paid to defence attorneys. Eradication of crops was the strategy behind the spraying of paraquat on Mexican marijuana crops in the 1970s. Some attempts at reducing drug production by creating more lucrative markets for non drug crops in drug-producing areas also have been made.

Reduction of Demand for Drugs

Attempts to reduce the demand for drugs in the main involve education and treatment. For the most part, responsibility for education falls to local schools and for treatment to local public hospitals or private treatment centres. The federal government gathers statistics and provides funds for treatment and rehabilitation programs. Certain laws are designed to promote the education of the public (e.g., those requiring warning labels on cigarettes and alcoholic beverages), and all states have Driving While Intoxicated (DWI) laws. Other drug laws attempt to reduce the demand for drugs by imposing stiff penalties for drug possession, manufacture, and trafficking. Drug testing in the workplace has been a controversial measure, weighing productivity and the safety of the workers and those for whom they are responsible against an individual's right to privacy, but it has resulted in increased public awareness. Some grassroots groups have had a profound effect; MADD (Mothers Against Drunk Driving) was instrumental in raising the drinking ages in many states.


Legalization and Decriminalization

The concept of controlling drugs is a relatively recent phenomenon and one that has been met with limited success despite the billions of dollars spent. Some people argue that if drugs were legalized (as occurred with the repeal of Prohibition), drug trafficking and the violence it engenders would disappear. Some contend also that with government regulation dosages would be standardized and dangerous contaminants eliminated, making drugs safer. It has also been suggested that resulting lower prices for drugs would preclude the need for criminal activity to raise money for their purchase and that billions of dollars saved from supply reduction programs could be put toward education and treatment. Nevertheless, a substantial majority of Americans polled have thought legalization a bad idea. Those opposed to legalization believe that removal of deterrents would encourage drug use, that people would still steal to buy drugs, and that many drugs are so inexpensive to produce that there would still be a black market.

Decriminalization is the elimination or reduction of criminal penalties for using or dealing in small amounts of certain drugs. Attitudes toward decriminalization change with the times and with actual and perceived dangers involved. Many localities decriminalized marijuana in the 1970s—and many reinstituted stricter laws in the 1980s.

History

Humans have used drugs of one sort or another for thousands of years. Wine was used at least from the time of the early Egyptians; narcotics from 4000 BC; and medicinal use of marijuana has been dated to 2737 BC in China.[3] But not until the 19th century. AD were the active substances in drugs extracted. There followed a time when some of these newly discovered substances—morphine, laudanum, cocaine—were completely unregulated and prescribed freely by physicians for a wide variety of ailments. They were available in patent medicines and sold by travelling tinkers, in drugstores, or through the mail. During the American Civil War, morphine was used freely, and wounded veterans returned home with their kits of morphine and hypodermic needles. Opium dens flourished. By the early 1900s, there were an estimated 250,000 addicts in the United States.


The problems of addiction were recognized gradually. Legal measures against drug abuse in the United States were first established in 1875 when opium dens were outlawed in San Francisco. The first national drug law was the Pure Food and Drug Act of 1906, which required accurate labelling of patent medicines containing opium and certain other drugs. In 1914 the Harrison Narcotic Act forbade the sale of substantial doses of opiates or cocaine except by licensed doctors and pharmacies. Later, heroin was banned. Subsequent Supreme Court decisions made it illegal for doctors to prescribe any narcotic to addicts; many doctors who prescribed maintenance doses as part of an addiction treatment plan were jailed, and soon all attempts at treatment were abandoned. Use of narcotics and cocaine diminished by the 1920s. The spirit of temperance led to the prohibition of alcohol by the Eighteenth Amendment to the Constitution in 1919, but Prohibition was repealed in 1933.

In the 1930s most states required anti drug education in the schools, but fears that knowledge would lead to experimentation caused it to be abandoned in most places. Soon after the repeal of Prohibition, the U.S. Federal Bureau of Narcotics (now the Drug Enforcement Administration) began a campaign to portray marijuana as a powerful, addicting substance that would lead users into narcotics addiction. In the 1950s, the use of marijuana increased again, along with that of amphetamines and tranquilisers. The social upheaval of the 1960s brought with it a dramatic increase in drug use and some increased social acceptance; by the early 1970s, some states and localities had decriminalized marijuana and lowered drinking ages. The 1980s brought a decline in the use of most drugs, but cocaine and crack use soared. The military became involved in border patrols for the first time, and troops invaded Panama and brought its de facto leader, Manuel Noriega, to trial for drug trafficking.

Throughout the years, the public's perception of the dangers of specific substances changed. The surgeon general's warning label on tobacco packaging gradually made people aware of the addictive nature of nicotine. By 1995, the Food and Drug Administration was considering its regulation. The recognition of fetal alcohol syndrome brought warning labels to alcohol products. The addictive nature of prescription drugs such as diazepam (Valium) became known, and caffeine came under scrutiny as well.

Drug laws have tried to keep up with the changing perceptions and real dangers of substance abuse. By 1970 over 55 federal drug laws and countless state laws specified a variety of punitive measures, including life imprisonment and even the death penalty.[4] To clarify the situation, the Comprehensive Drug Abuse Prevention and Control Act of 1970 repealed, replaced, or updated all previous federal laws concerned with narcotics and all other dangerous drugs. While possession was made illegal, the severest penalties were reserved for illicit distribution and manufacture of drugs. The act dealt with the prevention and treatment of drug abuse as well as control of drug traffic. The Anti-Drug Abuse Acts of 1986 and 1988 increased funding for treatment and rehabilitation; the 1988 act created the Office of National Drug Control Policy. Its director, often referred to as the drug "czar," is responsible for coordinating national drug control policy.


Impact on Adolescents in India

Every year, the International Day against Drug Abuse and Illicit Trafficking is celebrated on June 26 to sensitise individuals and communities around the challenge of drug abuse and addiction as well as its impact. With this global observance, individuals, communities and numerous organizations aim to not only raise awareness to fight against substance abuse but also strengthen comprehensive action and collaboration to achieve the aim of a global society free of drug abuse.

The epidemic of substance abuse in adolescents is increasing at an alarming rate in India and this is the direct result of the changing cultural values, fierce competition in the fields of education and employment, the growing economic burden on families and declining supportive bonds for adolescents in this transitional age. The impact is that adolescents witness their first experimentation towards various drugs, especially those that are easily available including glues, tobacco, cannabis, and alcohol. Amongst adolescents, the highest at-risk population include street children, child labourers, and teens who have a family history of drug abuse and other emotional and behavioural challenges at home.


According to a study conducted by the National Commission for Protection of Child Rights, the most common form of substance abuse amongst adolescents is tobacco and alcohol, followed by inhalants and cannabis. The average age of onset of tobacco use was observed to be as low as 12 years, while another study revealed that 46% of slum-dwelling adolescents started both smokeless and smoking tobacco, as well as alcohol and cannabis from childhood. With easy access to smokeless tobacco, studies in slums of Delhi have shown the age of initiation to be as low as 6 years data collected under project UDAYA, an initiative led by the Population Council, the Bill and Melinda Gates Foundation and the Packard Foundation, shows that substance abuse is high among adolescent boys (15-19 years). The UDAYA study probed on tobacco use, alcohol consumption and drug use and revealed that 20% of adolescent boys aged 15-19 in Bihar and 22% in Uttar Pradesh (UP) consumed tobacco and tobacco products; 4-5% of younger boys (10-14 years) also ever used tobacco products. The consumption is higher among rural boys in comparison to urban boys (21% vs 17% in Bihar: 23% vs 18% in UP). [5]One percent of older boys (15-19 years) in Bihar and UP reported use of brown sugar (a heroin product) cocaine, ganja, charas and bhang (3).

Regarding alcohol consumption, the figures were 8% (in Bihar) and 5% (in UP) for older boys whereas 2% younger boys in Bihar have been found to consume alcohol. Tobacco consumption among married older girls (15-19 years) was found to be higher (2% in Bihar and 5% in Uttar Pradesh) in comparison to younger girls (10-14 years; 1% each in both states) and unmarried older girls (2% in each state). The percentage of unmarried girls involved with drug abuse was 0.1% while none of the married older (15-19 years) and unmarried younger girls (10-14 years) and boys (10-14 years) reported using any drug ever.

The effect of substance abuse is highest on the psychological health of adolescents with the possibility of developing substance use disorder, leading to major behaviour changes observed, including mood disorders, depression, anxiety, thought disorders such as schizophrenia, as well as personality disorders like antisocial personality traits. The use of tobacco (nicotine) in adolescence and young adulthood poses a unique risk for long-term [6]and long-lasting effects on developing brains as nicotine changes the way synapses are formed, harming the parts that control attention and learning. The brain continues to develop until about the age of 25 years and during adolescence, the brain growth is not complete and is susceptible to the damaging effects of tobacco smoke. Consequences of substance abuse also include quarrels with friends, family or relatives, as well as accidents and severe health disorders, with some also losing their jobs or dropped out of school due to poor performance. One study reported that three percent of adolescents who used substances were also involved in criminal activities like petty thefts, burglary, vandalism of public and private property amongst others.

Intervention programmes for substance abuse should have a two-pronged approach that caters to both the prevention and treatment of drug abuse. Prevention programmes should focus on addressing the initiation of various drugs. The interventions must be aimed at younger age groups, focusing on before the usual age of initiation. Effective enforcement of substance abuse policies like the tobacco control act can efficiently curb access to these products to adolescents. One of the major contributors to such prevention programmes apart from teachers should be parents of at-risk youth and adolescents. Such interventions should focus on psychosocial development rather than only prevention of target drug use as it has the potential to improve various aspects of a person’s development. Regular parental monitoring, supervision, and enhanced child-parent communication can act as preventive measures towards substance abuse. Efficient parent training with family skill-building and structural family therapy can prevent illicit drug use.


CONCLUSION

Drug addiction affects both the brain and behaviour. It has multifaceted impacts on the patients’ body, mind, and nervous system. Psychoactive drugs induce consciousness for pleasure, by modifying the perceptions, feelings, and emotions of the user. When a psychoactive drug enters the user's body, it induces an intoxicating effect. While some people can use recreational and prescription drugs without becoming addicted, many individuals who start using drugs become physically and emotionally dependent on them. Drug abuse causes vary greatly, depending on everyone and the extent of his or her addiction. The psychological effects of drug addiction come from the reason the user is addicted to drugs, as well as the changes that take place in the brain once a person becomes a drug addict. Initially, many people start using drugs to cope with stress or pain. An effect of drug addiction is the creation of a cycle where anytime the user encounters stress or pain, they feel the need to use the drug. This is one of the psychological effects of drug addiction involved in the "craving" of the drug. Various Medicinal Plants used for Addiction Treatment are Ginseng extract, Passionflower, Caulis Sinoxenic, Camellia sinensis, Nigella Sativa, Peganum harmala, Chamomile, Datura, Berberis, Valeriana, Asafetida, L-Tetrahydropalmatine (l-THP).


BIBLIOGRAPHY

· Jiloha RC. Prevention, early intervention, and harm reduction of substance use in adolescents.

· Indian Journal of psychiatry. http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2017;volume=59;issue=1;spage=111;epage=118;aulast=Jiloha#ref11

· Arora M, Tewari A, Tripathy V, Nazar GP, Juneja NS, Ramakrishnan L, et al. Community-based model for preventing tobacco use among disadvantaged adolescents in urban slums of India. Health Promotion International. 2010 Jun 1;25(2):143-52.

· Access UDAYA data from the Harvard data verse repository. https://dataverse.harvard.edu/dataset.xhml?persistentId=dol:10.7.7910/DVN/RRXQNT.

· Katoki. K, et al. Silhouette of substance abuse amongst an adolescent sample group from urban slums of Guwahati metro, North East India https://www.ijmrhs.com/medical-research/silhouette-of-substance-abuse-amongst-an-adolescent-sample-group-from-urban-slums-of-guwahati-metro-north-east-india.pdf

· See H. Abadinsky, Drug Abuse (1989); H. T. Milhorn, Jr., Chemical Dependence (1990); D. Baum, Smoke and Mirrors: The War on Drugs and the Politics of Failure (1996); M. Massing, The Fix (1998); J. Jones, Hepcats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs (1999); publications of the Drugs & Crime Data Centre and Clearinghouse, the Bureau of Justice Statistics Clearinghouse, and the National Clearinghouse for Alcohol and Drug Information.

[1]36% of the United States population has tried marijuana, cocaine, or other illicit drugs. By comparison, 71% of the population has smoked cigarettes and 82% has tried alcoholic beverages.

[2]$17.9 billion on drug control in 1999 for interdiction, prosecution, international law enforcement, prisons, treatment, prevention, and related items.

[3]narcotics from 4000 BC; and medicinal use of marijuana has been dated to 2737 BC in China.

[4]1970 over 55 federal drug laws and countless state laws specified a variety of punitive measures, including life imprisonment and even the death penalty.

[5]20% of adolescent boys aged 15-19 in Bihar and 22% in Uttar Pradesh (UP) consumed tobacco and tobacco products; 4-5% of younger boys (10-14 years)

[6]Use of tobacco (nicotine) in adolescence and young adulthood poses a unique risk for long-term