Caught in the web of drugs

 Samir Parikh

Our society is grappling with alcohol and drug addiction. The abuse has a far-reaching impact on the physical, emotional and psychological being of the addict. Addiction can be defined as the continuous use of mood-altering substances, despite their detrimental effects on the body, mind and the immediate surroundings of the individual. 

The line between casual use and drug abuse is thin and dangerous, and more often than not, the consumer becomes an addict with a gradual increase in the quantity.  Drugs or alcohol are consumed to elevate mood or relieve pain. Youngsters turn to substances simply out of curiosity or even as a coping mechanism to deal with their feelings of loneliness, depression, stress or anxiety, or to cope with family-related problems.

There are typically two patterns relating to misusing substances. Either the individual has become a regular user in which case he or she will need to use the substance everyday and possibly several times a day. Or the person might be a binger, in which case he or she may not take drugs or drink alcohol for some time (usually a few days) and then will binge or take higher quantity of drugs or a lot of alcohol. 

Substance abuse is not the occasional use of alcohol or other substances. It is a continuous and frequent use of substances, despite being aware of its negative consequences to the person’s functioning at familial, academic and social levels over a period of time. 

Substance dependence occurs when the individual consuming it has become tolerant to the substance, which means that he or she needs to consume more of the substance than was previously required in order to achieve the same level of ‘high’. People who have developed a dependency on a substance would not be able to give it up without experiencing withdrawal symptoms, which are the immediate effects of discontinuing a substance after a prolonged use.

What is substance use disorder?

The disorder can be described as:

• Dependence on the substance: This happens when the addict feels compelled to take a drug even when he means not to and wants to stop. Substance abuse will negatively affect other activities and relationships.
• Disrupts daily life of the person: The individual is unable to lead a normal life because of drug addiction. Risk-taking behaviour like reckless driving, increased aggression become common traits. The person completely ignores daily responsibilities due to the substance use. He is all the time bothered about procuring the drug, which thereby hampers his physical, social as well as occupational functioning. 
• Evident mental and physical health consequences: Despite knowing that drug use is affecting health, as it may cause blackouts, memory loss, infection, depression, psychosis etc., the person would still continue to consume the substance. 

There are many forms of substance abuse. Prescription drugs are usually taken orally, while other drugs can be smoked, inhaled or taken intravenously. Drugs commonly fall under the following categories. 

• Narcotics (heroin and morphine)
• Stimulants (cocaine, nicotine)
• Depressants (alcohol, sedatives)
• Cannabis (marijuana and hashish)
• Hallucinogens (LSD, ‘ecstacy’)
• Inhalants (Glue, paint products, diluter)

Understanding effects of substance use 

Addiction is characterised by compulsive drug use causing significant changes in brain that further perpetuates the addiction cycle. 

• Drug use causes a rise in dopamine levels, making the user experience a high along with giving rise to a consequent desire to repeat this pleasurable event.
• In addictions, taking drug is given the same importance as survival behaviours such as eating to pacify hunger or thirst. 
• The physiological and psychological changes in the brain and body lead to clouding of judgment and clarity of thought process, making it difficult for the person to function normally without the drug.
• The level of insight among addicts is poor and they typically find many rationales to justify their drug use.

Symptoms of addiction

• Physical, behavioural and psychological withdrawal symptoms: The individual begins to use the substance to escape from experiencing withdrawal symptoms like sweating, tremors, nausea, or sleeplessness. 
• The individual’s tolerance level goes up: The person would need more of the substance to feel the ‘hit’. This happens as the person’s reaction to the same quantity of the substance gets reduced over a prolonged use, thereby making him increase the quantity of consumption. Such tolerance could be physiological as well as psychological.
• The individual is all the time preoccupied with either procuring of the substance or using it. Due to this, there is a significant reduction in other adaptive and occupational activities 
• There is a significant loss of control and the individual feels compelled to use the substance despite knowing about the negative consequences of consuming it.

Say yes to treatment

It is important to remember that substance use disorders are medical conditions, requiring adequate professional interventions, including a combination of medications and psychotherapy. Professional help is irreplaceable, and addictive behaviours do not change abruptly, but through a series of stages. Support and motivation are a very important part of the recovery process. And once a person has developed a dependence on a substance, there almost always remains a danger of relapse. Counseling in such a scenario for the recovering addict as well as motivation from family is very useful.

 The writer is Director, Mental Health and Behavioural Sciences, Fortis Healthcare, New Delhi