DRUG ABUSE: General consequences on brain cells and other parts of the body. Is it treatable and avoidable? Who are most affected and why?

Drug or substance abuse can be described as a patterned use of certain legal or illegal chemicals or mixture of chemicals through normal or abnormal routes for the purpose of creating pleasurable influence on the brain thereby presenting false mood and impression of your surroundings. There are other widely differing definitions of drug abuse used in public health, medical and criminal justice contexts. The essence of documents, such as this, is to add a feather to the creation of appropriate public awareness for a timely and informed personal decision on issues of drug or substance abuse.  

In addition to the long term damage to the body and brain cells, drug abusers who mature into addicts using needles for self-injection are at greater risk of contracting the dreaded HIV and hepatitis B and C infections. Addiction and dependence which can cause “relapsing” diseases are products of drug abuse. And the above twins often overrun, with harmful consequences, the abuser’s brain function of self control over those drugs prone to abuse. Simply put, when you abuse a drug to the point of addiction or dependence, the drug persistently interferes and tells you what to do, making you its slave even contrary to your will in a normal circumstance.

Drug abuse is a major public health challenge that affects basically every community and family globally. It is an important promoter of damaging antisocial behaviour, long term personality changes, psychological harm and criminal penalties among others.  It is estimated that annually, more than 336 million people between the ages of 15 and 65 years are involved in drug abuse worldwide. The rate of drug abuse with its huge cost implications is progressively increasing in alarming grade due to many environmental factors.  In 2018, drug misuse disorders caused about 307,900 deaths. Annually, drug abuse is associated with serious illnesses and major mental health problems including depression, bipolar, mood, anxiety and antisocial personality disorders; and suicide tendencies.

Drugs or substances mostly abused are commonly found among people at parties, hideouts and clubs. Drug peddlers and people who practice self-medication always expose people and themselves to drug abuse.  It is believed that drug abuse is associated with complex modifications between social, environmental and biochemical modulators; and the genetic composition of an individual.

Routes of drug administration

Route of drug administration is simply the pathway by which drug preparations such as solid, fluid, gaseous, lotion, poison or other substances are taken through the body channels into the systemic or blood circulation for pharmacological action. The routes are what define the location of the body at which the drug preparations are administered for targeted action or effect. The reasons for proper choice of routes of drug administration includes: physical (solid, liquid and gas) and chemical (pH, solubility, stability, irritancy etc) properties of the drug. Other reasons are extent of drug absorption from different routes and location of target action (localized or generalized). There are considerations for patient’s health condition and effect of digestive juices on certain drugs.

For purposes of public information, this topic is aim at sensitizing the public on the danger or untoward effects of abuse when the ideal routes for specific drug preparations are neglected or misused. Let’s briefly mention each route which has specific purposes, advantages and disadvantages.

  • Oral (enteral) route: It is generally most convenient and cost effective. It is good for formulations containing small molecules.
  • Parenteral route: For injectables or infusion administered through various body locations. Injectables are poorly absorbed or ineffective when they are given orally. And they are useful for unconscious patients and when acute onset of drug action is a priority.
  • Topical route: For applying medications into localized area of the body such as the eye (ocular) or the ear (optic); or to the general surface of the body regardless of the location of the effect.
  • Inhalation: This is an appropriate route for gaseous drugs and substances that need to be inhaled. This route permits drug entry into the lungs, usually through the mouth (by inhalation) or mouth and nose (by nebulization) for quick absorption for local and systemic actions.
  • Sublingually (under the tongue) or buccally (between the gums and cheek).
  • Rectal route is very useful if a patient suffers vomiting and unable to take oral medications. There is vaginal route for insertion of suppositories.

Drugs prone to abuse

In simple terms, drugs are chemical substances or preparations that can change how your body and mind works in response to the presence of the drug in your body. Drugs that can be abused or dangerous do make people get high and alter their feelings beyond normal. The drugs or substances that can be abused are such as marijuana, cocaine, heroin, alcohol, tobacco and some legally available drugs. For purposes of caution and alertness/information, some substances or drugs mostly abused are described here. The abusers describe them with different pet names.

Marijuana is a mixture of dried, shredded leaves and flowers from marijuana plant. It is mostly green, brown or gray in colour. The abusers can smoke it, use it as tea, vapourize it or add it to food.   Marijuana makes abusers feel silly, sleepy, relaxed, nervous and scared. It changes their senses of sight, hearing and touch thereby making them to have false happiness and hallucinations.

Cocaine is a white powder from cocaine plant. People who abuse it can snort, inject or smoke it. Cocaine is very addictive and stimulates, giving abusers false feeling of being full of energy and in control of their environment. It can also trigger restlessness, fear or anger in abusers.

Heroin is a white, black or brown sticky powder. Abusers can inject, snort or smoke it.  Heroin can cause sudden good feelings, vomiting and itching.  It can cause slow heart rate and breathing, with compulsive urge for more.

Common prescription drugs are legally available and commonly prescribed for illnesses by relevant health care professionals. The challenge is that some people who enjoy the feelings from the drugs take more than the prescribed dose, alter the dosing regimen or the route, leading to drug abuse.  For example, if a drug is prescribed for three times a day, stay with that and religiously complete the drug(s) as prescribed. But if for any reason you miss a dose for morning for instance, do not combine the dose you missed in the morning with the afternoon dose. Take the afternoon dose as prescribed and continue. Do not be careless over your drug use especially antibiotics. Stay far from their abuses which have grave and enduring bad health consequences. The drug abuse common among the youth who combine stimulants with cough mixtures or decongestants can cause elevation of blood pressure, irregular heartbeat, hallucinations and brain damage.

Many other painkillers are prone to abuse with serious withdrawal symptoms that make it very difficult for patients to stop the drugs once they are abused. Some of the drugs or substances that should be taken with caution based on their propensity for abuse are:

  • Opiate-based painkillers such as Vicodin, OxyContin, Demerol Darvocet, Percocet,Percodan, Lortab, Lorcet and Roxicodone.
  • Barbiturates and Benzodiazepines: are sedatives which depress brain faculties or cells like pentobarbital (Nembutal), phenobartital and secobarbital (Seconal), alprazolam (Xanax) and diazepam (Valium).
  • Amphetamines: Methamphetamine (meth) is a white bitter powder. When abused, it can stimulate the brain causing severe health problems including delusional psychosis.
  • Hallucinogens: These agents cause severe hallucinations resulting in many good health distortions. Examples include Mescaline, Lysergic Acid Diethylamide (LSD) and Ecstasy.
  • Alcohol (spirit, booze, ethanol), Cigarettes (cigars, cancer sticks, pipes, coffin nails) and Tobacco (snuff, wad, dip) have some chemicals that have adverse effects in the entire body even on routine use.

Signs and symptoms of drug abuse

Drug abusers often manifest these signs and symptoms. They include:

  • Changing their friends for no obvious reasons
  • Abnormally deciding to spend a lot of time alone especially in a solitary spot by avoiding family members and friends
  • Sudden lost of interest in favorite activities
  • Careless over bathing, wearing clean clothes or brushing of teeth
  • Easily tired and always exhibiting  irregular mood
  • Having abnormal eating habits and sleeping at odd hours
  • Temporarily energetic, talking fast, violent or saying senseless things
  • Missing or neglecting important appointments, responsibilities or activities at home, workplace or school
  • Experiences drug or substance-induced nausea, restlessness, insomnia, depression, sweating, shaking, blackouts, infections and anxiety

People most vulnerable to drug abuse

Different types of drugs or substances are misused at different rates by thousands of people globally. Researches show that drug or substance abuse is seen in various age groups and in individuals from all walks of life and socioeconomic status. However, men are more likely to abuse drugs or substances than women; the unmarried are more likely than married and urban dwellers are more likely than rural dwellers. Youths are also more likely to abuse drugs. The group of people who are mostly at risk or vulnerable to these drugs of abuse includes:

  • Immigrants and refugees: Immigrants and refugees are often under great stress, depression, physical trauma and anxiety which are motivated by many factors. So, for some who are abusers or potential abusers, drug or substance abuse serves as an alternative coping mechanism in dealing with the stressors and other relocation challenges.
  • Street children and prisoners: Some children and adults are thrown to the street and prisons mostly due to factors of wars, hunger, neglect, deaths and crimes. Many of such people resort to and teach others to join them to practice drug or substance abuse mostly in an attempt to dull their senses against the hardship of street life and been prisoners.
  • Musicians and veterans: These set of people most times expose themselves voluntarily to drug or substance abuse. They attempt to use it to enhance and sustain high quality performance, pleasure and other minor expectations.

How and why drugs are easily abuse

 Some of the reasons for drug abuse result from unauthorized sharing of drugs or drug information between family and friends, illegal buying of drugs at home, school or office. Other reasons are failure of patients to disclose or show the doctor the prescribed and self-acquired drugs presently in use as at the time of the clinical interactions. Others include:

  • Use of more than the regular dose of drugs
  • Use of someone else’s prescription.
  • Seeking good feeling most times for recreational purposes
  • Urge to ease stress
  • Attempt to avoid reality and obtain creative inspiration
  • Use of drugs outside its intended clinical need
  • Use of drug through abnormal route
  • Use of orthodox and traditional medications at the same time or within less than 24hours interval.
  • Curiosity and peer pressure, especially among school children and adolescents
  • Use of drug as part of religious practices or rituals

Consequences of drug abuse

The compulsive, excessive, preventable and self-damaging use of habit forming drugs or substances, leading to addiction or dependence can produce outcome of serious damages to the brain, kidneys, heart and liver. There could be memory loss, hallucinations, dysfunctional behaviour pattern and death.

When drugs are used the wrong way, they promote many major social problems such as stress, drugged driving which can result to accidents, child abuse and violence including sexual abuses. Drug abuse can cause broken home and relationships; crimes, homelessness, harm to fetus, suicide due to confusion and social segregation, work absence or problems with keeping a job and starvations due to sudden loss of interest or appetite for food and sex.

Abuse of drugs including alcohols particularly, cause physiological alteration of brain chemistry which can result to severe and sustained psychiatric disorders of depression and anxiety. The said alteration in brain chemical circuits also influences negatively the abuser’s sense of judgment, decision making, memory and ability to learn and manage stress.

Prevention of drug abuse

There are different types of treatment for drug abuse. But the best approach is prevention. Be under God’s control and prayerful. Keep your family safe, healthy, happy; free from street drugs, bad friends and illicit videos/contents; and do not start drug abuse at all. Since there are hundreds of drugs and thousands of pills and tablets of all shapes, colours and sizes, you should need a Pharmacist to identify and counsel you on appropriate use of drugs and substances for timely check on abuse.

Whenever you suspect that someone is abusing drug(s), do not keep quiet. Approach the suspect politely with determination to assist or refer for appropriate intervention. Families, communities, media, relevant government agents, teachers, parents and health care providers should be useful and ready contacts for crucial roles in educating people especially the young; and preventing drug abuse that can lead to addiction and dependence. Also appropriate prescribing, counseling and monitoring are major considerations and best practices in tackling drug abuse globally.

Treatment of drug abuse

Indeed, drug or substance abuse that could give birth to addiction and dependence is a complex disease and quitting is independent of good intentions or strong will power. The good news is that drug abuse is treatable and can be successfully managed, resulting to the restoration of productive life to abusers. The brain changes and other health challenges associated with drug abuse can be treated and reversed through therapy, exercise, drugs and other minor treatments protocols especially at the early stage. However, the major indicator of good treatment outcome is the abuser’s self-motivated resolve and determination to quit drug or substance abuse.
Sometimes it is easy for people to relapse, but that does not mean treatment failure. However, carefully reducing and monitoring the medication plan can eliminate most of the side effects and make the withdrawal process less cumbersome on the sides of patients and care providers. Therefore as it applies to other chronic health conditions, treatment of drug abuse should be ongoing and need to be adjusted based on how the patient responds. It implies that treatment plans need to be reviewed often by medical experts and modified to fit the patient’s changing needs.

Based on scientific documents from behavioural psychology and randomized clinical trials, there are many evidenced-based intervention methods for different grades of people. The methods which are administered by experts in different formats include motivational interviewing, community/family reinforcement therapy, behavioural marital therapy, contingency management, cognitive behavioural therapy and exposure therapy. According to the research reports, the intervention approaches mainly help to suppress cravings and compulsion for drug abuse, and mental anxiety; ease withdrawal symptoms, reduce the chances of relapse, and improve/redirect focus on treatment and learning new behavioural skills.

There are drugs approved for the treatment of drug/substance abuse. The drugs are prescribed, monitored and administered with appropriate counseling by expert health professionals at standard health facilities. The drugs include buprenorphine, disulfiram, methadone, bupropion, naltrexone, modafinil and acamprostate.

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