Substance abuse

This presentation is community medicine(PSM) point of view

1. SUBSTANCE ABUSE By Dr. Mayur Sayta Resident, Community Medicine Depart. B.J.Medical College, Ahmedabad.

2. Definition “Any substance that when taken into living organism, may modify one or more of its functions.” Drug abuse : self administration of drug for nonmedical reasons in quantities & frequencies which may impair an individual’s ability to function effectively and which may result in social , physical & emotional harm.

3. Drug dependence : A state , psychic and sometimes also physical resulting from the interaction between a living organism and a drug characterized by behavioral & other responses that always include a compulsion to take a drug on a continuous or periodic basis in order to experience its psychic effects & sometimes to avoid the discomfort of its absence.

4. Influence on a peer group, observers or individual exerts that encourages others to change their attitudes, values, or behaviours to conform to groups

5. In many occasions individuals get overwhelmed by their daily activities of which ultimately leads to them a resorting to an overdose of harmful substances to get rid of the stress

6. Growing up in a home where Alcohol and Drug abuse considered as Normal Behavior

7. In most cases individuals are faced with the pain of dealing with losing a loved one. Drugs and alcohol are usually the easy way out from the sad reality for the those dealing with the pain.

8. During adolescent most teenagers rebel against their parents which results to them abusing substances to prove a point or to show their parents that they know better and spite them in the process.

9. As a way getting away from the stress caused by relationship problems individuals tend to abuse substances to forget about the stress

10. Being unemployed leads to individuals resorting to substance abuse as a way of getting from reality.

11. Abuse producing substances : Tobacco Alcohol Cannabis Opiates Heroin Sedatives or hypnotics

12. 1. Tobacco 6% of total deaths are contributed by tobacco smoking. 30% of all cancer deaths are caused by tobacco. 3 major factors : -peer pressure -following the exp of siblings & parents - employment outside home Adverse effects : health problems social & family problems

13. Health problems Adverse effects on: lungs, heart, blood vessels, skin, cancer, bones, reproduction, unborn child, brain Passive smoking / second hand tobacco smoke : smoke from burning end of cigarette + smoke exhaled by smoker

14. Social problems Economic loss Family loss Poverty

15. China ranks 3 rd from all cigarettes producing countries in the world. 60% Chinese males smoke representing one third of all smokers globally. One out of every three cigarettes smoked in China. Global Adult tobacco Survey , India shows prevalence of tobacco smoke among male is 48% & among female it is 20%

16. 2. Alcohol: Act as sedative, tranquilizer, hypnotic or anesthetic depending upon the quality consumed . Marked effect on central nervous system and cause continuous depression Also produce physical & psychic dependence Acute & chronic intoxication, gastritis, pancreatitis, cardiomyopathy , peripheral neuropathy , cancer of mouth, larynx, pharynx & esophagus. Also responsible for automobile accidents, suicides & domestic violence .

17. Epidemiology of Alcohol use Accorrding to MINISTRY OF SOCIAL JUSTICE AND EMPOWERMENT GOVERNMENT OF INDIA 2019 Report

18. 3. Cannabis Derived from hemp plants Active ingredients are hashish or charas Dried leaves are known as bhang Development of dreamy state of altered consciousness Relaxation , euphoria, increase tendency to laugh, greater awareness of colors & sounds

19. Euphoria

20. OPIOID USE IN INDIA three different sub-categories of substances in the overall category of opioids : Opium (including doda / phukki /poppy husk ); Heroin (including brown sugar/smack) and (3) Pharmaceutical opioids (which itself includes a variety of medications of the opioid group).

21. Heroin Most commonly used opioid in india Morphine , codeine, methadone, pethedin are narcotic analgesics. Worst type of abuse because it produces craving.

22. Sedatives and Hypnotics This survey has studied the use of these substances in non-prescription, non-medical context .

23. Prevention & Control 1 . Primary prevention Legislative approach : COTPA ACT ( Cigarettes & other Tobacco products Act,2003) No person shall advertise, take part in advertise, of any tobacco product. No person shall sale cigarette or tobacco product to children <18 yrs or in area within radius of hundred yards of any educational institute.

24. Every packet of cigarette or any tobacco product should have label or pictorial depiction of skull & cross bones & prescribed warning of nicotine contents. Warning signs & labels should be prominent or as prescribed by rules & in English or any other Indian language. Central govt. shall notify the testing laboratory for estimation of nicotine & tar contents

25. Punishment for smoking in public place is a fine of 200rs/-. Punishment for sale of tobacco products to <18 yrs children is Rs 200/-. Any person who manufacture cigarette & other tobacco products if contravene this act is punishable with imprisonment up to 2 yrs / with fine up to 5000rs/-or with both.

26. - Awareness generation : community based programmes for awareness generation , preventive education , counseling, deaddiction, rehabilitation - Personality development

27. 2 . Secondary prevention : Educational counseling to abusers Family & parents act as a role model Drug deaddiction Centers : started to reduce prevalence of drug abuse 118 drug deaddiction centers are there in India Drug Deaddiction Programme started in 1987-88 at AIIMS, JIPMER Pondicherry, PGI Chandigadh & later started in all states.

28. 3. Tertiary prevention : - Advance treatment & Rehabilitation - community based rehabilitation

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