Discussion: Substance Abuse

People abuse substances such as drugs, alcohol, and tobacco for varied and
complicated reasons, but it is clear that our society pays a significant cost. The
toll for this abuse can be seen in our hospitals and emergency departments
through direct damage to health by substance abuse and its link to physical
trauma. Jails and prisons tally daily the strong connection between crime and
drug dependence and abuse. Although use of some drugs such as cocaine has
declined, use of other drugs such as heroin and "club drugs" has increased.
Finding effective treatment for and prevention of substance abuse has been
difficult. Through research, we now have a better understanding of the behavior.
Studies have made it clear that drug education and prevention aimed at children
and adolescents offers the best chance to curb abuse nationally.
The 2012 National Household Survey on Drug Abuse estimated the number of
users of illicit drugs in the United States ages 12 and over to be about 24 million.
In addition, the survey estimated that 6.8% of Americans abuse or are dependent
on alcohol (down from 7.7% in 2002), and 22% of Americans smoke cigarettes
(down from 26 percent in 2002).
Abused substances produce some form of intoxication that alters judgment,
perception, attention, or physical control.
Did You Know?
Under the Affordable Care Act, many health insurance plans will cover preventive mental
health services, including screening tests for depression and alcohol misuse, at no cost to
you.

Many substances can bring on withdrawal, an effect caused by cessation or
reduction in the amount of the substance used. Withdrawal can range from
mild anxiety to seizures and hallucinations. Drug overdose may also cause death.
Many substances, such as alcohol, tranquilizers, opiates, and stimulants, over
time also can produce a phenomenon known as tolerance, where you must use a
larger amount of the drug to produce the same level of intoxication.
Tobacco: People cite many reasons for using tobacco, including pleasure,
improved performance and vigilance, relief of depression, curbing hunger, and
weight control.
The primary addicting substance in cigarettes is nicotine. But cigarette smoke
contains thousands of other chemicals that also damage health. Hazards
include heart disease, lung cancer and emphysema, peptic ulcer disease,
and stroke. Withdrawal symptoms of smoking include anxiety, hunger, sleep
disturbances, and depression.
Smoking is responsible for nearly a half million deaths each year. Tobacco use
costs the nation an estimated $100 billion a year, mainly in direct and indirect
health care costs.
Alcohol: Although many people have a drink as a "pick me up," alcohol actually
depresses the brain. Alcohol lessens your inhibitions, slurs speech, and
decreases muscle control and coordination, and may lead to alcoholism.
Withdrawal from alcohol can cause anxiety, irregular heartbeat, tremor, seizures,
and hallucinations. In its severest form, withdrawal combined with malnutrition
can lead to a life-threatening condition called delirium tremens (DTs). Alcohol is
the most common cause of liver failure in the US. The drug can
cause heart enlargement and cancer of the esophagus, pancreas, and stomach.
In addition to its direct health effects, officials associate alcohol abuse with nearly
half of all fatal motor vehicle accidents. In 1992, the total economic cost of
alcohol abuse was estimated at $150 billion.
Marijuana (also known as grass, pot, weed, and herb): Marijuana, which comes
from the plant Cannabis sativa, is the most commonly used illegal drug in the
United States. The plant produces delta-9-tetrahydrocannabinol (THC), the active
ingredient associated with intoxication. Marijuana resin, called hashish, contains
an even higher concentration of THC. In 2012, there were 18.9 million Americans
age 12 and over who reported using marijuana in the past month, up from 14.4
million (5.8 percent) in 2007. The drug is usually smoked, but it can also be eaten.
Its smoke irritates your lungs more and contains more cancer-causing chemicals
than tobacco smoke. Common effects of marijuana use include pleasure,
relaxation, and impaired coordination and memory.

Often, the first illegal drug people use, marijuana is associated with increased
risk of progressing to more powerful and dangerous drugs such as cocaine and
heroin. The risk for progressing to cocaine is 104 times higher if you have
smoked marijuana at least once than if you never smoked marijuana.
Cocaine (also known as crack, coke, snow, rock): Cocaine use has gone down in
the last few years; from 2007 to 2012, the number of current users in the U.S.
ages 12 or older dropped from 2.1 million to 1.7 million.
Derived from the coca plant of South America, cocaine can be smoked, injected,
snorted, or swallowed. The intensity and duration of the drugs effects depend on
how you take it. Desired effects include pleasure and increased alertness.
Short-term effects also include paranoia, constriction of blood vessels leading to
heart damage or stroke, irregular heartbeat, and death. Severe depression and
reduced energy often accompany withdrawal.
Both short- and long-term use of cocaine has been associated with damage to
the heart, the brain, the lung, and the kidneys.
Heroin (also known as smack, horse): Heroin use continues to increase.
According to the National Survey on Drug Use and Health (NSDUH), in 2012
about 669,000 Americans reported using heroin in the past year, a number that
has been on the rise since 2007. The biggest increases are among users ages
18 to 25.
Effects of heroin intoxication include drowsiness, pleasure, and slowed breathing.
Withdrawal can be intense and can include vomiting, abdominal cramps, diarrhea,
confusion, aches, and sweating.
Overdose may result in death from respiratory arrest (stopping breathing).
Because heroin is usually injected, often with dirty needles, use of the drug can
trigger other health complications including destruction of your heart
valves, HIV/AIDS, infections, tetanus, and botulism.
Methamphetamines (also known as meth, crank, ice, speed, crystal): Use of this
drug also has increased, especially in the West. Methamphetamine is a powerful
stimulant that increases alertness, decreases appetite, and gives a sensation of
pleasure. The drug can be injected, snorted, smoked, or eaten. It shares many of
the same toxic effects as cocaine-heart attacks, dangerously high blood pressure,
and stroke. Withdrawal often causes depression, abdominal cramps, and
increased appetite. Other long-term effects include paranoia, hallucinations,
weight loss, destruction of teeth, and heart damage.
Club drugs: The club scene and rave parties have popularized an assortment of
other drugs. Many young people believe these drugs are harmless or even
healthy. These are the more popular club drugs.
Ecstasy (also called MDMA, Adam, and STP): This is a stimulant and
hallucinogen used to improve mood and to maintain energy, often for all-night
dance parties. Long-term use may cause damage to the brains ability to regulate
body temperature, sleep, pain, memory, and emotions.
GHB (also called Liquid XTC, G, and blue nitro): Once sold at health food stores,
GHB's effects are related to dose. Effects range from mild relaxation to coma or
death. GHB is often used as a date-rape drug because it is tasteless, colorless,
and acts as a powerful sedative.
Rohypnol (also called rookies, Roche): This is another sedative that can be used
as a date-rape drug. Effects include low blood pressure, dizziness, abdominal
cramps, confusion, and impaired memory.
Ketamine (also called Special K, K): This is an anesthetic that can be taken orally
or injected. Ketamine (Ketalar) can impair memory and attention. Higher doses
can cause amnesia, paranoia and hallucinations, depression, and difficulty
breathing.
LSD (also called acid, microdot) and mushrooms (also called shrooms, magic
mushrooms, peyote, and buttons): Popular in the 1960s, LSD has been revived
in the club scene. LSD and hallucinogenic mushrooms can cause hallucinations,
numbness, nausea, and increased heart rate. Long-term effects include
unwanted "flashbacks" and psychosis (hallucinations, delusions, paranoia, and
mood disturbances).
PCP (al known as angel dust, hog, love boat): PCP is a powerful anesthetic used
in veterinary medicine. Its effects are similar to those of ketamine but often
stronger. The anesthetic effects are so strong that you can break your arm but
not feel any pain. Usually, tobacco or marijuana cigarettes are dipped into PCP
and then smoked.

Ref.: http://www.webmd.com/mental-health/addiction/substance-abuse