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Epidemiology

Street drug issues of interest

Laws have evolved to regulate certain activities. Some of the reasons include:

  • To control supply
  • To control availability
  • To assist in the rehabilitation of addicts
  • To provide punishment and sanctions when laws are broken
  • Drug maintenance for addicts who are attempting to control their habit
  • Enforcement of drug laws
  • Research and development with respect to drug abuse
  • To promote public safety

Because this kind of control is not in line with user requirements, the user is forced to turn to illegal sources to obtain drugs. As a result the user's dependence on the criminal element and lifestyle is established.

In the early days, some attempt was made to deal with drug abuse as a medical problem. Several outpatient clinics were established to handle the perceived problem. It was believed that these clinics were unsuccessful because they spread drug use by making drugs easily available to drug userrs. In certain countries the arrest rate climbed substantially after the clinics were closed. It was postulated that the increased criminal activity was due to the decreased availability of drugs from "legal" sources.

Another approach views drug addiction not as a crime but as a disease. It sees chemical dependency as a biochemical or genetic disorder, which is activated by the patient's environment. This approach is supported by the well-known genetic predisposition to alcoholism and by the higher incidence of psychoactive drug addiction in the families of users than in the population at large.

Uses and abuses of drugs

Non-medical drug use is a vague term encompassing behaviors ranging from the occasional use of alcohol to compulsive use of narcotics, sedatives, stimulants and the like. It includes behaviors that may or may not be associated with adverse effects.

Non-medical use involves the experimental use of a drug on one or a few occasions, because of curiosity about its impact on the human organism, or to comply with the expectations of a peer group. It may involve the casual or recreational use of small amounts of a drug for its pleasurable effects, or use in a certain circumstances, such as stimulants to alleviate fatigue. These various forms of non-medical use may then lead to serious drug abuse resulting in dependence or compulsive drug use.

One of the hazards of compulsive drug use is that it may foster drug dependence. Users continue to take drugs, often despite adverse social and medical consequences, and they behave as if the effects of the drugs are needed for continued well-being. The magnitude of this need or dependence can vary from a mild desire to a craving or compulsion to use the drug. When the availability of the drug is uncertain, they may exhibit a preoccupation with locating sources for the contraband.

Dependence on a drug is not necessarily cause for concern. If the substance used has low toxicity and is relatively inexpensive (caffeine), a drug-using behaviour may meet the criteria for dependence but may not cause a significant medical or social problem. More commonly, compulsive use of drugs is detrimental both to the user and to society.

Why be concerned about drug abuse?

Some reasons might include:

  • Psychological and physical damage
  • Strained interpersonal relationships
  • Promotion of crime
  • Increased health costs
  • Usurping of youth
  • Promotion of anti-social behaviour
  • Loss of work
  • Performance enhancement, which is unethical and unhealthy
  • Work and public safety issues
  • Generation of high profits which are not taxable Affects the weak in society
  • Promotes disease
  • Cost of enforcement
  • Cost of incarceration
  • Genetic effects

Who becomes a drug abuser?

  • Anyone, no age discrimination
  • Worldwide problem
  • No specific psychological or physical profile that will identify those who might become drug users.

Drug use among youth

Drug use by young people has become of great concern to society. It is especially troubling because of the following factors:

  • Developmental risks
  • Toxic effects
  • Impairment of motor functions
  • The potential for physical or psychological dependence
  • The long term psychological and emotional effects of addiction
  • Behavioural difficulties

There are several grounds for concern about drug use by children and adolescents. All psychoactive drugs have acute effects on mood, concentration and cognitive functioning. They can impair memory and hence interfere with intellectual and emotional development.

The most favoured targets of traffickers are young people because they are the most easily tricked into using drugs. The experimentation mentality of the adolescent allows for risk-taking. The young are generally dealt with by the courts more leniently than adults.

It is the young who are most at risk, especially those in their teens. They are less accepting of parental control and values; they are beginning to assert their own individuality; and they are learning to cope with the balance between freedom and responsibility.

The assertion of individuality is usually accompanied by a desire to look and behave like other teenagers in their age group, in their choice of clothes, hair styles and makeup, and which rock groups they listen to. The impact of peer pressure is clear.

For some, expressing individuality includes experimentation with drugs.

Traditionally, drug addiction has been viewed as a phenomenon of the movies, television or novels. It has been generally viewed as someone else's problem. Not true!

Potentially hazardous environments

School environments may be dangerous for certain students. Large schools with crowded, impersonal surroundings can leave the student lost in his or her surroundings, only being noticed by school authorities because of either excellence or inferiority in performance.

In such surroundings, unsuitable friendships and liaisons can be established. Pupils on the lookout for drug customers to subsidize their own habit, or just looking to make money, can take advantage of the naive, the lonely, and those under physical or psychological stress.

The home can also be a place of risk. Adults have become part of a pill popping society. With medications being taken for every physical and psychological ailment, we sometimes fail to recognize the danger of taking drugs without medical supervision. We take pills to sleep better, fend off depression, keep awake, relax, and enhance our appearance.

Drug abuser epidemiology

A drug user's whole being is permeated with the overwhelming need to possess his drug so that he may survive the period which must elapse until he gets his next supply. This sense of urgency persists throughout all his waking hours.

Life is a continuous cycle of "panic" revolving around the need to get enough money to obtain the drug of choice, to take it for a brief period of comparative satisfaction, before beginning again the frantic search for the money to buy more drugs.

It is necessary therefore to consider the more deeply rooted factors that play a part in causing individuals of all backgrounds to turn to drug abuse.

Reasons for drug use

  • Loneliness
  • Lack of parental concern
  • Lack of companionship
  • Destruction of the extended family with its support structure, guidance and concern
  • Growing up without adequate supervision and discipline
  • Abandonment of old values and certainties
  • Little or no moral or religious teaching to fall back on
  • Promotion of cynicism by the media and entertainment industry
  • Hatred of authority, discipline, or parental control
  • Erosion of self respect
  • A great deal of consideration for personal rights with no regard for personal responsibility or accountability

Additional reasons for drug use

  • Glamour
  • Danger and high risks
  • Peer pressure
  • Curiosity
  • Showing off
  • Emotional problems
  • Family problems
  • School problems
  • Social life or lack thereof

The danger signs

There are signs that may become apparent if we are aware of them and alert to their possible significance. It must be remembered that what might appear to be drug use danger signals could also turn out to be normal adolescent behavior.

At home

  • Money and easily sold goods such as tape recorders and jewelry start disappearing from the house
  • Greater absenteeism from the home
  • Dropping out of extra-curricular activities previously enjoyed
  • Carelessness about appearance
  • Unusual displays of temper, frequently without cause (sudden mood swings)
  • Lack of appetite, excused by claims of dieting
  • Wearing sunglasses at unusual times, usually to hide dilated or contracted pupils.
  • Wearing long sleeved shirts at unusual times
  • Excessive use of aftershave or perfume to hide the smell of drugs
  • Unusual borrowing of money with no evidence of any purchases
  • Consistent paleness of complexion, unusual state of fatigue or excitation

At school

  • Parents alerted by reports from teachers of changes in their child's behavior
  • Being the subject of gossip by other children indicating that they are taking drugs
  • Keeping apart from other pupils
  • Being suspected of involvement in organized thefts
  • Association with an older person who is not a normal member of the group
  • Dropping a friend for no reason
  • Unusual absences from school or outside activities
  • Using the slang used by drug users

Objects that may indicate drug abuse

  • Unusual containers
  • Metal spoon discolored by heat
  • Small bottles
  • Pill Boxes
  • Straws, usually cut quite short
  • Spent matches
  • Cigarette lighters
  • Small pieces of foil discolored by heat
  • Twists of paper
  • Small packets
  • Butane gas containers
  • Plastic bags, used in solvent abuse
  • Tubes made of cardboard or any other materials, used to sniff heroin, cocaine
  • Scraps of paper or plastic, about 2-ft. square, folded like an envelope or sachet to hold powdered drugs.
  • Pieces of paper like stamps, which seem to have been in the mouth, for LSD dots.
  • Cigarette papers
  • Pieces or shreds of tobacco and cannabis
  • Syringes and needles
  • Unusual looking pharmaceutical preparations

These items are usually not lying around but well secured and hidden under floorboards, under carpets, in the base of couches or beds, garden sheds, garages, or vacant houses, play dens, etc. Because drug use is not acceptable behaviour in our society, drug paraphernalia is seldom in full view.

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