IV.

Results

Drug Problems in the Philippines

Reports of drug related crime are common in the Philippines media. The
main concern tends to be towards Shabu which gets the most media
attention. It does seem that illegal drug use is on the rise, and this has
worrying implications for the future. There is an urgent need to educate
young people as to the dangers of drug use, and there is also a great need
to help those who are already addicted to escape their misery. Failure to do
this could mean there will be further deterioration within many Filipino
communities.

Statistics for Drug Problems in the Philippines

A US government report in 2009 concluded that illegal drug use was a
significant problem in the Philippines due to corruption and poor law
enforcement. There was particular concern expressed about the amount of
methamphetamine (shabu) and cannabis production in the area. Drug
addiction appears to be on the rise in the Philippines. There are believed to
be as many as 6.7 million drug abusers according to figures from 2004- this
is a dramatic increase from 1972 when there was only believed to have
been around 20,000 drug users in the Philippines. The drug that is most
abused in the Philippines continues to be Alcohol they are the second
highest consumers of alcoholic drinks in South East Asia.

Most Commonly Abused Drugs in the Philippines

The most commonly abused drugs in the Philippines include:

* Alcohol
* Marijuana
* Heroin

* Cocaine
* Methamphetamine (locally known as Shabu)
* Inhalants such as nitrates and gasoline. These can be a cheap way for
people to get high.
* Opium
* Ecstasy (MDMA)
Concerns for Shabu Abuse
One of the most abused drugs in the Philippines is a local type of
methamphetamine mixed with caffeine known as Shabu. This stimulant is
believed to be the drug of choice for 90% of the Philippines illegal
substance users. This is a powerfully addictive drug that can cause people
to have intense hallucinations and become extremely paranoid. Some
users of this drug have even jumped off high rise buildings because they
believed they could fly. Shabu didnt arrive in the Philippines until the mid
eighties, but it soon became hugely popular among drug users.
Methamphetamine causes feelings of euphoria and the user feels full of
energy.

Problems Related to Drug Addiction

Drug abuse leads to many problems such as:

* The individual does not have to be abusing a substance like Shabu long
before they become addicted.
* Those individuals who become addicted can become obsessed with their
habit. This means that everything else in their life will take second place.
* The individuals behavior will change. They may become physically violent
or engage in other types of bad behavior.
* Those who abuse these drugs can struggle to keep down a job. They may
become unemployable.
* Young people who use these substances will be unable to perform well in
school or college. This means that they will be limiting their future
opportunities.
* When drug users run out of money to feed their habit they will be tempted
to turn to crime. This may mean stealing from family and friends or from
complete strangers.

* Many addicts fall into a life of crime and eventually end up in prison or
worse.
* If the drug addict is unable to escape this behavior it is highly likely to lead
to their death. This individual will shorten their lifespan as a result of their
behavior.
* Illegal drug users run the risk of overdose. It can be difficult to assess the
strength of illegal drugs, and it can be similar to playing a game of Russian
roulette every time the addict uses these substances it is even possible
for people to die of an overdose after only trying illegal drugs one time.

Cost of Drug Addiction in the Philippines

The cost of drug addiction is high for the Philippines and it involves:

* A great deal of domestic violence is associated with drug abuse.

* A huge proportion of criminal acts are committed by individuals who are
trying to satisfy their drug habit.

* The economy suffers because drug users become less productive in their
jobs or they become unable to work completely.
* The government needs to spend large amounts of money on tackling drug
problems. The resources used by law enforcement alone are a drain.
* Money that could be spent to improve the life of a family is wasted
because one member is a drug addict. It can lead to a situation where the
rest of the family is living in poverty while one of them wastes thousands of
pesos each week on drugs.
* A criminal underworld had developed in order to take advantage of the
desire for these illegal substances. The money made from selling drugs is
used to finance other criminal acts as well as terrorism.
* Drug addict can destroy communities. It can lead to a situation where
people are afraid to leave their homes because of fear of crime.
* The individual who falls into drug addiction can lose everything including
their own self respect. This miserable life is a waste of human potential.

Treatment for Drug Addiction in the Philippines

There are a number of treatment options available to people in the

Philippines who need help including:

* Narcotics Anonymous is a twelve step program that supports the

individual to escape their addictions. This fellowship is not just focused on
stopping the drug use but also on building a life worth living.
* There are a number of drug rehabilitation facilities in the Philippines
including Serenity at the Quarry.
* It is becoming more common for Filipinos to go abroad to seek the most
effective treatment for their addictions. Drug and Alcohol Rehab Asia is
based in Thailand and is considered to be one of the leading rehab in Asia.

With much of the focus on drug use in the United States, many people
probably dont pay much attention to drug addiction in the Philippines. Why
should we? Because it is an ever-increasing problem for the people of that
country and they shouldnt be ignored. Drug addiction in the Philippines
has increased at alarming rates since World War II. Sadly, the reasons why
arent clear cut.

Most of the drug users in the Philippines are young people. Illicit drugs that
are present include marijuana, LSD, opiates, and barbiturates. While there
are no hard fast statistics available, it is estimated that as many as 60,000
young people in the Philippines are dealing with drug addiction.

Within a period of ten years, the incidence of drug addiction rose

dramatically according to studies done in this tiny country. The majority of
drug users are students with marijuana being the drug of choice. Many
people believe that this rise is attributable to simple curiosity, but more
likely because Philippine youth are trying to emulate their Western
counterparts here in the United States.

Because so much attention is focused on drug addiction in America, the

information is readily available in the Philippines as are the drugs. This has
increased the demand for drugs thus pushing drug dealers to grow their
own cannabis plants, which is illegal in the Philippines. There have been
recent reports as well of drugs being manufactured in illegal laboratories.

Local narcotics police have made several raids to try and curb this activity,
but of course, to no avail.

To meet the challenge of the drug abuse problem several measures, both
private and governmental, are being taken. Violators of narcotic laws who
make known to the authorities the fact of their addiction and their desire to
be cured are referred to the Addiction Institute of the National Bureau of
Investigation so that they may undergo treatment and rehabilitation.

On another front, a new organization-the Narcotic Foundation of the

Philippines-has recently been formed. This is a private association not
related to Government institutions and treatment centers; its aims are to
raise funds for the treatment and reorientation of young addicts, and to
educate the public against the dangers of drug addiction. It is to be hoped
that the efforts made by this newly-founded organization, along with the
efforts of the Addiction Institute and other interested bodies, will help the
country to eventually cope with the alarming growth in local drug abuse.

Drug addiction in the Philippines is a growing problem, but it is one that the
Philippine government is trying to tackle and take hold of. Just as in the
United States, drug addiction is nothing to be taken lightly no matter where
it happens here or in the Philippines.
Drug abuse, also called substance abuse or chemical abuse, is a disorder
that is characterized by a destructive pattern of using a substance that
leads to significant problems or distress. Teens are increasingly engaging
in prescription drug abuse, particularly narcotics (which are prescribed to
relieve severe pain), and stimulant medications, which treat conditions
like attention deficit disorder and narcolepsy. drug abuse,
the use of a drug for a nontherapeutic effect. Some of the most commonly
abused drugs are alcohol; nicotine; marijuana; amphetamines;barbiturates;
cocaine; methaqualone; opium alkaloids; synthetic opioids; benzodiazepine
s, including flunitrazepam (Rohypnol); gamma-hydroxybutyrate; 3,4methylenedioxymethamphetamine (MDMA, ecstasy); phencyclidine; ketami
ne; and anabolic steroids. Drug abusemay lead to organ damage, addiction
, and disturbed patterns of behavior. Some illicit drugs, such as heroin, lyse
rgic acid diethylamide,and phencyclidine hydrochloride, have no recognize
d therapeutic effect in humans. Use of these drugs often incurs criminal pe

nalty inaddition to the potential for physical, social, and psychologic harm.
See also drug addiction.

Drug dependence is the body's physical need, or addiction, to a specific

agent. There is therefore virtually no difference between dependency and
addiction. Over the long term, this dependence results in physical harm,
behavior problems, and association with people who also abuse drugs.
With repeated use of heroin, dependence also occurs. Dependence
develops when the neurons adapt to the repeated drug exposure and only
function normally in the presence of the drug. When the drug is withdrawn,
several physiologic reactions occur. These can be mild (e.g., for caffeine) or
even life threatening (e.g., for alcohol). This is known as the withdrawal
syndrome. In the case of heroin, withdrawal can be very serious and the
abuser will use the drug again to avoid the withdrawal syndrome
In WHO, Dependence syndrome
The Tenth Revision of the International Classification of Diseases and
Health Problems (ICD-10) defines the dependence syndrome as being a
cluster of physiological, behavioral, and cognitive phenomena in which
the use of a substance or a class of substances takes on a much higher

priority for a given individual than other behaviors that once had greater
value. A central descriptive characteristic of the dependence syndrome is
the desire (often strong, sometimes overpowering) to take the
psychoactive drugs (which may or not have been medically prescribed),
alcohol, or tobacco. There may be evidence that return to substance use
after a period of abstinence leads to a more rapid reappearance of other
features of the syndrome than occurs with nondependent individuals.
In 1964 a WHO Expert Committee introduced the term dependence to
replace the terms addiction and habituation. The term can be used
generally with reference to the whole range of psychoactive drugs (drug
dependence, chemical dependence, substance use dependence), or
with specific reference to a particular drug or class of drugs (e.g. alcohol
dependence, opioid dependence). While ICD-10 describes dependence
in terms applicable across drug classes, there are differences in the
characteristic dependence symptoms for different drugs.
In unqualified form, dependence refers to both physical and
psychological elements. Psychological or psychic dependence refers to
the experience of impaired control over drinking or drug use while
physiological or physical dependence refers to tolerance and withdrawal

symptoms. In biologically-oriented discussion, dependence is often used

to refer only to physical dependence.
Dependence or physical dependence is also used in the
psychopharmacological context in a still narrower sense, referring solely
to the development of withdrawal symptoms on cessation of drug use. In
this restricted sense, cross-dependence is seen as complementary to
cross-tolerance, with both referring only to physical symptomatology
(neuro-adaptation).
ICD-10 Clinical description
A cluster of physiological, behavioral, and cognitive phenomena in which
the use of a substance or a class of substances takes on a much higher
priority for a given individual than other behaviors that once had greater
value. A central descriptive characteristic of the dependence syndrome is
the desire (often strong, sometimes overpowering) to take psychoactive
drugs (which may or may not have been medically prescribed), alcohol,
or tobacco. There may be evidence that return to substance use after a
period of abstinence leads to a more rapid reappearance of other
features of the syndrome than occurs with nondependent individuals
ICD-10 Diagnostic guidelines

A definite diagnosis of dependence should usually be made only if three

or more of the following have been present together at some time during
the previous year:

A strong desire or sense of compulsion to take the substance;

Difficulties in controlling substance-taking behavior in terms of its

onset, termination, or levels of use;

A physiological withdrawal state when substance use has ceased

or have been reduced, as evidenced by: the characteristic withdrawal
syndrome for the substance; or use of the same (or closely related)
substance with the intention of relieving or avoiding withdrawal
symptoms;

Evidence of tolerance, such that increased doses of the

psychoactive substance are required in order to achieve effects originally
produced by lower doses (clear examples of this are found in alcoholand opiate-dependent individuals who may take daily doses sufficient to
incapacitate or kill non-tolerant users);

Progressive neglect of alternative pleasures or interests because

of psychoactive substance use, increased amount of time necessary to
obtain or take the substance or to recover from its effects;

Persisting with substance use despite clear evidence of overtly

harmful consequences, such as harm to the liver through excessive
drinking, depressive mood states consequent to periods of heavy
substance use, or drug-related impairment of cognitive functioning;
efforts should be made to determine that the user was actually, or could
be expected to be, aware of the nature and extent of the harm.
ICD-10 Diagnostic criteria for research
Three or more of the following manifestations should have occurred
together for at least 1 month or, if persisting for periods of less than 1
month, should have occurred together repeatedly within a 12-month
period:

A strong desire or sense of compulsion to take the substance;

Impaired capacity to control substance-taking behavior in terms of

its onset, termination, or levels of use, as evidenced by the substance
being often taken in larger amounts or over a longer period than
intended, or by a persistent desire or unsuccessful efforts to reduce or
control substance use;

A physiological withdrawal state when substance use is reduced or

ceased, as evidenced by the characteristic withdrawal syndrome for the

substance, or by use of the same (or closely related) substance with the
intention of relieving or avoiding withdrawal symptoms;

Evidence of tolerance to the effects of the substance, such that

there is a need for significantly increased amounts of the substance to
achieve intoxication or the desired effect, or a markedly diminished effect
with continued use of the same amount of the substance;

Preoccupation with substance use, as manifested by important

alternative pleasures or interests being given up or reduced because of
substance use; or a great deal of time being spent in activities necessary
to obtain, take or recover from the effects of the substance;

Persistent substance use despite clear evidence of harmful

consequences as evidenced by continued use when the individual is
actually aware, or may be expected to be aware, of the nature and extent
of harm.

Drug dependence means that a person needs a drug to function normally.

Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is
the compulsive use of a substance, despite its negative or dangerous
effects.

A person may have a physical dependence on a substance without having

an addiction. For example, certain blood pressure medications do not
cause addiction but they can cause physical dependence. Other drugs,
such as cocaine, cause addiction without leading to physical dependence.
Tolerance to a drug (needing a higher dose to attain the same effect) is
usually part of addiction.

Causes
Drug abuse can lead to drug dependence or addiction. People who use
drugs for pain relief may become dependent, although this is rare in those
who don't have a history of addiction.
The exact cause of drug abuse and dependence is not known. However, a
person's genes, the action of the drug, peer pressure, emotional distress,

anxiety

depression

stress

, , and environmental all can be factors.

Peer pressure can lead to drug use or abuse, but at least half of those who
become addicted have depression, attention deficit disorder, post-traumatic
stress disorder, or another mental health problem.
Children who grow up in an environment of illicit drug use may first see
their parents using drugs. This may put them at a higher risk for developing
an addiction later in life for both environmental and genetic reasons.
People who are more likely to abuse or become dependent on drugs
include those who:

Have depression, bipolar disorder, anxiety disorders, and

schizophrenia

Have easy access to drugs

Have low self-esteem, or problems with relationships

Live a stressful lifestyle, economic or emotional

Live in a culture where there is a high social acceptance of drug use

Commonly abused substances include:

Opiates and narcotics are powerful painkillers that cause drowsiness

(sedation) and sometimes feelings of euphoria. These include

heroin

hydro morphine

, opium, codeine, meperidine (Demerol), (Dilaudid), and oxycodone

(Percocet, Percodan, and Oxycontin).

Central nervous system (CNS) stimulants include

amphetamines, cocaine, dextroamphetamine, methamphetamine, and
methylphenidate (Ritalin). These drugs have a stimulating effect, and
people can start needing higher amounts of these drugs to feel the same
effect (tolerance).

Central nervous system depressants include alcohol, barbiturates

(amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium,
Ativan, Xanax), chloral hydrate, and paraldehyde. These substances
produce a sedative and anxiety-reducing effect, which can lead to
dependence.

Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"),

and phencyclidine (PCP or "angel dust"). They can cause people to see
things that aren't there (hallucinations) and can lead to psychological
dependence.

Tetrahydrocannabinol (THC) is the active ingredient found

in marijuana (cannabis) and hashish.

There are several stages of drug use that may lead to dependence.
Young people seem to move more quickly through the stages than do
adults.

Experimental use -- typically involves peers, done for recreational

use; the user may enjoy defying parents or other authority figures.

Regular use -- the user misses more and more school or work;
worries about losing drug source; uses drugs to "fix" negative feelings;
begins to stay away from friends and family; may change friends to those
who are regular users; shows increased tolerance and ability to "handle"
the drug.

Daily preoccupation -- the user loses any motivation; does not care
about school and work; has obvious behavior changes; thinking about
drug use is more important than all other interests, including
relationships; the user becomes secretive; may begin dealing drugs to
help support habit; use of other, harder drugs may increase; legal
problems may increase.

Dependence -- cannot face daily life without drugs; denies problem;

physical condition gets worse; loss of "control" over use; may become
suicidal; financial and legal problems get worse; may have broken ties
with family members or friends.

Exams and Tests

Drug tests (toxicology screens) on blood and urine samples can show
many chemicals and drugs in the body. How sensitive the test is depends
upon the drug itself, when the drug was taken, and the testing laboratory.
Blood tests are more likely to find a drug than urine tests. However, urine
drug screens are done more often.
Opiates and narcotics are usually in the urine 12 to 36 hours after the last
use, depending on the amount used and how often the drug was used.
CNS stimulants such as cocaine can be found in urine for 1 to 12 days,
again depending on how often the drug was used.
CNS depressants such as Valium and Xanax are found up to 7 days after
the last day of use, mostly depending on the substance used and how
quickly the body removes it (its half-life).

Most hallucinogens also can be found in the urine up to 7 days after the
last use. Evidence of marijuana use can be found for up to 28 days after its
last use in regular users.

Treatment
Treatment for drug abuse or dependence begins with recognizing the
problem. Though "denial" used to be considered a symptom of addiction,
recent research has shown that people who are addicted have far less
denial if they are treated with empathy and respect, rather than told what to
do or "confronted."
Treatment of drug dependency involves stopping drug use either gradually
or abruptly (detoxification), support, and staying drug free (abstinence).

People with
o

acute

loses consciousness

intoxication or drug overdose may need emergency treatment.

Sometimes, the person and might need to be on a breathing machine

(mechanical respirator) temporarily. The treatment depends on the drug

being used.

Detoxification is the withdrawal of an abused substance in a

controlled environment. Sometimes a drug with a similar action is taken
instead, to reduce the side effects and risks of withdrawal. Detoxification
can be done on an inpatient or outpatient basis.

As with any other area of medicine, the least intensive treatment should be
the starting point.
Residential treatment programs monitor and address possible withdrawal
symptoms and behaviors. These programs use behavior modification
techniques, which are designed to get users to recognize their behaviors.
Treatment programs include counseling, both for the person (and perhaps
family), and in group settings. Drug abuse treatment programs have a long
after-care part (when the user is released from the medical facility), and
provide peer support.
Drug addiction is a serious and complicated health condition that requires
both physical and psychological treatment and support. It is important to be
evaluated by a trained professional to determine the best care.

If the person also has depression or another mood disorder, it should be

treated. Very often, people start abusing drugs in their effort to self-treat
mental illness.
For narcotic dependence, some people are treated with methadone or
similar drugs to prevent withdrawal and abuse. The goal is to enable the
person to live as normal a life as possible.

Support Groups
Many support groups are available in the community. They include
Narcotics Anonymous (NA), Ala-Teen, and Al-Anon. Most of these groups
follow the 12-Step program used in Alcoholics Anonymous (AA). SMART
Recovery and LifeRing Recovery are programs that do not use the 12-step
approach. You can find support groups in your phone book.

Outlook (Prognosis)
Drug abuse and dependence may lead to a fatal drug overdose. Some
people start taking the drugs again after they have stopped. Relapses can
lead to continued dependence.

Possible Complications

The complications of drug abuse and dependence include:

Bacterial endocarditis,
o

hepatitis

thrombophlebitis

pulmonary emboli

, , , malnutrition, or respiratory infections, caused by drug use by injection

Depression

Drug overdose

Increase in various cancer rates; for example, lung and pharynx

cancer are linked to nicotine use; mouth and stomach cancer are
associated with alcohol abuse and dependence

Infection with HIV through shared needles

Problems with memory and concentration, for example with

hallucinogen use, including marijuana (THC)

Problems with the law

Relapse of drug abuse

Unsafe sexual practices, which may result in unwanted pregnancies,

sexually transmitted diseases, HIV, or hepatitis B

Physical Dependence is a physiological state of adaptation to a substance,

the absence of which produces symptoms and signs of withdrawal. It is
possible to be physically dependent on a drug without being addicted to it.
Physical dependence is the result of physical changes in the brain.
Physical dependence refers to a state resulting from chronic use of a drug
that has produced tolerance and where negative physical
symptoms[4] of withdrawal result from abrupt discontinuation or dosage
reduction.[5] Physical dependence can develop from low-dose therapeutic
use of certain medications such as benzodiazepines, opioids, anti
epileptics and antidepressants, as well as misuse of recreational
drugs such as alcohol, opioids, and benzodiazepines. The higher the dose
used, the greater the duration of use, and the earlier age use began are
predictive of worsened physical dependence and thus more severe
withdrawal syndromes. Acute withdrawal syndromes can last days, weeks
or months, and protracted withdrawal syndrome, also known as "post-acute
withdrawal syndrome" or "PAWS" - a low-grade continuation of some of the

symptoms of acute withdrawal, typically in a remitting-relapsing pattern,

that often results in relapse into active addiction and prolonged disability of
a degree to preclude the possibility of lawful employment - can last for
months, years, or, in relatively common to extremely rare cases, depending
on individual factors, indefinitely. Protracted withdrawal syndrome is noted
to be most often caused by benzodiazepines, but is also present in a
majority of cases of alcohol and opioid addiction, especially that of a longterm, high-dose, adolescent-beginning, or chronic-relapsing nature (viz. a
second or third addiction after withdrawal from the self-same substance of
dependence). Withdrawal response will vary according to the dose used,
the type of drug used, the duration of use, the age of the patient, the age of
first use, and the individual person.

Symptoms
Physical dependence can manifest itself in the appearance of both physical
and psychological symptoms which are caused by physiological adaptions
in the central nervous system and the brain due to chronic exposure to a
substance. Symptoms which may be experienced during withdrawal or
reduction in dosage include increased heart rate and/or blood pressure,

sweating, and tremors. More serious withdrawal symptoms such

as confusion, seizures, and visual hallucinations indicate a serious
emergency and the need for immediate medical care. Sedative hypnotic
drugs such as alcohol, benzodiazepines, and barbiturates are the only
commonly available substances that can be fatal in withdrawal due to their
propensity to induce withdrawal convulsions. Abrupt withdrawal from other
drugs, such as opioids can cause an extremely physiologically and
psychologically painful withdrawal that is very rarely fatal in patients of
general good health and with medical treatment, but is more often fatal in
patients with weakened cardiovascular systems; toxicity is generally
caused by the often-extreme increases in heart rate and blood pressure
(which can be treated with clonidine), or due to arrhythmia due to
electrolyte imbalance caused by the inability to eat, and constant diarrhea
and vomiting (which can be treated
with loperamide and ondansetron respectively) associated with acute
opioid withdrawal, especially in longer-acting substances where the
diarrhea and emesis can continue unabated for weeks, although lifethreatening complications are extremely rare, and nearly non-existent with
proper medical management. Dependence itself and chronic intoxication on
psychostimulants can cause mild-to-moderate neurotoxic effects due to

hyperthermia and generation of free radicals. This is treated with

discontinuation; life-threatening complications are nonexistent.
Treatment
Treatment for physical dependence depends upon the drug being
withdrawn and often includes administration of another drug, especially for
substances that can be dangerous when abruptly discontinued. Physical
dependence is usually managed by a slow dose reduction over a period of
weeks, months or sometimes longer depending on the drug, dose and the
individual.[6] A physical dependence on alcohol is often managed with a
cross tolerant drug, such as long acting benzodiazepines to manage
the alcohol withdrawalsymptoms.
Drug Dependence That Cause Drug Abuse

All -opioids with any (even slight) agonist effect, such as (partial
list) morphine, heroin, codeine, oxycodone, buprenorphine, nalbuphine,
methadone, and fentanyl, but not agonists specific to non- opioid
receptors, such as salvinorin A (a k-opioid agonist), nor opioid
antagonists or inverse agonists, such as naltrexone (a universal
opioid inverse agonist)

All GABA agonists and positive allosteric modulators of both

the GABA-A ionotropic receptor and GABA-B metabotropic
receptor subunits, of which the following drugs are examples (partial
list):

alcohols such as ethyl alcohol (alcoholic beverage) (cf. alcohol

dependence, alcohol withdrawal, delirium tremens)

barbiturates such as phenobarbital, sodium

thiopental and secobarbital

benzodiazepines such
as diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax)
(see benzodiazepine dependence and benzodiazepine withdrawal
syndrome)

nonbenzodiazepines (z-drugs) such as zopiclone and zolpidem.

gamma-hydroxybutyric acid (GHB) and 1,4-butanediol

carisoprodol (Soma) and

related carbamates (tybamate and meprobamate)

baclofen (Lioresal) and its non-chlorinated analogue phenibut

chloral hydrate

glutethimide

clomethiazole

methaqualone (Quaalude)
gabapentin (Neurontin) and pregabalin (Lyrica), calcium channel

modifiers that affect GABA antiepileptic drugs such

as valproate, lamotrigine, tiagabine, vigabatrin, carbamazepine and oxc
arbazepine, and topiramate

possibly neuroleptic drugs such

as clozapine, risperidone, olanzapine, haloperidol, thioridazine, etc.

commonly prescribed antidepressants such as the selective serotonin

reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake
inhibitors (SNRIs) (cf. SSRI/SNRI withdrawal syndrome) blood pressure
medications, including beta blockers such as propanolol and alphaadrenergic agonists such as clonidine

androgenic-anabolic steroids

glucocorticoids

A wide range of drugs whilst not causing a true physical dependence

can still cause withdrawal symptoms or rebound effects during dosage
reduction or especially abrupt or rapid withdrawal. [23] These can
include caffeine, stimulants, steroidal drugs
and antiparkinsonian drugs.] It is debated if the entire antipsychotic drug
class causes true physical dependency, if only a subset does, or if none
does,[30] but all, if discontinued too rapidly, cause an acute withdrawal
syndrome.[31] When talking about illicit drugs rebound withdrawal is,
especially with stimulants, sometimes referred to as "coming down" or
"crashing".

Some drugs, like anticonvulsants and antidepressants, describe the drug

category and not the mechanism. The individual agents and drug classes in
the anticonvulsant drug category act at many different receptors and it is
not possible to generalize their potential for physical dependence or
incidence or severity of rebound syndrome as a group so need to be looked
at individually. Anticonvulsants as a group however are known to cause
tolerance to the anti-seizure effect.[32] SSRI drugs, which have an important

use as antidepressants, engender a discontinuation syndrome that

manifests with physical side effects. E.g., There have been case reports of
a discontinuation syndrome withvenlafaxine (Effexor).[17]

Fourth pages
Psychological dependence is a form of dependence that involves
emotionalmotivational withdrawalsymptoms (e.g., a state of unease or
dissatisfaction, a reduced capacity to experience pleasure, oranxiety) upon
cessation of drug use or engagement in certain behaviors. [1][2][4] Physical
and psychological dependence are often classified as a facet or component
of addiction, although some drugs which produce dependence syndromes
do not produce addiction, and vice versa, in humans.[5]Addiction and
psychological dependence are similar since they both involve a distinct
form of psychological reinforcement, which is a form of operant
conditioning.[1][2] Addiction is a compulsion for rewarding stimuli (associated

with positive reinforcement), which is essentially an intense desire or

craving.[1][2] Psychological dependence involves a desire to use a drug or
perform a behavior to avoid the unpleasant withdrawal syndrome (negative
reinforcement) that results from cessation of exposure to it.[1][2]
Psychological dependence develops through consistent and frequent
exposure to a stimulus.[6]Behaviors which can produce observable
psychological withdrawal symptoms (i.e., cause psychological dependence)
include physical exercise, shopping, sex and self-stimulation using
pornography, and eating food with high sugar or fat content, among others.
[4][7]

Behavioral therapy is typically employed to help individuals overcome

psychological dependence upon drugs or maladaptive behaviors that

produce psychological dependence.[8]

Psychological Dependence is an emotional need for a drug or substance

that has no underlying physical need. For example, people who stop
smoking recover physically in a short time. The emotional need for nicotine,
however, is much more difficult to overcome. They continually think they
need the nicotine to stay calm even though there is no physical need. The
drug for the addict is similar to what a security blanket would be for a child

(or some adults).

PSYCHOLOGICAL DEPENDENCY
According to the APA, Psychological Dependence refers to a mental a
cycle where one is dependent on a psychoactive substance for the
reinforcement it provides. To the lay person, what this signifies is that the
physiological response to the medication or drug precipitates and
simultaneously reinforces its continued abuse. For reasons of diagnostic
criteria, this generally falls under the heading addiction, and are typically
indivisible as phenomenon whereby craving is generated. The term with
regards to addiction refers to a particular substance that the addict abuses
compulsively because of the enjoyable mental affects it generates.
Causes of Condition
Typically, people become dependent on something because its ingestion
becomes associated with alleviation of mental duress. This mental duress
can manifest as Depression, Anxiety, or a host of other uncomfortable
emotional states, but it is the cessation of discomfort that reinforces and
creates the Psychological Dependence, as opposed to the physical
dependence manifesting as a result of the emotional relief. As with

other forms of addiction, each successive use tends to reinforce the next,
and where physiological addiction is present, the affect is that much more
amplified.
Spectrum of Term Usage
With regards to addiction per se, the term is actually falling out favor
because Psychological Dependence is now associated with a number of
compulsive behaviors that are not necessarily defined by abuse of a
medication or drug. Psychological Dependence now refers to gambling
disorders, sexually compulsive disorders, in addition to eating disorders
and even internet pornography. This is in part due to the inexact and vague
nature of the term itself. The fact that the term is so elastic that it covers
such a broad range of behaviors that as often as not have nothing to do
with addiction to a substance but rather a lifestyle has given rise to the
use of the term dependence instead.
Symptoms of Addiction
Additionally, as researchers learn more about addiction as a medical
condition, the term Psychological Dependence has also lost footing. Today,
Addiction is viewed as a complex interplay between psychological and
emotional factors, in addition to physiological traits and genetic

predispositions.
Generally speaking, features of Addiction include:

Preoccupation with alcohol and drugs.

Inability to control ones drinking or using.

Increased tolerance to alcohol or drugs.

The presence of Dependence, which typically manifests with

withdrawal symptoms.

Continued Abuse, despite increasingly severe and negative

consequences.

Distortions in thinking, usually demonstrated by what is referred to as

Denial.
Comprehensive Treatment
With the exception of the last entry denial addiction specialists more
and more have come to regard the process of addiction as being a process
that occurs on a physiological level, with the psychological traits taking
shape after the physical tendencies have taken form. At ARC, addiction is
treated comprehensively, which means that both the emotional factors and
underlying physiology is simultaneously treated as parts of the whole;

where the division between the Physiological Addiction and Psychological

Addiction, at least with regards to treatment protocols, is largely false.
Suffice to say by the time a person is in need
of residential or outpatient treatment; Chemical Dependency has
progressed into something far more overreaching than merely a set of
maladaptive, abusive behaviors and tendencies. Detoxification is rarely
enough, and in order for the Dependent person to truly surmount their own
pathological pitfalls and enjoy a life of recovery they must be willing to
confront and deconstruct a series of personality traits, assumptions, and
belief systems that are intertwined with their active Dependency.
Drugs with Abuse Potential
The following list is by no means comprehensive, and there is available a
multitude of drugs not on this list that nonetheless have enormous Abuse
potential (it should be noted that, as such, each of the following substances
listed occurs with its own set of psychological characteristics; each of which
require specialized attention to adequately address). However, for the sake
of expediency, the following substances are the most frequently abused
and include:

Alcohol

Marijuana

Hallucinogens

Cocaine

Amphetamines

Benzodiazepines

Opiates

Anabolic steroids

Inhalants

Methamphetamine

Nicotine

Drug dependence is that it is a condition resulting from theprolonged and

usually intenseconsumption of a drug or drugs which has resulted
in psychological and/orphysiological dependence on drug consumption.
This dependence causes significant problems in one or more areas of the
persons life.

A more specific and formal definition of drug dependence can be

formulated using the Diagnostic and Statistical Manual, 4th Edition, of the
American Psychiatric Association, (DSM-IV, 1994).
However the terms drug abuse and drug dependence are not used in
the DSM-IV or the other widely used classification system, the International
Statistical Classification of Diseases (ICD). Instead the terms substance
abuse and substance dependence are used.
The term substance in the DSM-IV not only includes psychoactive
chemicals of abuse but also medications and toxins with psychoactive
effects and includes the following 11 classes of chemicals: alcohol,
amphetamine or similarly acting sympathomimetics; cannabis; cocaine;
hallucinogens; inhalants; nicotine; opioids; phencyclidine or similarly
acting arylcyclohexylamines; and sedatives, hypnotics, and anxiolytics.
Using the DSM-IV criteria for substance dependence but applying it to the
case where the substance is one of the illicit drugs described above, the
diagnosis of drug dependence is made when one or more of the following
occurs over one year:

Tolerance which is defined by increased amounts of substance to

achieve same degree of intoxication

Withdrawal which is defined by a set of symptoms characteristic

of the specific substance alcohol or drug of abuse.

Substance is taken in greater amounts or over longer time periods

than intended

There is a persistent desire and or attempts to reduce or

stop substance use but these are not successful.

A great deal of time is spent making sure of the availability of

substance,consuming substance, or recovering from the negative
consequences of substance use; example the hangover.

Important social, occupational, or recreational

activities are diminished or given up completely because of
substance dependence.

Substance use continues despite awareness of causing persistent

physical orpsychological problems which have either been caused
by or intensified by taking the substance.

Drug abuse differs from drug dependence

Research has shown important differences between alcohol abuse and
alcohol dependence (Hartford and Muthen, 2001) and it reasonable to
conclude that the same distinction between drug abuse and drug
dependence.
For example in drug abuse there is no significant psychological or
physiological dependence whereas drug dependence and associated
symptoms e.g. withdrawal symptoms, craving etc are characteristic of drug
dependence. Also because of these differences in the nature of drug abuse
and drug dependence, there are critical differences between the treatments
of these two distinct conditions.
Prevalence of drug dependence
The lifetime prevalence for drug dependence was found to be 3.0% in a
large epidemiological study carried out recently in the United States
(Kessler et al, 2005). This makes it a little less than half the lifetime
prevalence of drug abuse which was found to be 7.9% in this same study. It
is to be noted that for both alcohol and drugs, dependence is less than half
as common as abuse.

Alcohol dependence and codependence (developmental trauma)

The presence of an addiction of some kind has long been held as a main
secondary symptom of codependency. Other names for codependency are
developmental trauma and complex PTSD.
There is indeed a lot of evidence that many individuals who abuse or
become dependent to any substance be it alcohol or illicit drugs have often
been exposed to previous trauma during their childhood or thereafter.
For example, a study of borderline personality disorder, a severe form of
what many call codependence, in patients with recent deliberate self-harm
in Hong Kong, found they were more likely to suffer from a current alcohol
and substance use disorder Wong (2010).
Also, research by Boriskin (2008) found that 25 to 50 percent of clients with
a substance use disorder also meet the conditions for a diagnosis of post
traumatic stress disorder (PTSD).
Hence there is strong reason to conclude that a person who experienced
repeated or prolonged trauma during their childhood (and hence is likely
codependent) is at greater risk of developing drug/alcohol abuse or
dependence in adulthood.

Treatments available for drug dependence

Fortunately there are a number of effective treatments for drug dependence
as listed below:

Psychotherapy: individual or group. Many psychotherapeutic

modalities e.g.cognitive behavioural therapy are used to treat drug
dependence with varying degrees of success.

It likely is the case that individual psychotherapy can be very useful

but only if there is a strong additional component of group
psychotherapy or attendance at a self-help group such as Narcotics
Anonymous. A limitation of individual psychotherapy is its cost,
particularly in the case of addictions where extended treatment with
a maintenance component is generally necessary.

Self-help groups such as Narcotics Anonymous are effective as

demonstrated by the fact that they have existed for decades and
many recovered through them. There is no evidence that self-help
groups are less effective than formal treatment by a mental health
worker.

Prochaska and his colleagues have shown there are five

stages which people progress through to recover from an
addiction: pre-contemplation,contemplation, preparation, action and
maintenance.

The final stage is maintenance because relapse is the main

problem in recovery from drug (substance) dependence.
Maintenance activity may be required for years, perhaps for the rest
of the recovered persons life. Very few individuals can afford long
term psychotherapy but the maintenance stage can be provided by
weekly attendance at NA meetings for extended periods of time.

Medications: There is increasing use of medications to reduce

withdrawal symptoms and to prevent illicit drug use. As in
alcoholism, but perhaps even to a greater degree, relapse is the
main problem in recovery from drug (substance) abuse.

Although withdrawal is dealt with relatively easily and detoxification

can be obtained, the person addicted to illicit drugs tends to relapse,
making long term abstinence for the drug the most difficult objective
of treatment to attain.

Methadone is a synthetic narcotic used in treatment of heroin

addicts because it relieves withdrawal without producing a strong
euphoria. Heroin antagonists prevent addicts form experiencing a
high when heroin is taken. Drugs are now being sought which will
alleviate the withdrawal symptoms of cocaine.

Detoxification facilities where the drug dependent person can

withdraw under medical care e.g. vigilance of seizures and
appropriate medical intervention including anti-seizure medications.

Rehabilitation and self-help residential homes have proved useful

and involve a total drug-free environment, charismatic role-models,
direct confrontation in group therapy, and separate the drug
dependent person from previous social contacts with other drug
users.

A factor that makes treatment especially important for drug

addicts is the risk of acquiring HIV infection since the virus can be
transmitted through the needles that addicts share with one another.
Since the addict may be married there is the risk of transmission the
spouse. This has resulted in increased attention to reaching out to

those dependent on opiates and in some countries to the provision

of free sterile needles to reduce HIV transmission.

Prevention is considered the best way to deal with drug

dependence.Psychoeducation is the most important tool in
preventing the development of drug dependence. Since generally
the introduction to drug use starts in teenage years or even earlier, it
is best to start drug education in school as soon as possible but at
an age appropriate level.

The Stages of Drug Addiction

Stage 1: Experimentation
Experimentation is defined as the voluntary use of drugs without
experiencing any negative social or legal consequences. For many,
experimenting may occur once or several times as a way to have fun or
even to help the individual cope with a problem. For many, experimentation
can occur without any desire to continue using the drug. For others, it can
start to become a problem when it moves into the next stage of addiction:
regular use.

Stage 2: Regular Use

Some people will be able to enter the stage of regular use without
developing a dependence or addiction. These people will be able to stop
the drug use on their own. The problem with regular use is that the risk for
substance abuse greatly increases during this stage. It also increases risky
behaviors such as driving under the influence, unexplained violence, and
symptoms of depression and anxiety.
Stage 3: Risky Use/Abuse
The line between regular use and risky use/abuse is a very thin one, but is
usually defined as continued use of drugs in spite of severe social and legal
consequences. What might have begun as a temporary form of escape can
quickly lead to more serious problems. This is the stage where the warning
signs of addiction will begin to appear: craving, preoccupation with the
drug, and symptoms of depression, irritability and fatigue if the drug is not
used.
Stage 4: Drug Addiction and Dependency
Physical dependence on a drug is often intertwined with addiction.
Characteristics of dependence and drug addiction include withdrawal
symptoms and compulsive use of the drug despite severe negative

consequences to his or her relationships, physical and mental health,

personal finances, job security and criminal record.

Sign and symptoms

Youve built up a drug tolerance. You need to use more of the drug to
experience the same effects you used to attain with smaller amounts.
You take drugs to avoid or relieve withdrawal symptoms. If you go too
long without drugs, you experience symptoms such as nausea,
restlessness, insomnia, depression, sweating, shaking, and anxiety.
Youve lost control over your drug use. You often do drugs or use
more than you planned, even though you told yourself you wouldnt.
You may want to stop using, but you feel powerless.
Your life revolves around drug use. You spend a lot of time using and
thinking about drugs, figuring out how to get them, and recovering
from the drugs effects.

 Youve abandoned activities you used to enjoy, such as hobbies,

sports, and socializing, because of your drug use.
You continue to use drugs, despite knowing its hurting you. Its
causing major problems in your lifeblackouts, infections, mood
swings, depression, paranoiabut you use anyway.

Causes factors
Recognizing drug abuse in family members
Sometimes it's difficult to distinguish normal teenage moodiness or angst
from signs of drug use. Possible indications that your teenager or other
family member is using drugs include:

Problems at school or work frequently missing school or work, a

sudden disinterest in school activities or work, or a drop in grades or
work performance

Physical health issues lack of energy and motivation

Neglected appearance lack of interest in clothing, grooming or

looks

Changes in behavior exaggerated efforts to bar family members

from entering his or her room or being secretive about where he or she
goes with friends; or drastic changes in behavior and in relationships
with family and friends

Spending money sudden requests for money without a reasonable

explanation; or your discovery that money is missing or has been stolen
or that items have disappeared from your home, indicating maybe
they're being sold to support drug use

Classification of dangerous drugs

According to a study published this month in The Lancet, alcohol and

tobacco rank among the ten most dangerous substances used by humans.
Both alcohol and tobacco have been assessed to be more dangerous than
illegal drugs like marijuana or ecstasy.
The following three factors were considered in ranking the harmfulness of
each drug that was evaluated:
Physical harm to the user
Addictive potential of the drug
The drug's overall impact on society
Psychiatrists who specialize in treating addictive behavior and legal or
police officials with scientific or medical expertise were asked to assign a
score to each of the three factors listed above for each drug that was

evaluated in this study. All told, 20 different drugs were evaluated, including
cocaine, heroin, ecstasy, amphetamines, and LSD.
Ranked from most to least dangerous, the ten most dangerous substances
were deemed to be:
1. Heroin - popular street names include smack, skag, and junk.
2. Cocaine - often referred to as snow, flake, coke, and blow.
3. Barbiturates - popular slang names include yellow jackets, reds,
blues, Amy's, and rainbows.
4. Street Methadone
5. Alcohol
6. Ketamine - a powerful hallucinogen, often referred to as Special K.
7. Benzodiazepines - a family of sedative drugs.
8. Amphetamines - known as greenies among baseball players.
9. Tobacco
10.

Buprenorphine - also called bupe or subbies.

The remaining drugs that were assessed in this study ranked as

follows:
1. Cannabis - includes marijuana.
2. Solvents - volatile substances that can be inhaled, such as glue, nail
polish remover, paints, hair spray, and lighter fuel (gas).
3. 4-MTA - is a derivative of amphetamine and has similar effects to
ecstasy.
4. LSD
5. Methylphenidate - central nervous system stimulant, commonly sold
as ritalin.
6. Anabolic steroids
7. GHB - short for Gamma hydroxybutyrate, a powerful central nervous
system depressant, most commonly known as the date rape drug.
8. Ecstasy
9. Alkyl nitrates - group of drugs commonly referred to as poppers.
10.

Khat - an amphetamine-like stimulant.

It is estimated that tobacco causes 40 percent of all hospital illnesses, while

alcohol is involved in more than 50 percent of all visits to hospital
emergency rooms. In light of these statistics, the authors of this study
question why alcohol and tobacco are legal to use within current drug
policies for Britain and the United States, while less harmful drugs like
ecstasy and LSD are deemed illegal to use.
The bottom line: alcohol and tobacco are two of the most dangerous
substances that you can expose yourself to on a regular basis. In terms of
overall potential to cause harm, if used regularly, alcohol and tobacco
belong in the same category as other recreational drugs like cocaine and
heroin.
Note: To receive valuable tips on how to use your food and lifestyle choices
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Effects of drug abuse

Effects to the family

How a parent with a drug or alcohol problem affects the whole family
It is well known that a parent with a drug or alcohol problem can have a
negative effect on their family members. You could say that the person with
the problem is like someone stuck in a bog. The other family members, in
their efforts to help, often get pulled down into the bog too. The first step in
putting things right is when the others start to get their own feet on solid
ground. Only after they have done this will they be able to help tackle the
addiction problem.
How a parent's addiction may affect their son or daughter

The son or daughter of a parent abusing alcohol or drugs can also end up
bogged down. They often adopt a role which helps the family, but they may
get stuck in the role and neglect their own needs. Sharon Wegscheider
describes some of these roles. Can you see yourself in one of these roles,
or in elements of a couple of them? You can change! Its easier if you get
support.
The Family Hero
This is often the eldest in the family. This person is responsible,
works hard for approval, and often appears successful. But inside,

this person often feels insecure, as if things are always going to go

wrong, and feels incompetent, confused and angry.
The Scapegoat
This person feels blamed when things go wrong. Everyone focuses
on this persons faults, which provides the family with a distraction
from the real problem. So this person often seems rebellious,
troublesome, law-breaking, tough and may be at risk of abusing
drugs themselves. Inside, this person is often full of fear, hurt,
rejection and loneliness, feeling angry at the unfairness of how they
are treated.
The Lost Child
This son or daughter appears as a dreamer, drifting above the
troubled waters that bother other people. But inside, the person is not
as contented as they appear. They are quietly hurt, angry, lonely, with
a feeling of being inadequate.
The Mascot
Sometimes also referred to as the clown, the person in this role is
often charming and cute, fun to be with, quick to make a joke.

Sometimes they are quite hyper-active and flit from one interest to
another; sometimes quite fragile and easily hurt. But they are good at
hiding the hurt, and other feelings of loneliness, insecurity, fear and
low self esteem.
If you recognise any of these roles as being you, the first step to
putting things right is to take time for yourself, to talk to a friend or a
counsellor. Stop thinking about the addicted person for a while (easier
said than done!) and pay attention to your own real needs. See the
family support section below.
How a son or daughter with an addiction affects the whole family
Whole families can seem to go to pieces when there is a son or daughter
using drugs or alcohol. Parents fall out with each other over how to handle
the situation, while other sons or daughters can get blamed for being a bad
example. The drug user gets so much attention that others are neglected.
Rows and bad language upset the peace. If peace and love are the oxygen
of life, then the whole family is gasping for breath.
In an airplane, if the oxygen masks are released, parents are supposed to
put on their own masks before attending to their childrens masks. The

same is true here. You must look after your own needs before helping the
one causing the problem.
Even if you are the only person in the family who recognises the alcohol or
drug problem, it is worth while getting support for yourself, from a friend or
a trusted teacher or a counsellor.
Family support
Community Alcohol Services and Community Drug Services are run by
many Health Boards and are generally free. Many provide support and
information for families to maintain their dignity and sanity when a family
member is abusing drugs or alcohol.
Many addiction treatment services provide support for families.

Effect to the community

Increase of petty crimes in the community (physical injuries, rape, akyatbahay etc.) Increase of drug dependence and drug pusher, aespecially at
night. Fear of community residents to a drugs dependent, especially at
night and the neighborhood association becomes inactive

Effects to the society

Increase of heinous or anti-social crimes, increase of immortality and loss
of moral fiber of the society (prostitute, or child abuse) or downfall of social
values of the country and limited movement of people, especially at night
time for fear of the drug dependent.

Effects to the law enforcement

Corruption of some law enforcement personnel , ineffective application and
implementation, of narcotic law and produces bad image and credibility to
the police agency.

Effects to the economy

to sabotage to the community, and to draining of huge amount of money
from our country and economic growth is slow.

Effects to the judiciary

Corruption of the court and one-sided criminal justice system , to corrupt of
some judicial personnel , maladministration in the dispensation of narcotic
case and coddling of drug abusers and violators of the Dangerous Drug
Act.

Weapons to the combat the drug menace

The abuse of drugs has become one of the most serious social problems in
the world. According to the United Nations Office on Drugs and Crime
(UNODC) latest report, between 149 and 272 million people used illicit
substances at least once in the year 2008. The world population of Problem
drug users, defined as regular users of illicit substances is estimated at
between 15 and 39 million. Amphetamines, cocaine, opiates and cannabis are
the most abused substances. In addition non-medical use of prescription

drugs is reportedly a growing health problem in a number of developed and

developing countries. Moreover, in recent years, several new synthetic
compounds have emerged. Many of these substances are marketed as legal
highs and substitutes for illicit stimulant drugs such as cocaine or ecstasy.
Two examples are piperazine and mephedrone, which are not under
international control. A similar development has been observed with regard to
cannabis, where demand for synthetic cannabinoids (spice) has increased in
some countries. The health consequences of drug use are dramatic: 2.8
million people who inject drugs are HIV positive. This means that nearly one in
five injecting drug users is living with HIV. The prevalence of Hepatitis C
among injecting drug users at the global level is estimated at 50%, suggesting
that there are 8.0 million injecting drug users worldwide who are also infected
with HCV. Deaths related to or associated with the use of illicit drugs are
estimated between 104,000 and 263,000 deaths each year, equivalent to a
range of 23.1 to 58.7 deaths per one million inhabitants aged 15-64. Over half
of the deaths are estimated to be fatal overdose cases. These facts clearly
point to a crucial need for developing and improving analytical methods to
identify such drugs. It is also critical to develop methods for the analysis of
drugs and their metabolites in biological specimen such as urine, blood, sweat
and saliva; particularly in a forensic context.

Many methods are commonly used in forensic laboratories and have already
been well researched and accepted in the scientific community. However,
these methods are prone to certain downfalls. Immunoassays are presumptive
tests that are not definitive and are subject to high rates of false negatives or
false positives due to crossreactivity or adulterants in the samples tested.
Chromatographic methods (LC and GC/MS) require sample preparation such
as extraction and derivatization of the compounds and extensive operator
training; they are also time consuming. Another powerful technique for the
detection of drugs of abuse is Nuclear Magnetic Resonance (NMR)
spectroscopy. NMR has many advantages: It allows definite positive
identifications, very little sample preparation or operator training is needed,
and a spectrum can be gathered in only a few minutes. Furthermore, it is a
non-destructive method and analyzed samples can be recovered. All those are
important considerations in a forensic setting. NMR spectroscopy also shows
signals from all NMR-active materials, and therefore is not limited to screening
for specific drugs. In addition, NMR spectra can be obtained directly from the
biofluid specimen (urine, plasma, saliva), providing a water suppression
technique is used. Problems of extraction, recovery, and chemical
derivatization or those that may be encountered with pH sensitive compounds
are consequently avoided. Finally, quantitation analysis can easily be

performed. All these facts indicate that NMR spectroscopy is a great technique
for the detection of drugs of abuse in biofluids in a forensic situation. Previous
examples include the use of NMR to identify and quantitate levels of methanol
and ethylene glycol ,methylenedioxymethamphetamine (ecstasy) or gammahydroxybutyric acid . However, compared with most chromatographic and
other spectroscopic techniques, NMR is relatively insensitive. Indeed the limit
of detection (LOD) of NMR ranges between 10 9 and 1011 mol whereas as
UVvis absorbance reaches 1013 to 1016 mol.
To conclude, NMR analysis of biofluids for the detection of drugs is a rapid,
convenient and conservative technique. In a forensic context, biofluids could
be quickly pre-analyzed by NMR in cases where there is a strong suspicion of
the presence of drugs. NMR analysis could be used as a pre-screening
method. However, for detections at lower levels, MS or UV based analyses are
required. To that end using LC-NMR in a synergistic way for rapid and
unequivocal identification of unknowns has shown great promise. MS and
NMR can also be combined with one LC to operate as LCNMR- MS, and this
combination has attracted considerable interest . Targeted analytes have
included acetaminophen metabolites in human urine . The forensic community
would greatly benefit from the development of dedicated instruments to further
improve the performance of these synergetic techniques for routine use in the

analysis of drugs in biofluids. LC-NMR-MS 2 is another hyphenated technique

in which the rapid and ultra-sensitive screening capability of MS (or the
advanced information content of real-time MS/MS), could be used to identify
peaks of interest in complex mixtures.

II. Research Problem

The researcher presented several questions to extend its research:

1.

What is drug abuse?

2.

What are the causes of drug abuse?

3.

What are the sign and symptoms of drug abuse?

4.

What are the effects of drug abuse?

5.

What is weapon combat to drug menace ?

I.

Introduction

A drug is, in the broadest of terms, a chemical substance that has known
biological effects on humans or other animals. Foods are generally
excluded from this definition, in spite of their physiological effects on animal
species.

In pharmacology, a drug is "a chemical substance used in the treatment,

cure, prevention, or diagnosis of disease or used to otherwise enhance
physical or mental well-being." Pharmaceutical drugs may be used for a
limited duration, or on a regular basis for chronic disorders.

Recreational drugs are chemical substances that affect the central nervous
system, such as opioids or hallucinogens. Alcohol, nicotine, and caffeine
are the most widely consumed psychotropic drugs worldwide.

They may be used for effects on perception, consciousness, personality,

and behavior. Many recreational drugs are also medicinal.

Some drugs can cause addiction and habituation and all drugs have side
effects. Many drugs are illegal for recreational purposes and international
treaties such as the Single Convention on Narcotic Drugs exist for the
purpose of legally prohibiting certain substances.

Natural or synthetic substance which (when taken into a living body) affects
its functioning or structure, and is used in the diagnosis, mitigation,
treatment, or prevention of a disease or relief of discomfort. Also called

legal drug or medicine. A legal or medicinal drug (such as amphetamines),

however, can be harmful and addictive if misused.

Habit forming stimulant or narcotic substance (such as alcohol, cannabis,

nicotine, or a derivative of cocoa or poppy) which produces a state of
arousal, contentment, or euphoria. Continued or excessive use (called drug
abuse or substance abuse) of such substances causes addiction or
dependence. Thereafter any attempt to discontinue their use results in
specific reactions (called withdrawal symptoms) such as sweating,
vomiting, and tremors which cease when the use is resumed. Also called
illegal drug where its production and/or use is prohibited.

Whether a substance is legal or illegal, however, may have nothing to do

with its potential for addiction or harm: alcohol and nicotine, both addictive
and harmful, are legal in most countries because they generate substantial
employment or government revenue through taxes.

War on Drugs is an American term commonly applied to a campaign of

prohibition of drugs, military aid, and military intervention, with the stated
aim being to define and reduce the illegal drug trade. This initiative includes

a set of drug policies that are intended to discourage the production,

distribution, and consumption of what participating governments and the
UN define as illegal psychoactive drugs. The term was popularized by the
media shortly after a press conference given on June 18, 1971, by United
States President Richard Nixonthe day after publication of a special
message from President Nixon to the Congress on Drug Abuse Prevention
and Controlduring which he declared drug abuse "public enemy number
one". That message to the Congress included text about devoting more
federal resources to the "prevention of new addicts, and the rehabilitation of
those who are addicted", but that part did not received the same public
attention as the term "war on drugs".The Drug Policy Alliance estimates
that the United States spends $51 billion annually on the War on Drugs.

On May 13, 2009, Gil Kerlikowskethe current Director of the Office of

National Drug Control Policy (ONDCP)signaled that the Obama
administration did not plan to significantly alter drug enforcement policy, but
also that the administration would not use the term "War on Drugs",
because Kerlikowske considers the term to be "counterproductive".ONDCP's view is that "drug addiction is a disease that can be
successfully prevented and treated... making drugs more available will

make it harder to keep our communities healthy and safe." One of the
alternatives that Kerlikowske has showcased is the drug policy of Sweden,
which seeks to balance public health concerns with opposition to drug
legalization. The prevalence rates for cocaine use in Sweden are barely
one-fifth of those in Spain, the biggest consumer of the drug.

In June 2011, a self-appointed Global Commission on Drug Policy released

a critical report on the War on Drugs, declaring: "The global war on drugs
has failed, with devastating consequences for individuals and societies
around the world. Fifty years after the initiation of the UN Single Convention
on Narcotic Drugs, and years after President Nixon launched the US
government's war on drugs, fundamental reforms in national and global
drug control policies are urgently neededThe report was criticized by
organizations that oppose a general legalization of drugs.

V. Conclusion
I therefore, conclude that Drug addiction is a powerful demon that can
sneak up on you and take over your life before you know it has even
happened. What started out as just a recreational lifestyle has overcome
your life and affected every single aspect of it. You dont have to be caught
up in the web of drug addiction. There are so many things you can do to
get yourself clean and sober, and theres no better time than the present.
Overcoming drug addiction is a long and often painful process. Leading a
clean lifestyle is something that is well within your reach. You now have the

tools you need go out and heal yourself. Remember that a thousand mile
journey always begins with one step and to take it one day at a time.

III. Learning Objectives

1. Identify the causes of drug addiction
2. Be familiar with the signs and symptoms of drug abuse
3. Be aware of the campaign made by the government to prevent drug
abuse
4. Develop an active participation in the prevention of drug abuse
5. Be familiar with the Comprehensive Dangerous drug acts of 2002

VI. Recommendation

Must stop the influx of using drugs to stop the torrent of it . Because very
many implications for us especially in the family, the community, the media
and much more. Because if the Philippines is that chronic users especially
overseas especially in the area of new york . But there is another legal
abroad and treated their illnesses . But it only provided at a lower dose .
But must be taken by the government for stopping the use of drugs .

VII. Bibliography
http://www.who.int/substance_abuse/terminology/definition1/en/
http://umm.edu/health/medical/ency/articles/drug-dependence
http://en.wikipedia.org/wiki/Physical_dependence

http://www.drugabuse.gov/publications/teaching-packets/neurobiology-drugaddiction/section-iii-action-heroin-morphine/8-definition-dependence
http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm
http://medical-dictionary.thefreedictionary.com/drug+abuse
http://www.medicinenet.com/drug_abuse/page2.htm
http://en.wikipedia.org/wiki/Psychological_dependence
http://www.alleydog.com/glossary/definition.php?term=Psychological
%20Dependence
http://www.arctreatment.com/psychological-dependence/
http://www.psychologymatters.asia/common_mental_illness/8/drugdependence.html
http://casapalmera.com/the-four-stages-of-drug-addiction/
http://www.helpguide.org/articles/addiction/drug-abuse-and-addiction.htm
http://www.scribd.com/doc/129477552/Drug-Abuse-Concepts-Prevention-andCessation-0521716152-pdf#scribd
http://drbenkim.com/ten-most-dangerous-drugs.html
http://drugaddictiontreatmentnow.blogspot.com/2013/02/drug-addiction-inphilippines.html
http://alcoholrehab.com/drug-addiction/drug-addiction-in-the-philippines/