Drug Addiction

Kabirul Bashar PhD

Department of Public Health
North South University

Basic Terminologies
Drug addiction means compulsive,
out of control drug use despite
negative consequences.
Addictive drugs induce
pleasurable states or relief from
distress thus motivating
repetition.
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Basic Terminologies
Types of addiction:
1) Physical addiction: It develops when a
persons body becomes dependent on a
particular substance.
If a physically addicted person stops
using a substance then he may develop
withdrawal symptoms like muscle
cramp, watering from eyes and nose,
anxiety, confusion, sleeplessness and
fits.
2) Psychological addiction: happens when
the cravings for a drug are
psychological or emotional. People who
are psychologically addicted feel
overcome by the desire to have a drug.
They may lie or steal to get it.

Signs of Addiction
Signs of physical addiction:

Changes in sleeping habit

Changes in eating habit

Weight loss or gain

Feeling shaky or sick when trying to stop

Signs of psychological addiction:

Problem with work at home, school or office

Loss of interest in activities that used to be

important

Changes in friendship

Anxiety, anger or depression

Stealing or selling belongings to be able to afford

drugs

Spending a lot of time figuring out how to get

drugs
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Anatomy & Physiology

of Addiction

1.
2.
3.

Addictive drugs act on brains reward

neurons.
Main component of brains reward
neurons is dopamine.
Dopamine is a neurotransmitter which is
released from neurons of the brain to
perform different activities.
Functions of dopamine:
Control of behavior, memory, learning
Control of voluntary movement
Inhibition of prolactin production
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Circuits Involved In Drug Addiction

All of these must be considered

in developing strategies to
effectively treat addiction

Anatomy & Physiology

of Addiction

Dopamine is released from the brain

in response to naturally rewarding
experiences like food, sex, drug etc.
Majority of the addictive drugs like
nicotine, cocaine, amphetamine
directly or indirectly cause an
increase of dopamine level in the
body.
Dopamine provides feelings of
enjoyment and thereby motivates a
person to desire for the rewarding
experience like food, sex, drug which
cause an increase in dopamine level
and thereby gives more pleasurable
feelings.

Brain

Gets Rewired
by Drug Use
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Risk Factors
Family

issues
Emotional trauma
Curiosity or imitation
Bad influence of friends
Poor self-image
Low religiosity
Poor school performance or any problem at
school
Parental rejection
Family dysfunction
Over or under-controlling by parents
Family history
Divorce or romantic breakup
Abuse

Different Types of
Drugs
Cannabinoids: Hashish, Marijuana
How Consumed: Swallowed, smoked
Effects: Euphoria, slowed thinking,
confusion, impaired balance and
coordination
Consequences of long term use:
Cough, frequent respiratory
infections, impaired memory,
increased heart
rate, anxiety, panic attacks
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Depressants
Depressants:

Barbiturates,
benzodiazepines
How Consumed: Swallowed, injected
Effects: Reduced anxiety, feeling of
well-being, slow pulse and breathing,
low blood pressure, poor concentration
Consequences of long term use:
Fatigue, confusion, impaired memory &
judgment, respiratory depression and
death
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Anesthetics
Anesthetics:

Ketamine
How Consumed: Injected,
swallowed, smoked
Effects: Increased heart rate and
blood pressure, impaired motor
function, panic, aggression
Consequences of long term use:
Memory loss, numbness,
nausea/vomiting, depression
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Hallucinogens
Hallucinogens:

LSD
How Consumed: Swallowed, smoked
Effects: Increased body temperature,
heart rate, blood pressure, loss of
appetite, sleeplessness, numbness,
weakness, tremors, nausea
Consequences of long term use :
Persisting perception disorder

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Opiods
Opiods:

Codeine, heroin, morphine,

opium
How Consumed: Injected, swallowed,
smoked
Effects: Pain relief, euphoria, drowsiness
Consequences of long term use: Nausea,
constipation, confusion, sedation,
respiratory depression and arrest,
unconsciousness, coma, death

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Stimulants
Stimulants:

Amphetamine, cocaine,
methamphetamine, nicotine
How Consumed: Injected, smoked,
swallowed
Effects: Increased heart rate, blood
pressure, metabolism, feelings of
exhilaration, energy, increased mental
alertness
Consequences of long term use : Rapid
or irregular heart beat, reduced
appetite, weight loss, heart failure,
nervousness, insomnia
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Other
Steroid

Injected, swallowed, applied to skin

Hypertension, blood clotting and cholesterol
changes, liver cysts and cancer, kidney cancer,
hostility and aggression, acne, premature
stoppage of growth, prostate cancer, reduced
sperm production, shrunken testicles, breast
enlargement, menstrual irregularities,
development of beard and other masculine
characteristics

Dextromethorphan

Swallowed
Distorted visual perceptions, memory loss,
numbness, nausea/vomiting
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Alcohol

How Consumed: Swallowed

Effects: It is an addictive agent that
depresses the central nervous system.
Consequences of long term use: Alcohol is
cumulatively poisonous and damages
many organs of the body when used
excessively (including the brain, liver, and
heart). Chronic, heavy use of alcohol may
lead to irreversible physical and
neurological damage.
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Impact of Drug
Addiction

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Physical Impact

Damage of Different body parts

Brain and liver damage Alcohol
Lung and heart disease Marijuana
Stroke and heart disease Cocaine
Heart disease and liver damage Amphetamine
Problems with Pregnancy
Transmission of STD and various other diseases
occur due to sharing of contaminated syringes
Overdose of cocaine, heroine, alcohol can kill
someone

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Psychological Impact

Influence of Amphetamines
Makes people alert, energetic
& confident.
Influence of Steroids
Leads to confusion, depression & paranoia.
Influence of Cocaine
Similar to amphetamines but short lived.
Regular users often become nervous, excited,
euphoric, nauseous.
Influence of Alcohol
Might lead to sweating, anxiety, trembling.
Influence of Analgesics
Makes people drowsy, contended.
Influence of Marijuana
Low dose leads to depression
High dose makes user distressed
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Social Impact
On

Family & Community

Distance grows with family members

Socially accepted norms are not followed
Drug abuse effects Central Nervous
System which changes mood and reduces
the capability of tolerating other people

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Impacts on Education
Overall performance decreases
Marijuana kills brain cells and disrupt
learning ability

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Impacts on Employment
Work efficiency decreases
Abusers have 55% more chances of
industrial accidents and 85% more
chances of injuries
Drug abuser employee becomes
liability
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Impacts on Criminal Activities

Rise in both violent & acquisitive crime
Abusers often resort to various crimes for
money
Strong link found between violent crimes &
drugs
Influence of alcohol is found in 50% of
murderers and 70% of assaulters.
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We Need to Treat the

Person and the Whole Community!
In the Social Context
Educate the Community, the
Adolescents, the Healthcare
Providers
Increased Prescription Monitoring
Working in Conjunction with Law
Enforcement
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Treatment Strategies For

Clients With Substance Abuse
Problems
Cognitive-Behavioral Therapies: Helps clients develop
the skills to deal with their addictions (e.g. self-control,
coping mechanisms, relapse prevention.)
Individual Psychodynamic/Interpersonal Therapies:
Formulation of the counseling relationship and skill
development.
Group Therapies: Gives support and encouragement
and generates problem-solving strategies.
Family Therapy: Some feel family therapy is necessary
as the addiction affects the family and the family
affects the addiction.
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Stages of Change During

Treatment
Precontemplation: Clients are resistant and deny
they have a problem.
Contemplation: Clients are aware they have a
problem and are actively wondering what they
should do about it.
Preparation: Client have taken some action,
were unsuccessful, but plan to try again.
Action: Clients are taking action and are making
changes.
Maintenance: Efforts are on relapse prevention.
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Relapse Prevention
It is estimated that 90% of all
clients have a relapse within four
years of treatment.
Factors that influence: Changes in
lifestyle or stress reduction .
Preventative factors: Coping
mechanisms and self-efficacy
development.
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The Counseling Process

Develop trust
Assess the problem
Establish goals
Implement a plan
Train for relapse avoidance or minimization
Termination
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The Counseling Process

Structuring the Sessions: Most counselors
provide strict guidelines (e.g. come straight;
do homework etc.)
Assessment: Examples of questions that
need to be answered are:
How significant is the problem?
How long has the client been a user?
Has the client tried to stop?
Does the client have a another disorder?
How has the client been functioning
socially?
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The Counseling Process

Goal Setting: It is usually either
abstinence or controlled use. It
might also include behavioral
change or lifestyle change.
Plan Implementation:
Implementation of plans to meet
goals.

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The Counseling Process

Relapse Prevention: Relapses are
most likely to occur within six
months. Help the client become
aware of what his or her triggers for
relapse are and develop a plan to
deal with these.
Termination: Termination occurs
when both counselor and client feel
the client can cope without the
substance.
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Protective Factors for

Adolescents to prevent Drug
Addiction
Nurturing

home with good communication

Teacher commitment
Positive self-esteem
Self-control
Assertiveness
Social competence
Academic achievement
Religiosity
Intelligence
Avoiding bad peers
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Thank you for your

patience hearing