User:Viriditas/Drug abuse
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Drug abuse is the overuse of a drug for a nontherapeutic effect. Some of the most commonly abused drugs are alcohol, amphetamines, barbiturates, cocaine, methaqualone, narcotics, opium, and tranquilizers. Drug abuse may lead to organ damage, addiction, and disturbed patterns of behavior. Use of these drugs often incurs criminal penalty in addition to the potential for physical, social, and psychologic harm. 1 Drug abuse is often used as a synonym for substance abuse, however substance abuse may entail psychological or physical dependence, and focuses on treatment and prevention in terms of the social consequences of substance use.
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[edit] Approaches to managing drug abuse
[edit] Harm reduction
Attempts by government-sponsored drug abuse control policy to eliminate drug abuse has been unsuccessful. In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens. In spite of the best efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.2
Alternatives involve replacing failed law enforcement policies with harm-reduction strategies such as how to reduce risks, avoid overdose, needle exchange and opioid substitution therapy. This pragmatic approach is known as the harm reduction paradigm. Harm reduction also addresses special populations, such as drug-using parents, pregnant drug users and users with psychiatric comorbidity. The philosophy of harm reduction accepts that drug use is part of the community, but that it must be addressed as a public health issue rather than a criminal one. 3
Harm-reduction measures are at odds with the prevailing framework of international drug control, which rests on law enforcement and the criminalization of behaviours related to illicit drug use. However, harm-reduction has had a notable impact and is slowly gaining popularity. In Brazil alone, a comprehensive harm-reduction and drug-access program successfully reduced AIDS mortality among injection drug users by 50%.4
[edit] Medical treatment
Any substance entering the body can have deleterious effects both acute and chronic. Furthemore, the addictive nature of some drugs limits the individual's ability to discontinue drug use even when experiencing these adverse health effects, it is also possible that people will choose to continue using a drug even when they become aware of the health risks.
Medical treatment then centers on two aspects: 1) breaking the addiction, 2) treating the health problems.
Most countries have health facilities that specialize in the treatment of drug abuse, although access may be limited to larger population centers and the social taboos regarding drug use may make those who need the medical treatment reluctant to take advantage of it. For example, it is estimated that only fifteen percent of injecting drug abusers are in treatment relative to the total thought to be in need. 5
Patients may require acute and long-term maintenance treatment and relapse prevention, complemented by suitable rehabilitation. 6
[edit] Therapy
The development of pharmacotherapies for drug dependancy treatment are currently in progress. New immunotherapies (depot medications) that counteract the effects of drugs like cocaine, methamphetamine, phencyclidine, nicotine, and opioid dependence are being tested. Buprenorphine is one new option for the treatment of opioid addiction. Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however, drugs for substance abuse treatment have faced many barriers . Naltrexone, a drug marketed under the name "ReVia," is a medication approved for the treatment of alcohol dependence. Unfortunately, this drug has reached very few patients. This may be due to a number of factors, including resistance by addiction treatment providers and lack of resources. 7
[edit] Legal treatment
Related articles: Prohibition (drugs), Arguments for and against drug prohibition
Most countries have lists of controlled substances, which are those substances that the society has restricted for their abuse potential and other reasons. For controlled substances, the legal punishments for the creation, distribution, possession and even personal use can be quite severe (including death penalty in some countries). Legal regimes vary across countries, and even within them, and have fluctuated widely throughout history.
Despite the illegality of controlled substances, many very large, organized criminal drug cartels operate world-wide. Advocates of decriminalization argue that it is the illegality of these substances that is making drug dealing such a lucrative business.
[edit] Sociology of drug abuse
As well as being a major public health problem, some consider drug abuse to be a social problem with far-reaching implications. Stress, poverty, domestic and societal violence, and various diseases (i.e., injecting drug users as a source for HIV/AIDS) are sometimes thought to be spread by drug use. Studies have also shown that individuals dependent on illicit drugs experience higher rates of comorbid psychiatric syndromes. 8
[edit] See also
[edit] Notes
- Note 1: (1998). Mosby's Medical, Nursing, & Allied Health Dictionary. Edition 5.
- Note 2: Wood, Evan, et al. (Apr 29, 2003). "Drug supply and drug abuse". Letters. Canadian Medical Association Journal 168:(9). See also: CMAJ, 2003;168(2):165-9.
- Note 3: Phillips, Prashant. (Oct, 2004). "Care of Drug Users in General Practice: a harm reduction approach." Book review. Mental Health Practice 8:i2. p. 29.
- Note 4: Editorial. (Mar 1, 2005) "HIV, harm reduction and human rights/VIH, reduction des prejudices et droits de la personne." Canadian Medical Association Journal. 172:(5). p.605.
- Note 5: Appel, P. W. Ellison, A. A. Jansky, H. K. Oldak, R. (Feb, 2004). "Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders". American Journal of Drug and Alcohol Abuse.
- Note 6: Qureshi NA, al-Ghamdy YS, al-Habeeb TA. (2000). "Drug addiction: a general review of new concepts and future challenges". East Mediterr Health J. Jul;6(4):723-33. PMID 11794078
- Note 7: Board on Behavioral, Cognitive, and Sensory Sciences and Education (BCSSE). (2004) New Treatments for Addiction: Behavioral, Ethical, Legal, and Social Questions. The National Acadamies Press. pp. 7–8, 140–141
- Note 8: Diala, C. Muntaner, C. Walrath, C. (May, 2004). "Gender, occupational, and socioeconomic correlates of alcohol and drug abuse among U.S. rural, metropolitan, and urban residents". American Journal of Drug and Alcohol Abuse.
[edit] External Links
- American Journal of Drug and Alcohol Abuse, Focusing on the pre-clinical, clinical, pharmacological, administrative, and social aspects of substance misuse, this journal provides an exchange of ideas between the various modalities involved in the study and treatment of drug abuse and alcoholism.
Category:Substance-related disorders Category:Stubstance abuse
