Misuse of Medicines and Drugs

Misuse of medicines involves unintentional or inappropriate use of prescribed or over-the-counter drugs.
Drug abuse involves intentional and inappropriate use, leading to physical, emotional, financial, social, or intellectual consequences.
Addiction is a chronic disease, often recurring, characterized by compulsive drug seeking, even despite negative consequences. This results from the drug's prolonged effects on the brain.

Environmental Influences: Cost of alcohol and other drugs, parental influence, community, peer influence, attitudes and beliefs, local laws, media portrayal (alcohol, tobacco, etc.)
Personal Influences: Personal situations, interpersonal and peer resistance skills, marketing of alcohol
Individual Influences: minimum purchase age, school policies

Experimentation: Curiosity, self-discovery.
Pleasure/Escape from Boredom: Seeking pleasure, reducing boredom through euphoria, positive reinforcement (physical or social reward).
Peer Influence: Acceptance, approval, social interaction; peer influence is a relatively greater role during adolescence but positive family relationships can deter abuse.
Personality Traits: Low self-esteem, poor interpersonal skills, need for immediate gratification, rebelliousness, little tolerance for anxiety/frustration/depression, impulsivity, risk-taking, low regard for personal health.
Desire to enhance sports performance: Anabolic steroids, human growth hormones, erythropoietin (EPO), androstenedione, stimulants are examples of drugs abused by athletes.

Dependency is needing a drug for pleasurable effects, behavioural change when use ceases, and needing increased dosage or frequency to maintain initial effects.
Physical dependence causes withdrawal symptoms (physical symptoms) after stopping use.
Psychological dependence refers to the perceived need for the drug.

Tolerance is repeated exposure to a drug, decreasing its effect, thus requiring higher doses for a similar response.
Commonly occurs with depressant and stimulant abuse (e.g., alcohol, opioids, benzodiazepines, barbiturates, cocaine, amphetamines).

Includes various categories such as narcotics, sedative-hypnotics, stimulants, hallucinogens, and marijuana/cannabis
Examples of specific substances are provided within their respective drug categories.

A class of drugs derived from opium and produce similar effects (e.g., pain killers).
Examples: Opium, morphine, heroin, codeine, synthetic opiates (pethidine, methadone, oxycodone, fentanyl).
Administration methods include oral (pills, chewing), inhalation (smoking), injection (hypodermic needle), and snorting.

Examples may include diarrhea, runny nose, constant yawning, insomnia, muscle aches/pain, dysphoria, tearing, nausea/vomiting, fever, and perspiration.

CNS depressants, including barbiturates (short-acting e.g., pentobarbital, secobarbital), benzodiazepines (e.g. Valium, Xanax).
Other: Antihistamines, sedatives, anxiolytics, hypnotics, amnesics.

Increase activity levels and alter mood; performance enhancers.
Examples: Amphetamines (e.g., methamphetamines, speed, crystal meth/ice), cocaine (snorting is a common intake).
Minor stimulants: OTC sympathomimetics (cold, allergy, diet medications), caffeine-like drugs.

Drugs that induce hallucinations and alter thoughts, feelings, and perceptions.
Examples: Serotonergic hallucinogens (LSD, mescaline, psilocybin); Phencyclidine (PCP); Methylene-dioxymethamphetamine (MDMA; Ecstasy).

Derived from the Cannabis sativa plant; primary psychoactive agent is Delta-9-tetrahydrocannabinoid (THC).
Works quickly when smoked, and is used to treat asthma, glaucoma, multiple sclerosis. Also used to relieve nausea and vomiting.

Produces a sedative effect on the central nervous system (CNS).
Affects every organ (brain, liver, gastrointestinal (GI) tract, cardiovascular (CV) system, immune system).
Frequently interacts with prescription medications, potentially having a synergistic effect on CNS depression.
Alcoholism is a state of physical & psychological addiction to ethanol, characterized by craving, loss of control or impaired control, physical dependence, and tolerance.

Volatile substances (aerosols, solvents, gases).
Examples: Spray paints, deodorants, hair sprays, toluene (in glues, paints, thinners, nail polish), butane/propane (hair and paint sprays), gasoline, freon, anesthetics (e.g., ether, chloroform, halothane, nitrous oxide).

Pharmacological Treatment: Includes treatment for opioid addiction (methadone, buprenorphine, naltrexone); and for alcoholism (disulfiram, naltrexone, acamprosate).
Psychosocial and Other Treatments: Counseling, self-help groups (e.g., Alcoholics Anonymous, Narcotics Anonymous), rehabilitation programs (short-term and long-term residential), medical detoxification.
Symptomatic Treatment for Withdrawal: Can alleviate physical withdrawal symptoms, useful where opioid substitution isn't possible; examples include loperamide for diarrhea, metoclopramide/prochlorperazine for nausea/vomiting, diazepam for agitation/anxiety, paracetamol/NSAIDs for muscular pain/headaches.

Pharmacists have a significant role in managing drug/substance use disorders.
Responsibilities include: involvement in substance abuse treatment, drug prevention initiatives, and drug education.