Misuse of Medicines and Drugs

Misuse of Medicines and Drugs

• Drug misuse is the unintentional or inappropriate use of prescribed or over-the-counter drugs.
• Drug abuse is the intentional and inappropriate use of a drug, resulting in negative physical, emotional, financial, social, or intellectual consequences.
• Addiction is a recurring chronic disease characterized by compulsive drug-seeking behavior despite negative consequences.

Reasons for Drug Abuse

• Experimentation: Curiosity is a common reason, especially among young people. It can also be perceived as a form of self-discovery.
• Pleasure/Escape from Boredom: Drugs increase pleasure or reduce boredom, reinforcing the euphoric effect. This can lead to positive reinforcement and physical/social reward.
• Peer Influence: Peer acceptance and social interaction are major influences, often starting in early adolescence. Positive family relationships can counteract this influence.
• Personality Traits: Low self-esteem, poor interpersonal skills, and a need for immediate gratification can increase the risk of drug abuse. Other traits can include rebelliousness, little tolerance for anxiety/frustration/depression, impulsivity, and low regard for personal health.
• Desire to Enhance Performance in Sports: Athletes may use anabolic steroids, human growth hormones, erythropoietin (EPO), androstenedione, and stimulants to boost performance.

Drug Dependency

• Dependency describes the need for a drug for pleasurable effects, behavioral changes when the drug use stops, and a need to increase the dosage or frequency of use to maintain initial effects.
• Physical Dependency: Marked by withdrawal symptoms (a range of physical symptoms) that appear when drug use stops.
• Psychological Dependency: Refers to the perceived need for a drug.

Tolerance

• Tolerance is the reduced effect of a drug after repeated use, requiring an increase in dosage to achieve a similar response.
• Commonly seen in depressant abuse (alcohol, opioids, benzodiazepines, barbiturates) and stimulant abuse (cocaine, amphetamines).

Narcotics

• Narcotics are drugs derived naturally from opium or have opium-like effects, acting as CNS depressants, causing respiratory depression etc.
• They alleviate pain and cause profound sleep (narcosis).
• Examples include opium, morphine, heroin, codeine, synthetic opiates (e.g. pethidine, methadone, oxycodone, fentanyl).
• Administration methods include oral administration (pills/chewing), inhalation (smoking), injection (hypodermic needle), and snorting.

Withdrawal Symptoms

• Withdrawal symptoms include diarrhea, runny nose, constant yawning, insomnia, muscle aches and pains, dysphoria (feeling unhappy/sad), tearing, nausea/vomiting, fever, and perspiration.

Sedative-Hypnotics

• Sedative-hypnotic drugs are CNS depressants, including barbiturates (short-acting: pentobarbital, secobarbital) and benzodiazepines (e.g., Valium, Xanax).

Stimulants

• Stimulants increase activity levels and alter mood, acting as performance enhancers.
• Examples include amphetamines (e.g., methamphetamines aka speed or crystal meth/ice) and cocaine. Common intake method is snorting.

Minor Stimulants

• Over-the-counter (OTC) sympathomimetic medications (e.g., cold, allergy, and diet medications) and caffeine-like drugs are minor stimulants.
• Caffeine is present in many plants (tea leaves, coffee beans, cocoa beans, kola nuts), and common products containing it include soda, candy, baked goods, ice cream, energy drinks, and supplements.

Hallucinogens

• Hallucinogens alter thoughts, feelings, and perceptions, potentially causing hallucinations.
• Examples include: serotonergic hallucinogens (e.g., LSD, mescaline, psilocybin), phencyclidine (PCP), and methylene-dioxymethamphetamine (MDMA, Ecstasy).

Marijuana/Cannabis

• Derived from the Cannabis sativa plant, its primary psychoactive agent is delta-9-tetrahydrocannabinoid (THC).
• Smoking delivers rapid and intense effects.
• It has been used to treat asthma, glaucoma, multiple sclerosis, nausea, and vomiting.

Alcohol

• Alcohol produces a sedative effect in the central nervous system (CNS) and affects various organs (brain, liver, gastrointestinal tract, cardiovascular system, and immune system)
• Alcohol significantly interacts with prescription medications, potentially producing a synergistic (stronger) CNS depressive effect.

Alcoholism

• Alcoholism involves physical and psychological addiction to ethanol.
• Major components include craving, impaired or lost control, physical dependence, and tolerance.

Inhalants

• Inhalants are volatile substances that cause psychological or physiological changes by inhalation.
• Examples include aerosols (spray paints, hairspray), chemicals like toluene found in glues, paints, and thinners, butane/propane in hair spray and paint spray cans, gasoline, freon, and anesthetic agents (e.g., ether, chloroform, halothane, nitrous oxide).

Substance Abuse Treatment

• Pharmacological treatments for opioid addiction include methadone, buprenorphine (Subutex/Suboxone), and naltrexone.
• Pharmacological treatments for alcoholism include disulfiram (deterrent), naltrexone (reduce craving), and acamprosate (treat withdrawal).
• Psychosocial and other treatment approaches include counseling, self-help groups (e.g., Alcoholics Anonymous, Narcotics Anonymous), short-term and long-term residential rehabilitation programs, and medical detoxification programs to safely and effectively withdraw from drugs like opiates. Symptomatic treatments for withdrawal symptoms can be employed if no other options are possible.

Role of Pharmacists

• Pharmacists play a crucial role in managing substance use disorders through involvement in treatment, drug prevention, and education, which include identifying patients, creating a list of resources, and providing pharmacotherapeutic choices, as well as collaborating with other healthcare professionals and family members, and performing daily dose preparation and documentation for methadone maintenance.
• They also contribute in substance abuse education and prevention, discourage inappropriate prescribing practices, and provide support for affected individuals.

This quiz explores the critical issues surrounding the misuse and abuse of medicines and drugs. It covers the definitions of drug misuse and drug abuse, as well as the reasons that lead individuals, particularly youth, to misuse substances. Understand the implications of addiction and the societal factors influencing drug-related behaviors.