Substance Use/Abuse Notes PDF

Substance use/abuse and their health impacts What is Substance Abuse?  The excessive or inappropriate use of psychoactive substances including alcohol, prescription drugs, and illicit drugs that interferes with one's everyday life, health, and obligations is known as substance...

Substance use/abuse and their health impacts What is Substance Abuse?  The excessive or inappropriate use of psychoactive substances including alcohol, prescription drugs, and illicit drugs that interferes with one's everyday life, health, and obligations is known as substance abuse.  Can develop into addiction.  Causes Genetic Factors: Family history of addiction Psychological Factors: Mental health conditions Environmental Factors: Peer pressure, socioeconomic status, and exposure to substance abuse at an early age. Social Influences: Cultural norms, availability of substances, and social acceptance of certain substances.  Abuse Addiction Improper or excessive use of substances Chronic and compulsive condition (legal or illegal) to achieve a desired effect, characterized by the inability to stop using a such as euphoria, relaxation, or altered substance despite harmful consequences perception. Occasional or repeated misuse of drugs, Dependence: The body develops a need for often in social settings. the drug to function normally, leading to withdrawal symptoms if usage stops. Not necessarily accompanied by physical Compulsion: An uncontrollable urge to use dependence or withdrawal symptoms. the drug, often disrupting daily life.  Abuse Addiction Can lead to harmful consequences such Tolerance: Needing increasing as poor judgment, accidents, or amounts of the drug to achieve the strained relationships. same effect. E.g. Recreational use of prescription Often associated with physical and painkillers without a medical need psychological dependence. E.g. : A person continuing to use or consuming alcohol excessively on opioids despite severe health issues and weekends. professional or personal consequences.  Types of substance abuse Alcohol: Lawful but frequently abused, causing serious health issues.  Nicotine, (tobacco): is the most widely used addictive drug in the world.  Illicit Drugs: This category includes drugs such as cocaine, heroin, ecstasy, methamphetamine, and others.  Prescription medications:  Stimulants, benzodiazepines, and opioids. Over the counter medications: Due to their psychotropic effects, some may be abused.  Alcohol and Health Effects on health depends on The Amount  Frequency Individual Health Status Genetic predispositions.  ABV (Alcohol by Volume ) The Alcohol percentage in beverages , known as ABV (Alcohol by Volume ) Beer Light beer: 3–5% ABV Regular beer: 4–6% ABV Strong beer: 7–12% ABV Specialty beers: Up to 15–20% ABV Wine Table wine: 11–14% ABV Sparkling wine (e.g., Champagne): 10–13% ABV Fortified wine (e.g., Port, Sherry): 15–22% ABV Liquors Vodka, rum, gin, tequila, whiskey: 35–50% ABV (70–100 proof) High-proof spirits: Up to 95% ABV (190 proof), such as Everclear or some types of moonshine. Ready-to-Drink Cocktails Canned or bottled cocktails: 4–12% ABV ABV can vary depending on the brand, production methods, and regional regulations.  Short-term Effects Low-to-moderate intake: Euphoria or relaxation. Reduced inhibitions and increased sociability. Impaired judgment, coordination, and reaction time (even after small amounts). High intake (binge drinking): Blackouts (memory loss). Nausea, vomiting, and dehydration. Increased risk of injuries and accidents. Acute alcohol poisoning, which can be life-threatening.  Long-term Effects Physical Health Risks: Liver Damage:  Fatty liver, hepatitis, cirrhosis, and liver cancer. Heart and Blood Vessels:  High blood pressure, irregular heart rhythms, cardiomyopathy, and stroke. Digestive System:  Inflammation of the stomach lining (gastritis), ulcers, and pancreatitis. Cancer Risk:  Increased risk of cancers of the mouth, throat, esophagus, liver, colon, and breast. Mental Health Risks: Depression, anxiety, and other mood disorders. Cognitive decline and memory loss (alcohol-related dementia or Wernicke-Korsakoff syndrome). Alcohol dependence and addiction (alcohol use disorder). Reproductive Health: Reduced fertility in both men and women. Fetal alcohol spectrum disorders (FASD) in children born to mothers who drink during pregnancy. Social and Economic Well-being: Strained relationships and family dynamics. Reduced productivity and job performance. Increased risk of legal problems (e.g., DUI offenses).  BAC (Blood alcohol Stage Clinical Features concentration) < 50 Sobriety Near normal behaviour, calm 50-100 Euphoria Feeling of well being , talkativeness, decreased inhibition, increased self confidence 100-150 Excitement Emotional instability, impairment of memory 150-200 Confusion Disorientation, confusion, vertigo, diplopia, slurred speech, staggering gate, +ve Rombergs sign, increased reaction time. 200-300 Stuper Diminished response to stimuli, vomiting, sleep 300-400 Coma Unconsciousness, abolished reflexes, laboured breathing, Mc Ewan’s pupil Treatment: Hospital care Psychotherapy  Bhang addiction Bhang is a preparation made from the leaves and buds of the cannabis plant. Commonly consumed in parts of India and other regions, often during cultural festivals like Holi or Shivratri. Overuse can lead to dependence or addiction, just like other cannabis products. Reason for addiction: hundreds of chemical present in the plant. The highest concentration is of THC (Tetrahydrocannabinol )which makes bhang more addictive. When HTC enters blood stream it binds to the cannabinoid receptors causing the brain to release feel good chemical dopamine. This strong feeling of pleasure causes the person to get addict on bhang.  Signs & Symptoms Physical Dependence: Increased tolerance (needing more to feel the effects). Withdrawal symptoms (anxiety, restlessness, irritability) when not consumed. Psychological Dependence: Craving for bhang. Preoccupation with obtaining and using it. Behavioral Changes: Neglect of responsibilities. Social withdrawal or changes in relationships. Health Effects: Impaired memory and concentration. Sleep disturbances. Long-term mental health issues like anxiety, depression, or paranoia.  Prolonged use risks Mental Health Issues: Chronic use can lead to cannabis use disorder. Potential for triggering psychotic episodes in vulnerable individuals. Cognitive Decline: Long-term use may affect memory, learning, and attention. Physical Health Problems: Respiratory issues if smoked or mixed with tobacco. Digestive problems when consumed in excessive amounts.  How to overcome? Acknowledgment and Support: Recognizing the problem. Seek support from family or friends. Professional Help: Consult a counselor, psychiatrist, or addiction specialist. Cognitive Behavioral Therapy (CBT) can help change habits. Detoxification: Gradual reduction or cessation with medical supervision if necessary. Address withdrawal symptoms with prescribed medications. Lifestyle Changes: Practice stress management (yoga, meditation, exercise). Maintain a balanced diet and proper sleep schedule. Join Support Groups: Groups like Narcotics Anonymous (NA) or similar local programs can provide guidance.  Treatment Medical Psychological  Social approaches. Relapse Prevention Identify Triggers: Understand and avoid situations or people associated with bhang use. Develop Coping Strategies: Learn ways to manage stress and negative emotions without reverting to substance use. Aftercare Programs: Long-term follow-up through counseling or support groups ensures continued progress.  Tobacco/ Nicotine Nicotine dependence, is a chronic condition characterized by a compulsive need to consume tobacco products despite the harmful consequences. Primarily driven by the addictive properties of nicotine, a chemical found in tobacco.  Mechanism of Addiction Nicotine stimulates the release of dopamine in the brain's reward system, creating pleasurable feelings. Over time, users develop tolerance, requiring higher doses to achieve the same effects. Withdrawal symptoms (e.g., irritability, cravings, anxiety) reinforce continued use.  Different Uses Cigarettes: The most common form of tobacco consumption. Smokeless Tobacco: Includes chewing tobacco and snuff. Cigars and Pipes: Associated with a slower release of nicotine. Electronic Nicotine Delivery Systems (ENDS): Includes e-cigarettes and vaping devices, which can also lead to nicotine addiction.  Treatment and Prevention Behavioral Interventions: Counseling or cognitive-behavioral therapy (CBT) to address triggers and coping mechanisms. Support groups and helplines (e.g., Quitlines). Pharmacotherapy: Nicotine Replacement Therapy (NRT): Includes patches, gum, lozenges, and sprays. Non-Nicotine Medications: Bupropion and varenicline are effective options. Preventive Measures: Public health campaigns to raise awareness of the dangers of tobacco use. Policies to limit tobacco advertising, sales to minors, and public smoking. School-based education programs emphasizing the risks of tobacco. Thank You