Transcript of DR. MUNIR A. BADAR DEPARTMENT OF COMMUNITY MEDICINE SH. ZAYED MEDICAL COLLEGE, RAHIM YAR KHAN.
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- DR. MUNIR A. BADAR DEPARTMENT OF COMMUNITY MEDICINE SH. ZAYED
MEDICAL COLLEGE, RAHIM YAR KHAN
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- DRUG ABUSE AND DRUG DEPENDENCE
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- Drug: Any substance when taken into the living organisms may
modify one or more of its functions Drug abuse: Self administration
of drug for non-medical reasons which impair individuals ability to
function, resulting in social, physical or emotional harm Long term
drug use may damage the heart liver and brain. Drug Dependence: A
state of interaction between a living tissue and a drug,
characterised by Behavioural and other responses which include a
compulsion to take the drug periodically or on continuous basis, in
order to experience its psychic effects and to avoid the discomfort
of its absence.
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- Drug Addiction A state of periodic or chronic intoxication
determined to the individuals and society produced by the repeated
intake of habit forming drugs. To call a person ----- a drug
addict, following criteria is to be considered. 1. Psychological
Dependence: An over powering desire to take the drug and obtain it
by all means 2. Physiological Dependence: Show of withdrawal
symptoms, --- Irritation, Violent behaviour, Nausea, Diarrhoea,
watering of eyes and nose. 3. Development of Tolerance: A tendency
to increase the dose.
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- Phases of Addiction: Tolerance diminished effect of the same
dose of a drug or the need to increase the size of dose to get an
effect to the earliest ones. Habitation the emotional and
psychological need felt for a drug. Physical dependence: Bodys need
to get the drug.
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- Agent factors Alcohol Opioids Cannabinoids Cocaine sedatives or
hypnotics Caffeine Hallucinogens Tobacco Volatile solvents
Amphetamine LSD (Lysergic acid diethylamide)
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- Symptoms of Drug Addiction: Loss of Appetite and Body weight
Unsteady gait, Clumpsy movements, Tremors Reddening and puffiness
of eyes, unclear vision Slurred speech Nausea, Vomiting and Body
pains Fresh, numerous injection marks on body and Blood stains on
cloths Drowsiness/Sleeplessness, Lethargy. Anxiety, Depression,
Profuse Sweating Changing mood, Temper, The personalisation and
Emotional detachment Impaired memory and concentration Presence of
Needles, Syringes and strange packets at home Loss of interest in
daily activities
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- ALCOHOL & ALOCOHOLISM Alcoholism: Ch. Diseases marked by a
craving for alcohol. Alcoholics : Develop a craving or a strong
urge to drink despite the awareness that drinking is creating
problems in their lives. One drink of alcohol is defined as
consuming: 12 oz of beer, 5 oz of wine, 1.5 oz of 90-proof liquor
Ethyl Alcohol (Ethanol) ----- In beers and wines, and in distilled
liquid (Whiskey, Gin & Rum) Alcoholic beverages contain: Beer
(5-6 % of alcohol), Rum, Gin & Brandi (40-45 % alcohol)
Moderate Drinking: One or less than two drinks a day Heavy
Drinking: More than 14 drinks per week or 4-5 drinks at one
sitting
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- ALCOHOL A symbol of prestige and social status Alcoholism is
world wide social and medical problem Used as Sedative,
Tranquillizer, Hypnotic or Anaesthetic Drinking by adults serves as
a role model for the young Rapidly absorbed from the stomach and
small intestine Can be detected in blood within 2-3 minutes after
consumption. Food in the stomach inhabits its absorption. Supplies
about 7 kcal / gm. A marked effect on CNS (not a stimulant but
produces depression) Produces psychotic dependence of mild to
strong but physiological dependence develops slowly.
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- Physical Effects Tension Fatigue Increase appetite Painful
Numbness Depression Lose of self confidence Anxiety Guilt Loud and
Slurred speech Impaired Judgment Affected Muscular coordination
& physical reflexes Loss of physical control - --- ending in
Stupor and Death
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- CAUSES 1. Physiological Causes: Large quantities of alcohol
drink produces and enhances tolerance for alcohol Alcoholic are 6
times more likely than non- alcoholic to have blood relatives (who
are alcoholic dependence) A genetic factor plays a role in
alcoholic dependence Many genes are involved in increasing and
individuals risk for developing alcoholic dependence.
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- CAUSES Environmental Causes: Direct Personal Behavioral skills
Peer influences early in life Parenteral behaviour Society and
cultural attitudes towards alcohol use. Life stress Availability of
alcoholic beverages Indirect Unemployment Ignorance /Neglect Gang
culture Tourism Sex workers Rapid urbanization Urban migration
Family tensions Delinquency (Crime)
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- CAUSES 3. Psychological Causes: Many drinkers develop a
psychological condition known as DENIAL, (in which they are unable
to acknowledge that alcohol use lies at the root of many of their
problems ) Cultural Factors: Upper class society use expensive
drugs and lower class people use illegally manufactured drugs e.g.
charas, bhang, tan, ganja etc. Drug addiction is more among
beggars, mujawars of argahs, malangs and darveshes inhabiting
takyas and shrines of saints.
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- Major alcohol related Problems Crime (e.g.: Rape, Assault,
Homicides) Loss of self confidence and will to work Physical health
and sexual energy weaken Traffic Accidents or injuries Absenteeism
Family disorganization Loss of productivity Foetal growth
retardation and mental retarded babies
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- Medical Complications: Liver damage (Fatty liver hepatitis,
liver cirrhosis) Cardiomyopathy (Enlarged both ventricles, Flabby,
Reduced heart pumping efficiency Reduces blood flow through the
kindness resulting in salt retention and water loss from the blood.
Arrhythmias (Heartbeat irregularities) Hypertension stroke Delirium
tremens confusion, sleeplessness, depression and hallucinations.
Gastritis & Pancreatitis Ca. mouth, pharynx, Larynx and
oesophagus Peripheral Neuropathy Psychosis Foetal alcoholic
syndrome (Intra-uterine growth retardation & Mental disorders,
craniofacial abnorm. & limb dislocations)
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- Why do the Addicts use the drugs? To allay anxiety or fatigue
To forget economic problems, social difficulties and worries To
enhance sexual capacity To meditate and attain mystical state
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- Treatment of addiction Drug takers have little or no motivation
to undergo treatment Alcoholics tend to deny that their consumption
is abnormal, others openly defend their habits. Long term treatment
is not only a medical problem but needs the cooperation of
Psychologists and Sociologist. Drug addiction may be considered as
the social problem so its management is medical care as
Identification of drug addicts and their motivation for
detoxification Detoxification (requires hospitalization for
therapeutic treatment) Post detoxification counselling and follow
up (based on clinic and home visits)
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- Prevention Cultivation of drug plants should be licenced
Manufacture, Profession, Sale and Transport of all intoxication
drugs should be checked and brought under control for appropriate
use. The Law prohibits use of alcohol but the majority of
population abstains from the use of alcohol. Legislation for
dealing the offenders and smugglers Pharmacological solutions
(Antidepressants & antipsychotic drugs) Prohibition of
advertisements that promote use of tobacco and alcohol Public
education and discussion. Rehabilitation of Ex-drug dependant
persons Unemployment problem should be solved by increasing job
opportunities
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