Substance abuse

Drug abuse is the use of any licit or illicit chemical substance that results in physical, mental, emotional, or behavioural impairment in an individual.

Societies in all parts of the world have discovered substances which can alleviate pain and cure various ailments or which give pleasurable sensations when consumed. However, all these substances are dangerous because they share the quality of giving temporary euphoria and contentment; one can develop a craving for them which, in a short time, leads to complete dependence. It is this dependence, both physical and psychic, which causes obvious harm to the user and to society. Modern-day society has witnessed a spectacular increase in the use of manufactured drugs in general and in the use of psychoactive drugs in particular.

Psychoactive drugs are substances which affect the activity of the central nervous system or, in simpler terms, exert a strong influence on the human mind and behaviour. The category of psychoactive drugs is very large, and includes pain killers, mood changing drugs and hallucinogens. The risks of psychoactive drug-taking are not limited to the individual drug taker; the habit can affect his environment and the society in which he lives. People can (and do) become addicted to certain psychoactive drugs and lead an entirely drug-orientated life (i.e., the 'street' heroin addict).

An individual may start drug-taking for one or several reasons. The simplest reason is true for only a minority of persons – that drug-taking starts with the administration of a narcotic or psychotropic drug for therapeutic purposes; the majority of drug abusers start from a search for pleasure (or freedom from pain), out of curiosity or ignorance or alienation (escape from reality), to cope with daily life, or to identify with a group or with a drug-orientated society. Drugs are very seductive because, in most cases, they initially provide what the user is seeking. Changing social structures, urbanization and unemployment are the principle social factors leading to loneliness, isolation, despair and lack of support which in turn may lead to drug taking.

The pleasurable effect of these drugs (euphoria) constitutes the first step to drug abuse; the second one comes when, after repeated administration of opiates, barbiturates, amphetamines or LSD, the individual does not experience the same pleasure, but requires greater and greater doses to produce the same pleasurable drug effect. This phenomenon is the development of tolerance. Regular and repeated drug administration leads to a state where the person has so adapted itself to the presence of the drug that an interruption in the continuity provokes abstinence (withdrawal) symptoms. These symptoms can be painful and severe, sometimes even fatal, as often happens in the case of barbiturates and opiates. This is the physical dependence on a drug. There are some drugs, such as cocaine, cannabis or LSD, which do not produce physical dependence. But the development of psychic dependence can create an even stronger compulsion for regular drug-taking than the 'craving' experienced by the physically dependent addict.

Society's defensive reaction against drug pollution has now reached the level of the international community. The World Health Organization and the United Nations are variously involved in the delicate balance-keeping policy which calls for decisions on the following problems: which kind of drugs have to be controlled; what kind of national control is required; and how to complete this control by international action and assure the cooperation of governments which have the responsibility of drug control.

From the standpoint of drug abuse and control, drugs can be divided into three categories: (1) Dangerous drugs: includes "hard" drugs, e.g. heroin, potent hallucinogens like LSD, injectable amphetamines and potent cannabis preparations like hashish; (2) Abusable drugs: includes barbiturates, oral amphetamines, marijuana and peyote; (3) Restricted drugs: includes non-prescriptive medications, such as cough syrups.

Many drugs (i.e. example: heroin, mescaline, and marijuana) are often doctored with other substances before being sold on the streets. Usually the added substances are inert (quinine and lactose), but when these are unobtainable (recent tighter control of quinine in US) other more dangerous substances may be added, for example, animal tranquilisers.

Until the end of the nineteenth century, the question of narcotic drugs was not widely regarded as an international problem calling for concerted action on a world-wide scale. Developments in the latter part of the nineteenth century, however, gave a new dimension to the problem. First, through technological progress, laboratories began producing from opium and coca leaf an increasing number of alkaloids and their derivatives. Further expansion of transport and international trade reduced geographical distances and natural barriers between nations until what originally seemed to be a local problem of a few countries became a matter of concern to the world community as a whole. Moreover, the relationships between drugs, misery, and crime contributed to a growing conviction that the sale of drugs could no longer be viewed as a regular commercial transaction, free from government interference. In some countries, addicts have been given prescriptions for a minimum daily 'fix' in an attempt to control or eliminate the black market in narcotics.

Drug abuse and drug addiction have taken on increasingly dangerous proportions in many parts of the world. Drugs users range from a Peruvian farmer chewing coca leaves to a bank vice president sniffing cocaine. A street kid might sniff glue. A prostitute or young executive might smoke crack. An international athlete may be using performance enhancing drugs. A housewife might be abusing prescription drugs. Thus, the problem is not confined to one social stratum or age-group; it has been shown recently to be rapidly increasing among high-level executives, with resulting danger to other employees from drug-induced behaviour and also encouragement of other evils such as blackmail.

The Report of the 37th Session (April 1994) of the UN Commission on Narcotic Drugs points out that drug abuse has worsened in several countries and is newly emerging in others, particularly in Africa, the Caribbean and the states in transition in Central and Eastern Europe. The reasons for the spread of drug abuse are complex and are different in different countries, and some of them are very difficult to remove. The situation is aggravated by the continuous introduction of new psychotropic substances which are liable to be misused.

According to a 1999 report, the number of regular drug users in the European Union between 1 million and 1.5 million, out of a total population of about 375 million. Most of those people are addicted to heroin. The number of people who take illicit drugs remained roughly the same in most EU countries. Although new cases appeared, a roughly equal number of drug addicts either gave up the habit or died. The typical regular drug user was a man, between 24 and 33 years of age. The largest number of addicts was to be found in Italy and Luxembourg – roughly 8 addicts per 1,000 inhabitants aged 15 and over. Germany, Austria, Finland and Sweden were on the other end of the spectrum, with roughly 3 per 1,000 inhabitants. According to an earlier estimate Scotland had more injecting drug addicts (about 30,000) than any other country in western Europe.