Drugs and Alcohol Abuse

Drugs and alcohol abuse harms health, family and society, and it often begins in adolescence. This page covers opioids such as heroin and morphine, cannabinoids, cocaine, hallucinogenic plants, misused medicines, tobacco and nicotine, the causes of abuse among adolescents, addiction and dependence, harmful effects including those of anabolic steroids, and ways to prevent abuse, as in the NCERT Class 12 chapter Human Health and Disease. NEET often asks about drug, source and effect pairs and steroid side effects in questions on drugs and alcohol abuse.

1. Drug and Alcohol Abuse: An Overview

• Surveys and statistics show that the use of drugs and alcohol is rising, especially among the youth.
• This is a cause of concern, because it can result in many harmful effects.
• Proper education and guidance help youth safeguard themselves against these dangerous behaviour patterns and follow healthy life styles.
• ★ Exam imp The drugs commonly abused are opioids, cannabinoids and coca alkaloids.
• The majority of these come from flowering plants; some come from fungi.

2. Opioids

• Opioids: drugs that bind to specific opioid receptors present in the central nervous system and the gastrointestinal tract.
• ★ Exam imp Heroin, commonly called smack, is chemically diacetylmorphine.
• Heroin is a white, odourless, bitter crystalline compound.
• It is obtained by acetylation of morphine.
• ★ Exam imp Morphine is extracted from the latex of the poppy plant, Papaver somniferum.
• Heroin is generally taken by snorting and injection.
• ★ Exam imp Heroin is a depressant: it slows down body functions.

3. Cannabinoids

• Cannabinoids: a group of chemicals that interact with cannabinoid receptors, present principally in the brain.
• ★ Exam imp Natural cannabinoids are obtained from the inflorescences of the plant Cannabis sativa.
• ★ Exam imp The flower tops, leaves and resin of the cannabis plant are used in various combinations to produce marijuana, hashish, charas and ganja.
• Cannabinoids are generally taken by inhalation and oral ingestion.
• They are known for their effects on the cardiovascular system of the body.
• These days, cannabinoids are also being abused by some sportspersons.

4. Coca Alkaloids and Hallucinogens

• Coca alkaloid, or cocaine, is obtained from the coca plant Erythroxylum coca, native to South America.
• ★ Exam imp Cocaine interferes with the transport of the neurotransmitter dopamine.
• Cocaine is commonly called coke or crack, and is usually snorted.
• ★ Exam imp It has a potent stimulating action on the central nervous system, producing a sense of euphoria and increased energy.
• Excessive dosage of cocaine causes hallucinations.
• Other well-known plants with hallucinogenic properties: Atropa belladonna and Datura.

5. Medicines that are Abused

• Drugs such as barbiturates, amphetamines and benzodiazepines are normally used as medicines.
• They help patients cope with mental illnesses such as depression and insomnia, but they are often abused.
• ★ Exam imp Morphine is a very effective sedative and painkiller, very useful in patients who have undergone surgery.
• Several plants, fruits and seeds with hallucinogenic properties have been used for hundreds of years in folk medicine, religious ceremonies and rituals all over the globe.

6. Tobacco and Smoking

• Smoking also paves the way to hard drugs.
• Tobacco has been used by human beings for more than 400 years; it is smoked, chewed or used as snuff.
• Tobacco contains a large number of chemical substances, including nicotine, an alkaloid.
• ★ Exam imp Nicotine stimulates the adrenal gland to release adrenaline and nor-adrenaline into the blood; both raise blood pressure and increase heart rate.
• Smoking is associated with increased incidence of cancers of the lung, urinary bladder and throat, and with bronchitis, emphysema, coronary heart disease, gastric ulcer, etc.
• ★ Exam imp Tobacco chewing is associated with increased risk of cancer of the oral cavity.
• ★ Exam imp Smoking increases the carbon monoxide (CO) content of blood and reduces the concentration of haem-bound oxygen, causing oxygen deficiency in the body.
• Cigarette packets carry a statutory warning that smoking is injurious to health, yet smoking is common among young and old.
• Knowing the dangers and addictive nature of smoking and chewing tobacco, young and old should avoid these habits.
• Any addict needs counselling and medical help to get rid of the habit.

7. Adolescence and Drug/Alcohol Abuse

• Adolescence means both 'a period' and 'a process' during which a child becomes mature in attitudes and beliefs for effective participation in society.
• ★ Exam imp The period between 12-18 years of age may be thought of as the adolescence period.
• Adolescence is a bridge linking childhood and adulthood.
• It is accompanied by several biological and behavioural changes, so it is a very vulnerable phase of mental and psychological development.

7.1 Why youngsters start

• Curiosity, need for adventure and excitement, and experimentation are common causes.
• A child's natural curiosity motivates experiments; effects of alcohol or drugs that are perceived as benefits complicate this further.
• The first use may be out of curiosity or experimentation; later the child uses these to escape facing problems.
• Stress from pressure to excel in academics, examinations and competitions has played a significant role; drugs are often tried for perceived benefits such as relief from stress.
• The perception that it is 'cool' or progressive to smoke or use drugs or alcohol is a major cause; television, movies, newspapers and the internet help to promote it.
• Other associated factors: unstable or unsupportive family structures and peer pressure.

8. Addiction and Dependence

• Because of perceived benefits, drugs are frequently used repeatedly.
• Most users fail to realise the inherent addictive nature of alcohol and drugs.

• These effects drive people to take drugs even when they are not needed, or even when their use becomes self-destructive.

8.1 The vicious circle of addiction

1. Drugs or alcohol are used repeatedly.
2. The tolerance level of the receptors in the body increases.
3. The receptors now respond only to higher doses.
4. This leads to greater intake and to addiction.
5. The user is pulled into regular use (abuse), from which he or she may not be able to get out.

• ★ Exam imp Use of these drugs even once can be a forerunner to addiction.
• Without guidance or counselling, the person gets addicted and becomes dependent on their use.

8.2 Dependence

• ★ Exam imp Dependence: the tendency of the body to show a characteristic and unpleasant withdrawal syndrome if the regular dose of drugs or alcohol is abruptly discontinued.
• Withdrawal syndrome: anxiety, shakiness, nausea and sweating, which may be relieved when use is resumed.
• In some cases withdrawal symptoms are severe, even life-threatening, and the person may need medical supervision.
• Dependence leads the patient to ignore all social norms to get enough funds, causing many social adjustment problems.

9. Effects of Drug/Alcohol Abuse

9.1 Immediate effects

• Reckless behaviour, vandalism and violence.
• ★ Exam imp Excessive doses may lead to coma and death due to respiratory failure, heart failure or cerebral hemorrhage.
• A combination of drugs, or drugs taken with alcohol, generally results in overdosing and even deaths.

9.2 Warning signs among youth

• Drop in academic performance; unexplained absence from school or college.
• Lack of interest in personal hygiene; withdrawal; isolation; depression; fatigue.
• Aggressive and rebellious behaviour; deteriorating relationships with family and friends.
• Loss of interest in hobbies; change in sleeping and eating habits; fluctuations in weight, appetite, etc.

9.3 Far-reaching effects

• An abuser who cannot get money for drugs or alcohol may turn to stealing.
• A drug or alcohol addict may cause mental and financial distress to his or her entire family and friends.
• ★ Exam imp People who take drugs intravenously (injection into a vein with a needle and syringe) are much more likely to acquire AIDS and hepatitis B.
• The viruses of these diseases pass from one person to another through shared infected needles and syringes.
• AIDS and hepatitis B are both chronic infections and ultimately fatal; both can also be transmitted through sexual contact or infected blood.
• Use of alcohol during adolescence may lead to heavy drinking in adulthood.
• ★ Exam imp Chronic use of drugs and alcohol damages the nervous system and the liver (cirrhosis).
• Use of drugs and alcohol during pregnancy adversely affects the foetus.

9.4 Misuse of drugs in sports

• Some sportspersons (mis)use narcotic analgesics, anabolic steroids, diuretics and certain hormones.
• Their aim: to increase muscle strength and bulk, promote aggressiveness and so increase athletic performance.

• These effects may be permanent with prolonged use.
• ★ Exam imp In adolescent males or females: severe facial and body acne, and premature closure of the growth centres of the long bones, which may stunt growth.

10. Prevention and Control

• The age-old adage 'prevention is better than cure' holds true here also.
• Smoking, drugs and alcohol are more likely to be taken up at a young age, more so during adolescence.
• So it is best to identify the situations that may push an adolescent towards drugs or alcohol, and to take remedial measures in time.
• Parents and teachers have a special responsibility here.
• ★ Exam imp Parenting that combines high levels of nurturance with consistent discipline is associated with a lowered risk of substance (alcohol, drugs, tobacco) abuse.

10.1 Measures for adolescents

1. Avoid undue peer pressure: respect and nurture each child's own choice and personality; do not push a child beyond his or her threshold limits in studies, sports or other activities.
2. Education and counselling: teach the child to face problems and stresses, and to accept disappointments and failures as a part of life; channelise energy into sports, reading, music, yoga and other extracurricular activities.
3. Seeking help from parents and peers: seek help immediately for proper guidance, even from close and trusted friends; this also lets the young vent feelings of anxiety and guilt.
4. Looking for danger signs: alert parents and teachers should identify the danger signs; friends who notice drug or alcohol use should tell parents or teachers; then diagnose the malady and its causes and start remedial steps or treatment.
5. Seeking professional and medical help: highly qualified psychologists, psychiatrists, and de-addiction and rehabilitation programmes are available; with effort and will power, the person can get rid of the problem completely and lead a normal, healthy life.

11. Exam Essentials

Pairs to Match

Numbers to Remember

• Groups of commonly abused drugs: 3 (opioids, cannabinoids, coca alkaloids).
• Heroin: diacetylmorphine (two acetyl groups added to morphine).
• Tobacco use by humans: more than 400 years.
• Adolescence: 12-18 years of age.
• Measures for prevention and control: 5.

Examples to Remember

12. Quick Revision

• Commonly abused drugs: opioids, cannabinoids and coca alkaloids; mostly from flowering plants, some from fungi.
• Opioids bind receptors in the CNS and gastrointestinal tract.
• Heroin (smack) = diacetylmorphine, from acetylation of morphine; a depressant; snorted or injected.
• Morphine comes from the latex of Papaver somniferum; it is a sedative and painkiller after surgery.
• Cannabinoids from Cannabis sativa: marijuana, hashish, charas, ganja; inhaled or eaten; cardiovascular effects.
• Cocaine (coke, crack) from Erythroxylum coca: blocks dopamine transport; stimulant; excess causes hallucinations.
• Hallucinogenic plants: Atropa belladonna, Datura; barbiturates, amphetamines and benzodiazepines are misused medicines.
• Drug abuse: use for non-medicinal purposes, or in amounts or frequency that impair body or mind.
• Nicotine: adrenaline and nor-adrenaline raise BP and heart rate; smoking adds CO to blood; many cancers.
• Adolescence: 12-18 years; curiosity, stress, the 'cool' image, family problems and peer pressure lead to abuse.
• Addiction: psychological attachment; rising receptor tolerance; dependence: withdrawal syndrome.
• Overdose: coma, death by respiratory failure, heart failure or cerebral hemorrhage.
• IV drug users risk AIDS and hepatitis B; chronic use damages nerves and liver (cirrhosis); harms the foetus.
• Anabolic steroids: masculinisation in females; small testicles, less sperm, breast enlargement in males; stunted growth in adolescents.
• Prevention: avoid peer pressure, educate and counsel, seek help, watch danger signs, get professional help.

13. Solved Examples

14. Practice Questions

Common Mistakes to Avoid