DRUG USE(1)

LECTURE ON DRUG USE

  • Presenter: DIBOR ALFRED
  • Title: Specialist Clinical Pharmacist
  • Credentials: B.Pharm Hons, MSC, MPH, Pg Cert, MPCPharm

DRUG DEFINITION

  • A Drug is defined as any chemical substance impacting the functioning of living organisms and the pathogens (viruses, fungi, bacteria) that infect them.
  • In pharmacology, a drug refers to a chemical substance with a known structure that, when administered to a living organism, produces biological effects.
  • A pharmaceutical drug (or medicine) is used for:
    • Treating
    • Curing
    • Preventing
    • Diagnosing diseases
    • Promoting well-being

DRUG VS MEDICINE

  • Distinction:
    • All medicines are drugs, but not all drugs qualify as medicines.
    • The classification of substances as poisons depends on their dosage.
    • Quote by Paracelsus (1493-1541):
    • “All things are poisons and nothing is without poison, only the dosage makes a thing not poison.”
  • Etymology:
    • The term “Drug” comes from the Greek “Pharmacon” meaning “Drug”.
    • The term “Medicine” derives from the Latin “Medicus” meaning “healing, or physician”.
  • Definitions:
    • A Drug: A chemical substance that alters physiological processes and is used for disease prevention, diagnosis, control, or treatment.
    • A Medicine: A formulated drug that has specific dosage and dosage forms for disease management.
  • Characteristics:
    • A Drug comprises only the active pharmaceutical ingredients (API) without guidance on suitable dosage forms or doses.
    • A Medicine is the formulation of the drug mixed with excipients or on its own.
  • Forms and Sources:
    • Drugs must be designed into suitable forms for treatment, while medicines are ready for treatment.
    • Sources of Drugs include: plants, animals, microorganisms, minerals, synthetic sources, semisynthetic sources, and recombinant DNA technology.
    • Medicines are derived from drugs and excipients.
  • Examples:
    • Drugs: Paracetamol (Acetaminophen, an analgesic and antipyretic), Morphine (analgesic), Ampicillin (antibiotic).
    • Medicines: Paracetamol tablet, Paracetamol syrup, Paracetamol elixir.

DRUG CLASSES GENERAL OVERVIEW

  • Categories of Drugs:
    • Depressants: Slow brain and body operations.
    • Examples: Alcohol, Xanax, Valium, Ambien.
    • Stimulants: Speed up brain and body operations.
    • Examples: Nicotine, Adderall, Cocaine, Meth.
    • Hallucinogens: Alter perceptions.
    • Examples: LSD, Psilocybin, Peyote.
    • Dissociatives: Cause detachment from reality.
    • Examples: PCP, DXM, Ketamine, Salvia.
    • Opioids: Can relieve pain, induce euphoria, and impact mood.
    • Examples: Heroin, Fentanyl, Vicodin, Codeine.
    • Inhalants: Breathable mind-altering substances.
    • Examples: Paint thinners, gasoline, "whip-it's".
  • Health Impacts:
    • Depressants: Slowed reaction time, disorientation, depression, fatigue.
    • Stimulants: Rapid heartbeat, increased respiration, heart attack, seizures.
    • Hallucinogens: Increased body temperature, sweating, psychosis.
    • Dissociatives: Disorientation, speech difficulties, anxiety, memory issues.
    • Opioids: Drowsiness, insomnia, collapsed veins, coma.
    • Inhalants: Slurred speech, suffocation, brain damage.

FUNCTIONS OF DRUGS

  • Drug functions include:
    • Easing disease symptoms.
    • Preventing diseases.
    • Curing or halting diseases.
    • Changing mood (e.g. relaxation) through opioids and tranquilizers.
    • Facilitating activity to help concentration (e.g. opioids, tranquilizers).
    • Managing effects of other substances (to enhance the effects of substances like opioids and alcohol).
    • Achieving physical effects to stay awake (e.g. caffeine).
    • Serving social purposes (e.g. reducing inhibitions through alcohol).

HUMAN MOTIVES IN DRUG USE

  • Major motives for drug use include:
    • Coping with life circumstances.
    • Enhancement of experience.
    • Conformity to social norms.
    • Social belonging or interaction.
    • Withdrawal from social situations or feelings.

USAGE TERMINOLOGY

  • Drug Use:
    • A general term for any drug-taking behavior, which could be legal (prescription) or illegal usage.
  • Drug Misuse:
    • Inappropriate use of prescription or over-the-counter drugs; not adhering to prescribed directions.
  • Drug Abuse:
    • Intentionally misusing or excessively using a substance to the detriment of health.

DRUG CLASSIFICATION

  • Classification of major drugs of abuse based on chemical makeup:
    • Alcohol: Beer, wine, liquor.
    • Opioids: Heroin.
    • Benzodiazepines: Valium.
    • Cannabinoids: Marijuana, hashish.
    • Benzodiazepines: Phenobarbital.

DRUG MISUSE

  • Definition: Drug misuse involves using a substance contrary to legal or medical guidelines (WHO, 2006). This has negative impacts and may lead to drug dependence or other harmful behaviors (DH, 2006b).
  • Dependence Defined: A strong desire or compulsion to consume a substance, difficulty controlling its use, a withdrawal state, tolerance, neglect of other interests, and persistent use despite harm.

EFFECTS OF DRUG MISUSE

  • Drug Dependence can lead to:
    • Physical health issues: thrombosis, abscesses, overdose, hepatitis B and C, HIV, respiratory and cardiac problems.
    • Mental health issues: depression, anxiety, paranoia, suicidal tendencies.
    • Social issues: relationship problems, financial difficulties, unemployment, homelessness.
    • Criminal justice problems.

SIGNS OF DRUG ADDICTION

  • Commonly Abused Drugs: Stimulants, marijuana, heroin, hallucinogens, alcohol, prescriptions.
  • Physical Signs:
    • Poor sleeping habits.
    • Changes in weight.
    • Dilated pupils.
    • Slurred speech.

SYMPTOMS OF DRUG ADDICTION

  • Psychological Symptoms:
    • Mental health issues such as headaches, paranoia, agitation.
  • Physical Symptoms:
    • Weight fluctuations, disrupted sleep.
  • Behavioral Symptoms:
    • Secretive behavior, withdrawal from social circles, loss of interest in hobbies.

DRUG TYPES SPECIFICS

  • Heroin:
    • Classified as narcotics, also known as opioids; derived from opiates with common forms such as morphine and heroin.
  • Hallucinogens:
    • Cause sensory hallucinations affecting senses, examples include LSD, PCP, peyote.
  • Amphetamines:
    • Stimulants increasing central nervous system activity; commonly used examples include amphetamines.
  • Cocaine:
    • A potent stimulant primarily used recreationally, often