Narcotics


Ecstasy

Marihuana

Heroin

Tablets and Steroids

Cocaine

LSD


History

In ancient civilizations people used natural drugs from their environment, mostly in magical and religious ceremonies. Using drugs out of that context was rare. In the second half of XX century, there was an expansion of drug abuse and dramatic rise of number of persons who was addicted to different types of drugs, of natural or synthetic origin, especially among young people. Typical for this is that in every country in the world every type of drug is available, no matter where it is made. More and more synthetic drugs are being used and their effect is stronger, and by that more dangerous than of natural drugs.

Definition

In science, drug definition is used for products of plants, animals and minerals that have medical effect. In everyday language this term is used for narcotic drugs, and for all psychoactive substances (substances which change the state of mind, temper and behavior) of natural and synthetic origin. Repeated usage of those substances can lead to addiction. As a consequence of a lot of undesirable and harmful effects, production and transport of these substances are either illegal (e.g. opium and cocaine production, and etc.) or are strictly controlled by the state (as amphetamine, morphine and etc.). New classification of diseases is precisely defining all health disturbances that can occur when using psychoactive substances, among which the most important are acute poisoning (intoxication), misusage and addiction of substances, tolerance and abstinence syndrome.

Acute intoxication
Transitory state, which appears after consummation of psychoactive substances, when mental functions change with disorder in functioning of consciousness, thinking, attention, emotions or behavior. The period of these changes is different and depends of type of substances that were used (e.g. acute intoxication of heroin is lasting for 8 hours, and of marihuana 3-5 hours). In case of taking excessive dose of substance, it may lead to death and that state is called overdose.

Misuse
Periodical usage of psychoactive substances that are leading to health damages, both in physical (as in hepatitis case, when drugs are taken with non-sterile needles) and mental (e.g. episodes of depressive disorders after intensive alcohol consuming).

Addiction of psychoactive substances

This implies at least three of following symptoms: longing for using substance, physical abstinence syndrome when the usage is ceased, tolerance on effect of previously effective substance doses, obsession with substance, neglecting other interests, spending great amount of time on obtaining and consuming substance even though aware of its harmful effect. There is psychical and physical addiction of psychoactive substances.

  1. Psychical addiction is appearing as strong emotional and mental need for taking psychoactive substances repetitively, because they cause pleasant mood or to avoid unpleasant moods.
  2. Physical addiction is changed state of organism, which after termination consumption of substances that cause addiction, is manifested as physical disorder. Those physical disorders are in fact abstinence syndrome. Psychoactive substances are used again in order to avoid physical disorders.

Alcohol, sedatives and opiate cause both psychical and physical addiction, but the other drugs are causing psychical addiction whose symptoms can be sometimes very significant and is influencing general psychophysical state of addicted person. As well, crossed addiction – state when addiction towards one psychoactive substance leads to addiction towards other substance from the same group.

Abstinence syndrome
That is a group of symptoms that are appearing after stopping consumption of psychoactive substances that person is addicted to. Start and flow of abstinence crises, as it is called in slang, is time limited and depends on sort and quantity of substance that is used. Symptoms of abstinence crisis can be visible on physical and psychical level.

Tolerance
The case when persons who are addicted to some substance, have to take more and more amount of substances over time, because lesser amounts do not have the same effect as previously. Crossing tolerance can appear, as well. The case when tolerance toward one substance is developing to tolerance toward one or more psychoactive substances from the same group.

Polytoxicomania
Frequent condition among young people which means taking more psychoactive substances at the same time by combination of different drugs, medicaments, and alcohol which is giving stronger effect.

Classification of psychoactive substances

Production and consumption of psychoactive substances can be legal, as well as illegal and sanctioned by the law. On this basis, substances are divided on:

  • Medicaments : analgesics, sedatives, etc.
  • Alcohol, coffee, tobacco - whose usage is well spread and socially allowed. • Drugs whose usage is illegal and unaccepted by society

Psychoactive substances are assorted in three big groups according to their effects on brain and nervous system.

  • Depressants - alcohol, sedatives, opiates, with depressive effects on central nervous system, sedation, with reduction of all psychomotor activities, decreasing activities of vital centers for heart and breathing.
  • Stimulants - cocaine, crack, amphetamine, ecstasy, cannabis, have stimulant effects on psychomotor activities, give feeling of growing power, happiness and self-confidence, and loosing fatigue.
  • Hallucinogens - LSD, mescaline, peyote and different synthetic products, are leading to state of changing observation and hallucinations, changed perception of time, space, and society.

Psychoactive substances that, by international classification, can bring to mental or other disturbances:

  • alcohol
  • opiates
  • cannabis
  • sedatives and hypnotics
  • cocaine
  • caffeine
  • hallucinogens
  • nicotine
  • evaporated dissolvers.

Grid No. 1 shows certain groups of psychoactive substances with Latin names of plants from which natural products are extracted, and the names of medicaments and the other synthetic products that can be misused.

Consequences

In grids no. 2, 3, and 4 clinical manifestations of acute intoxications with psychoactive substances are given, gradated from lighter to more severe symptoms and intoxication signs, and signs of abstinence syndromes.

Consequences of using drugs are numerous and harmful for man's health, whose brain through evolution is not prepared for prolonged exposure to their effects, that the usage of drugs is unacceptable by society for the reason of bringing life in danger. In addition, many young people try drugs, much more today than in decades before and usually from curiosity and influence by their peers. The first drug in the most cases is marihuana, and the number of those who are using this drug is rising. Many people think that marihuana is harmless drug, because its consequences are discreet and on the beginning usually damage mainly social-professional functioning. Statistics shows that many treated drug users start with marihuana. Less people are starting with drugs that bring to faster and harder damages of health. In our country, of these drugs, the most represented is heroin. In the world, especially in developing countries, beside heroin, cocaine is often present, but also synthetic drugs as ecstasy.

Consequences on organism can be:

Psychiatrically
They vary from short-term and lighter to continual and heavy. The most frequent ones are acute intoxication, abstinence syndrome, delirium, psychotic disorders, syndrome of amnesia, «flash back» reactions, dementia, and the other permanent cognitive disorders, personal and behavioral disturbances.

Neurological
Neuro-therapy (degenerative disorders of peripheral nerves), meningitis, encephalitis (brain inflammation), brain atrophy, and different neurological disorders

Physical (for other tissues and organs)
Damages of heart, lungs, kidneys, liver, immune system, genital-urinal system, muscles.

Researches of personalities of drug addicts showed that their normal development is stopped in early phases because of effects of many factors. Those factors are usually inadequate nurturing because of immaturity, disagreement or illness of the parents. The consequences of these traumas prevent person to make harmonious contacts within its own psyche and in relation with society. This disparity and immaturity, already in adolescent period, are manifested in distressed relations inside the family, in school or group of peers, mainly through the resistance toward authorities, failure in adequate solving problems, in relation with school tasks or in peer groups.

The family is place where the problems are noticed for first time, but their families cannot usually register and solve the problems. School is the next instance where the disorders in adolescent behavior is spotted, and if on it's not possible to solve problem on this level, as it is usually case with drug addicts, then they have to look for help in specialized health institution.

Statistic of misusing psychoactive substances

Institution for substance abuse works in Belgrade since 1987. In first years of work, they dealt with submissions of around 300 patients per year, but now that number is doubled. According to latest analyzes conducted in 2001, 50 patients is applying for treatment on monthly basis, what is more than two patients daily. Almost 80% are coming because of misuse/addiction to heroin or the other opiates (trodden, tea of poppy capsules), less procentage is of those that come because of extensive use of marihuana and the lowest number of patients is of those who because of psychical problems take sedatives and are getting addicted.

It's estimated that around 100 000 people are drug addicts in Yugoslavia . Percentage of HIV positive persons was very high, now it is beyond 15%, but the number of infected by hepatitis C virus is permanently rising.

The process of healing starts with examinations, after which usual phase is process of detoxication. After passing abstinent crises, established abstinence and stabilization, person is getting to the level in which the person is able to function in it's surrounding in the way it gives satisfaction to that person. In every phase of treatment the members of family of the patient are involved. Treatment is often interrupted by recidivism, but, in order to make a success, they need to continue with it and understand that life without drugs is possible.

The appearance widely present among young people and produced by some forms of culture and sub-culture and by modern life style, is starving for sensation or sensual starvation. That is passionate quest for new sensual experiences and lust for physical and social risk behavior headed for the unusual experiences. Those persons are almost under pressure directed to external stimulants. This is already deviation in process of building identity and represents high risk for deepening the disorders. We have to differ, this lust from healthy curiosity that makes limitations, contains responsibility, without forcing and anxiety escapes from themselves in the world of intensities stimulants. It isn't needed to specify described behavior, which is often defined as curiosity, is one of certain ways that leads to addiction.

Second, more serious sign of disordered identity, closely connected with risk of addiction disease is feeling which is often called loneliness or boredom, Feeling that young people often complaining about and stating as the reason for taking psychoactive substances. That feeling is well described by one of modern experts for identity problems, Salman Aktar, who said: ”Feeling of emptiness. The strange benumb of internal emotional experiences. Perception of self is starting to slide down. Forced intimacy, enormous intake of food, drinking alcohol, using drugs, impulsive sexual contact, provocative behavior – serve as necessary means for ”energy charging”. Self-hurting – looking own blood as it flows out, pain feeling - can be more primitive way to conquer internal emptiness, bloodless. Feeling of emptiness is different from loneliness and desire for somebody or something, that consciousness or common sense doesn't allow in reality. Internal world, although sad, is filled with pictures and live emotions. Emptiness, without desire, is deeply distressing and dehumanizing experience”.

Identity, as the nucleus of personality, and as axial force of its development and individualization, is key finger-pointer through which young person understands life track and follow it, and is faced with freedom and responsibility for its own life and life of the closest.

Family

Eventual ideas for family role when drug abuse is occurring, can be deduced to general attitudes and experiences of both laics' and experts' experiences that relations with the closest are source of health, satisfaction, happiness, but also suffer, misunderstanding, angriness. All that is under influences of different conditions, heredity, indigenous, internal and external, that are leading to different psychological textures; never completely healthy people; always people with internal troubles more or less visible. There does not exist precise type of family that makes someone more under possibility to be exposed to substance abuse. Still, some appearances can be emphasized as important - Intergenerational trend toward addictive behavior (alcoholism of some members of family, passivity, “parasitism”), or behavior with loss of control (pathologic gambling, kleptomania, pyromania). The very important “risk factor” is unequal parents attitude in educating – one of parents express unjustified tolerance, and the other unintelligible severity and aggressiveness.

Since the family is the base for satisfaction of one of the basic human needs – need for belonging, if it is not possible to give enough harmony, support and appreciation, the child will look for some more cohesive group (ex. group of addict) where he/she will find security and acceptance but often with consequences of loosing self-confidence and independence. Also, beside basic needs, there is a need for orientation according to age and circumstances. If within family clear and direct messages doesn't exist, nor conversations, free expression of feelings, if there is unexplainable change of behavior, atmosphere or expectations, child will be in some state of confusion (he will not understand what they say to him, what they expect, what do they love or not, etc). One that doesn't have orientation can't have self-confidence and can't make free decisions. That means child will not be able to normally mature as the person and develop its identity.

In families where the order is made through strong direct or indirect control, it is impossible for persons, which are not controllers, to be responsible for their behavior. They can either concord to the system of control or they can be rebellious and do everything opposite to it openly or hiding rebellious attitude (parents often hear their child is using drugs after a long time). Person needs to have freedom and internal control of himself/herself in order to be responsible. Freedom without self-control and responsibility is obstinacy and wandering without orientation.

In a nutshell, family need to ensure that children have some basis for satisfaction of their basic needs: needs for recognizing roots and being based – through clear and consistent value based system, needs for identity, orientation.

Society

The environment where people live can tolerate or even support usage of some psychoactive substances or totally opposite have openly repulsive or negative attitude. Western societies, but not ours, tolerate drinking alcohol while toward using drugs they often take and attitude of intolerance and prohibition. Some groups can have its special patterns of behaviors in society when it comes to psychoactive substances. For example, urban youth can support marihuana smoking, so as certain artistic circles of people. Among intellectuals often exist surprisingly tolerant attitude towards taking sedatives self-initiatively. These attitudes of surroundings surely have influences on number of people who are becoming addicted of this PAS. We have to say that this kind of “unofficial attitude” is being more efficient than legal acts in some societies.

It is important to say that when we say “society relation toward something”, that's opinion of the majority, and that means an opinion of people of “middle and older generation” towards whom young people naturally have critical and rebellion attitude. That is how it the gap is formed, the gap that can be useful and progressive, but when it comes to misusage of psychoactive substances, is often catastrophic for young people. We can often hear from addicts that their behavior is opposing to “untrue values of society, lethargy and fear” what cannot be acceptable, because in the state of addiction all real values are being ruined and the fear, lethargy and emptiness are the only things left.

Society cannot suppress this appearance solely with its restrictive attitude and legislation against drugs. Some kind of friendly activity, but not and unjustified indulgence toward young people needs to be initiated. Development of preventive program opens the ways of conversation, understanding and accepting young people with their frustrations and attitudes.

If we go back ton the beginning, on concept of substance abuse that results in interaction of four named factors, it can appear as very complicated to understand those complex relations. The guide through labyrinth of modern world can be a definition of mental health that was stated by “classical” Froyd. The things that characterize mature, mentally healthy persons are capacity to love and capacity to work.