Drug Addiction In Street Children Of Punjab

Drug Addiction In Street Children Of Punjab

Not many have had the opportunity to see the real face of growing India. I count myself in one of those fortunate few who could manage this chance. I have seen a part of the visage of growing youth – often called ‘the future of our country’. And believe me, it’s a countenance you would never want to see. It’s a face of India that everyone knows pretty well but chooses to ignore leaving the things the way they are. There are several problems that an average Indian youth faces today ranging from child labour and sexual exploitation to low education standards. But one among them rules them all – DRUGS.

Since the last decade, this country is in jeopardy like it has never been before. I am not talking about an epidemic of disease but about the hurricane of drugs. The drug menace in this country is something which very few people know about. Digest this statistic to know about the gravity of the situation – Today 73.5% of the total youth population of Punjab alone is addicted to drugs, three-quarters of Punjab youth have succumbed to the trap. Let us have a brief look at the picture of what drug taking is in the country. The rich ones afford expensive drugs like heroin, smack, husk and opium while the poor ones tend to go for the cheaper substitutes like Iodex, petrol,capsules,limotil tablets etc.

I had one such experience while persuading a boy named inderbir singh,youngest IDU(injectable drug user),I have ever seen at village kazikot,dist. TARN TARAN .Inderbir singh , a boy of ten, picked up garbage for his living. He didn’t want any education as he was more than satisfied in taking Ganja or marijuana and sometimes a whitener (a fluid used as a text erasing liquid) with the meagre Rs 30 that he earned per day out of his job. He was used to waking up in the morning, lifting rubbish and staying hungry just to get that one time high that he could afford with that paltry amount. Shocking but true!

It’s not only the poor and illiterate who are a prey to drugs, but also the educated. Marijuana is one of the principal favourites of the modern day youth. College students have coined a refined term for this practice-‘Weed Culture’. Apart from weed, they consume alcohol too since they can afford to do it. When asked why they opt smoking weeds or drinking even if they know that they are harmful, the answers range from peer pressure, overcoming stress, fear of rejection to the aesthetic highs they get from them.

Drugs & Sports

Drugs & Sports

Do you know?

• Anabolic steroids are chemically

manufactured drugs. They are a man-made

version of testosterone, the male sex

hormone.

• Athletes and body builders take anabolic

steroids to make their muscles bigger and

stronger. The drug also keeps their energy

high so they can train longer and harder

without getting tired and sore.

• Some men take steroids because they think

they will look better with bigger muscles.

• It is illegal to sell anabolic steroids

for the purpose of improving a person’s

performance in sports.

• There are a few very specific medical uses

for anabolic steroids, including treatment

for some forms of breast cancer and blood

disorders and for people who are not

growing properly.

• Some athletes take 5 to 10 times the

amount that a doctor might prescribe for

legitimate medical uses. Some body

builders and weight lifters may take 200

times the prescribed amount.

• Steroids are taken by mouth or by injection.

Athletes usually take them in a cycle that

lasts from four to 18 weeks.The cycle

includes starting with low doses of more

than one steroid, then gradually increasing

the dose, then stopping use entirely. This is

called “stacking.”

• Some athletes take other drugs besides

anabolic steroids in an attempt to improve

their performance. For example:

– stimulants (drugs that make them more

alert and delay tiredness, allowing them

to train longer). These may include

pseudoephedrine or caffeine.

– analgesics (substances that act on the

brain and spinal cord to reduce the

amount of pain that is felt). An example

is ibuprofen.

– diuretics (drugs that cause quick but

temporary weight loss). An example is

caffeine.

– marijuana (a drug that may have a

calming effect).

Short-term Effects

While using anabolic steroids a person may:

• be able to exercise longer and harder

without getting tired

• become stronger

• have feelings of confidence and enthusiasm

• feel aggressive and irritable (known as

“roid rage”)

• have mood swings (feel happy one minute

and sad the next)

• feel anxious and unable to sleep well

• feel depressed (sad)

• have headaches, stomach aches and

nosebleeds

• have high blood pressure and a faster

heart rate

Other drugs used to enhance performance

also have serious side effects, especially

when combined with anabolic steroids.

Drugs & Sports

Stunted Growth

When young people take steroids, they are

risking an extremely serious consequence:

the drug may prevent them from growing

to their full height.

Long-term Effects

After heavy use of anabolic steroids over a

long period of time, a person may experience:

• an increase in muscle size and rapid weight

gain (5 to 10 kg in 6 to 12 weeks)

• acne (pimples and cysts on the face, upper

back, shoulders and arms)

• a “moon face” (the face becomes round in

appearance)

• less flexible muscles and ruptured tendons

• jaundice (the whites of the eyes or the skin

take on a yellowish tinge, which is a sign

of liver problems)

• liver damage that cannot be cured

• stroke or heart attack caused by blood

clots and hardening of the arteries

• paranoid feelings (feeling scared or

suspicious for no reason)

• a tendency to be violent in their behaviour

Tolerance and Dependence

• People using steroids can become

psychologically dependent (they feel they

need it) as well as physically dependent

(the body needs it).

• Tolerance (a need for more steroids to

get the desired effect) does not develop

in users.

Withdrawal Symptoms

• Withdrawal symptoms include loss

of appetite, throwing up, headaches,

and sweating.

• Users may feel dizzy, irritable and sad.

• Users may crave the drug.

Other Risks

• Girls and women who use steroids for a

long time may experience changes to their

bodies that may be irreversible:

– hair growth on their faces and bodies

– lowered voices

– irregular menstrual periods

– a reduction in the size of their breasts

– male pattern baldness

– the inability to become pregnant

• Boys and men who use steroids for a long

time may experience changes to their bodies:

– the development of breasts

– a reduction in the size of their testicles

– the inability to have sexual intercourse

(impotence)

– a drop in their sperm count and

temporary infertility (cannot become

a father)

• For those who inject, sharing needles can

lead to infections such as HIV and hepatitis.

Treatments for heroin addiction

Treatments for heroin addiction

A variety of effective treatments are available for heroin addiction. Treatment tends to be more effective when heroin abuse is identified early. The treatments that follow vary depending on the individual, but methadone, a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms, has a proven record of success for people addicted to heroin. Other pharmaceutical approaches, such as buprenorphine, and many behavioral therapies also are used for treating heroin addiction. Buprenorphine is a recent addition to the array of medications now available for treating addiction to heroin and other opiates. This medication is different from methadone in that it offers less risk of addiction and can be prescribed in the privacy of a doctor's office. Buprenorphine/naloxone (Suboxone) is a combination drug product formulated to minimize abuse.

Detoxification

Opiate withdrawal is rarely fatal. It is characterized by acute withdrawal symptoms which peak 48 to 72 hours after the last opiate dose and disappear within 7 to 10 days, to be followed by a longer term abstinence syndrome of general malaise and opioid craving. Detoxification programs aim to achieve safe and humane withdrawal from opiates by minimizing the severity of withdrawal symptoms and other medical complications. The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state. Not in itself a treatment for addiction, detoxification is a useful step only when it leads into long-term treatment that is either drug-free (residential or outpatient) or uses medications as part of the treatment. The best documented drug-free treatments are the therapeutic community residential programs lasting 3 to 6 months.

Buprenorphine

Buprenorphine is a particularly attractive treatment for heroin addiction because, compared with other medications, such as methadone, it causes weaker opiate effects and is less likely to cause overdose problems. Buprenorphine also produces a lower level of physical dependence, so patients who discontinue the medication generally have fewer withdrawal symptoms than do those who stop taking methadone. Because of these advantages, buprenorphine may be appropriate for use in a wider variety of treatment settings than the currently available medications. Several other medications with potential for treating heroin overdose or addiction are currently under investigation by NIDA.

In addition to methadone and buprenorphine, other drugs aimed at reducing the severity of the withdrawal symptoms can be prescribed. Clonidine is of some benefit but its use is limited due to side effects of sedation and hypotension. Lofexidine, a centrally acting alpha-2 adrenergic agonist, was launched in 1992 specifically for symptomatic relief in patients undergoing opiate withdrawal. Naloxone and naltrexone are medications that also block the effects of morphine, heroin, and other opiates. As antagonists, they are especially useful as antidotes. Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending on the dose. Naltrexone blocks the pleasurable effects of heroin and is useful in treating some highly motivated individuals. Naltrexone has also been found to be successful in preventing relapse by former opiate addicts released from prison on probation.

Behavioral therapies

Although behavioral and pharmacologic treatments can be extremely useful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach. There are many effective behavioral treatments available for heroin addiction. These can include residential and outpatient approaches. An important task is to match the best treatment approach to meet the particular needs of the patient. Moreover, several new behavioral therapies, such as contingency management therapy and cognitive-behavioral interventions, show particular promise as treatments for heroin addiction, especially when applied in concert with pharmacotherapies. Contingency management therapy uses a voucher-based system, where patients earn "points" based on negative drug tests, which they can exchange for items that encourage healthy living. Cognitive-behavioral interventions are designed to help modify the patient's expectations and behaviors related to drug use, and to increase skills in coping with various life stressors. Both behavioral and pharmacological treatments help to restore a degree of normalcy to brain function and behavior, with increased employment rates and lower risk of HIV and other diseases and criminal behavior.

Heroin: Abuse and Addiction

Heroin: Abuse and Addiction

What is heroin?

Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the opiates. Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants. It is typically sold as a white or brownish powder or as the black sticky substance known on the streets as "black tar heroin." Although purer heroin is becoming more common, most street heroin is "cut" with other drugs or with substances such as sugar, starch, powdered milk, or quinine. Street heroin also can be cut with strychnine or other poisons. Because heroin abusers do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Heroin also poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles or other injection equipment.

Why are heroin users at special risk for contracting HIV/AIDS and hepatitis B and C?

Heroin users are at risk for contracting HIV, hepatitis C (HCV), and other infectious diseases, through sharing and reuse of syringes and injection paraphernalia that have been used by infected individuals, or through unprotected sexual contact with an infected person. Injection drug users (IDUs) represent the highest risk group for acquiring HCV infection; an estimated 70 to 80 percent of the 35,000 new HCV infections occurring in the United States each year are among IDUs.

NIDA-funded research has found that drug abusers can change the behaviors that put them at risk for contracting HIV through drug abuse treatment, prevention, and community-based outreach programs. They can eliminate drug use, drug-related risk behaviors such as needle sharing, unsafe sexual practices, and, in turn, the risk of exposure to HIV/AIDS and other infectious diseases. Drug abuse prevention and treatment are highly effective in preventing the spread of HIV.

Drug Abuse in the indian Youth

Drug Abuse in the indian Youth

As the drug epidemic continues to painstakingly seep into the country’s social and cultural aspects, drug abuse naturally trickles into our younger generation – a generation refusing to be left out.

Making up one-fifth of the population, 15-24 year-olds carry with them India’s future. The youth of our nation will eventually determine the country’s moral, political, and social persuasions. Bearing the burden of a densely populated country like India is no small task. And drug abuse does nothing to lighten the load. ¹

The youth of our nation has a massive responsibility. And as India’s potential rests delicately in their hands the drug epidemic continues to rage on the sidelines. Just as a single footballer’s attitude and actions can hurt his whole team and cause them to lose the match, illicit drugs have the potential to thwart the success of India’s future.

Teen and Young Adult Drug Use: Problems

“Educational attainment not only affects the economic potential of youth, but also their effectiveness as informed citizens, parents, and family members” says the National Family Health Survey of India (2009). ²

They bring up a good point: education is a vital part of any nation’s philosophy for success. Of course education is important, but education – like so many other ideas in life, is a two way street. If the students don’t end up doing their part in the educational process, the system can quickly backfire.

Public schooling can ironically turn into breeding grounds for addicts. In and out of the classroom, teens and young adults are influenced by the social acceptance of drugs. This lack of personal responsibility, and the general apathy surrounding the issue has filtered down to the youth – creating a normality in drug abuse.

Illicit drug use among the youth, specifically teenagers, presents an impending threat to our nation. The question: why do teens so quickly slip into drug abuse? has troubled Indian scientists and politicians for decades. The answer to impending predicament seems to be two-fold.

Why is drug abuse thriving amongst Indian Youngsters?

Two convincing theories attempt to answer this question. Each presents a viable explanation for the youth drug addiction problem in India.

Technical Approach: Based on scientific experimentation

A careful study, accomplished by a group of scientists at the university of Pittsburgh, discovered neuron activity in adolescent rats that might explain the irrationality of some teenagers and young adults.

For many youngsters, rewards are chosen before consequences are considered; the scientific study may reveal the biological root causing this propensity. Their findings offer a scientific explanation as to why adolescents continue to be more vulnerable to drug abuse, alcohol consumption, and smoking.

The research team recorded the brain-cell activity of adults and adolescents as each group performed “reward-driven tasks”. The team documented their findings, and what they discovered wasn’t surprising. The electrode recordings of the adolescent brains reacted with far greater intensity to rewards than the adult’s did.

According to one report, “A frenzy of stimulation occurred with varying intensity throughout the study along with a greater degree of disorganization in adolescent brains. The brains of adult rats, on the other hand, processed their prizes with a consistent balance of excitation and inhibition.” The lead researcher, Bita Moghaddam (professor of neuroscience), said the radical difference in brain activity provides possible physiological explanation as to why youngsters are more prone to experiment with drugs.

Practical approach: Based on peer pressure and curiosity

Usually it starts off innocently enough. Children grow older and reach the teenage and young adult stages of life. With age, the parents’ influence often diminishes, and as part of life’s natural progression, youngsters are influenced more and more by their peers.

Many detailed studies have shown the worrisome aspects of peer pressure. As one of the most powerful tools used to sway youngsters towards drug addiction – peer pressure in the area of drug abuse can begin as early as junior high.

One major youth drug addiction study declares, “In India, the majority (of addicts) became hooked on drugs after friends introduced drugs to them.” The study goes on to report that an additional 35% of subjects interviewed became addicted after trying out drugs for fun and out of curiosity.

Alcohol & Drug Abuse In India

Alcohol & Drug Abuse In India

What are the common drugs of abuse?
Common drugs in India are smoking (cigarettes, beedis) & chewing tobacco (gutkha, pan masala), alcohol, cannabis (ganja, bhang, charas), opioids (heroin, opium, injection Buprenorphine, capsule Spasmoproxyvon, cough syrups), Sedative-Hypnotics (sleeping pills, Alprazolam, Diazepam) and Inhalants (typewriter correction fluid).

Cocaine & Amphetamine (Ecstasy tablets) use is rare in India.

What are licit & illicit drugs?
Smoking & chewing tobacco and alcohol are licit (legal) drugs in most states in India. All other drugs are illicit (illegal), hence possession, use, etc. are punishable offences.

Narcotic pharmacological product use without appropriate physician’s prescription is considered illicit.

Different age limits exist for use of alcohol / tobacco products in various states of India.

In some countries all drugs (including tobacco & alcohol) are illicit, e.g. Saudi Arabia.

In some countries cannabis is a licit substance (in certain areas/districts), e.g. Denmark.

What are the socio-demographic characteristics of an average drug user?
Overall males use drugs much more than women. The pattern of use of licit drugs differs from that of illicit drugs. Licit drug use is prevalent between the ages of 16 to 60 years in all economic strata, more so in young adults. Illicit drugs are mainly used in lower & lower middle economic groups. Cocaine & Amphetamine use is rare and seen in some young adults from higher economic backgrounds.

What is the vulnerable age of slipping into DrugAbuse?
Youngsters between the ages of 16 and 21 years are most prone to initiating alcohol & drug use.

What is the natural history of Drug Abuse?
Many adolescents experiment with smoking & alcohol in their late teens. This usually occurs at parties. Some also try cannabis and rarely illicit drugs. Most of them outgrow these tendencies and move into adulthood as teetotalers. Some may continue with regular use of a single drug, e.g. cigarette smoking, or use drugs occasionally, e.g. alcohol.

Regular drug use results in several adverse consequences in the personal, social, occupational spheres of users in the 20s, 30s & 40s. Some quit intermittently and some quit for long durations. Most users usually quit drug use in their late 40s. Some may continue lifelong.

What are the medical harm associated with DrugAbuse?
Medical harm depends on type, amount, duration of drugs use, and certain protective factors.

Tobacco use is related to lung cancer (smoking), oral cancer (chewing), heart disease, chronic obstructive pulmonary disease (COPD), dental problems, chronic bronchitis, impotence in males & fetal defects in unborn children (in pregnant women)

Chronic alcohol use may lead to hepatitis or cirrhosis of liver, gastritis, pancreatitis , depression, impotence in males, cardiomyopathy, high blood pressure, neuropathy, obesity, predispose to some cancers (mouth, gullet, liver, colon and breast) and accidents – automobiles, domestic & workplace (injury, fire, drowning). Hooch use can cause severe illness & permanent blindness.

All drugs produce harm according to the route of intake. Those drugs that are inhaled cause respiratory tract infections and may predispose to tuberculoses of lungs. Those drugs which are injected can cause infections of the veins, infection in the blood, abscesses in various internal organs & muscle, and spread blood-brone infections (e.g. Hepatitis B & C) if needles are shared between users.

Opoids & sedatives may be dangerous if overdosed. Inhalants may produce burns in mouth, nostrils, abnormal heart rhythms & sudden death.

Protective factors include good nutrition, drug use restricted to social occasions (e.g. alochol) and regular contact with treatment facility.

What are the non-medical consequences of druguse?
These are in the context of marriage, family, society, workplace, finances & the law.

Marital complications: Disapproval of drug use by the spouse, deteriorating interpersonal relationships, impotence in males, frequent fights, separation & divorce.

Familial complications: Disapproval of drug use by family members, frequent fights, embarrassing events due to intoxication.

Social complications: Misbehavior with others, loss of prestige in society & social standing, alienation, exclusion of drug user & family from social occasions by other members of the society.

Occupational complications: Irregular work habits, absenteeism, poor work output, accidents due to intoxication, misbehavior & insubordination, frequent complaints, salary deductions, loss of pay, sacking, unemployment, difficulty on re-acquiring job, frequent change of jobs.

Financial complications: Cost of drugs, and paraphernalia (syringes), transport, additional snacks, medical costs, diversion of household expenses for drug procurement, stealing money from home, selling household items for drugs, loans from family, friends, office and other sources.

Legal complications: Driving & traffic accidents, brawls during intoxicated state, arrest for possession or use of illicit drug, peddling of drug for sustaining drug use habit.

 Are there any safe limits of drug use?
Safe limit is defined only in the context of alcohol use. In developed nations, recommended 'safe' limits for drinking alcohol are:

Men: less than 21 units per week (no more than 4 units in any one day)
Women: less than 14 units per week (no more than 3 units in any one day)
One unit of alcohol is one small measure (30 ml) of spirits (whisky / rum /brandy / vodka).

Use of any amount of tobacco or any other drug is considered harmful.

What are the signs of hidden drug use?

This occurs mainly in the initial phases of drug use, and also in extremely conservative societies.

Common signs include spending excessive time alone in one’s room, bathroom, or outdoors; returning home with unsteady gait, redness of eyes, poor hygiene, decreased attendance & functioning at school / work, asking for more pocket money, borrowing money from others, stealing money or other items from home, making excuses regarding money and time spent.

What the treatments available for Drug Abuse?

Medications & counseling are the main modalities of treatment of Drug Abuse. Minor levels of drug use are dealt with counseling alone. For higher grades of drug use a combination of medications & counseling is used. Definite treatments are available for alcohol, smoking and opoids (heroin, injections, cough syrup, etc.).

Who provides treatment of Drug Abuse & where?

Psychiatrists are formally trained in Alcohol, Smoking, and Drug Addiction Treatment. Some General Duty Medical Officers (GDMOs) are also trained by the Govt. of India in Drug Abuse treatments. Treatment is available in Psychiatry Departments of Government Hospitals, NGOs & by psychiatrists in the private sector.

What is the role of rehabilitation?

Rehabilitation involves imparting vocational training so that a drug user can be meaningfully employed and remain off drugs in the society. It is required in a small number of drug users, especially those who have been using for several years & have lost the habit of working.

What is the role of involuntary admission?

Forced admission for Drug Abuse is not legally permissible. If a drug user additionally suffers from a psychiatric illness, then involuntary admission is possible if the same is certified & the patient is admitted under care of a psychiatrist.

What are the phases of treatment?

An initial intensive phase of medical treatment (detoxification) lasts 2-3 weeks. It provides relief of the distressing symptoms (withdrawal symptoms) occurring after stopping drug use. The second phase is called the maintenance phase and it usually of one year duration. It involves medications & counseling and aims at preventing the patient from reusing drugs.

What is the adequate duration of treatment?

For smoking & chewing tobacco, Sedative-Hypnotic use and inhalant use, a treatment period of 3-6 months is required.

For alcohol and opoids (heroin, injections, cough syrup, etc.), treatment of one year is usually required.

What is the role of family members / spouse / parents?

The role of family members should be to detect drug use, to encourage to initiate & maintain in treatment and to look out for signs of re-use (relapse). Family members need to understand that drug abuse is currently considered as a Medical Disorder.

What are the steps for prevention of Drug Abuse?

Increasing awareness of the common drugs of abuse, their medical, social & occupational costs, in youngsters, parents and teachers.

What are the legal aspects of Drug Abuse?

Alcohol and tobacco use is permissible in adults with specific age limits. Production, transport, possession and use of all other drugs is under the purview of NDPS Act of 1987 and punishable with imprisonment of 6 months &/or fine of Rs.10,000/-. Penalties increase with increase in amounts, repeat offences.

Is there some softer options for first time offenders?

If a person has been arrested for drug use, a provision in the NDPS Act can exempt him/her if he/she is the first time offender & agrees to undergo treatment of Drug Abuse at a government facility.

What is the message for youngsters?

Be aware, refuse drugs the first time & every time, help is available and do not hesitate to ask for help.