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Drug Use Disorders
The drug problem is not a new one, nor is it an unexplored one. Rather it is extensively talked about. On social media, by media, my world leaders, organizations, and even in national and international policies. This is enough to establish that drug use problems are real and very big. However, the awareness of drug use continues to ruin lives and relationships.
Drug Use Disorder
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-V-TR) identifies multiple types of drug addictions. Specifically, it distinguishes between 10 drugs: Alcohol, caffeine; cannabis; hallucinogens; inhalants; opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco, and other substances. When taken in excess, all these drugs can directly activate the brain's reward systems.
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These reward systems are associated with reinforcement of behaviors and establishment of memories. Instead of activating reward systems through adaptive behaviors, these substances cause intense activation wherein normal activities may be neglected. Different drugs have a different pharmacological mechanism by which they produce 'reward' however, they typically activate the system and produce feelings of pleasure, often referred to as a "high."
All drug use disorder is characterized by a large intake of drugs or over a long period. The individuals may also have multiple unsuccessful attempts to cut down or discontinue their drug use. They spend a significant amount of time trying to obtain, use and recover from the effects of the drug. There is also a strong craving for the drug they indulge in. Drug use disorder also leads to social impairments manifested in terms of failure to fulfill major life roles and responsibilities, continuing drug use despite knowing the consequences, and relinquishing social, occupational, and recreational activities. It can also lead to dangerous situations wherein taking the drug can have a great physical cost. Individuals with drug use disorder may also build tolerance for the drug and may increase the intake amount. Moreover, when they do not consume the drug, they may experience withdrawal, pushing them to continue taking drugs.
Different drugs have different prevalence rates. The study report, for example, that 42% of people who consume cannabis do so to socially conform, while 29% do it to experiment and 24% for enjoyment; 12% use it to manage stress or relax. According to 2019 data, approximately 62 million people consumed opioids. About 10.2% of US adults have reported having misused pain relievers. 2018 data showed that for adolescents, there is a 26.3% of lifetime prevalence rate of alcohol, 15.4% for cannabis, and 13.4% for tobacco. For young adults, the numbers were 79.7% (alcohol), 51.5% (cannabis) and 55% (tobacco). Lifetime prevalence for cocaine was 11.4%, methamphetamine was 2.5%, and heroin was 1.3%.
In India, prevalence rates of alcohol use were found at 4.6% of males, cannabis at 2.8%, and opioids at 2.1%. Of this, 19% of users showed a dependent pattern of alcohol use, whereas the rate was 0.25% for cannabis users. Out of 2.1% opioid users, herein users showed the highest percentage at 1.14%, followed by pharmaceutical opioids at 0.96% and opium at 0.52%.
Management of Drug Use Disorder
There are multiple treatment options for drug use disorder, including, but not limited to, behavioral counseling, medication, and long-term follow-up.
Medication and devices, for example, can be used to suppress withdrawal symptoms, including detoxification. Detoxification is not the treatment but rather the first step towards treatment. Individuals who do not receive any follow-up after detoxification are likely to start their drug use. Certain devices are also used in the process of controlling withdrawal symptoms. For example, NSS-2 Bridge is a device placed behind the ear and sends an electrical pulse to stimulate brain nerves.
Medication is also given to reduce cravings and re-establish normal brain functioning. Medication is also given for treating opioids, tobacco, and alcohol use. Additionally, medication to treat cannabis and stimulants is being made.
Behavior preparation is also used with drug use disorders. They aim to modify individuals' attitudes and behaviors about drug use, develop healthy life skills, and continue with medicine and other forms of treatment. These can include cognitive-behavioral therapy (CBT), which assists patients in identifying, avoiding, and coping with situations when drug use is most likely. Multidimensional family therapy may also help families and teenagers with drug use disorder issues communicate better and address various factors contributing to drug abuse and family functioning. Motivational interviewing may be used to maximize individuals' willingness to reform their behavior and seek therapy.
Those whose symptoms are more severe could benefit from in-patient or residential treatment, which aims to help the individual live a drug-free, crime-free life after the completion of the treatment. Therapeutic communities are a 6 to 12-month residential treatment program wherein the entire community, both the people receiving treatment and those in recovery, serve as important change agents, affecting the patient's attitudes, understanding, and behaviors related to drug use. Shorter-term residential treatment focuses on initial intensive counseling and detoxification. Recovery housing is short-term, supervised housing frequently used after various in-patient or residential treatment programs. Recovery housing can assist people in the transition to independent life by teaching them how to handle their finances or look for work and linking them to community support services.
Drug use disorder has far-reaching effects on individuals, groups, and society. Despite policies, treatment, and awareness programs, not many go out to actively seek medical and psychological assistance. Additionally, the stigma around drug and drug use disorders makes it difficult for people to reach out even when they want to.
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