Drug abusers and addicts have cravings, and are unable to control their drug use. People with drug problems may hide their drug use and deny its connection to any social, legal, and medical difficulties.Caring family members often push patients to receive treatment.
Physical and behavioral symptoms depend on the drug taken Table 02. Marijuana (cannabis) creates a sense of well-being and relaxation. It depresses brain activity, making thoughts seem disconnected and uncontrolled. Colors, time, and spatial relations may be distorted during the dreamy state that ensues. Users can feel high or a sense of excitement, often depending on expectations and where and with whom the drug is used. Severe anxiety, panic attacks, disorientation, depression, and auditory hallucinations can occur. Marijuana can also cause an increase in heart rate.
Opiates such as heroin, Talwin, and other prescription drugs slow breathing and heart rate, lower blood pressure, produce drowsiness, constrict pupils, and cause constipation. They can also produce euphoria. Prescription narcotics relieve pain and can suppress coughs, and are frequently ordered to manage those symptoms.
Psychostimulants like cocaine produce agitation, restlessness, fast speech, grandiose feelings, irritability, insomnia, dilated pupils, and disordered thoughts. Psychosis, agitation, and paranoia can occur with chronic use. The drug increases blood pressure and heart rate, which can precipitate a heart attack. Seizures, nerve damage, and intestinal damage are also possible.
Sedative-hypnotics, including benzodiazepines, barbiturates, chloral hydrate, and other drugs cause drowsiness, decreased alertness, disorientation, lowered inhibitions, unsteady gait, and slurred speech. The drugs can cause reactions opposite of their intended action, resulting in irritability, combativeness, destructive behavior, and rapid emotional shifts. Doctors prescribe benzodiazepines to treat anxiety and insomnia; however, barbiturates are rarely ordered anymore.
Hallucinogens such as LSD distort users' perceptions, and can cause extreme anxiety, agitation, and a feeling of losing control. The drug can cause psychosis, especially in users with an underlying psychiatric problem. Days, months, or years after ingestion, hallucinogen users may suffer from flashbacks—brief alterations in perception similar to those experienced while on the drug.
Phencyclidine, known as PCP or angel dust, produces strange behavior, confusion, delirium, and an agitated, violent state. Users' blood pressure may increase, and muscle tremors can occur.
Designer drug MDMA, or Ecstasy, can cause hallucinations. It is thought to be toxic to the nervous system. Produced by altering amphetamine compounds, designer drugs can also cause increased alertness and a feeling of euphoria.
Inhaling fumes from common household products can produce intoxication, dizziness, drowsiness, confusion, an unsteady gait, and slurred speech that lasts for a few minutes or longer. Inhaling fumes can be deadly because of resulting changes in breathing and heart rate.
Table 2. Symptoms of Substance Abuse By Drug
Substance Intoxication symptoms Withdrawal symptoms Long-term effects Cocaine Tachycardia, hypertension, pyrexia, euphoria, hyperactivity, rapid speech, hallucinations, agitation Dysphoria, agitation, insomnia, fatigue Impotence, gynecomastia, menstrual irregularities Cannabis Euphoria, conjunctival injection, dry mouth, impaired motor function, increased appetite, paranoia, anxiety, derealization, hallucinations Tremor, nystagmus, sweating, vomiting, diarrhea, decreased appetite Depression, anxiety, amotivational syndrome, memory impairment, decreased sperm count and impaired motility, decreased pulmonary capacity Phencyclidine Psychomotor agitation, amnesia, tachycardia, hypertension, incoordination, derealization, depersonalization, sweating, nystagmus, catatonic-like behavior ? Psychosis Sedatives Sedation, euphoria, slurred speech, disorientation, irritability, nystagmus Anxiety, dysphoria, agitation, insomnia, nausea, sweating, depression Depression, delusions Opiates Nausea, vomiting, miosis, anorexia, constipation, sedation, euphoria, respiratory depression, orthostatic hypotension Yawning, lacrimation, irritability, anxiety, insomnia, papillary dilation, muscle cramps, nausea, vomiting, hot/cold flashes, tachycardia, tachypnea, fever Endocarditis, hepatitis Hallucinogens Tachycardia, sweating, pyrexia, hypertension, dry mouth, decreased appetite, hallucinations ? Schizophrenia, depression, anxiety, flashbacks, memory problems
Gender, a history of mental problems, and a family history are risk factors for drug abuse. Men are more likely to abuse drugs than are women. Women and older adults use more benzodiazepines, and young adults may take Ecstasy at "rave" dance parties. Patients in chronic pain and those in medical professions tend to be at higher risk for opiate addiction. Illegal drug use is higher in the Western states than in the Northeast.
Experimentation with drugs typically begins during or before adolescence. Some experts believe that marijuana, alcohol, and nicotine serve as a gateways to the use of heroin, cocaine, and other "harder" drugs.
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