Drug abuse

Drug abuse has a wide range of definitions, all of them relating to the use, misuse or overuse of a drug for a nontherapeutic effect. Some of the most commonly abused drugs include alcohol, amphetamines, barbiturates, cocaine, methaqualone, opium alkaloids, and minor tranquilizers. Use of these drugs may lead to criminal penalty in addition to physical, social, and pyschologic harm.{{an|mosby}} Other definitions of drug abuse fall into four main categories:

Approaches to managing drug abuse

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens. In spite of the best efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.{{fn|6}}

Related Topics:
United States - EU - Law enforcement - Public health

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In addition to being a major public health problem, some consider drug abuse to be a social problem with far-reaching implications. Stress, poverty, domestic and societal violence, and various diseases (i.e., injecting drug users as a source for HIV/AIDS) are sometimes thought to be spread by drug use. Studies have also shown that individuals dependent on illicit drugs experience higher rates of comorbid psychiatric syndromes. {{fn|diala}}

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Harm reduction

One alternative involves replacing failed law enforcement policies with harm-reduction strategies, which focus on reducing the societal costs of drug abuse and other drug use. Techniques include education to avoid overdose, needle exchange programs to reduce the spread of blood-borne diseases, and opioid substitution therapy to reduce crime related to the procurement of drugs. This pragmatic approach is known as the harm reduction paradigm. Harm reduction also addresses special populations, such as drug-using parents, pregnant drug users and users with psychiatric comorbidity. The philosophy of harm reduction accepts that drug use is part of the community, but that it must be addressed as a public health issue rather than a criminal one.{{an|phillips}}

Related Topics:
Needle exchange - Blood-borne disease - Harm reduction

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Harm-reduction measures are at odds with the prevailing framework of international drug control, which rests on law enforcement and the criminalization of behaviors related to illicit drug use. However, harm-reduction has had a notable impact and is slowly gaining popularity. In Brazil alone, a comprehensive harm-reduction and drug-access program successfully reduced AIDS mortality among injection drug users by 50%.{{an|cmaj2005}}

Related Topics:
Drug use - Brazil - AIDS

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Medical treatment

Beyond the sociological issues, many drugs of abuse can lead to addiction, chemical dependency, or adverse health effects, such as lung cancer or emphysema from cigarette smoking.

Related Topics:
Addiction - Chemical dependency - Lung cancer - Emphysema - Cigarette

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Medical treatment therefore centers on two aspects: 1) breaking the addiction, 2) treating the health problems.

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Most countries have health facilities that specialize in the treatment of drug abuse, although access may be limited to larger population centers and the social taboos regarding drug use may make those who need the medical treatment reluctant to take advantage of it. For example, it is estimated that only fifteen percent of injection drug abusers thought to be in need are receiving treatment.{{an|appel}} Patients may require acute and long-term maintenance treatment and relapse prevention, complemented by suitable rehabilitation. {{an|qureshi}}

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Therapy

The development of pharmacotherapies for drug dependency treatment are currently in progress. New immunotherapies that prevent drugs like cocaine, methamphetamine, phencyclidine, nicotine, and opioids from reaching the brain are in the early stages of testing. Medications such as Buprenorphine, which block the drugs active site in the brain are another new option for the treatment of opioid addiction. Depot forms of medications, which require only weekly or monthly dosing, are also under investigation.

Related Topics:
Phencyclidine - Nicotine - Opioids - Buprenorphine

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Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however, drugs for substance abuse treatment have faced many barriers . Naltrexone, a drug marketed under the name "ReVia," is a medication approved for the treatment of alcohol dependence. Unfortunately, this drug has reached very few patients. This may be due to a number of factors, including resistance by addiction treatment providers and lack of resources. {{an|bcsse}}

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Legal treatment

Related articles: Prohibition (drugs), Arguments for and against drug prohibition

Related Topics:
Prohibition (drugs) - Arguments for and against drug prohibition

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Most countries have legislation designed to criminalise drug abuse. Usually however this is limited to drugs specified by the legislation. These drugs are often called illegal drugs but, generally, what is illegal is their unlicensed production, supply and possession. The drugs are also called controlled substances. Legal punishments, even for simple possession, can be quite severe (including the death penalty in some countries). Legal regimes vary across countries, and even within them, and have fluctuated widely throughout history.

Related Topics:
Legislation - Unlicensed - Death penalty

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Despite (and perhaps because of) the legislation many large, organized criminal drug cartels operate world-wide. Advocates of decriminalization argue that it is the legislation which makes drug dealing such a lucrative business, and leads to much of the associated criminal activity.

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