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Drug abuse is the use of a drug for non-therapeutic purposes, including those for which it was not prescribed or intended. The most commonly abused drugs are alcohol, amphetamines, barbituates, cocaine, methaqualone, and opium alkaloids.
Approaches to managing drug abuse
Non-dietary substances entering the body can often have deleterious effects both acute and chronic. Furthemore, the addictive nature of most drugs limits the individual's ability to discontinue drug use even when experiencing these adverse health effects.
Medical treatment then centers on two aspects: 1) breaking the addiction, 2) treating the health problems.
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 injecting drug abusers are in treatment relative to the total in need. 2
Access to treatment facilities for patients with substance use disorders is an issue of concern as drug abuse is recognized as a chronic brain disease in the form of substance abuse and dependence. Patients may require acute and long-term maintenance treatment and relapse prevention, complemented by suitable rehabilitation. 3
The development of pharmacotherapies for drug abuse treatment are currently in progress. New immunotherapies (depot medications) that counteract the effects of drugs like cocaine, methamphetamine, phencyclidine, nicotine, and opioid dependence are being tested. Buprenorphine is one new option for the treatment of opioid addiction. 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. 4
Most countries in the world have lists of controlled substances, which are those substances that the society has deemed too harmful for individuals to exercise their individual choice to use. For controlled substances, the legal punishments for the creation, distribution, possession and even personal use can be quite severe (including death penalty in some countries). See Prohibition (drugs) and Arguments for and against drug prohibition for a more detailed treament of these subjects.
Despite the illegality of controlled substances, many very large, organized criminal drug cartels operate world-wide. Advocates of decriminalization argue that it is the illegality of these substances that is making drug dealing such a lucrative business.
Sociology of drug abuse
As well as being a major public health problem, drug abuse is also 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 spread by drug abuse. Studies have also shown that individuals dependent on illicit drugs experience higher rates of comorbid psychiatric syndromes. 5
- Institute of Medicine (IOM). (1996) Pathways of Addiction: Opportunities in Drug Abuse Research. The National Acadamies Press.
- MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine, National Institutes of Health, Department of Health & Human Services. Last accessed: April 20, 2005.
- Note 2: Appel, P. W. Ellison, A. A. Jansky, H. K. Oldak, R. (Feb, 2004). "Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders". American Journal of Drug and Alcohol Abuse.
- Note 3: Qureshi NA, al-Ghamdy YS, al-Habeeb TA. (2000). "Drug addiction: a general review of new concepts and future challenges". East Mediterr Health J. Jul;6(4):723-33. PMID 11794078
- Note 4: Board on Behavioral, Cognitive, and Sensory Sciences and Education (BCSSE). (2004) New Treatments for Addiction: Behavioral, Ethical, Legal, and Social Questions. The National Acadamies Press. pp. 7–8, 140–141
- Note 5: Diala, C. Muntaner, C. Walrath, C. (May, 2004). "Gender, occupational, and socioeconomic correlates of alcohol and drug abuse among U.S. rural, metropolitan, and urban residents". American Journal of Drug and Alcohol Abuse.
- American Journal of Drug and Alcohol Abuse, Focusing on the pre-clinical, clinical, pharmacological, administrative, and social aspects of substance misuse, this journal provides an exchange of ideas between the various modalities involved in the study and treatment of drug abuse and alcoholism.
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