Centre For Distance and Online Education

Punjabi University, Patiala

Class : B.A./B.A.(Honours)/B.Com/BCA/BBA - Part-I

(Drug Abuse) Semester : 2
Medium :English Unit:I
Last updated in July, 2024
LESSON No.

Lesson No 1.1 : Concept and Overview

Lesson No 1.2 : Introduction to Drugs of Abuse; Withdrawal
Symptom; Short Term And Long Term Effects
Lesson NO 1.3 : Amphetamine as Stimulant

: Drugs of Abuse

Lesson No. 1.8 : Steroids

website : www.pbidde.org
 OUT LINE FOR THE SYLLABUS OF A MODULE ON

PRE VEN TION

DRUG ABUSE: PROBLEM, MAN AGE MEN T AND
(Course Code: DAPB1201 T)
(2024-25)
VALUE ADDED COURSE
ester 2)
FOR ALL UNDERGRADUATE PRO GRA MS (Sem
Max Time: 1.5 b
Max Marks: 35 Lectures per week: 2
Internal Assessment: 15
Total Marks 50

INSTRUCTIONS FOR THE PAPER SETTERS

C. Each of sections A and B will have four questi ons from
The question paper will consist of three sections A, B and of 11
on shall carry 6 marks . Section C will consis t
the respective sections of the syllabus. Each questi
entire syllabus.
objective/short answe r type of I mark each coveri ng the
INSTIWCTIONS FOR THE CANDIDATES C are
each from sections A and B. All questi ons in Sectio n
Candi dates are required to attempt any two questions
compulsory.

SECTION A
UNIT: I - Problem of Drug Abuse : Conce pt and Overview; Types of Drugs often Abused
(a) Concept and Overview
What are drugs and what constitutes Drug Abuse?
Preval ence of menac e of Drug Abuse
Drug Addiction?
How drug Abuse is different from Drug Depen dence and
concep ts of drug tolerance
Physical and psychological dependence-
Short -term , Long- term effects & withdrawal symptoms
(b) Introduction to drugs of abuse:
Stimulants: Amphetamines, Cocaine, Nicotine
Phenobarbital Benzodiazepins -Diaz epam,
Depressants: Alcohol, Barbiturates- Nembutal, Seconal,
Alpraz olam, Flunitrazepam
Narcotics: Opium , morphine, heroin
h, hash oil)
Hallucinogens: Cannabis & derivatives (marijuana, hashis
Steroids and Inhalants

UNIT: D - Nature of th e Problem

Abuse - (Physical, Academic, Behav ioral and
Vu lnerable Age Groups. Signs and sympt oms of Drug
Psychological indicators)

SECTION B

UNIT : III - Causes and Consequences of Drug Ab use

a) Causes : Physio logical , Psychologica l, Sociologica l
fam ilies, For society & Nation
b) Consequences of Drug Abuse : For indivi duals, For

UNIT : IV- Management & Preven tion of Drug Abuse

, Role of Family , School, Media , Legisl ation &
Manag ement of Dru g Abuse, Preve ntion of Drug Abuse
Deadd iction Center s

Sugg1·~tl'd r ead ings

uth, New Delh i: Mittal Pub
J. Kapoo r T. ( 1985) Dru g Epidem ic among Indian Yo
Modi, lshwa r and Mod i, Shali ni ( 199 7) Drugs : Add icti on and Preven tion, Jaipur : Rawat Public ation.
.,
i\huj,1 R:111 C:'ClO l ), Social Problems in In dia, Rawat
Publications: Jaipur
·i
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.1 Author : Dr. RichaShri

Richa
Edited by: Mr. Jaswin
aswinder Singh

1.1.0 Overview
1.1.1 Learning Objective
1.1.2 Introduction:
1.1.3 What is a Drug?
1.1.4 Definition of drug
1.1.5 Drug Use
1.1.6 Drug Abuse
1.1.7 The Diagnostic Featur
atures of Substance Dependence
1.1.8 Drug Misuse
1.1.9 Prevalence in India
1.1.10 Warning Signs off Substanc
Substance Abuse:
1.1.11 Protective factors
1.1.12 Risk Factors
1.1.13 Summary
1.1.14 Short questions
1.1.15 Long questions
1.1.16 Suggested readings

1.1.0 Overview
This chapter provides a com
comprehensive overview of drugs, their definiti
efinitions, and
their impact on individual
uals and society. It explores drug use,, abuse,
abus and
addiction, emphasizing the diagnostic features of substance depen endence. The
chapter also discusses the
e trans
transition from drug abuse to addiction
on and the role of
physiological and psychol
chological dependence. Additionally, it hig highlights the
misuse and abuse of prescript
escription drugs and common substancesnces of abuse. The
prevalence of substance ab
abuse in India is examined, along with warwarning signs,
protective factors, and risk factors. The chapter concludes with ith suggested
questions for further disc
discussion and recommended readings ings for deeper
understanding.
1.1.1 Learning Objective
To know about:
● Drugs and its use anand misuse
● Drug abuse
● Drug dependence and its diagnostic features
● Warning sign of subst
bstance use
● Protective factor
● Risk factor
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1.1.2 Introduction:
Drug abuse is a major concern not only in developing countries like India but
also in developed counties. It is very important for the human to understand the
concept of drug use, mis-use and drug abuse along with its effects and side
effects.
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1.1.3 What is a Drug?

• A chemical substance used in the treatment, prevention
or diagnosis of disease or used to otherwise enhance
physical or mental well-being.
• Any substance recognized in the official pharmacopoeia or formulary
of the nation.
• Any substance intended for use in the diagnosis, cure, mitigation,
treatment, or prevention of disease in humans or other animals.
• Any article, other than food, intended to affect the structure or any
function of the body of humans or other animals.
• Any substance intended for use as a component of such a drug, but
not a device or a part of a device.
• A habit-forming medicinal or illicit substance, especially a narcotic.

1.1.4 Definition of drug

In the broadest terms, a drug is “any substance which changes the way the body
functions, mentally, physically or emotionally”.
This definition does not discriminate between:
礎 Alcohol
礎 Tobacco
礎 Caffeine
礎 Solvents
礎 Over The Counter Drugs
礎 Prescribed Drugs
礎 Illicit drugs

The use of a chemical, legal or illegal, which causes significant impairment in:
• physical functioning
• mental functioning
• emotional functioning
• social functioning
“Substance use disorder” is a preferred term in the scientific community.
According to the WHO:
Substance abuse refers to the harmful or hazardous use of chemicals, including
alcohol and illicit drugs.
Psychoactive substance use can lead to dependence syndrome - a cluster of
behavioural, cognitive, and physiological phenomena that develop after repeated
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substance use and that typically include a strong desire to take the drug,
difficulties in controlling its use, persisting in its use despite harmful
consequences, a higher priority given to drug use than to other activities and
obligations, increased tolerance, and sometimes a physical withdrawal state.
1.1.5 Drug Use
Drug use is a broad term to cover the consumption of any ‘substances’-alcohol,
tobacco, caffeine, solvents, over the counter drugs, prescribed drugs, and illicit
drugs within this there are stages:
• drug-free (i.e. non-use),
• experimental use,
• recreational use and
• harmful use, which is further sub-divided into misuse and dependence.
(The definitions are taken from the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR) a diagnostic manual for clinicians.)
1.1.6 Drug Abuse
Substance abuse is described as a: ‘maladaptive’ pattern of substance use
leading to clinically significant impairment or distress, as manifested by one (or
more) of the following within a 12 month period:
1 Recurrent use leading to failure to fulfil major role obligations (work, home,
school, etc.)
2 Recurrent use in situations where it is physically hazardous (e.g. drunk
driving)
3 Repeated substance related legal problems (repeated disorderly conduct while
drunk)
4 Persistent use despite recurrent social/interpersonal problems caused or
exacerbated by the effects of a substance (e.g. arguments with spouse or
physical fights)

1.1.7 The Diagnostic Features of Substance Dependence

Substance dependence is defined as a maladaptive pattern of use that results in
significant impairment or distress, as shown by the following features (3 or more)
occurring within the same year:
1. Tolerance for the substance, as shown by either
a. the need for increased amounts of the substance to achieve the desired
effect or intoxication, or
b. marked reduction in the effects of continuing to ingest the same
amounts.
2. Withdrawal symptoms, as shown by either
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 8 Drug Abuse : Problem,
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a. the withdrawal syndrome that is considered characteristic for the substance,
OR
b. the taking of the same substance (or a closely related substance, as when
methadone is substituted for heroin) to relieve or to prevent withdrawal
symptoms.
3. Taking larger amounts of the substance or for longer periods of time than
the individual intended (e.g., person had desired to take only one drink, but
after taking the first, continues drinking until severely intoxicated).
4. Persistent desire to cut down or control intake of substance or lack of success
in trying to exercise self-control.
5. Spending a good deal of time in activities directed toward obtaining the
substance (e.g., visiting several physicians to obtain prescriptions or engaging
in theft), in actually ingesting the substance, or in recovering from its use. In
severe cases, the individual’s daily life revolves around substance use.
6. The individual has reduced or given up important social, occupational, or
recreational activities due to substance use (e.g., person withdraws from
family events in order to indulge in drug use).
7. Substance use is continued despite evidence of persistent or recurrent
psychological or physical problems either caused or exacerbated by its use
(e.g., repeated arrests for driving while intoxicated).
Note: Not all of these features need be present for a diagnosis to be made.
Source: Adapted from the DSM-IV-TR (APA, 2000).
When people use the term “dependence,” they are usually referring to a physical
dependence on a substance.
Dependence is characterized by the symptoms of tolerance and withdrawal. While
it is possible to have a physical dependence without being addicted, addiction is
usually right around the corner.
Addiction is marked by a change in behaviour caused by the biochemical
changes in the brain after continued substance abuse. Substance use becomes
the main priority of the addict, regardless of the harm they may cause to
themselves or others. An addiction causes people to act irrationally when they
don’t have the substance they are addicted to in their system.
Addiction encompasses both a mental and physical reliance on a given
substance.
Repeated use of a substance may alter the body’s physiological reactions, leading
to the development of tolerance or a physical withdrawal syndrome.
Tolerance is a state of physical habituation to a drug, resulting from frequent
use, such that higher doses are needed to achieve the same effect.
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A withdrawal syndrome (also called an abstinence syndrome) is a cluster of
symptoms that occur when a dependent person abruptly stops using a particular
substance following heavy, prolonged use. People who experience a withdrawal
syndrome often return to using the substance to relieve the discomfort associated
with withdrawal, which thus serves to maintain the addictive pattern. Withdrawal
symptoms vary with the particular type of drug. With alcohol dependence, typical
withdrawal symptoms include dryness in the mouth, nausea or vomiting,
weakness, increased heart rate, anxiety, depression, headaches, insomnia,
elevated blood pressure, and fleeting hallucinations.
When does drug abuse become drug addiction?
It rarely happens with the first use of a drug. Drug abuse and drug addiction can
be thought of as points along a continuum.
Any use of a mind-altering drug or the inappropriate use of medication
(either prescription or over-the-counter drugs) is drug abuse, but the point
when drug abuse becomes drug addiction is less clear.
Different people may reach the point of addiction at different stages. Scientists
continue to investigate the factors that contribute to the transition to drug
addiction.
Drug addiction is defined as the continued compulsive use of drugs despite
adverse health or social consequences.
Drug-addicted people have lost control of their drug use. Individuals who are
addicted to drugs often become isolated from family or friends, have difficulty at
work or school, may commit crimes, and become involved with the criminal
justice system. For a person addicted to drugs, continuing to take them becomes
the primary focus in life.
By physiological dependence, we mean that a person’s body has changed as a
result of the regular use of a psychoactive drug in such a way that it comes to
depend on having a steady supply of the substance. The major signs of
physiological dependence are the development of tolerance and a withdrawal
syndrome.
Compulsive use of a substance to meet a psychological need.People can also
develop psychological dependence on a drug without becoming physiologically or
chemically dependent. These individuals come to compulsively use a drug to meet
psychological needs. We can think of someone who compulsively uses marijuana
to cope with daily stress, but is not physiologically dependent on the drug. On
the other hand, a person may become physiologically dependent on a drug but
not become a compulsive user. For example, people recuperating from surgery
are often given narcotics derived from opium as painkillers. Some develop signs
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of physiological dependence
nce, such as tolerance and a withdrawal syndrome,
syndr but
do not develop impaired contr
control over the use of these drugs

Prescription drugs are

e int
intended to help us, but can end up
p hurting
h us
when misused or abused.
ed.

1.1.8 Drug Misuse

• Taking a dose at the wrong time
• Forgetting to take a dosedo
• Stopping a medicatio
cation too soon
• Accepting prescriptio tion medication from a friend
• Taking drugs for reas easons other than what they were prescribed
ed for
Prescription Drug Abuse
• Taking someon
someone else’s prescription to self medicate
• Using withoutout a prescription
• Exceeding a re recommended dose
• Taking prescricription medicine in a way other than prescr
scribed
• Taking medicatication to get a high
(Improper Use se to Abuse)
This includes painkillers,
s, co
codeine based cough syrups, anti histamines,
ines, injectable
opioids, sedatives, anabolic
lic st
steroids etc.
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Substances that are commonly abused:
• Stimulants (amphetamines, cocaine)
• Depressants & sedatives (barbiturates)
• Hallucinogens (cannabis, LSD)
• Narcotic analgesics (opium, morphine, codeine)
• Volatile solvents (glue, gasoline)
• Legally sanctioned drugs (antihistaminics, painkillers)
• Steroids
• Tobacco
• Alcohol

Source: UNITED NATIONS OFFICE ON DRUGS AND CRIME , World Drug

Report, 2016

• Substance use and abuse crosses all boundaries:

• Gender
• Age
• Race and Ethnicity
• Socioeconomic Class
• It is widely prevalent, cutting across age, class and gender.
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Source: UNITED NATIONS

NS OFFICE ON DRUGS AND CRIME , W
World Drug
Report, 2016
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 13 Drug Abuse : Problem,
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1.1.9 Prevalence in India
• Cannabis and opium have been traditionally used in India for centuries.
The use of synthetic drugs and psychotropic substances is comparatively
new.
• Information on substance use in India is mostly anecdotal due to the
scarcity of data and reports available only from small-scale surveys.
• An epidemiologic study (Ray 2004) about substance use in India was the
National Household Survey (NHS) in 2000–01, with 40,697 male
respondents age 12 to 60 years in 25 states included in this study.
Alcohol, cannabis, and opiates were found to be the three most commonly
used substances and also the primary substances associated with the
development of a substance use disorder. In the preceding month, 21.4 %
used alcohol; 3.0 % used cannabis; and 0.7 % used opiates, which
translated to 8.7 million users of marijuana and 2 million users of opioids.
These data from the year 2004 are the most comprehensive data on
drug use in the country till now (Pawar et al. 2015).
• Some researchers estimated between 180,000 and 1.1 million users of
injected drugs in the country (Bergenstrom et al. 2013; Solomon et al.
2015).

1.1.10 Warning Signs of Substance Abuse:

• Physical changes
• Emotional changes
• Academic performance
• Social Interactions
• Problems with the family
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Effect of prolonged use of stimulants

40% start substance abuse between 13-20 years

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1.1.11 Protective factors

• a strong bond between children and their families;
• parental involvement in a child’s life;
• supportive parenting that meets financial, emotional, cognitive, and social
needs; and
• clear limits and consistent enforcement of discipline.
• success in academics and involvement in extracurricular activities;
• strong bonds with pro-social institutions, such as school and religious
institutions; and
• acceptance of conventional norms against drug abuse.
• Involvement in sports and cultural activities
1.1.12 Risk Factors
• ineffective parenting;
• a chaotic home environment;
• a caregiver who abuses substances, suffers from mental illness, or engages
in criminal behavior.
• inappropriate classroom behavior, such as aggression and impulsivity;
• academic failure;
• poor social coping skills;
• association with peers with problem behaviors, including drug abuse; and
• misperceptions of the extent and acceptability of drug-abusing behaviors
in school, peer, and community environments.
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1.1.13 Summary
Drug abuse is a major con concern in both developing and developed d countries.
co A
drug is a chemical substanc
stance used in the treatment, prevention, orr diagnosis
di of
disease or to enhance physical
hysical or mental well-being. Substance abusbuse refers to
the harmful or hazardous us use of chemicals, including alcohol and d illicit
il drugs.
Substance dependence is d defined as a maladaptive pattern of use that results in
significant impairment or distress. Drug use is a broad term to cover the
consumption of any substa stances, and there are stages: drug-free,
ee, ex
experimental
use, recreational use, and
nd h harmful use. The Diagnostic and Statistical
ical Manual of
Mental Disorders (DSM-IV IV-TR) a diagnostic manual for clinicians
linicians provides
definitions for substance ababuse, substance dependence, and drug use.
1.1.14 Short questions:
1. What is drug/substa
stance abuse?
2. What are the common
mon susubstances of abuse?
3. Why does substance ce abuse occur??
4. How can it be treated/
ted/prevented?
5. Role of a teacher/educ
educator?
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1.1.15 Long questions
1. What is a drug? Write about its use, misuse and about dependency and
withdrawal syndrome?
2. What is drug abuse/ substance abuse? What are the sign and symptoms
and the risk factor of substance use?
1.1.16 Suggested readings
1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and
Prevention,Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
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B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.2 Author : Dr. Nirmall Singh

Edited by: Mr. Jaswinde
nder Singh

Introduction to Drugs of A Abuse; Withdrawal Symptom; Short Term

erm and Long
Term Effects
1.2.0 Overview
1.2.1 Learning Objective
1.2.2 Introduction
1.2.3 Withdrawal Symptoms ms
1.2.3.1 Physical Depen
ependence
1.2.3.2 Psychological
cal Dependence
1.2.4 Factors Affecting Withdra
ithdrawal
1.2.5 Stimulants
1.2.5.1 Street Nameses
1.2.5.2 CNS Stimulan
timulants
1.2.6 Side Effects of Stimulants
mulants
1.2.7 Methods of Use
1.2.8 Mechanism of Action
1.2.9 Actions of Cocaine
1.2.10 Adverse Effects Off Co
Cocaine
1.2.11 Cocaine Withdrawal al Ef
Effects
1.2.12 Summary
1.2.13 Short Questions
1.2.14 Long Questions
1.2.15 Suggested Readings

1.2.0 Overview
This chapter provides an overview of withdrawal symptoms, with th a focus on
stimulants like cocaine.. IIt explains physical and psychological
ological dependence,
d
factors influencing withdra
drawal, and the various forms and street eet names of
stimulants. The chapterr d delves into the mechanisms and actionsns of cocaine,
detailing its short-term an and long-term effects. It also discuss
usses cocaine
withdrawal effects and sug suggests questions for deeper understandi
standing and
additional readings for comp
omprehensive study.
1.2.1 Learning Objective e
To make the learner familiar
iliar with the:
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 19 Drug Abuse : Problem,
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● Drug abuse
● Withdrawal symptoms
● factors affecting withdrawal
● Short term and long term effects of different drugs.
1.2.2 Introduction:
This chapter helps the readers to understand the concept of withdrawl
symptoms, types of dependence, side effects of various drugs, their short and
long term effects.

1.2.3 Withdrawal Symptoms

礏 Group of symptoms that occur upon the abrupt discontinuation or
decrease in intake of medications or recreational drugs.
礏 In order to experience the symptoms of withdrawal, one must have first
developed a form of drug dependence
磘 Physical Dependence,
磘 Psychological Dependence,
磘 or Both.
1.2.3.1 Physical Dependence
A person who is physically dependent on a drug is used to functioning with the
drug present.
1.2.3.2 Psychological Dependence
A person who is psychologically dependent on a drug may feel they have to use
the drug in order to function effectively, or to achieve emotional satisfaction.

Withdrawal
If a person who is physically or psychologically dependent suddenly stops taking
the drug, they may experience withdrawal symptoms as their body readjusts to
functioning without the drug.
There are many types of withdrawal symptom, such as depression, irritability,
cramps, nausea, sweating and problems with sleep.

1.2.4 FACTORS AFFECTING WITHDRAWAL

The symptoms of drug withdrawal, and the length of that withdrawal, vary
depending on factors including :
1. Length of time abusing the substance (Acute & Chronic)
2. Type of substance abused
3. Method of abuse (e.g., snorting, smoking, injecting, or swallowing)
4. Amount taken each time
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5. Family history and genetic
gene makeup
6. Medical and mental
al h
health factors etc.
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1.2.5 STIMULANTS
Stimulants are the agent
gents that primarily activate or stimulate CNS
C (central
nervous system) to incre
increase neural activity in the brain.
Stimulants tend to makeake people feel more alert, awake, or confident; and can
produce feelings of happi
ppiness or euphoria.
Stimulants increase heart rate, body temperature and blood press essure. reduce
a person’s appetite, dilat
ilate pupils.
Person has difficulty in sl
sleeping, and is talkative or agitated.
Some stimulants are also
als hallucinogenic.
Large quantities can cause
caus anxiety, panic, seizures, headaches hes, stomach
cramps, aggression andnd paranoia.
This class of drugs inclincludes prescription drugs such as amphetamines
amph
(Adderall® and Dexedrine
edrine®), methylphenidate (Concerta® and Ritalin®),
dietaids (such as Did Didrex®, Bontril®, Preludin®, Fastin®,, Adipex
A P®,
Ionomin®, and Meridi eridia®) and illicitly produced drugs such as
methamphetamine, cocaiocaine.
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1.2.5.1 Street names
Bennies, Black Beauties, Cat, Coke, Crank, Crystal, Flake, Ice, Pellets, R-Ball,
Skippy, Snow, Speed, Uppers, Vitamin R, Smart drug, JIF, Kibbles and bits.

Looks like: Stimulants come in the form of pills, powder, rocks, injectable liquids

Clinically they are useful in various conditions like:

Attention deficit disorder (ADD)
ADHD (attention deficit hyperactive disorder)
Narcolepsy (sleep disorder, where a person fall asleep several times a day)
Apnoea in premature infants
Obesity (anorectic agents)
Also used to
stay alert and focused,
lose weight,
stay awake, and get high

1.2.5.2 CNS stimulants:

1. Psychomotor stimulants
Cause: Excitement, Euphoria, Decrease feeling of fatigue & Increase motor
activity
eg. Methylxanthines (caffeine, theobromine, theophylline), nicotine, cocaine,
amphetamine, atomoxetine, modafinil, methylphenidate.

2. Hallucinogens (psychotomimetic):
Affect thought, perception, and mood, therefore produce
• profound changes in thought patterns & mood,
• little effect on the brain stem & spinal cord
eg. Lysergic acid diethylamide (LSD), Phencyclidine (PCP), Tetrahydrocannabinol
(THC), Rimonabant.

3. Mild stimulants
>caffeine (in tea, coffee and cola drinks)
>nicotine (cigarettes)
>ephedrine (used in medicines for bronchitis, hay fever and asthma)

4. Stronger stimulants
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>amphetamines (speed, crystal meth, ice)
>cocaine
>ecstasy
>slimming tablets (Duromine, TenuateDospan, Ponderax)
>khat

1.2.6 Side effects of stimulants

Side effects of stimulants on body include…
● tremor, headache, flushed skin, chest pains with palpitations, excessive
sweating, vomiting, and abdominal cramps.
Side effects on mind include…
● agitation, paranoia, hallucinations/hearing things, panic, aggression,
depression and suicidal tendencies.
Overdose can cause…
● high fever, convulsions, stroke, or heart problems like cardiac arrest,
sometimes leading to death. Physical activity (dancing or running) can
increase risks by putting more pressure on heart.
Cocaine (Stimulant)
● Cocaine is a powerful addictive stimulant from the leaves of the coca plant
Erythroxylon coca native to South America.
● Cocaine, the deadly white powder, creates a psychological dependency on the
drug.
● Medically it can be used as local anesthesia for some surgeries, cocaine is an
illegal drug.
● Tolerance develops very quickly making becoming addicted easier.
● People often mix cocaine with other drugs, such as heroin, marijuana,
tranquilizers, and amphetamines.

Street Names: “Coke, Snow, Snow White, Rock, Powder, Blow, Flake, Charlie,
Yeyo (Spanish), Nose Candy, Johnny, Sugar, Toot, Happy Trails” (CESAR)

1.2.7 Methods of Use:

Snorted (“sniffing the powder into the nasal passages”), injection, ingested orally,
rubbed on the gums, sprinkled on cigarettes or marijuana joints

Cocaine is produced in two main forms:

磘 Powdered cocaine that is smoked, snorted, or injected
磘 Rock form or “crack” cocaine that is typically smoked
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 24 Drug Abuse : Problem,
Management and Prevention
Cocaine (highly addictive drug)

1.2.8Mechanism of action:
Blockade of reuptake of the monoamines (NE, serotonin and dopamine)
Thus, potentiates and prolongs the CNS and peripheral actions of these
monoamines.

Initially produces the intense euphoria by prolongation of dopaminergic effects in

the brain’s pleasure system (limbic system).
Chronic intake of cocaine depletes dopamine. This depletion triggers the vicious
cycle of craving for cocaine that temporarily relieves severe depression.

1.2.9 Actions of cocaine:

A. CNS-behavioral effects: result from powerful stimulation of cortex and
brain stem.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 25 Drug Abuse : Problem,
Management and Prevention
• increase mental awareness, feeling of well being, euphoria, hallucinations
and delusions of paranoia.
• increases motor activity, and at high doses, it causes tremors and
convulsions, followed by respiratory and vasomotor depression.
B. Sympathetic NS: peripherally potentiate the action of NE→ fight or flight
C. Hyperthermia:
D. local anesthetic action:

1.2.10 Adverse effects of cocaine:

1. Anxiety reaction that includes: hypertension, tachycardia, sweating, and
paranoia.
Because of the irritability, many users take cocaine with alcohol. A
product of cocaine metabolites and ethanol is cocaethylene, which is also
psychoactive and cause cardiotoxicity.
2. Depression: cocaine stimulation of the CNS is followed by a period of
mental depression.
3. Addicts withdrawing from cocaine exhibit physical and emotional
depression as well as agitation.
4. Toxic effects:
5. Seizures, fatal cardiac arrhythmias

Very short half-life of less than an hour, meaning that it quickly takes effect
and also rapidly leaves the bloodstream.
Short-term Effects of Cocaine
磘 Elevate Heart Rate, Temperature, and Blood Pressure.
磘 Extreme Euphoria,
磘 Heightened Energy Levels
磘 Elevated Self-confidence,
磘 Loss of appetite (hunger)
磘 Nausea
磘 Disturbed sleep pattern
磘 Anxiety
磘 Paranoia
磘 Restlessness
Long-term Effects of Cocaine
• permanent damage to blood vessels of the heart and brain
• stroke
• high blood pressure
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 26 Drug Abuse : Problem,
Management and Prevention
• liver and kidney and lung damage
• severe depression
• addiction
• hallucinations
• death
Effects on Cardiovascular
• irregular heartbeats
• in some cases may cause a heart attack (athletes taking energy drink
mountain dew)

Psychological effects
• decreased sense of fatigue
• mood swings
• increase sense of confidence
• increase your anxiety and irritability

1.2.11 Cocaine Withdrawal Effects

3-Phases:
礎 Initial Crash period: 9-hours and four days
A person may sleep for days; increase in appetite, feel depressed and agitated.
礎 Acute withdrawal: 1-3 weeks
irritability, fatigue, depression, insomnia, anxiety, and drug cravings.
礎 Extinction period: several months
Cravings for cocaine along with depressed moods, Suicidal thoughts
1.2.12 Summary
The chapter discusses withdrawal symptoms, physical and psychological
dependence, and the various forms and street names of stimulants. Withdrawal
symptoms include depression, irritability, cramps, nausea, and problems with
sleep. Factors affecting withdrawal include length of time abusing the substance,
method of abuse, and medical and mental health factors. Stimulants are agents
that primarily activate or stimulate the central nervous system to increase neural
activity in the brain.
1.2.13 Short questions:
1. What are stimulants? Give examples.
2. Define Physical dependence and Psychological dependence.
3. Give Side effects of stimulants on body and mind.
1.2.14 Long questions
1. Explain Short-term effects and Long-term effects of cocaine.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 27 Drug Abuse : Problem,
Management and Prevention
2. Explain Cocaine withdrawal effects.

1.2.15 Suggested readings

1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 28 Drug Abuse : Pro
Problem,
Management
ent and Prevention
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abuse:
Abuse Problem,

Semester-II Management and P

Prevention

Lesson No. 1.3 Author : Dr. Nirmal

Nir Singh
Edited by: Mr. Jaswin
aswinder Singh

AMP
AMPHETAMINE AS STIMULANT
1.3.0 Overview
1.3.1 Learning Objective
1.3.2 Introduction:
1.3.3 Amphetamines Are
1.3.3.1 Examples off Amphetamines
1.3.4 Mechanism of Action:n:
1.3.5 Adverse Effects:
1.3.6 Physical Symptoms
1.3.7 Psychological Symptom
toms
1.3.8 Short Term Effect off Amphetamine:
Amph
1.3.9 Long Term Effect off Am
Amphetamine:
1.3.10 Withdrawal Symptoms
ptoms of Amphetamine
1.3.11 Taking Amphetamine ines with Other Drugs
1.3.12 Summary
1.3.13 Short Questions
1.3.14 Long Questions
1.3.15 Suggested Readings

1.3.0 Overview
This chapter provides an
n ov
overview of amphetamines as stimulants.. It introduces
amphetamines, their examamples, and street names. The chapter er explores
e the
mechanism of action, adve
dverse effects, physical and psychological symp
symptoms, as
well as short-term and lon
long-term effects of amphetamine use. It also discusses
withdrawal symptoms andnd the risks of mixing amphetamines with h other
o drugs.
Suggested questions and re
readings for further understanding are included.
include
1.3.1 Learning Objective
To learn about:
● Stimulants
● Amphetamines
● Mode of action
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 29 Drug Abuse : Problem,
Management and Prevention
● Adverse effects
● withdrawal symptoms
● Its use with other drugs
1.3.2 Introduction:
This chapter gives a brief idea about the amphetamines, their class, mechanism
of action, signs and symptoms of amphetamines.
1.3.3 AMPHETAMINES ARE :
礎 Strong central nervous system stimulants
礎 used in ADHD, weight loss, and narcolepsy.
礎 used to increase alertness, increase endurance, and enhance moods.
礎 Amphetamines, also known as “bennies,” “speed,” “uppers,” and “wake-
ups”
礎 It usually comes as a grey, white, or dirty white, pale pink or yellow
powder.
礎 This drug can be snorted, swallowed, injected or smoked, it has also been
known to be mixed with liquid and drank.
礎 Brand Names: Biphetamine, Dexedrine, Adderall, Vyvanse
礎 Street Names: Black Beauties, Truck Drivers, Uppers, Speed, LA
Turnaround, Hearts, Copilots, Eye-openers, Lid Poppers, Crosses,
Bennies, Whizz, Billy

1.3.3.1 Examples of amphitamines:

• dextroamphetamine is the major member of this class.
• methamphetamine (speed) is a derivative of amphetamine that is smoked
and is preferred by many abusers. Street Names: Meth, Crystal, Crystal
Meth, Ice, Glass, Redneck Cocaine, Crank, Speed, Tina, Tick-Tock,
Scootie, Yellow Barn/Powder, Hot Ice, Chalk
• Methylenedioxymethamphetamine (also known as MDMA, or Ecstasy) is a
synthetic derivative of methamphetamine with both stimulant and
hallucinogenic properties.
Street Names: Ecstasy, Molly, E, X, XTC, ADAM, Rolls, Pills, Love Drug, Go

1.3.4 Mechanism of action:

Amphetamine, act by
– releasing intracellular stores of catecholamines.
– also inhibits MAO, high level CAOs are readily released into synaptic spaces.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 30 Drug Abuse : Problem,
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Actions:
a. CNS: the major behavioral effects of amphetamine result from a combination
of its dopamine and NE release enhancing properties.
• Amphetamine stimulates the entire cerebrospinal axis, brainstem, and
medulla.
• This lead to increase alertness, decrease fatigue, depressed appetite, and
insomnia.
b. Sympathetic Nervous System: indirectly stimulating the receptors through
NE release.

1.3.5 Adverse effects:

The amphetamines may cause addiction, dependence, tolerance, and drug
seeking behavior.
a. CNS: insomnia, irritability, weakness, dizziness, tremor, hyperactive reflex,
confusion, delirium, panic states, and suicidal tendencies,
Chronic amphetamine use produce a state of “amphetamine psychosis”
long-term amphetamine causes psychic and physical dependence, tolerance to its
effects may occur within a few weeks.
b. CVS: palpitations, cardiac arrhythmia, high BP, anginal pain, and circulatory
collapse. Headache, chills, and excess sweating may also occur.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 31 Drug Abuse : Problem,
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c. GIT: anorexia (loss of appetite), nausea, vomiting, abdominal cramps, and
diarrhea.
The anorectic effect of amphetamine is due to its action in the lateral
hypothalamic feeding center.

1.3.6 Physical Symptoms

磘 Oversleeping
磘 Excessive hunger
磘 Pain and discomfort in the stomach as a result of overeating
磘 Lack of coordination
磘 Shaking and the potential for seizures
磘 Dehydration
磘 Tachycardia
磘 Arrhythmia
磘 Cardiac arrest

1.3.7 Psychological Symptoms

磘 Irritability
磘 Short-temper
磘 Hypersensitivity to light and sound
磘 Drug cravings
磘 Extreme mood Depression
磘 Anxiety
磘 Suicidal ideation
磘 Hallucinations
磘 Sensory misperception
磘 Auditory hallucinations
磘 Psychosis

1.3.8 Short term effect of Amphetamine:

These drugs are prescribed by doctors for treatment of narcolepsy (a sleep
disorder), attention deficit hyperactivity disorder (ADHD), and sometimes for
decreasing obesity. But if these drugs are not taken according to prescription and
are used for longer period, such drugs have some side effects also which includes
short term effects, long term effects and if abused for a longer period of time they
also produce severe withdrawal symptom when not provide to the body. These
effects are mentioned as below:
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 32 Drug Abuse : Problem,
Management and Prevention
Short-term effects of amphetamines may include:
abdominal pain
abrupt shifts in thought and speech that can make people difficult to
understand
blurred vision
chest pain
decreased appetite
difficulty urinating
dizziness
dry mouth
enlarged (dilated) pupils
euphoria and rush
faster reaction times
feeling more awake and alert, reduced need for sleep and difficulty
sleeping
feeling more energetic
feelings of euphoria, excitement and a sense of wellbeing
feelings of increased strength
hallucinations
headaches
hyperthermia
increased activity and wakefulness
increased attention and decreased fatigue
increased body temperature
increased breathing rate
increased confidence and motivation
increased heart rate and blood pressure
increased libido
increased respiration
increased sweating
increased talkativeness
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 33 Drug Abuse : Problem,
Management and Prevention
irregular heart beat, palpitations
irritability, hostility and aggression
itching, picking and scratching.
nervousness, anxiety, agitation and panic
nosebleed
paranoia
profuse sweating
rapid/irregular heartbeat
reduced appetite
repetition of simple acts
sense of power and superiority over others
shortness of breath (from smoking it)
stomach cramps
stomach irritation (if swallowed)

1.3.9 Long term effect of Amphetamine:

Repeated abuse for a longer period of time can lead to:
● breakdown of muscle and malnutrition
● cardiovascular problems, including stroke
● feelings of paranoia and hostility
● psychosis and delusions
● reduction in cognitive ability
Some of the long-term effects of amphetamine use include:

● breathlessness
● chronic sleeping problems
● cracked teeth and other dental
● damage to the heart muscle
● depression, anxiety and tension
● heart attack and heart failure
● high blood pressure and rapid and irregular heartbeat
● increased risk of stroke
● kidney failure
● malnutrition and rapid weight loss due to reduced appetite
● muscle rigidity
● panic and confusion
● paranoia
 B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 34 Drug Abuse : Problem,
Management and Prevention
● poor memory and concentration.
● reduced immunity and increased susceptibility
● violence

1.3.10 Withdrawal symptoms of Amphetamine

● Aches and pains
● Bodily movements and twitches
● Depression
● Dreams that are often vivid and sometimes unpleasant
● Fatigue and increased need for sleep
● Increased appetite
● Irritability and/or agitation
● Slowed reaction and movement

Withdrawal symptoms from amphetamine drugs are not as severe that they
cause death but these are put the abuser into very uneasy and uncomfortable
situations. Detoxification of such drugs can be done under the supervision of
medical practitioners

Withdrawal Factors

The time it takes for withdrawal signs to set in, the severity of symptoms one will
experience, and the length of time it will take to complete withdrawal from
amphetamines will depend on several factors, including:

● The length of time a person has been using amphetamines.

● The dose and frequency of that dose at the time of last use.
● Whether or not a person is also using other substances.
● Psychological and physical ailments that may complicate withdrawal.
● Biological factors such as gender, age, weight, and/or genes, which can affect
how each person metabolizes amphetamines during detox.

1.3.11 Taking amphetamines with other drugs

Sometimes a person is having the habit of polyabuse but in such cases the effects
and side effects of amphetamines with other drugs are unpredictable. So it
should not be mixed with other drugs like alcohol, OTC drugs (over the counter)
and even prescribed medicines also.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 35 Drug Abuse : Problem,
Management and Prevention
Amphetamine with stimulant type of drugs increases the effect of stimulant effect
due to synergism and exerts more pressure on heart walls and can lead to heart
attack.

Similarly, amphetamines when consumed with depressants like alcohol, it also

exerts pressure and keeps the body under stress.

1.3.12 Summary

The chapter provides knowledge of amphetamines, including their mechanism of

action, adverse effects, physical and psychological symptoms, short-term and
long-term effects, withdrawal symptoms, and risks of mixing with other drugs.
Amphetamines are strong central nervous system stimulants used to increase
alertness, increase endurance, and enhance moods. They can be snorted,
swallowed, injected, smoked, or mixed with liquid and drank. Amphetamine
stimulates the entire cerebrospinal axis, brainstem, and medulla, and indirectly
stimulates the sympathetic nervous system. Adverse effects include addiction,
dependence, tolerance, and drug seeking behavior. Methamphetamine is a
synthetic derivative of amphetamine with both stimulant and hallucinogenic
properties. Short-term amphetamine use can cause insomnia, irritability,
weakness, and panic states, while chronic use can lead to psychic and physical
dependence.

1.3.13 Short questions:

1. Define amphetamines.
2. Give examples and Street Names of amphetamines.
3. Give adverse effects of amphetamines.
1.3.14 Long Questions
1. Explain Physical Symptoms of amphetamines.
2. Explain Psychological Symptoms of amphetamines.
3. What are amphetamines, its mode of action, its adverse effect and
withdrawal symptoms?

1.3.15 Suggested readings

1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 36 Drug Abuse : Problem,
Management and Prevention
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012).
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 37 Drug Abuse : Pro
Problem,
Management
ent and Prevention
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.4 Author : Dr. Nirmal

Nir Singh
Edited by: Mr. Jaswin
aswinder Singh

NICOTINE AS STIMULANT
NI
1.4.0 Overview
1.4.1 Learning Objective
1.4.2 Introduction
1.4.3 Smoking Tobacco
obacco Use
1.4.4 Smokeless Tobacco UsUse
1.4.5 Actions Of Nicotine
1.4.6 Adverse Effects
1.4.7 Withdrawl Symptoms s
1.4.8 Summary
1.4.9 Suggested Questions
1.4.10 Suggested Readings

1.4.0 Overview
In this chapter, we delve in
into the exploration of nicotine as a stimulant
ulant found in
tobacco. We examine both th smoking and smokeless tobacco use, as well as the
actions of nicotine on thee c
central nervous system and its peripheral
eral effects. The
chapter also addresses the
he adverse effects of nicotine, withdrawal sym
ymptoms, and
concludes with suggested ed questions and recommended readings s for a deeper
understanding.
1.4.1 Learning Objective
To know about:
● Nicotine
● Smoking and smokel okeless tobacco
● Action of nicotine
● Withdrawal symptom oms
● Adverse effects
1.4.2 Introduction:
• Nicotine is found in the leaves of Nicotianarustica in amounts nts of 2–14%,
the tobacco plant Nicotianatabacum, Duboisiahopwo
pwoodii and
Asclepiassyriaca.
• It constitutes approx
oximately 0.6–3.0% of the dry weight of tobacco
obacco. It is the
active ingredient in
n toba
tobacco.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 38 Drug Abuse : Problem,
Management and Prevention
• Used in smoking cessation therapy.
• Nicotine remains important, because:
− it is 2nd only to caffeine as the most widely used CNS stimulant
− and 2nd only to alcohol as the most abused drug.

1.4.3 Smoking tobacco use

• Beedis
• Cigarettes and cigars
• Chillum
• Hookah

1.4.4 Smokeless tobacco use

• Khaini
• Gutkha
• Paan with tobacco
• Paan masala
• Mawa
• Mishri, gudakha and toothpastes

1.4.5 Actions of Nicotine

Low dose: ganglionic depolarization

High dose: ganglionic blockade
I. CNS:
1. Low dose: euphoria, arousal, relaxation, improves attention, learning,
problem solving and reaction time.
2. High dose: CNS paralysis, severe hypotension (medullary paralysis)
II. Peripheral effects:
• Stimulation of sympathetic ganglia and adrenal medulla→↑ Blood Pressure
and Heart Rate
• Stimulation of parasympathetic ganglia→↑ motor activity of the bowel
• At higher doses, BP falls & activating ceases in both GIT and bladder
• Most cigarettes contain 6-8 mg of nicotine, by inhaling tobacco smoke, the
average smoker takes in 1 to 2 mg of nicotine per cigarette.
• the acute lethal dose is 60 mg,
• 90% of nicotine inhaled in smoke is absorbed.
• Tolerance to toxic effects of nicotine develops rapidly.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 39 Drug Abuse : Problem,
Management and Prevention

1.4.6 Adverse effects:

• CNS; irritability and tremors
• Intestinal cramps, diarrhea
• ↑HR & BP
• Withdrawal syndrome
• physical dependence on nicotine develops rapidly.
• Transdermal patch and chewing gum containing nicotine

1.4.7 WITHDRAWL SYMPTOMS:

1. Urges to smoke
2. Depressed mood
3. Difficulty sleeping or sleep disturbances
4. Irritability, frustration or anger
5. Anxiety
6. Difficulty concentrating
7. Restlessness
8. Decreased heart rate
9. Increased appetite (hunger) or weight gain
10. Decreased adrenaline and cortisol (brain chemicals)

The symptoms of nicotine withdrawal can begin within 30-minutes of last

use of tobacco.

1.4.8 Summary
Nicotine is found in tobacco leaves and is used in smoking cessation therapy. It
has various effects on the central nervous system and peripheral effects. Nicotine
withdrawal symptoms can begin within 30 minutes of last use of tobacco. The
average smoker takes in 1 to 2 mg of nicotine per cigarette, and tolerance to toxic
effects of nicotine develops rapidly.
1.4.9 Suggested questions:
1. What is nicotine and from where it is obtained?
2. How is tobacco consumed?
3. What are the effects and withdrawal symptoms of tobacco?

1.4.10 Suggested readings

1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 40 Drug Abuse : Problem,
Management and Prevention
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 41 Drug Abuse : Pro
Problem,
Management
ent and Prevention

B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.5 Author : Dr. Amteshwar Sing

ingh Jaggi
Edited by: Mr. Jaswin
aswinder Singh

Drugs of Abuse
1.5.0 Overview
1.5.1 Learning Objective
1.5.2 Introduction to Substa
stance/Drug Abuse
1.5.3 Drug Dependency
1.5.4 Withdrawal Symptoms ms
1.5.5 Physical Dependence
1.5.6 Psychological depende
ndence
1.5.7 Opium
1.5.8 Therapeutic uses off OOpium and Morphine
1.5.9 Mode of Administration
tion in tthe body:
1.5.10 Short Term Effects
1.5.11 Signs of Morphine OvOverdose
1.5.12 Dependency and withd
withdrawal Symptoms
1.5.13 Withdrawal Symptoms
ptoms of opiates
1.5.14 Cannabis Sativa
1.5.14.1 Cannabis (Bha
(Bhang)
1.5.14.2 Marijuana,a, Hashish,
Ha Hashish Oil
1.5.14.3 Ganja vs Hashish
Ha
1.5.15 Immediate Effects of Cannabis
1.5.16 Short Term Bad Effeffects
1.5.17 Long Term Bad Effec
ffects
1.5.18 Dependency
1.5.19 Marijuana Myths and Facts
1.5.20 Summary
1.5.21 Suggested questionsns
1.5.22 Long questions
1.5.23 Suggested readings
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 42 Drug Abuse : Problem,
Management and Prevention
1.5.0 Overview
This chapter delves into substance and drug abuse, exploring drug dependency,
withdrawal symptoms, physical and psychological dependence. It delves into the
use and effects of opium, morphine, and heroin, alongside cannabis sativa. The
chapter discusses immediate and long-term effects, dependency, and dispels
myths regarding marijuana.

1.5.1 Learning Objective

To make students understands:
● Drug abuse
● Drug dependency
● Withdrawal symptoms
● Physical dependence
● Opium and opiates
● Cannabis and their derivatives
● Adverse effects
● Dependency
● Myth and facts of Marijuana
1.5.2 Introduction to Substance/Drug Abuse
● Use of a drug in which the user consumes the substance or drugs which
are harmful to themselves
● In 2013, drug use disorders resulted in 127,000 deaths
● In 1990, the number was 53,000
● The highest number of deaths are from opioid use disorders at 51,000

1.5.3 Drug Dependency

Body becomes tolerant to a drug quickly. Person takes the drug more and
more of the drug to feel the same effects. In doing that, the body becomes
dependent, on the drug.

1.5.4 Withdrawal Symptoms

The absence of a drug in the body induces development of abnormal
symptoms
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 43 Drug Abuse : Problem,
Management and Prevention

1.5.5 Physical Dependence

It is a physical condition caused by chronic use of a drug of abuse, in
which abrupt or gradual drug withdrawal causes unpleasant physical symptoms
Examples: increase in heart rate, blood pressure, sweating, tremors,
seizures (epileptic fits)

1.5.6 Psychological dependence

It is a form of dependence that involves emotional–
motivational withdrawal symptoms upon cessation of drug use.
Examples: Uneasiness, dissatisfaction, reduced capacity to experience pleasure,
development of anxiety

1.5.7 Opium
It is the dried latex obtained from the opium poppy (scientific
name: Papaversomniferum)
Morphine and Heroin
Opium latex contains approximately 12 percent of the analgesic (pain
relieving) alkaloid morphine
Morphine is chemically processed to produce heroin
B.A./B.A.(Honours)/B.Com./BCA
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Management
ent and Prevention

Heroin/Brown Sugar
erated form of heroin and is also called smack
Brown sugar is an adulterat mack
It is formed by mixing the drug with talcum powder, powdered milk, sugar and
other substances

1.5.8 Therapeutic useses of Opium and Morphine

Morphine is an opioid
ioid pain mmedication (Narcotic Analgesic)
Morphine is used to treat
at m
moderate to severe pain
Example: Surgical pain, Neu
Neuropathic pain, cancer pain etc.

1.5.9 Mode of Administratio

ration in the body:
Oral
Smoking
injection
1.5.10 Short Term Effects cts
These produce a stat
state of ‘HIGH’ which is:
Euphoria: It is an affectiv
ctive state in which a person experiences es pleasure or
excitement and intense feeli
eelings of well-being and happiness
False Feelings
o There is sensations soof warmth and safety, when they are high
h on
o heroin
o People often disconne
nnect from surrounding and there is a feeling
ling of floating,
dream-like state
o Intense relaxation,
ion, decreased perception of pain
Dangerous Effects of Hero
Heroin
Many people find herheroin very unpleasant
It can cause immediat
diate vomiting
Suppressing breathing
hing, cough reflex
Increases the risk of choking
c
It also causes constipa
tipation
Harmful Effects of Opiates
iates
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● Nausea
● Vomiting.
● Itchy skin
● Appetite loss
● Constricted, or pinpoint pupils.
● Urinary retention
● Constipation
● Shallow or slowed breathing
● Altered or irregular heart rate and rhythm.
● Chest pain.
● Cyanosis (blue tint to skin, lips, fingernails, etc.)
● Dizziness
● Confusion

1.5.11 Signs of Morphine Overdose

● Uncontrolled vomiting
● Breathing difficulties/respiratory arrest
● Bradycardia (slowed heartbeat)/cardiac arrest
● Convulsions
● Loss of consciousness
1.5.12 Dependency and withdrawal Symptoms
● When morphine is used in large doses and/or abused, the user can
quickly develop a physical and psychological addiction to the drug.
● Morphine withdrawal symptoms start to take place as soon as 6-12 hours
after the last dose
● Early onset withdrawal symptoms include watery eyes, yawning and
sneezing.

1.5.13 Withdrawal Symptoms of opiates

First 6-12 Symptoms usually present within six to 14 hours after

hours quitting the drug. Anxiety, mood swings and drug cravings
are often first symptoms.

15-48 Flu-like symptoms, such as sweating, chills, muscle aches,

hours fever and runny nose
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 46 Drug Abuse : Problem,
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3-5 days Most physical symptoms begin to fade. Muscle aches start to
curb, along with feelings of nausea. Psychological symptoms
usually persist.

> 6 days Physical symptoms subside, anxiety, irritability, depression

and drug cravings may continue for several weeks to months

Runny nose
Watery eyes
Fever
Vomiting
Nausea
Headaches
Sweating
Chills
Muscle aches
Diarrhea
Rapid heartbeat
Hypertension
Agitation
Anxiety
Irritability
Depression
Disorientation
Insomnia
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 47 Drug Abuse : Problem,
Management and Prevention

1.5.14 Cannabis Sativa

● Its seeds are chiefly used to make hempseed oil which can be used for
cooking, lamps, lacquers, or paints.
● The flowers (and to a lesser extent the leaves, stems, and seeds)
contain psychoactive chemical compounds known as cannabinoids (THC)
that are consumed for recreational and medicinal purposes
1.5.14.1 Cannabis (Bhang)
● Cannabis is mostly used recreationally
● It may also be used for religious or spiritual purposes
● It consists of the leaves and plant tops of the plant.
● It is usually consumed as an infusion in beverage form, and varies in
strength according to how much cannabis is used in the preparation.
● Typically, bhang is the most commonly used form of cannabis in religious
festivals.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 48 Drug Abuse : Problem,
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1.5.14.2 Marijuana, Hashish, Hashish Oil
● Marijuana (Ganja) is the mixture made of flowers, leaves and small stems
of Cannabis sativa
● Hashish (Charas) is a paste made of the resinous secretions which store in
the female flowers (so only the female individuals can deliver hashish), of
an intense coffee color
● Hashish is more powerful than marijuana, containing 40 % THC compared
to 10 % in marijuana
● Hashish oil is the essential oil of the female Cannabis Sativa plant

1.5.14.3 Ganja vs Hashish

Mode of Abuse
● Ganja and Hashish are usually smoked as a cigarette (called a joint or a
nail) or in a pipe or bong
● Some users also mix marijuana into foods or use it to brew tea.

1.5.15 Immediate Effects of Cannabis

● The effects of smoking hashish can last between one and three hours
● People feel relaxed, euphoric, drowsy, sedated, and silly,
● Hashish enhances their senses of sight, smell, hearing, taste and time.
Colors are more vivid and time moves slowly
● Contrary to popular belief, illusions and hallucinations occur infrequently.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 49 Drug Abuse : Problem,
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1.5.16 Short Term Bad Effects
● Problems with memory and learning
● Distorted perception (sights, sounds, time, touch)
● Difficulty in thinking and problem solving
● Loss of coordination;
● Increased heart rate, High blood pressure. This can be observed when the
blood vessels in the eyes dilate
● Anxiety, and panic attacks
● Hashish reduces your ability to understand what other people are saying,
to solve problems and to concentrate

1.5.17 Long Term Bad Effects

● People who smoke marijuana often have the same respiratory problems
● These individuals may have daily cough and phlegm, symptoms of chronic
bronchitis, and more frequent chest colds.
● They are also at greater risk of getting lung infections like pneumonia
● Chronic use of marijuana can reduce testosterone levels and production of
sperms in men
● In women, follicle-stimulating hormone, luteinizing hormone are reduced.
The menstrual cycle can also be affected.

1.5.18 Dependency
● Marijuana and cannabis do not provoke physical dependence,
● They can generate a great psychological dependence. Symptoms induce
anxiety, tension, insomnia, lack of appetite and temporary irritability, that
pass after a week.
● The symptoms will start within a day of not using hashish, peak on days
second and three of withdrawal, and disappear within a few weeks
● Some people keep having symptoms, such as nightmares and depression,
for months after they quit smoking hashish

1.5.19 Marijuana Myths and Facts.

MYTH: Marijuana is safe because it is a plant.

FACT: Many plants are toxic and unsafe for human use, including marijuana.
MYTH: Marijuana users do not go on to use other drugs.
FACT: Studies show that marijuana users may have a predisposition to use other
drugs.
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 50 Drug Abuse : Problem,
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MYTH: Marijuana wears off in a few hours.
FACT: Because marijuana is stored in the body, its effects may be felt for days or
weeks following ingestion.
MYTH: Marijuana relieves stress.
FACT: Marijuana, like all drugs, merely postpones coping with problems and
deadlines; marijuana can lead to depression.
MYTH: Marijuana is safer than alcohol.
FACT: Marijuana contains carcinogenic chemicals, and it is a dangerous
substance that should not be considered a "safe" alternative to other drugs.
MYTH: Marijuana expands the mind.
FACT: Marijuana clouds the mind, interfering with memory, speech,
comprehension and decision-making ability.
MYTH: Marijuana today is safer than earlier varieties.
FACT: Horticultural development has increased the potency of marijuana and
added many other dangerous chemicals.

1.5.20 Summary
Drug use disorders have resulted in 127,000 deaths in 2013. Opium is the dried
latex obtained from the opium poppy and contains approximately 12 percent of
the analgesic alkaloid morphine. Heroin is an adulterated form of heroin and is
formed by mixing the drug with talcum powder, powdered milk, sugar and other
substances. When morphine is used in large doses and/or abused, the user can
quickly develop a physical and psychological addiction to the drug. The
dangerous effects of heroin include immediate vomiting, suppressing breathing,
and the risk of choking.
1.5.21 Suggested questions
1. What is drug dependence?
2. Define psychological dependence?
3. Define Mode of Administration of morphine and heroin in the body.
4. Explain signs of morphine overdose.
5. What is Marijuana, Hashish and Hashish Oil?
6. Give Withdrawal Symptoms of opiates.
1.5.22 Long questions
1. What is opium and opiates? What are the therapeutic uses, mode of action
in the body, short term and long term effects and withdrawal symptoms of
opium and their opiates?
2. What is cannabis and also write about their derivatives?Explain long term
and short term effects of cannabis
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1.5.23 Suggested readings

1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 52 Drug Abuse : Pro
Problem,
Management
ent and Prevention
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.6 Author : Dr. Amteshwar Singh

Sin Jaggi
Edited by: Mr. Jaswin
aswinder Singh

DEPRESSANTS

1.6.0 Overview
1.6.1 Learning Objective
1.6.2 CNS Depressants
Depressants According To Their Actions:
1.6.3 Classification OfCNSDe
1.6.4 Alcohol
1.6.5 Barbiturates
1.6.6 Benzodiazepines
1.6.7 Ketamine
1.6.8 Opiates
1.6.9 Ghb
1.6.10 Oxycontin
1.6.11 Summary
1.6.12 Short Questions:
1.6.13 Long Questions
1.6.14 Suggested Readings

1.6.0 Overview
This chapter delves into
to CNS depressants, substances that slow low down the
Central Nervous System.m. It covers alcohol, barbiturates, benzo nzodiazepines,
ketamine, opiates, GHB,, anand Oxycontin. The chapter explains ins their
the effects,
withdrawal symptoms, andnd provides insights into their classifications
ns and modes
of action.
1.6.1 Learning Objective
To know about:
● Depressants
● CNS depressants
● Classes of CNS depre
pressants
● Alcohol
● Withdrawal effects of alcohol
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 53 Drug Abuse : Problem,
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● Barbiturates and their withdrawal effects
● Benzodiazepines and their withdrawal effects
● Ketamine
● Opiates
● GHB
● Oxytocin
1.6.2 CNS DEPRESSANTS –
• Drugs that depress the overall functioning of the Central Nervous System
(CNS) to induce sedation, muscle relaxation, and drowsiness.
Street names: Barbs, Benzos, Downers, Georgia Home Boy, GHB, Grievous Bodily
Harm, Liquid X, Nerve Pills, Phennies, R2, Reds, Roofies, Rophies, Tranks,
Yellows.
Available in the form of pills, syrups, and injectable liquids.
• They affect concentration and coordination, and slow down a person’s
ability to respond to unexpected situations.
• In small quantities depressants can cause a person to feel more relaxed.
• In larger quantities they can cause unconsciousness, vomiting and death.
Cause: Dose-Dependent CNS Depression
Depending on dose, a person may experience
• calming, relief from stress/anxiety
• slowing, sedation
• sleep
• anesthesia
• coma
• death due to respiratory depression
• Alcohol
• Barbiturates (Nembutal, seconal,Phenobarbital)
• Ketamine
• Opiates and opioids (heroin, opium, morphine, codeine, methadone,
pethidine, palfium)
• Cannabis (marijuana, hashish)
• Oxycontin
• GHB (gamma hydroxylbuteric acid)
• Benzodiazepines (calmpose, rohypnol, Valium, Serepax, MogadonNormison)
• Some solvents and inhalants (petrol, glue, paint thinners, lighter fluid)

1.6.3 Classification of CNS depressants according to their actions:

1. Sedative-hypnotics
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2. Tranquillizers
3. Anesthetics
CNS depressants generally:↓ vitality, ↓ excitability, ↓ HR &RR .
1. Sedative -hypnotics
Sedatives:
Drugs which decrease the activity, calm the recipient, cause sedation and
in large dose they induce sleep.
Hypnotics:
Drugs which induce sleep that resembles the natural sleep.e.g.
Barbiturates
2. Tranquillizers
Tranquillizers are drugs which relief mental anxiety and stress without
affecting the consciousness e.g. Chlorpromazine (CPZ)
3. Anesthetics
Drugs which cause unconsciousness and generalized loss of pain
sensation to permit the performance of surgery.e.g. thiopental (IV), halothane
(inhalation).
MOA: Decrease propagation of nerve impulses by interfering with electrolytes
conductance through the cell membrane.
1.6.4 ALCOHOL
Alcohol is the MOST ABUSED drug.
Alcohol is a Central Nervous System (CNS) depressant.
Alcohol is considered to be a gateway drug to other drug use.
Alcohol (Madira&sura)
• Clear colorless hydroxylated hydrocarbon a product of fermentation of
fruits, grains, or vegetables.
• In bloodstream it circulates to brain in about 30 seconds.
• Side effects from mild hangover-type symptoms to coma and death.
• Alcohol withdrawal syndrome is a potentially life-threatening condition
that occur in people who have been drinking heavily for weeks, months, or
years and then either stop or significantly reduce their alcohol
consumption.
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磘 Tremor
磘 Hallucinations
磘 Seizures
磘 Agitation
磘 Fluctuating Levels of Alertness
Cadiovascular system
cardiomyopathy, cardiac arrhythmias, abnormal metabolism, increase of
catecholamine, hypertension
磘 Gastrointestinal tract
Oesophagal reflux, barrett’soesophagus, gastric pain, mallory-weiss
syndrome and oesophagal cancer, gastric bleeding.
These effects are due to sudden withdrawal of alcohol and results in
increase in ca2+ ions.
1.6.5 BARBITURATES
礎 Barbiturates are prescription sedatives or tranquilizers.
礎 Barbiturates are multi-colored pills and tablets and are Central Nervous
System (CNS) depressants that cause drowsiness.
礎 Barbiturates are also known as: Downers, Sleepers,Stumbles, Barbs,
Red Devils, Rainbows.
礎 Mode of Action:
礎 They have GABA like action → ↑ opening time of chloride channels →
↑conductance of chloride ions →hyperpolarization.
礎 Classification according to their duration of action:
1. Long-acting.
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2. Intermediate-acting.
3. Short acting.
4. Ultrashort acting.
Mode of Action (MOA):
They have GABA like action → ↑ opening time of chloride channels →
↑conductance of chloride ions →hyperpolarization.
Classification according to their duration of action:
1. Long-acting.
2. Intermediate-acting.
3. Short acting.
4. Ultrashort acting.
BARBITURATES
● Nembutal
● Seconal
● Phenobarbital
● Nembutal (pentobarbital) is commonly prescribed to treat insomnia. It is a
highly addictive drug.
● Seconal (Secobarbital Sodium) is a barbiturate derivative that depresses
the CNS. Prescribed as a sleeping pill and sedative, can also be used to
treat epilepsy and as a preoperative anesthesia. Withdrawal symptoms can
begin within 24 hours of the last dose and can last for as long as eight
days.
● Phenobarbital (Brand Name: Solfoton) is a barbiturate used to treat or
prevent seizures. Phenobarbital is also used short-term to treat insomnia,
or as a sedative before surgery.
Some Well-Known Barbs
• sodium thiopental (Pentothal)(U)
• secobarbital (Seconal)(S)
• pentobarbital (Nembutal)(S)
• amobarbital (Amytal)(I)
• phenobarbital (Luminal)(L)
• mephobarbital (Mebaral) (L)
Barbiturates Withdrawal Effects
磘 Agitation
磘 Delirium
磘 Convulsions
磘 Weakness
磘 Anxiety
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 57 Drug Abuse : Problem,
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磘 Nausea and vomiting
磘 Sleep disturbances
磘 Tremors
磘 Hallucinations
磘 Dangerously high fevers
磘 Seizures
Onset : 8-16 hours after the last dose.
Duration: 15-days and more

1.6.6 BENZODIAZEPINES
礏 Benzodiazepines (benzos) used primarily to treat anxiety, panic disorders,
and seizures. They may also be used as sleep aids or muscle relaxants.
礏 When drug is suddenly removed, a rebound effect can occur.
礏 Acute phase: lasts anywhere from 7 - 90 days
礏 Post-acute: last up to 2-years.
礏 Benzodiazepines
礏 MOA:
礏 Bind non-selectively to benzodiazepine receptors
礏 (GABAA-dependent).
礏 GABAA receptors → increase Cl influx → hyperpolarization
礏 GABAB receptors → Gi protein → ↓cAMP → relaxation

Examples:
礏 Diazepam (sedative) .
礏 Triazolam (hypnotic) .
礏 Diazepam (Valium, calmpose): Valium withdrawal lasts longer than that of
most other benzodiazepines. Valium is a long-acting benzodiazepine
designed to deliver extended relief from anxiety.
礏 Alprazolam (Alprex; Xanax): a benzodiazepine that is used to treat anxiety
disorders, panic attacks and other related psychiatric disorders. Short-
acting anxiolytic.
礏 Flunitrazepam: is a potent hypnotic.
礏 It causing strong amnesia (memory loss).
礏 It also has sedative, muscle relaxant and anxiolytic properties
礏 In treatment of severe insomnia (sleep loss).
Withdrawal Symptoms
磘 Increased irritability and/or emotional outbursts
磘 Inability to concentrate, perform simple tasks and/or memory problems
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磘 Body Aches, pains, and/or muscle stiffness/soreness
磘 Sleep disturbance
磘 Anxiety and or panic attacks
磘 Suicidal thoughts, seizures, death (severe symptoms)
1.6.7 KETAMINE
Ketamine, or ketamine hydrochloride, is a Central Nervous System (CNS)
Depressant and a dissociative anesthetic, or a drug that separates
perception from sensation.
Ketamine is used primarily as an anesthetic in veterinary medicine, but is
also sometimes used with small children and elderly.
Ketamine can be found as a clear white liquid or as a white powder.
1.6.8 OPIATES
Opiates are drugs that are derived from the Poppy Plant and are Central
Nervous System (CNS) depressants.
The most common opiates are:
Opium
Heroin
Morphine
Codeine
Opiates are known by several different names: Smack, Soapium,
Chiva,Poppy, Flower, Hazel, Morf, H .
1.6.9 GHB
GHB, or Gamma Hydroxylbuteric acid, is a central nervous system (CNS)
depressant that sometimes causes hallucinations.
GHB is usually found as a clear liquid with a slightly salty taste, but can also
be found as a small tablet or capsule, all of which dissolve quickly in liquid.
GHB usually is sold by capful or teaspoon, also known as a “dose”.
1.6.10 OXYCONTIN
Oxycontin is a synthetic opium derivative that is available by prescription.
Oxycontin is an extremely potent pain killer that comes in time release
tablets that last for up to twelve hours.
Oxycontin is prescribed to cancer patients and chronic pain suffers to help
in managing pain.

1.6.11 Summary
CNS depressants are drugs that affect the Central Nervous System (CNS) to
induce sedation, muscle relaxation, and drowsiness. They come in the form of
pills, syrups, and injectable liquids and can affect concentration, coordination,
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 59 Drug Abuse : Problem,
Management and Prevention
and slow down a person's ability to respond to unexpected situations. In small
quantities, they can cause relaxation, but in larger quantities, unconsciousness,
vomiting, and death. Alcohol, barbiturates, ketamine, opioids, cannabis, and
benzodiazepines are some examples of CNS depressants. They can cause various
side effects, from mild hangover-type symptoms to coma and death, and are
considered a gateway drug to other drugs. Sedatives, sedatives, hypnotics,
tranquillizers, and anesthetics are classified according to their actions. Alcohol is
the most abused drug and alcohol withdrawal syndrome is a potentially life-
threatening condition.
1.6.12 Short questions:
1. What are CNS depressants?
2. What are the withdrawal effects of depressants?
3. Define sedatives, tranquilisers and anesthetics?
4. What are the withdrawal effects of alcohol?
5. What are the withdrawal effects of barbiturates?
6. What are GHB and opiates?
1.6.13 Long questions
1. Explain the withdrawal symptoms of opiates, ketamine, GHB and oxytoxin.
2. Explain what are barbiturates, their different types, mode of action,
adverse effect and withdrawal symptoms.
1.6.14 Suggested readings
1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi:
Mittal Pub
2. Modi, Ishwar and Modi, Shalini (1997) Drugs: Addiction and
Prevention, Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003), Social Problems in India, Rawat Publications:
Jaipur
4. 2003, National Household Survey of Alcohol and Drug Abuse. New
Delhi, Clinical Epidemiological Unit, All India Institute of Medical
Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social
Justice and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New
Delhi: Universal, 2012).
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 60 Drug Abuse : Pro
Problem,
Management
ent and Prevention
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.7 Author : Dr. Amteshwar Sing

ingh Jaggi
Edited By: Mr. Jaswinder
Jaswin Singh

INHALANTS

1.7.0 Overview
1.7.1 Learning Objective
1.7.2Terminology
1.7.3 Types of Inhalants
1.7.3.1 Solvents (comm
ommon household products)
1.7.3.2 Anesthetics
1.7.3.3 Nitrites
1.7.4 Why are Inhalants so Popular?
1.7.5 Inhalants: Pharmokine
okinetics
1.7.6 Inhalants: Effects
1.7.6.1 Nitrous Oxide
ide
1.7.6.2 Solvents
1.7.6.3 Poppers (Club
lub Drugs)
1.7.7 Inhalants: Effects on
n th
the Body
1.7.8 Summary
1.7.9 Suggested questions
1.7.10 Suggested readings

1.7.0 Overview
In this chapter, we delve lve into the realm of inhalants, which are substances
frequently abused through ugh methods like sniffing, huffing, or bagging.
b We
categorize inhalants into solv
solvents, anesthetics, and nitrites, providing
ing a detailed
examination of their effects
cts on the body and the reasons behind their
heir popularity,
especially among young ind individuals. Additionally, we discuss withdra
hdrawal effects
and cover relevant terminolo ology associated with inhalant abuse.
1.7.1 Learning Objective
To know about:
● Inhalants
● Types of inhalants
● Their pharmokinectis ctis
● effect sof different inha
inhalants
 B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 61 Drug Abuse : Problem,
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● Their tolerance and withdrawal effects

1.7.2Terminology
Sniffing - Inhaling vapors from an open container or off a heated pan
Huffing - Inhaling vapors from a volatile-soaked cloth held against the face
Bagging – Application of the volatile into a paper or plastic bag, which is then
held over the face.
Inhalants don’t get a lot of attention but in the 1990s, they were the
second most commonly-used illicit drug among 12- 17-year olds. (Brouette&
Anton, 2001).

1.7.3 Types of Inhalants

All different psychoactive substances are together grouped as Inhalants in
three groups.
1. Solvents
2. Anesthetics
3. Nitrites

1.7.3.1 Solvents (common household products)

Adhesives model airplane glue, rubber cement, household glue

Aerosols spray paint, hairspray, air freshener, deodorant, fabric

protector

Solvents and gases nail polish remover, paint thinner, type correction
fluid and thinner, toxic markers, pure toluene, cigar
lighter fluid, gasoline, carburetor cleaner, octane
booster

Cleaning agents dry cleaning fluid, spot remover, degreaser

Food products vegetable cooking spray, dessert topping spray

(whipped cream), whippets

1.7.3.2 Anesthetics:
Anesthetic nitrous oxide, ether, chloroform
Isofluorane, desflurane…
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1.7.3.3 Nitrites
Sodium nitrite Curing meat

Amyl Vasodilator; treatment for angina

Butyl “Poppers”, "Rush," "Locker room,"

"Bolt," "Climax," also marketed in head
shops as "video head cleaner"

1.7.4 Why are Inhalants so Popular?

● Easy to obtain
● The high is achieved instantly and lasts 5-15 minutes.
● Easy to conceal (e.g., permanent markers, correction fluid)
● Since inhalants are common, youths have misperception of safety
1.7.5 Inhalants: Pharmokinetics
● Route of Ingestion:
Inhaled, either directly or by pouring/spraying into a bag or onto a cloth
● Metabolism: in Liver
● Distribution: Some leave the body quickly others are absorbed by fatty tissues
in the brain and nervous system.
● Half life: Short half-life: Varies among Inhalants, typically 1-5 mins
1.7.6 Inhalants: Effects
● Chemicals become absorbed into fatty tissues in the brain and the nervous
system
● Typically affecting the myelin surrounding the bodies nerve cells
● with long term use myelin is broken down and ultimately nerve cells can not
transmit messages to one another.
1.7.6.1 Nitrous Oxide
EFFECTS:
● Immediate effects, usually lasts less than a min. Repeated use extends
and intensifies the experience.
● Results in temporary loss of motor control and a "dissociative"
psychological effect, where sensations and perceptions become
disconnected.
● Effects include a dreamy mental state, and mild audio and visual
hallucinations.
1.7.6.2 Solvents
● Immediate effects.
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● Effects include euphoria, delirium and hallucinations.
● Solvents are highly addictive and will cause damage to the liver and CNS.
1.7.6.3 Poppers (Club Drugs)
EFFECTS:
● Immediate effects: typically within a few seconds and lasts for 1-2 mins.
● Causes muscles to relax; therefore, the heart rate increases as well as
cardiac output. As a result oxygen-rich blood will quickly reach the brain
to produce a “rush”.
Users may experience:
● Euphoria
● Light-headedness
● Sleepiness
● Distorted Space Perception
● Nausea
● Spinning
● Drunkenness
● Altered shapes and colors
● Dizziness
● Numbness
Undesirable Effects
● Slowed breathing
● Slowed heart rate
● Disorientation
● Loss of body control
Death due to
Suffocation: Choking on one’s vomit while unconscious
Asphyxiation: Decrease in oxygen and increase in carbon dioxide.
Occurs after losing consciousness with plastic bag over the head.
“Sudden Sniffing Death”: Prolonged session of inhalation leading to the failure of
the heart.
Can happen any given time someone abuses inhalants.
1.7.7 Inhalants: Effects on the Body
A. Blood- inhalant chemicals will block the oxygen carrying capacity of blood
B. Lungs- repeated use causes damage
C. Heart- results in “Sudden Sniffing Death Syndrome”
D. Liver- components of aerosol and paints will damage the liver
E. Kidney- Toluene (inhalant substance) will damage the kidney’s ability to
control the amount of acid in the blood, may result in kidney stones.
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1.7.8 Summary
Inhalants are psychoactive
active substances that are inhaled from variorious sources
such as sniffing, huffing,
ing, and bagging. They are grouped into three
thr groups:
solvents, anesthetics, and nitrites. Solvents have immediate effects
fects such as
euphoria, delirium, and ha
hallucinations, but are highly addictive and can cause
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 66 Drug Abuse : Problem,
Management and Prevention
damage to the liver and CNS. Anesthetics cause temporary loss of motor control
and a "dissociative" psychological effect. Nitrous oxide breaks down the myelin
surrounding the body's nerve cells and produces a rush of oxygen-rich blood.
Inhalants have a short half-life and are easy to obtain and conceal, making them
popular among youths. The route of inhalation involves inhaling directly or by
pouring/spraying into a bag or onto a cloth, and the distribution is in the liver.
Effects include light-headedness, sleepiness, distorted space perception, nausea,
and dizziness. Undesirable effects include slowed heart rate, unconsciousness,
and loss of consciousness.
1.7.9 Suggested questions
1. What are inhalants?
2. What are the effects of inhalants?
3. Describe withdrawal effects of inhalants?
4. What is sniffing, huffing and bagging?
5. Define types of inhalants?
1.7.10 Suggested readings
1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, IshwarandModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003),Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 67 Drug Abuse : Pro
Problem,
Management
ent and Prevention
B.A./B.A.(Honours)/B.Com
B.Com./BCA/BBA–I Drug Abu
buse: Problem,
Semester-II Management and P
Prevention

Lesson No. 1.8 Author : Dr. Amteshwar Sing

ingh Jaggi
Edited by: Mr. Jaswin
aswinder Singh

STEROIDS
1.8.0 Overview
1.8.1 Learning Objectives
1.8.2 Steroids
1.8.3 Doping
1.8.4 Harmful effects
1.8.5 Dependence/Withdraw
hdrawal
1.8.6 Summary
1.8.7 Suggested questions
1.8.8 Suggested readings

1.8.0 Overview
This chapter discusses stesteroids, including anabolic steroids, their
ir therapeutic
uses, and harmful effects.
cts. It delves into doping in sports and listslis various
anabolic steroids. Additiona
nally, it covers the forms in which steroids
s are
a available
and highlights the potential
ntial for dependence and withdrawal symptoms ms.
1.8.1 Learning Objectives es
To make learner familiar wit
with:
● Steroids
● Anabolic steroids
● Doping
● Therapeutic use off ststeroids
● Their effect and withd
ithdrawal symptoms
1.8.2 Steroids
Steroids are a large group of chemical substances classifi lassified by a
particular carbon structure
ture.
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Steroids are commommonly used to relieve swelling and inflammation
inf
(Eg. prednisone and cortiso
ortisone).
Naturally occurring g steroids include vitamin D; sex hormonemones, such as
testosterone and estradiol.
1. Anabolic Steroids:: Anabolic steroids are steroidal androgen ens including
natural androgensns like
li testosterone as well as synthetic substanc
ubstances that
are structurally relate
lated and have similar effects to testosterone.
ne.

2. Testosterone
Induce the developme
lopment and maintenance of masculine characteristics
chara
such as the growth of the vocal cords and body hair.
These steroids are e anab
anabolic (increase growth and differentiati
iation of cells)
and increase protein within
thin cells, especially in skeletal muscles.

Skeletal muscle
In the presence off ad
adequate diet, these steroids increase the
e body
b weight
and result in increase
ased muscular strength through high-intensit
nsity exercise.
Anabolic steroids s are
a used in sports, racing, and bodyb ybuilding as,
nhancing drugs”
“Performance-enhancin
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 69 Drug Abuse : Problem,
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1.8.3 Doping: Doping refers to the use of banned athletic performance-

enhancing drugs by athletic competitors.
Many sports organizations have banned the use of performance-enhancing drugs
and have very strict rules and penalties for people who are caught using them.
List of anabolic steroids:
● Testosterone undecanoate
● Testosterone enanthate
● Testosterone cypionate
● Testosterone propionatenandrolone
● Nandrolonedecanoate
● Nandrolonephenylpropionate
● Stanozolol
● Methandrostenolone
Available forms: Oral Pills, creams, injectables, skin patches.
Therapeutic Uses :
Increase Maximum Inspiratory Pressure
Stimulate muscle growth and appetite
Stimulate growth of bone marrow
Induce male puberty
Hormone replacement therapy for men with low levels of testosterone
Treat chronic wasting conditions, such as cancer and AIDS
1.8.4 Harmful effects:
● Psychiatric symptoms including Anxiety, aggression and violence
● Growth defects (quickens bone maturation; may reduce adult height at
high doses)
● Kidney damage
● Liver damage
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 70 Drug Abuse : Pro
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● Gynecomastia in men (increased conversion of testosterone to e
estradiol)
● Masculinization in women
wom (increase in body hair, deepening of the
t voice)
● Hypertension
● Hyperlipidemia (Incre
Increase LDL, "bad" cholesterol and decrease
e HDL, "good"
cholesterol)
● Structural alterations
ions in heart (enlargement and thickening
ning of the left
ventricle)
● Carcinogenic
B.A./B.A.(Honours)/B.Com./BCA
BCA/BBA-I (Semester-II) 71 Drug Abuse : Pro
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1.8.5 Dependence/Withdrdrawal:
Mood disturbancess (depression,
(d mania, psychosis)
Fatigue
Restlessness
Loss of apetite
Insomnia
B.A./B.A.(Honours)/B.Com./BCA/BBA-I (Semester-II) 72 Drug Abuse : Problem,
Management and Prevention
1.8.6 Summary
Steroids are chemical substances used to relieve swelling and inflammation.
Anabolic steroids, including testosterone, are used in sports, racing, and
bodybuilding. Doping refers to the use of banned athletic performance-enhancing
drugs.

1.8.7 Suggested questions

1. What are steroids? Give examples.
2. Define doping.
3. What are the harmful effects o steroids?
4. Explain withdrawal symptoms of steroids?
1.8.8 Suggested readings
1. Kapoor.T. (1985) Drug Epidemic among Indian Youth, New Delhi: Mittal
Pub
2. Modi, Ishwar andModi, Shalini (1997) Drugs: Addiction and Prevention,
Jaipur: Rawat Publication.
3. Ahuja, Ram,(2003), Social Problems in India, Rawat Publications: Jaipur
4. 2003 National Household Survey of Alcohol and Drug Abuse. New Delhi,
Clinical Epidemiological Unit, All India Institute of Medical Sciences, 2004.
5. World Drug Report 2011, United Nations Office of Drug and Crime.
6. World Drug Report 2010, United nations Office of Drug and Crime.
7. Extent, Pattern and Trend of Drug Use in India, Ministry of Social Justice
and Empowerment, Government of India, 2004.
8. The Narcotic Drugs and Psychotropic Substances Act, 1985, (New Delhi:
Universal, 2012)
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