Drug

Abuse
and
Misuse

Community Pharmacy
PHM 307
Rabia Noor
Drug Abuse:
1. Refers to the intentional, non-therapeutic use of a substance, leading to
physical, psychological, or social harm to the individual. It involves the
consumption of drugs in a manner that deviates from approved medical
or social patterns.

2. The term often implies the misuse of both legal and illegal substances
and may include the use of substances in excessive quantities,
frequency, or in ways not medically indicated.

3. Drug abuse can lead to addiction, physical and mental health issues,
impaired judgment, and disruptions in relationships and daily
functioning.
Drug Misuse:
1. Drug misuse encompasses a broader range of behaviors related to the
inappropriate use of medications or substances, including both
prescription and over-the-counter drugs.

2. Unlike drug abuse, drug misuse may not always imply harmful or
addictive behavior, but it involves using substances in a manner other
than as directed by healthcare professionals or recommended on the
label.

3. Taking medications in incorrect doses, using someone else's prescription,

combining drugs without proper guidance, or using medications for
reasons other than their intended purpose.
Cont..

While not all instances of drug misuse lead to negative

consequences, it can increase the risk of adverse reactions,
complications, and potential harm to the individual's health.
 Addiction
Addiction is a complex and chronic
brain disorder characterized by
compulsive and uncontrollable
seeking, use, and craving of
substances (such as drugs or alcohol)
or behaviors (such as gambling),
despite harmful consequences.

It is often marked by a loss of control

over one's actions and a continued
engagement in the activity or use of
the substance despite negative effects
on physical health, mental well-being,
relationships, and overall quality of
life.
Dependence
Refers to a physiological or
psychological reliance on a
substance.

It is characterized by the
development of tolerance,
where increasing amounts of
the substance are needed to
produce the desired effect, and
withdrawal symptoms that
occur when the substance is
reduced or discontinued.
Tolerance
The need to use increasing
amounts of a substance to
achieve the same effect or a
diminished effect with
continued use of the same
amount.
Withdrawal
The development of
symptoms when the use of
the substance is reduced or
discontinued. Withdrawal
symptoms can be physical
and/or psychological and
vary depending on the
substance.
 Snorting
Refers to the act of inhaling a
substance, typically a powdered
substance, through the nose.

This method of administration is

often associated with drugs in
powder form, such as cocaine or
certain prescription medications.

When a substance is snorted, it is

absorbed through the mucous
membranes in the nasal passages,
entering the bloodstream and
producing effects relatively quickly.
Addiction Cycle
Stages of progression
 01
Based on substances
Illicit Drugs
Substances that are illegal to manufacture, possess, or distribute.
Examples include cocaine, heroin, and methamphetamine.
Prescription Drugs
Medications legally available only with a prescription. Abuse can involve
taking higher doses than prescribed or using them for non-medical
reasons.
Examples include opioids, benzodiazepines, and stimulants.
Over-the-Counter (OTC) Medications
Non-prescription drugs that
are available without a
prescription.

Misuse may involve taking

higher doses than
recommended or using them
for unintended purposes.

Examples include cough

syrups with codeine,
antihistamines, and pain
relievers.
 02
Based on pattern of use
Recreational Use:
Occasional use of substances for enjoyment or leisure, not necessarily
leading to dependence or negative consequences.
Dependent Use:
Chronic and compulsive use of a substance, often leading to physical
and psychological dependence.
Binge Use
Intermittent episodes of excessive substance use in a short period,
often associated with a loss of control.
 03
Based on Context
Social Drug Use
Use of substances in social settings, such as parties or gatherings,
without significant negative consequences.
Performance-Enhancing Drug
Use
Use of substances to improve physical or cognitive performance,
common in athletes or students.
Self-Medication:
Use of substances to alleviate physical or emotional symptoms without
professional guidance.
 04
Based on Route of
Administration
Oral Ingestion:
Swallowing a substance, as in the case of pills or liquids.
Inhalation
Breathing in a substance, often associated with the use of certain drugs
like cocaine or inhalants.
Injection
Introducing a substance into the body through a needle, commonly seen
with illicit drugs like heroin.
 04
Based on Age or
Demographics
Adolescent Substance Abuse
Substance abuse among individuals in the teenage years.
Adult Substance Abuse:
Substance abuse among individuals beyond their teenage years.
 Classification of drugs of abuse based on predominant effects on central and
autonomic nervous system
Stimulants Depressants Variable effects

Cocaine Alcohol Cannabinoids

Amphetamine-type stimulants: Benzodiazepines Classic hallucinogens: lysergic acid

amphetamine, methamphetamine, diethylamide (LSD), mescaline (peyote),
methylphenidate, and ephedrine psilocybin (mushrooms), and
dimethyltryptamine (DMT)

Cathinone: Khat and derivatives Z-drugs: zolpidem, zaleplon, zopiclone, Anticholinergic dissociative:
and eszopiclone scopolamine

Mephedrone and derivatives: “meow- Barbiturates Dissociative hallucinogens:

meow” phencyclidine, ketamine, and salvinorin

Methylenedioxy-methamphetamine Opioids Synthetic cannabinoids: spice

(MDMA) and derivatives: ecstasy

Caffeine and nicotine Volatile solvents Designer hallucinogens: N-methoxy-

benzyl (NBOMe) series

Modafinil Methaqualone Carisoprodol

 Impact of drug abuse on a global
HEALTH scale SOCIAL
CONSEQUENCES Family and Community
IMPLICATIONS
Physical and Mental
Disruption
Health
Stigma
0 and Discrimination
02
4

PREVALENC ECONOMIC
0 0
E AND 01
3 5
TRENDS HARM REDUCTION AND IMPACT
Global Reach Needle exchange programs Productivity Loss
TREATMENT
Changing Patterns Opioids substitution therapy Healthcare Cost

Rehabilitation
 Cont..
• Drug abuse is a global phenomenon affecting people of all ages, genders,
and socioeconomic backgrounds.
• The types of drugs abused and the patterns of use can vary across regions
and evolve over time.
• Drug abuse is associated with a range of health problems, including
cardiovascular issues, respiratory problems, infectious diseases (e.g,
HIV/AIDS, hepatitis), and neurological complications.
• Substance abuse can contribute to mental health disorders, including
anxiety, depression, and psychosis.
• Substance abuse can result in decreased productivity due to absenteeism,
impaired performance, and workplace accidents.
• Treating the health consequences of drug abuse places a significant burden
on healthcare systems globally.
 Cont..
• Drug abuse can lead to family breakdowns, child neglect, and increased
crime rates, impacting the social fabric of communities.
• Individuals with substance use disorders often face societal stigma, limiting
their access to support and treatment.
• Illicit drug trade is a transnational issue, involving complex networks of
production, transportation, and distribution.
• Drug trafficking contributes to violence, corruption, and instability in many
regions.
• There are international efforts to implement harm reduction strategies, such
as needle exchange programs and opioid substitution therapy, to minimize
the negative consequences of drug abuse.
• Disparities in access to treatment services exist globally, with some regions
facing challenges in providing adequate resources for prevention,
treatment, and rehabilitation.
 Cont..
• Countries collaborate through international agreements and organizations
to address drug-related issues, such as the United Nations Office on Drugs
and Crime (UNODC) and the World Health Organization (WHO).
• Various nations have implemented regulatory frameworks to control the
production, distribution, and consumption of certain substances.
• The emergence of novel substances poses challenges to regulatory
frameworks and public health responses.
• Online drug markets and digital platforms contribute to new challenges in
regulating substance availability.
• International organizations and governments work on global awareness
campaigns to educate the public about the risks of drug abuse and
promote preventive measures.
Pharmacist’s Role in Control
and Prevention
 Pharmacist Description
 Pharmacists should provide comprehensive counseling to patients when
dispensing medications, explaining proper use, potential side effects, and
the importance of adherence to prescribed regimens.
 Pharmacists can communicate the risks of drug abuse and misuse
associated with certain medications, especially those with abuse potential.
 Pharmacists should carefully verify and authenticate prescriptions, ensuring
that they are valid and issued for legitimate medical purposes.
 Pharmacists can use prescription monitoring programs to identify potential
patterns of misuse, such as frequent refills or obtaining similar medications
from multiple prescribers.
 Pharmacists are often in a position to recognize signs of potential misuse or
abuse, such as early refills, frequent requests for specific medications, or
behavioral changes in patients.
 Cont..
 Pharmacists can refer patients showing signs of misuse to appropriate
healthcare providers for further assessment and intervention.
 Pharmacists can collaborate with other healthcare professionals, such as
physicians, nurses, and addiction specialists, to develop comprehensive
treatment plans for individuals at risk of or currently experiencing drug
abuse.
 Maintaining open lines of communication with other healthcare providers
ensures a coordinated approach to patient care.
 Pharmacists can contribute to public awareness campaigns about the risks of
drug abuse and misuse, providing information on safe medication practices.
 Active involvement in community initiatives, such as awareness programs or
substance abuse prevention events, helps pharmacists contribute to the
overall well-being of the community.
 Cont..
 Pharmacists can educate patients on proper methods of medication disposal to
prevent unused or expired medications from being diverted or misused.
 Supporting and participating in medication take-back programs helps ensure
the safe disposal of medications.
 Pharmacists should stay informed about current trends, emerging substances,
and evolving regulations related to drug abuse and misuse through continuous
education.
 Training programs can enhance a pharmacist's ability to identify, intervene,
and manage cases of drug abuse.
 Pharmacists can advocate for and support policies and regulations aimed at
controlling the availability and distribution of substances with abuse potential.
 Engaging with local and national organizations to advocate for evidence-based
policies that promote public health.
Thank you!