Abuse of illegal substances is a vast and complex issue in current health practice, particularly because it covers a wide array of concerns, and because it affects young people and adolescents, who are in danger of developing addiction and destroy their entire lives. In the recent years, data has shown that abuse of dangerous drugs has recorded a steady decline, even though the abuse of marijuana, which is considered non-addictive and ‘safe’ as compared to other drugs, has increased. In addition, the medical world has recorded the emergence of new and potentially dangerous drugs, such as bath salts and spices. While research concerning the benefits of marijuana for medical and recreational purposes has failed for now to offer conclusive results, the research concerning the emerging drugs is itself at the beginning and the potential danger associated with it is still widely unknown. The present paper tries to cover these concerns and to discuss the role of the nurse in combating drug abuse. The nurse is able to identify the individuals who developed, or are in the verge of developing, drug addictions and has the obligation to deny prescription pills to those who do not need them for medical purposes. In addition, it is only by having strong knowledge on the effects and withdrawal symptoms of different drugs that the nurse is able to help those in need, and to fight side by side with other health care providers.
- According to the National Institute of Drug Abuse (2012), illicit drug use in America reached 8.7 % in 2011, the most recent year for which the National Survey on Drug Use and Health (NSDUH) was conducted. According to the same survey, drug abuse has increased with 0.04% over the past 9 years, the percentage being equivalent with the increase in marijuana use. As NIDA (2012) estimates, marijuana is the most often used illicit drug in the United States. Except for marijuana, the use of illicit drugs has remained constant or declined over the past decade, with cocaine use dropping in 2011 to 1.4 million users, from the 2.4 users who were recorded in 2006. As for alcohol, a progress has been also recorded, with 3.7% fewer teenagers aged between 12 and 20 consuming alcohol in 2011 as compared with 2002. The data provided by NSDUH also reveals that binge drinking is more prevalent in males than in women, and heavy drinking is also most common in males (9.1 %) than in women (2.6%). Finally, driving under the influence alcohol has also declined with 3.1% in 2011, as compared with 2002 (NIDA 2012).
- There are several risk factors which influence drug abuse and are able to predict who is more likely to become drug addict. The first important factor is the genetic predisposition. As NIDA (2010) explains, genetic vulnerability is able to explain up to 60% of abuse cases. Another important factor is related to the environment. A teenager who witnesses drug abuse at home or at school, among family members and peers, is more likely to become a drug addict as well. Apart from these two causes, other addiction predictors are early use and the method of administration. According to NIDA (2012), individuals who start abusing illicit substances very early in their lives are more likely to undertake more powerful substances, whereas those who smoke or inject drugs are more likely to become addictive due to the fact that the substances reach the brain within seconds. Addiction to drugs may cause long term damage to the brain by producing severe changes to neurons and brain circuits (NIDA 2010). Glutamate concentration is altered by drug abuse, which decreases the ability to learn. Moreover, drug abuse exposes the individual to conditioning, determining him to permanently associated drugs with certain environmental elements (NIDA 2010).
- Cocaine is a very powerful stimulant which is produced from the leaves of the coca plant. Its effect lasts up to 30 minutes and its constant abuse leads to serious health problems, and potentially, to death. Stimulants’ effects on the brain are euphoria, increased alertness and a feeling of well-being. Toxicity effects are tachycardia, hypertension and hypertermia. The withdrawal effects of stimulants are increased appetite, depression and exhaustion. LSD belongs to the group of hallucinogens. LSD is a powerful but non-addictive drug with low toxicity and no potential to cause brain damage which is used for recreational purposes. Hallucinogens produce auditory and visual hallucinations. They cause hypertension, may determine the loss of contact with reality, panic, paranoia, violent episodes and convulsions. Heroine is a synthetic morphine derivative which produces a rapid effect and is extremely addictive. Opioids, the category to which heroin belongs, produce nausea, euphoria, and are able to relieve pain. Their toxicity effects are indirect, caused by overdose or by the increased vulnerability to infections due to the impurities that are injected with heroin (Bryant and Knights 2011). The withdrawal effects of opioids are tremor, lacrimation and rhinorrhea, sweating and craving. Marijuana which belongs to the group of Cannabinoids , is obtained from the cannabis plant and is used as a recreational drug, being legal in some countries. Cannabinoids cause euphoria, incontrollable laughter, lethargy, hallucinations. The toxicity effects of the drug are anxiety, tachycardia. Mild withdrawal effects are anxiety, sleep disturbances, tremor, tremor and craving. Finally, ethanol belongs to the category of depressants and is used to decrease excitability, thus having an opposed effect to stimulants. The effects of depressants are muscle relaxation, somnolence, euphoria, and confidence. Toxicity effects include hypertension, decreased coordination, emotional instability and confusion, and may result even in the death of the abuser, in very high doses. Withdrawal effects include the well-known hangover, but also craving.
- Prescription drugs are substances which are recommended by doctors in certain circumstances, but are able to cause addiction when used incorrectly or for longer periods of time. According to NIDA (2012), in 2009, 16 million Americans had taken a prescription drug with nonmedical purposes. This is therefore a major problem in the society, particularly because these drugs can cause serious health problems, apart from being very addictive. Patients therefore need to be very well informed of the risks of prescription drugs, particularly when administered incorrectly or associated with other drugs. Nurses are in a position that allows them to notice when patients abuse prescription pills or when they are trying to obtain pills for nonmedical purposes. Also, if they notice that the problem for which the drug was prescribed no longer exists, they may refuse to administer the medication (Bryant and Knights 2011). Finally, nurses have a great responsibility to inform the patient correctly regarding prescription drugs and never to abuse their role by administering prescription drugs to patients without prescription or by changing the treatment. It is only by demonstrating concern and responsibility in regards to prescription drugs that the patients will also develop, from the beginning, an understanding of the seriousness of potential abuse.
- Emerging drugs have become more and more popular, particularly among youngsters. Spices are one category of drugs that are commonly abused, with serious effects on the brain. Spices produce relaxation and change the mood of the users, causing them anxiety, hallucinations and paranoia. According to NIDA (2012), the effects on the brain are not entirely known due to the fact that the product is usually a mix of several plants which may have a negative impact on the brain. Spices are very attractive for young people because they are perceived as safe, being natural and known not to cause addiction. In addition, they are legally available and are not expensive to buy. Another category of emerging drugs that prove attractive is bath salts. They are bought for the same reasons as the previous category, being a new product, and being legal and available both in stores and online. Finally, methamphetamine is a very popular, and a highly addictive drug, which is so attractive because it increases alertness, energy level, and sexual drive. People often take one dose when they need extra energy and are unable to quit afterwards.
- The NIDA screening tool allows clinicians to assess if a patient has abused drugs by using multiple choice questions. The evaluation begins with general questions which are aimed to discover which, if any, substances, the patient abuses. The questions are related to the frequency of drug and alcohol consume. If the patient has consumed a certain substance more frequently than recommended, than the questions further focus on that particular substance, trying to identify the signs of drug abuse and addiction, such as failure to control the use, interference with normal responsibilities, health, social or legal problems associated with the use of the substance.
- Marijuana’s use as medicine is intensely studied, attention being focused on its potential analgesic value, particularly for such diseases as Cancer and HIV. Tests demonstrated that moderate amounts of smoked marijuana were able to reduce pain (Wallace 2007). Also, research suggests that marijuana may be beneficial in the treatment for multiple sclerosis by reducing spasticity which is associated with this disease. As a result of its ability to relieve pain, to control nausea and to stimulate appetite, 16 states have legalized its medical use (NIDA 2012). Used for recreational purposes, marijuana use is legalized in some countries, and is very popular among young people, who consider that it is safe to use and has no dangerous effects. Though they are wrong to consider that marijuana has no negative impact on health, it is true that its effects are milder than those of other illegal drugs. The decline of more dangerous substances may be correlated with the increase of marijuana use, thus meaning that marijuana may be useful in controlling the use of major drugs, such as cocaine and heroin, which are potentially lethal.
Bryant, B.& Knights, K. (2011). Pharmacology for Health Professionals. Chatswood: Elsevier.
NIDA (2010). Drugs, Brains and Behavior: The Science of Addiction. Retrieved From: http://www.drugabuse.gov/publications/science-addiction . Accessed 30th March 2013.
NIDA (2012). Drug Facts: Nationwide Trends. Retrieved from: http://www.drugabuse.gov/publications/drugfacts/nationwide-trends . Accessed 30th March 2013.
NIDA (2013). Emerging Drugs. Retrieved from: http://www.drugabuse.gov/drugs-abuse/emerging-drugs . Accessed 30th March 2013.
Wallace, M. (2007). Analgesic Efficacy of Smoked Cannabis. Center of Cannabis Research. Retrieved from: http://www.cmcr.ucsd.edu/index.php?option=com_content&view=article&id=157:analgesic-efficacy-of-smoked-cannabis&catid=41:research-studies&Itemid=135 , Accessed 30th March 2013.