Like alcohol abuse, drug abuse can wreck lives and break up families. But to many experts the problem of drug abuse is far more serious than alcohol abuse. The trade in addictive, harmful drugs is not only unlawful; it has grown year by year, to the point where many believe it is out of control. Since the mid-1980's the U.S. government has spent approximately one and half billion dollars a year to combat illegal drug importation, calling on units of the military to join the campaign. Nevertheless, the amount of illegal drugs seized and the amount estimated to elude detection increase each year.
The forms that drug abuse takes, and the numbers of drugs, are numerous and increasing. Many authorities believe we should examine our whole American society for the “pill-happy” context in which drug abuse occurs. Dr. Joel Fort, former consultant on drug abuse to the World Health Organization, called America
“a drug-prone nation.... The average ‘straight’ adult consumes three to five mind-altering drugs a day, beginning with the stimulant caffeine in coffee, tea, and Coca Cola, going on to include alcohol and nicotine, often a tranquilizer, not uncommonly a sleeping pill at night and sometimes an amphetamine the next morning.”
The social effects of drug abuse rank among the most alarming of all the symptoms of what has been called the drug crisis. By estimate, drugs are involved in one-third to one-half of all crimes committed in the United States in a typical year. In a single recent year, medical treatments for drug abusers cost the nation more than $2 billion. The costs of abuse to families, communities, and to abusers themselves cannot be calculated.
Making the problem of control of drug abuse unbelievably complex is the fact that literally thousands of drugs and drug combinations have basic roles in medical treatments. Legal and illicit uses may, because of the close connections, become confused. Physicians’ instructions regarding use of such legal drugs as sleeping pills may be ignored or neglected. Legitimately prescribed drugs may, in some cases, unintentionally lead to abuse or dependency.
Other facts make it difficult to control drug abuse. More and more, for example, abusers are turning to multiple substance abuse. Cocaine “sniffers” may take alcohol in one form or another to soften the uncomfortable and even painful effects of cocaine withdrawal. Physicians report that “polydrug” abuse leads to progressive worsening of such medical symptoms as stomach ailments and liver problems.
Designer drugs add another complicating factor. Made in clandestine chemical laboratories, these drugs are created by altering the existing molecular structure of other drugs, such as cocaine, heroin, amphetamines, and many other controlled substances. The chemical composition of a designer drug is enough like that of the banned or controlled drug it imitates that it produces similar effects, but it is different enough to be a new drug. The federal Drug Enforcement Administration must then take steps to declare the new drug illegal. Far more powerful than the basic drugs they imitate, the designer forms have been implicated in hundreds of deaths.
A designer drug called Ecstasy is an imitation methamphetamine (speed). It contains the industrial chemical MPTP, a suspected causative element in cases of Parkinson's disease. A number of Ecstasy abusers also had classic Parkinson's symptoms: rigidity, tremors in the arms, legs, and even the head, and slow or difficult movement. Thus new research has focused on MPTP as a possible clue to the degenerative brain processes that lead to Parkinson's.
Americans consume over-the-counter (OTC) drugs in enormous quantities. Purchasable without a physician's prescription, these drugs have limited but real potential for abuse. They range from headache remedies to cold nostrums and from acne ointments to vitamins. In general, good practice is to use OTC drugs as seldom as possible, for short-term, minor illnesses. Medicines of proven effectiveness should be used exclusively: taking an aspirin for a headache is a good example. The U.S. Public Health Service offers these guidelines:
- • Self-prescribed drugs should never be used continuously for long periods of time.... A physician is required for abdominal pain that is severe or recurs periodically; pains anywhere, if severe, disabling, persistent, or recurring; headache, if unusually severe or prolonged more than one day; a prolonged cold with fever or cough; earache; unexplained loss of weight; unexplained and unusual symptoms; malaise lasting more than a week or two....
The Food and Drug Administration (FDA), a branch of the U.S. Public Health Service, is responsible for establishing the safety and usefulness of all drugs marketed in the United States, both OTC and prescription. You can be assured that OTC drugs are safe provided you take them in strict accordance with the label instructions. These indicate the appropriate dosages, among other things, and carry warnings against prolonged or improper use, such as “discontinue if pain persists,” or “do not take if abdominal pain is present.” This labeling information is regulated by the FDA
In addition to alcohol, the drugs of potential abuse fall into six categories: stimulants, depressants, and narcotic preparations, all of which can have legitimate medical uses; hallucinogens; cannabinoids such as marijuana; and inhalants (or volatile inhalants) such as aerosol sprays, glues, and fuels. See the accompanying table:
|Stimulants||Amphetamines Cocaine derivatives|
|Narcotics (opioids)||Morphine Codeine|
|Hallucinogens||LSD Mescaline Psilocybin|
|Marijuana (cannabinoids)||Marijuana Hashish|
|Inhalants||Gasoline Amyl nitrate|
Drug abuse can lead to at least three kinds of addiction or dependency. Physical addiction results in unpleasant withdrawal symptoms, including, nausea, headache, or cold sweats when the abuser does not take the drug. Sudden withdrawal from some physically addictive drugs can cause heart failure. Psychological addiction , more subtle, is a stage at which the abuser believes he or she cannot cope without the drug. In functional addiction , the abuser grows dependent on such drugs as decongestant nasal sprays to remain free of an annoying physical condition.