Problems due to use of alcohol and other psychoactive substances

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Classification Systems ◽  
Drug Misuse ◽  
Psychoactive Substances ◽  
Victorian England ◽  
True Incidence ◽  
Medicinal Use ◽  
The Individual ◽  
The Uk

Archaeological evidence has demonstrated that for at least the past 10,000 years humans have been using psychoactive substances. From the chewing of coca leaves in Ancient Peru (c.4000– 3000 bce) to the popular use of laudanum in Victorian England, the recreational, cultural, and medicinal use of ‘mind- altering’ substances has been widespread. As of 2016, alcohol and other psychoactive substances remain a leading cause of medical and social problems world­wide: humans are clearly vulnerable to their attrac­tion. Although a myriad of substances are available, only a few are commonly used, and all tend to produce similar harms upon the individual and society. This chapter will provide a general approach to managing a patient presenting with a problem stemming from substance misuse. It is extremely difficult to gather accurate data on the use of substances in the general population, especially if they are illegal. It is therefore likely that most figures are underestimations of the true incidence. The WHO estimates that tobacco, alcohol, and illicit drugs are a factor in 12.4 per cent of all deaths worldwide. This is a stark reminder of the severity that problems associated with substance usage can reach, but the morbidity sur­rounding them affects a much wider section of society. In the UK, 80 per cent of adults drink alcohol, 19 per cent smoke tobacco, and 30 per cent admit to having used an illegal drug at least once in their lifetime. Worldwide, the highest prevalence of drug misuse is found in the 16- to 30- year age group, with males outnumbering females at a ratio of 4 to 1. Table 29.1 shows a selection of epidemiological figures associ­ated with commonly used substances. Substance misuse is associated with an array of con­fusing terminology, the majority describing different disorders that may occur due to use of any substance. The following terms are internationally agreed and ap­pear in major classification systems:… ● Intoxication is the direct psychological and physical effects of the substance that are dose dependent and time limited. They are individual to the substance and typically include both pleasurable and unpleasant symptoms.

scholarly journals Commentary

2000 ◽  
Vol 6 (1) ◽  
pp. 39-40
Author(s):  
Roch Cantwell
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Illicit Drug ◽  
Information Gathering ◽  
Drug Misuse ◽  
High Prevalence ◽  
The Rich ◽  
The Uk ◽  
Tabloid Journalism ◽  
Timely Reminder

In the sometimes sensational world of illicit drug reportage, there is one unsung villain. While heroin misuse remains the bête noir of tabloid journalism, ecstasy the demon of the dance floors and cocaine caricatured as the choice of the rich and famous, amphetamine misuse has lurked the shadows. Its use defies such simple categorisation and spans several groups in society. Bruce has provided a timely reminder of this neglected area in substance misuse literature and, in the process, has highlighted the relevance of basic information gathering as the most important tool in the armamentorium of drug misuse workers. The lack of prominence given to what they describe as a “hidden epidemic” is striking. Could this be because amphetamine misuse is a less prevalent problem than that of other illicit drugs? Evidence suggests otherwise. Amphetamine is the second most common illicit drug seized in the UK (after cannabis). It is easily produced and used in a variety of modes, and recent research confirms a high prevalence of misuse in this country reflecting that found in North American and Australian literature.

scholarly journals The Destructive Capacity of Drug Abuse: An Overview Exploring the Harmful Potential of Drug Abuse Both to the Individual and to Society

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Peter Fox ◽  
Govind Oliver ◽  
Sophie Marie Ellis
Keyword(s):  
Drug Abuse ◽  
Substance Misuse ◽  
Crack Cocaine ◽  
Illegal Drug ◽  
Drug Misuse ◽  
Western World ◽  
Public Health Perspective ◽  
Published Evidence ◽  
The Individual ◽  
The Uk

From a public health perspective, substance abuse has long been a source of major concern, both for the individual’s health and for wider society as a whole. The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug (see the tables) (Nutt et al. (2007)). The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it: (1) the direct physical harm of the substance to the individual user, (2) the tendency of the drug to induce dependence, and (3) the effect of abuse of the drug on families, communities, and society (Gable (2004, 1993)). In this report, we discuss published evidence relating to the harm of substance misuse and consider the neuropsychopharmacological mechanisms behind addiction in an attempt to gain an improved picture of the potential devastation that abuse of these substances may evoke.

scholarly journals Exploration of the Use of New Psychoactive Substances by Individuals in Treatment for Substance Misuse in the UK

2018 ◽  
Vol 8 (4) ◽  
pp. 58 ◽  
Author(s):  
Rosalind Gittins ◽  
Amira Guirguis ◽  
Fabrizio Schifano ◽  
Ian Maidment
Keyword(s):  
Substance Misuse ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
The Uk

scholarly journals Snapshot of narcotic drugs and psychoactive substances in Kuwait: a qualitative analysis of illicit drugs and their associated mortality in Kuwait from 2015 to 2018

2020 ◽  
Author(s):  
Abdullah Al-Matrouk ◽  
Mohammed Al-Hasan ◽  
Neamat Al-Abkal ◽  
Hanan Mohammed ◽  
Meshaal Haider ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Mortality Rate ◽  
Drug Use ◽  
Illicit Drugs ◽  
Drug Misuse ◽  
Health Concern ◽  
Psychoactive Substances ◽  
Gulf Region ◽  
Chromatography Mass Spectrometry ◽  
Narcotic Drugs

Abstract Background The misuse of illicit substances is associated with increased morbidity and mortality; thus, substance abuse is a global health concern. However, a lack of laboratory-based research has limited the scientific assessment of drug misuse in the Arabian Gulf region. Thus, the primary aim of this study was to assess the problem of illicit drugs in Kuwait using laboratory-based analyses. Methods We investigated the type and quantity of detained narcotic drugs and psychotropic substances from 2015 to 2018, number of abusers, and mortality among abusers. In total, 6220 cases from the Narcotic and Psychotropic Laboratory and 17,755 cases from the Forensic Toxicology Laboratory were reviewed and analyzed. Substances were identified and documented using gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry. Results Cannabis, including marijuana, was the most seized substance, followed by heroin, opium, and cocaine. Amphetamines, including methamphetamine, in the form of powder or pills, were seized in larger quantities than other psychoactive substances. Benzodiazepines, tramadol, Khat, synthetic cannabinoids, and psilocin were also seized. The most consumed substances were, in order, amphetamines (including methamphetamine), benzodiazepines, cannabis, and heroin. Drug misuse was considerably higher among men than among women. We report the death rate associated with the abuse of various illegal drugs according to sex. The mortality rate associated with single-drug use was the highest among abusers of heroin, benzodiazepines, and methamphetamine. The mortality rate asscoaited with multiple-drug use was the highest among abusers of heroin–benzodiazepines, cannabis–benzodiazepines, and cannabis–amphetamines. Conclusions Our study shows the changing trends in quantity and variety of substances illegally abused and marketed in Kuwait. Additionally, we report a direct gender-based association between mortality and consumption of certain substances. These findings suggest that there is a growing need to conduct larger scale studies to implement new strategies, policies, and interventions in populations affected by illicit drugs.

Substance misuse and dependence: older people deserve better services

1999 ◽  
Vol 9 (4) ◽  
pp. 327-342 ◽  
Author(s):  
Ilana B Crome ◽  
Ed Day
Keyword(s):  
Older People ◽  
Large Scale ◽  
Substance Misuse ◽  
Drug Misuse ◽  
Definition Of ◽  
The Uk ◽  
Available Information

It is not easy to establish with any confidence the prevalence of drug misuse in older people. The issue is confounded by variations in definition of what constitutes ‘elderly’ and ‘drug misuse’, and by the types of sample used (Tables 1 and 2). There are few large-scale studies in the UK, and much of the information has been extrapolated from the American findings. The available information can be organized into four main areas:

Drug Policy and the Public Good

2018 ◽  
Author(s):  
Thomas Babor ◽  
Jonathan Caulkins ◽  
Benedikt Fischer ◽  
David Foxcroft ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
Public Good ◽  
Drug Policy ◽  
Illicit Drugs ◽  
Supply And Demand ◽  
Epidemiological Data ◽  
Drug Misuse ◽  
Drug Supply ◽  
Psychoactive Substances ◽  
Public Health Perspective ◽  
The Public

Drug Policy and the Public Good presents the accumulated scientific knowledge of direct relevance to the development of drug policy on local, national, and international levels. The book explores both illicit drug use and non-medical use of prescription medications within a public health perspective. A conceptual basis for a rational drug policy is presented, along with new epidemiological data on the global dimensions of drug misuse, significant trends in drug epidemics, and the global burden of disease attributable to drug misuse. The markets for both illicit and legally prescribed psychoactive substances are described, showing that these two sources of drug supply are becoming increasingly connected in many countries. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; treatment interventions and harm reduction approaches; attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; decriminalization and penal approaches; and control of the legal market through prescription drug regimes. The final chapters discuss the trend toward legalization of some psychoactive substances in different parts of the world and describe the need for a new approach to drug policy that is evidence-based, realistic, and coordinated. The evidence reviewed in this book suggests that an integrated and balanced approach to evidence-informed drug policy is more likely to benefit the public good than are uncoordinated efforts to reduce drug supply and demand.

Young people and substance misuse

2018 ◽  
Vol 11 (11) ◽  
pp. 601-607
Author(s):  
Irene Hernandez Sanchez
Keyword(s):  
Substance Misuse ◽  
Warning Signs ◽  
Assessment Tools ◽  
Drug Misuse ◽  
Mental Performance ◽  
Illegal Drug Use ◽  
And Performance ◽  
The Uk ◽  
Drunk Alcohol

In the UK in 2017, 9% of pupils aged 11–15 reported having drunk alcohol in the previous week, which is the lowest rate since the 1980s. Illegal drug use in the previous year reported by 15-year olds halved between 2001 and 2014. Despite these promising figures, adolescence is deemed to be decisive for future biopsychosocial development and performance. Initiation during adolescence may therefore have long-term implications, affecting mental performance and educational outcomes. This article focuses on patterns of drug misuse in teenagers. The warning signs of drug misuse and useful assessment tools are also introduced. For the purposes of this article, alcohol will be defined as a drug.

Treating depression complicated by substance misuse

2001 ◽  
Vol 7 (5) ◽  
pp. 357-364 ◽  
Author(s):  
Claire McIntosh ◽  
Bruce Ritson
Keyword(s):  
Depressed Mood ◽  
Illicit Drugs ◽  
Substance Misuse ◽  
Biological Action ◽  
Drug Addict ◽  
Way Of Life ◽  
Low Mood ◽  
The Individual ◽  
The Way ◽  
At Home

Dependence on alcohol or other drugs is a depressing experience. The way of life of the individual who is dependent on alcohol is replete with incidents that are demoralising, waking daily with a hangover or with tremor and retching, coupled with amnesia for events of the night before, a sense of inability to face the day ahead and awareness of recriminations at work and at home. Little wonder that depressed mood is common in such circumstances. Similarly, the drug addict, when life is dominated by the daily problem of obtaining supplies of a substance that brings transient relief or pleasure but also experiences of an impoverished existence and low mood. Add to this the fact that the biological action of many commonly misused substances can induce depression then it is hardly surprising that depression is common in this population. There are also a smaller number who use alcohol or illicit drugs to cope with primary depression. Teasing out the interplay of affect and substance misuse is a challenge for the general psychiatrist and the addiction specialist.

Multiple Exclusion Homelessness in the UK: Key Patterns and Intersections

2011 ◽  
Vol 10 (4) ◽  
pp. 501-512 ◽  
Author(s):  
Suzanne Fitzpatrick ◽  
Sarah Johnsen ◽  
Michael White
Keyword(s):  
Substance Misuse ◽  
Institutional Care ◽  
Drug Misuse ◽  
Multi Stage ◽  
Low Threshold ◽  
The Uk ◽  
High Degree ◽  
Personal Trauma ◽  
Very High ◽  
Prevalent Form

This article presents preliminary results from a multi-stage quantitative study of ‘multiple exclusion homelessness’ (MEH) in seven urban locations across the UK. It demonstrates a very high degree of overlap between a range of experiences associated with ‘deep social exclusion’ – namely, homelessness, substance misuse, institutional care and ‘street culture’ activities (such as begging and street drinking). It also provides evidence to support the contention that homelessness is a particularly prevalent form of exclusion, with its experience reported as widespread by those accessing low threshold support services targeted at other dimensions of deep exclusion, such as drug misuse. Further, the analysis presented indicates that the nature of MEH varies geographically, with the profile of the population affected looking quite different in Westminster (London) than in the other urban locations. The main explanation for this appears to be the exceptionally high proportion of migrants in the MEH population in Westminster, who tend to report lower overall levels of personal trauma and vulnerability than the indigenous MEH population.

scholarly journals Piloting the UK’s First Home-Office-Licensed Pharmacist-Led Drug Checking Service at a Community Substance Misuse Service

2020 ◽  
Vol 10 (8) ◽  
pp. 121
Author(s):  
Amira Guirguis ◽  
Rosalind Gittins ◽  
Fabrizio Schifano
Keyword(s):  
Public Health ◽  
Illicit Drugs ◽  
Substance Misuse ◽  
Synthetic Cannabinoids ◽  
Cascade Process ◽  
Home Office ◽  
Ethical Decisions ◽  
Drug Sample ◽  
Drug Checking ◽  
The Uk

(1) Introduction: Drug-related deaths in the UK are at concerning high levels. The unknown content and purity of illicit substances can cause unpredictable adverse effects and thus a public health risk with no sign of abating. On-site drug checking is a public health strategy that has previously been implemented, predominantly in festival settings, but without Home Office licensing. (2) Aims: The aim of this study was to pilot the UK’s first pharmacist-led, Home Office-licensed community drug checking service. (3) Methods: A bespoke protocol incorporating legally, professionally and ethically binding documents was implemented. This free, confidential service ran between February and March 2019, was available to anyone over 18 who were purposefully recruited, gave informed consent and agreed to relinquish their drug sample. Samples were checked on-site within an established Substance Misuse Service (SMS) using a handheld Raman spectrometer to determine likely drug content and adulterants. In parallel, participants completed a questionnaire about their substance use and the drug sample(s) being tested. A pharmacist-led multidisciplinary approach was adopted to discuss the analytical findings. Informed by the results of the analysis and the questionnaire, people who used the service received tailored harm reduction advice. (4) Results and Discussion: The pilot operated for a total of four days over four weeks. Eleven people visited and relinquished a total of thirteen samples. Half of the participants had previously overdosed and were known to the SMS. Seventy per cent were male, all were White British individuals, 30% were employed and two people disclosed visiting from another nearby town. Samples included what was thought to be heroin, synthetic cannabinoids, stimulants, benzodiazepines and LSD and none required activation of the “alerts cascade” process. Most participants drank alcohol regularly and the concomitant use of traditional illicit drugs and prescribed medication (including opioids, anxiolytics and antidepressants) with sedating profiles was common. Given some of the ethical decisions and interpretation of the results, specialist pharmacist involvement was deemed essential. (5) Conclusions: This pilot demonstrated the proof-of-concept that a pharmacist-led Home Office-licensed drug checking service can be successfully implemented in community SMSs.

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