Drug addiction is an increasing psychological problem through out the world. All addictive drugs have powerful action on the central nervous system and their harmful, adverse and detrimental effects are related to different personality characteristics. The nature of the effects of drug and dependence may be temperamental or physical both: All addictive and dependence producing drugs create emotional dependence, that is to say that the drug has to be taken as a means of coping with life's stresses and to produce various effects desired by the person on his emotions, drives, perceptual powers, conflicts and problems. It is a highly complex, subject which encompasses the biomedical and psychopharmacological effects on body functions and behavioral response of the user. It has been assumed to be an international phenomenon, where in, the drug or a toxic agent, the person who takes if and the society with is value system interact with each other. Thus it has been a serious problem almost for all the countries in the world. The most destructive of this social problem is restriction, comprehension and course deterrent punishment for those in this nefarious trade. Its another most terrible aspect is that it is causing impairable loss of manpower by reviving the physical and mental health of millions of people, particularly of the young generation. The health problems due to drug addiction need to be assessed from psychological perspective. An overall knowledge of the health problem in relation to drug addiction is very necessary. After all, health , a bio-psycho phenomenon is a broad issue and must not be dealt exclusive by medically qualified professionals only. The young adolescents, the budding generation is very much victimized of this menace.
There are many books on psychology and psychiatry dealing with this burning psychological problem DRUG ADDICTION written by well known experts of western countries. Experience suggested that the knowledge derived from work done in western countries could not be directly applied to the Indian situation since most of our higher research works are based on western studies, there is always a gap between the theoretical knowledge and the practical realities within which we have to operate. In clinical practice the knowledge and techniques needed to be modified and adapted in Indian context. To study drug addiction in Indian perspective we need literature on detail psychological study exploring the main causes of drug addiction and remedial technique in Indian experience and orientation. The present study is an example to show that how much psychological factors are related with this menace and to apply some intervention program for temperamentally susceptible subjects. It is a comprehensive account of personality characteristics of male adolescent drug addicts, fully based on a major research project sponsored by ERIC, NCERT, where the first author was the Principal Investigator and the second author was co-investigator. It is designed to be a reference book for students at the Post graduate as well as Doctoral level of psychology, psychiatry and social work.
The book is divided into six chapters. The first chapter deals with the concept of drug addiction, different types of drugs and their harmful effects. The second chapter deals with the review of literature and the third one with methodology the SPINE of a scientific research. The sampling technique and psychological tools used in the study has been dealt in the chapter of methodology. The fourth chapter explored the results. Results have been shown in detail by tables, charts, figures and graph. The fifth chapter gives the full analysis interpretation and discussion. Result of the relevant statistical measures and psychological tools used are given in Appendix.
It is a matter of most delight for me to acknowledge my indebledness to the Member Secretary ERIC, NCERT for giving me an opportunity to work on such a burning psycho-Social problem i.e. DRUG ADDICTION.
I deem it my pleasent duty to acknowledge my gratefulness to Prof. M. C. Joshi formerly Vice Chancellor Kumaune University, Nainital for his valueble suggestions rendered to me in presentation of data and its interpretation. It would be no exaggeration to say that without his support, work of a multidisciplenary nature such as this, could not have been accomplished.
I am extremely grateful to Prof. R. H. Singh, Vice Chancellor, Rajasthan Ayurveda University, Jodhpur, Rajasthan for his invaluable help in the design and execution of this work. His keen interest in the completion of this academic venture, especially writing the foreword for this book, was a source of great moral support for me.
I express my sincere thanks to Prof. Satvir Singh, Head of the Department of Educational Survey & Data Processing NCERT, New Delhi, Prof. Neerja Shukla, Head, Department of Education of Groups with special needs, NECRT, New Delhi. Prof. S. K. Bhattacharya formerly Head, department of Pharmocology, Banaras Hindu University, Varanasi. Prof. Indra Sharma, Head Department of Psychiatry, B. H. U., Varanasi and Dr. Sunil K. Das, formerly Director Narcotics Control Bureau, Government of India, Varanasi, for their valuable suggestions which have been incorporated in this book.
In the process of data collection Mr. Kiran Sharma, Director Nav Chetna, Drug Deaddiction Centre, Varanasi, Dr. Sanjay Gupta, Reader, Department of Psychiatry, B. H. U., Varanasi and Principal, Central Hindu Boys School, Varanasi, have helped me to a great extent for which I am highly thankful to them.
My thanks are also due to Prof. C. B. Dwivedi, Department of Psychology, B. H. U., Varanasi, for his interest, co-operation and encouragement in my present endeavour.
My special thanks are also due to M/s Chaukhamba Surbharati Prakashan, Varanasi who undertook the publication of this book at a very short notice.
I am very thankful to my son Mr. Ashutosh Banerjee who always agreed to sit at odd hours for correction in the typed manuscripts and proof reading.
In the last, but by no means the least, I am thankful to all of the hospitalized addicts and students (non drug taking subjects) on whom the study was made. All those who were helpful for the completion of this work, I thank them collectively.
Alcohol and drug abuse have emerged as a major mental health hazard throughout the World. India is no more an exception. The problem has increased rapidly in this country in all forms of society. The adolescents appear to be the prime victims. Drug abuse is not only a social evil; it is clearly a form of mental illness. Although social and environmental factors playa great role in afflicting the people taking in the grip of drug abuse and dependence; but it has become more and more evidenced that the tendency of drug abuse has also a genetic background. It has been observed that the people of a particular temperament and personality are more prone to this ailment.
Use of alcohol and hallucinogenic drugs begins initially in the innocent people as a tool of defensive coping against anxiety and tension. The temporary feeling of wellbeing produced by the substance use prompts an individual to repeat the consumption, initially off and on, but later-more regularly. Soon, the psycho-emotional attraction is converted into physiological dependence when many body functions including certain vital ones get adopted to the substance used. In such cases withdrawl of the used substance leads to major physiological upset and at many occasions such uncared withdrawl of a substance may prove fatal.
Thus drug abuse and dependence is a major morbidity in the present day society. Moreover the individuals afflicted with these sick situations become prone to many other associated hazards such as sexually transmitted diseases, infections traveling through medications particularly parenteral uses viz HIV-AIDS and HBV etc. Organ failures due to specific tissue damage because of the chemo toxicity of substance used such as hepatic failure in alcoholics are also very common. Thus drug abuse is a multifaceted medical disorder.
Higher incidence in adolescents particularly of intellectual class has a notable socio economic impact. The mental physical health and the future career of these young individuals are doomed. Many of these individuals are involved in many kinds of crimes. They do not work and their productivity is lost and as such it is a significant economic handicap. Thus the whole issue is of major national importance and warrants to be tackled with top priority. The Strategy should be :
1. to present drug abuse through social awareness and emotional care of the prone individuals and by strategic stop- page of the availability of abused druges in such hands;
2. to manage the problems of those who are already fallen victim.
The former strategy needs social and administrative activism while the latter is a specialized Medicare which involves expert medical care in active de-addiction and rehabilitation programmes. The role of a psychologist is important in both these aspects.
It is not true that alcohol and drug abuse were unknown in ancient times. At least Ayurvedic texts give a vivid account of alcoholism and its management besides the abuse of certain other narcotics. Ayurved propounds its own approach in this context. Many contemporary centers of traditional care deliberate to employ strategies of social and environmental correction on the principle of Swastha vritta, Sadvritta and Acara besides practice of Yoga meditation and relaxation for prevention and re- habilitation. They advocate internal bio-purification by Panchakarma and Ayurvedic Massage therapy. Sometimes the Satkarmas of Hatha yoga tradition are also used for bio-purification of the milieu interior. Rasayana Therapy specially Medhya Rasayanas drugs are used for inducing psycho-emotional stability. However, there is a need of standardizing these procedures to develop a comprehensive traditional strategy of indigenous origin for prevention and management of drug abuse.
I have gone through the book "Drug Addiction in Male Adolescents: In Psychological Perspectives" authorized by Dr. Shubhra Banerjee and Dr. Anjana Mukhopadhyay. Both are noted scholars of clinical psychology, logical counseling and personality studies. They are fully equipped to handle any problem related to this field. This book presents a critical review on the problem of drug abuse particularly in adolescents besides its own research components. It contains significant scientific data of permanent value besides the comprehensive methodology developed by the authors for applying to the present study.
This book may prove a very useful reading for postgraduate students and researchers in this field, it may also become' a scientific manual for all workers involved in the field of prevention and care of drug abuse. I congratulate the authors for producing a good piece of research on an important topic of great relevance to the present day society. The publisher also deserves acknowledgement for this important scientific addition to the literature in this field.
Historically the use of drug is as old as human civilization on earth. It is stated in Indian mythological literature that "Shiva, the destroyer, thousands of years ago used Bhang and Dhatura whenever he went in meditation." Soma-rasa an intoxicant, pre- pared by herbs was used by God and Madira was used by demons. In the western world also use of drug was made for pleasure and merry-making in 17th century and even earlier. It is evident from the literature that throughout the history of civilization the use of several kinds of drugs continued in different forms for various purpose but definitely in the last two decades the use of drugs has phenomenally increased among school/college going young adolescents. This rapidly increasing rate of use of drugs has posed a great danger, to the physical and mental health of adolescents thus ruining the overall personality make up.
Drugs have been defined in different ways by researchers in the field but the simplest definition of a drug may be given as "any chemical substance that alters mood, perception and is injurious to the physical and mental health of the individual." Thus drug addiction may be defined as a state of periodic or persistent intoxication, detrimental to the individual, to society or both and characterized to the following features:
(a) A strong need / drive compulsion to continue taking the drug.
(b) The development of tolerance with a tendency to increase the dose to produce desired effects.
(c) Physical and emotional dependence
The distinction between a drug addict and drug abuser is that the drug abuser includes both habituation and addiction. Addiction is a state of periodic or chronic intoxication produced. by the' repeated abuse or misuse of a psychoactive drug characterized by (1) an overpowering desire or need (compulsion) to continue taking a drug and obtain it by any means, (2) a tendency to increase the dose, (3) a psychological dependence and generally also a physical dependence on the effect of the drug, and (4) a detrimental effect on the individual and society.
Habituation is a condition of repeated use of a drug characterized by (1) a drive (but not compulsion) to continue taking the drug for a feeling of well being, (2) Little or no tendency to increase the dose, and (3) some degree of psychic dependence on the effect of the drug (WHO, 1957). An individual who has been addicted to drugs for at least one year as defined above is termed as a drug abuser.
Both abuse and any subsequent drug addictions are usually subdivided into abuse of alcohol and abuse of other drugs. Abuse of other drugs can be further subdivided into opiate abuse and non-narcotic abuse.
Classification of Drugs
Classification of drugs is based on the variety of effects on human behaviour. In seeking relief from pain or boredom, people has learned to use a variety of drugs with four known effects on the organism, viz., sedation, tranquilization, stimulant and delirium. A sedative drug slows the organism and diminishes the responsiveness. Hallucinogens are used mainly to pro- duce numbness and insensibility and eventually stupor.
Tranquilizers have proved helpful in alleviating anxiety and tension, particularly in relation to specific life stresses. The minor tranquilizers are potentially dangerous because of possible side effects, because of ill advised practices associated with their use. Tranquilizers like meprobamates, have been implicated in an increasing number of suicide attempts (Coleman, 1974).
A stimulant drug acts on the brain and sympathetic nervous system to alter motor activity and to prevent fatigue and sleep. As a rule, it also increases neuromuscular irritability and the level of anxiety. A deliriant drug produces an acute brain syndrome marked by confusion, illusion and hallucinations and sometimes temporarily increased psychomotor activity. Usage of drugs within each of these four classes commonly lead to habituation or addiction.
Drugs may also be classified in various other ways. These categories of drugs overlap considerably and even within the same category there are marked differences, in the effects. Even chemically similar compounds may have radically different effects, eg., there are stimulant as well as depressant. Among the central nervous stimulants, the diversity of action (effect) is even greater and the harmful effect varies drug to drug individually. Besides the differences in the mode and site of action, there is a multiplicity of side effects.
Psychologically, drugs may be classified into depressant and stimulant types, and the classification may further be divided into drugs which primarily effect the central nervous system' and those, which act primarily on the autonomic nervous system. The American Psychological Association (APA) has classified the major types of drugs, which are more frequently abused and which have more potent effects on mental processes and human behaviour as (1) the narcotics (such as opium and its derivatives); (2) sedatives (such as barbiturates); (3) the stimulants (such as amphetamines); (4) the mild tranquilizers (such as, meprobamate and the hallucinogens (such as marijuana).
It does not include many new drugs such as Ritalin, which produces multiple effects, the less commonly used volatile hydrocarbon (such as glue, paint, thinner, gasoline and nail polish remover etc.) which are very dangerous. Caffeine and nicotine are also drugs of dependence, but they are not included in APA classification. However, all the psychoactive drugs have an abuse potential, and they may produce tolerance and psychological / physiological dependence. The extent to which the drug effects behavioural processes depends upon the type, amount and duration of drug usage, the psychological and physiological makeup of the individual and in some instances, social setting in which the drug experience takes place.
The term narcotic refers to the so-called hard drugs that characteristically relieve pain and produce a state of tranquility, elatedness and sometimes sleep. This category consists largely of the opiates, the best known of which are opium, morphine. heroin, codeine and methadone. It has generally a depressant action on the entire central nervous system, including the center contouring the most vital physiological functions. These drugs are commonly used into the body by smoking, snorting (inhaling the bitter powder), eating, skinpopping (injecting the drug into the blood stream). The opiates appear to reduce sensation to pain, other drive states such as hunger, sex and other activities.
Generally, it affects the emotional and motivational states and give a sense of well-being, serenity and relief from fear and apprehension. Initially there is an intensely pleasurable sensation, described as euphoria, followed by depression, drowsiness, dizziness the inability to focus attention or concentrate, apathy, lethargy and subsequently irritability and agitation produced by the. use of heroin. The individual often remains quiet, unagressive, withdrawn and uninterested in the outside world after an intake of heroin. Talking and motor activity reduces and thinking and judgement become insufficient. Continued use of narcotic drugs (Heroin) leads to secondary symptoms of alternating constipation and diarrhea, loss of appetite, malnutrition, loss of weight, and lower resistance to infection.
Psychic dependence develops when the drug user increasingly turns to narcotics to shut out his problems and anxieties. However, the anguish or misery he endured before taking the drug returns after the effects wear off. Dangerously enough not only does the euphoria wear off, but the anticipation of the severe withdrawal illness drives the narcotic user to seek his next "fix".
Addiction to narcotic drugs usually leads to a more gradual deterioration of well being. Typically, the life of a narcotic addict is increasingly centered around obtaining and using drugs, hence the addiction usually leads to socially maladaptive behaviour as the individual is eventually forced to lie, steal and associate with undesirable companies in order to maintain his supply of drugs (Carson, Butcher & Mineka, 1996).
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