The drug problem

The drug problem

By Thomas E. Cone, Jr., M.D.

The use of chemical substances to alter mood, perception, and behavior
has become part of growing up in Western society. In recent years, drug
and alcohol abuse by young people has markedly increased. Some surveys
indicate that over 80 per cent of schoolchildren in the United States
have used one or more substances (drugs) for nonmedical purposes. Today,
young people have access to a wide variety of potentially dangerous and
sometimes addictive drugs.

Why young people misuse drugs

There is no single reason why young peo­ple turn to drugs. Some try them
out of curiosity or for “kicks.” Others consider drugs the “in” thing to
do. Many children feel isolated from their families and from a society
they consider to be infested with hypocrisy, materialism, and distorted
values. The misuse of drugs or alcohol is thus a way to rebel against
parents and other authority figures. Some teen-agers even experiment
with drugs because they perceive adoles­cence to be a time for living
dangerously.

Other children may have emotional or psychological problems for which
they re­ceive little parental understanding or help. Still others may be
congenitally predisposed to have a high initial tolerance to alcohol or
other drugs and therefore find them relaxing or stimulating, according
to their needs. To these youngsters, drugs provide an escape from a
fast-moving world where they feel insecure and confused, unable to cope
with the problems and pressures of everyday living.

Studies among young teen-agers show that a constantly increasing number
drink alco­hol, not only for social reasons, but also to relieve boredom
and anxiety. The “shift to alcohol” among adolescents may represent a
trend toward reconciliation with society’s “drug of choice.”

There is no good reason to misuse drugs. But in a world where pills and
other drugs are available for the relief of many ills and alcohol is
socially acceptable, experimenta­tion with drugs is understandable,
though not justifiable.

Habit-forming and addictive drugs

Marijuana, PCP, and LSD are habit­forming. This means that if used at
regular intervals, they can cause psychological de­pendence. Users
develop a mental or emo­tional need for the drug, even though their
bodies do not develop a physical craving for the drug.

Heroin, cocaine, amphetamines, barbitu­rates, nicotine, and alcohol are
addictive drugs. They create both a psychological and a physical
dependence. Addicts actually be­come physically ill if they cannot get
the drug to which they are addicted. Further­more, the body becomes so
used to the drug that doses must be increased to achieve the desired
effect.

Sudden withdrawal from addictive drugs is painful and dangerous. On the
average, about 18 hours after taking a last dose of heroin an addict may
have severe leg and stomach cramps, chills, nausea, and diar­rhea. The
body may shake uncontrollably

and perspire a great deal. Sudden with­drawal from barbiturates or
amphetamines is extremely dangerous. It can cause convul­sions, mental
disturbance, and even death. Withdrawal from cocaine can produce
pro­longed periods of depression or even psycho­sis. Withdrawal from
nicotine is often accom­panied by an increase in nervousness,
irritability, and fatigue. Withdrawal from any drug should be gradual
and done under a doctor’s supervision.

Withdrawal from alcohol may cause trem­ors, convulsions, hallucinations,
and delir­ium. The symptoms develop after a period of relative or
absolute abstinence from alcohol.

Experimentation does not necessarily lead to drug dependence. Alcohol is
one example of this. Most people who try alcohol do not become dependent
on it. It would be untrue to say that one or even a few tries of a
habit-forming drug will “hook” a person, with the exception of heroin,
cocaine, and maybe amphetamines. Yet all experimenta­tion must be
regarded as risky. The drugs to which children are most commonly ex­posed
can lead to psychological dependence or addiction. It is important that
children understand the dangers involved.

Commonly misused habit-forming drugs

Marijuana, also known as “pot,” “grass,” and “dope,” is most often
smoked in a home­made cigarette called a “joint” or a “reefer.” Heavy
doses can alter perception, impair judgment, and slow down reflexes and
motor coordination.

PCP (phencyclidine), known as “angel dust” and “hog,” is an animal
tranquilizer. It can be inhaled, injected, or swallowed. A small amount
can produce a state similar to drunkenness, ranging from euphoria to
de­pression and hallucinations. Larger doses can cause convulsions,
psychosis, rage, coma, cardiac irregularities, and death.

LSD (lysergic acid diethylamide), also known as “acid,” is a psychedelic
drug. If unadulterated, it is colorless, tasteless, and odorless, and so
powerful that a very tiny amount (0.2 mg) can cause strange mental
images and distort hearing, sight, smell, and

touch. Greater doses may induce an anxiety or rage so strong as to lead
to suicide or homicide. LSD may remain in the body for weeks, and
persistent adverse reactions may recur long after the initial dose is
taken, the so-called flashback phenomenon.

Both PCP and LSD are rarely available anymore, since they are relatively
difficult to produce and not made in quantity.

Commonly misused addictive drugs

Heroin, also known as “H,” “junk,” or “smack,” is a narcotic. It is
related to mor­phine, but is more addictive. Usually, it is mixed with
lactose (milk sugar) or quinine. Heroin addicts are always in danger of
death from an overdose, because they can never be sure how much heroin
there is in the mixture “bag” they buy. Most heroin addicts inject the
drug into their veins, a method known as “mainlining.” Adolescents may
use the subcutaneous or “skin popping” route. Unsterilized needles can
lead to hepatitis or acquired immune deficiency syndrome (AIDS). Heroin
addicts usually suffer from chronic liver infections and malnutrition.
They are also at high risk for AIDS.

Cocaine, also known as “snow” and “coke,” is usually sniffed. It can
also be injected, rubbed on the gums, or free-based (chemi­cally
concentrated and smoked). It produces a feeling of well-being,
depression of appe­tite, a deceptive feeling of unbounded en­ergy, rapid
heartbeat, and increased blood pressure. Chronic use causes emaciation,
insomnia, tremors, and convulsions.

Cocaine is very addictive, according to most drug abuse experts. One
form, called “crack,” is especially addictive. The drug is boiled down
into crystalline balls, about the size of peas, which can be smoked. It
is a far more potent form of cocaine than the powder used for sniffing.
Because there is a marked psychological dependence on cocaine, its use
tends to become compulsive.

Amphetamines, also known as “uppers” and “speed,” are stimulants. They
are some­times prescribed by doctors for obesTy, narcolepsy, fatigue,
attention deficit disor­der, and hyperactivity. Large doses can

induce extreme talkativeness, irritability, hallucinations, and other
dangerous or un­predictable actions, sometimes indistinguish­able from
acute paranoid schizophrenia.

Barbiturates, also known as “downers” and “barbs,” are depressants and
sedatives. Doctors prescribe them to induce sleep and to relieve nervous
tension. Barbiturates are extremely dangerous when misused. Large doses
distort vision, slow down reactions, lessen the ability to think and to
concen­trate, and cause staggering and slurred speech. The effect of a
large dose is similar to intoxication. An overdose, or a mixture of
barbiturates and alcohol, may cause death.

Alcohol is a depressant, although the ini­tial effect may be that of a
high, since drink­ing often breaks down inhibitions that regu­late
acceptable behavior. Studies done in the United States and Canada report
a precipi­tous increase in the use of alcohol by young teen-agers.
Alcohol has been “rediscovered” by some adolescents as an alternative to
marijuana. Further, the social acceptance of alcohol among adults has
lessened the anxi­ety of parents toward drinking by their chil­dren. Many
adults tend to be far more per­missive in their attitude toward alcohol
than toward marijuana. Using marijuana is often considered drug abuse,
while using alcohol is ignored. Yet alcohol continues to be the most
dangerous and most abused drug in the United States and Canada.

Signs to look for

The sooner parents and teachers act when they suspect a youngster of
experimenting with drugs, the better the chances are of preventing
addiction. It is not easy to tell when children are misusing drugs.
Those who do so become adept at hiding the fact. But there are a number
of telltale signs, none of which are absolutely conclusive, that should
alert parents and teachers to the possibility that a youngster may be
taking drugs and in need of help:

• Change in a child’s behavior, such as in­creasing aggressiveness or
  sluggishness,

unusual flare-ups of temper, or uncharacter­istic passivity.

• Change in school attendance (frequently absent or late).

• Change in work habits (sloppy homework, apathy).

• Shying away from family activities and a general withdrawal from
  former pastimes. ■ Poor physical appearance.

• Associating with known drug misusers.

• Stealing or borrowing money, needing more money than before.

Where to get more information and help

As soon as parents suspect that a child is misusing drugs, they should
get in touch with the family doctor. The doctor, if unable to deal with
the problem, will refer them to someone who is qualified in the
treatment of drug misuse. The family doctor may refer the child to an
established Adolescents’ Unit, a residential treatment center staffed by
physicians who are specially trained in the management of drug misuse,
including alcohol.

You can obtain the hot lines to drug infor­mation and treatment centers
by dialing Directory Assistance for the telephone num­ber of the local
Poison Control or Poison Information centers. For problems related to
cocaine and other drugs, you can call the toll-free cocaine hotline,
1-800-COCAINE. To find a drug-treatment center in your area, you can
call the National Family Re­source Center, 1-800-241-7946. And the
Na­tional Institute on Drug Abuse, 1-800-662- HELP, will refer you to
local programs.

For help with alcohol abuse, Alcoholics Anonymous (AA) provides
dedicated assist­ance and guidance 24 hours a day. Many AA chapters have
teen-age members. Local chapters of Alcoholics Anonymous are listed in
telephone directories.

If you suspect that your child is misusing drugs, keep calm and act
intelligently. Re­member, the problem is yours as much as it is the
child’s.