Q: Endnotes

1. Donlon, pages 113 - 115. 2. Cohen, pages 195 to 200.

Q: Bibliography

Cohen, S. The Substance Abuse Problems . Volume Two. New York, NY: The Hayworth Press. 1985.Donlon, P. T., et. al. A Manual of Psychotropic Drugs . Bowie, MD: Robert J. Brady Co. 1983.

Question 1

Drugs and Their Uses

Accepted Answer

There are many types of drugs. Drugs are sought out in cultures around the world for their ability to alter mood and awareness.

Purified and used in medicine, these substances have been used as analgesics, anesthetics, soporifics, muscle relaxants, central nervous system stimulants, anti-psychotic and anti-anxiety medications. When used strictly for these purposes under medical supervision, they have been a boon to suffering patients. After trauma, during acute illness, pre- and post-operatively, and during convalescence, they have relieved pain, quelled anxiety, and lowered depression.

They have been used socially in cultures outside the medical setting to release inhibitions, to lubricate social intercourse. In ritual settings, they have been used to commune with the collective unconscious, as in the Peyote rites of Native Americans of the American Southwest.

Different drugs have become the culturally accepted substances for altering mood, energy levels, and awareness. For example:

In many of the industrialized countries of North America, Europe and Asia, coffee, alcohol and tobacco are widely used.
Among the Native American tribes of the high Andean villages of South America, chewing coca leaves, that contains the active alkaloid, cocaine, is an accepted stimulant to help overcome the strain on the heart and lungs of living and working at high altitudes.
In the Middle East and Asia, tea, opium and cannabis have been enjoyed, occupying a central role in these cultures as the preferred intoxicants and social lubricants.
Among Native Americans of North and South America, a series of hallucinogenic substances have been used to alter mood and awareness. They have ingested fungi such as Fly Agaric or Psilocybin mushrooms; plants of the Datura family such as Jimson Weed or Tolache; cacti such as Peyote from the American Southwestern and Mexican deserts; and native vines such as yagé or cohaba from the tropical South American rain forest.
Among Polynesians and Melanesians, kava kava is used.

In fact, one is hard pressed to find a culture among the world's people that has not adopted one form or another of a drug or beverage as their social lubricant.

The pharmaceutical industries that serve the medical establishment in industrialized countries have developed a large number of alternatives to the natural preparations used traditionally throughout the world.

Today, as modern medical and public health outreach throughout the world have introduced these powerful forms of psychoactive substances throughout the world, they are beginning to emerge as new drugs of use, abuse and addiction.

Heroin, morphine and a host of other narcotic opioids have produced addicts throughout the world who inject, sniff, eat, or smoke these preparations to savor its dreamlike euphoria.
Highly purified cocaine, as cocaine hydrochloride powder, as basuco paste, as crystallized "rock" or "crack" is sniffed, smoked and injected to enjoy the swift, intense rush of energy and elevation of mood, coupled with anaesthetic effects.
Amphetamines such as Benzadrine, Dexadrine and Methamphetamine, and newer stimulants such as Ritalin and Preludin have been eaten, sniffed and injected to produce a state of increased energy and hyperalertness.
Depressant, hypnotic and sedative drugs have been utilized as alternatives to alcohol to produce states of disinhibition and intoxication. Barbiturates (such as Amytal, Luminal, Nembutal, Seconal and Tuinal), barbiturate-like agents (such as Doriden, Noludar, Placidyl, and Quaalude), benzodiazepines (such as Librium, Valium, and Clonopin), carbamates (such as Miltown), and other depressants (such as Chloral Hydrate or Paraldehyde) have shown their potential for abuse and addiction. [1]
Hallucinogens such as d-lysergic acid diethylamide tartrate (LSD), Phencyclidine (PCP), psilocybin (Psilocyn), peyote (Mescaline), dimethyltryptamine (DMT), diethyltryptamine (DET), dimethoxymethylamphetamine (DOM), ketamine, and the amphetamine derivatives MDA and MDMA have been widely sought out for their ability to alter sensory perception, awareness, and thinking. [2]
Other substances of abuse include inhalants (such as airplane glue, gasoline, ether, or nitrous oxide), scopolamine-containing medications (including belladonna), caffeine-containing beverages and tablets, and even over the counter medications such as decongestants (ephedrine and others), and antihistamines.

Recovery becomes necessary when drug use causes personal problems or addictions. Drug use progresses from infrequent social use, to social use with behavioral problems (problem drug use), to voluntary habitual use (habituation), and to involuntary habitual use (addiction) replete with psychological and physiological withdrawal symptoms.

Question 2

From Trial to Addiction

Accepted Answer

There are many reasons why people try drugs:

Curiosity based on what other people say about a drug may influence some people to start using it.
There may be peer pressure to do what is forbidden by some social groups, or normative in others.
Drugs or alcohol have been used as an initiation into peer groups such as fraternities or youth gangs.
Upon observing the effects in other people, some people may try the drug to feel less depressed, inhibited or shy, as a kind of self-meditation.
Others try them to experience altered states of consciousness or mood, to explore the mind's potentials.

Whatever starts people using drugs, for the majority of people, drugs do not cause them problems. They manage to control the ill effects of drug taking by moderating their intake, by taking them ritually with mutually agreed-upon limits and guidelines, and controlling the set and setting of drug use, so that emotional and behavioral problems do not arise.

For other individuals, however, these social controls do not halt them progressing into habituation to drugs.

Habituation is marked by regular use without the craving, tolerance effects, and withdrawal syndromes that characterize addiction.

People become habituated to drugs because it has become a reliable way to feel "good," relaxed, or "high" upon demand.

It helps them to forget the pain and shame of the past experienced with family, significant other, or friends, or in school, military, or employment settings.

It may make them feel they are being accepted by peers who are doing the same thing.

People progress from habituation to addiction because there are changes in the chemistry of the brain and other tissues that create an artificial need for the drug, as psychoactive substances taken over an extended period of time begin to substitute for, replace or mimic naturally occurring neurotransmitters.

Addiction is further characterized by the experience of dysphoric withdrawal symptoms, which range in severity from a cold or flu-like syndrome to a life-threatening illness coupled with alarming psychiatric symptoms.

It is further marked by an obsession or craving for the drug; the addicted person's entire life can become focused upon obtaining the drug to stave off withdrawal symptoms to feel "normal"again.

Once a person becomes addicted to drugs, he or she can cause multiple problems for him or herself and for other people.

1. Health risks range from mild to life threatening. Withdrawal symptoms may be uncomfortable, but relatively tolerable.

More serious diseases transmitted by contaminated hypodermic needles can cause damage to the heart, lungs, liver and kidneys.

Cancers of the mouth, larynx, esophagus, pancreas, stomach, and bladder may be produced by carcinogens absorbed when smoking drugs.

Long term drug use may lead to permanent brain damage resulting in loss of memory, dementia, and other cognitive deficits.

2. There can be legal consequences leading to imprisonment or fines by using illegal illicit drugs or by using pharmaceutical drugs in illegal ways.

Drug users will often neglect to pay their parking tickets, and these will go to warrant.

It is not uncommon for an active drug user to drive under the influence of alcohol or drugs, be arrested, and place his or her driver's license in jeopardy.

Addicts who have developed a high tolerance often must come up with hundreds of dollars per day to support their habit, and they will commit crimes of burglary, robbery, and prostitution to earn the money to obtain drugs—they may be arrested for any of these illegal activities.

3. There may be social costs, as well. The addict's parents, relatives, spouse and children, or friends may come to mistrust the addict and even abandon contact with him or her. The addict's social network becomes reduced to contacts with active users, and he or she becomes more enmeshed in the drug subculture.

4. There may be problems that affect the family.

Active addiction and alcoholism may lead to child abuse or incest, spouse battering, sexual problems, breakdown of communication, constant arguments and tension.

In this highly dysfunctional family environment, the children and spouse suffer because of the insanity and abuse that they experience on a daily basis with an addict or alcoholic in the home.

Many of these children, at a rate two and one half times that in homes where one or more parent is not an alcoholic or addict, go on to become alcoholics or drug addicts themselves.

5. Then there is the cost to society. In addition to the crimes against property, and the involvement in prostitution or other vice crimes, drug use has other deleterious effects.

Intoxicated people are at greater risk of traffic accidents.

Gangs and syndicates that bring illegal drugs into the country may commit murder, often of innocent bystanders.

Drug dealers spread drug use through active sales to established users and solicitation of new users.

The net cost to society is an atmosphere of fear and tension, the reduction in the quality of life, and the investment of billions of dollars in attempts to interdict and control this rampant epidemic.

6. Drug use may lead to financial problems.

Addicts readily deplete their savings, pawn their possessions, take out second mortgages on the house, charge credit cards to the maximum, or spend an inordinate portion of the monthly pay on drugs or alcohol.

They may go through financial resources to the extent where housing and nutrition are compromised.

7. There are problems at work.

Besides reduced productivity, increased absence from work, higher utilization of sick time and disability that are seen in alcoholics and addicts that are employed, the employee may come to work intoxicated, or drink alcohol or use drugs while on the job.

There may be theft of property or embezzlement of company funds to obtain extra money for drugs.

If the employee is operating machinery or driving a vehicle, he or she is at a higher risk for accident or injury.

This may lead to confrontation of the employee by the company management, threatening or even terminating employment.

8. There may be psychological problems which develop, ranging from minor personality changes such as withdrawal, defensiveness, irritability, secretiveness, and moodiness to disordered thinking, bizarre behavior, hallucinations, delusions, paranoia--symptoms of severe mental illness.

Parents may witness their "A" student active in school extracurricular activities over a few short months' involvement with alcohol or drugs begin being absent from school, his or her grades plummet, his or her cheerful extroversion become moody, introverted, secretive and defensive withdrawal.

Drugs and alcohol can bring out a latent psychological condition: many people who have used hallucinogenic drugs or stimulants like amphetamines or cocaine have often precipitated a full-blown psychotic condition.

Long term drug or alcohol use may damage the brain, leading to deficits in the ability to remember and in intellectual functioning.

9. There may be spiritual or moral deterioration. When using drugs or alcohol, a person may lose his or her inhibitions and engage in behavior that formerly would have been unacceptable.

The rejection of moral values together with the adoption of a hedonistic and narcissistic lifestyle leads to profound changes in a person's character and behavior.

When addiction has totally possessed a person, he or she may wantonly disregard the rights and property of other people, resorting to criminal or violent behavior to obtain his or her desires.

This further leads to a deadening of the higher sensibilities, coupled with the abandonment of faith and religious values, produces a disconnection from one's spiritual nature and higher potentials.

The end result of this downhill slide is spiritual death—the lack of any sense of meaning or value in a person's life.

Question 3

From Denial to Recovery

Accepted Answer

Once an addicted person comes to recognize he or she has a problem with drugs or alcohol, many of these problems may have become exaggerated, and create many pressures for him or her.

During the active course of addiction, a person develops many protective defenses to deny responsibility and to not face the impact that drugs or alcohol have on his or her life.

This denial of any problem, with attempts to explain the problem away, to minimize it, to blame others for the problems, to withdraw into fantasy only prolongs the period of active drug or alcohol use and hastens the deterioration of the individual.

Unless this denial is broken and the problem confronted head on, the individual will continue to deteriorate and cause pain and misery for him or herself and those around him or her.

Question 4

The Way Back

Accepted Answer

The way to rebuild an addicted person's life, health and self-respect, and to begin the process of reintegrating him or her back into the family and the larger community is called recovery.

Since alcoholism and drug addiction are progressive, chronic, and if untreated, deadly diseases, they will inevitably lead to debilitation, deterioration, and death if unchecked.

Unless the individual chooses, or is pressured into recovery, it is highly likely that he or she will end up in a prison, a hospital, a mental institution or the graveyard if the disease is allowed to run its course.

Recovery, to be effective, must address each aspect of the individual:

Physically – the person's nutrition must be improved, with supplementation of vitamins used as necessary to correct long term vitamin and mineral deficits or electrolyte imbalances. A program of regular exercise will be helpful, and attention must be paid to restoring normal sleep patterns and ensuring adequate rest.
Emotionally – the person must learn how to feel his or her emotions again, how to relate intimately and honestly with others, how to communicate his or her feelings and needs to others without manipulation and deception, and how to cope with frustration, betrayal and loss.
Mentally – the person needs to learn about chemical dependency and the process of recovery. He or she must learn to overcome deficits in memory and cognition caused by long term drug use by utilizing strategies such as keeping notes, recording thoughts in a journal, or learning mnemonic tricks. Further, the individual may have neglected his or her education in the course of his or her active addiction, and he or she may wish to continue his or her education or train for a new career.
Volitionally – the person must learn to take responsibility for his or her own life, to face his or her problems courageously, to set goals for him or herself, and to live with honor, self-respect, excellence and integrity.
Spiritually – the person must learn to reconnect with his or her higher potentials. Spirituality must be reawakened. He or she needs to develop or renew a relationship with a Higher Power, to rebuild a morality and ethical value system, to fellowship with others in meditation, prayer, and worship, and to express his or her spirituality through loving service and charity to others.
Socially – the person needs to learn how to rebuild his or her relationships based on trustworthiness, honesty, integrity, and intimacy. The injuries that have been wrought must be gradually healed by genuine behavior change, honesty, sincere contrition and humility, and by relating to others with kindness, love and respect.
Legally – the person's legal obligations must be discharged as required by law: fines paid, community service commitments fulfilled, and jail time served. Further legal complications need to be avoided by scrupulous observance of community and traffic laws. In a larger sense, the person must repay his debt to the community by making amends to others he or she has harmed. This may take the form of personal or written apologies, paying back money owed, restoring property damaged, paying child support, or by doing charitable or volunteer service to in some way make up for the injury he or she has caused.
Financially – the person must learn to budget and to set financial goals. The budget must be adhered to strictly, and where possible, some of the income must go to discharging debts or other ongoing obligations and to rebuild creditworthiness where prodigality has strained the goodwill of lenders. The habit of saving for the future, investing for retirement and other financial goals must be re-established.
Vocationally – the person must strive to discharge the duties of his or her job with diligence, efficiency and excellence. The person should arrive punctually, observe employment rules and policies, and strive to perform his or her job duties with cheerfulness, with an aim to make the customer happy and help the company prosper. In some cases, job retraining or securing a new career may be necessary where employment has been lost and the former employer is unwilling to rehire the person, even on a probationary status.

The addicted person has two major obstacles to deal with in the recovery process:

The acute withdrawal from alcohol or drugs and the protracted post-addiction period where the body must regenerate itself from the effects of long term drug or alcohol use.
The maintenance of sobriety and his or her rehabilitation through the practice of recovery measures.

Question 5

Supportive Modalities for the Acute and Post-Withdrawal Phase

Accepted Answer

Supportive modalities that help the person through these two stages are summarized below.

Hatha Yoga or other stress relieving exercises to promote relaxation and improve health.
Neuroelectric therapy (NET), including electric acupuncture, biofeedback and psychotronic devices to build up neurotransmitters and train the individual to relieve the symptoms of physiological stress and to access healing and creative states of mind.
Nutritional supplementation, systemic detoxification and purification using vitamins and minerals, special diets, or herbal formulations to build health and eliminate toxins from the system.
Hypnosis or autosuggestion to change self-defeating beliefs in the subconscious mind
Behavior modification and aversion therapy to extinguish the craving for drugs
Individual and/or group psychotherapy to teach coping skills and promote emotional growth
Psychiatric and medical treatment as necessary to address psychological and physical sequelae to active substance abuse
Massage or bodywork therapy to relieve stress and facilitate body-mind integration
12 step programs to build an ongoing support group for sobriety and to work the steps of personal recovery
Meditation and prayer to help reconnect with spirituality and to experience a spiritual awakening. Fellowship with a spiritual or recovery group to rebuild supportive and positive interpersonal relationships.
Acupuncture to build endorphins and improve flow of life energy in the body to promote health
Herbs, Bach Flower remedies, and homeopathic remedies (where naturopathic approaches are preferred by the individual) to address other emotional and physical symptoms that arise during the post detoxification period

Question 6

Practices that Lead to Long Term Maintenance of Sobriety

Accepted Answer

Practices that will help maintain sobriety include:

Stay away from people who use drugs, places where drugs are used at present or where a recovering person has used drugs in the past. Stay away from objects that remind one of drug or alcohol use, such as hypodermic needles or alcohol bottles.
Have an ongoing personal recovery program and work it daily.
Create a network of non-using friends and talk to them when you feel depressed or lonely.
Attend counseling, therapy, or 12-step recovery groups regularly.
Contact your Higher Power daily through prayer and meditation and spiritual fellowship.
Make a commitment to do whatever it takes to maintain sobriety.
Pursue ongoing personal growth, self-discovery and the adventure in everyday living. There are too many interesting and worthwhile things to do instead of using drugs and alcohol.

Question 7

Drugs and Their Role in Society: What Must Be Done

Accepted Answer

People are attracted to consume drugs because drugs make life appear less difficult, boring, or painful.

Whether drugs are legal or illegal, they have been used in some form in most cultures of the world throughout mankind's history.

Drugs are so widespread in their use that some researchers have theorized that there may be a built-in drive to alter our state of consciousness.

For millennia, people have been fascinated and obsessed with drugs. People will continue to use and abuse drugs, creating problems for themselves and other people whether society declares them legal or not—as long as people desire to use drugs, they will find a way to get them.

Cultural beliefs about drugs and the laws that grow out of those beliefs condition how a society perceives and responds to drugs in each generation.

One generation's sweetheart drug becomes another generation's bogeyman.

It is interesting to note that two of the drugs that the industrialized countries of North America, Europe, and Asia have chosen to legalize—alcohol and tobacco—have the greatest amount of health risks, account for the greatest loss of productivity, traffic accidents, and homicides than any other drug.

Drugs are substances that humans extract from natural plants or synthesize in the laboratory from other substances.

In and of themselves, drugs are not good or evil. It is rather the use to which they are put which determines whether they benefit or harm individuals and society.

If individuals are going to continue to use drugs, and going to cause themselves and other people problems by doing so, Society's response must be to make these individuals accountable for their actions and to require that they address the problem with a personal recovery program.

Further, Society must make an effort to keep future generations away from destructive drug use by substance abuse education.

It must be able to offer them viable and meaningful alternatives within the community to engage them, instead of losing them to the siren of drug abuse with all of its associated costs to the individual and the community.

Question 8

Endnotes

Accepted Answer

1. Donlon, pages 113 - 115.2. Cohen, pages 195 to 200.

Question 9

Bibliography

Accepted Answer

Cohen, S. The Substance Abuse Problems. Volume Two. New York, NY: The Hayworth Press. 1985.Donlon, P. T., et. al. A Manual of Psychotropic Drugs. Bowie, MD: Robert J. Brady Co. 1983.