Alcohol and Drugs
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Medical issues with drug use

The same dose of the same drug can have different outcomes

  • Depends on the amount taken, number and timing of doses or route (mouth, smoking or injection)
  • Rate broken down, user’s past experience, expectations, motivations and tolerance.
  • Whether drug is taken alone or in combination with other drugs, the atmosphere or company.
  • Type of person, inherited biology, health or mood.

Psychological Effects

  • Euphoria/ increase sense of pleasure.
  • Mood Disturbance, depression, suicidal behaviour, acute anxiety, panic, apathy and irritability. 
  • Sexual aggression, agitation.
  • Impaired attention or memory loss.
  • Social withdrawal.
  • Reduction of self confidence, inability to cope.
  • Hallucinations.
  • Psychological Dependence.

Sociocultural Effects

  • Additional pressures on family, marital/family conflict, tension.
  • Occupation (sickness, inefficiency, poor judgement, unreliability, drift down social scale).
  • Peer group interactions/relationships.
  • Loneliness (loss of friends and interests)
  • Academic Problems (poor attainment, truancy and stealing).
  • Debts, Crime or Prostitution.
  • Antisocial Behaviour, Violence, Homeliness (30% being problem drinkers).

Issues with common drugs

Anxiolytics and Hypnotics


These are depressants that include: Benzodiazepines e.g. Diazepam, temazepam, nitrazepam, zimovane (may be injected after crushing). They are commonly referred to as Downers.

Side effects / Risks

  • Reduce anxiety and help to induce sleep.
  • Cause disinhibition, particularly in high doses.
  • Enhanced effects when taken with either opiates or alcohol.
  • Counteracts effects of stimulant drugs.
  • Over-sedation, slurred speech, inappropriate, intoxicated and violent disinhibited, behaviour, amnesia, accidents (in combination with alcohol).

Withdrawal effects

  • Anxiety.
  • Panic, insomnia, depression.
  • Sweating, tremor, irritability.
  • Sudden Cessation; withdrawal seizures.

Alcohol


Side effects / Risks

  • Highly toxic to almost all human organ systems
  • Acute intoxication.
  • Blackouts.
  • Persistent Brain Damage.
  • Nerve and Muscle Damage.
  • Respiratory; Pneumonia or inhalation of vomit.
  • Cancers - mouth, pharynx, larynx, breast, oesophagus, pancreas.
  • Risk of self-harm and suicide.
  • Gastrointestinal
    • Gastritis, Pancreatitis, Gastrointestinal haemorrhage, malnutrition.
    • Hepatitis, Cirrhosis of liver.
  • Cardiovascular
    • Cardiac arrhythmias.
    • Hypertension.
    • Cardio-myopathy.

Cannabis


Side effects / Risks

  • Negative mood states and dysphoria.
  • Short term memory impairment.
  • Physical ill-effects - dry mouth, red eyes, increased heart rate.
  • Fatigue, craving for food (the munchies).
  • Nausea and vomiting.
  • Transient anxiety, panic and paranoia.
  • Psychosis may be precipitated in those at high risk.
  • Individuals with serious mental illness may increase relapse.

Note: The use of Street cannabis - tetrahydrocannabinol [THC] has risen from 6% to 12%

Opiates


Side effects / Risks

  • Nausea.
  • Vomiting.
  • Appetite suppression.
  • Constipation leading to weight reduction and nutritional deficiencies.
  • Overdose.
  • Death from respiratory depression.
  • Tolerance reduces with abstinence or reduced intake.
  • Opiates in combination with alcohol / benzodiazepines enhances their effect.

Illicit drug use


Side effects / Risks

  • Complications arising from needle sharing and contaminants.
  • Cellulitis, abscesses, thrombophebitis, septicaemia, hepatitis, arterial puncture, increased risk of HIV, gangrene.
  • Respiratory complications.
  • Higher rates of liver and renal disease.
  • Dietary complications - weight loss and malnutrition.
  • Risk of self-harm - Crowe et al (2000) Pomeroy (2002 cited in Harrison and Hart, 2006).

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