International Day Against Drug Abuse:

Abuse of prescription drugs - looming problem

By Prof Ravindra Fernando

The International Day against Drug Abuse and Illicit Trafficking is a United Nations International Day against drug abuse and the illegal drug trade. On 26th June every year, United Nations Office of Drugs and Crime (UNODC) marks the International Day. This year, the campaign theme is “Listen First”. The aim is to increase support for prevention of drug use that is based on science and is thus an effective investment in the well-being of children and youth, their families and their communities.

Non-medical use of drugs can be for experimentation, recreational use or for their helpful effects, which are not medically approved. A drug is a substance when taken into the living organism that can modify one or more of its functions. Drug abuse may be considered as the use of a drug, usually by self-administration, in a way different from the approved medical or social patterns in a given culture.

The morbidity from drugs can be due to direct physical or mental pharmacological effects, consequences of the methods used, and the effects of dependence and abstinence.

Drug dependence is a state characterized by an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means is considered drug addiction. It is sometimes accompanied by physical dependence and the resulting state is detrimental not only to him, but also to the society.

There are many addictive or dependence producing drugs. They include,

* Alcohol and barbiturate type drugs
* Amphetamine, methamphetamine
(Ecstasy) and anti-obesity drugs

* Cannabis
* Cocaine
* Hallucinogens (LSD, certain mushrooms)
* Khat type
* Opiates including heroin
* Volatile solvents
* Benzodiazepines, methaqualone and similar pharmaceuticals

* Tobacco products

In Sri Lanka, major illicit drugs used are cannabis and heroin.

Cannabis is the most widely produced and consumed illicit substance in Sri Lanka. The estimated land area under Cannabis cultivation is nearly 500 hectares. The present trends indicate the incidence abuse of cannabis has become a serious problem in Sri Lankan society. A significant increase is reported of in the Kerala variety of Cannabis smuggled from India.

Heroin is the second largest and the most commonly consumed opiate in Sri Lanka. Heroin has become a major health and social problem in the country. Based on heroin seizures, the estimated street level supply of heroin in Sri Lanka is estimated to be nearly 800 Kg per annum.

Heroin causes a sense of well being, euphoria, contentment, detachment from emotional/physical distress and pain relief. It can cause drowsiness, lack of concentration, respiratory depression and even death. Addiction to heroin causes serious withdrawal symptoms when heroin is not present in blood. Addicts experience anxiety, restlessness, sweating, yawning, runny nose, watering of the eyes, diarrhoea, incontinence of urine, abdominal pains, muscle cramps, hallucinations and delusions.

Inhaled

In Sri Lanka heroin is inhaled. This is much less harmful than intravenous injections. Intravenous drug addicts are more prone to get infections. They die prematurely from acute heroin overdose, inhalation of vomit, acute ulcerative endocarditis, bronchopneumonia and hepatitis. They are more likely meet with accidents and commit suicide.

Pharmaceutical drug abuse has recently gained popularity in Sri Lanka and is becoming a major health concern. Pharmaceutical Drug Abuse can be defined as taking of prescription drugs, whether obtained by prescription or otherwise, other than in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed.

* The real scale of the problem is unknown, due partly to lack of data on the non-medical use of prescription drugs, and partly to the existence of many gaps in the monitoring of their legal use for medical purposes as prescribed by healthcare professionals

The impact of drug abuse on the individual, his family and on the society is very significant. The family and the community can be the origin of drug problems, but they can also be a potent force for treatment. The disrupted family life can lead to drug problems, while drug problems can lead to disruption of family life.Drug abuse is common among poor families, while a drug abuser in a family makes them poorer. Drug abuse impairs family life, results in unproductive employment and reduces the quality of life. Impaired performance at work can lead to poor productivity and reduced income. Absence from work and intoxication at work can lead to disciplinary problems, accidents at work and excess medical claims.

Premature

It is very unfortunate that young drug addicts face premature death. The cost to the health services and the economy of the country can be significant.

While illicit cultivation, production, distribution and possession of drugs are crimes, drug abusers commit crimes for money and after influence of drugs. Drug trade is involved with money laundering. Drug trafficking leads to all types of crime, violence, gun use and even terrorism. Monetary costs from theft and other crimes by abusers to support their drug habits, and money spent for law enforcement agencies and the judiciary can be significant.

Many recommendations are made to prevent and treat drug abuse. Return to old family values in the society is one. There should be adjustment to accept the return of a family member who was a drug abuser. Family counselling for change, informing and educating parents, and support and strengthen religious values is also recommended. The National Dangerous Drugs Control Board (NDDCB), in terms of the National Policy, * functions as the National Competent Authority (Focal Point) for control of drug abuse in Sri Lanka and coordinate the drug control activities of all relevant organizations. It monitors, and reviews the Sri Lanka National Policy for “Prevention and Control of Drug abuse”.

Other activities of the NDDCB include, managing information, conducting research, setting and validating norms and standards, and developing and testing new technologies, tools and guidelines. As Kofi Annan, a former UN Secretary-General said, “Illicit drugs destroy innumerable individual lives and undermine our societies. Confronting the illicit trade in drugs and its effects remains a major challenge for the international community.”

The writer is Chairman, National Dangerous Drugs

Control Board