While many people believe that drug culture is fairly new, recreational drug use actually dates way back in history. For centuries, the natives of Peru for example, have been chewing leaves of the South American Coca plant, which contains cocaine as a natural alkaloid- it alleviated the rigors of high altitude, but also gave an exhilarating thrill and surge in energy. As time progressed, people found ways to synthesise deadlier drugs- crystal meth for example, can be manufactured from just a few over-the-counter items like acetone from nail polish remover or lithium obtained from batteries. According to the World Drug Report 2017, 255million people took ‘some form of drug in just 2015, 190 000 of which died mostly from overdoses.

Just like natural rewards-food, chronic drug use activates the brain’s reward system, causing intense feelings of well-being, and sets it in a mode where it is always craving for more, leading to addiction. Simultaneously, drug addicts also experience tolerance, a phenomenon in which they need increasing doses to achieve their initial high. The person soon develops physical and psychological dependence, whereby abrupt discontinuation of the drugs causes unpleasant physical symptoms and emotional withdrawal responses like uneasiness, dissatisfaction, anxiety, depression, insomnia among others. Street drugs users will experience ecstatic peaks of euphoria then drop straight to the depths of despair and craving- ultimately they may be left to carry brain damage for the rest of their lives.

Among the legal drugs available, alcohol and tobacco are the most abused. In 2010, a UK drug survey published on ‘The Economist’ actually found alcohol to be the number one substance abuse most damaging to health, followed by heroin, methamphetamine and tobacco. Since alcohol is metabolised in the liver, its chronic use and abuse is most prominent as liver diseases: its metabolite, acetaldehyde can rise to toxic levels causing alcoholic hepatitis and liver cirrhosis –ultimately, when the liver can no longer remove toxins from blood, they reach the brain causing hepatic encephalopathy and loss of brain function. On the other hand, the effects of long term tobacco smoking are most notable in the lungs; cigarette smoking is the leading risk factor for lung cancer due to various carcinogens inhaled (metals like cadmium and lead, tar and radioactive compounds). Oxidising chemicals present in cigarette can react with cholesterol leading to plaque buildup on artery walls and eventually causing heart attacks and strokes.

One of the dangers of taking a drug via the intravenous route includes contracting blood-borne pathogens –HIV, Hepatitis, via the sharing of needles. Heroin is the most common. It acts through opioid receptors to produce analgesia- the user experiences suppression of pain and a feeling of well-being but soon after, withdrawal sets in, causing restlessness, anxiety, shivering, muscle and bone pain. Relating to pregnancy, a paper from the Western Journal of Medicine stated that the neonatal mortality rate from mothers addicted to heroin was four times higher than in the normal population; the principal causes of death were prematurity and growth retardation. In fact, babies born from such mothers can be addicted to the drug since birth, experiencing withdrawal symptoms of hyper-irritability, tremors, poor feeding, vomiting and diarrhoea from the moment they are born, a condition known as neonatal abstinence syndrome.

Cocaine and methamphetamine are the commonest abused drugs among the CNS stimulants. The highs of cocaine include boundless energy , heightened awareness and self-confidence while the lows comprise of headaches, tremors , teeth-grinding, paranoia and aggression- in 2009 , the police in Manchester examined 1000 violent crimes and found that nearly half of the offenders tested positive for drugs , with 86 % testing positive for cocaine.

Methamphetamine is a derivative of amphetamine, a potent CNS stimulating drug- it is one of the drugs included in the ‘dope test’ of athletes since it gives a boost in athletic performance, followed by depression. Methamphetamine is commonly referred as ‘Meth’, and one of its derivatives is the drug Ecstasy, a widely used party drug that boosts self-confidence, empathy and pleasure. At the CNS level, methamphetamine causes exhaustion of dopamine, a neurotransmitter primordial for regulating coordinated movements. This results in Parkinsonism, a condition characterized by bradykinesia (slow movements), tremors, muscle rigidity and postural instability. Meth users are also affected physically; they usually have a hollowed out facial appearance: their skin shows scarring and they bear a characteristic ‘meth mouth’, which shows extensive tooth decay as a result of damage from the drug and severe teeth grinding.

The above mentioned drugs are only a few among the countless of other options currently available in the black market. Billions of dollars are spent every year rehabilitating addicts. Tackling substance abuse starts with education and it will take a global effort to solve this emerging problem.

Poornavada Ujhoodha

Bachelor of Medicine, Bachelor of Surgery

Aspiring Member

JCI Curepipe