DNB (Psychiatry), DPM, MBBS
Alcohol and other substances are known to cause intoxication to man since the oldest found records. Much has been talked about the ill effects of all these substances and yet their use is rampant in all society - rich, poor, young, old, male, female & all the races around the world. Why? intoxication.
Everybody has a certain amount of dopamine & endorphins in their which are the pleasure chemical. Some people produce less of it, genetically or due to other reasons. These individuals seek out substance in various forms for their dopamine & endorphin levels to be maintained. Tolerance. Different genetically programmed individuals start consuming substances at different age. And after a certain level, they need more of the same substance for the desired effect. This is called tolerance.
Withdrawal. When a person is addicted to a substance long enough that when one stops its suddenly, it can cause physicals effects like tremors, sleeplessness, cravings, body ache, etc. These features are known as withdrawals.
When all these three features are seen in a person along with a lifestyle which only involves getting & consuming the substance as main priority, then we can diagnose the person as substance dependence. The main substances of abuse seen in our country are:
- tobacco (cigarettes, bidis, gutkha, tambaku, khaini, paan, zarda)
- alcohol (beer, spirit)
- cannabis (ganja, charas, weed, grass, marijuana)
- opioids (garad, brown sugar, heroin, cough syrup)
- benzodiazapenes (button, roofies)
- inhalant (whitener, nail paint remover)
- hallucinogens (lsd, acid, mushrooms, amphitamines)
And many more which can be experimented with and can become drugs of abuse.
The main thing to keep in mind regarding treatment of substance dependence is that it is a psychiatric illness like diabetes or hypertension, and that it is not under the voluntary control of the patient. The patient requires strong social support to strengthen his motivation to leave the substance. Medications can only help in suppressing the withdrawal features & control cravings to some extent. But acceptance of substance dependence as a mental illness by the society is the need for the hour.
Any patient should not try leaving substance on their own as withdrawal can lead to further complications. Please consult your nearest psychiatrist for medication & further help.