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DRUG ABUSE

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Ishrat Eshita
Bangabandhu Sheikh Mujib Medical University
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National Institute of Preventive and Social
Medicine (NIPSOM)

Masters of Public Health in

Community Medicine

Assignment
Drug Abuse

Dr. Ishrat Rafique Eshita

Introduction

World Health Organization (WHO) defines Drug; it is a

chemical substance of synthetic, semi synthetic or natural
origin intended for diagnostic, therapeutic or palliative use or
for modifying physiological functions of man and animal.
Drug abuse or addiction is now prevalent everywhere in
Bangladesh; in the house, streets, in the workplace, parks,
slums, markets and even in educational institutions both in
rural and urban areas.
 The spread of multiple drug use has aggravated the
overall problem, personal and social days function,
impairment of health, crime and other violent behavior.
Drug abuse, chronic or habitual use of any chemical
substance to alter states of body or mind for other than
medically warranted purposes. The term "substance abuse" is
now frequently used because of the broad range of
substances (including alcohol and inhalants) that can fit the
addictive profile. Psychological dependence is the subjective
feeling that the user needs the drug to maintain a feeling of
well-being; physical dependence is characterized by tolerance
and withdrawal symptoms.
Bangladesh scenario :
Since 1970 drug abuse in Bangladesh no longer
containable by traditional restraints. Near about 25 lakh
people are drug addicted. In Bangladesh about 80 percent
of the drug addicts are adolescents and young of 18 to 30
years of age and they are from all strata of the society.
Bangladesh is situated in the central point between the
‘golden triangle’ (Mayanmar, Thailand and Laos) and the
‘golden crescent’ (Pakistan, Afghanistan and Iran) in terms
of geographical location. The geographical position for
drug trafficking, the process of rapid urbanization,
weakening of family relationship, widespread
unemployment, economic stress, lack of psychological
resources to deal adequately with inner conflict etc. have
continued to create a growing narcotic glutting in
Bangladesh.
Table : The Main Border Crossing Points In Bangladesh That
Are Highly Used For Smuggling
Region Country Border Crossing point
Western India Benapol, Dorshona, Dogachi, Parsha,
Hilly, Birol, Balubari, Banglabandha.
Eastern India & Latu, Ahamadabad, Akhaura, Koshba,
Myanmar Amratoly, Razapur, Braymmapara,
Bibirbazar, Chaddagram, Suagazi,
Mirja nagar, Ramghar, Barkal, Ukhia,
Teknaf
Northern India Tinbigha Corridor, Patgram,
Mogholhat, Ailatoly, Tamabil
In Comilla India & Amratoly, Razapur, Braymmapara,
(Eastern Myanmar Bibirbazar, Chaddagram, Suagazi
region)

(Source: Graphosman’s New Atlas)

Epidemiological aspects of drug abuse

Host Factors :
Excitement, Fashion, Relaxation, Curiosity,
Escape from problem, Bored situation.

Agent Factors :
Availability, Entrance, Injudicious prescription of
drugs.

Environmental Factors:
Broken parenthood, Slum area, Psycho-social
instability.
Drug vs. Medicine
Character Drug Medicine
A drug is a substance that is The word ‘medicine’ expresses a
Definition often considered narcotic, preparation used for the treatment
hallucinogen or a stimulant. or prevention of disease.
Stupefaction Drugs can cause Medicine does not cause
stupefaction. stupefaction.
Addiction Addiction to drugs can be Medicine do not cause addiction.
harmful.
Drugs are substance. Medicine can be broadly
Nature understood as the science or
practice of the diagnosis, treatment
and prevention of disease.
Drug abuse related terms

Drug Addiction : is a state of periodic or chronic intoxication

produced by the repeated consumption of a drug (natural or
synthetic).

Drug Habituation : is a psychological dependence which

produces a desire but not a compulsion to certain drug taken
for the sense of well being it produces

Drug Dependence : is the body’s physical need or addiction

to a specific agent. Drug dependence causes withdrawal
symptoms. A person may be dependent upon more than one
drug.
Available drugs in Bangladesh

 Opium;  Cannabis(Marijuana):
1. Heroin 1. Ganja
2. Pethedine 2. Chorosh
3. Cocaine 3. Bhang
4. Hashish

 Stimulant;  Sleeping pill:

1. Yaba ( methamphetamine 30% 1. Tranquilizer
and caffeine 70%) 2. Diazapam;
2.Ectasy
3. Viagra (sildenafil)

Cough syrup;  Glue

1.Phensidyl (codeine, pseudoephedrine
and chlorpheniramine)
2. Dexpotent
Drug addicted in percentage

1. Male 93.9 %
2. Female (in Dhaka city) 20.6 %
3. Unmarried 64.8 %
4. Either students or unemployed (youth generation) 56.1 %
5. Smokers 95.4 %
6. Influenced by friends 85.7 %
7. Addicted to codeine-containing cough syrup 65.8 %
8. Addicted to more than one drug 64.3 %
9. Took drugs in groups 65.8 %
10. A history of unprotected sex 63.8 %.

(Source : A review article on “Drug addiction in Bangladesh and its effect)

Reasons for being addicted
•Easy access to drugs
•Unemployment problem
•Surrounding atmosphere
•Estranged in love
•Mental stress due to family problem
•Encouragement from friends
•To get immediate relief from tension
•Derailed from study
•Medical professionals
•Irrational prescribing of drugs.
Sources of money for buying drugs
•From own income
•From pocket money
•Loan from friends, family members
•Collect money by criminal activities like hijacking, extortion
etc.
Where from abusers collect drugs/the nearest drug
spots

• Specific sellers in the locality

• Drug smugglers in town
• Houses near border area
• Drug smugglers in border crossing points
• From police, BDR
• Spots beside lanes/roads

Persons involved in drug business / smuggling

• Some elites in society

• Some political leaders/so-called student leaders
• A syndicate of smugglers
• Some members of the police/BDR
e-Cigarettes

e-cigarettes are increasingly popular battery operated

devices marketed as a safer alternative to smoking
conventional cigarettes. They produced flavored nicotine
aerosol that looks and feels like tobacco smoke but without the
tar or other chemicals produced by burning tobacco leaves.
However, while e-cigarettes do not produce tobacco smoke, it
is still unclear how safe they are. They still deliver nicotine,
which is highly addictive drug.
Economical & Social impacts
The average cost of drugs per person were from $1.9 to $3.1
per day or from $707 to $1135 per year. The pattern and cost of
drug abuse is also increasing among drug abusers for admitting to a
drug dependence treatment centre in Dhaka, Bangladesh.
Some Negative effects due to drug abusing from Respondents
view : Physical impatience, Insomnia, Sense of perception doesn’t
work, Increased head-ache, Feeling dizziness until taking drugs,
Hallucination syndromes, Decreased working capability and
stability, Sexual problem, Abnormal behavior, Loose humanity and
every kind of assessment, Lack of discipline in daily life.
Changes in social behavior according to the abusers:
Increased hijacking, Increased extortion, Increased stealing,
robbery, Deteriorated law and order situation and respectness to
elder, Increased personal and family expenditure, Lost of interest in
education, Change in morality.
Management
Substance abuse often includes problems with impulse control and
impulsive behavior. The primary goals of recovery are :
Motivation,
Drug detoxification,
Psychotherapy (Individual, Group & Behavioral),
Relapse prevention and rehabilitation,

From the applied behavior analysis literature, behavioral

psychology and from randomized clinical trials, several evidence based
interventions have emerged :
Behavioral marital therapy,
interviewing,
Community reinforcement approach,
Exposure therapy,
Contingency management.
Prevention :
1. Development of public polices :

which should include-

a) Laws to prohibit or control manufacture,
transport, sale and use of drugs
b) Eradication, replacement, diversification of
crops producing addictive substances
c) Combating offenders.
d) Harsh penalties for offenders
 e) Strict control of imported drugs with
medical values as well as addictive
properties.
f) Prescribing & dispensing restriction on
drugs
like morphine pethidine, barbiturates &
benzodiazepines.
g) Warning labels on dependence producing
drugs & cigarettes.
h) Rational prescribing of drugs.
i) Strong political commitment.
2. Altering population at risk :

high risk group may be identified by

considering family history of drug abuse, broken
home, low income, lake of family discipline, lake
of religious training, association with drug
dependent peer, poor work environment.
Conclusion
Drug addiction beings on rapid erosion of educational and
cultural, moral and family values. The addicts lose their
professional and educational capabilities, self-dignity, and get
involved in criminal activities. The Drugs and Narcotics
Department was created nearly two decades ago, especially to
counter the production and availability of addictive drugs. But it
has done little over the years to attain its given objectives. Political
commitment is required to combat the illicit drug-traffickers who
are sucking the blood of innocent youths and becoming rich very
quickly through smuggling of drug.
 Thank You

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