File Name: youth and drug abuse in india .zip
Addiction is a biopsychosocial disorder characterized by repeated use of drugs, or repetitive engagement in a behavior such as gambling, despite harm to self and others. The brain disease model posits that addiction is a disorder of the brain's reward system which arises through transcriptional and epigenetic mechanisms and develops over time from chronically high levels of exposure to an addictive stimulus e. Addiction exacts an "astoundingly high financial and human toll" on individuals and society as a whole. Examples of drug and behavioral addictions include alcoholism , marijuana addiction , amphetamine addiction , cocaine addiction , nicotine addiction , opioid addiction , food addiction , chocolate addiction , video game addiction , gambling addiction , and sexual addiction.
Addiction is a biopsychosocial disorder characterized by repeated use of drugs, or repetitive engagement in a behavior such as gambling, despite harm to self and others.
The brain disease model posits that addiction is a disorder of the brain's reward system which arises through transcriptional and epigenetic mechanisms and develops over time from chronically high levels of exposure to an addictive stimulus e. Addiction exacts an "astoundingly high financial and human toll" on individuals and society as a whole. Examples of drug and behavioral addictions include alcoholism , marijuana addiction , amphetamine addiction , cocaine addiction , nicotine addiction , opioid addiction , food addiction , chocolate addiction , video game addiction , gambling addiction , and sexual addiction.
With the introduction of the ICD gaming addiction was appended. Addiction can occur in the absence of dependence, and dependence can occur in the absence of addiction, although the two often occur together. Cognitive control and stimulus control , which is associated with operant and classical conditioning , represent opposite processes i. The term behavioral addiction refers to a compulsion to engage in a natural reward — which is a behavior that is inherently rewarding i.
Reviews of preclinical studies indicate that long-term frequent and excessive consumption of high fat or sugar foods can produce an addiction food addiction. Chocolates' sweet flavour and pharmacological ingredients is known to create a strong craving or feel 'addictive' by the consumer. Chocolate is not yet formally recognised by the DSM-5 as a diagnosable addiction.
Gambling provides a natural reward which is associated with compulsive behavior and for which clinical diagnostic manuals, namely the DSM-5 , have identified diagnostic criteria for an "addiction".
There is evidence from functional neuroimaging that gambling activates the reward system and the mesolimbic pathway in particular. There are a number of genetic and environmental risk factors for developing an addiction, that vary across the population. It has long been established that genetic factors along with environmental e. For example, altered levels of a normal protein due to environmental factors could then change the structure or functioning of specific brain neurons during development.
These altered brain neurons could change the susceptibility of an individual to an initial drug use experience. In support of this hypothesis, animal studies have shown that environmental factors such as stress can affect an animal's genotype. Overall, the data implicating specific genes in the development of drug addiction is mixed for most genes.
One reason for this may be that the case is due to a focus of current research on common variants. Genome-wide association studies GWAS are used to examine genetic associations with dependence, addiction, and drug use.
These studies employ an unbiased approach to finding genetic associations with specific phenotypes and give equal weight to all regions of DNA, including those with no ostensible relationship to drug metabolism or response. These studies rarely identify genes from proteins previously described via animal knockout models and candidate gene analysis. Instead, large percentages of genes involved in processes such as cell adhesion are commonly identified.
This is not to say that previous findings, or the GWAS findings, are erroneous. The important effects of endophenotypes are typically not capable of being captured by these methods. Furthermore, genes identified in GWAS for drug addiction may be involved either in adjusting brain behavior prior to drug experiences, subsequent to them, or both.
A study that highlights the significant role genetics play in addiction is the twin studies. Twins have similar and sometimes identical genetics. Analyzing these genes in relation to genetics has helped geneticists understand how much of a role genes play in addiction. Studies performed on twins found that rarely did only one twin have an addiction.
In most cases where at least one twin suffered from an addiction, both did, and often to the same substance. If one family member has a history of addiction, the chances of a relative or close family developing those same habits are much higher than one who has not been introduced to addiction at a young age.
In , 72, overdose deaths happened in the U. There were 81, overdose deaths, exceeding the records exponentially from Environmental risk factors for addiction are the experiences of an individual during their lifetime that interact with the individual's genetic composition to increase or decrease his or her vulnerability to addiction.
The National Institute on Drug Abuse NIDA cites lack of parental supervision, the prevalence of peer substance use, drug availability, and poverty as risk factors for substance use among children and adolescents. Adverse childhood experiences ACEs are various forms of maltreatment and household dysfunction experienced in childhood. The Adverse Childhood Experiences Study by the Centers for Disease Control and Prevention has shown a strong dose—response relationship between ACEs and numerous health, social, and behavioral problems throughout a person's lifespan, including substance abuse.
As a result, the child's cognitive functioning or ability to cope with negative or disruptive emotions may be impaired.
Over time, the child may adopt substance use as a coping mechanism, particularly during adolescence. Family conflict and home management is also a cause for one to become engaged in alcohol or other drug use. Adolescence represents a period of unique vulnerability for developing an addiction. This consequentially grants the incentive-rewards systems a disproportionate amount of power in the behavioral decision-making process. Therefore, adolescents are increasingly likely to act on their impulses and engage in risky, potentially addicting behavior before considering the consequences.
Statistics have shown that those who start to drink alcohol at a younger age are more likely to become dependent later on. As for alcohol abuse or dependence, the numbers start off high with those who first drank before they were 12 and then drop off after that. This percentage is even lower, at 2. Most individuals are exposed to and use addictive drugs for the first time during their teenage years.
Individuals with comorbid i. Epigenetic genes and their products e. The general classes of epigenetic alterations that have been implicated in transgenerational epigenetic inheritance include DNA methylation , histone modifications , and downregulation or upregulation of microRNAs.
Chronic addictive drug use causes alterations in gene expression in the mesocorticolimbic projection. The release of dopamine in the nucleus accumbens plays a role in the reinforcing qualities of many forms of stimuli, including naturally reinforcing stimuli like palatable food and sex. Understanding the pathways in which drugs act and how drugs can alter those pathways is key when examining the biological basis of drug addiction.
The reward pathway, known as the mesolimbic pathway , or its extension, the mesocorticolimbic pathway , is characterized by the interaction of several areas of the brain. Dopamine is the primary neurotransmitter of the reward system in the brain.
It plays a role in regulating movement, emotion, cognition, motivation, and feelings of pleasure. Excessive intake of many types of addictive drugs results in repeated release of high amounts of dopamine, which in turn affects the reward pathway directly through heightened dopamine receptor activation. Prolonged and abnormally high levels of dopamine in the synaptic cleft can induce receptor downregulation in the neural pathway.
Downregulation of mesolimbic dopamine receptors can result in a decrease in the sensitivity to natural reinforcers. Drug seeking behavior is induced by glutamatergic projections from the prefrontal cortex to the nucleus accumbens. This idea is supported with data from experiments showing that drug seeking behavior can be prevented following the inhibition of AMPA glutamate receptors and glutamate release in the nucleus accumbens.
Reward sensitization is a process that causes an increase in the amount of reward specifically, incentive salience [note 5] that is assigned by the brain to a rewarding stimulus e. In simple terms, when reward sensitization to a specific stimulus e. Research on the interaction between natural and drug rewards suggests that dopaminergic psychostimulants e. CREB transcription in the nucleus accumbens is implicated in psychological dependence and symptoms involving a lack of pleasure or motivation during drug withdrawal.
The set of proteins known as " regulators of G protein signaling " RGS , particularly RGS4 and RGS , have been implicated in modulating some forms of opioid sensitization, including reward sensitization. Altered epigenetic regulation of gene expression within the brain's reward system plays a significant and complex role in the development of drug addiction.
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5 uses the term " substance use disorder " to refer to a spectrum of drug use-related disorders.
The DSM-5 eliminates the terms " abuse " and "dependence" from diagnostic categories, instead using the specifiers of mild , moderate and severe to indicate the extent of disordered use. These specifiers are determined by the number of diagnostic criteria present in a given case. In the DSM-5, the term drug addiction is synonymous with severe substance use disorder.
The DSM-5 introduced a new diagnostic category for behavioral addictions; however, problem gambling is the only condition included in that category in the 5th edition. Past editions have used physical dependence and the associated withdrawal syndrome to identify an addictive state. Physical dependence occurs when the body has adjusted by incorporating the substance into its "normal" functioning — i. Withdrawal refers to physical and psychological symptoms experienced when reducing or discontinuing a substance that the body has become dependent on.
Symptoms of withdrawal generally include but are not limited to body aches, anxiety , irritability , intense cravings for the substance, nausea , hallucinations , headaches , cold sweats, tremors , and seizures.
Medical researchers who actively study addiction have criticized the DSM classification of addiction for being flawed and involving arbitrary diagnostic criteria. While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each.
The strength of each of the editions of DSM has been "reliability" — each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.
In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Given that addiction manifests in structural changes to the brain, it is possible that non-invasive neuroimaging scans obtained via MRI could be used to help diagnose addiction in the future.
According to a review, "in order to be effective, all pharmacological or biologically based treatments for addiction need to be integrated into other established forms of addiction rehabilitation, such as cognitive behavioral therapy, individual and group psychotherapy, behavior-modification strategies, twelve-step programs , and residential treatment facilities.
A meta-analytic review on the efficacy of various behavioral therapies for treating drug and behavioral addictions found that cognitive behavioral therapy e.
Clinical and preclinical evidence indicate that consistent aerobic exercise, especially endurance exercise e. Alcohol, like opioids, can induce a severe state of physical dependence and produce withdrawal symptoms such as delirium tremens. Because of this, treatment for alcohol addiction usually involves a combined approach dealing with dependence and addiction simultaneously. Benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal and are considered the gold standard of alcohol detoxification.
Pharmacological treatments for alcohol addiction include drugs like naltrexone opioid antagonist , disulfiram , acamprosate , and topiramate. These drugs can be effective if treatment is maintained, but compliance can be an issue as alcoholic patients often forget to take their medication, or discontinue use because of excessive side effects. Behavioral addiction is a treatable condition. Treatment options include psychotherapy and psychopharmacotherapy i. Cognitive behavioral therapy CBT is the most common form of psychotherapy used in treating behavioral addictions; it focuses on identifying patterns that trigger compulsive behavior and making lifestyle changes to promote healthier behaviors.
Because cognitive behavioral therapy is considered a short term therapy, the number of sessions for treatment normally ranges from five to twenty. During the session, therapists will lead patients through the topics of identifying the issue, becoming aware of one's thoughts surrounding the issue, identifying any negative or false thinking, and reshaping said negative and false thinking. While CBT does not cure behavioral addiction, it does help with coping with the condition in a healthy way.
India has one of the largest proportion of children and adolescents in the world, but the threat posed by child substance use remains under-researched. We discuss i the existing knowledge on the prevalence of child substance abuse in India; ii perspectives and insights gained from the recent nation-wide study on its pattern and profile; and iii recommendations for substance use prevention and treatment among children in the Indian context. A multipronged approach involving all stakeholders is required to address the issues of prevention and treatment. Advanced Search. Adolescent substance use: America's 1 public health concern.
Substance use patterns are notorious for their ability to change over time. Both licit and illicit substance use cause serious public health problems and evidence for the same is now available in our country. National level prevalence has been calculated for many substances of abuse, but regional variations are quite evident. Rapid assessment surveys have facilitated the understanding of changing patterns of use. Substance use among women and children are increasing causes of concern. Preliminary neurobiological research has focused on identifying individuals at high risk for alcohol dependence. Clinical research in the area has focused primarily on alcohol and substance related comorbidity.
Official websites use. Share sensitive information only on official, secure websites. We have expanded funding and training opportunities, established more productive protocols based on our government-to-government relationship with the Tribes, and have sought to be more clearly accountable for our efforts…The Tribal Law and Order Act of has been good for Indian Country and good for those of us working to ensure justice in Indian country. Trent Shores, U.
Get the latest information from CDC coronavirus. Trying drugs may fulfill all of these normal developmental drives, but in an unhealthy way that can have very serious long-term consequences. The family environment is also important: Violence, physical or emotional abuse, mental illness, or drug use in the household increase the likelihood an adolescent will use drugs.
Bearing the burden of a densely populated country like India is no small task. And drug abuse does nothing to lighten the load. The youth of our nation has a massive responsibility.
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