Introduction

       Substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of substance-related disorder. Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behavior occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

       Drugs most often associated with this term include: alcohol, cannabis, barbiturates, benzodiazepines, cocaine, methaqualone, opioids and some substituted amphetamines. The exact cause of substance abuse is not clear, with theories including one of two: either a genetic disposition which is learned from others , or a habit which if addiction develops, it manifests itself as a chronic debilitating disease. In 2010 about 5% of people (230 million) used an illicit substance.Of these 27 million have high-risk drug use otherwise known as recurrent drug use causing harm to their health, psychological problems, or social problems or puts them at risk of those dangers. In 2015 substance use disorders resulted in 307,400 deaths, up from 165,000 deaths in 1990.Of these, the highest numbers are from alcohol use disorders at 137,500, opioid use disorders at 122,100 deaths, amphetamine use disorders at 12,200 deaths, and cocaine use disorders at 11,100.

        People abuse substances such as drugs, alcohol, and tobacco for varied and complicated reasons, but it is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospitals and emergency departments through direct damage to health by substance abuse and its link to physical trauma. Jails and prisons tally daily the strong connection between crime and drug dependence and abuse. Although use of some drugs such as cocaine has declined, use of other drugs such as heroin and "club drugs" has increased.

         Finding effective treatment for and prevention of substance abuse has been difficult. Through research, we now have a better understanding of the behavior. Studies have made it clear that drug education and prevention aimed at children and adolescents offers the best chance to curb abuse nationally. The National Institute on Drug Abuse estimated the number of users of illicit drugs in 2014 in the United States ages 12 and over to be about 7 million. In addition, the survey estimated that 6.4% of Americans (roughly 17 million adults) abuse or are dependent on alcohol.

            Meaning/Definition

                                    Substance use is when someone consumes alcohol or drugs. Remember Jeremy? The very first time that he took a sip of alcohol, he was using. Substance use does not always lead to addiction; many people occasionally use alcohol or certain drugs without being addicted. However, substance use always comes with the risk that it might lead to addiction.

                          Substance abuse, meanwhile, is when a person consumes alcohol or drugs regularly, despite the fact that it causes issues in their life. The issues caused by abuse may be related to their job, their personal life, or even their safety. People who abuse drugs and alcohol continue to consume them, regardless of the consequences. Last month, Jeremy's girlfriend threatened to break up with him because he drank too much and was mean to her when he did. Instead of using that as a warning sign, he kept drinking and lost his girlfriend. This is an example of substance abuse: He continues to drink, even though there are consequences.

              Importance of Substance Abuse Treatment

                                    Why do we treat substance abuse? It’s just like asking, why do we treat diabetes or heart disease or hypertension? It’s because just like any of these other medical conditions, substance abuse when left untreated robs people of the quality of life that they would otherwise enjoy with the rest of us. Left untreated, drug addiction reduces human beings into tragic shadows of the people they could be. No one deserves to be neglected in their time of need and one thing is certain here, substance abusers cannot get better by themselves.

                                    Substance abuse and addiction is one of the more serious problems of the modern world. Apart from the health risks, drug addiction can drive those afflicted with it to certain high-risk behavior that can possibly harm not just them but the people around them, their families, their friends and even strangers.

                Health Risks of Drug Abuse & Addiction

Drug abuse is associated with various medical problems including:

• Cardiovascular diseases
• HIV/AIDS
• Stroke
• Hepatitis
• Lung disease
• Cancer

The Economic Costs of Drug Abuse & Addiction

• Health Care

The treatment of substance abuse will result to great savings on health care. Substance abusers who stay untreated or undertreated consume a big chunk of this country’s health care dollars. They crowd clinics and emergency rooms again and again for various ailments brought on by their compromised health conditions. A recent study on federal and state spending found that over $200 billion is spent annually on health care for alcohol, tobacco and drug abuse patients. A total of 2.3 million hospital admissions are due to substance abuse alone.

It was found that even the children of drug users incur three times the health care costs of the children of non-using parents. Women who used cocaine while pregnant give birth to babies who cost over $5000 more to care for than infants who had not been exposed to the drug.

Men who have received substance abuse treatment demonstrated a 26% drop in their total medical costs. This figure came from a recent study done in California, which suggests that more investment must be made towards appropriate substance abuse rehabilitation in order to achieve greater overall savings on health care.

• Legal Costs

           The more drug abusers that become rehabilitated, the less drug-related crimes there will be. We can only imagine how many hours are spent sorting out the many drug-related cases in our courts, not to mention all the financial and human resources spent on law enforcement, restitution, state-sponsored counseling and community service projects etc.

          Substance abuse and addiction destroys lives, families and careers. It affects the community in a negative way. Society has a stake in the fight against drug addiction, a fight that we all cannot risk to lose. We need to help find a way to break the addiction cycle. This is the number one objective of drug addiction rehabilitation. Only then can we hope to bring back a lost soul into the folds of mainstream society, whole again and able to function independently and productively.

        Drug Abuse is a disorder that is characterized by a destructive pattern of using a substance that leads to significant problems or distress; it is a kind of disease which leads to significant problems involving tolerance or withdrawal from the substance cause for sufferer.

        Drug Tolerance is the use of increasing amounts of a drug upon repeated exposure, to experience its original effect. If a person has high drug tolerance and if he increases his dose of the drug; then this may prove to be costly and harmful in the long run.

       DIFFERENT TYPES, SIGNS AND SYMPTONS OF DRUG DEPENDENCE

                       Drug Dependence is of two types :

• Physical Dependence: It refers to the body’s need for a drug. It exists when the use of a drug is stopped and may result in withdrawal symptoms such as vomiting, fever, hypertension etc.
• Psychological Dependence: It refers to the mind’s need for a drug. It is a craving or a strong psychological need for pleasurable mental effects produced by a drug.

                     Types of Drugs:

• Narcotics: - This drug type produced from “opium poppy seeds”, this group includes: opium, heroin, morphine, codeine, methadone, and meperidine. All these drugs act as depressants upon the central nervous system.
• Heroin: - This kind of drugs obtained from “morphine” by a simple chemical process. The informally this can be known as horse, smack, shit, junk, or Mexican Mud etc. It can be inhaled, smoked or injected. The user experience “rush” or “flash”.
• Barbiturates: - Informally known as barbs, reds, yellow jackets, and goofballs etc. it can be either swallowed or injected. All these drugs act as depressants upon the central nervous system.
• Tranquillizers: - It is in form of capsules and tablets. They are prescribed by the Psychiatrists and Psychologists themselves. They help to reduce mental tension and is effective for people suffering from insomnia.
• Amphetamines: - it affects on central nervous system. Informally known as speed, bennies, defies, and, uppers etc. Cocaine: - This is also known as coke, snow, flake etc. Strong psychological affect on individual.
• Marijuana: - It either smoke or swallowed. Other types of it are bhang, ganja, marijuana tobacco, hashish, and hashish oil. Locally known as grass, pot, Acapulco gold, Mary Jones, weed, harsh, and harsh oil.
• Hallucinogens: - They are also known as acid, big D, mesc, button, and peace pills etc. One of it s powerful form is LSD. LSD (Lysergic acid Diethylamide):- LSD is found in three forms- tablet, powder, liquid. Once the LSD is kept on the tongue it leads to convulsions and the person gets a different kind of experience that they are in a different world and the person loses his mental balance. Many times people commit suicide under the influence of LSD. Brown Sugar : It is an impure form of Heroin which is  popularly know as „Gard‟. The fashionable and High Class teenagers call it as „Smock‟. It is taken by „Chasing‟ or in the form of a cigarette. Chasing means inhaling by creating a smoke.

             Signs and Symptoms of Drug Addiction:-

• Repeated health complaint
• Depression
• Fatigue
• Increase or decrease in appetite
• Needle marks or bruises on lower arm, legs or bottom of feet.
• Extreme hyperactivity
• Sudden mood changes
• Irritability
• Secretive or suspicious behaviour
• Explained need for money
• Increased use of toilets and remaining in toilet for long hours.
• Change of personality.
• Increase in demand for money.
• Acute pain in the abdomen.
• Withdrawal from family etc.

                Cause of Drug Addiction:-

• Availability of Drugs: If the drugs are readily available, the people are bound to use them and those who have already experienced it may use them regularly. Even if the drugs are nor easily available, potential abusers are ready to go to any extent to obtain them. Hence many times drugs are smuggled in the country.
• Peer pressure: The teenagers take drugs to be accepted by the group or else they may feel isolated. Drug abusers seek approval for their behavior from their peers so they often try to convince others to join their habit.
• Personality traits: Many drug abusers are immature and hence they are not able to cope with problems, anxieties and frustrations in a mature and rational way. For them drug provides a temporary source of adequacy and a feeling of being able to cope with the pressures in life. In short, drugs are used as a means of escapism from reality.
• Curiosity: Many people have a temptation for drugs. Just for the sake of curiosity they experience with a drug and this later on develops into addiction. The teenagers, generally belong to this category. The first taste and its effects on the user will influence the users decision to use it again or not.
• Alienation: People want a family, peer group, a community and a country. Many people feel isolated in the rush of people and those who are not able to sustain themselves in the competitive world do feel the pressure. They become alienated from the society and if they find drugs, they get addicted to it.
• Hedonism: It means the idea that pleasure is the most important thing in life. Some people are hedonistic and they simply want good experiences every time. This is provided only by the drugs.
• Psychological dependence: There are some drugs that have the power to affect or change the mood. It directly affects the central nervous system of the body and creates a psychological dependence for its use.
• Physical dependence: When the drug abuser stops the use of drug he experiences withdrawal symptoms such as vomiting, fever, hypertension etc. This leads to physical dependence. Parental influence: The children of the addict are at a high risk of drug addiction because the children are bound to imitate the parents. Hence if the parents take drugs, their children may also become drug addicts.
• Socio-cultural factors: In certain societies of the world taking drugs like bhang, charas etc is a normal practice. People in such a society do this only for the feeling of unity and fatigue.

                       Effects of Drug Addiction:-

Physiological Effects:- The drug addicts develop the following physical signs and symptoms which proves life threatening for them.

•Brain cell damage
•Cardio-vascular problem
•Loss of muscular coordination
•Sensory and perceptual disturbance
•Vomiting
•Nausea
•Hand tremors
•Shivering
•Weight loss
•Muscular weakness
•Chest pain
•Coma and Death
•Reduced immunity
•Hepatitis and HIV infection occurs in a state of addiction Psychological Effects:- The drug addicts suffers from the following mental disturbances :
•Frustration
•AnxietyAggressive behavior

 Social Effects:- The drug addicts harm the society in many ways. Some of them are as follows:

•Immoral judgments
•Reduced sociability
•Commit suicide
•Disturbance to family and society
•Increase in violence
•Criminalization increases in the society. 
 Gambling, prostitution, murders, rape, molestation, kidnapping etc are some types of crimes committed by the addicts. Economic Effects: The drug addict naturally has defective personality and lacks concentration. So many of them suffer joblessness. They face the following economic problems : Economic loss as drugs are very costly Lethargy in work which affect daily work Poor work performances or dismissal Increase health care costs.

            Impact of Drug Abuse on Youth

               Drug abuse at any age can cause serious health effects, but teens who abuse drugs are at particular risk for negative consequences. Teens who abuse drugs are more likely to struggle with addiction later in life and have permanent and irreversible brain damage. Some other common negative effects of teen drug abuse are:

1.  Emotional problems. Drug abuse can cause or mask emotional problems such as anxiety, depression, mood swings, suicidal thoughts and schizophrenia. In fact, among teens with major depression, 34.6 percent report using drugs. Unfortunately, drug use can also increase the severity of these emotional problems. For example, teens that use marijuana weekly double their risk of depression and anxiety.
2.  Behavioral problems. Teens who abuse drugs have an increased risk of social problems, depression, suicidal thoughts and violence. According to a recent survey by the Substance Abuse and Mental Health Services Administration, teens who abuse drugs are more likely than teens who don’t abuse drugs to engage in delinquent behaviors such as fighting and stealing.
3. Addiction and dependence. Studies prove that the younger a person is when they begin using drugs the more likely they are to develop a substance abuse problem and relapse later in life.
4.  Risky sex. Teens that use drugs are five times more likely to have sex than teens who don’t use drugs. Teens that use drugs are also more likely to have unprotected sex and have sex with a stranger. This leads to higher risks of STDs, teen pregnancy and sexual assault.
5. Learning problems. Drug abuse damages short-term and long-term memory and can lead to problems with learning and memory later in life.
6.  Diseases. Teens who abuse drugs with needles increase their risk of blood-borne diseases like HIV, AIDS and Hepatitis B and C.
7.  Brain damage. Drug abuse among teens can result in serious mental disorders or permanent, irreversible damage to the brain or nervous system. Brain damage among teens who abuse drugs includes brain shrinkage; impaired learning abilities; amnesia and memory problems; impaired reasoning, perception and intuition; increased or decreased socialization; and changes in sexual desire.
8.  Car accidents. Teenagers who abuse drugs are more likely to be involved in car accident-related injuries or death. One study showed that 4 to 14 percent of drivers who are injured or die in traffic accidents test positive for THC.

     Teen Drug Treatment

        If you know a teen who is abusing drugs, don’t wait to intervene. The sooner your teen gets help for drug abuse, the more likely they’ll be to avoid the long-lasting consequences. Fortunately, there are many different teen drug rehabs to choose from. The most effective teen drug rehab, however, may be a residential treatment program. Here your teen will have access to 24/7 supervision and care, detoxification, dual diagnosis treatment and a variety of holistic treatments based on their individual needs. Talk to a medical doctor about your teen’s symptoms and determine which type of drug abuse treatment is best for your teen.

                      MEASURES TO SOLVE THE PROBLEM OF DRUG ADDICTION

              Preventive Measures against Drug Addiction: Education: The general public should be made aware about the causes and ill effects of the drug addiction. Also provide the education related preventive measures and curative treatment in public as well as school and colleges. Organizing Youth Centers: Social service organization and NGOs should establish Youth Centers and youngster should be enlightened about the danger of this drug addiction Stringent Action Against Drug Pushers: The government should initiate stringent action against drug pushers such as imprisonment and death sentence because they are destroying the lives of lakhs and cores of young lives. The country like U.A.E. and Saudi Arabia has provided death penalty of drug pushers. Watching for early signs of possible Drug Addiction: Loss of appetite, behavioral changes, withdrawal from family, poor academic/ work performance these are common sign and symptoms usually observe in drug addict. It should be observed addict himself as well as family, friends, well wishers etc and as soon as possible get the person rid of this worst addiction. 

                                   CURATIVE TREATMENT

                Hospitalization: Drug addicts must be hospitalize and go through medical examination which help to know which drug addict using accordingly medical treatment given in primary level on withdrawal symptoms. Behavioral Therapies: Psychotherapy, counseling, support group, family therapy etc, this kind of therapies help addict to come out from addiction. Occupational Therapy: This therapy required for the addict when he is undergoing through medication and psychotherapy because of it he will not getting isolation, loneliness, and boredom like feelings and keep him away from drugs. Approach of Narcotics anonymous: The group of former addicts can share their ideas, experiences about their dreaded conditions and educate them why they should quit from their abuse.