The Health Care Professionals: the Avenues of Promoting Drug Abuse - Research Paper Example

Stimulants are defined as a group of psychoactive drugs that enhances the brain activity. The drugs elevate mood, alertness and awareness. Although some are legal and widely used by people, they all have an addictive property. Stimulants can be classified as caffeine, cocaine, nicotine, prescription drugs and amphetamines, although this study will variably focus on cocaine, amphetamines and prescription drugs (Griffiths et al, 2008; Druglink, 2004). The potential, harmful; impacts of stimulants include abdominal pains, constipation, anorexia, headache and insomnia. Other effects include palpitations, jitteriness, withdrawal, psychosis as well as death in extreme cases. Stimulant abusers can be identified by symptoms such as anxiety and excited speech, aggressiveness and paranoia, tremors and, convulsions, depression, confusion, worsening academic performance and increased wastefulness as well as enhanced physical activity. Overview of the Prevalence of Drug Abuse The high prevalence in the rates of stimulant use among the young people in the UK is correlated to the high prevalence in the global use of illicit drugs. According to Karalliedde (2013), the 2010 statistics indicate that approximately 300 million people globally, aged between 15-64 years had used an illicit substance in the previous year. This represents 3.4% to 6.6% of the global population within this age range. According to 2010/2011British Crime Survey (BCS) conducted among the general population aged 16-59 years, the lifetime prevalence rates of the drug use in England and Wales was found to be 36.3% (European Monitoring Centre for Drugs and Drug Addiction, 2012a). The 2009/2010 study by Scottish Crime and Justice Survey (SCJS) in Scotland showed a prevalence rate of 31.1% of people aged 16-64% for the studies on the use of illicit drugs who had used illicit drugs at least once in their lifetime. According to the Scottish Government (2008), the rate of stimulant use among Scottish adults increased e.g. the use of cocaine increased by 3% from 1996 to 2006. According to European Monitoring Centre for Drugs and Drug Addiction (2012a), the 2009/2010 Northern Ireland Crime Survey (NICS) in Northern Ireland identified the prevalence of the drug use to be 23.3% for the population aged between 16-59 years. This is an indication that the general drug use in Northern Ireland is much lower compared to that of Wales, England or Scotland. Among the young people in the UK, the life time prevalence for the 11-15 year olds was 17.7% in 2010, with 12.5% having used drugs in the previous year while 6.6% had used the drugs in the previous month. Sudden Death and Use of Stimulant Medications in Youths Concerns have risen in the recent past over the association of the stimulants and the risk of deaths among youths. The results of the Stiefel and Besag (2010) study are consistent with these concerns. The probability of unexplained sudden death occurring among those using stimulants i.e. cocaine and nicotine, was found to be higher than the non-abuser or any other cause of death such as accidents. These results are biologically plausible considering the central and peripheral catecholaminergic effects of the stimulants as well as increased blood pressure and heart rates that characterise their use. Use of Stimulants among the Young People The recent research on the use of stimulants among the young people has identified that the problem is a growing concern. Stewart et al, (2011) blames the use of stimulants among young people to the users’ misconception on the positive gains accrued from their use or the lack of knowledge on its perceived negative impacts. Many of the users consider stimulants, whether illicitly acquired or prescribed, as the most convenient way to improve performance or induce euphoric tendencies. The reasons for the abuse of stimulants among young people are numerous. Research studies have affirmed that most students misuse the drugs to become euphoric. A study conducted by Stewart et al., (2011) affirmed that most of the young people under stimulant prescription misuse their own prescription medication in order to enhance their moods or get high. The most common abusers of the stimulants are the stressed or depressed group. This helps them to cope and perform better in their immediate environment. Stimulant users believe that the drugs are suitable for improving their energy levels, increase their concentration capacity, recreation and lowering their desire to sleep. Prevention of the drug abuse, especially the stimulant drugs among teenagers is a key focus of most countries, including the United Kingdom. The strategy entails focusing on better education and enhancing awareness on the dangers associated with drug abuse among the most vulnerable groups; the youths. The focus on universal drug prevention has seen the education curriculum being transformed to incorporate drug prevention subjects. Most schools have also established policies regarding drug education and the required guidelines of dealing with incidents related to drug abuse (Donohew, Sypher and Bukoski, 2011). Measures have also been put in place for identifying the vulnerable groups and apply the necessary intervention strategies that extend at the family levels. The focus on the family background is crucial because most of the abuse cases are instigated by the family set-up. The family strategy includes interventions such as imparting skills related to parenting skills, offering drug education to children, offering them the necessary parent motivation to enable them stay together and supporting the kinship carers and children counselling to enable them reach out to more children within the affected areas. Selective intervention strategies are also applied through focusing on highly vulnerable groups such as the homeless, the young offenders as well as the ethnic and sexual minorities (Bellack, Bennett and Gearon, 2006). According to European Monitoring Centre for Drugs and Drug Addiction (2012a), the positive futures in Wales and England engages the high vulnerable young people and offers them opportunities, training and employment. A new program ‘choices’ which has been financially catered for in the 2011/2012 financial year has been designed for strengthening of the community initiatives geared towards preventing and reducing the drug menace among the young people. Treatment According to European Monitoring Centre for Drugs and Drug Addiction (2012a), the outpatient and inpatient treatment centres provides the data necessary for the analysis of the treatment requirements of the population. The 2009/2011 statistics indicates that a total of 127 893 drug abusers were treated, 44 924 of which consisted first tome drug abusers. Young people under the age of 25 years encompassed 38% of the new entrants being treated. The most crucial key for the treatment of addiction is for the willingness of the addicted person to give up their addiction habits. The willingness m is the foundation for the success of any preventive process. Physical withdrawal from drug abuse is difficult because the psychological effects are difficult to comprehend. The victims may sometimes feel that life without stimulants is extremely flat. If such victims are not psychologically stable, such thoughts might leave them unstable and at risk of relapse. This is why the recovering victims should be exposed to some activities that ensure commitment to help them perform better in their recovery programs. Escaping the clutches of cocaine or amphetamine addiction can be an unpleasant experience for the first few weeks although this subsides as one becomes used to the lack of these drugs. The initial recovery phases require that the victims be provided with the necessary support. Some of the symptoms involved in the withdrawal include depression, restlessness, agitation, insomnia, seizures, suicidal thoughts, moodiness, anxiety and strong urges to the use of drugs. Successful treatment of the drug addiction especially addiction cases related to stimulants, requires application of improved medical principles that frustrates the tradition of drug dependence among victims. One of the crucial treatment principles outlined by Department for Work and Pensions (2008) is encouraging and motivating addicts to change. Social and educational support can be enhanced through involvement of network of non-governmental organizations, self help, Professional Organizations, and other implementation group. Victims can also be provided with direct advice on health practices and techniques required in harm reduction. Efficient treatment also requires continued supply of drugs and undertaking inpatient or outpatient detoxification if recommended (Department for Work and Pensions, 2008). Treatment of the physical conditions should be prioritised to ensure that conditions such as pain or agony that enhances the rate of stimulant use are eliminated. Such complications include accidental overdose, abscesses, and septicaemia as well as skin infections. Addicts can also be provided with Hepatitis B vaccine if not immune as well as medical advice on the modalities of ensuring that they recuperate fast. Psychological interventions can also be applied through group psychotherapy and cognitive behavioural therapy. Group psychotherapy involves one or more therapists treating a small group of addicts together. Some of the skills imparted during the group therapies include anger management, relaxation training and mindfulness. Cognitive behavioural therapy combines basic cognitive and behavioural principles that address maladaptive behaviours and dysynfuctional emotions. Cognitive behavioural therapy is effective for the treatment of stimulant-induced conditions such as anxiety, mood as well as psychotic disorders. Psychosocial interventions can also be included in the treatment measures whereby the victims are provided with the drug advice and information, harm reduction, motivational interviewing and alternative therapies. Bean and Nemitz (2004) propose that addicts should also be rehabilitated to enable them abandon the drug subculture and acquire the new social culture and associations. The victim can be referred to a short term-term or long-term rehabilitation program depending on the extent of the addition and the responsiveness to the treatment. Treatment of Stimulant Addiction among Young People According to Department for Work and Pensions (2008), psychotherapy is the main treatment strategy for the victims of stimulant addiction. Various techniques can be applied in enabling the patients shun addiction, resist cravings and establish a drug free life. Some of the options that can be applied in psychotherapy include cognitive behavioural therapy, contingency management and application of a multi-pronged method i.e. the multi-pronged method (Haile and Kosten, 2009; Bean and Nemitz, 2004). According to Bean and Nemitz (2004), drugs meant for other purposes can be used although further research is required before their application. Some of the drugs under study include Disulfram, Baclofen, Modafinil and Topiramate (Department for Work and Pensions, 2008). Disulfram is used to treat alcohol dependence. Studies have affirmed that the drug can be applied in the treatment of cocaine addiction. The drug is safe although it should not be applied by people with cardiovascular liver or mental defects. Another drug that can be applied include Baclofen which acts as a muscle relaxant research has shown that if combined with counselling, it can be effective in the reduction of cocaine use. The anticonvulsant, Topiramate, can also be applied. Research has already affirmed its use in the reduction of cocaine use and minimising the carvings for its use. The last medication that can be applied in the treatment of stimulants’ addiction is Modafinil, a stimulant with the capability of reducing cravings for amphetamines and cocaine. Further research has also affirmed that the drug can be used in the reduction of the impulsive reactions that characterises the underlying addictions. Haile and Kosten,(2009) further suggest that vaccines can also be used in the reduction of the pleasurable impacts of the drug abuse and cravings that are associated with it. One of the vaccines that have reached clinical trials is the anti-cocaine vaccine although others are still in the developmental stages. Prescribing Stimulating According to Nissen, (2006), the United Kingdom health restrictions require the clinicians to follow strict guidelines and appropriate protocols while prescribing stimulants of medical importance such as amphetamines to the youths. Some of the therapeutic roles of stimulants include counteracting lethargy, reducing sleepiness, treating narcolepsy, decreasing appetite to enhance weight loss i.e. treating obesity, improving attention and focus for people suffering from attention disorders such as Attention deficit-hyperactivity disorder (ADHD), and treating clinical depression. The health centres handling youth addiction cases such as college health centres should develop efficient policies and guidelines for addiction prevention and treatment. When administering a stimulant prescription, physicians should ensure that the measures applied do not enhance addiction cases among youths. The amount prescribed should be limited and the college students should be required to produce the necessary diagnosis directive required for stimulant prescription. The laws and policies guiding on the dosage units for the prescription should also be followed. The national health standards dictate that the victim should be exposed to a neuropsychiatric evaluation to check any attention deficit problems (Department for Work and Pensions, 2008). It is advisable for the school systems to adopt the necessary policies that require the students to submit their neuropsychiatric evaluation reports. The student is also required to supply the necessary documentation from the prescribing physician confirming that the necessary monitoring process has been administered and the approved scale has verified the effectiveness of the prescribed stimulant. If the student does not have the necessary health documentation to prove his/her worthiness for the prescription for the stimulants, the health centre should take the initiative and ensure that thorough screening is administered. Those offered prescription stimulants should be made to understand that they act as a popular attention getter to other young people. They should be provided with the essential education and usage directives to ensure that they do not contribute to abuse towards other peers. They should also be advised not to exceed the physicians prescribed levels and made aware of the long term dangers that such an act could have on health well being. According to Nissen (2006), young people with past or active drug use tendencies should not be prescribed stimulants as they are likely to abuse them. Sports are another area that makes many young people fall into the temptation of abusing drugs (Bellack, Bennett and Gearon, 2006). Athletes should be warned of the impending danger of abusing drugs on their physical as well as emotional well-being. Policies that contribute to banning of stimulants such as Methylphenidate should also be applied to deny them access. Harm Reduction The harm related to stimulants use such as the drug-related deaths, acquiring infectious diseases as well as co morbidity are key to the enactment of drug prevention strategies (Rassool, 2009). Harm reduction calls for the application of intervention strategies such as the information campaigns associated with the drug abuse and information related to the safety in the delivery of health care (Inciardi and Harrison, 1999). Harm-reduction efforts in the United Kingdom were spearheaded by the Department of Health and the National Treatment Agency that published a documented entitled “Reducing drug-related harm: an action plan” (European Monitoring Centre for Drugs and Drug Addiction, 2012a). One of the prominent uses of the document is improvement of service delivery through issuing guidance on the strategies required for the reduction of the harm that may be brought about by the contact with the drugs. The document offers guidance to commissioners, carers, service users and the people working with the drug users. The action plan was adopted for England, Scotland, Wales and Northern Ireland. As a result of the 2010 increase in the abuse of stimulants among youths, a dedicated web page was created that provided frequent treatment and prevention updates for the affected groups such youths and medical professionals (European Monitoring Centre for Drugs and Drug Addiction, 2012b). Improvement in awareness through the establishment of the webpage enhanced information dissemination as it was being harnessed by the medical practitioners to reduce harm caused by addiction. The web pages provide information related to the negative impacts of abuse of stimulants such as causation of anxiety and heart failure. This serves to scare potential abusers from engaging practises that may promote addiction. The web information can also serve to educate clinicians on the efficient measures of ensuring that the prescription practises do not enhance addiction. The syringe exchange strategy is made successful through inclusion of a wide range of services necessary for ensuring distribution. Such services include specialist syringe exchange services, application of outreach and mobile units, emergency services and pharmacies. According to European Monitoring Centre for Drugs and Drug Addiction, (2012b), the services have successfully been distributed across all regions in England although information and data has not been successfully disseminated. The 2010/2011 statistics for needle in Wales, Northern Ireland and Scotland are 2 980 000,180 000 and 4 680 000 respectively (European Monitoring Centre for Drugs and Drug Addiction, 2012b). This shows unequal distribution, with Scotland receiving the largest share while Northern Ireland receiving the least number of needles. Medical trials are still being undertaken in England to identify the impact of application of injectables in the enhancement of the harm reduction when dealing with drug abuse among young people. The United Kingdom legislation guiding on the misuse of drugs, especially stimulants was amended in 2003 to allow doctors provide the preventive drugs to abusers who obtained controlled drugs without prescription. The preventive substances supplied include sterile water, swabs and citric acid among others. The United Kingdom administrations have assisted in the support of the pilot schemes geared towards establishment of substances capable of effective management the adverse cases of drug abuse e.g. Naloxone has been developed for the management of overdoses related to opiates (BioMed Central Ltd, 2004). Conclusion The health care professionals should be able to discern the young people using stimulants. They should relate the signs and symptoms to assess and analyse the likelihood that the subjects could be abusing stimulants. This enables them to apply the necessary strategies suitable for curbing the tendencies related to abuse of stimulants once their abuse is confirmed. Clinicians should be aware that individuals insisting on being offered large dosages may be using the extra doses to quench their urge for addiction. Suspicious clinical conditions such as those that do not fit the previous health records should be viewed as the avenues of promoting drug abuse. 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