Herione Use and Teenagers - Term Paper Example

Heroin Use and Teenagers Introduction During the past few decades it has been noticed that the terms ‘drug abuse’ and ‘teenagers’ have almost become synonymous. Substance drug abuse is very common amongst adolescents, a very worrying trend, which has turned out to become one of the major issues of social concern in today’s world. The seriousness of the problem is quite evident from the figures of drug abuse amongst teenagers, which has reached quite dangerous proportions as Compton and Volkow (2005) report “The extent of the problem is staggering, with national surveys showing that in 2003 approximately 15 million American ages 12 and older used a psycho-therapeutic for a condition other than medical use... This includes non-medical use of opioid analgesics, sedatives/tranquilizers and stimulant medications. Prescription drug misuse was second, after marijuana, in terms of prevalence among the illicit substances among 12th graders... Notably, the incidence of analgesic abuse increased from 628,000 initiates in 1990 to 2.4 million initiates in 2001” (Compton and Volkow, 2005). Therapeutic drugs like analgesics derived from opium and other stimulants form the main agents that are used for substance drug abuse. Heroin, clinically known as diamorphine or diacetylmorphine, is semi-synthetic opium derivate, synthesized from morphine. It is used medically, to alleviate pain, but has to be administered in controlled doses, as the drug is extremely fast acting and highly addictive in nature. Though heroin is banned in most countries under the Controlled Substances Act as Schedule I and IV, the easy availability of the drug in a pure form and at a cheap price, has made this drug much sought after, amongst the teenagers. The ability of an addict to inhale or snort heroine, without necessarily having to actually inject it, has made it the number one in drug substance abuse, and its misuse has spread like wild fire from the lower social class strata to the upper sections of the society. Worrying figures as presented by the National Drug Intelligence Centre revealed that in 2006, “an estimated 3,091,000 U.S. residents aged 12 and older have used heroin at least once in their lifetime. The survey also revealed that many teenagers and young adults have used heroin at least once--76,000 individuals aged 12 to 17 and 474,000 individuals aged 18 to 25. Heroin use among high school students is a particular problem. Nearly 2 percent of high school seniors in the United States used the drug at least once in their lifetime, and nearly half of those injected the drug…”(National Drug Intelligence Centre, 2006). This article will take a close look at this drug abuse amongst teenagers. It will explore the adolescent mindset and try to find out as to why this particular age seems to be so vulnerable to drugs and substance abuse. It will also present factual details about heroin and the harm it causes to its users. It will also present the various therapeutic treatments available, which are used to deal with this addiction, amongst adolescents. Body Etymology, history and uses of Heroin: Heroin was first used as a drug in 1895, and was marketed by Bayer, a drug company in Germany. The word heroin was derived from the German word "heroisch" meaning ‘heroic’ referring to the supposed heroic effects on the person who used it. It was made available as a non addictive cough suppressant, as a substitute for the highly addictive morphine drug. However, soon heroin became more addictive and created a dependency that was even higher, than what morphine had ever produced. Heroin has a very long history, as a derivative of morphine. Morphine, a simple chemical compound, is one of the major components of the complex structure that is known as opium, which actually is a mix of nearly 40 alkaloids. Opium is made from the juice of the poppy pods, obtained from the plant, Papaver somniferum, also known as the Oriental poppy, and has been in use for past thousands of years, especially in China and India. The word ‘poppy’ is a Latin derivative meaning ‘sleep inducing’. In the ancient times its use was mainly to stop diarrhoea, alleviate pain and to produce a feeling of transcendental euphoria. Opium had always been a very precious and lucrative trade substance, and the famous Opium Wars were fought from 1839-1842 and again in 1856, between England and China, in a bid to gain control over the opium cultivation and trade. So in the earlier days opium was quite openly sold in the market and there was nothing illegal about possessing this drug. Opium and its derivatives have been put under scrutiny only recently, as a suspect for causing addiction, after the drug wars in the late twentieth century. The scenario with heroin, a derivative of opium, was slightly different, and it had been banned in US as early as 1926, because of its regular association with ‘death and moral degeneration’. Right from its invention it had been dealt with precaution and wariness. The drug was first invented by C.R.A. Wright, a British pharmacologist, in 1874 and when analysed by Pierce on dogs and rabbits, produced results like “…great prostration, fear, and sleepiness speedily following the administration, the eyes being sensitive, and pupils constrict…respiration was at first quickened, but subsequently reduced, and the hearts action was diminished, and rendered irregular…”(Wright, 1874). When Bayer first marketed heroin 21years later, this very ability of heroin, to reduce the respiration rate of the user was marked, to suppress cough in tuberculosis patients. Nearly twenty years later, it was discovered that heroin metabolised into morphine very quickly, and was even faster acting than the latter, and it soon became illegal to possess, buy or sell heroin. Heroin is used medically as analgesics, and to relieve pain. It is given in the form of injection via the intramuscular, intravenous, or the subcutaneous channel and is given only in cases of acute pain as for example, in the end stages of terminal illnesses like cancer, severe trauma, post-surgical chronic pain or in myocardial infection. Heroin is also given in very small doses as ‘maintenance drugs’ in treatment of drug addicts, though this form of usage is highly controversial for those supporting zero tolerance policy towards drug users. Heroin is however popularly used as recreational drugs mostly amongst teenagers. It is a much favoured drug because of the feeling of intense pleasure and the infinite, almost spiritual relaxation that it gives. This feeling of ‘highness’ is much faster in heroin than in any other opiate drugs. Tolerance for this drug develops very fast and every time a user takes heroin, it will have to be in a larger dose than the previous one, to get the same effects. As for example a person who is taking heroin for the first time will require around 5-20mg of this drug, while a seasoned user will require a few hundred mgs of heroine to reach the same ‘high’. The most common way to take heroin is to get it diluted, with a mixture of water and acid, heated, and then injected intravenously (known amongst drug users as ‘shooting up’ or ‘slamming’). Other ways of taking this drug is to snort it, or inhale the vapours when the heroin is heated inside a rolled up cigarette or an aluminium foil. Intravenous injections are the fastest way to feel the effects of this drug. When a person takes an injection of heroin he feels the first ‘rush’ which is accompanied with warm skin flushes, dry mouth, heaviness in the arms and legs and mental fogging. After this ‘rush’ he moves into a semi conscious state where he alternates between falling off to sleep and keeping awake. Snorting or inhaling may not give the initial ‘euphoria’ or ‘rush’, but all other effects remain the same. There are actually three steps in the process of this drug addiction. These are ‘anticipation’ when the person feels the urge to take the drug and is about to use the substance, the next step is ‘intoxication’ where the person is actually taking the drugs, and the last stage is the ‘withdrawal symptom’ where the person feels disconnected from reality. This process keeps on repeating itself with the tolerance level for heroin going up every time, making it essential for the user to increase the level of intake each time he decides to snort or inhale or inject. Adolescence mindset: Adolescence is the period in a person’s life when he is out to experiment and try out new things. This is also the period of ‘Storm and Stress’ as Hall in 1904 had once pointed out, and it very aptly describes the mental conditions of a teenager. Adolescence sets, in and around the age of 12 years, at the onset of puberty, a time of drastic physical and mental changes within the body, when that individual is not a child any more, yet he does not belong to the world of adults, either. There are more parental conflicts with the teenagers, than with children of any other age group. The very word ‘adolescence’ in many cases, is associated with rebellious nature and defiance of any sort of authority, impulsive and erratic behaviour with great mood fluctuations, insecurity, ‘anti-social’ behaviour and acute depression. As Hall (1904) explains “the wisdom and advice of parents and teachers is overtopped, and in ruder natures may be met by blank contradiction" (Hall, 1904). At this time adolescents also tend to think rather abstractly and perceive many underlying meanings to words and sentences or events, which in reality do not occur. Such incorrect way of looking at things and interpreting them according to their own abstract thinking, also makes the adolescents more sensitive to everything that is being said or done. This results in constant mood fluctuations and a perpetual irritability. As Larson and & Richards, (1994) concluded from their experiments on adolescents known as, ‘Experience Sampling Method’, where they said such abstract thinking in adolescents “allow them to see beneath the surface of situations and envision hidden and more long-lasting threats to their well-being" (Larson and Richards, 1994). Such irrational behaviours also tend to make adolescents more prone to depression and suicides. This phase in adolescence makes them more liable to act against social and parental rules and norms, producing what is best described as the ‘risk behaviour’. Risk behaviour in adolescence includes alcohol and substance drug abuse, rash driving and or having risky sex lives. Things that are forbidden especially appeal to the people of this age range and mindset. Heroin use, being specially banned and illegal will attract adolescents, who with their adventurous mind will try to venture out for the sake of one time experience, and will soon fall into a loop and turn into a full time addict. It is also a sort of quick-fix escape from the reality, into a pleasant state of oblivion. As Goldberg observes “drugs are a quick fix. To overcome illnesses or to experience pleasure quickly, some people look to drugs because they fulfil immediate needs...both parents working outside the home, the rising cost of living, the emphasis on immediate gratification, mass media, and the high degree of mobility- all have contributed to stresses on the family. To deal with these stresses, some people experiment with drugs, others use drugs occasionally, and still others take drugs frequently or compulsively” (Goldberg, 2005, 48). What is drug addiction? When a person shows complete dependency on a certain drug, which is not required for his body in medical terms, however, without which his physical and mental functioning comes to standstill, then that person can be referred to as an addict. In 1964 we find that WHO defines drug abuse or addiction as “persistent or sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice” (WHO, 2010). The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine define drug addiction as follows “Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving” (American Pain Society, 2001). Thus in simpler terms drug addiction is the complete physical dependency of a person on a drug, without any medical reason what so ever, and if the drug is stopped or the dosage decreased, that person starts showing withdrawal syndrome. Here the American Pain Society (2001) defines the term ‘physical dependency’ as “a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist (American Pain Society, 2001). Here it must be noted that when patients are treated with opioid drugs for over a long period of time, does not necessarily mean that he becomes a drug addict. His physical dependency is definitely there, and his tolerance level also may increase, but the addiction in most cases is not there. So to clarify the differences between addiction, dependency and tolerance American Pain Society tells us “Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals” (American Pain Society, 2001). So the terminology ‘biologically and psychologically vulnerable individuals’, as used by American Pain Society, brings us to the stage in human development which is known as ‘adolescence’, a period of ‘storm and stress’, both psychologically and physically. Adolescence and drug addiction: It has been noticed by that Kandel and Logan (1984) in their various experiments that adolescents follow a pattern in their addiction. First they start with tobacco, then coffee, then alcohol and lastly drugs. Tobacco is their gateway to any addiction which they take on later. Kandel and Logan also noticed that adolescence is the high risk age group period when one may fall prey to alcohol, substance and drug abuse, however if an adolescent can abstain from illicit drug addictions till age 21, then chances are that he will never taste these drugs later in life. When teenagers were questioned as to what made them turn towards substance abuse, what they said is reported by Hutchison “adolescents cite the following reasons: to have a good time friends, to relieve tension and anxiety, to deal with the opposite sex, to get high, to cheer up and to alleviate boredom…to get more energy and to get away from problems” (Hutchison, 2003). Adolescents also cite certain factors that make them choose certain drugs over the other, like “the individual characteristics of the drug, the individual characteristics of the user, the availability of the drug, the current popularity of the drug, and the socio cultural traditions and sanctions regarding the drug” (Hutchison, 2003). Looking at the above stated factors we can now understand as to why heroin is a popular drug amongst teenagers. Heroin is extremely fast acting and creates a ‘high’ even faster than morphine does, the drug is more easily available and is sold in many forms like the pure white form/ black solid substance/ brown powder form, it is extremely popular amongst the current generation as it can be snorted or inhaled without having to actually inject it. Heroin is a drug that is even more tempting to the teenagers because it is an illegal drug, and had been banned quite an early in the 1920’s owing to its association with ‘death’. An adolescent with a rebellious mindset that goes against all norms and social rules, will find heroin an extremely attractive option to go against parental and social edicts. However, what the teenagers fail to understand is that doing something without any cause and just for the sake of rebelling and getting ‘high’, may make him an addict for life. The transition from having fun to becoming a serious addict is just a thin line and one may not be even aware as to when he has crossed the line and moved towards self destruction and death. If we explore a little more in detail as to why adolescents go for drug and substance abuse, we will find that there are certain reasons which form common factors in all cases involving teenage substance abuse. These are: 1. Curiosity – Amongst all age groups, an adolescent is more likely to be ready to experiment with something new and unknown. With all the awareness programmes and news articles labelling heroin as dangerous, a teenager may be curious and try to experiment with it perhaps to just check whether the reports about this drug and its effects are correct or not. 2. To alleviate the feeling of boredom – Some adolescents may take in drugs to feel the pleasure. A person who is in a state of perpetual boredom will seek ways to find pleasure, and taking drugs is one such easy way. Such drugs taken to escape boredom are in nature generally reinforcing. The pleasure or the ‘high’ the user experiences, gives a sort of positive reinforcement, that makes the user want to repeat the whole procedure again, every time he feels bored. This is a very dangerous positive reinforcement and turns the user into a drug addict. Goldberg in his research found out that “in one survey of high school seniors, 49% indicated that they used drugs ‘to feel good or get high’, 41% ‘because it tastes good’, and 23% ‘because of boredom, nothing else to do’ ” (Goldberg, 2005, 48). 3. Peer pressure – often adolescents start taking drugs for the sake of peer acceptance. It is not so much of peer pressure that matters, as it is for peer approval. Fear of rejection by friends may force some adolescents to take this step. As Goldberg surmises “peer influence is particularly strong during adolescence…an adolescent’s social network, more than peer pressure, is an important predictor of substance use” (Goldberg, 2005, 49). During adolescence peer influence becomes an important factor, in fact, more important than parental advice and guidance. 4. Psychological factors like depression caused due to failure to score well in school, single parent family, poverty and deprivation, need for immediate gratification, all these may push an adolescent towards addiction, who is desperate to escape the unwanted and unhappy situation. As Humphrey frames it, “addiction represents a framing of turning away from life…particularly if the individual is confronted with problems, disappointments, frustrations, or failures, which invite a desire to escape...” (Humphrey, 2002, 103). Teenage drug addict statistics and recent figures: Humphrey also gives us some figures that give an insight into this worrying social problem and show us to some extent the widespread affliction of heroin usage, amongst teenagers. According to him, about half of 17 year olds see no risk in using marijuana, cocaine, or heroin, experimentation with drug use of mid-teens (15-17) increased by about two-thirds in the three year period 1992-94, teenage use of LSD, other hallucinogens, inhalants, stimulants, and barbiturates continued to increase in 1994, experimentation with drug use among high school seniors increased by about one-half in a one year period, 1993-94” (Humphrey, 2002, 104). The 1990’s were in fact a troubled era with the term ‘heroin chic’ capturing the imagination of the world of glamour and fashion. A very controversial ad from the Calvin Klein fragrance house showed ‘heroin chic’ models in bizarre positions, which made the entire world speak out in outrage against the wrong message being send out to the impressible teenagers on the use of heroin. Deaths from heroin overdoses which had always made headlines as they were mostly related to famous personalities now began to be printed as a warning to the young addicts. Death and drugs soon came to be shown as complementary to each other. Drug deaths were highlighted to scare off the teenagers. Famous photographer Davide Sorrenti, who started this ‘heroin chic’ look, was found dead from an overdose of this drug in 1997. Kurt Cobain, a famous singer from the band ‘Nirvana’ committed suicide after failed attempts to give up heroin. In June 2006, a seventeen year old teenager Joseph Krecker, who was a good athlete with a bright future, was found dead in Chicago with a bag of heroin still in hand. Many more deaths were reported during these times and they were attributed to a combination of heroin and a pain killer drug known as fentanyl, a mixture that has earned the nickname ‘Get High or Die Trying.” However, what is heartening is that, after innumerable public awareness programmes and various other counselling programmes for the teenagers, after 1999, the figures have shown a gradual declination, giving clear signs that drug abuse is on the wane and ‘heroin chic’ is not fashionable any more. If we look at the current statistics we will find that, though not showing further decrease in numbers of teenage heroin addicts, the figures of drug abusers are actually now quite low and not showing any upward growing trend either. As the data given by NIDA or National Institute of Drug Abuse we find that amongst 8th graders, the heroine use from 2006-2009 show a very slight increase from 0.3 to 0.4 %. In 2009, if we take a closer look we will find that there has been a steady decrease in figures from lifetime users to last month users with the percentage dipping from 1.3 to a heartening 0.4. Amongst 10th graders, the figures in 2006-09 show a small percentage of decrease from 0.5% to 0.4%. A look at the 2009 figures only, tells us that from life time users’ percentage of 1.5 the figures have gone down to only 0.4. For the 12th graders 2006-09 shows a steady 0.4%. The 2009 figures reveal that the percentage for lifetime users has gone down from 1.2% to past month user of only 0.4%. Thus, we notice a very positive change in the figures of heroin addicts especially when we compare them with the trends as was seen during the 1990’s (NIDA InfoFacts: High School and Youth Trends, December 2009). As NIDA aptly sums it up “Heroin use has been steadily declining since the mid-1990s. Recent peaks in heroin use were observed in 1996 for 8th-graders, 1997–2000 for 10th-graders, and 2000 for 12th-graders. Annual prevalence of heroin use in 2008 dropped significantly, by between 40 and 51 percent...”(NIDA, NIDA InfoFacts: Heroin , September 2009). Treatments and drug rehabilitation programmes and drug abuse prevention for the adolescents: Creating teenage awareness about the risks involved in substance and drug abuse, is a very good process in the prevention of this ‘epidemic’. It has to be made known that drug abuse may also cause HIV by using infected needles, and having unprotected sex while being on a ‘high’. Schools and parents both have a large role to play in giving this education to the young people. It has been seen that school awareness programmes have helped to bring down the number of drug addicts quite significantly in the past few years. Parents will have to make adolescents feel that they are an important part of the family and include them in all decision making, pertinent to family matters. Adolescents crave love and attention, and the parents will have to provide that, so that they do not feel depressed or bored enough to go for drugs. A strong family bond, in most cases, takes care that adolescents lead a happy life without having to take heroin to feel ‘high’. Treatments for drug addicts include a combination of both medications and behavioural therapies. It starts with detoxifying and cleansing the body of any drugs. Clonidine and buprenorphine are given to control withdrawal symptoms. To prevent relapse of the drug abuse syndrome, Naltrexone, Methadone and Buprenorphine are commonly used. Behavioural therapies include group or individual counselling, teaching cognitive-behavioural skills to learn how to cope with stress, and contingency management programmes with the patient. Conclusion Heroin has been in use from times long past. It is only in the recent times starting in the 70’s and continuing till the late 90’s, that heroin drug abuse had become a large problem affecting many teenagers and their families. Adolescents mainly for the sake of experimenting and sometimes under peer influence had fallen prey to this drug addiction. Heroin is a very dangerous drug, in the sense that it is extremely addictive, produces a ‘high’ very fast, and needs an extra ‘shot’, every time the user takes it. Though percentages of drug addicts in recent times have fallen significantly, however it is still safer for schools and parents to continue with the awareness programmes and drug education for all teenagers. Correct psychological handling of the adolescents is also necessary, so that they don’t feel the need to go for substance abuse. Addicts in the rehabilitation centres must be given proper cognitive-behavioural training to deal with stress in life, so that they do not feel the need to go back to the old habits under life’s daily wear and tear. Teenagers will have to be taught that heroine or morphine and other opiate derivatives are simply drugs to ease physical pain and suffering, not to be taken as an easy means to escape from the realities of life. As Paracelsus once famously said “All things are poison and nothing is without poison, only the dose permits something not to be poisonous." References American Pain Society. (2001). Definitions Related to the Use of Opioids for the Treatment of Pain. Recommendations. Retrieved from http://www.painmed.org/pdf/definition.pdf Compton, W and Volkow, N. (2005). Abuse of prescription drugs and the risk of Addiction. Drug and alcohol dependence 83S (2006) S4–S7. 1. Retrieved from http://www.drugaddiction.overtheweb.us/Lecture%203/abuseOfPresciptionDrugs.pdf Goldberg, R. (2005). Drugs across the spectrum. Belmont: Cengage Learning. Hall, G. S. (1904). Adolescence: Its psychology and its relation to physiology, anthropology, sociology, sex, crime, religion, and education (Vol. II). Englewood Cliffs, NJ: Prentice- Hall. 79. Humphrey, J. (2002). Teenagers will be teenagers. New York: Nova Publishers. Hutchinson, E. (2003). Dimensions of human behavior: The changing life course. London: Sage publishers. 290. Larson, R and Richards, M, H. (1994). Divergent Realities: the emotional lives of mothers, fathers, and adolescents. New York: Basic Books. 86. NIDA. (September 2009). NIDA InfoFacts: Heroin and NIDA InfoFacts: High School, and Youth Trends. Retrieved from http://www.drugabuse.gov/infofacts/heroin.html http://www.drugabuse.gov/infofacts/HSYouthTrends.html National Drug Agency Centre –US department of Justice. (2006). Heroine Fast Facts. Retrieved from http://www.justice.gov/ndic/pubs3/3843/3843p.pdf World Health Organization. (2010). Abuse (drug, alcohol, chemical, substance or Psychoactive substance). Definition. Retrieved from http://www.who.int/substance_abuse/terminology/abuse/en/ Wright, C.R.A. (1874). "On the Action of Organic Acids and their Anhydrides on the Natural Alkaloids". Journal of the Chemical Society 27: 1031–1043. Retrieved from http://web.archive.org/web/20040606103721/http://adhpage.dilaudid.net/heroin.html Read More