Drug misuse abused substances

Before leaving the discussion on prescription-drug misuse and abuse, we should note that a variety of over-the-counter substances with psychoactivc properties are also subject to abuse. Examples are nonprescription hypnotics that contain antihistamines, nonprescription cold and allcrg) products, laxatives, nonprescription stimulants, and diet pills. These arc described in more detail in Chapter 14. 

In sports, sophisticated pharmacological products and methods have been used over the recent years. Besides stimulants and narcotics, anabolic agents and peptide hormones, many substances are used and abused to improve the mental and/or physical performance of athletes. This is called doping and contradicts both sport and medical ethics. The credibility of the excellence of performance and unpredictability of the outcome of a competition attract much enthusiasm from the public. If drug misuse or pharmacological manipulations of the athletes remove that unpredictability, the public will lose its interest in the outcome of these sports. Sports practitioners are basically healthy and should not be administered... 

These substances are generally determined in biological matrices together with the drugs of abuse because the mixtures consumed by the users often contain some of them. Diuretics, p-blockers, and stimulants are prohibited by the WADA due to their documented potential misuse as performance-enhancing substances. 

Additional restrictions on supply are imposed by the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations. Substances that have a potential for abuse are scheduled under three categories. Class A, B and C. 

It is clear that legislation alone will not prevent substance abuse. Education is an essential complement and all health care workers should play their r51e in individual or group education. They should also be good role models. Health professionals have easy access to drugs and they must be very careful that they do not fall temptation to the misuse of psychoactive products to alleviate their mood, prevent tiredness, and to combat other stress related symptoms. They should manage their patients along the same lines. 

There are many different kinds of toxicants. Chemicals that are used for industrial and household purposes can be poison when misused or when there is an accident. Agricultural pesticides in the field can also cause poisoning. Chemicals might come in the form of conventional drugs which we use in a legitimate way, or in the form of designer drugs used illicitly for recreational substance abuse. Natural toxins found in the environment, such as mushrooms, plant toxins, snake/insect toxins and marine toxins, can also inadvertently harm a patient. 

Within the personal factors, clearly family disruption, trauma and physical or sexual abuse can all predispose to conduct disorder in adolescence and personality disorder in adulthood (Paris 1996b, Spataro et al. 2004). Links between such factors and subsequent substance misuse have been consistently found (Bartholomew Rowan-Szal 2002, Poikolainen 2002), while the associations between established personality disorder and drug... 

Cochrane Review). The Cochrane Library. Chichester John Wiley Sons Solberg U, Burkhart G Nilson M (2002). An overview of opiate substitution treatment in the European Union and Norway. International Journal of Drug Policy, 13, 477-84 Soyka M (2000). Substance misuse, psychiatric disorder and violent and disturbed behaviour. British Journal of Psychiatry, 176, 345-50 Spataro J, Mullen PE, Burgess PM, Wells DL Moss SA (2004). Impact of child sexual abuse on mental health. Prospective study in males and females. British Journal of Psychiatry, 184, 416-21... 

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