Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. Called as Alcohol Dependence in DSM IV & Alcohl addiction in lay man words.

 To be diagnosed with an AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of an AUD—mild, moderate, or severe—is based on the number of criteria met.

 To assess whether you or loved one may have an AUD, here are some questions to ask.  In the past year, have you:

• Had times when you ended up drinking more, or longer than you intended?
   
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
   
• Spent a lot of time drinking? Or being sick or getting over the aftereffects?
   
• Experienced craving — a strong need, or urge, to drink?
   
• Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
   
• Continued to drink even though it was causing trouble with your family or friends?
   
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
   
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
   
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
   
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
   
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present.

However severe the problem may seem, most people with an alcohol use disorder can benefit from treatment. Unfortunately, only of a fraction of people who could benefit from treatment receive help.

Ultimately, receiving treatment can improve an individual’s chances of success in overcoming an AUD/Alcohol Addiction. Talk with your doctor to determine the best course of action for you

 The most commonly abused drugs as of now are as below. Mere information will not help you identify drug abuse in your child. Consult qualified medical professionals i.e. a psychiatrist for assistance in drug abuse identification and intervention. 

The most commonly abused drugs (excludes alcohol & nicotine) include:

• Cannabis / Marijuana
• LSD
• Cocaine
• Heroin
• Meth 

Cannabis / Marijuana

Cannabis  is a plant indigenous to Asia, and is commonly consumed in three forms:

• Hashish—the resin of the plant—usually reddish brown to black in colour
• Ganja—refers to the leaves and stem, and is usually greenish in colour
• Bhang—a dark brown or black preparation of marijuana leaves and flowers and other additives such as herbs and spices

Common Terms and names :

• Hashish is also known as hemp, hash, charas, cream, Malana cream, Afghan snow, Kasa, Bombay Black
• Other terms for Ganja are pot, grass, dope, Mary Jane, weed, blunt, herb
• Spliff: Marijuana cigarette
• Bong: Water pipe for smoking
• Joint / Bob: Marijuana cigarette made of rolling paper
• Ganga-Jamuna: Marijuana-hash combination

Bhang is usually eaten or mixed with a cold drink of milk and dry fruits. Hashish and ganja are crushed and mixed with tobacco. The mixture is rolled in a cigarette & smoked.

Visible Signs

• Bloodshot eyes
• Extreme form of anxiety or fear
• Uncontrollable bouts of laughter
• Lack of clear and orderly thought or behaviour
• Sluggish speech
• Eating binges
• Peculiar herbal smell in hair, clothes, or in the area where the drug was consumed
• Presence of marijuana seeds, smoking devices (chillums and bongs), smoking paper, 'roaches' (rolled-up cardboard to create an artificial filter)

Health Risks

• It is estimated that one marijuana cigarette damages the body.
• A marijuana abuser risks all the dangers of smoking and many more, including brain damage, psychosis, infertility,loss of motivation and loss of memory.
• Marijuana is a gateway drug, which means that prolonged abuse of marijuana leads to a higher tolerance to the drug, resulting in the abuser trying dangerous drugs such as heroin, cocaine and meth.

LSD

Lysergic acid diethylamide (LSD) is a popular party drug, which is extremely potent even in small quantities. This odourless, tasteless, and colourless drug can induce strong hallucinations where the user sees different colours and has strange experiences.Also known as Acid, stamp, Lucy, sunshine, microdots

LSD/ Acid is usually licked or swallowed. It is sold as tablets, capsules, or in its liquid form added to sugar cubes, postage stamps, 'windowpanes' (gelatine or cellophane), blotters (small pieces of paper).

Visible Signs

• High body temperature
• Dilation of pupils
• Increased heart beat and blood pressure
• Sweating
• Loss of appetite

Health Risks

• The worst effect of LSD is what is known as a 'bad trip' in which users develop extreme forms of paranoia and fear.
• 'Flashback' or a sudden recurrence of the user's experience can trigger traumatic or strange experiences, even after many hours or months of abstaining from the drug.
• Fatal accidents can occur with LSD usage, especially while driving.
• Schizophrenia and severe depression may occur with long-term use.

Cocaine

Cocaine is a highly addictive stimulant derived from the leaves of the coca plant. It is usually a white crystalline powder. Crack, a cheaper form of cocaine, is even more addictive and dangerous than cocaine. Even a single dose is enough to trigger addiction. Cocaine abusers typically develop a tolerance to the drug, and take in higher doses to maintain the same high.Also known as Coke, namak (salt in Hindi), coca, flake, snow, heaven dust, crack .

Cocaine is either snorted or dissolved in a liquid and then injected. Some also mix cocaine with cannabis and tobacco and smoke it.

Visible Signs

• Increased excitation ,fast speech or talkativeness
• Increased heart rate and blood pressure
• Dilated pupils
• Panic
• Runny or bloody nose
• Restlessness, irritability, sleeplessness
• Bouts of high energy followed by exhaustion

Health Risks

• Seizure, cardiac arrest, respiratory problems that can lead to death
• Hallucinations,abnormal body sensations of bugs or worms
• Severe paranoia
• HIV and other diseases resulting from infected needles

Heroin

Heroin is a highly addictive derivative of morphine, an extract from the poppy plant. In its purest form, it is a white powder but can also be brown in colour because of the presence of impurities. However, heroin is never sold in its pure form, and is often mixed with talcum powder, starch, sugar, powdered milk, or quinine. As the drug is adulterated, it is difficult to determine the actual dose of heroin, which can be fatal.

After just few hours or days of the last administration, withdrawal symptoms such as intense craving for the drug, restlessness, pain, sleeplessness, vomiting, and kicking can be seen in the average heroin abuser. Also known as Smack, horse, junk, H, Skag

A tin foil containing heroin powder is heated underneath. This results in the solid powder turning into a liquid. Users either inhale the fumes or inject the liquid. Heroin is also smoked.

Visible Signs

The heroin addict typically rushes to the bathroom in the morning for his morning dose. Heroin abuse also often causes constipation, leading to prolonged use of the bathroom. Here are other visible signs of heroin abuse:

• Runny nose, coughing, sneezing, fever, chills
• Mental confusion
• Staggered gait
• Lack of hygiene
• Poor appetite
• Vomiting
• Scratch marks
• Pupil dilation
• Calmness (when high) and restlessness (when not high)

Health Risks

• Coma
• Death
• HIV and other diseases resulting from infected needles
• Collapsed veins
• Infections

Other Drugs

It is not easy to identify drug abuse because there are several drugs with different effects and health risks. Some drugs are available for research, medical, and other legal uses, but are often abused. If you notice any suspicious behaviour in your child/spouse, do not panic, but consult a qualified psychiatrist with experience in drug abuse treatment. A few other commonly abused groups of drugs include:

• Opiods: Opium and morphine, along with heroin, belong to the group of drugs derived from the poppy plant.
  
  
• Hallucinogens: In addition to ecstasy, drugs like mescaline and psilocybin are often used to induce altered states of perception.
  
  
• Inhalants: Paint thinners, petrol, gases (butane, propane, and laughing gas) are easily available but highly dangerous, causing death within seconds. Every year, several teenagers accidentally inhale these substances, with some developing an addiction over time.

NICOTINE / TOBACCO / CIGARETTE ADDICTION   

Cigarettes: Also known as: “smokes,” “cigs,” or “butts”

Smokeless tobacco: Also known as: “chew,” “dip,” “spit tobacco,” “snus,”,"Khaini", "Masheri" or “snuff”

Hookah: Also known as: “narghile,” “argileh,” “shisha,” “hubble-bubble,” or “goza”

Tobacco is a leafy plant grown around the world, including India. There are many chemicals found in tobacco or created by burning it (as in cigarettes), but nicotine is the ingredient that can lead to addiction. Other chemicals produced by smoking, such as tar, carbon monoxide, acetaldehyde, and nitrosamines, also can cause harm to the body. For example, tar causes lung cancer and other serious diseases that affect breathing. Carbon monoxide causes heart problems, which is one reason why people who smoke are at high risk for heart disease.

Tobacco use is the leading preventable cause of disease, disability, and death in India. There are millions of premature deaths in India each year—from smoking or exposure to secondhand smoke—about hundreds of deaths every day. Additional millions people suffer with a serious illness caused by smoking. Thus, for every 1 person who dies from smoking, 20 more suffer from at least 1 serious tobacco-related illness.

Various modalities involved in treatment of Alcohol or Drug De addictions (Mumbai ,India)

consists of different steps & different strategies for different sub-types
like -

1. COUNSELLING


2. BEHAVIOR THERAPY  


3. COGNITIVE BEHAVIOR THERAPY  


4. INTERPERSONAL THERAPY


5. GROUP THERAPY


6. MOTIVATIONAL THERAPY


7. DRUG-ANONYMOUS GROUP PARTICIPATION 


8. DETOX


9. TREATMENT OF COMORBID PSYCHIATRIC DISORDER IF ANY


10. DRUG REHABLITATION 

.
. 

CONTACT DR. PAVAN SONAR,

PSYCHIATRIST & SEXOLOGIST MUMBAI, 

For Appointment,

SMS/ WhatsApp on -

9920930911 

OR

9930316786

STRICTLY BY APPOINTMENT ONLY 

Email :

drpavansonar@gmail.com 

Dr.Pavan A. Sonar is senior consultant psychiatrist , psychotherapist , sexologist & counselor, providing  services to the patients & clients in the area of Mumbai suburbs. He has been serving areas including Andheri, Lokhandwala, Juhu, Goregaon ,Malad, Kandivali, Borivali & Dahisar.