1. Objectives
2. Introduction
3. Emerging Phenomenon
4. Definition of Important Concepts
5. What is a Drug?
6. Drug Use and Abuse
7. Addiction, Tolerance and Dependence
8. The Process of Addiction
9. Addiction to Alcohol
10. Addiction to Drugs
11. Causes of Addiction
12. Physiological Causes
13. Individual or Psychological Causes
14. Socio cultural/Environmental Causes
15. Intervention : Treatment, Rehabilitation and Prevention
16. Tobacco, Effects of Physical Activity on Smoking, Deaths and illnesses,


Give an overview of the global situation of drug and alcohol abuse an addiction
Describe what drugs are and how the process of addiction occurs;
Explain the causes of addiction


Drug addiction and alcoholism are also deviant activities. We begin the unit by defining some important concepts like drug use and abuse, addiction, tolerance and dependence. We then deal with some important facts about alcohol, and narcotic drugs. The process of addiction is described both for alcohol and for drugs. Next, the causes of addiction are explored. Also the connection between drugs, crime and politics is discussed. Finally we deal with treatment, rehabilitation and prevention of drugs and alcohol abuse.
Addiction to drugs and alcohol is today a worldwide crisis. Both supply and demand for natural and laboratory-produced drugs is on the increase. Many new countries are being affected and the number of addicts is increasing. National productivity has suffered as a result. Most countries are now beginning to take serious note of the problem and are taking steps to reduce this problem. This unit presents the problem of drug addiction and alcoholism from the point of view of:

  • The extent of the problem
  • The nature of drugs and alcohol
  • The causes of addiction
  • The rehabilitation programmes
  • The relationship between drugs and crime.


If data on the world situation is examined, it is seen that alcohol, opium and cannabis are the main drugs abused. Men more than women are their addicts. Over the last few years, addiction to heroin in particular is rising rapidly. Taking drugs by injection exposes the individual to a high risk of developing other diseases and health problems like AIDS (Acquired Immune Deficiency Syndrome) as well as of death due to some of these problems and due to taking an over-dose. Earlier, addiction was restricted to only some groups but today there is a wide range of users. In fact, using many drugs simultaneously, e.g. combining narcotic drugs with alcohol is increasingly practiced. Experimenting with drugs including alcohol is beginning at an earlier age than before. In India, the problem is steadily increasing, both among urban and rural populations, due to

  • The growing prosperity
  • The stresses of modern life
  • High economic and social disparity
  • An increasing sense of dissatisfaction with one’s life.

Drug Addiction and Alcoholism

If we look at drug and alcohol production we find that in almost all countries, drug and alcohol production has risen in spite governmental control. To fight the problem, (i) governments have begun strict vigilance, (ii) have often ordered destruction of poppy fields and laboratories, (iii) passed harsh laws against trafficking (i.e. dealing in drugs for financial profit), and (vi) have offered international co-operation on all matters related to drug use. Governments are also encouraging preventive education programmes. Public awareness programmes are being taken up by governmental and nongovernmental agencies for prevention of addiction. Such strong efforts, however, are not noticed in the case of alcohol which is a more socially accepted drug and has become a part of the daily life of people. Other than high taxes, in most countries, no curbs are placed on its production, sale and use. Alcohol continues to be a major income-earner for many countries. Alcoholism affects a larger section of society than drug addiction and affects all socio-economic sections. Today there is a strong demand to view alcoholism as a serious social problem along with drug addiction. It is important to understand why addiction is viewed as a phenomenon that alienates and deprives. Alcohol is today almost a part of life in many societies. Legalisation of some drugs is being seriously considered in some nations. Then how can addiction be seen as alienating and depriving? This is because of the havoc caused by the substance to which one is addicted.

An addict is one

  • Who cannot function physically and psychologically without drugs or alcohol,
  • Who takes alcohol/drugs beyond the socially or culturally accepted level and at times even on an inappropriate place and time,
  • Who faces harmful consequences on his/her personal, family, work and social life.
  • Strangely this phenomenon only affects some persons who consume alcohol and drugs and not all. It is viewed as a deviation in most countries.
  • It is necessary to understand why alcoholism and drug addiction occur. But first, let us understand the substance itself, viz. alcohol and other drugs.


In the following subsections we are going to discuss the definitions of some of the important concepts like drug use and abuse, addiction, tolerance, dependence and so on.

What is Drug?

Any substance (usually chemical) which influences our bodies or emotions when consumed may be called a drug, i.e. it is a chemical substance, that, when put into your body can change the way the body works and the mind thinks. These substances may be medicinal i.e. prescribed by a doctor for reducing minor ailments or problems, e.g. lack of sleep, headache, tension, etc. but are also used without medical advice

Drug Use and Abuse

Using drugs to cure or prevent an illness or improve one’s health may be called drug ‘use’. Using drugs (medicinal/non-medicinal) in quantity, strength, frequency or manner that damages the physical or mental functioning of an individual, is termed as drug abuse. This means that even taking medicines in excess or too often or too long or for the wrong reasons or in the wrong combination implies drug ‘abuse’.

Addiction, Tolerance and Dependence

Such ‘abuse’ leads to addiction, i.e. inability to lead a regular life in the absence of the drug/alcohol. It causes tolerance and dependence, and withdrawal symptoms may occur in its absence. Explained simply, tolerance means the need for more quantity and more frequent use of the drug to produce the same effect as before. Dependence can be both physical and psychological. Physical means that the body cannot function without taking the drug. Psychological dependence means constantly thinking about the drug and its use, continuously trying to get it and being emotionally and mentally unable to lead one’s regular life without it. Some drugs like cannabis produce only psychological dependence while others like opium and heroin produce both physical and psychological dependence.

If the drug consumption is suddenly stopped after one became a dependent on it, withdrawal symptoms occur. These range from mild discomfort to severe vomiting and convulsions, depending on the drug being used. All drug addicts may not experience the severe withdrawal symptoms shown in TV serials and films.

The severity of these symptoms varies with.
i) The type of drug
ii) The amount regularly consumed
iii) The duration of taking the drug and the treatment provided in special medical units, where such withdrawal is usually managed.

Helping the person through ‘withdrawal’ from drugs (usually medically supervised) so that the person’s body gradually gets released from the clutches of the addiction is known as detoxification. It is important to note that withdrawal symptoms make it, especially difficult to give up drugs as they are very unpleasant. The user is thus afraid to quit drugs, even if he/she knows the harmful effects of drugs on his/here life.

It is generally recognised today that addiction is a disease and not simply a sign of moral weakness or of a lack of will power. It this section, the process of addiction to alcohol and drugs are examined separately, though the general path is similar.

Addiction to Alcohol
Alcoholism has been described as chronic illness which is characterised by repeated drinking of alcoholic drinks, to the extent that it exceeds customary use and social standards of a community, interferes with the drinker’s health and social or economic functioning and leads to continuing problems.
An alcoholic is unable to take note of these problems or if he/she takes note, is not able to stop drinking completely.

Alcoholism has been described in the following way. It is a disease by itself and not just a symptom of a psychological problem. The disease itself causes psychological and physical problems, which can be handled, only if the alcoholism itself is treated. It is a progressive disease, i.e. in the absence of treatment, it worsens. It can be a terminal illness, i.e. if untreated for medical problems like
Cirrhosis, the person can die. It is a treatable disease, i.e. it can be checked or its progress stopped with proper treatment, which aims at totally giving up alcohol. An alcoholic thus cannot drink one in a while, i.e. he/she cannot become a ‘social drinker’. This is so even if he/she has remained sober, i.e. without alcohol, for many years. Even if he/she takes a small quantity of alcohol he/she will return to frequent drinking.

Drug Addiction and Alcoholism
As a progressive disease, it goes through various phases. The signs of these
Phases are described below:

i) Early Phase
a) Need for more alcohol for the same effects, as earlier.
b) Avoid stalk about alcohol due to guilt.
c) ‘Blackouts’, i.e. forgetting all that one did under the influence of alcohol.
d) Preoccupation with drinks, i.e. thinking of how, when and where one can get the next drink.

ii) Middle Phase
a) Loss of control over the quantity, time and place of consumption.
b) Giving excuses for one’s drinking to others and self.
c) Grandiose behaviour, i.e. doing things beyond one’s capacity, e.g. spending too much or showing off.
d) Aggression through words and action.
e) Guilt and regret.
f) Temporary periods of giving up drink.
g) Changing the drinking pattern, e.g. changing the type of drink, the time/place of drinking, etc, to limit one’s drinking, which does not give any positive results.
h) Problems in social relationships and increase of problems in family, job and financial matters.
i) Morning drinking in some cases in order to handle the hangover i.e. the feeling of illness and unpleasant physical symptoms the morning after an evening of heavy drinking.
j) At times, the alcoholic may seek help for alcoholism at this stage.

iii) Chronic Phase
a) Decreased tolerance i.e. now get ‘drunk’ even with a very small quantity.
b) Physical complaints.
c) Binge drinking, i.e. continuous drinking for days together.
d) Keeping a constant watch over the quota of one’s drinks, due to fear of being without a drink.
e) Criminal behaviour to get alcohol and ethical breakdown, i.e. unable to live up to social values.
f) Paranoia or suspicious feelings that everybody is against him/her.
g) Loss of sexual desire/functioning in men which increases their suspicion about their wife’s fidelity.
h) Fears of simple things, e.g. being alone.
i) Lack of motor coordination, i.e. shakes and tremors, prevent him from performing simple acts.

Addiction to Drugs
Addiction to drugs is similar to alcohol addiction, in terms of its characteristics.
The stages of addiction to drugs are also similar and are described below.

Early Phase
a) The amount of drug and the number of times it is taken goes up.
b) The person begins to spend more time and money on drugs and less on other activities in life.
c) Thoughts about drugs and the need to have them become important.

Middle Phase
a) The person needs the drug in larger quantity than before to feel well, i.e. addiction occurs.
b) Loss of control over drug use in spite of repeated efforts and decisions to stop or reduce the taking of drug.
c) Begins to hide drug supplies.
d) Problems in all areas of life, e.g. educational, work, family, etc.
e) Neglect of personal hygiene.
f) Staying away from friends and earlier interests.
g) Change in personality.

Chronic Phase
a) Total loss of control over drug use.
b) Almost constantly under the influence of drugs.
c) Needs people to attend to own needs, e.g. eating.
d) Remains only with other drug taking persons.
e) Possibility of early death.

Drug addiction thus leads to changes and deteriorations in behaviour, and social life, as well as in mental faculties like judgment, thinking and emotions.

Addiction is a complex phenomenon that research indicates is likely to be caused by a variety of factors rather than a single one. It was earlier believed that people who were of a certain type, viz. deviant were more likely to become addicted. There is no fixed type of personality which is addiction prone. Some factors may however, create a favourable environment or the development of addiction, while some factors may make it more difficult to give up addition.
These are looked at in the following sub-sections.

Physiological Causes
It has been found that if both parents of a child are addicted, the child has greater chances of developing addition. While this does not mean that children of all addicts will become addicts, it suggests a greater possibility. Alcoholism, in particular, tends to run in the family, suggesting that the predisposition to be an addict may be inherited. However, several other factors may also effect the development of the problem, viz.
i) Amount of drug taken and frequency
ii) The route of intake (injected drugs and more addicting)
iii) The availability, access and price
iv) The influences in one’s environment, other than familial.
Several other physiological factors are believed to contribute towards the
Development of addiction, e.g. in the case of alcoholism, nutritional deficiency,
Dysfunction of different body system, e.g. endocrine system, etc. However
None of these have been conclusively proved.

Individual or Psychological Causes

For several years, addition has been viewed as a mental abnormality, caused by individual problems. Studies have indicated that addicts are insecure people.
Many addicts report symptoms that range from mild to severe mental disturbance. However, it is not clear whether mental disturbance causes addiction or addiction causes mental problems. Whatever the relationship, there is enough evidence to indicate that addicts suffer from deep personality problems, feelings of inadequacy, dependency, powerlessness, isolation and low sense of self-respect–Childhood-related problems are observed among addicts as well as current stresses before the setting in of addiction.

It is also argued that addiction is the result of learning. After taking drugs initially, there is a pleasurable feeling or experience. This acts as a reward, and may lead to a continuous increase in the intake. Thus, initial experience, if pleasant, may lead to addiction. However, the generally believed theory is that some personalities are more prone to addiction than others.

Socio-cultural /Environmental Causes
Several theories are offered today which claim that addiction has socio cultural origins. People in societies that view that consumption of drugs and/or alcohol a acceptable, and where drugs are easily and cheaply available are likely to have high consumption of drugs/alcohol. In some tribal societies, the consumption of alcohol is a part of religious rituals and ceremonies. Such regular consumption may cause some people to become addicted. This does not mean that only availability and acceptance encourages addiction. In societies where this consumption is not accepted, some people turn to drugs/ alcohol. Youth often take drugs as a rebellion against adult norms and values. The cultural defiance theory thus, indicates that drug addiction develops because of these emotional and social ties, with a nonconventional group.


It is fortunate that addiction is a treatable disease. Like a physical illness, it requires some medication. However, this medication does not cure addiction.
It can be used to encourage appetite, build up stamina and strength, handle withdrawal symptoms and recover from other illnesses developed due to the addiction. The aim of treatment is basically to give up alcohol or drugs totally (abstinence) over a period when relapse (or a slip into taking alcohol or other drugs) will occur at sometime or the other as a natural event.

This phase begins after detoxification i.e. the period during which the patient is medically supervised and managed, through his physical withdrawal from the substance. During this phase, psychological help via counselling to the patient and family, individually, in groups, on couples or in the family is given.
This is aimed at overcoming problems in the area of job, finance, recreation, family and daily living. The focus is on changing attitudes, improving lifestyles and restoring the place in society that the addict had lost. This is done by helping the ex-addict to locate a job, be accepted in his family and society, take up recreation and hobbies, etc. Related emotional problems need to be handled as well as concrete details of daily living, e.g. managing money, and finding alternative way to relax.

Various methods and resources are being used for the above phases. Physical management may be organised in hospitals (special/general), special centres or even at homes, under guidance. Psychological help is provided

i) Professionally run places like hospitals, general hospitals, mental hospitals, private hospitals, or units specially meant for de-addiction, i.e. moving away from addiction.
ii) Institutions (day-care or residential) run by recovering addicts and/or professionals,


Common name for tobacco include: cigarettes, cigars, pipes, chew, dip, smoke, butt, snuff, bone, coffin nail, and cancer stick.

• Cigarette smoking is the leading preventable cause of disease and death
• One third of all new smokers will eventually die from tobacco use
• A pack-a-day habit costs about $1000 per year
• Smoking causes cancer, heart disease, lung disease and strokes
• 43% of people who smoke as few as three cigarettes have become addicted

What problems does tobacco cause?

More people die from tobacco-related illnesses than from AIDS, car accidents, illegal drugs, murders and suicides combined .In the short-term, tobacco use results in increased blood pressure and heart rate, increased blood flow from the heart and narrowed arteries. Tobacco also gives you bad breath, yellow teeth, and smelly clothes. In the long-term, tobacco is the cause of many chronic diseases, including cancer, heart disease, stroke and chronic obstructive lung disease. These tobacco-related diseases often cause premature death. On average, someone who smokes a pack or more of cigarettes each day lives 7 years less than someone who never smoked. More than 440,000 people die from tobacco-related illnesses each year

Youth Smoking

• 80% of smokers started before they were 18 years old
• 9 out of 10 adults began smoking during their teenage years…if you don’t start as a teen; chances are you’ll never smoke
• 1 in 5 youth aged 12-17 are smokers
• Most adolescents think they can quit, but after 6 years 75% still smoke
• Girls can become addicted in 21 days compared to 6 months for boys

Why do people smoke?

If it’s so bad for you, why do people smoke? Tobacco results in an addiction to the drug known as nicotine, due to a combination of biological, psychological and socio-cultural factors. All tobacco products contain the nicotine, a drug that is as addictive as cocaine and heroin. Nicotine causes feelings of reward and arousal, one of the reasons why smoking is often used as a coping mechanism for handling negative emotions such as stress, anger, pain or depression. Tobacco products are often used out of habit, or as a way of identifying with social groups. Tobacco is most commonly smoked, but can also be “dipped” or “chewed” allowing the nicotine to be absorbed more quickly via the gums. Smoking affecting lifestyles Smoking vs. Drugs: Youth smokers are 8 times as likely to use illicit drugs and times as likely to drink heavily as non-smoking youth. Smoking vs. School: The majority of people start using tobacco before they finish high school. Therefore, if youth stay smoke-free in school, they will probably never smoke. Smoking vs. Grades: Kids who start smoking are more likely to get lower grades in school. They tend to hang out with other kids who smoke, have a lower self-image and don’t know how to say no to tobacco. Second-Hand Smoke: Smokers are not only hurting themselves, they are hurting people around them. Second-hand smoke kills about 53,000 people every year.

Effects of Physical Activity on Smoking

√ Students who participate in at least one high school sport are 40% less likely to
Become regular smokers and 50% less likely to become heavy smokers than those who do not participate in sport 2
√ Smokers who exercise vigorously and regularly are more likely to cut down or stop smoking

Deaths and illnesses

More people die from tobacco-related illness than from AIDS, car accidents, illegal drugs, murders and suicides combined. Studies show that smokers lose 7 minutes of their lives every time they smoke a cigarette. Smoking causes cancer, heart disease, lung disease and strokes. Smokers as young as 18 have shown signs of heart disease.
Smoking causes 87% of all lung cancers. One third of all new smokers will eventually die from tobacco us

Tobacco Companies

Tobacco companies spend $16 million every day to advertise cigarettes. Tobacco ads are often aimed at new, young smokers. Tobacco companies try to make smoking look cool by using good-looking models. Tobacco gives you bad breath, yellow teeth, and clothes that smell like an ashtray. They don’t advertise that!


80% of smokers started before they were 18 years old. 43% of people who smoke as few as three cigarettes become addicted. If you don’t start as a teen, chances are you’ll never smoke. 70% of teens don’t smoke. Teens who smoke cough and wheeze three times more than non-smoking teens. It’s hard to do will at sports and other physical activities if you are short of breath from smoking.

Second-hand smoke

Smokers not only hurt themselves – they hurt people around them. Second hand smoke kills about 53,000 people every year. Smoking during pregnancy increases the risk of having a miscarriage. Babies whose parents smoke are seven times more likely to die from Sudden Infant Death Syndrome (SIDS). Children of parents who smoke have more colds, flu, ear infections and asthma.

“Other” forms of tobacco

Cigars and chewing tobacco contain cancer-causing chemicals, just like cigarettes. Because of their size, smoking one cigar is like smoking about 10 cigarettes. Cigar smokers are 4 to 10 times more likely to suffer from cancer of the throat, larynx and oesophagus than non-smokers. Smokeless tobacco makes you spit slimy brown tobacco juice. Smokeless tobacco causes cancer of the mouth, tongue and throat.


If you do smoke, the best thing you can do is quit. About 70% of people who smoke wish they could quit. Within days of quitting, a smoker’s sense of taste and smell returns to normal. Five to ten years after quitting, a smoker’s risk of heart disease returns to that of a non smoker. Half of all Americans who ever smoked have now quit.

YOU DON’T NEED IT! Take care of your health and your future. You’re worth it!