Socially Significant Diseases

Man is a social animal and lives in highly complex societies. Societies are specially meant to make life easier, smoother and more comfortable. A society also offers competition, stress and strain. Such social factors, if prolonged, may cause mental tension and mental illness (like depression, anxiety, etc.) in some persons, which may create various behavioral changes in them. These changes may be disturbing for himself and his society too. Thus, any abnormal change that causes distress and discomfort to the lives of both the concerned person & the people around him may be termed as socially significant disease.

A person is said to be mentally ill when he or she exhibits abnormal changes in behaviour due to abnormality in thinking, feeling, memory, perception and judgment. The disturbances listed above may alter his/her day-to-day activities and his/her relationship with others. In order to reduce tension, to get relief and to escape from reality, such persons often lead to acquisition of certain habits like smoking, drinking, drug abuse, etc.

                                    Drug Abuse

A drug is defined as any chemical substance that alters the physiological state of body. Drugs are widely used as medicine for the prevention, diagnosis and treatment of diseases. They include analgesics, antibiotics, anaesthetics, antihistamines, anticoagulants etc. The term drug is derived from the French word drouge that means a dry herb. The study of drug is called pharmacology.

Abuse means wrong or bad use. Thus, drug abuse indicates the misuse or bad use of drugs. Drug abuse may be defined as the use of any substance in an illegal and un-medical way that alters the ability of the individual. In most cases, drug abuse involves the agents that affect the higher functions of the brain and that are used to alter mood and perception. Many of these drugs are habit forming and their use is illegal. Prolonged use of such drugs may lead to the dependence of the body on them. This is called drug dependence or drug addiction. Some people start taking drugs without any medical advice and soon become drug addicts. It is possible to get rid of drug addiction but because of serious withdrawal effects, it is extremely difficult to give up those drugs on which the body becomes dependent.

Causes of Drug Addiction: There are a number of social, economical and other reasons which may compel a person to take these drugs.

·         Due to pressure of friends

·         To satisfy his own curiosity.

·         For the feeling of relaxation.

·         To escape from a difficult or unpleasant situation.

·         In search of a more satisfying life.

·         Some people take drugs to increase their working capacity.

·         Students usually take drugs to study all night during examinations.

Types of Drugs: The drugs which act on the brain and alters the perception and behavior of a person are called psychotrophic drugs. Due to this, these drugs are also referred to as mood altering drugs. According to the mode of action, the psychotrophic drugs are classified into two types:

(a)     Narcotics or depressants: These have depressing effects on the activities of the central nervous system or decreases th functioning of nervous system eg. Opium and its derivatives.

(b)     Stimulants: These increase the activities of the central nervous system like Cocaine.

The different narcotics and stimulants are broadly categorized into following groups;

(i)   Sedatives and Tranquilizers: These drugs have a negative or depressing effect on the brain. They produce a feeling of calmness, relaxation or drowsiness in the body. Higher doses induce sleep. Tranquilizers differ from sedatives in that they reduce tension, worry and anxiety without inducing sleep.

(ii)    Opiate Narcotics: These are a group of pain relieving drugs that include opium and its derivatives like morphine, heroin, codein, methadon, etc. Of these, heroin is the most dangerous drug and is now banned even for medical use. All the opiate drugs are pain-killers and reduce anxiety, worry and tension in the body. They also lower the blood pressure and the rate of breathing, causing drowsiness and lethargy.

(iii)   Stimulants or Antidepressants: These are drugs that temporarily increase mental alertness and self confidence. Some of the stimulants are caffeine (present in tea, coffee, cocoa and cola drinks), cocaine and amphitamine. Cocaine and amphitamines are strong stimulants while the caffeine is a mild one. However, effective intake of caffeine may be addictive. These drugs produce feelings of excitement, a sense of well being and flow of new ideas. They also reduce the appetite in the body These do not show withdrawal symptoms.

(iv) Hallucinogens: Hallucinogens are drugs or chemicals that cause alterations in perception (usually visual), mood and thought. These include a wide range of compounds like LSD (Lycergic acid diethylamide) obtained from the Argot fungus Claviceps, bhang, marijuana, hashish, etc. Bhang, charas and ganja are obtained from the dried leaves and flowers of hemp plants (Cannabis incdica) while marijuana is obtained from another hemp plant (Cannabis sativa). These drugs have a strong effect on the brain and the sense organs.

LSD is a psychedelic drug. It affects the mind by changing the perception of all the senses regarding space, time, rate & concept of thought. It causes nightmares (horrible dreams), floating sensation and sometimes severe damage to the central nervous system leading to mental break down and suicides.

Bhang, charas and ganja (products of hemp plants) dilate the pupil, raise the blood sugar level, increase the frequency of urination and cause anxiety. When taken along with alcohol, they show very dangerous symptoms.

Effects of drug abuse: Both the narcotic and stimulant drugs are harmful to the body. Once the body receives these, it demands more and more. Such persons live a miserable life. Instead of spending their money on food, they spend it for drugs wherever they can get them.

Types of Drugs and Their Effects

Group	Drugs	Sources	Effects
Sedative & Tranquiliz-ers	Barbiturates	Derived from barbituric acid.	Produce feelings of calmness, relaxation, induce sleep, so called sleeping pills.
Opiate narcotics	Opium	Extracted from unripe capsules of poppy plant.	Reduces respiratory and cardio vascular activity, causes nausea & vomiting.
	Morphine	Extracted from opium	Supresses brain activity, provides releif from severe pain
	Heroin	Synthetic compound from morphine.	Anxiety, fever, chills, painful gastro-intestinal disruption
Stimulants	Caffeine (mild stimulant)	Obtained from tea, coffee plants & cocoa.	Mental alertness and restlessness
	Nicotine	Obtained from tobacco	Affects nervous impulses, musculature relaxation, Blood pressure & heart beat.
	Cocaine	Obtained from cocoa plant	Lack of sleep & appetite.
Hallucinog ens	LSD	Synthesized from lysergic acid produced by Argot fungus.	Severe damage to CNS leading to suicide, serious mental breakdown.
	Hashish Bhang, charas, Ganja.	Obtained from Hemp plants (Cannabis species)	Dilates pupils, damages lungs; raises blood sugar level, urination, anxiety; alert feelings and perceptions.

Besides these, the major effects observed due to narcotic drugs are as follows:

·         On continued intake of drugs, the abuser becomes a drug dependent.

·         The drug addict loses control over the quantity and frequency of taking drugs.

·         Drug addicts start absenting themselves from their classes, place of work and even from home.

·         There is a marked decline in their academic and working performance.

·         They start losing appetite and body weight.

·         Loss of interest in hobbies, sports, class & friends.

·         The addicts feel unusual smells, strains or marks.

·         Speech is slurred.

·         They become irresponsible, irritable, unreliable and socially withdrawn.

·         Since the addicts get their supply of drugs from illegal sources, they encourage smuggling.

Besides these behavioral changes, drug abuse also creates serious permanent physiological damages in the body of the abusers. The body fails to work without drugs. Ultimately, other organs are also damaged, and the drug abusers become victims of various diseases like AIDS, sexually transmitted diseases, etc.

Control Measures: Drug addicts can be cured by applying the following major steps:

·         Early detection, treatment and rehabilitation of addicts,

·         Parents should set a warm and friendly atmosphere at home.

·         Motivation of the addicts to make their mind up for detoxification.

·         The institutes and NGOs must provide moral education to both the students and their parents.

·         The youth should be motivated to be involved in the fight against drug abuse.

·         By educating the community about the problems of drug addiction.

·         Enforcement of laws, rules and regulation for the control and supply of drugs.

Alcoholism

The term alcohol generally refers to Ethyl alcohol or Ethanol (C₂H₅OH). It is the drug found in beer, wine, liquor and in certain other beverages. Ethanol is produced by the fermentation (the action of yeast) on fruits and grains. The products of fermentaion are further distilled and thus, pure alcohol is manufactured. Alcoholic drinks are further prepared from this in three common forms— Beer, wines and hard liquor. Hard liquor includes vodka, whisky, gin, rum, brandy and scotch. The alcoholic content of beer is about 3-6%. Wines vary in alcoholic contents from 12% to 20%. The alcoholic content of hard liquor ranges from 40-50%. It is much popular and frequently consumed by the people of lower as well as higher societies.

The moderate use of alcoholic beverages is commonly believed to be a mild stimulant like coffee and tea. Most of the elders experience comfort warmth and cheer. As their bodily processes are slow, they feel the stimulating effects of alcohol. Alcohol dilates the capillary blood vessels and thus, may improve circulation temporarily in elderly people because by that time the age has made the blood vessels less elastic and labile. Because they contain calories, alcoholic beverages can be classed as food but they have no nutritional value other than calories.

The stage where an individual tends to continue excessive or compulsive use of alcoholic drinks and becomes an addict to alcohol is called alcoholism. It impairs the psychological, physiological and socio-economic conditions of the drinker (addict). Therefore, alcoholic addiction is considered a sort of a disease now.

Causes of drinking alcohol: A person may take a drink for a variety of social, cultural, religious or medical reasons. Some people take a moderate amount of alcohol in panics or   other social occasions. Some other reasons for drinking alcohol are as follows:

·         Due to pressure of friends.

·         To escape from worries or problems.

·         Due to frustration and poor parental guidance.                          

·         Some may drink as a part of religious or social traditions.               

·         Influence of skillful advertising and image making etc.

·         Some may drink to relax.

To determine whether a person is an addict or about to become an addict or not, the American Psychiatric Association (APA) introduced a test called "CAGE" test in 1974. The test is called 'CAGE' after the initials of four key words of the four question test. The test is as follows:

(1) Does the drinker ever feel he should Cut down on his drinking?

(2) Does he ever get Annoyed when people criticize his drinking?

(3) Does he ever feel Guilty about his drinking?

(4) Does he ever have an Eye-opening drink as a first thing in the morning to start the day with a comfortable and pleasant mood?

If the answer is 'Yes* to only question 4 or *Yes' to all the questions then the person is an addict. However, if the answer is 'Yes' to one or two questions excluding four then he is on the boarder of becoming an addict.

Effects of Alcohol: In fact the alcohol is a depressant or sedative drug that decreases the activity of central nervous system and lowers the level of activity of many body functions. The excessive consumption of alcohol is poisonous to the human body and health as it causes several health hazards. Along with health, it also affects the user's family life and ultimately creates several social problems.

            Effects on Health: Following consumption, alcohol does not provide any useful nutrient to the body; instead it gives empty calories (7-2 calories/gm) and poisonous substances. It shows several harmful effects on different organs of the body soon after consumption.

·         On Nervous System: Alcohol depresses the activity of the nervous system, thus acting as a sedative, analgesic and anaesthetic agent. It affects the coordination of hands, limbs and eyes- Prolonged use of alcohol causes neuritis, the inflamation of axons of the nerves.

·         On Digestive System: A large dose of high concentration of alcohol causes inflammation of gastric mucosa (gastritis) by increasing the secretion of gastric juice.

The most important organ which is damaged by alcohol is the liver. Alcohol replaces the stored glycogen of hepatic cells by fats, a condition called fatty liver syndrome. Due to this, the liver gradually hardens and dries up called cirrhosis of liver that finally may be fatal.

·         On Cardio-vascular System: Alcohol dilates the blood vessels. Due to constant dilation the arterial walls become brittle and rigid. It lowers the blood sugar level. Due to long term use of alcohol, alcoholic fats are deposited on the walls of the blood vessels and thus, increase the blood pressure that ultimately leads to several heart diseases.

·         On Excretory Organs: In alcoholic persons, perspiration increases as a response to the rise in blood temperature at the skin surface. Water in the kidneys is reabsorbed to compensate for the loss of water through the skin. As a result nitrogenous wastes collect in the kidneys, interfering with the normal filtration process. Drinking alcohol removes water from the body, resulting in general dehydration.

·         On Reproduction: Alcohol shows effects on ovulation and menstruation in females. Infants of the women who drink during pregnancy may suffer from fetal alcohol syndrome (FAS), causing physical and mental disabilities. Immediate effects of FAS are low birth weight, below-average length, general weakness and heart defects.

            Effects on Family and Society: The consumption of alcohol not only creates problems to the drinker but directly or indirectly affects the family and society as well.

·         Excessive expenses on costly drinks create a financial crisis or leads to poverty.

·         Break down of family relationships, the person may be violent to his wife and children.

·         Their children suffer from insecurity, frustration and anxiety.

·         Injuries from falls, fights burns and immature death.

·         Increase in road accidents and crimes, like rapes, corruption, etc.

Symptoms of Alcoholism:

·         Feeling of relaxation and warmth,

·         Light headedness & lack of coordination,

·         Decreased reaction time; Lack of judgment,

·         Slurred speech; blurred vision,

·         Deep coma,

Control of Alcoholism:  The following measures are believed to be helpful in the prevention and control of alcoholism;

·         The examples set by parents in the family play the most important role.

·         To educate the community about the problems & effects of alcoholism.

·         To encourage community people to make an alcohol free environment and to discourage people from drinking.

·         Drinking should be prohibited at public places, parties and family celebrations.

·         To penalize the drunkards in place of tolerating their behavior.

·         Early detection and proper treatment of sick persons.

·         To increase alcohol taxation.

Smoking

Consuming tobacco smoke in the form of cigarettes, bidis or cigar is known as smoking. It is very common in our country. It is a psychological habit which is the most common form of addiction in society.

Tobacco comes from Nicotiana tobaccum, a tall leafy plant of the solanaceae family, After being dried and crushed, tobacco leaves are smoked in cigarettes, cigars, pipes,

hubble-bubble (hookkah), etc. Tobacco is also inhaled or chewed. The major drug found in tobacco is nicotine. It is a stimulant, a drug that increases the activity of the central nervous system. Nicotine can cause addiction the user can become dependent on the presence of the drug and thus find it difficult to do without. A smoker gets more nicotine and tar if he smokes tobacco. According to a report, a person shortens his life span equal to the time he spends in smoking. It has been estimated that the amount of nicotine present in one cigar may be fatal, if it is injected intravenously in the body. During smoking, only about 10% of the smoke is inhaled.

Causes of Smoking: Smoking is generally used as a means of relaxation specially during tension. Survey reports indicate that smoking habit begins in the early teens. Studies have also shown that youngsters, whose parents smoke, will also tend to smoke. Besides these, some other probable reasons for smoking are as follows:

·         Imitation and pressure of friends.

·         Influence of skillful advertising and image making

·         Many people consume it just for fashion or to show off.

·         Lack of proper guidance and unhealthy friends circle.

·         To reduce tension and to get relief from pain.

·         Due to frustration.

·         Due to tradition or on religious occassions.

Types of Smoking: Smoking is done in a variety of ways. Besides tobacco, several people use the products of Hemp plants or a mixture of both for smoking.

·         Tobacco: Tobacco smoke contains highly poisonous alkaloid drug nicotine and a mixture of approximately 4000 different chemicals, including some poisonous chemicals like carbon monoxide, cyanide, formaldehide, etc.

·         Hemp Plant: Bhang, ganja and charas are the three drugs which are obtained from the dried leaves and flowers of Hemp plant, Cannabis indica. Drug marijuana is derived from another species of Hemp plant, Cannabis sativa. The active ingredient found in these is THC (9 - tetra-hydro-cannabinol). When smoked or when heated and eaten, these act on nervous system. They produce the feeling of disorientation in time and space. Continuous use of these may lead to psychological addiction and to a suppressed activity level, often referred to as amotivational syndrom.

Symptoms of Smoking: During smoking, nicotine and other chemicals are absorbed into the blood stream through the lining of the mouth & the lungs. These are transported to the brain in 7.5 seconds. Their effects show some remarkable symptoms as follows:

·         The smoker feels relaxation for a while.

·         Smoking irritates the delicate lining of the nose, throat, trachea and bronchial tube and results in coughing.

·         Excessive smoking causes reduced life expectancy.

·         It increases the rate of heart beat by upto 33 beats a minute and increases blood pressure.

·         Smoking may also cause chronic bronchitis.

·         Excessive smoking leads to cough or hoarseness of the voice.

·         Smoking makes the lips darker, dulls the taste of food and reduces appetite.

·         In case of Hemp products, the mouth becomes dry and the eyes red.

·         Regular use causes addiction.

Effects of Smoking: Scientific experiments have repeatedly shown that smoking can have severe effects on the body. Each year, an estimated 350,000 Americans die from tobacco related diseases. The various short and long term effects of smoking on smoker's health and society may be summarized as follows:

·         Cancer: Tobacco is carcinogenic in nature. Long term smoking may causes cancer of lungs. Nearly 90% of all lung cancer deaths can be attributed to smoking. Chewing of tobacco has a higher rate of lip, gum and mouth cancer.

·         Bronchitis: Many smokers are highly susceptible to chronic bronchitis (an inflammation of bronchi and bronchioles) and emphysema (a degenerative lung disease) Emphysema results from the rupture of alveoli.

·         Heart Diseases: As smoking constricts peripheral blood vessels and increases the heart rate, it increases the chances of heart disease.

·         Birth Defects: In pregnant women, smoking increases the chance of miscarriage. Their babies are often much smaller, weaker and of low birth weight. Such babies may have mental disability, damaged internal organs and physical deformation and are most likely to die in the first few months.

·         Asthma: The carbon monoxide present in the smoke of tobacco binds with haemoglobin in the lung and reduces the oxygen carrying capacity of blood. This produces asthma like symptoms in chain smokers. Smoking may also cause pulmonary tuberculosis.

·         Stomach Disorders: Smoking increases the secretion of gastric juice. This may cause gastric and duodenal ulcers and is specially harmful to a person already having peptic ulcers.

      Socio-economical Effects:

·         It leads to economic loss.

·         Careless smoking improves the chances of fires and loss of social lives.

·         It causes annoyance to non-smokers.

Control of Smoking: The following measures are believed to be helpful in the prevention and control of smoking;

·         By providing health education.

·         By providing information about the evils of smoking.

·         Smoking should be discouraged by the community.

·         By banning the production and sale of tobacco, bhang and hemp plants on a commercial scale.

·         Strict implementation of laws to discourage smoking.

·         Treatment and hospitalization of sick persons.

·         Smokers may be suggested for substitutes like chewing gum, carrots, etc.