Drug Misuse
In this section we will explore:
Please be aware that there is a course run by the Royal College of General Practitioners (the certificate in management of drug misuse part one & two) which goes into more detail about drug misuse and treatments in primary care.
The growing issue of ADDICTION TO PRESCRIPTION MEDICATIONS is dealt with in a separate section.
What is Drug Misuse?
Drug misuse is defined as the use of a substance for a purpose not consistent with legal or medical guidelines (WHO, 2006). In the U.K, drugs were classified into categories A,B or C under the misuse of drugs act 1971. The categories rate the drugs according to the harm thought to arise to the person and to society through misuse.
Class A includes : heroin, cocaine (including crack), Ecstasy (MDMA), Methadone, LSD and Magic Mushrooms
Class B includes: Amphetamines, Barbituates, Codeine, Cannabis and Mephedrone.
Class C includes: Benzodiazepines, GH/GBL, Ketamine, Anabolic Steroids and benzylpiperazines (BZP).
Drugs in these categories are illegal to have, produce, give away or sell without a license.
What Drugs are Misused?
The 2012/13 Crime Survey for England and Wales showed hat 8.1% of adults (aged 16-59) have taken an illicit drug in the past year (2.7 million people). 850,000 of them had taken a class A drug. One third have taken an illicit drug sometime in their life but only 2.8% of them take drugs on a monthly basis or more frequently (Home Office, 2013).
Cannabis is the most misused substance (6.4% adults int he past year), followed by powder cocaine (1.9%) and then ecstasy (1.3%). Opiate abuse is happening at a lower rate now than historically has been the case (Home Office, 2013). The OVERALL trend for illicit drug use is down since the surveys were last carried out but certain trends are rising. Use amongst vulnerable groups (such as people leaving care), the offending population and young people is higher then use in the general adult population (RCGP, 2013).
Growing areas for misuse are legal highs and polydrug use. Legal highs are chemicals which produce similar effects to elicit drugs but have not yet been included under the Misuse of Drugs Act 1971. It is still illegal to sell them for human consumption and so they are often sold in 'head-shops' as incense, salts or plant foods. There is usually little research data to explore the safety of such substances for human use or when mixed with other substances/alcohol. Like all street drugs, you cannot be certain what is contained in a legal high and whether it is safe or not.
Poly-drug use is now common and presents further complications, for example the additional sedative effect of alcohol and benzodiazepines will make opioid use (whether illicit or prescribed) more dangerous. It is important to get a clear picture of a person's exact drug use in order to best advise them about how to reduce the likelihood of harm.
For more information about individual drugs, their effects, alternative terminology and legal specifics I would suggest looking at FRANK's information leaflets.
Effects of Drug Misuse
The next parts of this module will focus on the effects of drug misuse and then go on to deal with the management options available to primary care services.
- What drug misuse means and which drugs are most often abused
- The effects of drug misuse
- A consultation model for dealing with a first presentation of drug misuse
Please be aware that there is a course run by the Royal College of General Practitioners (the certificate in management of drug misuse part one & two) which goes into more detail about drug misuse and treatments in primary care.
The growing issue of ADDICTION TO PRESCRIPTION MEDICATIONS is dealt with in a separate section.
What is Drug Misuse?
Drug misuse is defined as the use of a substance for a purpose not consistent with legal or medical guidelines (WHO, 2006). In the U.K, drugs were classified into categories A,B or C under the misuse of drugs act 1971. The categories rate the drugs according to the harm thought to arise to the person and to society through misuse.
Class A includes : heroin, cocaine (including crack), Ecstasy (MDMA), Methadone, LSD and Magic Mushrooms
Class B includes: Amphetamines, Barbituates, Codeine, Cannabis and Mephedrone.
Class C includes: Benzodiazepines, GH/GBL, Ketamine, Anabolic Steroids and benzylpiperazines (BZP).
Drugs in these categories are illegal to have, produce, give away or sell without a license.
What Drugs are Misused?
The 2012/13 Crime Survey for England and Wales showed hat 8.1% of adults (aged 16-59) have taken an illicit drug in the past year (2.7 million people). 850,000 of them had taken a class A drug. One third have taken an illicit drug sometime in their life but only 2.8% of them take drugs on a monthly basis or more frequently (Home Office, 2013).
Cannabis is the most misused substance (6.4% adults int he past year), followed by powder cocaine (1.9%) and then ecstasy (1.3%). Opiate abuse is happening at a lower rate now than historically has been the case (Home Office, 2013). The OVERALL trend for illicit drug use is down since the surveys were last carried out but certain trends are rising. Use amongst vulnerable groups (such as people leaving care), the offending population and young people is higher then use in the general adult population (RCGP, 2013).
Growing areas for misuse are legal highs and polydrug use. Legal highs are chemicals which produce similar effects to elicit drugs but have not yet been included under the Misuse of Drugs Act 1971. It is still illegal to sell them for human consumption and so they are often sold in 'head-shops' as incense, salts or plant foods. There is usually little research data to explore the safety of such substances for human use or when mixed with other substances/alcohol. Like all street drugs, you cannot be certain what is contained in a legal high and whether it is safe or not.
Poly-drug use is now common and presents further complications, for example the additional sedative effect of alcohol and benzodiazepines will make opioid use (whether illicit or prescribed) more dangerous. It is important to get a clear picture of a person's exact drug use in order to best advise them about how to reduce the likelihood of harm.
For more information about individual drugs, their effects, alternative terminology and legal specifics I would suggest looking at FRANK's information leaflets.
Effects of Drug Misuse
The next parts of this module will focus on the effects of drug misuse and then go on to deal with the management options available to primary care services.
References
The Home Office. Drug Misuse: findings from the 2012 to 2013 Crime Survey for England and Wales. 2013 - https://www.gov.uk/government/publications/drug-misuse-findings-from-the-2012-to-2013-csew/drug-misuse-findings-from-the-2012-to-2013-crime-survey-for-england-and-wales
RCGP Guide to The Management of Substance Misuse in Primary Care. 2nd Edition. Royal College of General Practitioners, 2013. p.39.
The Home Office. Drug Misuse: findings from the 2012 to 2013 Crime Survey for England and Wales. 2013 - https://www.gov.uk/government/publications/drug-misuse-findings-from-the-2012-to-2013-csew/drug-misuse-findings-from-the-2012-to-2013-crime-survey-for-england-and-wales
RCGP Guide to The Management of Substance Misuse in Primary Care. 2nd Edition. Royal College of General Practitioners, 2013. p.39.