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Community Information and Factsheet 1 - Drugs and Problems

Created by Foundation for Local Development

Thailand www.fldasia.org

February 2014

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Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 2 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

This Factsheet explains what drugs are, their effects and the problems they can cause for people.

What is a drug? A drug is: “a chemical substance that affects the body in some way”.

A drug can affect different parts of the body, such as the kidneys or liver or stomach or heart or the brain.

There are many different types of drugs. Most drugs are made in laboratories, although some drugs come from plants. When they are made from plants they are usually called “herbs”.

Different types of drugs Drugs are used to manage sickness (such as those that are used to treat malaria or infections) or improve health (such as vitamins or herbs). Drugs that are used to manage sickness or to improve health are also called medicines.

The word “drug” is often used to describe those substances that are taken for recreation. That is, a substance taken not to fix illness or improve health, but because a person wants the effect the drug has on their mood, their level of alertness, and their perceptions.

Some drugs that people use for recreation are legal (alcohol, nuts, ). Other drugs that people use for recreation are illegal (, , marijuana and , yaba, ya-ice).

Why do people use drugs? People use drugs for many reasons including:

• Medical: Doctors prescribe drugs (medicines) for illnesses such as infections, malaria, diabetes. These drugs can be harmful to health if not used properly. • Social or Ceremonial: In many cultures everyday life involves the use of drugs such as alcohol, betel nut or tobacco. Alcohol is often used as a symbol of hospitality and friendship. • Relaxation: Drugs such as alcohol, amphetamines, tranquillisers, marijuana, and opium are used by some people to feel more comfortable in social situations.

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 3 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

• Peer pressure / belonging: Some young people take drugs because they want to be the same as others in their social group. • Pleasure: Some drugs such as and LSD are used because they can provide strong feelings of pleasure or excitement. They can also cause very uncomfortable feelings in some people. • Managing pain: Drugs can temporarily help people stop feeling physical, psychological or emotional pain. • Exploration & experimentation: Some people - particularly young people – want to try things that are different. Some are trying to understand their own minds and emotions. • Dependence or : Some people develop a dependence or addiction to drugs. This is a major problem with illegal drugs as they can lead to people spending a lot of money on the drug, and having problems in relationships with family and friends and work. Drugs such as opium are very addictive. is a legal drug, and does not harm social relationships like opium, but is very addictive and harmful to health.

The effects of any drug will be different depending on a number of things, including: • How much is taken • How it is taken (how often, with or without other drugs) • The individual (age, sex, weight, past use of the drug, mood and activities while using the drug)

What types of drugs are there? The drugs that are used for recreation are ‘psychoactive’ drugs. That is, these drugs affect the central nervous system (brain and spinal cord), and so change the way we feel and think and sense things around us.

Psychoactive drugs can be put into 3 groups depending on the way they affect the central nervous system. 1. Depressants slow down the central nervous system. These drugs decrease alertness, produce feelings of calmness, relaxation and drowsiness. In large doses they can produce deep sleep, emotional depression, poor motor co-ordination, coma and sometimes death. Common drugs in this group are alcohol, tranquillisers (such as valium), , opium based drugs, and marijuana in low doses.

2. Stimulants speed up the central nervous system. These drugs speed the body up and produce excessive talking, over-activity, irritability, nervousness,

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 4 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

(happiness) and insomnia (lack of sleep). In large doses they can cause seizures (fits) and possible death from muscle spasm. Common drugs in this group are amphetamines (ya-ba, ya-ice), , and betel nut.

3. Hallucinogens alter or change the central nervous system. These drugs alter the messages received by the brain. This produces hallucinations. Hallucinations are when a person sees, hears or feels something quite differently to the real thing. Hallucinations can be caused by other means such as illness or trance states for example. Common drugs in this group are LSD, ya-E, marijuana in high doses, and other “party” drugs.

Some people also use (petrol, glue and spray cans) known as “sniffers”. These are very dangerous and frequent use always leads to brain damage, and sometimes death.

How drugs work There are 4 main ways for a drug to get into the body: 1. Orally - through the mouth, by swallowing. 2. Injection - directly into the veins (intravenous or IV), into muscle (intramuscular or IM), or under skin (subcutaneous or SC). 3. Inhalation - through the lungs. 4. Absorption - through the mucous membranes, e.g. nose, mouth, rectum.

When a drug enters the body it is absorbed into the blood stream and travels to all areas of the body and to the brain. The drug is eventually broken down and made less toxic (usually by the liver) and excreted in waste (mostly in urine).

Terms relating to drug use Here are some commonly used terms relating to drug use that apply to all drugs taken for any reason. Intoxication means that the person is obviously affected by a drug. Abuse means using so much of the drug that the person is severely affected, and unable to function normally. The person may not use the drug often, but when they do they take a high dose. For example, some people do not drink alcohol often, but when they do they drink so much that they become sick, or even unconscious. Tolerance develops from continuous use of some drugs. This means that a person using the drug needs larger doses to achieve the same effect they once had from low doses.

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 5 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

Drug dependence is when a person feels a strong need for occasional or everyday use of the drug, and feels very uncomfortable without it. It usually refers to a strong desire for the drug, but may not have a physical addiction. Addiction occurs when a person needs a drug to function normally, and is unable to stop use of a drug without experiencing bad physical and psychological effects. Some drugs are much more addictive than other drugs, and some people are more likely to become addicted than others. Drugs based on opium (heroin, ) are very addictive. Tobacco is also very addictive, as are cocaine and alcohol. Some prescription drugs like are also highly addictive. Withdrawal symptoms are what people who are addicted experience when they stop using the drug. They can be minor or severe feelings of discomfort, anxiety, cramps, sweating. Some people find it very hard to manage such withdrawal symptoms, and choose instead to keep using the drug. Overdose is when a person takes too much of the drug. With some drugs, this is only uncomfortable. With other drugs such as heroin, this can cause death.

Why is drug use a problem? The main problem with drug use is the risk of abuse, dependence or addiction. Drug abuse with many drugs (heroin, alcohol or yaba) can harm physical health, interfere with family and work responsibilities, and cause problems in relationships. Other drugs also can have very bad physical effects. Tobacco has been shown to cause cancer in the mouth, throat and lungs. Chewing betel nuts causes cancers of the mouth. Marijuana can cause mental health problems.

QUICK DRUG REFERENCE The following provides some more detailed information about the most commonly used drugs in Asia. These are: • ya ba / ya ice () • opiates • alcohol • tobacco • marijuana (cannabis) • betel nut

Methamphetamines (Ya ba or Ya ice) Ya ba is found easily in and . It is cheap, and is often used by factory workers and drivers so that they can work longer hours. It is usually taken

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 6 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org) orally, although it can be injected or smoked. Ya ice is a stronger form of the drug, and is usually smoked or injected. Short term effects. Changes in mood, increased energy, talkative, restless, alert, reduced appetite, rise in heart rate and blood pressure, dilated pupils, increased sex drive, risk of HIV, hepatitis and heart attack. Larger doses, longer use Very strange behaviour, excitability, a feeling of power, being aggressive towards other people, delusions, hallucinations, violence, high blood pressure, dry mouth, fever, loss of weight, sweating and insomnia. Long-term effects: Ya ba decreases the appetite and also increases the metabolism of the body. So it is easy to lose weight with ya ba, although the poor nutrition means people are more likely to develop infections and other illnesses. Can lead to work, financial and family problems. Long term use of ya ba also causes kidney damage, lung problems, strokes, other tissue damage, tolerance, psychological dependence and impaired brain function. Snorting (inhaling) can cause damage to the nasal passages leading to frequent nose bleeds. Withdrawal symptoms Withdrawal often takes a long time, and the person will have troubled sleep, anxiety, paranoia, aches and pains, extreme hunger, depression and suicidal thoughts.

To go further

For those with access to the internet, there are many resources to increase knowledge about methamphetamines. One useful publication that gives more information about the drug and also discusses treatment approaches to help people stop using can be found at: http://www.druginfo.adf.org.au/attachments/344_PRQ06Sept08_final.pdf Warning: This publication needs a high level of English comprehension.

Opiates – Heroin, Opium, Morphine, It first stimulates and then depresses brain activity. It can be taken orally, smoked, injected, and sniffed.

Short-term effects There is a sudden feeling of pleasure, dulling of hunger and pain, restlessness, nausea and vomiting, slow speech, decreased sex drive, warm body, heavy limbs,

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 7 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org) dry mouth and becoming unaware of the surroundings. Because people can become unaware of what they are doing so that it also increases the risks of getting HIV and hepatitis from . Larger doses, longer use Very sleepy, small pupils, cold moist bluish skin, slower breathing. Overdose can cause death due to breathing failure. Very dangerous if taken with alcohol. Long-term effects Can cause heart, liver and brain damage, reduction in sex hormones, weight loss, rapid tolerance, physical addiction and psychological dependence. Withdrawal symptoms Anxiety, vomiting, diarrhoea, sweating, abdominal cramps, yawning, goose bumps, jumping legs, crawling sensations on the skin and a craving for drug.

Alcohol The immediate effects of alcohol can make a person feel happy and sociable, but it slows down the actions of the brain and central nervous system. After some time a person drinking alcohol becomes sleepy. The liver then breaks down the alcohol. Many people are able to drink small amounts of alcohol on social occasions without any harm. But for some people alcohol is addictive, and if a person drinks a lot of alcohol they will damage their liver so much it can cause death. Alcohol, like most drugs, affects people differently depending on their age, body weight, gender, previous experience with the drug. Short-term effects Effects vary a lot for men and women, with the amount a person drinks, and if they have eaten or not. Initially there is relaxation and a feeling of warmth. Later effects include sleepiness and loss of ability to think clearly, loss of inhibitions and poor coordination. Larger doses, longer use This leads to slower reflexes and thinking, risk taking behaviour, blackouts, slurred speech, unsteady walking, unconsciousness and vomiting. Effects are stronger if used with other depressants such as tranquillisers, barbiturates, opiates and antihistamines. The effects of larger doses often leads to problems such as accidents or violence and can be fatal, often due to choking on vomit while unconscious.. Longer term effects Alcohol can affect any organ in the body, so can cause many health problems. Brain damage and severe liver problems are common with heavy users. Withdrawal symptoms There are many withdrawal symptoms including insomnia, headaches, appetite loss, nausea, sweating, tremors, anxiety, convulsions, hallucinations and sometimes death.

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 8 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

Tobacco (nicotine) Smoked in cigarettes, cigars, cheroots, and pipes or chewed on its own or in mixtures with betel nut. The drug in tobacco is the nicotine. Nicotine is an addictive substance, which makes the person want to smoke more. Nicotine enters the bloodstream through the lungs and when the level of nicotine in the blood drops the person craves another cigarette. Nicotine stimulates the vomit centres in the brain, reducing feelings of hunger. This feature is actually used by labourers or factory workers when they don’t have time to eat. This can encourage the development of stomach ulcers. Short term effects Nicotine causes the heart to beat faster, the blood pressure to go up, and an increase in fatty substances in the blood. This causes constriction of the blood vessels and leads to heart disease. Longer term effects There are many negative long-term effects from . The two main problems are: 1. The lungs are affected, so that they stop working well. At first, this causes “shortness of breath” when exercising. Later, it causes diseases including bronchitis, emphysema and lung cancer. 2. The blood vessels are affected so that they become blocked. This leads to heart disease, and problems with blood supply to the feet. Poor blood supply to the feet can cause ulcers and gangrene, so that the foot (or feet) has to be amputated. Three and a half times more 'Below Knee Amputations' in the world are due to rather than to any other cause. Effects in pregnancy Women who smoke when they are pregnant are much more likely to have: • premature birth • low birth weight babies • still birth • miscarriage • chronic chest problems in babies and small children. People who do not smoke are also at risk if they are in the same room or house as people who are smoking. This is called Passive Smoking. Because of these risks smoking is banned in many public places, government buildings, public transport and workplaces.

Withdrawal symptoms It is very easy to become addicted to nicotine, but it is very difficult to stop. People who stop experience many uncomfortable feelings, such as severe anxiety, craving (hunger) for nicotine, confusion, increased appetite, irritability and mood swings.

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 9 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

Cannabis (marijuana, ganja, grass, pot, , ) Cannabis can be dried leaves and flowers, compressed resin (hashish) or oil (hashish oil). It is usually smoked, but can also be cooked in cakes, biscuits and be eaten. When smoked cannabis enters the bloodstream from the lungs. It travels quickly to the brain; the effects are felt after only a few minutes and can last for up to 3 to 5 hours. When eaten it is absorbed through the stomach and takes up to an hour to reach the brain and the effects may last from 4 to 7 hours. Cannabis is fat-soluble which means that it is not easily excreted in the urine like other water-soluble substances. Cannabis can take up to a month to finally leave the body. Short-term effects Causes a 'high' or happy feeling; increased appetite; faster pulse rate; red eyes, sleepiness, loss of concentration, impaired balance and coordination Larger doses, longer use Distorts hearing, sight, touch and sense of time. Harms short-term memory, the ability to think clearly and to perform complex tasks. Taken with alcohol or sedatives increases the effect, and very large doses create hallucinations

Longer-term effects • Loss of energy and ambition • Risk of bronchitis, lung cancer • Reduced sex hormones • Impaired judgment, memory • Possible decrease in immunity • Retards foetal growth • Psychological dependence • Moderate tolerance. Withdrawal symptoms People who stop using cannabis often suffer insomnia, irritability, appetite loss and anxiety while their body adjusts to not using the drug.

Inhalants There are many different chemicals that people inhale for their effects. The main one is petrol. Others include nail polish remover, , glue, amyl nitrate, , pressurised deodorants, hair sprays, insecticides, spray paints etc. These are not so commonly used in Myanmar or south-.

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 10 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org)

Short-term effects Light-headedness, confusion, slurred speech, dizziness, distorted perception, hallucinations, poor muscular control, fits / convulsions / seizures, vomiting, drooling, sneezing, slow reflexes, headaches, memory loss, sensitivity to light and feelings of power. There is a risk of suffocation and a risk of throat spasm causing death. Larger doses, longer use Sleepiness, unconsciousness, severe disorientation, hallucinations, antisocial behaviour and damage to nerves. There is a risk of sudden heart failure Long-term effects Pale skin, thirst, sores around mouth, eye and nose, mental confusion, anger, depression, fatigue, weight loss, possible damage to liver, kidney and brain, birth defects, physical and psychological dependence. Most are very dangerous, and can easily lead to death. Withdrawal symptoms Restlessness, anxiety, irritability, stomach upsets, chills, headache, hallucinations and delirium.

Tranquillisers and sleeping pills These drugs depress the central nervous system. Short-term effects Reduced activity, less responsive to pain, very relaxed muscles, reduced alertness, impaired memory, confusion, loss of inhibition and impaired driving ability. Larger doses, longer use Causes a euphoric (high mood) and intoxicated feeling, loss of muscle coordination, dizziness and low blood pressure. Combined with alcohol, sedatives, opiates, and antihistamines can be fatal. Long-term effects Tolerance to anxiety/tension-relieving effects, affects newborn babies, strong psychological and physical dependence. Withdrawal symptoms Long lasting anxiety, development of phobias (fears), restlessness and insomnia. Abdominal discomfort, appetite loss, sensitivity to light, sound and smells.

Betel () Nuts Betel nuts are widely used in south-east Asia, and known by many names (“paan” in , “mark” in , “kun ja” in parts of Burma). The nuts are chewed to help reduce tension, produce a feeling of wellbeing and help social interactions and strengthen social ties.

The most common method of using betel nut is to slice it into thin strips and roll it in a betel leaf with slaked lime (powder). This leaf package may also contain tobacco and other

Drugs and Alcohol – Factsheet 1: Drugs and Drug Problems 11 COMMUNITY INFORMATION - Ethnic Peace Resources Project (www.eprpinformation.org) additives such as , cardamom and nutmeg to increase the flavour. The active ingredient in betel nut is , which is poisonous in large doses.

Around 10 to 20% of the world's population chews betel nut in some form. This makes it the 4th most widely-used recreational drug, after nicotine, alcohol and caffeine.

Short-term effects Some of the immediate effects of chewing betel nut are: • mild euphoria and a sense of wellbeing • increased alertness • increased heart rate • increased blood pressure • sweating • facial flushing and a warm sensation in the body

Larger doses, longer use People who chew large amounts and / or for longer times may experience: tremor (shaking), dizziness, upset stomach, vomiting, diarrhea and acute psychosis. People chewing betel nut for the first time may have the same effects. Pregnant women are advised to stop chewing betel nut because it can have harmful effects on the baby.

Long term effects Long-term use of betel nut has been associated with a number of health-related problems such as: • discolouration of teeth and gums, sometimes turning reddish-brown • mouth ulcers and gum disease • oral cancers • stomach ulcers • increased risk of heart disease.

Withdrawal symptoms Betel nut withdrawal is much more difficult when people use betel nut mixed with tobacco. If only betel nut is used, then there are only mild symptoms of withdrawal.

To go further

Anyone seeking further information about drugs on the internet will find many sources. One of the best is: http://www.druginfo.adf.org.au/drug-facts/drug-facts