rugs are chemicals that can affect both the brain and the body. It is important to note that different drugs can have different effects. Drug abuse and addiction have a devastating impact on the behaviour and mind of a person, but they can also permanently affect the body, destroying vital organs and causing systemic changes.

The physiological impacts of drugs vary depending on the quantity, frequency, purity and method of use, i.e., whether these are ingested, injected or inhaled. At the same time, the mental impacts (including but not limited to psychological effects) depend on whether the drug in question is a stimulant, depressant or hallucinogen.

There is no safe level of drug and alcohol use. Even when used in limited quantities, drug addiction is a genuine concern that poses a significant risk to the mental and physical well-being of the user.

“Different drug types affect the body in different ways. Some of the impacts can be short-term, but others can be quite serious and long-term,” says Dr Tariq Aziz, a psychiatrist with over 25 years of experience. The rehabilitation expert says that many people begin taking drugs for recreational reasons or to deal with stress, anxiety, trauma and depression but end up developing addictions that can have life-long impacts.

“Why are opioids one of the most abused classes of drugs? The answer is simple. Their use leads to a release of endorphins in the brain. Endorphins are commonly called the ‘feel-good’ hormones,” says Shahwaiz Faiz, a pharmacist. There are prescription opioids, such as painkillers used post-surgery, and there are illegal derivatives, including heroin and the deadly synthetic variant fentanyl. “For some, prescription opioids can become a way to achieve a sense of euphoria. To feel that pleasurable sensation caused by the release of endorphins, users may start abusing prescription drugs,” adds Faiz.

Opioids that impact the opioid receptors of the brain slow down the heart rate and breathing, and provide a sense of pleasure and pain relief, corroborates the psychiatrist. “Cannabinoids (cannabis, marijuana) are responsible for psycho-active effects on the body. They can make a person feel relaxed or cause panic. These drugs can have hallucinogenic properties, impacting a person’s understanding of self and their surroundings,” says Dr Aziz.

“There are two routes through which drug use can affect the liver; one is the intravenous route, and the other is oral. Alcohol-use-related liver injury is quite common in Western countries. Some incidents of alcohol-abuse cirrhosis have also been reported in Pakistan,” says Dr Israr-ul Haque Toor.

Over time, those who use drugs regularly can develop tolerance and dependence. “Developing tolerance means that a person needs larger quantities of a drug to feel the high they experienced on their first/ early use. Whereas dependence can be both physical and psychological,” explains the psychiatrist.

“Many drug users, particularly those injecting intravenously, are at great risk for catching hepatitis and HIV,” says Dr Israr-ul Haque Toor, professor of medicine and gastroenterology at the King Edward Medical College, Lahore. Needle sharing is common amongst drug users, making them vulnerable to viral diseases and STDs.

The senior gastroenterologist explains, “There are two routes through which drug use can affect the liver; one is the intravenous route, and the other is oral. Alcohol-use-related liver injury is quite common in Western countries. Some incidents of alcohol-abuse cirrhosis have also been reported in Pakistan,” says Dr Toor. However, it is the added burden of hepatitis and HIV/ AIDS amongst drug addicts that remains the main cause of alarm for Pakistan’s overburdened healthcare system.

“Cognitive problems are a real consequence of drug use and abuse. Insomnia, irritability, and recklessness are just some of the impacts of drug addiction on a person,” says Dr Aziz. “A drug addict’s liver, kidneys and heart are at risk. Respiratory distress is also common among regular users,” he adds.

Rehabilitation of drug addicts requires effort and consistency depending on the damage caused by addiction to prescription or illegal/ recreational and severe dependency-inducing drugs. Interventions depend on the condition of individual patients. In case of bodily injuries such as liver, brain or cardiovascular damage, a person may require hospital admission and medical care. In other cases, a psychiatric intervention might be needed.

“Depending on the case, we may need to isolate a patient, particularly if they become violent. Individual psychotherapy or group therapy can also help patients.” According to Dr Aziz, drug withdrawal can have challenging symptoms, making it difficult for people to give up drug use. Proper medical supervision is often needed by individuals trying to quit drug usage, as they can experience severe nausea, tremors, chills and others requiring medications to manage.

Drug addiction is treatable and preventable. The long-term impacts of drug abuse can be mitigated by timely intervention and proper psycho-physiological support by trained medical professionals. However, if not treated, drug addiction can be fatal. Not only is substance-use-related mortality (overdose and poisoning) a painful reality, but so are a number of diseases caused by reckless drug use.

The writer is a staff membe