Adverse outcomes can be immediate or deferred. Any form of intoxication carries the risk of accidents and other consequences of impaired judgement or self-concern. The impact of alcohol is terrifying: 1000 British people are killed and more than 20 000 hospitalized by drunk drivers each year; half the reported violent attacks upon strangers and acquaintances, and a third of all domestic violence is perpetrated by people who are drunk at the time. (7) The immediate risks of street drugs are largely related to the low priority to which criminals ascribe to quality control. Variable purity means that accidental overdose is always possible, street drugs often contain toxic by-products, bulking agents, or adulterants, and organic material may be contaminated with pesticides, fungi, or bacteria. The psychological impact of stimulants or hallucinogens can be overwhelming, and young people are at risk from the lifestyle consequences of the street drug scene such as violence or sexual exploitation. In the United States alone more than half a million unborn babies are exposed to illicit drugs each year. Families can be split apart, education disrupted, and careers terminated.
However, most legal and illegal drug users escape such acute disasters, and there is an enormous discrepancy between the large numbers revealed through population surveys to have experimented with various drugs and those who go on to develop problems with them later in life. Prospective studies (1.1 l31,4 and1.5) also suggest that modest controlled consumption rarely produces measurable long-term damage. Some people are able to use 'hard' drugs such as heroin, cocaine, and amphetamine in a controlled way, and differ significantly in their personal characteristics and patterns of use from those who surface in clinics or police cells as a result of legal, medical, or social problems. (16>
On the other hand, an early onset of legal or illegal drug use, or regular heavy consumption during the teenage years, is certainly associated with a detrimental impact on mental or physical health later in life, difficult family, social, and sexual relationships, and disrupted education and employment. Such 'problem drug use' is likely to overlap with other undesirable behaviours such as delinquency, teenage pregnancy, and school drop-out, and probably shares many causative factors. Approximately 10 per cent of experimenters with alcohol or drugs will go on to develop problems with them at some time, and vulnerability factors include physiological attributes related to genetics and neurochemical balance, certain personality traits, attitudes, and mood states, parental attitudes and behaviour, peer influences, quality of schooling, socio-economic circumstances, and availability and cost of drugs. (1Z>
In those who become dependent a chaotic lifestyle will greatly aggravate the damage, particularly if the intravenous route is adopted. Long-term follow-up suggests that opiate dependence is usually a chronic relapsing and remitting condition with a mortality rate of 10 to 15 per cent over 10 years. On the other hand, up to half the subjects will be abstinent from opiates by the end of this period. The relatively benign prognosis in those who survive supports a harm-reduction approach aimed at minimizing day-to-day risks. There is no comparable research that could provide information about outcome for polydrug users or people dependent upon drugs other than opiates.
Drug and alcohol abuse among the seriously mentally ill is associated with greater consumption of inpatient care and poorer compliance with treatment. (18> The prevalence of violence is higher than in severe mental illness alone. (19) In the United States, specialized services for 'dual-diagnosis' patients have evolved and appear more effective than general psychiatric units.(20)
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Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.