POLICE ASSOCIATION OF NOVA SCOTIA 59 What are the Harmful Consequences of Drug Use? Drugs can be considered harmful when their use causes physical, mental, social, legal or economic problems. Not all drugs are equally hazardous. Drugs sold legally in Canada for medicinal purposes are generally considered safe when taken according to the directions on the label. However, some of these drugs may produce unpleasant side effects even when used under medical guidance. Drugs obtained illegally are more likely to be hazardous; their effects are much less predictable and potentially dangerous. Many drugs are harmful when used in large doses, or in combination with other drugs. Safety Hazards Most psychoactive drugs can reduce physical coordination, distort the senses or impair memory, attention and judgment. These effects can lead to serious safety risks, especially if the person who uses the drugs drives a vehicle or operates machinery. Many road injuries and fatalities are caused by drivers intoxicated by alcohol or some other drug or combination of drugs. Also, effects such as reduced physical coordination and impaired judgment can lead to falls and other serious accidents. People who have taken alcohol or other drugs are often unaware of the extent of their impairment. This makes the risk that much greater. Physical Health Problems All psychoactive drugs have effects other than those for which they are used, and some of these can be very damaging to physical health. Smoking marijuana or tobacco, for example, can cause lung damage. Alcohol abuse can cause liver damage. Sniffing cocaine can damage the inside of the nose. People who inject drugs by hypodermic needles can get infections such as hepatitis or HIV. Mental Health Problems Some drugs can cause short-term confusion, anxiety or mental disturbance ("bad trips"). In the longer term, drug abuse can result in personality disturbances, learning problems, and loss of memory, and can contribute to mental health problems. A person who turns to drugs as a way of avoiding normal anxiety and sadness may be establishing a pattern of behaviour that can be hard to break. Many people who use drugs in this way come to believe that they cannot function normally without drugs. People with histories of serious emotional or mental health problems may also turn to drugs as a way of coping with unpleasant feelings. Also, experience of physical or sexual abuse is common among people with alcohol or other drug problems. Violence and Crime Use of drugs is sometimes associated with violence and crime. Although, alcohol or other drugs do not cause violence, both the victims and perpetrators of violence may be using certain drugs. Date rape is one example, where the effects of benzodiazepines or alcohol may put the victim at increased risk for such violence. Two drugs, Rohypnol (flunitrazepam) and GHB (gamma-hydroxy butyrate) have been associated with date rape because their effects incapacitate the victim and make the person unable to resist the sexual assault. Because they are colourless, odourless and tasteless, the victim may not be aware that the drug has been deliberately added to their drink. People may also commit crimes in order to make money to buy drugs, and drug problems are frequent among criminal offenders. Tolerance Tolerance means that, over time and with regular use, a person who uses drugs needs more and more of a drug to get the same effect. Tolerance increases the physical health risks of any drug simply because it can result in increased drug use over time. Tolerance also increases the risk of dangerous or fatal overdose, for two reasons. First, the body does not necessarily develop tolerance to all the effects of the drug to the same extent. Long-term use of barbiturates, for example, causes a person to become tolerant to the mood-altering effect of barbiturates, but less so to their depressant effect on respiration. When this happens, the dose required to achieve the mood-altering effect may be dangerously close to the lethal dose and death can result from respiratory failure. Second, if a person has not taken the drug in a long time, the expected tolerance may actually have decreased. So, after a long period of abstinence, the size of the dose the person had previously become accustomed to may actually be enough to cause a life threatening or fatal overdose. As people age, physiological changes may mean they need less of a drug to get the same effect. This result may be compounded if their liver or kidneys have been damaged by chronic disease. Physical Dependence Physical dependence occurs when a person's body becomes so accustomed to a particular drug that it can only function normally if the drug is present. If people who use drugs Canada’s Drug Strategy - Straight Facts About Drugs and Drug Abuse (continued...)