Drug use in Turkey has dropped to as young as 10 years old

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Ebru Öztepe Yavaşçı, a psychiatrist at VM Medical Park Bursa Hospital, noted that drug use in Turkey has dropped to as young as 10 years old and said that families play the most important role in protecting children from drugs.

    Experts, noting that throughout history people have struggled with health issues that threaten their lives, said that people with substance use disorders generally do not want to recover from their condition. Mental Health Specialist Ebru Öztepe Yavaşçı, noting that only a very small percentage of people with substance use disorders seek treatment—regardless of how low their quality of life and living standards may be—said, “In fact, addiction is a craving to use something excessively. Substance addiction is the same. The individual struggles to control their substance use and experiences an intense craving to use the substance excessively. They use more of the substance to achieve the same effect. One of the key criteria for substance dependence is that if a patient has been using a substance for 12 months, they can be considered a substance-dependent individual. “We cannot label everyone who has tried a substance as a substance-dependent individual. There is no single cause of addiction. The causes of addiction are as numerous as the number of people who use substances,” he said.

    Yavaşcı, noting that the belief that addiction is incurable and the claim that “trying it just once won’t lead to addiction” are both very wrong, said, “Even trying it just once is significant in terms of addiction. Because anyone can become addicted. There is no rule that says only people lacking willpower will become addicted. No one sets out thinking, ‘I’m going to become addicted.’ In addiction, taking a break—not quitting—is very important. The longer the break, the higher the success rate of treatment. Drug testing can be performed using hair or urine samples taken from the individual. Drugs can remain detectable in hair for 4 to 6 months and in urine for about 4 days. In addition, certain withdrawal symptoms such as general behavioral changes, difficulty concentrating, insomnia, and irritability may appear,” he said.

    Highlighting that the lifetime prevalence of substance use in Turkey is 2.7 percent according to the latest study, Yavaşçı said, “The youngest age at first substance use was 10, and the oldest was 67. Children and adolescents are the age group in which substance use is most common. “For this reason, families need to be very vigilant. Families play a major role in keeping their children away from bad habits. Setting a good example as a society is also important. Parents should guide their children by explaining what is right, without overpunishing or judging their behavior.” Children must be taught about harmful substances as early as preschool. During adolescence, however, children begin to separate from their families. The behavioral characteristics typical of adolescence run parallel to those exhibited by people with addictions. Therefore, it is not a given that every adolescent will become addicted. However, close supervision is necessary. We must teach children and adolescents to say “no” to harmful substances. It is also very important to ensure that children have access to sports activities where they can burn off their energy. We also need to monitor their peer groups and the relationships they form, even from a distance. We must teach them what addiction is. They need to know how to protect themselves. Because substance use often begins through a close friend. Curiosity or a desire to fit in with a peer group can lead to first exposure to substances,” he said.

    Abdullah Çibir
    BURSA

    The Historical Development of Narcotic Substances

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    It is known that, from the very beginning of human history, psychoactive substances have been used for pleasure, pain relief, and healing. In primitive societies, during healing ceremonies, tribal rituals, and rites of passage into manhood, methods such as fasting, dehydration, sleep deprivation, social and emotional isolation, painful stimuli, dance, meditation, prayer, auditory stimuli, and hypnotic suggestions—to reach states of consciousness distinct from everyday levels. In addition to these methods, psychoactive substances such as hallucinogenic plants, opium derivatives, coca leaves, and cannabis played a major role (Ögel, 1997).

    It is known that the Aztec and Maya civilizations used mushrooms containing hallucinogenic substances in shamanic rituals. Amanita muscaria, a psychoactive substance, was also a type of mushroom used in shamanic rituals on the Asian continent. Cocaine is still used today by South American indigenous peoples to cope with harsh natural conditions, hunger, and fatigue during long journeys on foot. In Hindu texts dating back 3,000 years, cannabis was held in a sacred place. In ancient Rome and Greece, opium was used to treat many illnesses and alleviate various problems—for example, to quiet children who cried excessively. Before the Common Era, these substances were widely used in Egyptian, Persian, and Indian civilizations. In Mesopotamia, records related to the Assyrians and Sumerians also mention the cultivation of opium and hemp. These substances were considered divine and sacred plants. There is evidence that these substances were used in shamanic rituals in the Mongol, Turkic, and Siberian regions. In China, however, evidence of the use of these substances dates back only to the 10th century (Ögel, 1997).

    In Neolithic villages in Switzerland dating to the fourth millennium B.C., consisting of houses built on stilts, remains of cultivated poppy seeds and their capsules have been found. According to botanical analyses, these are Papaver somniferum or a hybrid species (Booth, 1996).

    Around 3400 B.C., opium poppies were being cultivated in the Tigris-Euphrates river systems of Lower Mesopotamia. The Sumerians, who were the first in the world to establish a civilization and develop agriculture, used the ideograms “hul” and “gil” for opium poppy, which translates to “plant of pleasure” (Köknel, 1976).

    In the book on medicinal plants known as “Pun Tsao,” which is said to have been written in 40 volumes by the Chinese Emperor Shen Nung, who lived around 2735 B.C., “Cannabis” is listed among the 265 medicinal substances (Köknel, 1976).

    By the end of the second millennium B.C., opium was already known in Europe, the Middle East, and North Africa. Medical tablets in the library of Ashurbanipal, King of Babylon, mention the sap of the opium poppy. However, these are thought to be copies of older texts. According to the physicians of the time, opium was a cure for almost every ailment and was sometimes used in combination with licorice root or melesene. Of the 115 plant mixtures mentioned, 42 involve opium. Opium was harvested in the early morning hours by women and children, and the sap oozing from the incisions in the poppy capsules was collected using small iron ladles (Booth, 1997).

    The oldest opium find also came from Egypt; a sample was discovered in the tomb of Cha, dating from the 15th century B.C. Around the same time, the city of Thebes in Egypt had become so famous for its poppy fields that opium produced in Egypt was referred to as “Theban opium.” The name of the alkaloid “thebaine” also derives from this city. In the 1552 B.C.E., the Theban Medical Papyrus, as well as in other sources such as the Veterinary and Gynecological Papyri found at Kahun and dating from 2160–1788 B.C.E., opium is frequently mentioned alongside other natural remedies and medicines: Opium is included among the 700 remedies listed in the first source—sometimes referred to as the Ebers Papyrus after the scholar Georg Moritz Ebers, who discovered the document—and an entire section is devoted to explaining how to use opium to calm unruly children. The prescription in this section recommends mixing opium with fly droppings to form a paste, sifting it through a sieve, and using it for four days (Booth, 1997).

    Opium, which has been known as a medicine in China since the 7th century, suddenly took on a new dimension in the 17th century with the spread of tobacco—first to Europe and then to Asia—from the Americas, and the growing popularity of tobacco smoking. The practice of mixing opium with tobacco and burning it slowly—which provided pleasure without the life-threatening risks associated with oral consumption—rapidly popularized its use. The Chinese emperors were quick to recognize the economic implications of this rapidly growing habit in their country, and as early as 1729, Emperor Yuang-Çeng banned its sale and consumption. In 1773, the British recognized the importance of this trade, and the British East India Company secured a monopoly on the cultivation of opium in Bengal and its export to China. Despite the ban imposed by Yuang-Çeng in 1729, the 200 chests of opium gum that reached China that same year had increased to 1,000 chests by 1767. In 1796, Emperor Jiaqing completely banned the import and cultivation of opium. Between 1820 and 1830, the annual amount of opium entering China reached 10,000 chests. This trade exceeded 40,000 chests in 1838, and thus the Company’s trade with China shifted in Britain’s favor. Until then, Britain had been forced to pay with gold and silver to obtain Chinese porcelain and silk, but now it was paying solely with opium. However, the Chinese Empire subsequently launched a serious campaign against opium and, in 1839, had 20,000 chests of opium seized from warehouses burned in the city square in Canton. The loss to the British East India Company was devastating (Babaoğlu, 1997).

    In February 1840, the British government decided to launch an expedition against China. British forces attacked Canton in May 1841 and withdrew after receiving a ransom of six million dollars. Thus, the First Opium War began. Later, in 1842, a second war broke out, resulting in the signing of the Treaty of Nanking and the cession of Hong Kong to Britain. Five ports were opened to Britain, and the right to trade—which until then had been granted as a favor by the Chinese Empire—became a definitive privilege; furthermore, 21 million dollars in reparations were paid to Britain, and subsequently, a series of wars broke out, again due to opium. The number of Chinese who lost their lives in connection with the opium trade ranged from 200 million to 500 million, according to various estimates (Babaoğlu, 1997).

    REFERENCES:
    1) BABAOĞLU, A.N., (1997) Drugs and Their History, Analiz Printing, Publishing, Design, and Production Ltd., Kaynak Publications, Istanbul.
    2) BOOTH, M., (1996) From Opium to Heroin: The 6,000-Year History of Drugs, Acar Printing, Istanbul.
    3) KÖKNEL, Ö., (1976) Drug Problems Throughout Human History, Gelişim Publications, Çelik Cilt Printing House, Istanbul.
    4) ÖGEL, K., (1997) Narcotics and Addiction, İletişim Publishing, Şefik Printing House, Istanbul.

    Inhibitory Implants and Injections for Alcohol and Heroin Addiction

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    Alcohol and heroin addiction are considered among the most significant health problems today. Beyond the problems faced by people who use alcohol and drugs due to the effects of these substances, there is also a risk of death from complications associated with alcohol and heroin use—such as alcoholic hepatitis, hepatitis B, cirrhosis, hepatitis C, and AIDS, as well as stomach diseases, esophageal tears, and respiratory arrest—all of which can result from the use of alcohol and heroin—making it a significant public health issue due to the associated risk of death.

    As we have noted on many previous occasions, these addictions can only be treated through long-term psychotherapy, appropriate medication, and the full support and cooperation of the individual and their family in the treatment process.

    Alcohol and heroin addiction are types of addiction for which medication-based treatments can be quite effective compared to other forms of addiction. In recent years, many new treatment options and alternatives have emerged for both alcohol and heroin addiction. In addition to the psychotherapy patients receive to help them overcome their addiction, there is a growing number of medications designed to reduce cravings for the substance of choice and eliminate the pleasure derived from it. These include medications such as acamprosate, naltrexone, naloxone, and buprenorphine.

    It is also important to mention disulfiram, which is used specifically in the treatment of alcohol dependence. When taken with alcohol, disulfiram produces a substance called acetaldehyde, which causes unwanted symptoms of intoxication such as fainting, facial flushing, a drop in blood pressure, and vomiting. When patients are informed of these effects before taking the medication, it can help treat alcohol dependence by acting as a deterrent for a certain group of patients. Now, let’s discuss naltrexone and disulfiram—which are widely used, particularly in Turkey—in a bit more detail.

    Naltrexone (tablet, injection, and pellet forms) For any substance to have an effect on the human brain, it must bind to a specific site; this binding site is called a “receptor.” For example, heroin exerts its effects by binding to a specific binding site in the brain called an opioid receptor. Naltrexone is a medication that binds to the same site where heroin binds, completely blocking heroin’s effects. In other words, if we compare heroin to a key, naltrexone prevents the key from fitting into the lock, so the person cannot experience the effects of heroin. Naltrexone completely eliminates the effects of heroin; when used against alcohol, it works by significantly reducing the urge to drink. It is the only medication in the world used to treat both alcohol and heroin addiction. Although naltrexone is such an effective medication, addicts often hesitate to continue this treatment. For this reason, alternative methods have been developed in addition to the oral tablet form. For example, a long-acting, one-month injection form has begun to be sold worldwide. Forms that are implanted under the skin through a minor procedure and dissolve into the bloodstream in small amounts each day are called “pellets.” Pellets can last for 2, 3, or 6 months. During this period, the individual is unable to use heroin, or even if they do, they experience no sense of pleasure. If the pellet (naltrexone) is administered due to heavy alcohol use, it reduces the individual’s craving for alcohol and decreases the number of episodes of uncontrolled drinking caused by a loss of control over alcohol consumption.

    Disulfiram (available in tablet, injection, and pellet forms) is a medication that, as previously mentioned, when taken with alcohol or when alcohol is present in the body at the same time, causes the release of a substance called acetaldehyde, which leads to unwanted side effects. In Turkey, it is also known as Antabuse. Severe side effects include nausea, vomiting, excessive sweating, a feeling of faintness, dizziness, and a drop in blood pressure. For this reason, it forces the individual to abstain from alcohol. As with naltrexone, there may be difficulties and hesitations regarding continuing treatment with disulfiram. For this reason, in addition to the oral tablet form, there is also an injectable form that remains effective for about 4–6 weeks. There is also a pellet form that is implanted under the skin through a minor procedure; it dissolves over two months, releasing small amounts into the bloodstream daily. These alternatives provide protection for 4–8 weeks even if the person stops taking the medication or wishes to discontinue treatment, thereby creating new opportunities.

    Source:

    http://www.ipe.com.tr/tr/icerik/49/alkol-ve-eroin-bagimliliginda-engelleyici-implant-ve-enjeksiyonlar