|Year : 2015 | Volume
| Issue : 1 | Page : 31-32
Commentary on recreational drugs
Prakash B Behere1, AN Mulmule2
1 Department of Psychiatry, Jawahar Lal Nehru Medical College, DMIMS, Deemed University, Wardha, Maharashtra, India
2 Department of Psychiatry, Jawahar Lal Nehru Medical College, Wardha, Maharashtra, India
|Date of Web Publication||19-Feb-2015|
Dr. Prakash B Behere
Department of Psychiatry, Jawahar Lal Nehru Medical College, DMIMS, Deemed University, Wardha - 442 004, Maharashtra
Source of Support: None, Conflict of Interest: None
Recreational drugs are those drugs, which are taken for the sole purpose to create positive feeling and emotions by altering the conscious state of the user. In recent years, the "rave club drug" scene has changed significantly as many new synthetic drugs have become available. Here is a brief commentary based on the evolving menace of recreational drug.
Keywords: Designer drugs, narcotic drugs and psychotropic substances act, recreational drugs
|How to cite this article:|
Behere PB, Mulmule A N. Commentary on recreational drugs. J Mahatma Gandhi Inst Med Sci 2015;20:31-2
| Introduction|| |
In recent years, the "rave club drug" scene has changed significantly as many new synthetic drugs have become available.  A Merriam-Webster online dictionary defines a recreational drug as "a drug used without medical justification for its psychoactive effects often in the belief that occasional use of such a substance is not habit-forming or addictive." 
The recreational drugs are also called as "designer drugs." They are chemical substances generally commonly used for recreational purposes but have no legitimate medicinal assignment.  The term "designer" signifies that the chemical compound represents a derivative of a controlled substance, one that is illicit or sometimes to subvert a legal ban. 
There is also a term called as "entactogen" sometimes also termed as "empathogen." Empathy is seen to be induced on the use of such a compound. Amphetamine and methamphetamine are primarily potent central nervous system stimulants and known to produce "entactogenic" effects. 
The term "new psychoactive substances" had been legally defined earlier by the European Union as "a new narcotic or psychotropic drug, in pure form or in a preparation, that is, not scheduled under the single convention on narcotic drugs of 1961 or the convention on psychotropic substances of 1971, but which may pose a public health threat comparable to that posed by substances listed in those conventions." 
India has been ranked among the first 20 major hubs for trafficking of illegal drugs in a 2007 government report, published by United States. The list also included Pakistan, Afghanistan and Burma. 
These drugs have a wide range of effects over brain and patients tend to display spectrum of symptoms ranging from agitation, hallucinations, delusions, withdrawn behavior, aimlessness, irritability, confusion, affective symptoms and many more. 
Newer drugs mephedrone and methylone act as substrates at plasma membrane transporters for norepinephrine, dopamine and serotonin, thereby stimulating nonexocytotic release of these neurotransmitters.  They increase extracellular levels of dopamine and serotonin in the brain, similar to the effects of 3 4-methylenedioxymethamphetamine. High abuse liability of synthetic cathinones is attributed to its property of enhancing dopamine transmission in the brain. 
| Narcotics Drugs and Psychotropic Substances Act|| |
"Narcotics drugs and psychotropic substances (NDPS) act" came into force on 14 November 1985. Under the NDPS act, it is illegal for a person to produce or manufacture or cultivate, possess, sell, purchase, transport, store, and/or consume any narcotic drug or psychotropic substance. Until date, it has been amended twice in years 1988 and 2001. With reference to this act Narcotic Control Bureau was established in March 1986. "Controlled substances" as mentioned in the act defines list of those substances banned or controlled in India under the NDPS act. Under the act a person is granted rigorous imprisonment-up to 10 years and fine rupees 100,000 to maximum 200,000 for activities such as cultivation of opium, cannabis or coca plants without license, engaging in or controlling trade of these substances, financing traffic and harboring offenders etc. However, the law has been criticized as "poorly thought-out" for it similar punishment to all sort of drug use. 
Highlights of treatment of unknown recreational drug intoxication in the accidents and emergency settings:
- Benzodiazepines, especially lorazepam, commonly used to treat both agitation and seizures associated with drug intoxication. Antipsychotics should be used with caution.
- Restraints may be needed in some circumstances when agitation cannot be controlled with benzodiazepines alone, to ensure safety for the patient, as well as that of others in the emergency department.
- Routine laboratory tests should be part of the workup of patients suspected of being under the influence of drugs. These include a complete blood cell count, complete metabolic panel, and urine toxicology. 
Thus, it has been said "drug addiction can be treated. However, after treatment, unless the addict is rehabilitated and helped, there are high chances that he may return to drugs". The addict needs counseling even after treatment not only to retain him drug free but also to help him return to a normal life. Thus, as proposed by NDPS act in India, a drug addict has to undergo following three phases: Treatment, rehabilitation, social reintegration. 
For further modification and advances in handling a drug overdose patient, we need to have more evidence based research to draw a scientific conclusion, which will aid in their treatment and rehabilitation.
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