Understanding Substance Misuse And Mental Health: Attitudes And Methods Of Working Over Time

Classification of Drugs in UK

According to the reports published in The Guardian (2015), more than 15 million people in UK that on nearly out of three adults use illegal drugs. Moreover, the proportion of the population who have ever consumed drugs is also increasing over time. There is no gender variability in the consumption of drug in UK. As per the survey conducted by Observer, 31% of drug users in UK belong under the age group of 16 to 24 years however, the higher number of drug users belongs to under the age group of 35 to 44 years (47%). The following essay aims to highlight the long-term and short term consequences of substance misuse and how the people of UK are getting mentally affected by it. The report also plans to throw light on the stigmatization of such substance misuse people and how it is affecting them negatively. Towards the end the report will provide a brief recommendation in order to overcome the problem.

In UK, the illegal drugs are sub-divided into three different categories namely class A, B and C. the classification is based on the controlled analysis of Misuse of Drugs Act 1971 and the allocation against any one class is based on the harm it cause to the mankind. The drugs which belong to class A category attract most serious punishments along with penalties. Under the Misuse of the Drugs Act, it is a punishable offence to unlawfully possess a controlled drug along with taking intent to supply the same. The Misuse of Drugs Act also condemns unlawful supply of any controlled drug and providing premises for the use of such controlled drugs (National Institute of Health 2017).

According to the National Institute of Health UK (2017), legal drugs are those drugs which are used as medicines like pain-killer, anti-depressant, stimulants, suppressants and drugs for central nervous system. However, these drugs are also frequently misused for example dextromethrophan (DXM) an over-the-counter medicine is use as cough suppressant but DXM are at times swallowed directly or administered via mixing with soda, a process known as robo-tripping” or “skittling. They are also injected directly intravenously or are taken in combination with alcohol or marijuana.

According to the reports published in The Guardian, the illegal drugs which are popular in UK are crack cocaine, cocaine, diamorphine, ecstasy (MDMA), heroin, LSD, magic mushrooms. The route of drug administration is the method that is employed in order to take the drug inside the body. Smoking is the common route of drug administration and the drugs administered via smoking include marihuana, opium, cocaine, cannabis, crack, heroine and tobacco. Snorting of drugs or insufflations is another mode commonly used by the drug addicts for the administration of drugs inside the body. Heroin, cocaine, amphetamines and ecstasy are inhaled via the process of snorting. Recently drug is injected directly inside the body via the use syringe the methods include subcutaneous, intravenous and intramuscular.  Injection is regarded as the most dangerous mode of drug administration as it hits the body within a fraction of seconds. Some drugs are also taken orally like chewing of tobacco.

Legal and Illegal Substances and Forms of Consumption

According to Hall and Degenhardt (2014), regular intake of drugs increases dependence syndrome and leads to the generation of impaired respiratory function, cardiovascular complications, negative effects on the adolescent psychological development, mental health disease and residual cognitive impairment. Volkow et al. (2014) further opined that young people without cardiovascular risk may develop complex cardiac problems in long-term upon regular use of drug. Tetrahydrocannabinol (THC) a major component of cannabis impairs the normal functioning of the mitochondrial respiratory chain and thereby increasing the concentration of reactive oxygen species within the body and increasing the vulnerability of stroke (Volkow et al.2014). Use of drugs such as cocaine can cast detrimental effects upon the pregnant women for example cocaine, it a regarded as a potential teratogen. The reports published by Zhang and Tantibanchachai (2013), revealed that cocaine use during pregnancy increases several obstetric complications like spontaneous abortion, premature delivery or uterine rupture.  As per a report published in The British Journal of Psychiatry, short term cannabis intake cause short-term symptoms like depersonalisation, irrational panic, feeling of loss of control a fear of dying or paranoia. Acute or large doses of cannabis cause organic psychosis along with confusion and hallucination.

According to Livingston et al. (2012), substance misuse disorders are extremely stigmatised in comparison to other health conditions. Stigma is often employed as a tool to discourage and marginalised substance misuse which in turn has a collateral consequences of devaluing and marginalizing social groups. Attitude of stigmatizing against specific mannerism (substance misuse during pregnancy) and group (injection of illegal drugs) are globally accepted and culturally endorsed. Livingston et al. (2012) have further opined that reducing the stigma of substance misuse may generate adverse outcomes like increase rate of drug use among youth and reducing motivation to vouch help among drug addicts. Substance use disorders are mostly treated as criminal offense than that of adverse health concern. This projection of criminal offense exacerbates stigma and elicits exclusionary processes that strengthens the marginalisation of addicted people. Thus social processes which are generated to restrict substance abuse in turn contribute to its continuance (Livingston et al. 2012).

When dual diagnosis comes into action, it is imperative that the treatment addresses both the substance abuse and mental health complications. If only single aspect is addressed, original recovery cannot be achieved on contrary recurrence is likely to happen when the basic symptoms of the untreated disorders accelerates. An optimised treatment for substance misuse and mental illness signifies one-on-one therapy. This therapy occurs in a face-to-face format with a psychiatrist who has experienced in tackling challenges associated with addiction and mental health. Medication can be employed to manage several psychiatric disorders. It is also used to reduce the withdrawal symptoms associated which the detoxification process. Behavioural modification therapies and experiential treatments can accelerate a therapy regime. This will help to alter the thoughts and behaviours (Drake et al. 2001).

Impact of Short-term and Long-term Intoxication of Substances on Mental and Physical Health

Harm reduction is described as a process directed towards individuals with an aim to reduce the self-harm elicited in response to drug addiction. Harm reduction approaches decreases mortality and morbidity associated with complex mental health behaviours. Harm reduction is achieved mostly via counselling and with reducing the withdrawal symptoms and engaging the drug misused individuals into some group activities (Leslie 2008).

Stigmatizing behaviour of healthcare practitioners towards people with substance misuse negatively affects the health care industry and leads to avoidance of treatment or interruption during disease relapse (van Boekel et al. 2015). Moreover, negative attitudes of the healthcare professionals towards the patients with substance misuse, causes poor communication between the nurse or doctors and patients. This lack of communication diminishes therapeutic alliance causing diagnostic overshadowing. Moreover, negative attitudes of the healthcare professionals have a significant adverse effect on the empowerment of the patients and as a result, patient suffers from poor-self-esteem(van Boekel et al. 2015).

The increase of the drug dependence has increased with time. For example, pregabalin and gabapentin are licensed in UK for the treatment of neuropathic pain and epilepsy. In UK, pregabalin is also used for treating anxiety disorder. Dependence on supratherapeutic doses has increased in specific settings like prisons. This is because the drug has an ability to generate euphoria along with a sensation of relaxation. Some users’ have also reported stimulant effect. On the other hand, it can also be stated that despite the success with the reduction in the number of young people addicted to heroin, the mortality and morbidity and long-term needs of an ageing cohort with inclination on heroine highlights that therapy is difficult and proper coordination between services is important (Department of Health UK 2017).

National Institute of Health (NIH) is willing to take active efforts to decrease the group of population using illegal drugs while increasing the group of people who has successfully recovered from drug abuse. NIH is supporting children during the initial years, preventing them to indulge in drug misuse during the later stages of their life. Through Business Rates Retention Scheme, NIH has funded £2 billion to local councils of UK in between 2014 to 2015 in order to use the money to sponsor special programs to prevent young people from drug misuse. NIH has also extended its hands to help adults to recover from drug dependence while helping offenders to get proper rehabilitation treatment. National Crime Agency is also helping NIH to take national and international efforts to reduce drug supply.

Social Issue that Contribute to Misuse


Drug abuse is a criminal offense in UK. Regular intake of illegal drugs and high level intake of legal drugs cause significant long-term and short term-effect along with mental health complications. Moreover from the above discussion it can also be seen that there exists a stigmatization against these people in the society which prevent substance abuse people from the process of speedy recovery. The healthcare professionals also have certain negative feelings against this particular group of population which delays the overall recovery and proper treatment. Thus more specific education along with proper training of the healthcare professionals are required to refine the attitude of these healthcare professionals towards the patients with substance misuse.


Alcohol Rehab. 2017. Ways of Taking Drugs – Alcohol Rehab. [online] Available at: https://alcoholrehab.com/drug-addiction/routes-of-drug-administration/ [Accessed 10 Feb. 2018].

Department of Health UK., 2017. Drug misuse and dependence UK guidelines on clinical management. Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf

Dingle, G.A., Stark, C., Cruwys, T. and Best, D., 2015.Breaking good: Breaking ties with social groups may be good for recovery from substance misuse. British Journal of Social Psychology, 54(2), pp.236-254.

Drake, R.E., Essock, S.M., Shaner, A., Carey, K.B., Minkoff, K., Kola, L., Lynde, D., Osher, F.C., Clark, R.E. and Rickards, L., 2001. Implementing dual diagnosis services for clients with severe mental illness. Psychiatric services, 52(4), pp.469-476.

Gov.uk. 2017. 2010 to 2015 government policy: drug misuse and dependency – GOV.UK. [online] Available at: https://www.gov.uk/government/publications/2010-to-2015-government-policy-drug-misuse-and-dependency/2010-to-2015-government-policy-drug-misuse-and-dependency [Accessed 10 Feb. 2018].

Hall, W. and Degenhardt, L., 2014. The adverse health effects of chronic cannabis use. Drug testing and analysis, 6(1-2), pp.39-45.

Johns, A., 2001. Psychiatric effects of cannabis. The British Journal of Psychiatry, 178(2), pp.116-122.

Leslie, K.M., 2008. Harm reduction: An approach to reducing risky health behaviours in adolescents. Paediatr Child Health, 13(1), pp.53-6.

Livingston, J.D., Milne, T., Fang, M.L. and Amari, E., 2012. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction, 107(1), pp.39-50.

rugabuse.gov. 2017. Over-the-Counter Medicines. [online] Available at: https://www.drugabuse.gov/publications/drugfacts/over-counter-medicines [Accessed 10 Feb. 2018].

The Guardian. 2017. British drugs survey 2014: drug use is rising in the UK – but we’re not addicted. [online] Available at: https://www.theguardian.com/society/2014/oct/05/-sp-drug-use-is-rising-in-the-uk-but-were-not-addicted [Accessed 10 Feb. 2018].

vanBoekel, L.C., Brouwers, E.P.M., van Weeghel, J. and Garretsen, H.F.L., 2015. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. TijdschrPsychiatr, 57(7), pp.489-497.

Volkow, N.D., Baler, R.D., Compton, W.M. and Weiss, S.R., 2014. Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), pp.2219-2227.

Woorank.com. 2017. aleretoxicology.co.uk | Website Review for aleretoxicology.co.uk | WooRank.com. [online] Available at: https://www.woorank.com/en/www/aleretoxicology.co.uk [Accessed 10 Feb. 2018].

Zhang, M. and Tantibanchachai, C., 2013.Cocaine as a Teratogen. Embryo Project Encyclopedia

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