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Chapter # 1

Introduction

1.1Statement of the Problem


Drug addiction (dependence) is compulsively using a substance, despite its negative and
sometimes dangerous effects. Drug abuse is using a drug excessively, or for purposes for
which it was not medically intended, (Benjamin W. Van Voorhees, 1997-2008).

A physical dependence on a substance (needing the drug to function) is not always part of
the definition of addiction. Some drugs (for example, some blood pressure medications)
don't cause addiction but do cause physical dependence. Other drugs cause addiction
without physical dependence (cocaine withdrawal, for example, doesn't have symptoms
like vomiting and chills; it mainly involves depression).

Drug abuse can lead to drug dependence or addiction. People who use drugs for pain
relief may become dependent, although this is rare in those who don't have a history of
addiction.

The exact cause of drug abuse and dependence is not known. However, the person's
genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and
environmental stress all can be factors, (Christos Ballas. 2/6/2008).

Peer pressure can lead to drug use or abuse, but at least half of those who become
addicted have depression, attention deficit disorder, post-traumatic stress disorder, or
another psychological problem.

Children who grow up in an environment of illicit drug use may first see their parents
using drugs. This may put them at a higher risk for developing an addiction later in life
for both environmental and genetic reasons, (Kleber HD, Weiss RD, Anton RF, George
TP, Greenfield SF, Kosten TR. 2007).

Signs of drug use in children include but are not limited to:

• A change in the child's friends


• Withdrawn behavior
• Long unexplained periods away from home
• Lying
• Stealing
• Involvement with the law
• Problems with family relations
• Acting drunk or high (intoxicated), confused, impossible to understand, or
unconscious
• Distinct changes in behavior and normal attitude

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• Decreased school performance

• Opiates and narcotics are powerful painkillers that cause drowsiness (sedation)
and feelings of euphoria. These include heroin, opium, codeine, meperidine
(Demerol), hydromorphone (Dilaudid), and Oxycontin.
• Central nervous system stimulants include amphetamines, cocaine,
dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). Caffeine
and nicotine are the most commonly used stimulants. These drugs have a
stimulating effect, and people can start needing higher amounts of these drugs to
feel the same effect (tolerance), ( Eric Perez, MD. 7/18/2007).
• Central nervous system depressants include barbiturates (amobarbital,
pentobarbital, secobarbital), benzodiazepine (Valium, Ativan, Xanax), chloral
hydrate, and paraldehyde. The most commonly used, by far, is alcohol. These
substances produce a soothing sedative and anxiety-reducing effect and can lead
to dependence.
• Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and
phencyclidine (PCP or "Angel Dust"). They can cause people to see things that
aren't there (hallucinations) and can lead to psychological dependence, ( Jennifer
K. Mannheim, David Zieve. 10/20/2008).
• Tetrahydrocannabinol (THC) is the active ingredient found in marijuana
(cannabis) and hashish. Although used for their relaxing properties, THC-derived
drugs can also lead to paranoia and anxiety.

Symptoms of opiate and narcotic use:

• Needle marks on the skin in some cases (called "tracks")


• Scars from skin abscesses
• Rapid heart rate
• Small pupils (pinpoint)
• Relaxed and/or euphoric state ("nodding")
• Coma, respiratory depression leading to coma, and death in high doses

Symptoms of opiate and narcotic withdrawal:

• Anxiety and difficulty sleeping


• Sweating
• Goose bumps (piloerection)
• Runny nose (rhinorrhea)
• Stomach cramps or diarrhea
• Enlarged (dilated) pupils
• Nausea and vomiting
• Excessive sweating
• Increase in blood pressure, pulse, and temperature

Symptoms of alcohol use:

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• Slurred speech
• Lack of coordination
• Decreased attention span
• Impaired judgment

Symptoms of alcohol withdrawal:

• Anxiety
• Shaking (tremors)
• Seizures
• Increased blood pressure, pulse, and temperature
• Delirium

HALLUCINOGENS

Symptoms of LSD use:

• Anxiety
• Frightening images of things that aren't there (hallucinations)
• Paranoid delusions
• Blurred vision
• Dilated pupils
• Tremors

STAGES OF JUVENILE DRUG USE

There are several stages of drug use. Young people seem to move more quickly through
the stages than do adults.

• Experimental use -- typically involves peers, done for recreational use; the user
may enjoy defying parents or other authority figures, (Soyka M, Roesner S.
2006).
• Regular use -- the user misses more and more school or work; worries about
losing drug source; uses drugs to "fix" negative feelings; begins to stay away from
friends and family; may change friends to those who are regular users; shows
increased tolerance and ability to "handle" the drug, (Williams SH. 2005).
• Daily preoccupation -- the user loses any motivation; does not care about school
and work; behavior changes become obvious; thinking about drug use is more
important than all other interests, including relationships; the user becomes
secretive; may begin dealing drugs to help support habit; use of other, harder
drugs may increase; legal problems may increase, (Srisurapanont M,
Jarusuraisin N. 2005).
• Dependence -- cannot face daily life without drugs; denies problem; physical
condition gets worse; loss of "control" over use; may become suicidal; financial
and legal problems get worse; may have broken ties with family members or
friends by this time, (Simojoki K., Virta A. et.al .2007).

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Drug abuse and drug dependence represent different ends of the same disease
process.Drug abuse is an intense desire to obtain increasing amount of a particular
substance or substance to the exclusion of all other activities. Drug dependence is the
body’s physical need, or addiction, to a specific agent. Over the long term, this
dependence result in physical harm, behavior problems, and association with people
who also abuse drug. Stopping the use of the urge can result in a specific withdrawal
syndrome, ( Comer SD, Sullivan MA, Hulse GK. 2007).

• Drug abuse is a common problem that plagues all ethnic groups and social
classes worldwide. Control of drug abuse is a top priority of the united state
surgeon general as outlined in the healthy people 2010 goals for the nation,
(Shoptaw, S , Ling W. 2006).
• Different people will be affected by drugs in different ways. Some people are
more prone to addiction than others. (Preti A .2007).
• Drug abuse and dependence is disease and not a character defect. A person
being treated for this condition requires the same respect as a person with any
other medical condition, (Garwood C.L, Potts L.A .2007).
• A person who abuse drug may not realize tat he or she has a problem. Family
members often bring the abuse to the attention of a health care provider.
Unfortunately, same people who abuse drugs only realize they have a problem
after they have been arrested for a drug-related problem.( White L, Baron
M .2007).
• A wide variety of substances can be abused. These take the form of illegal
drugs (such as phencyclidine known as PCP and heroin), plant products (such
as, marijuana or hallucinogenic mushrooms), chemicals (the inhalation of
gasoline, for example), or prescription medication. More information can be
found at the National instate on drug Abuse, (Frishman WH. 2007).

• Substances can be taken into the body in several ways:


o Oral ingestion (swallowing)
o Inhalation (breathing in) or smoking
o Injection into the veins (shooting up)
o Depositing onto the mucosa (moist skin) of the mouth or nose
(snorting). (Siu EC, Tyndale RF. 2007).
• In addition to health care cost from drug abuse, society pays a huge price for
this disease, (Alper, KR, Lotosof HS, & Kaplan CD. 2008)

o Monetary costs from theft by abusers to support their drug habits


o Additional tax money to pay for law enforcement agencies, including the
US Coast Guard

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o Loss to society of the potential contribution the drug abuser would have
made to his or her community had he or she remained sober and
productive

The signs and symptoms displayed y a person depend on what substances the person has
abused. A person who has not abused drugs extensively may experience unpleasant
symptoms and may seek help from family members and friends. Chronic drug abusers
generally know what to expect from their drug use and rarely seek help for themselves,
(Bahi a, Dreyer JL. 2005).

• Most agents cause a change in level of consciousness usually a decrease in


responsiveness. A person using drugs may be hard to awaken or may act
bizarrely.
• Suppression of brain activity can be so severe that the person may stop breathing,
which can cause death.
• Alternatively, the person may be agitated, anxious, and unable to sleep.
Hallucinations are possible.
• Abnormal vital signs (temperature, pulse, respiratory rate, blood pressure)are
possible and can be life threatening. Vital sign reading can be increased,
decreased, or absent completely.
• Sleepiness, confusion, and coma are common. Because of this decline in
alertness, the drug abuser is at risk for assault or rape, robbery, and accidental
death.
• Skin can be cool and sweaty, or hot and dry.
• Chest pain is possible and can be caused by heart or lung damage from drug
abuse.
• Abdominal pain, nausea, vomiting, and diarrhea are possible. Vomiting blood, or
blood in bowel movements, can be life threatening.
• Sharing IV needles along people can transmit infectious diseases, including HIV
(the virus that causes AIDS) and hepatitis types B and C.

People abuse drugs for a number of deferent reasons.

• Drug abuse by pregnant women results in the developing fetus (baby) being
exposed to these same drugs. The baby may develop birth defect. The baby may
be born with an addiction and go into withdrawal. The baby may be born with a
disease associated with drug abuse such as HIV/AIDS.
• Many psychiatric diseases can be complicated by substance abuse. Similarly, drug
abuse may be a sign of a more serious mental health problem.

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Behavior

Understanding how learning and behavior work in the reward circuit can help understand
the action of addictive drugs. Drug addiction is characterized by strong, drug seeking
behaviors in which the addict persistently craves and seeks out drugs, despite the
knowledge of harmful consequences. Addictive drugs produce a reward, which is the
euphoric feeling resulting from sustained DA concentrations in the synaptic cleft of
neurons in the brain. Operant conditioning is exhibited in drug addicts as well as
laboratory mice, rats, and primates; they are able to associate an action or behavior, in
this case seeking out the drug, with a reward, which is the effect of the drug. Evidence
shows that this behavior is most likely a result of the synaptic changes which have
occurred due to repeated drug exposure. The drug seeking behavior is induced by
glutamatergic projections from the prefrontal cortex to the NAc. This idea is supported
with data from experiments showing the drug seeking behavior can be prevented
following the inhibition of AMPA glutamate receptors and glutamate release in the NAc.

The Parenting Style


The permissive parent attempts to behave in a no punitive, acceptant and affirmative
manner towards the child's impulses, desires, and actions. She [the parent] consults with
him [the child] about policy decisions and gives explanations for family rules. She makes
few demands for household responsibility and orderly behavior. She presents herself to
the child as a resource for him to use as he wishes, neither as an ideal for him to emulate,
nor as an active agent responsible for shaping or altering his ongoing or future behavior.
She allows the child to regulate his own activities as much as possible, avoids the
exercise of control, and does not encourage him to obey externally defined standards. She
attempts to use reason and manipulation, but not overt power to accomplish her ends (p.
889).
The authoritarian parent attempts to shape, control, and evaluate the behavior and
attitudes of the child in accordance with a set standard of conduct, usually an absolute
standard, theologically motivated and formulated by a higher authority. She [the parent]
values obedience as a virtue and favors punitive, forceful measures to curb self-will at
points where the child's actions or beliefs conflict with what she thinks is right conduct.
She believes in keeping the child in his place, , in restricting his autonomy, and in
assigning household responsibilities in order to inculcate respect for work. She regards
the preservation of order and traditional structure as a highly valued end in itself. She
does not encourage verbal give and take, believing that the child should accept her word
for what is right.
The authoritative parent attempts to direct the child's activities but in a rational, issue-
oriented manner. She [the parent] encourages verbal give and take, shares with the child
the reasoning behind her policy, and solicits his objections when he refuses to conform.
Both autonomous self-will and disciplined conformity are valued. [She values both
expressive and instrumental attributes, both autonomous self-will and disciplined
conformity] ... Therefore she exerts firm control at points of parent-child divergence, but
does not hem the child in with restrictions. She enforces her own perspective as an adult,
but recognizes the child's individual interests and special ways. The authoritative parent

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affirms the child's present qualities, but also sets standards for future conduct. She uses
reason, power, and shaping by regime and reinforcement to achieve her objectives, and
does not base her decisions on group consensus or the individual child's desires. [... but
also does not regard herself as infallible, or divinely inspired.] [Note that portions in
brackets are significant additions to the prototype in Baum rind (1967).]
Background Information: Child Qualities & Parenting Styles
Authoritative Parenting
• lively and happy disposition
• Self-confident about ability to master tasks.
• well developed emotion regulation
• developed social skills
• less rigid about gender-typed traits (exp: sensitivity in boys and independence in
girls)
Authoritarian Parenting
• anxious, withdrawn, and unhappy disposition
• poor reactions to frustration (girls are particularly likely to give up and boys
become especially hostile)
• do well in school (studies may show authoritative parenting is comparable)
• not likely to engage in antisocial activities (exp: drug and alcohol abuse,
vandalism, gangs)
Permissive Parenting
• Poor emotion regulation (under regulated)
• Rebellious and defiant when desires are challenged.
• Low persistence to challenging tasks

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1.2 Purpose of study:
The research was conducted to explore the influence of parental behavior and drug
abuse behavior, because many different researches have explained that negative family
environment is major a cause of drug abuse behavior beside peer influence. Mother and
Father play significant role in family and influence the lives of then children.

1.3 Hypotheses:
1) Drug addict, would score higher on authoritarian sub scale of parental attitude
questionnaire (PAQ) than non-addicts.
2) Drug addict would have higher score on total score of PAQ than non-addicts.
3) Non-addicts would score higher on authoritative subscale of PAQ than drug
addicts.
4) Non-addicts would score lower on total score of PAQ than drug addicts.
5) Drug Addict would score higher on permissive subscale than non drug addict.

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Chapter # 2
Method
2.1 Sample

The sample (N=30) comprised of 30 male participants. Data was collected from Sindh
university of Jamshoro and Sircowasjee Institute of Psychiatry Hydrabad. The age range
of participant was from 23 to 26 years. The participants were belonged to middle class
socioeconomic status. The purposive sampling techniques was used to collect data of
drug addicts, while simple random sampling technique was used for non addicts.

2.2 Instruments

Following instruments were used in this research.

A. Parenting Authority Questionnaire (PAQ)

This Questionaire was originally developed by Dianna Baumrind in 1968, Beck


translation and adopted at NIP in 1985. This quesrionnaire is valid and reliable for
Pakistan population.

B. Personal information Questionnaire (PIQ)

This instrument was used to gather personal information about Participant including
Age, Sex, education , socioeconomic status, parents education, parents occupation,
mother tongue, number of siblings, both order and residence.

2.3 Procedure:

Researcher directly meets the participant and data was collected. Firstly data was
collected from Sindh university students for non drug addicts, than collect the data from
C.J hospital in hydrabad and Karachi Psychiatric hospital, also effected area for drug
addicts. The process of data collection was very interesting and attitude of student and
hospitalized patient was very cooperative. Other student also responds well and gives
their responses actively. They were in trusted ask any question about any item of the
scale, in hospital, I ask myself over all questionnaire because they are not understanding
form terminology.

Nearly questionnaire was filled by a participant student within 20 minutes and


with patient get time maximum 30 minutes

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Chapter # 03

Analysis of Results

Mean, Standard Deviation and Mean Differences were used to analyze the
results of participants on instruments.

Table=1

Mean S.D and T-value, the score of drug addict and non-drug addict on scale total score
of (PAQ) for Mother.

N=(30) Mean S.D t –Value


Drug Addict 71.4 15.312
(N= 15) 3.239
Non-Drug Addict 72 12.312
(N=15)

Shows significant mean differences among the score in drug addicts (x=71.4) and
non drug addicts (x=72)on PAQ subscale for Mother, thus hypothesis No.1 was
conformed

Table= 2
Mean, S.D and T value, the score of drug addict and non-drug addict. Scale
(Total) score of (PAQ) for father.

N=(30) Mean S.D t –Value


Drug Addict 74.26 16.854
(N= 15) 2.15
Non-Drug Addict 73.06 13.147
(N=15)

Shows significant mean differences among the score in drug addicts (x=74.26)
and non drug addicts (x=73.06)on PAQ subscale for Father, thus hypothesis No.2 was
conformed

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Table= 3

Mean S.D and T-value, the score of drug addict and non- drug addict on scale
Authoritarian score of (PAQ) for father.

N=(30) Mean S.D t –Value


Drug Addict 23.133 9.408
(N= 15) 1.486
Non-Drug Addict 23.866 7.494
(N=15)

Shows Non Significant mean differences among the score in drug addicts
(x=23.133) and non drug addicts (x=23.866) on PAQ subscale for Father, thus
hypothesis No.3 was not conformed

Table = 4
Mean, S.D and T-value, the score of drug addict and Non-drug addict on scale
Permissive score of (PAQ) for Mother.

N=(30) Mean S.D t–Value


Drug Addict 28.26 6.345
(N= 15) 1.206
Non-Drug Addict 30.266 5.409
(N=15)

Shows Non Significant mean differences among the score in drug addicts
(x=28.26) and non drug addicts (x=30.266)on PAQ subscale for Mother, thus hypothesis
No.4 was not conformed

Table = 5
Mean S.D and T-value, the score of drug addict and Non-drug addict on scale
Authoritarian score of (PAQ) for Mother.

N=(30) Mean S.D t –Value


Drug Addict 24.73 10.69
(N= 15) 1.147
Non-Drug Addict 25.73 2.254
(N=15)

Shows non Significant mean differences among the score in drug addicts
(x=24.73) and non drug addicts (x=25.73)on PAQ subscale for Mother, thus hypothesis
No.5 was not conformed

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Table = 6
Mean, S.D and T-value, the score of drug addict and Non-drug addict on scale
Authoritative score of (PAQ) for Mother.

N=(30) Mean S.D t–Value


Drug Addict 19.2 6.832
(N= 15) 0.287
Non-Drug Addict 16 3.162
(N=15)

Shows Non Significant mean differences among the score in drug addicts
(x=19.2) and non drug addicts (x=16)on PAQ subscale for Mother, thus hypothesis No.6
was not conformed

Table = 7
Mean, S.D and T-value, the score of drug addict and Non drug addict on scale
Authoritative score of (PAQ) for Father.

N=(30) Mean S.D t–Value


Drug Addict 22.6 10.300
(N= 15) 0.208
Non-Drug Addict 18.3 4.94
(N=15)

Shows Non Significant mean differences among the score in drug addicts
(x=22.6) and non drug addicts (x=18.3)on PAQ subscale for Father, thus hypothesis No.7
was not conformed

Table = 8
Mean, S.D and T-value, the score of drug addict and Non drug addict on scale
Permissive score of (PAQ) for Father.

N=(30) Mean S.D t–Value


Drug Addict 28.2 5.774
(N= 15) 0.432
Non-Drug Addict 31.2 4.77
(N=15)

Shows Non Significant mean differences among the score in drug addicts
(x=28.2) and non drug addicts (x=31.2)on PAQ subscale for Father, thus hypothesis No.8
was not conformed.

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