It’s very simple now to order drugs over the Internet, and most pharmacies in Asia will sell medicines over the counter that are only available by prescription in the West. Most popular products in the online catalogs are amphetamines, potency pills and antidepressants. But self-medication is actually risky, particularly with amphetamines (such as Ritaline / methylphenidate),  which can enhance performance and concentration leading to dependency and requiring withdrawal treatment at specialized clinics or psychotherapists after months or years of abuse.

According to a study of U.S. pediatricians, the number of ‘doping’ students has increased by 75 percent over the last 8 years. Often the drugs are used incorrectly, like when the cause of poor concentration or erection problems lies somewhere else than where the drug attaches. Erectile dysfunction in men aged less than 55 years, for instance, mostly has purely psychological causes. Habitual intake often leads to overdosing and increased susceptibility to disease-causing side effects. At some point, the user might in fact just treat the withdrawal syndrome (for erectile dysfunction this is often fear of having sex without first taking the drug) – they feel no significant effect of the drug anymore but can not discontinue its use and thus enter a vicious circle. Multiple dependencies, like the use of amphetamines during the day and then in the evening intake of alcohol and / or tranquilizers or sleeping pills, makes everything even more complicated and dangerous. Abuse of prescribed medications causes more accidental deaths in the United States than anything else except automobile crashes, which kill more than 30,000 Americans every year.

The first signs of psychological dependence on drugs can be feelings of insecurity or fear if no intake is possible, or if there is an increase of the dose over time, but the effect of the drug doesn’t feel the same or is completely absent. Another alarm signal could be if over the years, more and more substances are taken in without consulting a medical doctor (this also includes food substitution drugs, injections of hormones, tranquilizers, sleeping pills, nose drops, etc.).

In most cases, drug dependence is admitted very late, after diseases of the organs have developed or accidents occured (often caused by a lack of concentration). For the psychological withdrawal, a combination of psychotherapy and support groups is very effective, but a medical checkup for possible physical damage is also essential.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)