(Article derived from The Funk & Wagnalls Enclopedia ®)
Chemical substances that alter mood, behavior, perception, or mental functioning. In current professional practice, psychoactive substances known as psychotropic drugs have been developed to treat patients with severe mental illness. Psychoactive substances exert their effects by modifying biochemical or physiological processes in t he brain. Psychoactive drugs act by altering neurotransmitter function. The drugs can be divided into six major classes based on their desired behavioral or psychological effect: alcohol, sedative-hypnotics, narcotic analgesics, stimulant-euphoriants, hallucinogens, and psychotropic agents.
Sedative-hypnotics, such as the barbiturates and Valium, include brain depressants, which are used medically to help people sleep and antianxiety agents, which are used to calm people without inducing sleep. Sedative-hypnotics are used illegally to produce relaxation, tranquillity, and euphoria. Overdoses of sedative-hypnotics can be fatal; all can be physiologically addicting, and some can cause a life-threatening withdrawal syndrome.
Narcotic analgesics-opiates such as morphine and heroin-are prescribed to produce analgesia. Because the relief of pain is one of the primary tasks of medical treatment, opiates have been among the most important and valuable drugs in medicine. Illegal use of narcotic analgesics involves injecting these substances, particularly heroin, into the veins to produce euphoria. Opiates are physiologically addicting and can produce a quite unpleasant withdrawal syndrome. Stimulant-euphoriants, such as amphetamines, are prescribed by physicians to suppress the appetite and to treat children often diagnosed as hyperactive (see Hyperactivity). Although amphetamines stimulate adults, they have a paradoxically calming effect on certain children who have short attention spans and are hyperactive. Cocaine is used medically as a local anesthetic. Amphetamines and cocaine are used illegally to produce alertness and euphoria, to prevent drowsiness, and to improve performance in physical and mental tasks such as athletic events and college examinations. Hallucinogens-psychedelic drugs such as LSD, mescaline, and PCP thus far have little medical use. They are taken illegally to alter perception and thinking patterns. Marijuana is a weak hallucinogen that may be medically useful in suppressing the nausea caused by cancer treatments and possibly in reducing eye pressure in certain severe glaucomas.
Psychological and sometimes physical state characterized by a compulsion to use drugs in order to experience the psychological effects. Addiction is a severe form of dependence, usually marked by physical dependence. The latter state exists when the drug has produced physiological changes in the body, as evidenced by the development of tolerance (increasing amounts of the drug are needed to achieve the same effect), and of a withdrawal syndrome after the drug's effects have worn off. The syndrome is marked by such symptoms as nausea, diarrhea, or pain; these vary with the type of drug. Psychological dependence is present when the compulsion to take a drug is strong, even in the absence of physical withdrawal symptoms. The drugs that are commonly abused, besides substances such as alcohol and tobacco can be grouped into six classes: the opioids, sedative-hypnotics, stimulants, hallucinogens, cannabis, and inhalants.
This class includes drugs derived from opium (such as morphine and heroin) and its synthetic substitutes (such as methadone). Medically, morphine is a potent pain reliever; indeed, it is the standard by which other pain-relieving drugs are measured. It and other opium derivatives also suppress coughing, provide relief from diarrhea and induce a state of psychological indifference. Heroin, a preparation synthesized from morphine, was introduced in 1898 as a cough suppressant and nonaddicting substitute for morphine. The addictive potential of heroin was soon recognized, however, and its use was prohibited in the United States, even in medical practice. Users report that heroin produces a rush or a high immediately after it is taken. It also produces a state of profound indifference and may increase energy. Opioids produce different effects under different circumstances. The drug taker's past experience and expectations have some influence, as does the method of administering the drug. Symptoms of withdrawal include kicking movements in the legs, anxiety, insomnia, nausea, sweating, cramps, vomiting, diarrhea, and fever. Physical dependence on opioids may develop in persons who have a deficiency in enkephalins, which are naturally occurring opiates in the brain.
The principal drugs of abuse in this class are the barbiturates, which have been used since the early 1900s to relieve anxiety and induce sleep. They are also used medically in the treatment of epilepsy. Some abusers of the barbiturates ingest large amounts daily but never appear intoxicated. Others use the drugs for binges of intoxication, and still others use them to boost the effect of heroin. Many abusers, especially those of the first type, obtain their drugs routinely from physicians. Barbiturates produce severe physical dependence; in this, as in their effects, they closely resemble alcohol. Abrupt withdrawal results in similar symptoms: shaking, insomnia, anxiety, and sometimes, after a day, convulsions and delirium. Death can occur when barbiturates are suddenly discontinued. Toxic doses, often little more than is required to produce intoxication are often taken accidentally. Barbiturates are particularly lethal when combined with alcohol. Other sedative-hypnotics include Valium and Librium. These are the so-called minor tranquilizers that are used in the treatment of anxiety, insomnia, and epilepsy. They are generally safer than the barbiturates and are now commonly used instead of the older drugs, but tranquilizer addiction, in turn, has become a problem.
Commonly abused stimulants are cocaine and drugs of the amphetamine family. Cocaine, a white, crystalline powder with a bitter taste, is obtained from the leaves of the coca plant and is used medically as a local anesthetic and to constrict blood vessels and reduce bleeding during surgery. It is also widely abused as a drug. Cocaine has long been known as a drug of abuse, but it came into particular prominence in the late 1970s and the 1980s. Cocaine hydrochloride, a water-soluble salt, is a dry white powder (known on the street as "snow") that is usually inhaled through a thin tube inserted into the nostril. More rarely, cocaine is injected into a vein. The drug may also be smoked in a purified form through a water pipe ("freebasing") or in a concentrated form ("crack") shaped into pellets and placed in special smoking gear. Users experience euphoria, exhilaration, and a decreased appetite. The drug also increases heart rate, elevates blood pressure, and dilates the pupils. Chronic use can lead to skin abscesses, perforation of the septum of the nose, weight loss, and damage to the nervous system. Negative mental effects include extreme restlessness, anxiety, irritability, and, occasionally, paranoid psychosis. Death from even a small dose can occur, and is usually caused by seizures or heart attacks.
Amphetamines were introduced in the 1930s for the treatment of colds and hay fever, but were later found to affect the nervous system. For a while they were commonly used as an appetite suppressant by people trying to lose weight. Today their use is restricted primarily to the treatment of narcolepsy, a sleep disorder characterized by sudden sleep attacks throughout the day; and of hyperactivity in children, in whom amphetamines produce a calming effect. For adults, however, amphetamines rightfully earn their street name, (speed). These drugs heighten alertness, elevate mood, and decrease fatigue and the need for sleep, but they often make users irritable and talkative. Both cocaine and amphetamines, after prolonged daily use, can produce a psychosis similar to acute schizophrenia. Tolerance to both the euphoric and appetite-suppressing effects of amphetamines and cocaine develops rapidly. Withdrawal from amphetamines, particularly if the drug is injected intravenously, produces a depression so acute, that the user has a strong incentive to keep using until he or she collapses.
These drugs are not used medically in the U.S. except occasionally in the treatment of dying patients, the mentally ill, drug abusers, and alcoholics. Among the hallucinogens that were widely abused during the 1960s are lysergic acid diethylamide, or LSD, and mescaline, which is derived from the peyote cactus. LSD can create a feeling of lack of self-control and extreme terror. Physical effects include drowsiness, dizziness, dilated pupils, numbness and tingling, weakness, tremors, and nausea. Temporary abnormal thinking induced by LSD, such as a sense of omnipotence or a state of acute paranoia, can result in dangerous behavior. Long-term adverse reactions such as persistent psychosis, prolonged depression, or faulty judgment have also been reported following LSD ingestion. Although tolerance to these drugs develops rapidly, no withdrawal syndrome is apparent when they are discontinued.
Phencyclidine, known popularly by such names as “angel dust and rocket fuel, has no current legal use for humans but is occasionally used by veterinarians as an anesthetic and sedative for animals. It became a common drug of abuse in the late 1970s and is considered a particular menace because it can easily be synthesized. Its effects are quite different from those of other hallucinogens. LSD, for example, produces detachment and euphoria, intensifies vision, and often leads to a mixing of the senses (colors are heard, sounds are seen). PCP, by contrast, produces a sense of detachment and a reduction in sensitivity to pain; it may also result in either triggering or producing symptoms so like those of acute schizophrenia that even professionals can confuse the two states. The combination of this effect and indifference to pain has sometimes resulted in bizarre thinking, occasionally marked by violently destructive behavior.
The plant Cannabis sativa is the source of both marijuana and hashish. The leaves, flowers, and twigs of the plant are crushed to produce marijuana; its concentrated resin is hashish. Both drugs are usually smoked. Their effects are similar: a state of relaxation, accelerated heart rate, perceived slowing of time, and a sense of heightened hearing, taste, touch, and smell. These effects can be quite different, however, depending on the amount of drug consumed and the circumstances under which it is taken. Marijuana and hashish are not thought to produce psychological dependence except when taken in large daily doses. The drugs can be dangerous, however, especially when smoked before driving. Although the chronic effects are not yet certain, marijuana is probably injurious to the lungs in much the same way that tobacco is. A source of concern is its regular use by children and teenagers, because the intoxication markedly alters thinking and interferes with learning. Most physicians others working with children and adolescents believe that its use is may interfere with psychological and possibly physical maturation. Experimental work has been done using its active ingredient, (THC), for treating alcoholism, seizures, pain, the nausea produced by anticancer medications, and glaucoma.
In this class are substances that usually are not considered drugs, such as glue, gasoline, and aerosols such as nasal sprays. Most such substances are sniffed for their psychological effects and act to depress the central nervous system. Low doses can produce slight stimulation, but in higher amounts they cause their users to lose control or lapse into unconsciousness. The effects, which are immediate, can last as long as 45 minutes. Headache, nausea, and drowsiness follow. Sniffing inhalants can impair vision, judgment, and muscle and reflex control. Permanent damage can result from prolonged use, and death can result from sniffing highly concentrated aerosol sprays. Although physical dependence does not seem to occur, tolerance to some inhalants does develop. Another source of medical concern is the widespread misuse, of so-called "poppers", chemicals such as isoamyl nitrite that have legitimate medical functions as blood-vessel dilators. Continued sniffing of these easily obtainable substances can damage the circulatory system and have related harmful effects.
A Few Social Issues:
Drug use for nonmedical purposes occurs throughout society. Crack Cocaine is currently identified as the number one problem but heroin is making a strong comeback. Crack and heroin addiction often leads to criminal behavior to pay for the drug. In addition, drug usage among high school age children is reputed to be as high as one out of every two individuals.
With the exception of treatment for heroin or crack cocaine dependence, medical attention to the problems of the drug abuser are largely confined to dealing with overdoses, acute reactions to drug ingestion, and the incidental medical consequences of drug use, such as malnutrition and medical problems caused by unsterilized needles. Abusers of barbiturates and amphetamines may require hospitalization for detoxification, as is common among alcoholics. Others, such as those arrested repeatedly for possession of marijuana, may, in lieu of imprisonment, be forced to undergo treatment designed primarily for opioid abusers. Whatever the substance abused, the goal of most treatment programs is abstinence.
Three types of treatment programs are used for most opioid users. Therapeutic communities require the drug abuser to take personal responsibility for his or her problem. Typically, the idea behind this treatment is that the drug abuser is emotionally immature and must be given a second chance to grow up. Harsh encounters with other members of the community are typical; the support of others, together with status and privilege, are used as rewards for good behavior.
The second model for opioid abuse treatment is the use of heroin substitutes. One such substitute is methadone, which acts more slowly than heroin but is still addictive. The idea is to help the user gradually withdraw from heroin use while removing the need for finding the drug on the street. A more recent treatment drug, naltrexone, is nonaddictive but does not provide an equivalent high, it also cannot be used by persons with liver problems, which are common among addicts.
The third treatment option is the 12 Steps of Narcotics Anonymous®. Narcotics Anonymous® is a support group commonly used by those undergoing therapy and in some cases can help addicts to recover without recourse to formal treatment.
The Alpine Group
521 W. Locust St.
Davenport, IA 52803
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