The use of psychoactive substances and their dependence on them

Among people who use psychoactive substances, some use them in large quantities, often enough and long, before they become addicted. A simple definition of the relationship does not exist. Help in the definition of the term dependence of the concept of tolerance, mental and physical dependence.

Tolerance is the need to progressively increase the dose of the drug in order to obtain the effect previously achieved at lower doses.

Mental dependence includes a sense of pleasure and a desire to again take the substance or avoid unpleasant sensations in the absence of this substance. This expectation of the effect is a powerful factor for the chronic use of psychoactive substances, and for some substances may be the only obvious factor associated with a craving and a clearly compulsive use. Strong desire and motivation to receive a substance leads to its consumption in a larger amount and longer than was originally expected. Mental addiction also includes neglect of social, occupational activity or entertainment due to the use of psychoactive substances or continued use, despite the knowledge that existing physical or mental problems are probably related or exacerbated by substance use. Substances that cause psychic dependence often have one or more of the following effects: decreased anxiety and stress; elated mood, euphoria and other mood changes, pleasant for the person taking the drug; increased mental and physical activity; violation of sensory sensations; changes in behavior. The drugs that cause predominantly psychic dependence include marijuana, amphetamines, 3,4-methylenedioxymethamphetamine (MDMA) and hallucinogens such as lysergic acid diethylamide (LSD), mescaline, psilocybin.

Physical dependence is manifested by withdrawal (abstinence) syndrome, when severe somatic disorders are observed as a result of discontinuation of the substance or neutralization of its effects by a specific antagonist that displaces the agonist from the compounds with cellular receptors. Substances that cause severe physical dependence include heroin, alcohol and cocaine.

Addiction - a concept that does not have a permanent, universally recognized definition - is used to describe compulsive consumption and full involvement in the process of substance use, which involves spending more and more time purchasing a drug, consuming it, and recovering from the drug's drug effect; can also be observed in the absence of physical dependence. Addiction implies the danger of harmful consequences and the need to stop taking the substance, regardless of whether the patient understands and agrees with it.

Abuse of substance is determined only by social disapproval. Abuse may include trial use of a psychoactive substance or for the purpose of entertainment, while the substance is often prohibited; unauthorized or illegal use of psychoactive substances, leading to complications or development of certain symptoms; consumption of the drug initially for two of the above reasons, but in the future because of the development of dependence and the need to continue taking at least part of the prevention of withdrawal symptoms. The use of illicit drugs does not involve dependence, although illegality is a criterion of abuse. Conversely, the use of permitted substances, such as alcohol, can lead to dependence and abuse. Abuse of prescription and illegal drugs occurs in various socio-economic groups, among people with higher education and high professional status.

The use of psychoactive substances for the purpose of entertainment is growing and becoming part of Western culture, although in general the society is not approved. Some consumers have no obvious complications, they use drugs occasionally and in relatively small doses, which prevents toxic effects, the development of tolerance and physical dependence. Many of the substances used for entertainment (for example, uncooked opium, marijuana, caffeine, hallucinogenic mushrooms, coca leaves) are natural, and alcohol is also referred to. They contain a mixture of psychoactive components in fairly low concentrations, and are not isolated psychoactive substances. Recreational drugs are usually taken orally or inhaled. The use of these drugs in the form of injections makes it difficult to control the desired and undesirable effects. Consumption for the purpose of entertainment is often accompanied by rituals, is done according to certain rules, rarely alone. Most of these drugs - psychostimulants or hallucinogens, are designed to cause an "upsurge" or states of altered consciousness, rather than alleviate mental distress; depressants are difficult to apply in such a controlled manner.

Intoxication manifests itself as a reversible, substance-specific syndrome of mental and behavioral changes, which may include cognitive impairment, reduced criticality, impaired physical and social functioning, mood instability, and aggressiveness.

In the United States, the 1970 Comprehensive Drug Abuse Prevention and Control Act ("Comprehensive Drug Abuse Prevention and Control Act") and its subsequent changes require special conditions for the pharmaceutical industry to store and strictly account for certain classes of drugs. Controlled substances are divided into 5 lists (or classes) based on the risk of abuse, proper medical use and appropriate safety of use under medical supervision. Substances from List I have a high risk of abuse, the possibility of not using evidence and lack of proper safety in use. Drugs from the V list are unlikely to be used for abuse. This classification by lists determines how the drug is controlled. Preparations from the list I can be used only on legally approved conditions for research. The appointment of drugs from the lists II-IV is carried out by doctors who have a federal license of the Drug Enforcement Administration (DEA). Some of the drugs in List V are prescribed without a prescription. State lists may differ from federal lists.

Reason for dependence on psychoactive substances

Commonly used psychoactive substances differ in their ability to cause addiction. The development of dependence on psychoactive substances is difficult and not entirely understandable. This process is affected by the properties of the substance used; predisposing the physical characteristics of the consumer (probably including genetic predisposition), personality, socioeconomic class, cultural and social environment. Human psychology and the availability of the drug determine the choice of psychoactive substance and, at least initially, the characteristics and frequency of consumption.

The progression from experimental to periodic consumption, and then to dependence, has been studied only partially. Factors leading to increased consumption and dependence or addiction include peer group or emotional distress, which is symptomatically alleviated by the specific effects of the drug, sadness, social isolation, external stress (especially accompanied by a sense of the importance of effective change or achievement of the goal). Doctors may inadvertently contribute to substance abuse by overly zealously assigning them to patients in a state of stress, falling under the influence of patients prone to manipulation. Many social factors and the media can contribute to the assumption that psychoactive substances safely relieve stress or give pleasure. Simply put, the outcome of the use of a substance depends on the interactions between the drug, the consumer and the environment.

There are only small differences in the biochemical, pharmacokinetic, physical reactions of people who developed addiction or dependence, and those who have not developed, although there is an intensified search for these differences. However, there are exceptions: the alcohol-free drinkers have a reduced reaction to alcohol. Because of their higher tolerance, they need to drink more to achieve the desired effect.

The neurological substrate of the reflex fixation (the tendency to search for psychoactive substances and other stimuli) was studied in animals under model conditions. These studies show that the self-administration of such drugs as opioids, cocaine, amphetamines, nicotine, benzodiazepines (anxiolytics) is associated with an increase in dopaminergic transmission in specific parts of the midbrain and cortex. These data confirm the presence of cerebral conductive pathways, including dopamine, in the brain of mammals. However, evidence that hallucinogens and cannabinoids activate this system is not enough, not everyone receiving such a "reward" develops addiction or dependence.

The addictive personality was described by a multitude of scientists engaged in behavioral sciences, but so far there is not enough evidence for such existence. Some experts describe addictive people as escaping from reality, who can not face reality, run away from it. Other specialists describe addicts as people with schizoid traits, such as fearfulness, detachment from others, with a sense of depression, suicidal attempts and self-damaging behavior in the anamnesis. Addicts are also often described as addicted, easily attached in relationships, often demonstrating vivid, unconscious anger and immature sexuality. However, before a person develops addiction, he is usually not inclined to deviant, search-oriented, irresponsible behavior, characteristic for ad-dictates. Doctors, patients and society often perceive substance abuse in the context of dysfunctional life or life episodes, condemning only the substance, rather than the psychological characteristics of the addict. Sometimes addicts justify the use of psychoactive substances by temporarily alleviating anxiety and depression caused by the crisis, difficulties at work, family problems. Many addicts abuse alcohol and other psychoactive substances at the same time, they may have repeated hospitalizations due to overdoses, side effects, withdrawal symptoms.