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Encyclopedia > Drug addiction
Drug abuse
Drug addiction
Substance abuse
Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment
Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1]

Drug addiction is considered a pathological state. The disorder of addiction involves the progression of acute drug use to the development of drug-seeking behavior, the vulnerability to relapse, and the decreased, slowed ability to respond to naturally rewarding stimuli. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) has categorized three stages of addiction: preoccupation/anticipation, binge/intoxication, and withdrawal/negative affect. These stages are characterized, respectively, by constant cravings and preoccupation with obtaining the substance; using more of the substance than necessary to experience the intoxicating effects; and experiencing tolerance, withdrawal symptoms, and decreased motivation for normal life activities.[2] By definition, drug addiction differs from drug dependence and drug tolerance.[3] Image File history File links Question_book-3. ... Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1] This article is an overview of the nontherapeutic use of alcohol and drugs of abuse. ... Also see Alcoholism and Drug addiction. ... Recreational drug use is the use of psychoactive drugs for recreational rather than medical or spiritual purposes, although the distinction is not always clear. ... The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ... Drug addiction, or dependency is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ...

Contents

Drugs causing addiction

Drugs known to cause addiction include illegal drugs as well as prescription or over-the-counter drugs. Zoloft, an antidepressant and antianxiety medication A prescription drug is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained. ... Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ...

Addictive drugs also includes a large number of substrates that are currently considered to have no medical value and are not available over the counter or by prescription. Sustained-Release 15mg Dexedrine Spansules. ... Amphetamine or Amfetamine(Alpha-Methyl-PHenEThylAMINE), also known as beta-phenyl-isopropylamine and benzedrine, is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder (ADHD) in adults and children. ... This article is about the psychostimulant, d-methamphetamine. ... For other uses, see Caffeine (disambiguation). ... For other uses, see Cocaine (disambiguation). ... This article is about the chemical compound. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... This article does not cite any references or sources. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... Alprazolam, also known under the trade names Xanax and Niravam, is a short-acting drug in the benzodiazepine class used to treat severe anxiety disorders and as an adjunctive treatment for anxiety associated with clinical depression. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ... Temazepam (marketed under brand names Restoril®, Normison®, Planum®, Tenox® and Temaze®) is a benzodiazepine derivative with powerful hypnotic properties. ... Nimetazepam (marketed under brand name Erimin®) is a drug which is a benzodiazepine derivative. ... Methaqualone tablets and capsules. ... Gamma-hydroxybutyrate (4-hydroxybutanoic acid, C4H8O3) is both a drug and a naturally occurring compound found in the mammalian brain, where it might function as a neurotransmitter. ... gamma-Butyrolactone, also known as GBL, butyrolactone, 1,4-lactone, 4-butyrolactone, 4-hydroxybutyric acid lactone, and gamma-hydroxybutyric acid lactone, is a hygroscopic colorless oily liquid with a weak characteristic odor and moderate solubility in water (≥ 10 g / 100 ml). ... For other uses see Opiate (disambiguation), or for the class of drugs see Opioid. ... An opioid is a chemical substance that has a morphine-like action in the body. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ... This article is about the drug. ... Codeine (INN) or methylmorphine is an opiate used for its analgesic, antitussive and antidiarrheal properties. ... For other uses, see Heroin (disambiguation). ... Not to be confused with oxytocin. ... Hydromorphone is a drug developed in Germany in the 1920s and introduced to the mass market beginning in 1926. ... Fentanyl is an opioid analgesic, first synthesized by Janssen Pharmaceutica (Belgium) in the late 1950s, with a potency many times that of morphine. ... Pethidine (INN) or meperidine (USAN) (also referred to as: isonipecaine; lidol; operidine; pethanol; piridosal; Algil®; Alodan®; Centralgin®; Demerol®; Dispadol®; Dolantin®; Dolestine®; Dolosal®; Dolsin®; Mefedina®) is a fast-acting opioid analgesic drug. ... Methadone (Dolophine®, Amidone®, Methadose®, Physeptone®, Heptadon® and many others) is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. ... Crystal structure of human sex hormone-binding globulin, transporting 5α-dihydrotestosterone. ... This article is about the plant genus Cannabis. ...


An article in the Lancet compared the harm and addiction of 20 drugs, using a scale from 0 to 3 for physical addiction, psychological addiction, and pleasure to create a mean score for addiction. Caffeine was not included in the study. The results can be seen in the chart above.


Addictive potency

The addictive potency of drugs varies from substance to substance, and from individual to individual


Drugs such as codeine or alcohol, for instance, typically require many more exposures to addict their users than drugs such as heroin or cocaine. Likewise, a person who is psychologically or genetically predisposed to addiction is much more likely to suffer from it. Codeine (INN) or methylmorphine is an opiate used for its analgesic, antitussive and antidiarrheal properties. ... This article does not cite any references or sources. ... For other uses, see Heroin (disambiguation). ... For other uses, see Cocaine (disambiguation). ... This article is about the general scientific term. ...


Although dependency on hallucinogens like LSD ("acid") and psilocybin (key hallucinogen in "magic mushrooms") is listed as Substance-Related Disorder in the DSM-IV, most psychologists do not classify them as addictive drugs. Lysergic acid diethylamide, commonly called LSD, LSD-25, or acid. ... Psilocybin (also known as psilocybine) is a psychedelic alkaloid of the tryptamine family, found in psilocybin mushrooms. ... Spical brie whisc tunitec handig. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR is a manual published by the American Psychiatric Association and includes all currently recognized mental health disorders. ...


Prevalence

The most common drug addictions are to legal substances such as:

This article does not cite any references or sources. ... This article is about the chemical compound. ... Shredded tobacco leaf for pipe smoking Tobacco can also be pressed into plugs and sliced into flakes Tobacco is an agricultural product processed from the fresh leaves of plants in the genus Nicotiana. ... Unlit filtered cigarettes. ... For other uses, see Caffeine (disambiguation). ...

The biological basis of drug addiction

Researchers have conducted numerous investigations using animal models and functional brain imaging on humans in order to define the mechanisms underlying drug addiction in the brain. This intriguing topic incorporates several areas of the brain and synaptic changes, or neuroplasticity, which occurs in these areas. Neuroplasticity challenges the idea that brain functions are fixed in certain locations. ...


Acute effects

Acute (or recreational) drug use causes the release and prolonged action of dopamine and serotonin within the reward circuit. Different types of drug produce these effects by different methods. DA appears to harbor the largest effect and its action is characterized. DA binds to the D1 receptor, triggering a signaling cascade with in the cell. cAMP-dependent protein kinase (PKA) phosphorylates cAMP response element binding protein (CREB), a transcription factor, which induces the synthesis of certain genes including C-Fos.[4] Recreational drug use is the use of psychoactive drugs for recreational purposes rather than for work, medical or spiritual purposes, although the distinction is not always clear. ... For other uses, see Dopamine (disambiguation). ... For the professional wrestling stable, see Ravens Nest#Serotonin. ... In cell biology, cAMP-dependent protein kinase (cAPK), also known as protein kinase A (PKA, EC 2. ... CREB (top) is a transcription factor capable of binding DNA (bottom) and regulating gene expression. ... In molecular biology, c-Fos is a cellular proto-oncogene belonging to the immediate early gene family of transcription factors. ...


Reward circuit

When examining the biological basis of drug addition, one must first understand the pathways in which drugs act and how drugs can alter those pathways. The reward circuit, also referred to as the mesolimbic system, is characterized by the interaction of several areas of the brain. A reward is something that an animal will work to obtain, for example, food. ...

  • The ventral tegmental area (VTA) consists of dopaminergic neurons which respond to glutamate. These cells respond when stimuli indicative of a reward are present. The VTA supports learning and sensitization development and releases dopamine (DA) into the forebrain.[5] These neurons also project and release DA into the nucleus accubems[6], through the mesolimbic pathway. Virtually all drugs causing drug addiction increase the dopamine release in the mesolimbic pathway,[7] in addition to their specific effects.
  • The nucleus accumbens (NAcc) consists mainly of medium-spiny projection neurons (MSNs), which are GABA neurons.[8] The NAcc is associated with acquiring and eliciting conditioned behaviors and involved in the increased sensitivity to drugs as addiction progresses.[5]
  • The prefrontal cortex, more specifically the anterior cingulate and orbitofrontal cortices,[4] is important for the integration of information which contributes to whether a behavior will be elicited. It appears to be the area in which motivation originates and the salience of stimuli are determined.[9]
  • The basolateral amygdala projects into the NAcc and is thought to be important for motivation as well.[9]
  • More evidence is pointing towards the role of the hippocampus in drug addiction because of its importance in learning and memory. Much of this evidence stems from investigations manipulating cells in the hippocampus alters dopamine levels in NAcc and firing rates of VTA dopaminergic cells.[6]

Grays FIG. 712– Transverse section of mid-brain at level of superior colliculi. ... Dopaminergic means related to the neurotransmitter dopamine. A synapse is dopaminergic if it uses dopamine as its neurotransmitter. ... Neurons (also called nerve cells) are the primary cells of the nervous system. ... Glutamate is the anion of glutamic acid. ... For other uses, see Dopamine (disambiguation). ... In the anatomy of vertebrates, the prosencephalon is a part of encephalon, or brain. ... The mesolimbic pathway is one of the neural pathways in the brain that link the ventral tegmentum in the midbrain to the nucleus accumbens in the limbic system. ... The nucleus accumbens (NAcc), also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus leaning against the septum), is a collection of neurons located where the head of the caudate and the anterior portion of the putamen meet just lateral to the septum pellucidum. ... Gaba may refer to: Gabâ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... “Prefrontal” redirects here. ... Anterior cingulate cortex (ACC) is the frontal part of the cingulate cortex and includes Brodmanns area 24 (ventral ACC) and 32 (dorsal ACC). ... The orbitofrontal cortex (OFC) is a region of association cortex of the human brain involved in cognitive processes such as decision making. ... For other uses, see Hippocampus (disambiguation). ...

Stress response

In addition to the reward circuit, it is hypothesized that stress mechanisms also play a role in addiction. Koob and Kreek have hypothesized that during drug use corticotropin-releasing factor (CRF) activates the hypothalamic-pituitary-adrenal axis (HPA) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with drug addiction. They have found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid (CSF). In rat models, the separate use of CRF antagonists and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed a dysregulation in other hormones associated with the HPA axis, including enkephalin which is an endogenous opioid peptides that regulates pain. It also appears that the µ-opioid receptor system, which enkephalin acts on, is influential in the reward system and can regulate the expression of stress hormones.[2] Corticotropin-releasing hormone (CRH), also called corticotropin-releasing factor (CRF) or corticoliberin, is a polypeptide hormone involved in the stress response. ... It has been suggested that HTPA be merged into this article or section. ... This article is about part of the human brain. ... Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... Endorphins are endogenous opioid biochemical compounds. ... Opioid Peptides are short sequences of amino acids which mimick the effect of opiates in the brain. ... The μ opioid receptors (MOR) are a class of opioid receptors with high affinity for enkephalins and beta-endorphin but low affinity for dynorphins. ...


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.[4][2] 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.[5] Evidence shows that this behavior is most likely a result of the synaptic changes which have occurred due to repeated drug exposure.[4][2][5] 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.[4] Operant conditioning is the use of consequences to modify the occurrence and form of behavior. ... Categories: Chemistry stubs | Biochemicals ...


Allostasis

The concept of allostasis is the process of achieving stability through changes in behavior as well as physiological features. Allostasis appears to adjust as a person progresses into drug addiction and enters a new allostatic state, defined as divergence from normal levels of change which persist in a chronic state. Addiction to drugs can cause damage to your brain and body as you enter the pathological state; the cost stemming from damage is known as allostatic load. The dysregulation of allostasis gradually occurs as the reward from the drug decreases and the ability to overcome the depressed state following drug use begins to decrease as well. The resulting allostatic load creates a constant state of depression relative to normal allostatic changes. What pushes this decrease is the propensity of drug users to take the drug before the brain and body have returned to original allostatic levels, producing a constant state of stress. Therefore, environmental stressors may induce stronger drug seeking behaviors than in the presence of no environmental stressors.[2] Allostasis is the process of achieving stability, or homeostasis, through physiological or behavioral change. ...


Neuroplasticity

Neuroplasticity is the putative mechanism behind learning and memory. It involves physical changes in the synapses between two communicating neurons, characterized by increased gene expression, altered cell signaling, and the formation of new synapses between the communicating neurons. When addictive drugs are present in the system, they appear to hijack this mechanism in the reward system so that motivation is geared towards procuring the drug rather than natural rewards.[5] Depending on the history of drug use, nucleus accumbens (NAc) excitatory synapses experience two types of neuroplasticity, or bidirectional plasticity, long-term potentiation (LTP) and long-term depression (LTD). Using mice as a model, Kourrich et al. displayed that chronic exposure to cocaine increases the strength of synapses in NAc after a 10-14 day withdrawal period, while strengthened synapses did not appear within a 24 hour withdrawal period after repeated cocaine exposure. A single dose of cocaine did not display any attributes of a strengthened synapse. When drug experienced mice were challenged with one dose of cocaine, synaptic depression occurred. Therefore, it seems the history of cocaine exposure along with withdrawal times affects the direction of glutamatergic plasticity in the NAc.[8] Neuroplasticity challenges the idea that brain functions are fixed in certain locations. ... The nucleus accumbens (NAcc), also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus leaning against the septum), is a collection of neurons located where the head of the caudate and the anterior portion of the putamen meet just lateral to the septum pellucidum. ... Long-term potentiation (LTP) is the persistent increase in synaptic strength following high-frequency stimulation of a chemical synapse. ... Long-term depression (LTD), in neurophysiology, is the weakening of a neuronal synapse that lasts from hours to days. ...


Once a person has transitioned from drug use to addiction, behavior becomes completely geared towards seeking the drug, even though addicts report the euphoria is not as intense as it once was. Despite the differing actions of drugs during acute use, the final pathway of addiction is the same. Another aspect of drug addiction is a decreased response to normal biological stimuli, such as food, sex, and social interaction. Through functional brain imaging of patients addicted to cocaine, scientists have been able to visualize increased metabolic activity in the anterior cingulate and orbitofrontal cortex (areas of the prefrontal cortex) in the brain of these subjects. The hyperactivity of these areas of the brain in addicted subjects are involved in the more intense motivation to find the drug rather than seeking natural rewards, as well as an addict’s decreased ability to overcome this urge. Brain imaging has also shown cocaine-addicted subjects to have decreased activity, as compared to non-addicts, in their prefrontal cortex when presented with stimuli associated with natural rewards. The transition from recreational drug use to addiction occurs in gradual stages and is produced by the effect of the drug of choice on the neuroplasticity of the neurons found in the reward circuit. During events preceding addiction, cravings are produced by the release of DA in the prefrontal cortex. As a person transitions from drug use to addiction, the release of dopamine (DA) in the NAc becomes unnecessary to produce cravings; rather, DA transmission decreases while increased metabolic activity in the orbitofrontal cortex contributes to cravings. Before a person becomes addicted and exhibits drug-seeking behavior, there is a time period in which the neuroplasticity is reversible. Addiction occurs when drug-seeking behavior is exhibited and the vulnerability to relapse persists, despite prolonged withdrawal; these behavioral attributes are the result of neuroplastic changes which are brought about by repeated exposure to drugs and are relatively permanent.[4] Anterior cingulate cortex (ACC) is the frontal part of the cingulate cortex and includes Brodmanns area 24 (ventral ACC) and 32 (dorsal ACC). ... The orbitofrontal cortex (OFC) is a region of association cortex of the human brain involved in cognitive processes such as decision making. ...


The exact mechanism behind a drug molecule’s effect on synaptic plasticity is still unclear. However, neuroplasticity in glutamatergic projections seems to be a major result of repeated drug exposure. There are several ways in which glutamate transmission is altered. One way is by increasing presynaptic release of glutamate and the other is increased response to glutamate.[4][5] The two main glutamate receptors involved are NMDAR and AMPAR. The expression of these receptors on the cell surface increases with repeated drug use. This type of synaptic plasticity results in LTP, which strengthens connections between two neurons; onset of this occurs quickly and the result is constant. In addition to glutamatergic neurons, dopaminergic neurons present in the VTA respond to glutamate and may be recruited earliest during neural adaptations caused by repeated drug exposure. As shown by Kourrich, et al, history of drug exposure and the time of withdrawal from last exposure appear to play an important role in the direction of plasticity in the neurons of the reward system.[5] The NMDA receptor (NMDAR) is an ionotropic receptor for glutamate (NMDA is a name of its selective specific agonist). ... The AMPA receptor (AMPAR) is a non-NMDA-type ionotropic transmembrane receptor for glutamate that mediates fast synaptic transmission in the central nervous system. ...


An aspect of neuron development that may also play a part in drug-induced neuroplasticity is the presence of axon guidance molecules such as semaphorins and ephrins. After repeated cocaine treatment, altered expression (increase or decrease dependent on the type of molecule) of mRNA coding for axon guidance molecules occurred in rats. This may contribute to the alterations in the reward circuit characteristic of drug addiction.[10]


Neurogenesis

Drug addiction also raises the issue of potential harmful effects on the development of new neurons in adults. Eisch and Harburg raise three new concepts they have extrapolated from the numerous recent studies on drug addiction. First, neurogenesis decreases as a result of repeated exposure to addictive drugs. A list of studies show that chronic use of opiates, psychostimulants, nicotine, and alcohol decrease neurogenesis in mice and rats. Second, this apparent decrease in neurogenesis seems to be independent of HPA axis activation. Other environmental factors other than drug exposure such as age, stress and exercise, can also have an effect of neurogenesis by regulating the hypothalamic-pituitary-adrenal (HPA) axis. Mounting evidence suggests this for 3 reasons: small doses of opiates and psychostimulants increase coricosterone concentration in serum but with no effect of neurogenesis; although decreased neurogenesis is similar between self-administered and forced drug intake, activation of HPA axis is greater in self-administration subjects; and even after the inhibition of opiate induced increase of corticosterone, a decrease in neurogenesis occurred. These, of course, need to be investigated further. Last, addictive drugs appear to only affect proliferation in the subgranular zone (SGZ), rather than other areas associated with neurogenesis. The studies of drug use and neurogenesis may have implications on stem cell biology.[6] Neurogenesis (birth of neurons) is the process by which neurons are created. ... Neurogenesis (birth of neurons) is the process by which neurons are created. ...


Psychological drug tolerance

The reward system is partly responsible for the psychological part of drug tolerance; Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ...


The CREB protein, a transcription factor activated by cyclic adenosine monophosphate (cAMP) immediately after a high, triggers genes that produce proteins such as dynorphin, which cuts off dopamine release and temporarily inhibits the reward circuit. In chronic drug users, a sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for an additional "fix". CREB (top) is a transcription factor capable of binding DNA (bottom) and regulating gene expression. ... In molecular biology, a transcription factor is a protein that binds DNA at a specific promoter or enhancer region or site, where it regulates transcription. ... Structure of cAMP cAMP represented in three ways, the left with sticks-representation, the middle with structure formula, and the right with space filled representation. ... For other uses, see Gene (disambiguation). ... Dynorphin (Dyn) is a popular and powerful opioid ligand. ...


Sensitization

Sensitization is the increase in sensitivity to a drug after prolonged use. The proteins delta FosB and regulator of G-protein Signaling 9-2 (RGS 9-2) are thought to be involved:


A transcription factor, known as delta FosB, is thought to activate genes that, counter to the effects of CREB, actually increase the user's sensitivity to the effects of the substance. Delta FosB slowly builds up with each exposure to the drug and remains activated for weeks after the last exposure—long after the effects of CREB have faded. The hypersensitivity that it causes is thought to be responsible for the intense cravings associated with drug addiction, and is often extended to even the peripheral cues of drug use, such as related behaviors or the sight of drug paraphernalia. There is some evidence that delta FosB even causes structural changes within the nucleus accumbens, which presumably helps to perpetuate the cravings, and may be responsible for the high incidence of relapse that occur in treated drug addicts. The nucleus accumbens (NAcc), also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus leaning against the septum), is a collection of neurons located where the head of the caudate and the anterior portion of the putamen meet just lateral to the septum pellucidum. ...


Regulator of G-protein Signaling 9-2 (RGS 9-2) has recently been the subject of several animal knockout studies. Animals lacking RGS 9-2 appear to have increased sensitivity to dopamine receptor agonists such as cocaine and amphetamines; over-expression of RGS 9-2 causes a lack of responsiveness to these same agonists. RGS 9-2 is believed to catalyze inactivation of the G-protein coupled D2 receptor by enhancing the rate of GTP hydrolysis of the G alpha subunit which transmits signals into the interior of the cell.


Individual mechanisms of effect

The basic mechanisms by which different substances activate the reward system are as described above, but vary slightly among drug classes. A reward is something that an animal will work to obtain, for example, food. ...


Depressants

Depressants such as alcohol and benzodiazepines work by increasing the affinity of the GABA receptor for its ligand; GABA. Narcotics such as morphine and methadone, work by mimicking endorphins—chemicals produced naturally by the body which have effects similar to dopamine—or by disabling the neurons that normally inhibit the release of dopamine in the reward system. These substances (sometimes called "downers") typically facilitate relaxation and pain-relief. A depressant, referred to in slang as a downer, is a chemical agent that diminishes the function or activity of a specific part of the body. ... This article does not cite any references or sources. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , often abbreviated to benzos) are a class of sedative hypnotic psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... 19th century Heroin bottle This article is about the drug classification. ... This article is about the drug. ... Methadone (Dolophine®, Amidone®, Methadose®, Physeptone®, Heptadon® and many others) is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. ... For other uses, see Endorphin (disambiguation). ... This article is about cells in the nervous system. ...


Stimulants

Stimulants such as amphetamines, nicotine, and cocaine, increase dopamine signaling in the reward system either by directly stimulating its release, or by blocking its absorption (see "reuptake"). These substances (sometimes called "uppers") typically cause heightened alertness and energy. They cause a pleasant feeling in the body, and euphoria, known as a high. This high wears off leaving the user feeling depressed. This sometimes makes them want more of the drug, and can worsen the addiction. Sustained-Release 15mg Dexedrine Spansules. ... Amphetamine or Amfetamine(Alpha-Methyl-PHenEThylAMINE), also known as beta-phenyl-isopropylamine and benzedrine, is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder (ADHD) in adults and children. ... This article is about the chemical compound. ... For other uses, see Cocaine (disambiguation). ... Reuptake, or re-uptake, is the reabsorption of a neurotransmitter by the neurotransmitter transporter of a pre-synaptic neuron after it has performed its function of transmitting a neural impulse. ...


Theories about causes for epidemic outbreak of addiction

Nils Bejerot

Nils Bejerot (1921 –1988) was a Swedish psychiatrist and criminologist. He attacked the symptom theory of addiction - that addictions are a symptom of other more fundamental personal or socioeconomic problems - and separated five essential factors from all of the other factors that are involved in addiction. Bejerot's point was that all of these other factors should be understood as susceptibility or risk factors. Therefore mental illness may make someone susceptible to drug experimentation and use, but it is not a causal factor. Similarly, poverty may increase susceptibility, but there is no automatic causal relationship with addiction. Many poverty-stricken communities are free of addiction epidemics, as are many people with mental illness. Nils Bejerot (born September 21, 1921 in Stockholm - died November 29, 1988) was a Swedish psychiatrist and criminologist, best known for several things: His role as a psychiatric advisor during the Norrmalmstorg robbery and coinage of the term Stockholm syndrome to refer to the way a hostage reacts in some...


Bejerot's analysis was that the presence of six factors on their own constitutes a risk that an individual will become an addict, or that a community will be affected by an epidemic of addiction:

  • Availability of the addictive substance
  • Money to acquire the substance
  • Time to use the substance
  • Example of use of the substance in the immediate environment
  • A permissive ideology in relation to the use of the substance. [11]
  • Permissive laws for the substance, for ex. for personal use and possession

Treatment

Treatments for drug addiction vary widely according to the types of drugs involved, amount of drugs used, duration of the drug addiction, medical complications and the social needs of the individual.


Determining the best type of recovery program for an addicted person depends on a number of factors, including: personality, drug(s) of addiction, concept of spirituality or religion, mental or physical illness, and local availability and affordability of programs.


Many different ideas circulate regarding what is considered a "successful" outcome in the recovery from addiction. It has widely been established that abstinence from addictive substances is generally accepted as a "successful" outcome, however differences of opinion exist as to the extent of abstinence required.


In the USA and in many other countries, the goal of treatment for drug dependence is generally total abstinence from all drugs, which while theoretically the ideal outcome, is in practice often very difficult to achieve. Other countries particularly in Europe argue the aims of treatment for drug dependence to be more complex, with treatment aims including reduction in use to the point that drug use no longer interferes with normal activities such as work and family commitments, shifts away from more dangerous routes of drug administration such as injecting to safer routes such as oral administration, reduction in crime committed by drug addicts, and treatment of other comorbid conditions such as AIDS, hepatitis and mental health disorders. These kind of outcomes can often be achieved without necessarily eliminating drug use completely, and so drug treatment programs in Europe often report more favourable outcomes than those in the USA because the criteria for measuring success can be met even though drug users on the programme may still be using drugs to some extent.[12][13][14] The supporters of programs with total abstinence from drugs as a goal stress that enabling further drug use mean prolonged drug use and a risk for an increase of total number of addicts; the participants in the program can introduce new users in the habit. [15]



Drug addiction is a complex but treatable brain disease. It is characterized by compulsive drug craving, seeking, and use that persist even in the face of severe adverse consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence. In fact, relapse to drug abuse occurs at rates similar to those for other well-characterized, chronic medical illnesses such as diabetes, hypertension, and asthma. As a chronic, recurring illness, addiction may require repeated treatments to increase the intervals between relapses and diminish their intensity, until abstinence is achieved. Through treatment tailored to individual needs, people with drug addiction can recover and lead productive lives. The ultimate goal of drug addiction treatment is to enable an individual to achieve lasting abstinence, but the immediate goals are to reduce drug abuse, improve the patient's ability to function, and minimize the medical and social complications of drug abuse and addiction. Like people with diabetes or heart disease, people in treatment for drug addiction will need to change behavior to adopt a more healthful lifestyle.[16]


Residential

Residential drug treatment can be broadly divided into two camps: 12 step programs or Therapeutic Communities. 12 step programs have the advantage of coming with an instant social support network though some find the spiritual context not to their taste. In the UK drug treatment is generally moving towards a more integrated approach with rehabs offering a variety of approaches. These other programs may use Cognitive-Behavioral Therapy an approach that looks at the relationship between thoughts feelings and behaviors, recognizing that a change in any of these areas can affect the whole. CBT sees addiction as a behavior rather than a disease and subsequently curable, or rather, unlearnable. CBT programs recognize that for some individuals controlled use is a more realistic possibility. Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ...


12 step program

One of many recovery methods is the 12 step recovery program, with prominent examples including Alcoholics Anonymous and Narcotics Anonymous. They are commonly known and used for a variety of addictions for the individual addicted and the family of the individual. Substance-abuse rehabilitation (or "rehab") centers frequently offer a residential treatment program for the seriously addicted in order to isolate the patient from drugs and interactions with other users and dealers. Outpatient clinics usually offer a combination of individual counseling and group counseling. Frequently a physician or psychiatrist will assist with prescriptions to assist with the side effects of the addiction (the most common side effect that the medications can help is anxiety). // A twelve-step program is a set of guiding principles for recovery from addictive, compulsive, or other behavioral problems, originally developed by the fellowship of Alcoholics Anonymous (AA) for recovery from alcoholism. ... AA meeting sign // Alcoholics Anonymous (AA) is an informal meeting society for recovering alcoholics whose primary purpose is to stay sober and help other alcoholics achieve sobriety. ... This article is about the 12-step program of Narcotics Anonymous (NA). ... Substance-abuse rehabilitation is a process of medical and/or psychotherapeutic treatment, for dependency on psychoactive substances. ... The word counseling or counselling comes from the Middle English counseil, from Old French conseil, from Latin cōnsilium; akin to cōnsulere, to take counsel, consult. ... Pharmacology (in Greek: pharmakon (φάρμακον) meaning drug, and lego (λέγω) to tell (about)) is the study of how drugs interact with living organisms to produce a change in function. ...


Anti-addictive drugs

Other forms of treatment include replacement drugs such as methadone or buprenorphine, used as a substitute for illicit opiate drugs.[17][18] Although these drugs are themselves addictive, opioid dependency is often so strong that a way to stabilize levels of opioid needed and a way to gradually reduce the levels of opioid needed are required. In some countries, other opioid derivatives such as levomethadyl acetate,[19] dihydrocodeine,[20] dihydroetorphine[21] and even heroin[22][23] are used as substitute drugs for illegal street opiates, with different drugs being used depending on the needs of the individual patient.[24] Methadone (Dolophine®, Amidone®, Methadose®, Physeptone®, Heptadon® and many others) is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. ... Buprenorphine, is an opioid drug with partial agonist and antagonist actions. ... Levomethadyl acetate, also known as levo-α-acetylmethadol (LAAM) is a synthetic opioid similar in structure to methadone. ... Dihydrocodeine, also called DHC, Drocode, Paracodeine and Parzone and by the brand names of Synalgos DC, Panlor DC, Panlor SS, SS Bron, Drocode, Paracodin, Codidol, Didor Continus, Dicogesic, Codhydrine, Dekacodin, DH-Codeine, Didrate, Dihydrin, Hydrocodin, Nadeine, Novicodin, Rapacodin, Fortuss, Dico, and DF-118 amongst others, is a semi-synthetic opioid... China is one of the only countries in the world to prescribe Dihydroetorphine, (a close relative of Etorphine) to humans. ... For other uses, see Heroin (disambiguation). ...


Substitute drugs for other forms of drug dependence have historically been less successful than opioid substitute treatment, but some limited success has been seen with drugs such as dexamphetamine to treat stimulant addiction,[25][26] and clomethiazole to treat alcohol addiction.[27] Dextroamphetamine (also known as dextroamphetamine sulfate, dexamphetamine, dexedrine, Dexampex, Ferndex, Oxydess II, Robese, Spancap #1, and, informally, Dex), a stereoisomer of amphetamine, is an indirect-acting stimulant that releases norepinephrine from nerve terminals, thus promoting nerve impulse transmission. ... Clomethiazole (also called Chlormethiazole) is a sedative and hypnotic that is widely used in treating and preventing symptoms of acute alcohol withdrawal. ...


Other pharmacological treatments for alcohol addiction include drugs like disulfiram, acamprosate and topiramate,[28][29] but rather than substituting for alcohol, these drugs are intended to reduce the desire to drink, either by directly reducing cravings as with acamprosate and topiramate, or by producing unpleasant effects when alcohol is consumed, as with disulfiram. These drugs can be effective if treatment is maintained, but compliance can be an issue as alcoholic patients often forget to take their medication, or discontinue use because of excessive side effects.[30][31] Additional drugs acting on glutamate neurotransmission such as modafinil, lamotrigine, gabapentin and memantine have also been proposed for use in treating addiction to alcohol and other drugs.[32] Disulfiram is a drug used to support the treatment of chronic alcoholism by producing an acute sensitivity to alcohol. ... acamprosate ... Topiramate (brand name Topamax) is an anticonvulsant drug produced by Ortho-McNeil Neurologics, a division of Johnson & Johnson. ... Glutamate is the anion of glutamic acid. ... Modafinil is a eugeroic drug generally prescribed to treat narcolepsy, made by the pharmaceutical company Cephalon Inc. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... Memantine is the first in a novel class of Alzheimers disease medications acting on the glutamatergic system by blocking NMDA glutamate receptors. ...


Opioid antagonists such as naltrexone and nalmefene have also been used successfully in the treatment of alcohol addiction,[33][34] which is often particularly challenging to treat. These drugs have also been used to a lesser extent for long-term maintenance treatment of former opiate addicts, but cannot be started until the patient has been abstinent for an extended period, otherwise they can trigger acute opioid withdrawal symptoms.[35] Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. ... Nalmefene (Revex) is an opioid receptor antagonist used primarily in the management of alcohol dependence, and also has been investigated for the treatment of other addictions such as pathological gambling and addiction to shopping. ...


Treatment of stimulant addiction can often be difficult, with substitute drugs often being ineffective, although newer drugs such as nocaine, vanoxerine and modafinil may have more promise in this area, as well as the GABAB agonist baclofen.[36][37] Another strategy that has recently been successfully trialled used a combination of the benzodiazepine antagonist flumazenil with hydroxyzine and gabapentin for the treatment of methamphetamine addiction.[38] Sustained-Release 15mg Dexedrine Spansules. ... The Nocaine family includes a diverse assortment of piperidine based cocaine mimics. ... Vanoxerine, also known as GBR-12909, is a piperazine derivative which is a potent and selective dopamine reuptake inhibitor. ... Modafinil is a eugeroic drug generally prescribed to treat narcolepsy, made by the pharmaceutical company Cephalon Inc. ... Baclofen (brand names Kemstro® and Lioresal®) is a derivative of gamma-aminobutyric acid, and is an agonist specific to mammalian but not fruit fly (Drosophila) GABAB receptors[1][2]. It is used for the treatment of spastic movement, especially in instances of spinal cord injury, spastic diplegia and multiple sclerosis. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , often abbreviated to benzos) are a class of sedative hypnotic psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Flumazenil (flumazepil, Anexate®, Lanexat®, Mazicon®, Romazicon®) is a benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose. ... Hydroxyzine (pronounced ) is a first-generation antihistamine, of the piperazine class that is an H1 receptor antagonist. ... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... This article is about the psychostimulant, d-methamphetamine. ...


Another area in which drug treatment has been widely used is in the treatment of nicotine addiction. Various drugs have been used for this purpose such as bupropion, mecamylamine and the more recently developed varenicline. The cannaboinoid antagonist rimonabant has also been trialled for treatment of nicotine addiction but has not been widely adopted for this purpose.[39][40][41] This article is about the chemical compound. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Mecamylamine is a nicotinic antagonist that is well absorbed from the gastrointestinal tract and crosses the blood-brain barrier. ... Varenicline (trade name Chantix in the USA and Champix in Europe, Mexico and Canada, manufactured by Pfizer, usually in the form of varenicline tartrate) is a prescription medication used to treat smoking addiction. ... Rimonabant (SR141716) is an anorectic anti-obesity drug. ...


Ibogaine is a psychoactive drug that specifically interrupts the addictive response, and is currently being studied for its effects upon cocaine, heroin, nicotine, and SSRI addicts. Alternative medicine clinics offering ibogaine treatment have appeared along the U.S. border.[42] Ibogaine treatment for drug addiction can be reasonably effective, but potentially dangerous side effects which have been linked to several deaths have limited its adoption by conventional medical practice.[43] A synthetic analogue of ibogaine, 18-methoxycoronaridine has also been developed which has similar efficacy but less side effects, however this drug is still being tested in animals and human trials have not yet been carried out.[44][45] Ibogaine is an indole alkaloid, a long-acting hallucinogen which has gained attention due to its application in the treatment of opioid addiction and similar addiction syndromes. ... 18-methoxycoronaridine. ...


Alternative therapies

Alternative therapies, such as acupuncture, are used by some practitioners to alleviate the symptoms of drug addiction. In 1997, the American Medical Association (AMA) was adopted as policy following statement after a report on a number of alternative therapies including acupuncture: Acupuncture chart from Hua Shou (fl. ...

There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.

Accupuncture has been shown to be no more effective than control treatments in the treatment of opiate dependence.[46] Acupuncture, acupressure, laser therapy and electrostimulation have no demonstrated efficacy for smoking cessation.[47] Acupressure (a portmanteau of acupuncture and pressure) is a traditional Chinese medicine (TCM) technique based on the same ideas as acupuncture. ... Photobiomodulation also called Low Level Laser Therapy (LLLT), Cold Laser Therapy, Laser Biostimulation, phototherapy or just Laser Therapy. ... Electro-stimulation can be performed in the context of: Cranial electrotherapy stimulation Skeletomuscular electrostimulation animal husbandry as part of the artificial insemination process Erotic electrostimulation - a form of BDSM Categories: Disambiguation | Stub ...


Medical definitions

The 1957 World Health Organization (WHO) Expert Committee on Addiction-Producing Drugs defined addiction and habituation as components of drug abuse: WHO redirects here. ... Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1] This article is an overview of the nontherapeutic use of alcohol and drugs of abuse. ...

Drug addiction is a state of periodic or chronic intoxication produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include: (i) an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; (ii) a tendency to increase the dose; (iii) a psychic (psychological) and generally a physical dependence on the effects of the drug; and (iv) detrimental effects on the individual and on society. Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ...

Drug habituation (habit) is a condition resulting from the repeated consumption of a drug. Its characteristics include (i) a desire (but not a compulsion) to continue taking the drug for the sense of improved well-being which it engenders; (ii) little or no tendency to increase the dose; (iii) some degree of psychic dependence on the effect of the drug, but absence of physical dependence and hence of an abstinence syndrome [withdrawal], and (iv) detrimental effects, if any, primarily on the individual.

In 1964, a new WHO committee found these definitions to be inadequate, and suggested using the blanket term "drug dependence":

The definition of addiction gained some acceptance, but confusion in the use of the terms addiction and habituation and misuse of the former continued. Further, the list of drugs abused increased in number and diversity. These difficulties have become increasingly apparent and various attempts have been made to find a term that could be applied to drug abuse generally. The component in common appears to be dependence, whether psychic or physical or both. Hence, use of the term 'drug dependence', with a modifying phase linking it to a particular drug type in order to differentiate one class of drugs from another, had been given most careful consideration. The Expert Committee recommends substitution of the term 'drug dependence' for the terms 'drug addiction' and 'drug habituation'.

The committee did not clearly define dependence, but did go on to clarify that there was a distinction between physical and psychological ("psychic") dependence. It said that drug abuse was "a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis." Psychic dependence was defined as a state in which "there is a feeling of satisfaction and psychic drive that requires periodic or continuous administration of the drug to produce pleasure or to avoid discomfort" and all drugs were said to be capable of producing this state:

There is scarcely any agent which can be taken into the body to which some individuals will not get a reaction satisfactory or pleasurable to them, persuading them to continue its use even to the point of abuse — that is, to excessive or persistent use beyond medical need.

The 1957 and 1964 definitions of addiction, dependence and abuse persist to the present day in medical literature. It should be noted that at this time (2006) the Diagnostic Statistical Manual (DSM IVR) now spells out specific criteria for defining abuse and dependence.


In 2001, the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine jointly issued "Definitions Related to the Use of Opioids for the Treatment of Pain," which defined the following terms [3]:

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ...

Tolerance is the body's physical adaptation to a drug: greater amounts of the drug are required over time to achieve the initial effect as the body "gets used to" and adapts to the intake. Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ...

Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may “clock watch,” and may otherwise seem inappropriately “drug seeking.” Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.

Addiction and drug control legislation

Depending on the jurisdiction, addictive drugs may be legal only as part of a government sponsored study, illegal to use for any purpose, illegal to sell, or even illegal to merely possess.


Most countries have legislation which brings various drugs and drug-like substances under the control of licensing systems. Typically this legislation covers any or all of the opiates, amphetamines, cannabinoids, cocaine, barbiturates, hallucinogenics and a variety of more modern synthetic drugs, and unlicensed production, supply or possession is a criminal offence. Water and steam are two different forms of the same chemical substance A chemical substance is a material with a definite chemical composition. ...


Usually, however, drug classification under such legislation is not related simply to addictiveness. The substances covered often have very different addictive properties. Some are highly prone to cause physical dependency, whilst others rarely cause any form of compulsive need whatsoever. Also, under legislation specifically about drugs, alcohol is not usually included. This article does not cite any references or sources. ...


Although the legislation may be justifiable on moral or public health grounds, it can make addiction or dependency a much more serious issue for the individual: reliable supplies of a drug become difficult to secure, and the individual becomes vulnerable to both criminal abuse and legal punishment.


It is unclear whether laws against drugs do anything to stem usage and dependency. In jurisdictions where addictive drugs are illegal, they are generally supplied by drug dealers, who are often involved with organized crime. Even though the cost of producing most illegal addictive substances is very low, their illegality combined with the addict's need permits the seller to command a premium price, often hundreds of times the production cost. As a result, the addict sometimes turns to crime to support their habit. These lollipops, above, were found to contain heroin when inspected by the US Drug Enforcement Administration In jurisdictions where legislation restricts or prohibits the sale of certain popular drugs, it is common for an illegal drugs trade to develop. ... Organized crime or criminal organizations are groups or operations run by criminals, most commonly for the purpose of generating a monetary profit. ...


History of addiction

The phenomenon of drug addiction has occurred to some degree throughout recorded history (see "opium"), though modern agricultural practices, improvements in access to drugs, advancements in biochemistry, and dramatic increases in the recommendation of drug usage by clinical practitioners have exacerbated the problem significantly in the 20th century. Improved means of active biological agent manufacture and the introduction of synthetic compounds, such as methamphetamine are also factors contributing to drug addiction. Image File history File links Question_book-3. ... For other uses, see Phenomena (disambiguation). ... This article is about the concept of addiction. ... This article is about the study of the past in human terms. ... This article is about the drug. ... Wöhler observes the synthesis of urea. ... This article is about the psychostimulant, d-methamphetamine. ...


In 1971, United States President Richard Nixon declared a war on illegal drugs in an attempt to control the growing problem of drug addiction and drug-related crime. Nixon redirects here. ... Massive mark-ups for drugs, areas/drugs/index. ...


See also

This article is about the concept of addiction. ... There are a variety of addiction recovery groups and methods other than those that follow the Twelve Steps and Twelve Traditions of Alcoholics Anonymous. ... Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ... The prohibition of drugs is a subject of considerable controversy. ... Demand reduction is a term used by drug control authorities to refer to educational and other efforts aimed at stopping people from seeking drugs, as opposed to cutting off their supply. ... Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1] This article is an overview of the nontherapeutic use of alcohol and drugs of abuse. ... Drugs and prostitution are related in that some drug addicts, most commonly heroin or crack cocaine users, obtain their drugs primarily through prostitution. ... There is an established and possibly increasing trend for recreational drug users to use two or more drugs in combination to achieve a particular effect. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... The Drug Intervention Program is a key part of the United Kingdoms strategy for tackling drug abuse[1]. It aims to engage substance misusing individuals involved in the Criminal Justice system in formal addiction treatment, thereby reducing drug related harm and reducing offending behaviour [2]. Introduced in 2003, it... The Diagnostic and Statistical Manual published by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR is a manual published by the American Psychiatric Association and includes all currently recognized mental health disorders. ... Harm reduction is a philosophy of public health, intended to be a progressive alternative to the prohibition of certain potentially dangerous lifestyle choices. ... Nils Bejerot (born September 21, 1921 in Stockholm - died November 29, 1988) was a Swedish psychiatrist and criminologist, best known for several things: His role as a psychiatric advisor during the Norrmalmstorg robbery and coinage of the term Stockholm syndrome to refer to the way a hostage reacts in some... Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ... An assortment of psychoactive drugs A psychoactive drug or psychotropic substance is a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behavior. ... This article or section does not adequately cite its references or sources. ... Treatment Improvement Protocols (TIPs) are a series of best-practice manuals for the treatment of substance use and other related disorders. ... Dr. Bruce K. Alexander Rat Park was a study into drug addiction conducted in the 1970s by American psychologist Bruce K. Alexander at Simon Fraser University in British Columbia, Canada. ... Kevin M. Murphy and Nobel Prize Winner Gary S. Becker published the Theory of Rational Addiction in the Journal of Political Economy in 1988 (Volume96: 675-700). ... Holding Punishing a person for a medical condition is a violation of the Eighth Amendment ban on cruel and unusual punishment. ... The Supreme Court Building, Washington, D.C. The Supreme Court Building, Washington, D.C., (large image) The Supreme Court of the United States, located in Washington, D.C., is the highest court (see supreme court) in the United States; that is, it has ultimate judicial authority within the United States...

Literature

  • Sainsbury, Drug and the Drug Habit (New York, 1909)
  • C. A. McBride, Modern Treatment of Alcoholism and Drug Narcotism (New York, 1910)
  • G. E. Pettey, Narcotic Drug Diseases and Allied Ailments (Philadelphia, 1913)
  • Fitz Hugh Ludlow wrote The Hasheesh Eater (1857) and The Opium Habit (1868), designed as a warning.
  • Thomas de Quincey, Confessions of an English Opium Eater (London, 1822)
  • William S. Burroughs, Junkie (New York, 1953)

Fitz Hugh Ludlow Fitz Hugh Ludlow, sometimes seen as “Fitzhugh Ludlow,” (September 11, 1836 – September 12, 1870) was an American author, journalist, and explorer; best-known for his autobiographical book The Hasheesh Eater (1857). ... Thomas de Quincey from the frontispiece of Revolt of the Tartars, Thomas de Quincey (August 15, 1785 – December 8, 1859) was an English author and intellectual. ... Wikiquote has a collection of quotations related to: William S. Burroughs William Seward Burroughs II (February 5, 1914) — August 2, 1997; pronounced ), more commonly known as William S. Burroughs, was an American novelist, essayist, social critic, painter and spoken word performer. ...

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A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

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Drug addiction at the Open Directory Project The Open Directory Project (ODP), also known as dmoz (from , its original domain name), is a multilingual open content directory of World Wide Web links owned by Netscape that is constructed and maintained by a community of volunteer editors. ...


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