Addiction

compulsive use of the drug in spite of

adverse consequences, and a high tendency to relapse after quitting.

Withdrawal
is a negative reaction that occurs when drug use is stopped. Withdrawal symptoms are due
at least in part to the nervous system’s having adapted to the drug’s effects, so they are
typically the opposite of the effects the drug produces. For example, the
relaxation, constipation, chills, and positive mood of heroin are replaced by agitation,
diarrhea, fever, and depression during withdrawal.

Regular use of most abused drugs results in tolerance,

- which means that the individual becomes less responsive to the drug and requires
increasing amounts of the drug to produce the same results. Like withdrawal, tolerance
results from compensatory adaptation in the nervous system, mostly a reduction in receptor
number or sensitivity. Tolerance is one reason for overdose, because tolerance can develop
in response to the drug’s pleasurable effects without developing in response to others. Thus,
if the drug abuser takes larger doses of
heroin to achieve the original sense of ecstasy while the tendency to produce sleep and
respiratory arrest are undiminished, overdose is nearly inevitable, and the consequences
can be deadly.

Psychoactive drug

A drug is a substance that on entering the body changes the body or its functioning

Psychoactive drugs are those that have psychological effects, such as anxiety relief or
hallucination.

1.) Opiates
The opiates are drugs derived from the opium poppy (Papaver somniferum,

Opiates have a variety of effects: They are analgesic (pain

relieving) and hypnotic (sleep inducing, which is where it gets its scientific name), and they
produce a strong euphoria (sense of happiness or ecstasy).
Their downside is their addictive potential due to the euphoria.

Examples of opium ingredients

Codeine, another ingredient of opium, has been used as a cough
suppressant, and dilute solutions of opium, in the form of paregoric and laudanum (literally,
“something to be praised”), were once used to treat diarrhea and to alleviate pai
; paregoric was even used to quiet fretful children.

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 Morphine continues to be used with cancer patients and is showing promise of safe use
with milder pain in a time-release form that virtually eliminates the risk of
addiction.
opiates have mostly been replaced by
synthetics.
These are called opioids, to indicate that they are not derived from
opium, at least not directly, though the term is increasingly used to include all substances
that affect the endogenous receptors. Although the synthetic opioids are safer, they too are
subject to abuse.

Heroin is the most notoriously abused opiate, due to its intense effect: a glowing,
orgasm-like sensation that occurs within seconds, followed by drowsy relaxation and
contentment. Because heroin is highly soluble in lipids, it passes the blood-brain barrier
easily; the rapid effect increases its addictive potential.
The major danger of heroin use comes from overdose—either from the attempt to maintain
the pleasant effects in the face of increasing tolerance or because the user unknowingly
obtains the drug in a purer form than usual

why opioid drugs are so effective as pain relievers: The body has receptors that are
specific for these drugs, because it manufactures its own endogenous (generated withinthe
body) opioids, known as endorphins. One effect of endorphins is pain relief, as you will see
in. Stimulation of endorphin receptors triggers some of the positive effects of opiates; others
occur from indirect activation of

2.) Depressants

Depressants are drugs that reduce central nervous system activity. The group includes
sedative (calming) drugs, anxiolytic (anxiety-reducing) drugs,
and hypnotic drugs.

Alcohol, of course, is the most common and is the most abused .

● Alcohol , Ethanol, or alcohol, is a drug fermented from fruits, grains, and other plant
products; it acts at many brain sites to produce euphoria, anxiety reduction, sedation,
motor incoordination, and cognitive impairment

At low doses, say, a couple of drinks, it turns off the

inhibition the cortex normally exerts over behavior, resulting in behavioral
stimulation, but it also has a direct stimulatory effect by increasing dopamine
release

inhibits the release of glutamate

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 increases the release of gamma-aminobutyric acid (GABA), the
most prevalent inhibitory neurotransmitte

The combined effect at these two receptors is

sedation, anxiety reduction, muscle relaxation, and inhibition of cognitive and motor
skills. Alcohol also affects opiate receptors (in turn increasing dopamine release),
serotonin receptors, and cannabinoid receptors, which are also excited
by marijuana (Julien, 2008); these actions likely account for the pleasurable aspects
of drinking.

High levels of any depressant drug have the potential to shut down the brain stem,
resulting in coma or death;

Binge drinkers are more likely to be impulsive and to have learning and memory
impairments

Alcohol withdrawal involves tremors, anxiety, and mood and sleep disturbances; more
severe reactions are known as delirium tremens—hallucinations, delusions, confusion, and,
in extreme cases, seizures and possible death.

● Barbiturates and Benzodiazepines

Like alcohol, barbiturates in small amounts act selectively on higher cortical centers,
especially those involved in inhibiting behavior; in low doses, they produce talkativeness
and increased social interaction, and in higher doses, they are sedatives and hypnotics.
Barbiturates have been used to treat insomnia and prevent epileptic seizures.

Benzodiazepines act at the benzodiazepine receptor on the GABAA complex to produce

anxiety reduction, sedation, and muscle relaxation. They reduce anxiety by suppressing
activity in the limbic system, a network of structures w

3.) Stimulants

Stimulants activate the central nervous system to produce arousal, increased alertness, and
elevated mood. They include a wide range of drugs, from the legal (caffeine) to the illegal
(cocaine), which vary in the degree of risk they pose. The greatest danger lies in how they
are used.

● Cocaine
Cocaine, which is extracted from the South American coca plant, produces euphoria,
decreases appetite, increases alertness, and relieves fatigue. It

Effect: Cocaine blocks the reuptake of dopamine and serotonin at synapses, potentiating

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their effects. Dopamine usually has an inhibitory effect, so cocaine reduces activity in much
of the brain, as the positron emission tom ography (PET)

cocaine produces euphoria and excitement because dopamine removes the inhibition, the
cortex usually exerts on lower structures. Reduced cortical activity is typical of drugs that
produce euphoria, including benzodiazepines, barbiturates, amphetamines, alcohol, and
morphine, although localized activation is often reported in frontal
areas (R. Z. Goldstein & Volkow, 2002; London et al., 1990).

Withdrawal effects are typically mild, involving anxiety, lack of motivation, boredom, and
lack of pleasure. Three
decades ago, addiction was defined in terms of a drug’s ability to produce withdrawal, and
because cocaine’s withdrawal symptoms are so mild, it was not believed to be addictive

As usage increased in the population, we

learned that cocaine is one of the most addictive of the abused drugs. The intensity of
the drug’s effect makes treatment for addiction very difficult, and no treatment is generally
accepted as successful. Complicating rehabilitation is the fact that cocaine addicts typically
abuse other drugs, and they have a very high rate of psychological disorders, including
depression, anxiety, bipolar disorder, and posttraumatic stress disorder

Cocaine users have impairments in memory and in executive functions, including

impulse control, decision making, and assessment of emotional stimuli. These deficits
are accompanied by reduced activity in the prefrontal cortex, and by a loss of gray matter
in prefrontal and temporal areas during middle age that is almost twice as fast as in
nonusers

neurotransmitter system is involved in the effects of all stimulant drugs

Amphetamines
Amphetamines are a group of synthetic drugs that produce euphoria and increase
confidence and concentration.

Amphetamines increase the release of norepinephrine and dopamine, and they mimic
the actions of epinephrine. Increased release of dopamine exhausts the store of transmitter
in the vesicles, which accounts for the period of depression that follows. The effects of
amphetamine injection are so similar to those of cocaine that individuals cannot tell the
difference between the two

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Heavy use can cause hallucinations and delusions of persecution that are so similar to
the symptoms of paranoid schizophrenia that even trained professionals cannot recognize
the difference (resulting in occasional emergency room mistreatment).

Nicotine
Nicotine is the rimary psychoactive and addictive agent in tobacco.
help regulate mood and behavior

The withdrawal reactions are well known because smokers “quit” so often. The
most prominent symptoms are nervousness and anxiety, drowsiness,
lightheadedness, and headaches

Caffeine
Caffeine, the active ingredient in coffee and tea, produces arousal, increased
alertness, and decreased sleepines

Withdrawal symptoms include headaches, fatigue, anxiety, shakiness, and

craving, which last about a week. Withdrawal is not a significant problem,
because caffeinated beverages are in plentiful supply, but heavy drinkers may
wake up with a headache just from abstaining overnight

4.) Psychedelics

Psychedelic drugs are compounds that cause perceptual distortions in the user. The term
comes from the Greek words psyche (“mind”) and delosv(“visible”). “Visible mind” refers to
the expansion of the senses and the sense of increased insight that users of these drugs
report. Although the drugs are often referred to as hallucinogenic, they are most noted for
producing perceptual distortions: Light, color, and details are intensified; objects may change
shape;
sounds may evoke visual experiences; and light may produce auditory
sensations. Psychedelics may affect the perception of time, as well as self-perception; the
body may seem to float or to change shape, size, or identity.
These experiences are often accompanied by a sense of ecstasy, which makes
recreational use of these substances common. Psychedelics fall into three classes
in terms of their pharmacological effects: serotonin receptor agonists, serotonin
releasers, and NMDA antagonists.

Although LSD is
serotonergic, its ability to stimulate dopamine receptors makes it unusual among
psychedelics. Other classic psychedelics include psilocybin and psilocin (LSD-
like drugs from the mushroom Psilocybe mexicana); DMT (a chemical extracted
from a native flowering vine in the Brazilian Amazon); and mescaline, the active

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ingredient in the “button” on the top of the peyote cactus. Some of these
psychedelics have been authorized for religious use as protected First
Amendment religious rights: The Native American Church uses peyote in
religious ceremonies (Julien, 2008), and DMT-containing tea is permitted in
several religions originating from Brazil (“Supreme Court Rules . . . ,” 200

5.) Marijuana

Marijuana is the dried and crushed leaves and flowers of the Indian hemp
plant, Cannabis sativa (Figure 5.9)
psychoactive ingredient is delta-9-tetrahydrocannabinol (THC). THC is particularly
concentrated in the dried resin from the plant, called hashish.

THC is a cannabinoid, a group of compounds that includes two known

endogenous cannabinoids, anandamide and 2-arachidonyl glycerol, or 2-AG

reduced volume in the

hippocampus and amygdala and impaired white matter connectivity in the
hippocampus and corpus callosum

Reward refers to the positive effect an object or a condition—such as a drug, food, sexual
contact, or warmth—has on the user. Reward is accompanied by a tendency to repeat the
behavior that brought about the reward and, typically, by feelings of pleasure. The most
important reward circuit is the mesolimbic pathway, which consists of dopaminergic neurons
originating in the ventral tegmental area and connecting to several targets in the limbic
system, especially the nucleus accumbens (Figure 5

abused drugs target the mesolimbic dopamine system and increase

dopaminergic activity. If dopamine activity is blocked, rats will not learn to press a lever for a
drug injection, and those that have learned previously will stop lever
pressing after receiving the dopamine-blocking drug (Wise, 2004). In PET scan
studies, human volunteers who had the greatest increase in dopamine in the
general area of the nucleus accumbens during drug administration also
experienced the most intense “highs” (Volkow, Fowler, & Wang, 2003). In one
study, participants began reporting that they felt “high” when cocaine had
blocked 47% of the dopamine reuptake sites in the nucleus accumbens (Vo