Drug abuse and dependence

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The term drug abuse most often refers to the use of a drug with such frequency that it causes physical or mental harm to the user or impairs social functioning. Although the term seems to imply that users abuse the drugs they take, in fact, it is themselves or others they abuse by using drugs.

Traditionally, the term drug abuse referred to the use of any drug prohibited by law, regardless of whether it was actually harmful or not. This meant that any use of marijuana, for example, even if it occurred only once in a while, would constitute abuse, while the same level of alcohol consumption would not. In 1973 the National Commission on Marihuana and Drug Abuse declared that this definition was illogical. The term abuse, the commission stated, "has no functional utility and has become no more than an arbitrary code word for that drug presently considered wrong." As a result, this definition fell into disuse.

The term drug is commonly associated with substances that may be purchased legally by prescription for medical use, such as penicillin, which is almost never abused, and Valium, which is frequently abused, or illegal substances, such as angel dust, which are taken for the purpose of getting high, or intoxicated, but actually have no medical use. Other substances that may be purchased legally and are commonly abused include alcohol (see alcoholism) and nicotine, contained in tobacco cigarettes. In addition, in recent years, chemists working in illegal, clandestine laboratories have developed new chemicals that have been used for the purpose of getting high. (These are called "designer drugs".) All of these substances are psychoactive. Such substancesÑlegal and illegalÑinfluence or alter the workings of the mind; they affect moods, emotions, feelings, and thinking processes.

Drug Dependence

Drug abuse must be distinguished from drug dependence. Drug dependence, formerly called drug addiction, is defined by three basic characteristics. First, users continue to take a drug over an extended period of time. Just how long this period is depends on the drug and the user. Second, users find it difficult to stop using the drug. They seem powerless to quit. Users take extraordinary and often harmful measures to continue using the drug. How dependency-producing a drug is can be measured by how much users go through to continue taking it. Third, if users stop taking their drugÑif their supply of the drug is cut off, or if they are forced to quit for any reasonÑthey will undergo painful physical or mental distress. The experience of withdrawal symptoms distress, called the withdrawal syndrome, is a sure sign that a drug is dependency-producing and that a given user is dependent on a particular drug. Drug dependence may lead to drug abuseÑespecially of illegal drugs.

Psychoactive, or mind-altering, substances are found the world over. The coca plant grows in the Andes of South America and contains 1 to 2 percent cocaine. The marijuana plant, Cannabis sativa, contains a group of chemicals called tetrahydrocannabinol, or THC. This plant grows wild in most countries, including the United States. The opium poppy is the source for opium, morphine, heroin, and codeine. It grows in the Middle East and the Far East. Hallucinogens (such as LSD), the amphetamines (speed), and sedatives, such as methaqualone (Quaalude, or ludes) and barbiturates, are manufactured in clandestine laboratories worldwide. As a result, psychoactive drugs are used for the purpose of intoxication practically everywhere (see drug trafficking).

Classification of Psychoactive Drugs

Pharmacologists, who study the effects of drugs, classify psychoactive drugs according to what they do to those who take them. Drugs that speed up signals passing through the nervous system, which is made up of the brain and spinal cord, and produce alertness and arousal and, in higher doses, excitability, and inhibit fatigue and sleep, are called stimulants. They include the amphetamines, cocaine, caffeine, and nicotine. Drugs that retard, slow down, or depress signals passing through the central nervous system and produce relaxation, a lowering of anxiety, and, at higher doses, drowsiness and sleep, are called depressants. They include sedatives, such as barbiturates, methaqualone, and alcohol, and tranquilizers, such as Valium. Constituting one distinct kind of depressants are those which dull the mind's perception of pain and in medicine are used as painkillers, or analgesics. These drugs are called narcotics. They include heroin, morphine, opium, and codeine. In addition to their painkilling properties, these depressants also produce a strong high and are intensely dependency-producing. Some drugs cannot be placed neatly in this stimulant-depressant spectrum. Hallucinogens include LSD, mescaline, and psilocybin. Such drugs produce unusual mental states, such as psychedelic visions. Marijuana is generally regarded as not belonging to any of these categories but as a drug type unto itself.
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History of Drug Abuse in the United States

During the 19th century there were virtually no controls on the importation, sale, purchase, possession, or use of psychoactive drugs at the federal level and very few at the state level. Dangerous substances such as opium, cocaine, and morphine were basic ingredients in patent medicines that could be purchased by anyone for any reason, without a prescription. These nostrums were used to cure headaches, toothaches, depression, nervousness, alcoholism, menstrual crampsÑin fact, practically every human ailment.

As a result of the ready availability of addicting drugs, and as a ...

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