USE DRUGS---- PAY TO DIE

DRUGS ADDICTION

A drug, broadly speaking, is any chemical substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in medicine, government regulations, and colloquial usage. Drug addiction is widely 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, everywhere 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 the American Society of Addiction Medicine definition, drug addiction differs from drug dependence and drug tolerance.[3TYPES OF DRUGSThere are two types of Drugs

1) Beneficial medication

2) Negative addiction

Q1)

What causes drug addiction? Many factors influence a persons initial drug use. Personality characteristics, peer pressure, and psychological stress can all contribute to the early stage of drug abuse. These factors are less important as drug use continues and the person repeatedly experiences the potent pharmacological effects of the drug. This chemical action, which stimulates certain brain systems, produces the addiction, while other psychological and social factors become less and less important in influencing the individuals behavior. When the pharmacological action of a drug dominates the individuals behavior and the normal psychological and social control of behavior is no longer effective, the addiction is fully developed. This self-perceived "loss of control" is a common feature of drug addiction and reflects the biological nature of the problem.

Q2) How addictive are different drugs/narcotics?

Answer:

How easily someone gets addicted to drugs depends on various things. A lot of people, who use drugs for the first time, do that to experiment, out of curiosity, or because they are looking for a certain feeling. Whether someone continues to use drugs after that first time depends, among others things, on the effects of the drugs and the susceptibility of the person to them. Also the motives for using drugs are involved; someone who uses because he feels bad runs more risk of becoming a problematic user than someone who uses and feels good.

There is no drug that leads to addiction when only used once. Therefore, it is not possible to maliciously make another person addicted, for instance, by putting drugs in his/her drink. It all depends on the kind of drugs and the kind of person who gets in touch with them. Some drugs lead to more addiction problems, like social problems and criminal activities, than other drugs. Heroin, for example, is very addictive. Cocaine and amphetamines are less addictive, and XTC, hashish and marijuana even less. Crack cocaine is more addictive than cocaine alone. Nevertheless, it is true that someone who is addicted to, say, XTC is more likely to get in contact with dealers and users of heroin, for example.

MAIN GROUPS OF DRUGSThere are three main groups of drugs: depressants, stimulants, and hallucinogens. Most drugs fit into one or more of these groups.

Depressants

These drugs slow down the central nervous system. They make people feel relaxed, less tense, and less aware of events around them.

Examples of depressants are:

Alcohol Heroin Inhalants Sleeping Pills Ketamine Prescription Pain Killers

Opioids OxyContin: Straight talk Stimulants

These drugs speed up the central nervous system. They help people feel more alert and they increase the users physical energy. Stimulants are taken to make people feel happy and to decrease appetite.

Examples of stimulants are:

Tobacco Cocaine Crack Amphetaminess (Including Speed and Ice)

Methamphetamine Hallucinogens

These drugs are sometimes called mind-altering or mind-expanding drugs. They can increase a persons awareness of sight, touch, taste, feeling and hearing. Objects may take on different shapes and sizes, sounds may be heard louder or softer. Hallucinogens can also alter a persons mood.

Examples of hallucinogens are:

Marijuana (Cannabis or Weed) Ecstasy LSD (lysergic acid diethylamide) Other Drugs

Steroids Herbal Q3) What are psychoactive drugs? Many drugs interact with brain mechanisms involved in affect, cognition, and behavior. These compounds are termed psychoactive drugs. Drugs are usually classified according to their primary therapeutic actions. Antipsychotic drugs are used to treat schizophrenia and produce a normalization of the disordered thought processes associated with this illness. Antidepressant drugs are used to treat psychological depression and produce a normalization of disturbed affective states characteristic of depression. And antianxiety drugs (i.e., anxiolytics) are used to treat anxiety and produce a calming action in nervous individuals. These and numerous other drugs have important clinical uses and have revolutionized the treatment of many mild to severe mental disorders. Some work at the ASnet and its laboratory facilitythe Addiction Research Unit (ARU) at the University at Buffaloinvestigates the actions of these drugs, but research focuses on psychoactive drugs that are addictive. Recent work has also investigated the effects of mildly psychoactive compounds found in over-the-counter medicines (e.g., pseudoephedrine, diphenhydramine) and compares their effects with prototypic addictive drugs (e.g., cocaine, heroin). This comparison helps sharpen the distinction between addictive and nonaddictive substance use and is used in comparing the effects of other commonly used substances (i.e., caffeine, nicotine).

Behavioral Perspectives on the Neuroscience of Drug AddictionAbstract LEVELNeuroscientific approaches to drug addiction traditionally have been based on the premise that addiction is a process that results from brain changes that in turn result from chronic administration of drugs of abuse. An alternative approach views drug addiction as a behavioral disorder in which drugs function as preeminent reinforcers. Although there is a fundamental discrepancy between these two approaches, the emerging neuroscience of reinforcement and choice behavior eventually may shed light on the brain mechanisms involved in excessive drug use. Behavioral scientists could assist in this understanding by devoting more attention to the assessment of differences in the reinforcing strength of drugs and by attempting to develop and validate behavioral models of addiction.

Drug addiction continues to take a massive toll in terms of economic loss and human misery. For the purpose of this article, we define drug addiction as the final outcome of a process that begins with occasional drug-taking, and ends with consumption of excessive amounts of drug to the detriment of society and the individual. Drug addiction is a chronic, relapsing disorder that provides research and treatment challenges to scientists from widely ranging disciplines. Among these, geneticists and epidemiologists are particularly intrigued by the fact that drug-taking behavior exists on a continuum in humans: some people engage in it to excess, most in moderation, and many not at all.

Clearly, genetic differences and specific societal-environmental conditions can play a role in the development of drug abuse. Psychiatrists and clinical psychologists attend more to the individual characteristics of the drug abuser, and consider how other cognitive co-morbidities, such as anxiety or depression, contribute to the development and maintenance of drug abuse and addiction. Pharmacologists tend to focus on the drugs themselves, studying their mechanisms of action and attempting to develop potential drug antagonists that might be useful in the treatment of drug abuse. And behavioral pharmacologists look for clues to the etiology and control of drug abuse in the effects of drugs on the behavior of humans or animals under controlled experimental conditions.

Neuroscience, because it searches for relationships between brain function and behavior, is in an especially appropriate position to study the neural correlates of the behavior of drug abuse, and neuroscientists have contributed a tremendous amount to our understanding of the effects of drugs of abuse on the brain and nervous system. This article will address some of the neuroscience research on the problem of drug abuse, but will touch only on limited aspects of what is a massive area of scientific inquiry.

The first section on brain reward circuitry is included because this is the neuroanatomical basis for virtually all hypotheses and research on the neuroscience of drug abuse. The next section describes some recent research from a few of the many neuroscientists who have concentrated their efforts on drug addiction. What is interesting and somewhat distressing for behavioral scientists is how little behavior is regarded in much of this research.

Because drug addiction generally is conceived as a process caused directly by chronic administration of drugs of abuse, the investigative effort is concentrated on a search for changes in the morphology or molecular biology in relevant parts of the brain as a function of chronic drug administration. The neuroscience skills and techniques used by these investigations are formidable, and interesting neuronal changes have been observed following chronic drug administration. Even more technically fascinating is the possibility of recreating these localized neurobiological changes in the absence of drug administrationin effect producing an addicted brain without giving the addicting substance. Animals so treated then can be evaluated behaviorally, to determine whether they are, in fact, addicted. Unfortunately, the behavioral measures used in these types of studies often are weak and not validated, bringing the conclusions of much of this work into question.

Our generally negative critique of much of the most prominent work on the neuroscience of drug abuse is followed by a description of a strictly behavioral approach to drug abuse. This behavioral approach is presented as an additional avenue to be explored by neuroscientists and others investigating drug abuse. We argue that drug addiction involves the excessive choice of a drug over other environmental stimuli, perhaps because the drug is a more potent reinforcer relative to competing reinforcers in the addict's life. This section serves two purposes: one is to present an option to the neuroscience approach and to suggest how addiction can be described more appropriately; the other is to prepare for the next section which returns to neuroscience, but in a more behavioral context.

In this next section, we describe some experiments that indicate that neuroscience embedded in a more behavioral context potentially can identify the neurological correlates of behavioral constructs, such as reinforcer strength. For example, investigations of the brain correlates of choice eventually may clarify the regions in the brain and the patterns of brain activity that are correlated with preference for higher magnitude reinforcers. Although the work described in this section does not involve studies of drugs as reinforcers per se, it easily could be extended to complement a behavioral model of addiction.

The behavioral approach to drug addiction presupposes that drugs are not qualitatively different from non-drug reinforcers. The last section of this article describes recent neuroscientific studies that assess the validity of this assumption. For example, do the brain changes that accompany reinforcement differ if the stimulus is cocaine compared with other non-drug stimuli?

Finally, the perspectives offered in this paper are limited by both space and our time. It would add useful knowledge to review what is known about the neuroanatomy and neurophysiology of Pavlovian conditioning (e.g., Cardinal & Everitt, 2004; LeDoux, 2000). Also useful would be a discussion of several psychological theories that have been posited to explain drug addiction, many of which were put forward by neuroscientists and based on hypothesized or observed drug-induced brain changes (e.g., Koob & Le Moal, 1997; Lubman, Yucel, & Pantelis, 2004; Robinson & Berridge, 1993, 2000). However, our interest in data rather than theories led us to exclude this conjunction of drug addiction and neuroscience.

Behavioral scientists generally regard drug addiction as a behavioral disorder that results when drug reinforcers assume control over a substantial portion of an individual's behavioral repertoire (Higgins, Heil, & Lussier, 2004). As such, addiction to drugs can be considered a form of excessive behavior, occurring when other activities are expected and appropriate. Overeating and excessive gambling are other examples of inappropriate and excessive behaviors often attributed to an addiction of some kind, but do not involve drug administration. A characteristic of each is that initial exposure to a reinforcing stimulus (e.g., euphoria, food, money) is followed by a progressive escalation in the behavior that produced it. Behavior that results in the availability of these reinforcers may eventually dominate the behavioral repertoire simply because these stimuli function as more potent reinforcers than others available in an individual's environment. This may be due, in part, to genetic predispositions or, more likely, to particular learning histories combined with relatively easy access to these reinforcers (i.e., a high rate of reinforcement) and insufficient contact with alternative sources of reinforcement.

One advantage of a behavioral approach to drug abuse is that, contrary to the drug-based neuroscience theories, it not only accounts for excessive behavior that does not involve drugs, but it also accounts for situations in which repeated exposure to drugs is not followed by addiction. For example, people who use drugs to excess while they are young are likely to stop using drugs when they get older, a process called maturing out (Chen & Kandel, 1995). When a young person is exposed to reinforcers that are incompatible with drug taking, such as those associated with marriage, family, and employment, the relative reinforcing functions of drugs usually decrease to the point where they no longer maintain the drug-taking behavior. People who do not mature out of their excessive drug taking may not have these other reinforcers available, may not seek them out, or may not find them to be superior to the drugs they are taking due to particular learning histories and/or genetic predispositions.

As a second example of repeated drug use not leading inevitably to addiction, consider that soldiers who used heroin to excess while in combat situations in Vietnam typically did not continue this use when they returned home (Robins, 1994). A third situation occurs in patients who self-administer opioids for the treatment of pain but have no inclination to continue to use the drug following recovery. The reinforcing effect of the drug in this case is related to its ability to reduce pain, and following recovery there is no reason to continue to use the drug. There is also the fact that a great many people have successfully stopped smoking cigarettes, at least in part because the health risks became overwhelmingly obvious (Centers for Disease Control and Prevention, 2004). It clearly is not the case that simple exposure to drugs, even in the context of their strong reinforcing effects, necessarily leads to a permanent state of drug addiction.

A behavioral approach also is much more hopeful about the potential for treating drug addiction (Higgins et al., 2004). Theories that subscribe to drug-induced changes in the nervous system present more hopeless scenarios (once-a-drug-addict-always-a-drug-addict) that are more likely bereft of treatment possibilities. Behavioral management of drug use, however, is one of the most successful intervention strategies, particularly with cocaine abuse for which there is no pharmacological treatment yet available. Contingency management procedures typically involve giving patients vouchers if they have drug-free urine samples on a regular basis. The vouchers can be exchanged for various goods and services. Some contingency management therapies increase the value of the voucher over time, as long as the client remains drug free, and resets the value if cocaine use is detected or if the client refuses to submit a urine sample. These procedures were far superior to standard therapy in producing drug-free clients and retaining them in treatment over a 24-week study (Higgins et al., 1993). At this point, a behavioral approach is uniquely able to generate successful strategies for prevention and treatment.

If one finds a behavior/reinforcement approach to drug abuse and addiction more satisfying than the notion that drugs themselves are responsible for drug addiction, does that make neuroscience an irrelevant perspective on drug addiction? Certainly not. But it does mean that a rather different type of neuroscience should be evaluated for what it might contribute to our understanding of addictive behavior. For example, neuroscientists are beginning to look at activity in the brain that accompanies choices between reinforcing stimuli that differ in magnitude or frequency, as described below (e.g., Cromwell & Schultz, 2003; Platt & Glimcher, 1999). Although drugs have yet to be evaluated in this type of work, the work could easily progress to this point in the future, and understanding the neurological correlates of the reinforcing strength of drugs may lead to a more unified account of drug addiction.SUBSTANCE RELATED DISORDERS

Substance Use Disorders

Substance Dependence

Substance Abuse

Substance-Induced DisordersSUBSTANCE DEPENDENCIES OF

Tolerance

Withdrawal

Use beyond intention

Inability to reduce usage

Time-consuming

Valued activities are abandoned or reduced

Use continues despite problems

SUBSTANCE ABUSE OF

Failure to meet obligations

High risk behaviors under the influence

Legal problems

Persistent social or relational problems

SUBSTANCE INDUCED DISORDERS

Substance Intoxication

Substance Withdrawal

Substance-Induced Delirium

Substance-Induced Persisting Dementia

Substance-Induced Persisting Amnestic Disorder

Substance-Induced Psychotic Disorder

Substance-Induced Mood Disorder

Substance-Induced Anxiety Disorder

Substance-Induced Sexual Dysfunction

Substance-Induced Sleep Disorder

Hallucinogen Persisting Perception Disorder (Flashbacks)

Specific substance labels for disorders Each of the above diagnoses is further multiplied by the number of specific substances or categories of substances which may produce it.

The diagnostic label begins with the name of the responsible substance or category

Examples of substance labels DSM-IV lists 11 substances or categories:

Alcohol

Amphetamine

Caffeine

Cannabis

Cocaine

Hallucinogen

Inhalant

Nicotine

Opioid

Phencyclidine

Sedative, Depressant,

or Anxiolytic; plus

Polysubstance

Other.

Alcohol as an example Substance use disorders:

Alcohol Dependence

Alcohol Abuse

Substance-Induced Disorders

Alcohol Intoxication

Alcohol Withdrawal

Alcohol Intoxication Delirium

Alcohol Withdrawal Delirium

And so on.CASE STUDIES

CASE STUDY 1

From Pakistan(OMAR MINHAS KARACHI)Im 36 years old and come from a very loving family.

But at the age of 14 I began to have problems at

school. Exams stressed me, other pupils taunted me

because I was overweight and I didnt have a girlfriend.

I began to feel I didnt fit in, so to win acceptance I

turned to stealing. I knew it was wrong but it helped

me to make friends and the girls began to like me.

Spiralling into addiction

I left school at 16 and began stealing cars. I even stole

from my parents to pay for new clothes and alcohol.

I constantly lied to them and told them I had started a

new job, only to leave home at 8.00am to hang about

the streets with my pals.

Then I was introduced to cannabis and quickly became

hooked. It seemed to boost my confidence. As I

spiralled into addiction I broke every moral boundary

I ever had. When I was 17 the KARACHI police arrested me

regularly and I spent a month in prison. Things got so

bad that my parents kicked me out.

At 19 I started doing speed at parties and at 20

I joined the rave scene and used ecstasy and acid

tablets like they were sweets. By now I was selling

cannabis to fund my habit. My run-ins with the police

got worse and I spent another two months in prison.

At 21 I started to use cocaine. I was at a rave and

having popped about four ecstasy pills I thought,

What the hell!

By now I was losing friends fast. They urged me to get

a grip of myself but I thought they were the idiots

who were missing out, not me. I had plenty of signs to

tell me I was an addict but I was in denial.

By the time I was 22 I started selling ecstasy and soon

owed the dealers money. I realised that if I didnt sort

myself out I was going to get hurt. Then someone

suggested going on a SAWAT or AFGANISTAN and I thought

that might help.

There were no drugs on the SAWAT so I took to

drinking heavily without realising I was substituting

my addiction.. Within months I was selling weed. I bought it

cheap in SAWAT, packing rucksacks full of it and

walking straight back over the border. Flush with

money, I met a girl who introduced me to heroin. My

money soon went. I got careless with my dealings and

at the age of 25 I got caught. The police raided me

and I was put in an SAWAT prison.

How heroin almost

destroyed me

I returned to the KARACHI hoping to get off heroin. I tried

methadone programmes, sleeping pills

and short-term counselling but all my efforts failed.

I was in a hopeless state and when the girl I met in

SAWAT left me, my whole world caved in.

Within days I injected for the first time not just

heroin but crack as well. That was a near-fatal

decision. My habit overpowered me. I was living from

day to day by shoplifting. I smelled bad, looked awful

and had no friends left apart from other addicts. All

my veins collapsed in my arms, so I injected into my

legs. They soon collapsed too and I switched to my

addiction.CASE STUDY 2 Debbie

I was in a caf, shaking, lonely and sweating profusely. I needed a fix! I picked up a magazine and came across an advertisement for Drugslines Support and Crisis Line. But I didnt ring it. I couldnt accept I was a junkie.

I went further downhill. I was living in a one-roomed, dirty bedsit where men visited me so that I could scrape a living and afford my drugs. My life was going nowhere. My body was in ruins.

In despair I finally called Drugsline. I was scared and in tears but a friendly voice calmed me and assured me I was not alone. I desperately needed their help and advice, though it took time for me to accept what I was being told! After that my counsellor stuck by me all the time and was stillthere for me when I went into a treatment centre.

Without Drugslines help I couldnt have done it. Even though the disease of addiction is with me for life I am growing stronger day by day and making real friends. Now I face up to my problems rather than using drugs to forget my pain.Debbie, aged 20. CASE STUDY 3 Inadequacy, Fear and Dependency

Deep down I was miserable. I lacked confidence and often my thoughts gave way to despair. Feelings of anger, jealousy and depression the buried resentments of an unhappy upbringing welled up inside me. But above all there was fear.

I masked all of this by playing the macho man. I desperately needed to be accepted. At times my inadequacies and fears were so immense that I became almost suicidal.

Then I got lucky and discovered drink and drugs. They gave my life a whole new meaning. They changed the way I felt inside. When I felt fear, a stiff drink would fix it. When I felt inadequate, a joint would calm me down and boost my confidence.

Of course, it didnt last. All my despairs, frustrations and fears came flooding back, intensified many times over. But now there were other feelings too. Shame, self-loathing, damaged pride and the dreaded feelings of guilt. Dependency hadnt worked. It was a living hell.

After 10 years of addiction I had reached the gutter. But this time fear saved me the sheer fear of death.

My road to recovery wasnt easy. It began with Twelve Step meetings at AA and NA. Then I met a counsellor who accepted me for what I was and gradually won my friendship and trust, helping me to accept my feelings and understand them. My recovery from addiction has been tough but through the work of Drugsline, now my greatest reward is being able to help others to set out on the same journey from dependency to recovery free from drugs and drink, and free from the inner fears they produce.A Drugsline counsellors account of his own experiences and how he now helps fellow sufferers.