Psychoactive drug
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A psychoactive drug, psychopharmaceutical, psychoactive agent, or psychotropic drug is a chemical substance that changes the function of the nervous system and results in alterations of perception, mood, cognition, and behavior.[1] These substances may be used medically, recreationally, for spiritual reasons (for example, by altering one's consciousness, as with entheogens for ritual, spiritual, or shamanic purposes), or for research.[2] Some categories of psychoactive drugs may be prescribed by physicians[3] and other healthcare practitioners because of their therapeutic value.
Some psychoactive substances may be used in detoxification and rehabilitation programs for people who may have become dependent upon or addicted to other mind-altering or mood-altering substances.[4] Drug rehabilitation attempts to reduce addiction through a combination of strategies such as psychotherapy, support groups, and sometimes medication such as psychoactive substances.[5]
Psychoactive substances often bring various changes in consciousness and mood that the user may find rewarding and pleasant (e.g., euphoria or a sense of relaxation) or advantageous in an observable or measurable way (e.g., increased alertness).[6] Substances that are rewarding and thus positively reinforcing have the potential to induce a state of addiction – compulsive drug use despite negative consequences.[7] In addition, sustained use of some substances may produce physical or psychological dependence, or both, associated with somatic or psychological-emotional withdrawal states, respectively.[7]
Psychoactive drug misuse, dependence, and addiction have resulted in legal measures and moral debate.[8] Governmental controls on manufacture, supply, and prescription attempt to reduce problematic medical drug use. Ethical concerns have also been raised about the overuse of these drugs clinically and about their marketing by manufacturers.[9] Popular campaigns to decriminalize[10] or legalize the recreational use of certain drugs (e.g., cannabis) are also ongoing.
History
Psychoactive drug use can be traced back to prehistory. There is archaeological evidence of the use of psychoactive substances, mostly plants, dating back at least 10,000 years and historical evidence of cultural use over the past 5,000 years.[13] The chewing of coca leaves, for example, dates back over 8,000 years ago in Peruvian society.[14][15]
Medicinal use is one important facet of psychoactive drug use. However, some have postulated the urge to alter one's consciousness as primary, as well as the drive to satiate thirst, hunger, or sexual desire.[16] Supporters of this belief contend that the history of drug use, and even children's desire for spinning, swinging, or sliding indicate that the drive to alter one's state of mind is universal.[17]
One of the first people to articulate this point of view, set aside from a medicinal context, was American author Fitz Hugh Ludlow (1836–1870) in his book The Hasheesh Eater (1857):
[D]rugs are able to bring humans into the neighborhood of divine experience and can thus carry us up from our personal fate and the everyday circumstances of our life into a higher form of reality. It is, however, necessary to understand precisely what is meant by the use of drugs. We do not mean the purely physical craving ... That of which we speak is something much higher, namely the knowledge of the possibility of the soul to enter into a lighter being, and to catch a glimpse of deeper insights and more magnificent visions of the beauty, truth, and the divine than we are normally able to spy through the cracks in our prison cell. But there are not many drugs which have the power of stilling such craving. The entire catalog, at least to the extent that research has thus far written it, may include only opium, hashish, and in rarer cases alcohol, which has enlightening effects only upon very particular characters.[18]
During the 20th century, many governments across the world initially responded to the use of recreational drugs by
[T]he existing drug policies have failed in their intended goals of addressing the problems of crime, drug abuse, addiction, juvenile drug use, stopping the flow of illegal drugs into this country and the internal sale and use of illegal drugs. By fighting a war on drugs the government has increased the problems of society and made them far worse. A system of regulation rather than prohibition is a less harmful, more ethical and a more effective public policy.[19][failed verification]
In some countries, there has been a move toward harm reduction by health services, where the use of illicit drugs is neither condoned nor promoted, but services and support are provided to ensure users have adequate factual information readily available, and that the negative effects of their use be minimized. Such is the case of the Portuguese drug policy of decriminalization, which achieved its primary goal of reducing the adverse health effects of drug abuse.[20]
Types
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Psychoactive drugs are divided according to their pharmacological effects. Common subtypes are listed below:
- Anxiolytics. Medicinally used to reduce the symptoms of anxiety, and sometimes insomnia.
- Example: benzodiazepines such as Xanax and Valium; barbiturates
- Empathogen–entactogens. A drug class that alters one's emotional state, often resulting in an increased sense of empathy, closeness, and emotional communication.
- Example: AMT
- Example:
- Stimulants. This class increases activity, or arousal, of the central nervous system. Stimulants may be used to enhance alertness, attention, cognition, mood and physical performance. Some stimulants are used medicinally to treat individuals with ADHD and Narcolepsy.
- Examples: amphetamines, caffeine, cocaine, nicotine
- Depressants Depressants, opposite to stimulates, reduces (or depresses) activity and stimulation in the central nervous system. Drugs within this classification includes sedatives, hypnotics, and opioids. This classification encompasses a spectrum of substances with sedative, soporific, and anesthetic properties.
- Examples: Ethanol (alcohol), opioids such as morphine, fentanyl, and codeine, cannabis, barbiturates, and benzodiazepines.
- psychedelics, dissociatives, and deliriants. This category encompasses all substances that produce distinct alterations in perception, sensation of space and time, and emotional states.[21]
- Examples:
Uses
Anesthesia
Pain management
Psychoactive drugs are often prescribed to
Mental disorders
Psychiatric medications are psychoactive drugs prescribed for the management of
- eating disorders, and borderline personality disorder.[27]
- Stimulants, used to treat disorders such as attention deficit hyperactivity disorder and narcolepsy, and for weight reduction.
- Antipsychotics, used to treat psychotic symptoms, such as those associated with schizophrenia or severe mania, or as adjuncts to relieve clinical depression.
- Mood stabilizers, used to treat bipolar disorder and schizoaffective disorder.
- Anxiolytics, used to treat anxiety disorders.
- hypnotics, sedatives, and anesthetics, depending upon dosage.
In addition, several psychoactive substances are currently employed to treat various addictions. These include
Exposure to psychoactive drugs can cause changes to the brain that counteract or augment some of their effects; these changes may be beneficial or harmful. However, there is a significant amount of evidence that the relapse rate of mental disorders negatively corresponds with the length of properly followed treatment regimens (that is, relapse rate substantially declines over time), and to a much greater degree than placebo.[29]
Recreation
Many psychoactive substances are used for their mood and perception altering effects, including those with accepted uses in medicine and psychiatry. Examples of psychoactive substances include
Classes of drugs frequently used recreationally include:- euphoriceffects.
- deliriants), which induce perceptual and cognitive alterations.
- Hypnotics, which depress the central nervous system.
- Opioid analgesics, which also depress the central nervous system. These are used recreationally because of their euphoric effects.
- Inhalants, in the forms of gas aerosols, or solvents, which are inhaled as a vapor because of their stupefying effects. Many inhalants also fall into the above categories (such as nitrous oxide which is also an analgesic).
In some modern and ancient cultures, drug usage is seen as a status symbol. Recreational drugs are seen as status symbols in settings such as at nightclubs and parties.[31] For example, in ancient Egypt, gods were commonly pictured holding hallucinogenic plants.[32]
Because there is controversy about regulation of recreational drugs, there is an
Some people who take psychoactive drugs experience drug or substance induced psychosis. A 2019 systematic review and meta-analysis by Murrie et al. found that the pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%–35%), compared with 36% (95% CI 30%–43%) for brief, atypical and not otherwise specified psychoses.[35] Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%–46%), hallucinogens (3 studies, 26%, CI 14%–43%) and amphetamines (5 studies, 22%, CI 14%–34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up.[35]
Ritual and spiritual
Certain psychoactives, particularly hallucinogens, have been used for religious purposes since prehistoric times. Native Americans have used peyote cacti containing mescaline for religious ceremonies for as long as 5700 years.[36] The muscimol-containing Amanita muscaria mushroom was used for ritual purposes throughout prehistoric Europe.[37]
The use of entheogens for religious purposes resurfaced in the West during the counterculture movements of the 1960s and 70s. Under the leadership of Timothy Leary, new spiritual and intention-based movements began to use LSD and other hallucinogens as tools to access deeper inner exploration. In the United States, the use of peyote for ritual purposes is protected only for members of the Native American Church, which is allowed to cultivate and distribute peyote. However, the genuine religious use of peyote, regardless of one's personal ancestry, is protected in Colorado, Arizona, New Mexico, Nevada, and Oregon.[38]
Military
Psychoactive drugs have been used in military applications as non-lethal weapons.
Both military and civilian American intelligence officials are known to have used psychoactive drugs while interrogating captives apprehended in its "war on terror". In July 2012 Jason Leopold and Jeffrey Kaye, psychologists and human rights workers, had a Freedom of Information Act request fulfilled that confirmed that the use of psychoactive drugs during interrogation was a long-standing practice.[39][40] Captives and former captives had been reporting medical staff collaborating with interrogators to drug captives with powerful psychoactive drugs prior to interrogation since the very first captives release.[41][42] In May 2003 recently released
Additionally, militaries worldwide have used or are using various psychoactive drugs to improve performance of soldiers by suppressing hunger, increasing the ability to sustain effort without food, increasing and lengthening wakefulness and concentration, suppressing fear, reducing empathy, and improving reflexes and memory-recall among other things.[43][44]
The first documented case of a soldier overdosing on methamphetamine during combat, was the Finnish corporal Aimo Koivunen, a soldier who fought in the Winter War and the Continuation War.[45][46]
Route of administration
Psychoactive drugs are administered via oral
The psychiatric drugs
Determinants of effects
The theory of dosage, set, and setting is a useful model in dealing with the effects of psychoactive substances, especially in a controlled therapeutic setting as well as in recreational use.
- Dosage
The first factor, dosage, has been a truism since ancient times, or at least since Paracelsus who said, "Dose makes the poison." Some compounds are beneficial or pleasurable when consumed in small amounts, but harmful, deadly, or evoke discomfort in higher doses.
- Set
The set is the internal attitudes and constitution of the person, including their expectations, wishes, fears, and sensitivity to the drug. This factor is especially important for the hallucinogens, which have the ability to make conscious experiences out of the unconscious. In traditional cultures, set is shaped primarily by the worldview, health and genetic characteristics that all the members of the culture share.
- Setting
The third aspect is setting, which pertains to the surroundings, the place, and the time in which the experiences transpire.
This theory clearly states that the effects are equally the result of chemical, pharmacological, psychological, and physical influences. The model that Timothy Leary proposed applied to the psychedelics, although it also applies to other psychoactives.[49]
Effects
Psychoactive drugs operate by temporarily affecting a person's
Drugs that increase activity in particular neurotransmitter systems are called
Exposure to a psychoactive substance can cause changes in the structure and functioning of
Affected neurotransmitter systems
The following is a brief table of notable drugs and their primary neurotransmitter, receptor or method of action. Many drugs act on more than one transmitter or receptor in the brain.[52]
Addiction and dependence
Addiction and dependence glossary[62][63][64] | |
---|---|
| |
Psychoactive drugs are often associated with
Many professionals, self-help groups, and businesses specialize in drug rehabilitation, with varying degrees of success, and many parents attempt to influence the actions and choices of their children regarding psychoactives.[67]
Common forms of
Legality
The legality of psychoactive drugs has been controversial through most of recent history; the
In the United States, the Food and Drug Administration (FDA) has authority over all drugs, including psychoactive drugs. The FDA regulates which psychoactive drugs are over the counter and which are only available with a prescription.[72] However, certain psychoactive drugs, like alcohol, tobacco, and drugs listed in the Single Convention on Narcotic Drugs are subject to criminal laws. The Controlled Substances Act of 1970 regulates the recreational drugs outlined in the Single Convention on Narcotic Drugs.[73] Alcohol is regulated by state governments, but the federal National Minimum Drinking Age Act penalizes states for not following a national drinking age.[74] Tobacco is also regulated by all fifty state governments.[75] Most people accept such restrictions and prohibitions of certain drugs, especially the "hard" drugs, which are illegal in most countries.[76][77][78]
In the medical context, psychoactive drugs as a treatment for illness is widespread and generally accepted. Little controversy exists concerning
Effect on animals
A number of animals consume different psychoactive plants, animals, berries and even fermented fruit, becoming intoxicated. An example of this is cats after consuming catnip. Traditional legends of sacred plants often contain references to animals that introduced humankind to their use.[81] Animals and psychoactive plants appear to have co-evolved, possibly explaining why these chemicals and their receptors exist within the nervous system.[82]
Widely used psychoactive drugs
This is a list of commonly used drugs that contain psychoactive ingredients. Please note that the following lists contains legal and illegal drugs (based on the country's laws).
- Alcohol
- Benzodiazepines
- Caffeine
- Cannabis
- Cocaine
- Heroin
- LSD
- Methamphetamine
- Ecstasy
- Nicotine
- Opioids
- Psilocybin mushrooms
See also
- Contact high
- Counterculture of the 1960s
- Demand reduction
- Designer drug
- Drug
- Drug addiction
- Drug checking
- Drug rehabilitation
- Hamilton's Pharmacopeia
- Hard and soft drugs
- Harm reduction
- Neuropsychopharmacology
- Psychopharmacology
- Poly drug use
- Project MKULTRA
- Psychedelic plants
- Psychoactive fish
- Recreational drug use
- Responsible drug use
- Self-medication
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