The commission identified heroin as the number one drug problem because heroin addiction may lead to criminal behavior to pay for the drug. Adding to the problem is the fact that chemically similar drugs can be synthesized and sold on the street because they are not yet classified as controlled substances.
In a 1999 household survey by the Substance Abuse and Mental Health Services Administration an estimated 14.8 million people in the United States classified themselves as current illicit drug users. Among youths aged 12 to 17, close to 8 percent of respondents were regular users of marijuana. The percentage of youths in the same age range who used cocaine at least once a month was 49.8 percent.
The survey also reported an estimated 1.6 million U.S. residents used prescription drugs for nonmedical purposes in 1998. The state with the highest rates of dependence on illicit drugs was Alaska with 2.8 percent of its 12 and older population dependent on illicit drugs and 7.3 percent dependent on illicit drugs or alcohol. (Encarta ® 2006. © 1993-2005 Microsoft Corporation)
Psychoactive Drugs are chemical substances that alter mood, behavior, perception, or mental functioning. Throughout history, many cultures have found ways to alter consciousness through the ingestion of substances. In current professional practice, psychoactive substances known as psychotropic drugs have been developed to treat patients with severe mental illness.
Psychoactive substances exert their effects by modifying biochemical or physiological processes in the brain. The message system of nerve cells, or neurons, relies on both electrical and chemical transmission. Neurons rarely touch each other; the microscopic gap between one neuron and the next, called the synapse, is bridged by chemicals called neuroregulators, or neurotransmitters. Psychoactive drugs act by altering neurotransmitter function.
The drugs can be divided into six major pharmacological classes based on their desired behavioral or psychological effect: alcohol, sedative-hypnotics, narcotic analgesics, stimulant-euphoriants, hallucinogens, and psychotropic agents.
Alcohol has always been the most widely used psychoactive substance. In most countries it is the only psychoactive drug legally available without prescription. Pleasant relaxation is commonly the desired effect, but intoxication impairs judgment and motor performance. When used chronically, alcohol can be toxic to liver and brain cells and can be physiologically addicting, producing dangerous withdrawal syndromes. (Encarta ® 2006. © 1993-2005 Microsoft Corporation)
With the exception of treatment of opioid dependence, medical attention to the problems of the drug abuser is largely confined to dealing with overdoses, acute reactions to drug ingestion, and the incidental medical consequences of drug use such as malnutrition and medical problems caused by unsterilized needles. A
busers of barbiturates and amphetamines may require hospitalization for detoxification, as is common among alcoholics. Others, such as those arrested repeatedly for possession of marijuana, may, in lieu of imprisonment, be forced to undergo treatment designed primarily for opioid abusers. Whatever the substance abused, the goal of most treatment programs is to foster abstinence in the patient.
Two types of treatment programs are used for most opioid users. Therapeutic communities require the drug abuser to take personal responsibility for his or her problem. Typically, the idea behind this treatment is that the drug abuser is emotionally immature and must be given a second chance to grow up. Harsh encounters with other members of the community are typical; the support of others, together with status and privilege, are used as rewards for good behavior.
The other model for opioid abuse treatment is the use of heroin substitutes. One such substitute is methadone, which acts more slowly than heroin but is still addictive. The idea is to help the user gradually withdraw from heroin use while removing the need for finding the drug on the street. A more recent treatment drug, naltrexone, is nonaddictive but does not provide an equivalent “high;” it also cannot be used by persons with liver problems, which are common among addicts.
Encarta ® 2006. © 1993-2005 Microsoft Corporation
National Institute on Drug Abuse, http://www.nida.nih.gov/
Paul M. Insel and Walton T. Roth, The Use and Abuse of Psychoactive Drugs ‘Core concepts in Health’ Chapter 7
U.S. Substance Abuse and Mental Health Services Administration]]>