Why do some drugs make us feel so good that we can very easily become addicted to them? It is a good question, that is been only partially elucidated. I was going to write this solely about addictive recreational drugs, but I have expanded it to include non-addictive recreational drugs like psychedelics. Well the reason for their pleasurable effects is usually roughly the same ― they increase the levels of a neurotransmitter called dopamine in the synapses of the mesolimbic pathway (MLP) of the brain. There are six major categories of recreational drugs:
- Stimulants (“uppers”, such as amfetamines, cocaine, caffeine and nicotine). These cause increased alertness and generally speed up communication in the brain.
- Depressants (“downers”, such as alcohol, benzodiazepines, barbiturates, etc.). These are the drugs that calm one down and often cause drowsiness as their chief desired action.
- Cannabinoids (compounds with cannabis-like properties which they exert by activating the cannabinoid receptors)
- Opioids (compounds with opium-like properties which they exert by activating the opioid receptors)
- Hallucinogens (compounds who’s chief recreational uses arise from their ability to induce hallucinations)
- Others (these are agents that do not fit into the mould of the other drugs of abuse, they are usually aerosolized agents like butane)
Points of misunderstandingsEdit
There is some overlap between these different categories. For example, opioids and cannabinoids have depressant actions as do certain hallucinogens such as the deliriants (such as hyoscine, found in certain plants) and dissociatives (such as ketamine and phencyclidine). Plus cannabinoids are known to induce hallucinations and delusions in some susceptible individuals. Certain opioids also induce hallucinations at even therapeutic doses (which are usually significantly lower than their recreational doses).
Drug policies, my viewsEdit
All drugs carry a potential for harm, despite this I am of the opinion (which is actually more popular than you might think) that the best way to minimize the harms of drugs is to legalize all of them and educate people more comprehensively about their risks and the best ways to minimize their potential for harm. See criminalized substances have no safety and quality control, hence toxic impurities are lurking around every corner for drug users, as there is no telling what is in the “stuff” your dealer gives you – sometimes what you might be ingesting, snorting or even injecting will contain absolutely none of the desired drug. The World Health Organization, in July 2014, published an eBook that recommended that all drugs be decriminalized.
The dangers of prohibitionEdit
For mushrooms this uncertainty about what is in the stuff your dealer gives you can be particularly dangerous, suppose some dealer makes a mistake, or even intentionally chooses to sell you a different variety of mushroom, then you could be playing Russian roulette with your life. There are only two compounds (psilocybin and psilocin) found in mushrooms that are commonly used recreationally to induce hallucinations (although two other compounds can induce hallucinations, they are just not usually pleasant ones), yet there are at least half a dozen compounds that can be found in mushrooms that can cause ill effects such as irreversible damage to your internal organs, or even death. Examples of such substances include: alpha-amantin (which usually takes about 6-12 hours before any ill effect is seen, then it causes liver damage and, potentially, kidney damage), orellanine (which can cause kidney failure, which usually begins about 2-20 days after mushroom ingestion), gyromitrin (which usually seizures, that, in turn, may lead to death), etc.
According to Goodman and Gilman (GG)[note 1] your odds of getting psilocybin in any mushrooms you buy off the street are pretty slim. Other than the risk of a psychotic break, however, or flashbacks from past experiences with psychedelics in the future, psilocybin and other psychedelics tend to be pretty benign with a rather large therapeutic index of approximately 1,000.
Likewise, in Russia, circa 2010, when a project lead by the U.N. hit illicit Afghani opium production hard, many heroin addicts were forced, via the insanely high price of heroin at the time and/or its lack of availability, to produce their own opioids from legal, over-the-counter, codeine tablets they could buy in shopping centres and pharmacies alike. The one they choose was desomorphine, popularly known by the street name “Krokodil”. It was called Krokodil for a number of reasons, for one, one of the intermediates in its synthesis from codeine had a name that resembled krokodil, two it left its addicts injured by gangrene and severe skin irritation near injection sites, leaving their skin tough and leathery, additionally many addicts became maimed from the gangrene the drug has caused. The impurities the drug contained were so severe that it often caused severe vein irritation near to the injection site, additionally gangrene from impurities causing blood clots to form was and still is fairly common.
Heroin itself is not actually all that dangerous, the major dangers comes from unclean needles or impurities in the heroin or misinformation. There is a risk of overdose, but I believe that if we legalize heroin, regulate it to reduce the risk of toxic impurities and educate addicts as to the safe dosage range many of their lives can and would be saved. Additionally if we supply addicts with needles containing naloxone in case of overdose any bystander can quickly reverse the toxic effects of overdose if it does, in fact, happen. As is supported by recent clinical trials in Canada and Europe, which found that maintaining addicts with legal heroin and clean needles vastly improved their patient outcomes. Likewise, criminalization of drug use is also used to fund organized crime, see when a drug is prohibited by the state, it becomes more expensive and where does all this money go? To drug dealers and many of them are involved in organized crime! Just look at the history of alcohol prohibition in the United States (featured article candidate on the English Wikipedia is available here); prohibition does not work, it just makes matters much worse.
Decriminalization of drugs is sort of like saying, "The drugs get into the hands of drug users magically" as it criminalizes drug trafficking, but not drug possession. Hence I believe legalization and strict supervision of drug sales by the state is the best solution.
The potential benefits of legalizationEdit
Legalization could also help with our financial problems too, as taxing the drug trade, as well as cutting back on anti-drug police activities could significantly reduce the amount spent by the government every-year, hence reducing taxes on things we really care about like our food, our vehicles, our income, etc. and enabling us to spend more money on things like education (perhaps making university education free) and healthcare. Legalization would also aid medical research into the consequences of drug use, for instance, if tobacco was illicit we would probably know a tenth of what we know about the dangers of smoking, as fewer people would be so open about their habit. Medical research would also be aided further by the fact that these drugs could be investigated as potential medicines without the whole activity costing too much to the taxpayer (so as to ensure, via a police presence and other interventions, that the drugs are being used the way they are intended to be) or being unbelievably tedious. For instance, for decades the medical value of MDMA and psychedelics went unappreciated as the law would not allow any clinical trials to take place, now we are finally realising that these compounds possess truly unique properties that would be an asset in our arsenal against disease.
Every drug has its potential for harm, this harm potential is often increased by the concurrent use of other drugs such as medications for diseases such as mood disorders and schizophrenia. For example, any recreational drug that interacts with serotonin receptors or serotonin levels in the brain (such as MDMA, amfetamines, cathinones, LSD and other psychedelics) can interact with antidepressants, mood stabilizers and even antipsychotics, in a potentially fatal way, namely, via induce a serotonin syndrome. Harm minimization may be achieved by being intelligent about one’s drug use. For one, any stimulant has the potential to raise your body temperature, hence if possible it would be a good idea to carry around a thermometer and, if dancing or doing other forms of physical activity whilst using said drugs, to take regular breaks and drink a decent amount of water. If you seem to require increasingly higher doses of a drug to produce the same effect this is a bad sign as it likely means you are at a high risk for addiction.
Psychedelics are the sole exception to this rule as they cause the formation of tolerance very rapidly and are hence unable to induce addiction as this tolerance builds up too rapidly for any effect to be seen within a few days of continued use. The harms associated with drug use is also influenced by the route of administration, smoking and injecting are usually the most dangerous routes of administration, followed by nasal administration. The reason why is that smoking and injecting any drug is likely to amplify the toxicity of any impurities left from the manufacturing process or that the dealers cut it with, to increase its volume. Additionally unclean needles carry their risk of giving one HIV and/or hepatitis C.
I would like to conclude this introduction with two quotes from two former U.S. presidents, Bill Clinton (link: G), which I rather like:
“Don't be drug-free because it’s illegal. Be drug-free because it’s a key to your freedom, it’s a key to your future.”
and Thomas Jefferson:
“If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.”
Before I proceed I think it would be worth mentioning that there currently is ongoing research into vaccines against various drugs of abuse, which are designed to stimulate an immune response to the drug, thereby eliminating the drug and attenuating its effects in the body. I have not mentioned these treatments in this document as they are yet to prove themselves in clinical trials.
Main page: Preliminary information
The main page is stimulants.
These are agents that wake one up, usually by activating the body's fight or flight response.
Amfetamines are substituted phenethylamines.
Main article: Metamfetamine
Main page: Amfetamine
Main page: Dexamfetamine
Main page: Methylphenidate
Main article: Empathogens-entactogens
Main article: Mephedrone
Main article: Methylone
Main article: Natural cathinones
Main page: Cocaine
Main page: Nicotine
Main page: Caffeine
Members of the plant genus, ephedra, have been used for hundreds of years in Traditional Chinese Medicines (TCM) in the treatment of various different conditions. They all contain a small yet significant quantity of ephedrine and pseudoephedrine in their leaves, which are both sympathomimetic in nature, similar to amfetamines. Nowadays the sale of both is heavily restricted by the federal government on most countries, the reason being the fact that they can be used illicitly to produce amfetamines, including metamfetamine.
They are medically used to treat the following conditions (usually given orally):
- Nasal congestion (i.e., a runny nose)
- Diabetic neuropathic oedema – the collection of fluids around a particular area of the body due to diabetes-induced nerve damage, leading to swelling.
- Urinary retention
Lesser-known stimulants include mazindol (link: P. Brand names: Mazanor, Sanorex, Teronac), pemoline (link: P. brand names: Cylert, Vilotal) and pipradrol (link: P. brand name: Alertonic). Their effects and dangers are pretty similar to those of the amfetamines, except pemoline and mazindol are also associated with risks of liver damage and heart defects, respectively. Mazindol is believed to be a NDRI, similarly to cocaine, whereas pemoline and pipradrol are likely noradrenaline-dopamine releasing agents like the amfetamines. Mazindol and pemoline are used to treat ADHD, although their use is no longer recommended. Pipradrol is used to treat obesity.
- ↑ This is an American source, so it might not be too accurate at predicting this in Australia or the U.K.; plus this was in the early 2000s, before amfetamine-type psychedelics became available
- ↑ World Health Organization (July 2014). Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations (PDF). Geneva, Switzerland: World Health Organization. ISBN 978-92-4-150743-1.
- ↑ Lima, AD; Costa Fortes, R; Carvalho Garbi Novaes, MR; Percário, S (March-April 2012). "Poisonous mushrooms: a review of the most common intoxications." (PDF). Nutricion Hospitalaria 27 (2): 402–8. doi:10.1590/S0212-16112012000200009. PMID 22732961.
- ↑ United Nations Office on Drugs and Crime (May 2013). "WORLD DRUG REPORT 2013" (PDF). United Nations Office on Drugs and Crime (Vienna, Austria: United Nations). ISBN 978-9-21-056168-6. Retrieved 7 June 2014.
- ↑ Gahr, M; Freudenmann, RW; Hiemke, C; Gunst, IM; Connemann, BJ; Schönfeldt-Lecuona, C (June 2012). ""Krokodil":revival of an old drug with new problems.". Substance Use & Misuse 47 (7): 861–3. doi:10.3109/10826084.2012.669807. PMID 22468632.
- ↑ Gahr, M; Freudenmann, RW; Hiemke, C; Gunst, IM; Connemann, BJ; Schönfeldt-Lecuona, C (2012). "Desomorphine goes "crocodile".". Journal of Addictive Diseases 31 (4): 407–12. doi:10.1080/10550887.2012.735570. PMID 23244560.
- ↑ Grund, JP; Latypov, A; Harris, M (July 2013). "Breaking worse: the emergence of krokodil and excessive injuries among people who inject drugs in Eurasia.". The International Journal on Drug Policy 24 (4): 265–74. doi:10.1016/j.drugpo.2013.04.007. PMID 23726898.
- ↑ Katselou, M; Papoutsis, I; Nikolaou, P; Spiliopoulou, C; Athanaselis, S (May 2014). "A "krokodil" emerges from the murky waters of addiction. Abuse trends of an old drug.". Life Sciences 102 (2): 81–7. doi:10.1016/j.lfs.2014.03.008. PMID 24650492.
- ↑ Ferri, M; Davoli, M; Perucci, CA (December 2011). "Heroin maintenance for chronic heroin-dependent individuals.". The Cochrane Database of Systematic Reviews (12): CD003410. doi:10.1002/14651858.CD003410.pub4. PMID 22161378.
- ↑ Goldstein, F; Andrade; Souto Correa, T; et al. (2011). "Breaking the Taboo". Sundog Pictures, Spray Filmes.
- ↑ 10.0 10.1 Brayfield, A, ed. (12 December 2013). "Pseudoephedrine". Martindale: The Complete Drug Reference. London, UK: Pharmaceutical Press. Retrieved 19 June 2014.
- ↑ 11.0 11.1 Brayfield, A, ed. (13 December 2013). "Ephedrine". Martindale: The Complete Drug Reference. London, UK: Pharmaceutical Press. Retrieved 19 June 2014.
- ↑ 12.0 12.1 Eccles, R (January 2007). "Substitution of phenylephrine for pseudoephedrine as a nasal decongeststant. An illogical way to control methamphetamine abuse.". British Journal of Clinical Pharmacology 63 (1): 10–4. doi:10.1111/j.1365-2125.2006.02833.x. PMC 2000711. PMID 17116124.