Drug Classes and Abuse
Knowing the drug class of a substance is important information when dealing with substance abuse questions. Drug abuse is a serious problem around the world, and the United States is no exception. According to the National Institute on Drug Abuse (NIDA), the abuse of legal and illegal psychoactive drugs costs the U.S. $740 billion each year in lost productivity and in costs associated with law enforcement and health care.1 But the greater cost of drug abuse can’t be calculated in dollars and cents. Drug and alcohol abuse affects not only the lives of people with substance abuse disorders but also the lives of everyone close to them. It disrupts the functioning of the family system, damages relationships, and may fuel poverty, mental illness, and abuse.
A 2015 study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that four percent of Americans had met the criteria for a substance use disorder in the preceding year, and 10 percent had had a substance use disorder at some point in their lives. All told, more than 23 million Americans have struggled with the problematic use of drugs, including alcohol. Unfortunately, fewer than 20 percent of people who have a drug or alcohol use disorder get the help they need to recover successfully.
Drugs of Abuse, Defined
Substance Use Disorders, Explained
Whether a psychoactive drug is legal (like alcohol or cough medicine) or illegal (like heroin or cocaine), abusing it can have serious consequences, including addiction and dependence.
Drug abuse, addiction, and dependence are terms that are often used interchangeably, but they aren’t the same.
Drug abuse is the act of using any psychoactive drug in a risky way or in a way that causes problems with relationships, finances, health, or legal status due to substance abuse. Prescription drug misuse is a common form of drug abuse that involves either using prescription drugs in a way other than that which was prescribed or taking someone else’s prescription medication. Both types of prescription drug abuse are illegal.
Addiction results from changes in brain function due to heavy drug abuse, which may cause the learning, reward, and memory systems of the brain to communicate in a way that causes intense cravings. People who are addicted engage in compulsive drug use despite negative consequences. Whether an addiction will develop depends on a number of factors, including genetic, biological, environmental, cultural, and social factors. Genetics accounts for about half the risk of developing an addiction.
Dependence also results from brain changes caused by heavy drug abuse. As substance abuse escalates, the brain alters the function of neurotransmitters in order to compensate for the effects of the drugs. This causes tolerance, which means that larger doses of the drug are required in order to get the desired effects. At some point, the brain may adjust and become more comfortable when drugs are present. Then, when drug use is suddenly discontinued, normal neurotransmitter function returns, causing physical withdrawal symptoms. These symptoms vary depending on the drug, but in some cases, withdrawal can be dangerous or fatal. Since 2013, substance abuse, addiction, and dependence have been diagnosed under the umbrella of “substance use disorders” (SUDs). Eleven criteria are used to diagnose substance use disorders, which are classified as mild, moderate, or severe, depending on the number of criteria met. Here, we look at the different classes of psychoactive drugs that can cause a substance use disorder.
Drugs classified as hallucinogens alter perceptions, awareness, thoughts, and feelings. They can produce hallucinations and cause people who use them to feel disassociated from their bodies and environments. Historically, hallucinogens have been used in religious and healing rituals. In modern times, people report using them to get high, have fun, experience spiritual awakenings, or just feel different.
How Hallucinogens Work
Hallucinogens work by temporarily disrupting the communication between systems in the brain and spinal cord. Some hallucinogens interfere with the neurotransmitter serotonin to cause mood changes and changes in sensory perceptions. Dissociative hallucinogens interfere with the neurotransmitter glutamate, which regulates the perception of pain and emotions and affects learning and memory.
Long-term Effects of Hallucinogens
Long-term use of hallucinogens can cause persistent psychosis, which includes visual disturbances, paranoia, mood changes, and disorganized thinking. Flashbacks are common among people who heavily abuse hallucinogens. During a flashback, a person who is not currently using the drug will experience the sensations of being on the drug; these symptoms may be mistaken for symptoms of a stroke or a brain tumor.
There are two types of hallucinogens. Psilocybin mushrooms and LSD are examples of “classic hallucinogens,” a group that also includes DMT, peyote, and 251-NBOMe. The other category is dissociative drugs. These include PCP, ketamine, DXM, and salvia. Dissociative drugs cause users to feel disconnected from their bodies and environments and can also lead to feelings of loss of control. Long-term use of these hallucinogens can cause speech problems, memory loss, anxiety, depression, and suicidal thoughts. The most commonly used hallucinogens are LSD and psilocybin mushrooms.
Other Drug Classes
Anabolic steroids are synthetic versions of testosterone, a male sex hormone. On the street, steroids are known as gear, juice, roids, and stackers. While steroids are prescribed to treat hormonal issues and muscle loss from diseases like cancer and AIDS, they’re commonly abused by bodybuilders and athletes trying to boost performance and improve their physique.
Anabolic steroids work differently on the brain than other psychoactive drugs. They don’t activate the reward system and cause a “high.” However, they do alter brain function, causing problems like paranoid jealousy, extreme irritability, aggression, delusional thinking, and impaired judgment. Long-term steroid misuse can lead to kidney failure, liver damage, tumors, an enlarged heart, and high blood pressure.
Some over-the-counter drugs, which can be purchased without a prescription, are misused in order to produce highs. Dextromethorphan, or DXM, is a cough suppressant found in some OTC cold medicines, which may be misused with alcohol and marijuana. In large doses, DXM has hallucinogenic effects.
Another commonly abused OTC drug is loperamide, an anti-diarrheal medication. Loperamide is an opioid, but it doesn’t act on the brain’s opioid receptors as other opioids do. However, in large amounts, loperamide can have effects similar to other opioids.
It’s possible to overdose on OTC medications, and it’s possible to develop a substance use disorder involving them. Over-the-counter medications should always be taken as directed on the packaging or as directed by a physician.
Treatment for a substance use disorder involves a period of detox, during which all traces of the drug leave the body so brain function can return to normal. After detox, treating the addiction involves a variety of therapies that help individuals change their mindsets, restore order to their lives, and learn to cope with negative emotions, cravings, stress, and other relapse triggers. Treatment helps people find purpose and meaning in a life of sobriety.
Hope is the foundation of recovery, according to the Substance Abuse and Mental Health Services Administration. As long as patients hold on to hope for a better future free of addiction, recovery is possible. Treatment works for most people who fully engage with their treatment plan. Regardless of the type of drug, the severity of addiction, or the damage the drug has done to a person’s life, long-term recovery is always within reach of those who reach out for help.
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