If until 1989 the term „drug” was addressed to the western culture, after the borders opening, over the years, it become a new challenge for our society, not only at medical level but also at a psychosocial one. Its incidence increases by the day, resulting in the entire system in a fight, sometimes unsuccessfully, against a scourge hard to stop. This paper proposes an overview of the categories and use of psychoactive substances.
“ Men’s happiness or misery is [for the] most part of their own making” John Locke
Drug history begins in the ancient times, because the man has always been concerned with finding means to create momentary pleasures. At first these substances were purchased from plants. First drug used in the Neolithic period was opium, obtained from the poppy capsules. A famous mention about using opium is found in the „Odyssey” of Homer, wich reminds of a drink capable of leading to forgetting the pain and troubles.(Achim Popescu, 2004)
Etymologically, the word comes from the Dutch word droog drug, which means dry or dry product. Another version would be „droug” – Celtic word that means bad or bitter.
The objective of the work
Listing the psychoactive substances in the abuse context , but also with their physiological mechanisms.
Materials and methods
Am analizat aricole și publicații din perioada 2007-2014 referitoare la consumul de substanțe
We analyzed articles and publications on the use of psychoactive substances,covering the period 2011-2014.
„The drug is defined as any illicit or licit substance that, consumed either for medical reasons or for other reasons, give dependency phenomena. So, consumed dose escalation is required wich makes the consumption interruption very difficult .” (Rascanu, 2004).
European Monitoring Centre for Drugs and toximanie (EMCDDA) reports that at least 85 millions of European adults have used an illegal drug at some point in their lives, which means a quarter of the adult population of Europe. The majority reported consuming cannabis (77milioane) ,the consumption of other drugs being much lower duaring life : 14.5 million cocaine, amphetamine 12 million, 11.4 million ecstasy.
In Romania, until 1990, the concept of drug use was attributed to European culture through legislative restriction of leaveing the borders,beaing a taboo subject, assigned strictly for the West. Without perceiving danger, Romania was considered a country of „transit” for drugs from Turkey to western countries. The scourge has extended IN 2000, especially among young people, particularly affecting adolescents and young adults in schools. (Andrei Botescu,2011)
Types of illicit drugs
While the US marijuana consumption is predominantly, in Europe it is that of hashish.
Cannabis sativa Linnaeus is the only existing species of producing psychoactive preparations for human consumption. They were called the Americana or Indica, various variants that differ only in terms of geographical location.
Cannabis sativa is included in Cannabaceae family (along with hops).
Both specimens, the male and the female contain psychoactive substances, although they are in larger quantities for the female specimens, showing larger extreme flowering. The resin plant is rich in cannabinoids, reason why the plants grown in hot and dry climates have a higher psihoactivity. Cannabis can grow in almost any climate or type of soil, including artificial light.
The preparations that can be obtained from the plant in for smoking or ingestion, are achieved by crushing and pressing o parts of the plant, or the reisin, or mixing both.
In the US the most often used preparation is called marijuana, and consists of a mixture of chopped leaves and squeezed petals.
Hashish has been used in Europe, which is derived from the plant resin. In general both of them are smoked mixed with tobacco (joint).
Delta-9-THC (delta-9-tetrahydrocannabinol), is the active alkaloid of the plant. The cannabis plant have been identified as having at least 426 different chemical compounds, of which more than 60 are cannabinoid with psychoactive effects.
Tetrahydrocannabinol (THC) and its active hydroxylated metabolites, in particular delta-9-THC are are primarily responsible of the effects of cannabis. Through combustion and pyrolysis novel compounds occur, which in turn may have psychoactive effects.
Preparations wich can be smoked are more active than those ingested orally.
THC tolerance develops quickly enough both for subjective and physiological effects. (Gabriel Cicu,2007).
Cannabis use in Europe remain high by historical standards, with an extensive and relatively strong market, and also a variety of increasingly larger types of cannabis products available. In the countries of Central and Eastern Europe, Cannabis has increased considerably in the 2000s is the moast illicit tried drug most by European students. In ESPAD (European School Survey on Alcohol and Drugs) surveys, in 2011, lifetime cannabis use among adolescents aged 15-16 years ranges from 5% in Norway to 42% in the Czech Republic. As regards the general trend, cannabis has increased in the period 1995-2003 and will decline slightly in 2007 and maintainins a stable curve in the coming years. (EDCDDA, 2013)
Opiaceele sunt substanțe care, în măsură diferită, au proprietăți similare cu opiul și morfina.
Opioids are substances which, to varying degrees, have properties similar to opium and morphine.
The word „opium” derives from the Greek word corresponding to „juice” because the compound was obtained from the juice of the poppy „Papaver somniferum”.
Opioids act on several receptors by three subtypes, μ, γ, δ. The human brain synthesizes its own endogenous opioids. These are peptides derived from proteins called propiomelanocortina precursors (POHC) proencephalin and prodinorphin.
Exogenous opioids used as analgesics (codeine or morphine like) or used as drugs of abuse (such as heroin), mainly acts on receptors of type µ. (Gabriel CICU, 2007)
The fhirst opioid consumed in Europe is heroin, that can be injected, smoked or inhaled. A number of other synthetic opioids such as buprenorphine, methadone and fenantyl are also available on the illicit market. Some countries report that in the last decade, heroin and HIV outbreaks decreased, except Greece and Romania, where outbreaks of HIV, resulted from heroine injecting, increased. In 2011 there were 1, 4 million consumers. (EMCDDA 2013).
Psychostimulants produce alert stimulation sensations, improved intellectual efficiency, and improved manual execution of tasks, sensations of energy, decreased fatigue, diminshed sleep, diminished hunger. One can say that produce arousal or stimulation of the central nervous system.
Many of psychostimulants have natural origins, are extracted from plants.
Most of the amphetamine derivatives are psychostimulants, some haveing a chemical structure similar to mescaline and produce hallucinogenic effects.
Psychostimulants mainly include amphetamine and its derivatives: dextroamphetamine, ephedrine, cathinone and underbrush, methylphenidate, pemoline, fenilpropanoamina), synthetic drugs (amphetamines and hallucinogens entactogene), methylxanthines (caffeine, theobromine, theophylline) nicotine, cocaine.
Since amphetamines are chemically phenylethylamine derivatives, their structure has a certain similarity to endogenous neurotransmitters (norepinephrine, dopamine and serotonin) and hallucinogens such as mescaline.
Synthetic drugs are usually presented in the form of tablets in evocative colors and symbols.
Amphetamines are classified as indirect sympathomimetic. Postsynaptic receptors are those that produce stimulating neuronal release of noradrenaline, dopamine and serotonin in the synaptic space. These neurotransmitters unite with and initiate pharmacological action. (Gabriel Cicu, 2007)
Amphetamine, methamphetamine and their derivatives carrie more dopaminergic actions than or serotonergic or adrenergic,while synthetic drugs are more active in serotonergic transmission less than adrenergic. General trends in synthetic stimulants substance use is complicated by the fact that they are often replaced with each other because consumer choices depend on the availability, price and perceived quality. Amphetamines and ecstasy remain the most consumed drug synthetic stimulants in Europe. Recent data indicate the increasing availability of methamphetamine, and in some markets, this substance replaces now amphetamine. There is evidence that suggest a decreased of recent years in Ecstasy’s popularity, which probably reflects the fact that many pills sold were low purity.
High levels of drug stimulants tend to be associated with the specific context of club music and nightlife in which these drugs are often consumed in combination with alcohol.
Data on prevalence shows that incentives drug market in Europe is one of geographically divergent, cocaine is more widespread in southern, western Europe amphetamines most common in central and northern Europe, while Ecstasy is the stimulus with the highest prevalence in southern and eastern Europe. (EMCDDA,2013)
Cocaine is a natural substance produced from the Coca plant. It is consumed in various forms prepared: coca leaf, coca paste, cocaine hydrochloride and cocaine alkaloid.
Cocaine hydrochloride powder is usually snorted or dissolved in water and injected intravenously. The combination resulting from the mixture of heroin is known as the speed-ball. Cocaine is a strong central nervous system stimulant.
Sympathomimetic action of cocaine and CNS stimulation occurs due to the reuptake blocking process of certain catecholamines (dopamine and norepinephrine) and other monoamines (serotonin) that causes the immediate effect of an increase in dopaminergic neurotransmission, noradrenergic and serotonergic. Chronic use of cocaine causes a decrease in dopamine, norepinephrine and serotininei, in the brain, which translates into a depressant CNS effect.
Powder cocaine is mainly snuffed or inhaled but is injected while the crack is usually smoked..
Only a few countries report problems with crack cocaine, and it often overlaps over consumption of problematic substances, including heroin. Powder cocaine consumption is more common, but tend to be concentrated in a relatively small number of countries in Western Europe. Overall, both cocaine and indicators related to the offer have been a downward trend in recent years.
„Cocaine, amphetamines and Ecstasy are the most consumed stimulant drugs in Europe ‚(EMCDDA,2013).
Hallucinogens produce perceptions changes, especially visual distortions under the illusions from to true hallucinations.
These substances are in fungi, plants, animals or a product of chemical synthesis. We know almost 100 plants or mushrooms containing hallucinogenic substances.
Classification hallucinogens substances consider the similarity with the brain neurotransmitters and some chemical structural features such as: chemical structure of serotonin: indolalchimanine (lysergic acid derivatives and substituted triptamide); chemical structure similar to that of catecholamines: phenylethylamines (mescaline, elemicina, miristicina) fenilizopropilamine and other aricicloalchilamide (fenilciclidina, ketamine) tropane derivatives (atropine, hioscinamina, escopolamina) salvinonina A, thujone, cannabinoids.
Overall prevalence levels of hallucinogenic mushrooms and LCD (lysergic acid) in Europe were generally low and stable for several years. (Gabriel Cicu,2007).
6.Sedatives, hypnotics, anxiolytics
They are called psychotropic substances, thesubstances that are capable of altering the mental or emotional functions. Include both drugs and drugs of abuse.
The category of psychotropic substances fall anxiolytics, sedatives and hypnotics.
Among the substances is remarkable anxiolytic benzodiazepines and buspirone, which are generally used for the treatment of the generalized anxiety disorder and panic disorder.
There are two types of GABA receptors:
GABA neurons is coupled to a chloride channel and seem truly connect with actions cents (anxiolytics, hypnotics and sedatives)
GABA B is peripheral coupled to a G-protein system and seems to mediate muscle relaxation.
GABA A receptor consists of five subunits which together form a channel which penetrates the chlorine ion. The 5 sub-units are formed by combining four different proteins: alpha, beta, gamma and delta. The most common form is the one that combines two units of alpha, beta and two drive units range. Some authors have suggested that this receptor is called omega but most commonly is called benzodiazepine GABA-receptor complex.
The term includes all substances, solvents or solvent gases, liquids and solids very volatile, psychoactive, most of them flammable or highly flammable almost always with intense odor.
With the exception of nitrous oxide, inorganic compound, disssolvents are organic substances with generally mild chemical formulas.
They are used in industry, commerce and are found in pharmaceutical products and domestic use. It is calculated that there are hundreds of illegal use of solvents likely that a large proportion are in the house, garage or shed any person.
There are various products, readily available and cheap. These characteristics underlie consumption in children, youth and adults from marginal population, whose access to other drugs is a matter of restriction from certain social factors. (Gabriel Cicu, 2007).
8. New psychoactive substances
The consumption of new substances with psychoactive properties, SNPP known as ethnobotanicals drew attention to the negative effects on children’s lives and adolescent who initiated consumption and rapid growth of the phenomenon visible in the general population.
The consumption of new psychoactive substances appeared in 2008 in Romania and has experienced accelerated growth and diversification in recent years, with the decline and recovery of the implementation of legislative rules to impose control initiated by the government.
In terms of the form of presentation is Divided into two main categories:
A mixture of herbs and chemicals, smoking-products of „Spice”.
B. mixtures of chemical powders injectable or prize -synthetic psychoactive substances or hallucinogenic effect energizing marketed under different names and mixed with known energizing caffeine, creatine etc.
Substanțele sunt amestecate și împărțite în plicuri în vederea vânzării după rețete și concentrații neverificate. (Andrei Botescu, 2011).
Information on the real content of the product and its effects on health are insufficient or missing.
A growing number of new psychoactive substances more often designed to mimic the effects of controlled drugs are available in Europe.
EU rapid alert system continues to receive reports about a new substance per week in 2013. Recent years have seen the emergence of new synthetic agonists of cannabinoid receptors, phenethylamine and cathinones. Many products contain mixtures of sale.(Andrei Botescu,2011)
In 2012, 73 new psychoactive substances were changed for the first time by the Member States through the EU rapid alert system. The Internet is an important market for new psychoactive substances, EMCDDA snapshot performed an exercise to monitor the number of online stores that offer consumers products identified europeni.Numărul stores in January 2012 was 693. After being subject to control measures most new psychoactive substances tend to be replaced which is a particular challenge for intervention measures in this area. (EMCDDA, 2013)
Pathophysiological mechanisms believed to be involved in the consumption of substances
Brain reward system
Brain reward system areas that are to be stimulated are: the ventral tegmental area and its projections in the accumbes, lateral prefrontal cortex and hippocampus.
The reward system is integrated thrugh dopaminergic pathways of the mesolimbic and meziocortical system. In the ventral tegmental area there are neuronal bodies whose extensions reach the accumbes nucleus and the prefrontal cortex. Ventral tegmental area dopamine neurons send projections to the hypothalamus side also. Lateral hypothalamus, amygdala, prefrontal cortex, hippocampus and thalamus dorsomedial nucleus accumbens and send projections to turn this ventral tegmental area and the lateral hypothalamus.
These cores are interrelated through anatomical and functional circuit called limbic-motor circuit bounty limbic circuit being involved in motivational and emotional phenomena and the motor circuit in locomotor activation phenomena.
The accumbes nucleus appears to play therefore acts as a carrier of information between different brain regions. Most neurotransmitter involved in the drug self-administration behavior is dopamine
In the accumbes nucleus and the ventral tegmental area there is not only dopamine, there are also several neuropeptides such as colecistochimina, neurotensin, angiotensin II and vasopressin, etc. Opioid peptides were also involved in the reward system involved in various brain functions such as modeling nociceptive response, painful stimuli, or the ingestion temperature of food and water. Another neurotransmitter involved is GABBA eadictive certain behavior.
Neurotranmitters correspondence and its function and drugs
Acetylcholine is involved in muscle activity, heart rate, sleep, sexual behavior, memory, motivation. Similarly acts marijuana, LSD (lysergic acid), nicotine cocaine. Dopamine plays a role in muscle activity, sensation of pleasure, energy as well as caffeine, amphetamines, opiates, marijuana.Opioidele, narcotics, alcohol, solvents similar role endorfinelor- analgesic role and reward mechanisms. GABA is involved in the processes of sleep anxiety inhibition acts as narcotics, alcohol, marijuana, barbiturates, benzodiazepines. Norepinephrine induces awakening, alertness, energy, feeling happy. Like most involved and incentives including cocaine, amphetamines, nicotine. Serotonin produces aggression, depression, sleep, appetite, domination, inhibition. LSD, alcohol, cocaine, amphetamine, esctazy have a similar action.
Steps involved in consumption
- Initiation consumption – the first contact with the drug will develop positive reinforcement, which is the one that will lead to repeat drug.
- Development adictiv- stage occurs neuroadaptare repeated drug administration. The body will change operation to try to counteract the metabolic changes produced by the drug. At this stage may appear negative reinforcement processes. This negative affective state that changes , brings an emotional homeostasis, new reason to drug ingestion unpleasant condition that occurs due to giving up consumption.
- Consumption initiation – the first contact with the drug will develop positive reinforcement, which is the one that will lead to repeat drug.
- Adictivity development- the neuroadaptation occurs at repeated drug administration. The body will change operation to try to counter the metabolic changes produced by the drug. At this stage negative reinforcement processes may appear. This negative affective state that changes it brings an emotional homeostasis new reason to drug ingestion, unpleasant condition that occurs due to giving up consumption.
- Interruption consumului- alterations in the functioning of the brain, caused by prolonged use of the drug are responsible for the unpleasant effects that occur during this period. Once completed this stage, the individual will recover conduct that would qualify as normal, but the brain’s condition remained „marked” drug. Neural systems did not return to the previous situation consumption and adapted to new behavioral stages. Although there is no urgent need to take drugs, remains a latent propensity to consume.
- The occurrence of relapses- once completed the detoxification we can not say that the individual is fully healed very different circumstances can lead to the resumption of consumption after periods of abstinence that can reach several years. (Gabriel CICU, 2007)
Drug use is a real phenomenon and worried by the extent of acquired in society.
People have varied acquisition vulnerability substance dependence, so the consumption of a substance does not necessarily attract dependence for all consumers.
It is important to know the extent of this phenomenon took and the implications it may have on health.
The consumption of illicit drugs often begins in adolescence with a peak around the age of 20, and is beginning todecrease substantially. However, some individuals, continue to use drugs in adulthood.
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- Dr. Gabriel Cicu, Psih. Daniela Georgescu, Psih. Ana Maria Moldovan, Concepte de Baza privind Tulburarile Datorate Consumului de Substante, AgentiaNationala Antidrog, Bucuresti,2013 pg 28-31, 95-103,127-129,146-148, 191-197, 223-224
- Ioniță Mihail Alexandru, Proiect de cercetare, consumul de droguri în rândul adolescenților 14-18 ani, Universitatea din București Facultatea de Sociologie și Asistență socială,2006, pg 5-15
- Observatorul European pentru Droguri și Toximanie (EMCDDA), Oficiul pentru Publicatii al Uniunii Europene, Luxemburg,2013 pg 18-20, 30-42
- Popescu .O, Achim, V. Popescu A, Viața în hexagonul morții(tutunul, alcoolul, drogurile, HI/SIDA, poluarea, malnutriția-Editura Fiat Lux București 2004, p89
- Rășcanu Ruxandra, Alcool și droguri, virtuți și capcane pentru tineri-Editura Universității din București,2001, pg 9
- Stancu Camelia, Cotruș Andrei, Factori psihologici și sociali implicați în consumul de droguri la adolescenți –Revista SNPCAR martie 2014, pg 27-33