Main groups of narcotic drugs
Modern pathophysiology identifies several key groups of substances that cause dependence:
- Cannabism: includes cannabis derivatives—marijuana, hashish, and concentrated hashish oil.
- Cocaine dependence: dependence caused by the use of cocaine.
- Opioid addiction: a group of substances with a pronounced narcotic effect, such as morphine, codeine, heroin, and omnopon.
- Hallucinogens: agents that alter the perception of reality, for example, lysergic acid diethylamide (LSD), mescaline, and psilocybin.
The concept of polydrug addiction
Polydrug addiction poses a particular danger. This condition is characterized by the patient using not just one, but two or more narcotic drugs simultaneously or alternating their intake. This practice significantly complicates the clinical picture and impedes treatment due to the unpredictable interaction of various substances in the body.
Factors in the development of dependence
The development of drug addiction is a complex process influenced by four main factors:
- Agent: the chemical nature and pharmacological properties of the drug.
- Dose: the amount of the substance entering the body.
- Duration: the history of use, which determines the depth of pathological changes.
- Route of administration: the method of delivering the substance, affecting the speed and intensity of its impact on the central nervous system.
Briefly: answers to topical questions
What is the pathogenesis of physical dependence formation on drugs?
The pathogenesis of physical dependence formation consists in the incorporation of the psychoactive substance that caused the dependence and its metabolites into the metabolism of nervous tissue and organs as essential components and regulators.
The manifestation of physical dependence is the need for repeated substance intake. Upon withdrawal, an abstinence syndrome develops. It arises against the background of established physical dependence and manifests as a complex of mental, vegetative, and physical disorders: anxiety, anguish, discomfort, irritability, muscle pain, muscle cramps in the legs, stomach and intestinal pain, nausea, vomiting, diarrhea, blood pressure fluctuations, tachycardia, sweating, muscle weakness, and insomnia.
How does psychological dependence differ from physical dependence?
Psychological dependence manifests as a pathological craving for a psychoactive substance, whereas physical dependence is associated with the incorporation of the substance and its metabolites into the metabolism of nervous tissue and organs.
| Sign | Psychological dependence | Physical dependence |
|---|---|---|
| Essence | Pathological craving for a psychoactive substance, determining all aspects of the patient's mental life | The psychoactive substance and its metabolites are incorporated into the metabolism of nervous tissue and organs as essential components and regulators |
| Manifestations | Thoughts about the psychoactive substance, dreams of the drug, a feeling of helplessness against the power of craving, constant search for the substance | Repeated consumption of the substance is required |
| Upon withdrawal | Not identified as an obligatory sign of psychological dependence in the cited sources | Abstinence syndrome develops |
What is the mechanism of action of cocaine on CNS synapses?
The mechanism of action of cocaine from the leaves of the plant Erythroxylon coca is based on the blockade of transmembrane transport of biogenic amines into neurons.
- Blockade of dopamine transporters — cocaine blocks transport proteins in the presynaptic membrane, preventing dopamine from being reabsorbed back through the presynaptic membrane, leading to its accumulation in the synaptic cleft.
- Inhibition of catecholamine reuptake — blockade of catecholamine reuptake by the endings of adrenergic nerve fibers occurs.
The result of these processes is the activation of the sympathoadrenal system. Single-use cocaine consumption is associated with improved mood and well-being, increased heart rate and blood pressure, and elevated body temperature.
What are the main stages in the development of drug addiction?
The pathogenesis of drug and substance abuse identifies three consistently developing stages.
- Initial stage — also referred to as the adaptive stage, the stage of psychological dependence, asthenic, or neurasthenic stage. Its essence lies in the formation of the need to take psychoactive substances as the main way to achieve positive emotions, improve mood, relieve anxiety and depression, and increase performance. The key characteristic is psychological craving for the psychoactive substance.
- Stage of physical dependence.
- Final stage.
To memorize the main groups, use the abbreviation "C-CO": Cannabism, Cocaine dependence, Opioid, Hallucinogens.
Class and exam questions
What is polysubstance dependence?
This is the simultaneous or alternating use of two or more narcotic drugs.
What drugs belong to opioid addiction?
These include morphine, codeine, heroin, and omnopon.
What does the classification of types of drug addictions depend on?
The classification is based on the type of narcotic drug, its dosage, duration of use, and route of administration into the body.
What else to study on this topic
- Pathophysiological mechanisms of opiate tolerance development.
- Comparative characteristics of the effect of hallucinogens on neurotransmitter systems.
- Features of cannabinoid metabolism in the liver.
- Clinical manifestations of abstinence syndrome in various types of drug addictions.
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