The term drug of abuse better defines what we colloquially understand as a drug: “substance for non-medical use with psychoactive effects (capable of producing changes in perception, mood, consciousness, and behavior) and capable of being self-administered”.
medical criteria
Thus, the difference between a drug and a drug is not given by pharmacological, chemical, or medical criteria, but by two small nuances of an instrumental and social type: the fact that it is the individual who administers the substance without a medical prescription and that the objective be different from that of curing a pathology.
drug prescription
Some substances can be considered drugs or drugs depending on the context: steroids are, in principle, prescription drugs, but if they are used in gyms to improve physical performance, they would be considered drugs. Although multiple objections can be made to this definition, it is the most commonly accepted and the one we will use when referring to drugs in this course.
An important nuance is that the definition “drug of abuse” refers to substances. Thus, supposed pathologies such as “addiction” to mobile phones, the Internet, sex, video games, shopping, and other “addictions without substance” … should be considered behavioral or educational problems and not drug dependencies. On the other hand, pathological gambling is a disorder more related to a lack of impulse control than to drug addiction (in fact, the DSM-IV and ICD-10 classifications classify it together with trichotillomania, pyromania or kleptomania) and whose approach is different to drug use
How Is Drug Addiction Diagnosed?
To be diagnosed as such, substance dependence must entail a maladaptive pattern of consumption that includes discomfort or deterioration (physical, psychological, or social) and together with which at least three of the following criteria must be present at some point for a continuous period of 12 months.
- Tolerance
- Abstinence syndrome
- The substance is consumed in larger amounts or for a longer period than originally intended.
- There is a persistent desire or unsuccessful efforts to stop or control use.
- Much time is spent in activities related to obtaining the substance, using it, or recovering from its effects.
- There is a significant reduction in the subject’s daily activities due to the intake of the substance.
- People continue to use the substance despite being aware of its potential risks.
How Can Drug Addiction Be Treated?
- Drug addiction treatment aims to help the addict stop compulsive drug seeking and use.
- Since drug addiction is often a chronic disorder characterized by occasional relapses, a single short-term course of treatment is usually not enough.
- For many people, treatment is a long-term process that involves several interventions and constant supervision.
Drug Addiction Intervention
There are several scientifically based approaches to treating drug addiction. Drug addiction Intervention may include behavioral therapy (such as individual or group therapy, cognitive therapy, or contingency management), medication, or a combination of these. The specific type of treatment or combination of treatments varies depending on the individual needs of the patient and often the type or types of drugs used. The severity of the addiction and previous attempts to stop using drugs can also influence the approach to treatment. Finally, addicts often suffer from other health (including other mental disorders), occupational, legal, family, and social problems, all of which must be treated concurrently.
There are medications, such as methadone, buprenorphine, and naltrexone, which are used to treat people addicted to opioid substances, while for tobacco addicts there are nicotine preparations (patches, gum, lozenges, and nasal spray) in addition to the medicines varenicline and bupropion.
Disulfiram, acamprosate, and naltrexone are medications used to treat alcohol dependence, which commonly occurs along with other drug addictions. Most severely addicted people are multi-drug users and require treatment for all the substances they abuse. It has even been proven that people who have problems with alcoholism and smoking can receive treatment simultaneously for both problems.
Psychoactive medications, such as antidepressants, anxiolytics, mood stabilizers, or antipsychotics, may be critical to successful treatment when patients have co-occurring mental disorders such as depression, anxiety disorder (including post-traumatic stress disorder ), bipolar disorder, or schizophrenia.