WHAT IS DRUG ADDICTION?
Drug addiction is a compulsive craving for a drug and has several components. One of the most important is tolerance—the need to use more and more of a drug to achieve the same effects. Since the body becomes tolerant to the effects of many drugs, users eventually feel less of an effect and therefore need to increase the dose of the drug to achieve the same high. This phenomenon of tolerance can increase a person's dependence on drugs.
Withdrawal symptoms are also an important component of addiction. When use of a drug is stopped, the user can experience a wide range of physical and/or psychological symptoms that will disappear if the drug use is resumed.
Drug addiction is apparent when use is maintained despite significant physical and/or psychological cost to the user or to the user's family and friends. Some experts expand the idea of addiction to include abuse, which they define as the use of any drug, illegal or legal, in circumstances that threaten a person's health or impair his or her social functioning and productivity. For example, a chronic user of LSD or Ecstasy can sometimes lose touch with his or her environment and peers. Missed school time and a lack of attention to personal hygiene and health can be signs of a teen who is abusing hallucinogens or other drugs—just as cigarette smokers who have chronic bronchitis, yet continue to smoke, are abusing tobacco. Thus, addiction, and by extension drug abuse, can be
Short-term Effects after Ecstasy is Gone
After Ecstasy depression-like reelings, irritability
During Ecstasy elevated mood
After Ecstasy depression-like reelings, irritability
The short-term withdrawal symptoms an Ecstasy user may experience are caused by a chemical change at the neuronal level, as depicted in this diagram. Ecstasy use increases the concentration of the neurotransmitter serotonin normally found in the synaptic space (left), leading to sustained activation of serotonin receptors and an elevated mood (center). Eventually, neurons cannot produce serotonin quickly enough to replace that which was lost during Ecstasy use (right). Less serotonin is released with each electrical impulse, leading to feelings of depression and anxiety.
summarized as a compelling desire to use a drug, a need for ever-increasing quantities of that drug, withdrawal symptoms if a drug is not used regularly, and continuation of drug use regardless of circumstances or consequences.
PHYSICAL AND PSYCHOLOGICAL DEPENDENCE ON HALLUCINOGENS
Since all drugs have particular, self-defining characteristics, experts generally speak of a drug in terms of the user's dependence on it, rather than the user's addiction to it. Though the two terms are very close in meaning, drug addiction is a special kind of dependence marked by physical changes in the body as a result of tolerance to and withdrawal from a drug.
Research shows little evidence of physical dependency upon hallucinogens. As with almost all drugs, hallucinogens can create some temporary, short-lived psychological dependency in the user. This psychological dependence can have many of the same characteristics as physical dependence—cravings, tolerance, withdrawal, and the continuation of the drug despite negative consequences.
We can sense, intuitively and practically, how almost anything can create dependency. Some teens say they "cannot live" without chocolate. Others may simply love to jog every day, rain or shine. Still others might read Rolling Stone magazine every month without fail or play poker for money every afternoon with their buddies. Researchers and teenagers alike often wonder, "How does psychological dependence differ from doing something repeatedly just because you like to do it?" Ongoing debate over the roots of addiction and dependency seeks to answer these types of questions.
Many researchers suggest that the essence of dependence lies in the limiting of personal freedom. We are all dependent upon food, water, and other people to live—no one is completely self-sufficient. However, what distinguishes drug dependency from other "needs" is that it can take over and control a person's life, often at the expense of virtually everything else. Some LSD users, for example, report that the illusory effects from the drug can "fool" them into perceiving "real" life as the illusion. This can delude users into thinking that their drug-induced lifestyle is representative of "normal" life and thus is essential for daily living. As each day or week becomes governed by how, when, and where drug use will occur, it is easy to see how drug dependency can limit personal freedom.
It requires a great deal of effort to break free from dependency on anything. Studies show that once a person becomes dependent upon a drug, there is often no route to ending the dependency other than abstaining from drug use altogether. Unfortunately, many people who try to end drug dependency often wind up switching one dependency for another. Hence, we can see that dependency on drugs, including hallucinogens, can be a very serious problem with many negative consequences. It is therefore important that we examine in greater detail the physical and psychological aspects of dependence upon hallucinogens.
Some hallucinogen users do develop a set of short-lived physical withdrawal symptoms. For example, chronic, habitual LSD users sometimes experience temporary withdrawal symptoms such as restlessness or depression for a few days after stopping the drug. A few cases of dependence on MDMA have also been reported, with chronic users experiencing brief withdrawal symptoms similar to those from amphetamines— restlessness, sleep disturbances, and jitteriness.
Nevertheless, an overwhelming majority of researchers consider hallucinogens to be non-addicting and non-dependency forming. Studies show that most hallucinogen users do not experience withdrawal effects after stopping use of these drugs; many correlate the ease of withdrawal to the rapid tolerance that develop to hallucinogens. Indeed, according to the 2001 Monitoring the Future survey, few teens seem to use either MDMA or LSD in a frequent, monthly way, but rather seem to experiment on more of an occasional basis.
Looking specifically at MDMA, tolerance seems to limit frequent dosing of MDMA. As tolerance develops in the MDMA user, escalating doses decrease the drug's euphoric effects while increasing the stimulating amphetamine aspects of the drug. Many Ecstasy users find these latter effects uncomfortable and unpleasant, leading them the stop the drug. Current data suggests that infrequent, low-dose use of
MDMA does not create the same tolerance and withdrawal patterns as high-dose usage.
In attempting to predict future drug use by looking at current patterns of use, studies have shown that it is possible to be psychologically dependent on a drug without being physically dependent on it. For instance, after spending time in jail or in a treatment facility, many drug users often go back to using drugs despite the fact that their physical cravings and/or withdrawal symptoms have long since passed. Research shows that physical dependence is "all or nothing"—the drug is either addicting or it is not—while psychological dependence operates on more of a continuum. Some drugs create more psychological dependence (cocaine is high on this continuum), while others do not (hallucinogens are low on this continuum). Most scientific research shows that psychological dependence on hallucinogens varies greatly from drug to drug but is usually neither intense nor long-lived.
TEENS AT RISK OF HALLUCINOGEN DEPENDENCY
Because individual motivations to use drugs can vary so greatly, it can be difficult to know which teens will experiment with hallucinogens and then stop, and which teens will use hallucinogens on a more regular basis. Although any adolescent can develop a drug dependency, some are at higher risk than others.
Despite these predictive challenges, teenagers at risk for developing an abusive relationship with hallucinogens can include those who:
• Live with family conflict and discord. Adolescents whose parents are often in conflict, frequently absent, or inconsistent in setting boundaries and guidance are more likely to use illegal drugs. Teens may use hallucinogens to cope with family stress, low self-esteem, depression, anger, and anxiety.
• Do not fit in with peers. Some adolescents, particularly those girls who physically mature sooner than others, may feel out of place. Cognitive differences—from attention deficit syndrome to extraordinary intelligence—can put some distance between students and their contemporaries. Those excluded from the mainstream may find that drug use means ready acceptance among a cluster of new friends.
• Associate with drug-using friends. As discussed earlier, peer influence is one of the strongest factors in predicting hallucinogen use among teens.
REINFORCEMENT: The Key Motivator
One of the keys to understanding psychological dependence on hallucinogens is the concept of "reinforcement," which is viewed by many experts as the underlying motivator of drug-taking behavior. Indeed, some researchers believe that psychological dependence, based on reinforcement, is the driving force behind drug addiction. Reinforcement occurs when a teen receives a pleasurable sensation from using hallucinogens and is then motivated to use hallucinogens again to achieve the same pleasurable experience. The intensity of the pleasure that a drug delivers to the user is also a reinforcer of the experience. According to studies, taking an intensely pleasurable drug over a period of time leads to a powerful desire to repeat the experience (perhaps at the expense of personal or scholastic conduct).
In a similar way, research has shown that negative or bad trip experiences are equally as reinforcing as good trip experiences. Many teens have reported that it only took one profoundly bad experience while under the influence of hallucinogens to permanently stop using the drug.
Achieving pleasant or euphoric moods is clearly a perceived benefit of hallucinogen use. It is equally important to recognize that avoiding unpleasant moods or situations
Drug use among teens continues even though more than 50 percent of the 70,000 males and females aged 12 and older polled for the 1999 National Household Survey on Drug Abuse felt that using marijuana, LSD, cocaine, or heroin placed them at great risk.
can be another important motivator which provides another dimension of reinforcement. Both experiences—pleasure or avoidance of pain or sadness—can lead the teen hallucinogen user to become psychologically dependent on hallucinogens. In fact, researchers believe that teens who use hallucinogens to seek relief from emotional pains such as anger, depression, or family/school problems are experiencing even stronger reinforcement for repeated hallucinogen use than those motivated by a desire for "euphoria."
Certain routes of exposure to a drug are more reinforcing than others. The quicker a drug enters the bloodstream, the faster it gets to the brain, and the sooner its euphoric effects will be experienced by the drug user. Thus, drugs that are injected or smoked have been found to be more physically (and psychologically) dependency-forming than drugs such as hallucinogens, which are most frequently eaten. The entry of ingested drugs into the bloodstream is slowed down by the digestive process, thereby delaying the time it takes to reach the brain. Injected and smoked drugs bypass this digestive process, and have more direct access to the brain.
PREVENTING HALLUCINOGEN USE: What Works, What Doesn't
It is the opinion of many educators, researchers, policymakers, and social scientists that prevention of drug abuse is easier than, and preferable to, treatment for drug abuse. The earlier a possible drug dependency is identified in a drug user, the better the chance of correcting it. For example, researchers tell us that by understanding the predictive factors of teen hallucinogen use, young children can be identified as "at risk" for use of drugs prior to using drugs. They suggest that informing potential young users about the negative effects and risks of hallucinogen use (or any drug), as well as exploring drug alternatives, may be an effective prevention tool.
Current U.S. antidrug education and prevention campaigns increased in reach and frequency in the 1980s. Since then, adolescents have seen antidrug messages seemingly everywhere: on shopping bags, comic books, restaurant place mats, billboards, television, bumper stickers, and candy wrappers. Beginning in elementary school, the DARE (Drug Abuse Resistance Education) program sends uniformed police officers into schools to teach about the dangers of drugs. Researchers tell us that today's teenagers have had more drug education than any group of young people in American history.
In fact, it is estimated that over 80 percent of 12- to 17-year-olds have either seen or heard a drug prevention message outside of school in the past year; nearly the same percent have been exposed to a drug prevention message inside of school. Yet, as we saw in Chapter 5, past-year use of MDMA increased 130 percent among twelfth graders and 60 percent among tenth graders. Thus, antidrug education in America faces the challenge of a continuing trend toward increased MDMA (and other drug) use among teenagers.
The concept of "zero tolerance" drives much of today's legal and educational policy. The zero tolerance policies teach that using a drug such as a hallucinogen even once puts the user at risk for dependence and abuse of the drug. Most American drug education programs are built around this zero tolerance message. Proponents of this policy stress that the purpose of drug education is to prevent drug experimentation; therefore, the topic of drug use is practically forbidden. Additionally, as part of this zero tolerance policy, most schools impose
Continue reading here: The Problem With Antidrug
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