Substance dependence, commonly called drug addiction is defined as a drug user's compulsive need to use controlled substances in order to function normally. When such substances are unobtainable, the user suffers from substance withdrawal. Submitted to:- Ms. Pratibha Submitted By:- Rahul Verma Roll No:-261 Drug Addiction Causes • Drugs known to cause addiction include both legal and illegal drugs as well as prescription or over-the-counter drugs, according to the definition of the American Society of Addiction Medicine. • Stimulants (psychic addiction, moderate to severe; withdrawal is purely psychological and psychosomatic): • Amphetamine and methamphetamine • Cocaine • Caffeine • Nicotine • Sedatives and hypnotics (psychic addiction, mild to severe, and physiological addiction, severe; abrupt withdrawal may be fatal): • Alcohol • Barbiturates • Benzodiazepines, particularly alprazolam, flunitrazepam, triazolam, temazepam, and nimetazepam Z- drugs like Zimovane have a similar effect in the body to Benzodiazepines. • Methaqualone and the related quinazolinone sedative-hypnotics • Opiate and opioid analgesics (psychic addiction, mild to severe, physiological addiction, mild to severe; abrupt withdrawal is unlikely to be fatal): • Morphine and codeine, the two naturally occurring opiate analgesics • Semi-synthetic opiates, such as heroin (diacetylmorphine; morphine diacetate), oxycodone, buprenorphine, and hydromorphone • Fully synthetic opioids, such as fentanyl, meperidine/pethidine, and methadone Addictive Potential • The addictive potential of a drug varies from substance to substance, and from individual to individual. Dose, frequency, pharmacokinetics of a particular substance, route of administration, and time are critical factors for developing a drug addiction. Say No To Drugs Behavior Of a Addictive Person • Understanding how learning and behavior work in the reward circuit can help understand the action of addictive drugs. Drug addiction is characterized by strong, drug seeking behaviors in which the addict persistently craves and seeks out drugs, despite the knowledge of harmful consequences. Addictive drugs produce a reward, which is the euphoric feeling resulting from sustained dopamine concentrations in the synaptic cleft of neurons in the brain. Operant conditioning is exhibited in drug addicts as well as laboratory mice, rats, and primates; they are able to associate an action or behavior, in this case seeking out the drug, with a reward, which is the effect of the drug. Evidence shows that this behavior is most likely a result of the synaptic changes which have occurred due to repeated drug exposure. The drug seeking behavior is induced by glutamatergic projections from the prefrontal cortex to the NAc. This idea is supported with data from experiments showing the drug seeking behavior can be prevented following the inhibition of AMPA glutamate receptors and glutamate release in the NAc. Management • Addiction is a complex but treatable condition. It is characterized by compulsive drug craving, seeking, and use that persist even if the user is aware of severe adverse consequences. For some people, addiction becomes chronic, with relapses possible even after long periods of abstinence. As a chronic condition addiction may require continued treatments to increase the intervals between relapses and diminish their intensity. Most people with substance misuse issues recover and lead fulfilling lives however a small minority need additional support, usually in the form of drug counselling delivered in the community. For a very small percentage of very complex users this is insufficient and they require intensive inpatient or a series of long term treatments. The ultimate goal of addiction treatment is to enable an individual to manage their substance misuse for some this may mean abstinence. Immediate goals are often to reduce substance abuse, improve the patient's ability to function, and minimize the medical and social complications of substance abuse and their addiction this is called Harm Reduction. People in treatment for addiction may need to change behavior to adopt a more healthful lifestyle. • Treatments for addiction vary widely according to the types of drugs involved, amount of drugs used, duration of the drug addiction, medical complications and the social needs of the individual. Determining the best type of recovery program for an addicted person depends on a number of factors, including: personality, drug(s) of choice, concept of spirituality or religion, mental or physical illness, and local availability and affordability of programs. • Many different ideas circulate regarding what is considered a "successful" outcome in the recovery from addiction. Programs that emphasize controlled drinking exist for alcohol addiction. Opiate replacement therapy has been a medical standard of treatment for opioid addiction for many years. Comprehensive Drug Abuse Prevention and Control Act of 1970 • The Comprehensive Drug Abuse Prevention and Control Act of 1970, Pub. L. No. 91-513, 84 Stat. 1236 (Oct. 27, 1970), is a United States federal law that, with subsequent modifications, requires the pharmaceutical industry to maintain physical security and strict record keeping for certain types of drugs. Controlled substances are divided into five schedules (or classes) on the basis of their potential for abuse, accepted medical use, and accepted safety under medical supervision. Substances in Schedule I have a high potential for abuse, no accredited medical use, and a lack of accepted safety. From Schedules II to V, substances decrease in potential for abuse. The schedule a substance is placed in determines how it must be controlled. Prescriptions for drugs in all schedules must bear the physician's federal Drug Enforcement Administration (DEA) license number, but some drugs in Schedule V do not require a prescription. State schedules may vary from federal schedules. • The Controlled Substances Act (CSA), Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, is the legal foundation of the government's fight against the abuse of drugs and other substances. This law is a consolidation of numerous laws regulating the manufacture and distribution of narcotics, stimulants, depressants, hallucinogens, anabolic steroids, and chemicals used in the illicit production of controlled substances. The act also provides a mechanism for substances to be controlled, added to a schedule, decontrolled, removed from control, rescheduled, or transferred from one schedule to another.