Have you ever wondered why people get addicted to certain things so easily? You've probably seen people like that around you. Today we're going to talk about what these 'addictive things' really are, how dangerous they are, and whether you can get rid of them. This is a very important topic, because they can affect anyone, at any age.
What are these "Addictive Substances"?
Simply put, these are chemicals, medications, or drugs that we are addicted to and cannot stop using. To be precise, this is a chronic condition . That is, even though you know that these things are harmful to you, you continue to seek them out. It's like being drawn to a magnet.
Now, let's take a look at what falls into this category. Some of them you may have heard of, and some may be a little new:
- Alcohol : So there's nothing special to say about this.
- Caffeine : Yes, yes, the caffeine in the tea and coffee we drink is also in this group. But the effect depends on the quantity.
- Cannabis/Marijuana : This is also something that is being talked about a lot right now.
- Hallucinogens : Examples include Phencyclidine (PCP) and Lysergic acid diethylamide (LSD). These can cause you to see things you can't see or hear things you can't hear.
- Hypnotics, sedatives and anxiolytics : This includes medications like `(Benzodiazepines)` and `(Barbiturates)`. Even if prescribed by a doctor, they can be addictive if used incorrectly.
- Inhalants : Things like paint thinners, some aerosol sprays, gases, and nitrites. These are very dangerous.
- Prescription and nonprescription opioids : This includes painkillers like `(Codeine)`, `(Oxycodone)`, as well as the drug `(Heroin)`.
- Prescription and nonprescription stimulants : These include Adderall® (which contains amphetamine/dextroamphetamine), cocaine, and methamphetamine (meth).
- Tobacco/Nicotine : Smoking cigarettes, using electronic cigarettes (e-cigarettes or vaping) all fall into this category.
The word 'substances' itself makes it clear that this is not limited to just 'powders'. There are many different things that can be addictive and pose a threat to our health without us even realizing it.
What are the most addictive things? Why is that?
Research has found that some things are more addictive than others. The most prominent of these are:
- Alcohol
- Cocaine
- Heroin
- Methamphetamine
- Nicotine
Remember, not everything is equally addictive. The likelihood of someone becoming addicted to certain things, or their "addiction liability," varies from person to person. This depends on several factors:
- The way you use it: For example, the effects vary depending on whether you take it orally, inject it, or inhale it. The faster it enters the bloodstream, the greater the risk of addiction.
- The speed at which it reaches the brain and the way it stimulates the brain's "pleasure center" (reward pathway): Some things go straight to the brain and start a chemical process that makes us feel happy and satisfied. It's like a little 'kick' to the brain. It also affects the speed at which it crosses the ``blood-brain barrier''.
- The time it takes to feel the effects of using the substance: The sooner the effects are felt, the more likely you are to use it again.
- This can lead to an increase in the body's "tolerance" and/or the possibility of "withdrawal symptoms": we'll talk about this a little later.
What are "Controlled Substances"?
'Controlled substances' are drugs or chemicals that have a high potential for misuse and a high risk of developing a Substance Use Disorder (SUD) . These cannot be purchased over the counter.
For example, in the United States, there are strict laws regarding the manufacture and distribution of prescription controlled drugs. Examples include morphine (a painkiller) and methylphenidate (a stimulant). It is also illegal to possess and distribute over-the-counter controlled substances, such as methylenedioxymethamphetamine (MDMA) and heroin.
The Drug Enforcement Administration (DEA) has divided these controlled substances into five categories, or "schedules," which give an idea of their dangerousness and the level of control they require.
- Schedule I: These are the drugs with the highest potential for misuse and addiction. Examples: `(Heroin)`, `(LSD)`, `(MDMA)` and marijuana `(Marijuana)`. (Although marijuana is legal in some American states, it is still in this category at the federal level.)
- Schedule II: These also have a high risk of misuse and addiction. Examples: `(Fentanyl)`, `(Morphine)`, `(Methamphetamine)` and `(Oxycodone)`. Doctors have to follow strict rules when prescribing these drugs (e.g. no refills).
- Schedule III: These drugs have a lower risk of misuse, but some risk of addiction. Examples: Benzphetamine, Ketamine, and Anabolic steroids. These drugs also have time limits on their release (e.g., they can only be given five times within a six-month period).
- Schedule IV: Has a lower risk of misuse and addiction than the first three schedules. Examples: `(Clonazepam)`, `(Diazepam)`, `(Lorazepam)`, `(Tramadol)` and `(Triazolam)`. Even if the medication is reissued, it is closely monitored.
- Schedule V: These are the drugs with the lowest potential for abuse or addiction, but they are not without some risk. Examples: Some medications containing `(Codeine)`, antidiarrheal medications containing `(Atropine/diphenoxylate)`, `(Pregabalin)`. Doctors will monitor you closely while you are being treated with these medications.
Although this classification is not the same in Sri Lanka, it can give us an idea of how controlled certain things should be and should only be used under medical advice.
What happens to the brain and body when we use these things?
The immediate effect of using a substance is called "intoxication." There are several things that can happen here:
- Mood changes: You may suddenly feel light-headed or sleepy. You may feel extremely happy and energetic. You may also feel suspicious or paranoid at other times.
- Hallucinations: Seeing or hearing things that are not really there.
- Changes in thinking and decision-making ability: inability to choose right from wrong, confusion in thinking.
- Difficulty with coordination: Staggering when walking, difficulty holding things.
- Increased or decreased appetite: This varies depending on the substance.
Exactly how you feel depends on what you took, how much you took, and whether you had other medications or drugs in your system at the time.
Substance Withdrawal
When you use a substance continuously and frequently, your body becomes accustomed to it. It's like something you do every day. Then, when you suddenly stop using it, or when its effects on your body wear off, you start to experience unpleasant symptoms. This is called "withdrawal symptoms" or "discontinuation symptoms."
Here are some common withdrawal symptoms:
- Agitation
- Feeling cold (Chills)
- Diarrhea
- Difficulty sleeping
- Muscle aches
- Nausea and vomiting
- Stomach cramps
- Sweating
The severity of these withdrawal symptoms depends on what you've been using and how much your body has become accustomed to it (tolerance). Some substances, such as opioids, can cause withdrawal symptoms that are so severe that you may want to use them again to get rid of the pain. This is why substance use disorder can sometimes be so difficult to treat.
Effect on the brain
These addictive substances directly affect the "pleasure center" in your brain. Think about it, we all biologically want to feel happy and fulfilled. Most of the time, we get this happiness from good, healthy things. When you spend time with someone you love, or when you eat a delicious meal, your body produces a chemical called dopamine . This dopamine is what makes us feel happy and fulfilled. So it's like a cycle - you get good feelings, so you want to do those things again and again.
Do you know what happens when you take these addictive substances? Your brain suddenly produces a large amount of dopamine. This means that it artificially creates a lot of pleasure. This high dopamine level can cause harmful changes in your thoughts, feelings, and behaviors. This means that you are more likely to pursue the artificial pleasure that you get from these substances than the pleasure that you get from those healthy things.
Over time, these substances change the chemistry of your brain. Then, you no longer feel the same pleasure from the amount you took before. This means you develop a "tolerance" to the substance. Then, you need to use more and more of the substance to get the same pleasure. This can lead to using more and more, taking dangerous doses, or mixing different substances. This can lead to life-threatening conditions such as an "overdose."
What is the difference between just using and being addicted?
Simply 'using' (substance use) and 'misusing' (substance misuse) are different from a chronic, habitual pattern that leads to a Substance Use Disorder (SUD) . A person may use something occasionally, but that does not make them a ``SUD''.
But, not everyone gets that opportunity. Sometimes, even if you use it incorrectly a couple of times, your body can get used to it (tolerance) and it can become an addiction. That means you can fall into this trap more easily than you think.
The important thing is that substance use disorder is a treatable condition. If you're ready, there are treatments, counseling, and medications that can help you manage this chronic condition.
How should we take care of this in everyday life?
Sometimes, doctors prescribe certain medications to help with severe pain after surgery or to manage a chronic condition. There are also some household chemicals (e.g., a spray to clean a keyboard). These are necessary things.
However, misuse of these products is also common. Therefore, it is important to be well-informed about the medications your doctor prescribes or the products you have at home. Keep them in a safe place and use them only as directed .
If you think you or someone you love may be at risk of developing an addiction, don't hesitate to talk to a doctor . They are there to help you whenever you are ready. Don't be afraid, don't be ashamed. This can happen to anyone, and there is help for this.
Finally, a few things you should remember (Take-Home Message)
So, from what we've discussed, you've probably gotten some idea of how serious these addictive substances are, and how important it is to be aware of them.
- Addiction is not a weakness, it's a disease: it can affect anyone. So it's not good to marginalize anyone.
- The addictive potential of each substance is different: some things can be addictive faster than we think.
- Even prescription medications can be dangerous if not used properly: Always follow your doctor's instructions.
- Your brain develops tolerance to these things: This means that over time you need more and more of them. This is dangerous.
- Withdrawal can be severe: This is why many people are tempted to use again.
- There is help! If you or someone you know is having this problem, there are doctors and counselors to help. Don't suffer alone.
Talking about this can be difficult. But, being aware is the first step. You and your family need to talk about this and be aware. Only then can we avoid these pitfalls and live a healthy life. If you have any further questions, don't be afraid to ask a doctor.
` Addiction, drugs, alcohol, nicotine, substance use disorder, mental health, dopamine
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