Substance abuse

From WikiLectures

Narcotic and psychotropic substances (hereinafter referred to as OPL ) is the designation for a number of substances, also referred to as addictive substances (NL) or drugs . When used, they cause qualitative or quantitative changes in thinking , behavior , experience, etc. The use of OPL can lead to addiction , withdrawal syndrome ( withdrawal symptoms ) and numerous somatic diseases (either due to the effect of the active substance directly or inappropriate application). NL abuse can limit a person in other areas as well (deterioration of work performance and relationships, committing crimes under the influence of OPL, etc.)

Division of narcotic and psychotropic substances[edit | edit source]

OPLs are often divided into different groups. However, this division is problematic and often inaccurate.

By origin:

  • Synthetic ( meth , LSD)
  • Natural - typically of plant origin ( cocaine , marijuana ), but also of animal origin (excreta of some toads containing bufotenin), or of mushroom origin (shrimp, red toadstool).

The label "semi-synthetic" (typically the production of heroin from morphine or cocaine from coca) is not appropriate, as the basic precursor of every synthetic drug is always a natural substance.

According to the risks associated with use:

  • Soft (usually tobacco, alcohol, caffeine, sometimes cannabis)
  • Hard ( meth , heroin , cocaine )


According to the effect: These are substances that stimulate the activity of the CNS (otherwise known as stimulants, psychostimulants, analeptics ), substances that dampen the activity of the CNS (also sedatives, hypnotics, tranquilizers ) and hallucinogens.

  • Stimulants (e.g. amphetamine and its derivatives or analogues, cocaine , methylphenidate, caffeine ) increase alertness, delay fatigue, and a subjective feeling of increased performance occurs. The reaction time is shortened, but often at the expense of priority. The somatic component usually represents tachycardia, restlessness, anxiety, paranoia or hallucinations (toxic psychosis) in case of overdose. Nicotine is also usually included here, or tobacco.
  • Sedatives (alcohol, opiates, benzodiazepines , barbiturates ) - often referred to as narcotics or hypnotics. These include medicines (primarily benzodiazepine anxiolytics - alprazolam, bromazepam, clonazepam). In general, they are characterized by a rapid onset of dependence (both psychological and physical), and withdrawal states can be life-threatening ( delirium tremens with alcohol, status epilepticus with benzodiazepines).
  • Hallucinogens ( LSD , lysohlavky, DMT, clary sage) - cause significant qualitative changes in perception. Hallucinogens are a very dangerous risk of developing toxic psychosis ( bad trip in slang ). In such cases, paranoid delusions, massive anxiety, etc. may develop, to which the intoxicated person may react inappropriately due to lack of foresight by escaping from the situation (jumping out of a window, running over a busy road). On the other hand, the risk of addiction (especially for the mentioned representatives) is almost minimal - there is a sharp increase in tolerance. Most conventionally used hallucinogens are also only minimally toxic. Hallucinogens usually also include marijuana.


Even this division is not unambiguous - tobacco is usually placed on the border between stimulants and sedatives, while cannabis is between sedatives and

Diagnostic criteria[edit | edit source]

Currently, a standardized questionnaire of six or seven closed questions. If the answer to three of them is positive, the patient can talk about harmful use or addiction. We use the ICD classification for diagnosis:

Code Diagnosis
F10 Mental and behavioral disorders caused by alcohol use
F11 Mental and behavioral disorders caused by opioid use
F12 Mental and behavioral disorders caused by the use of cannabinoids
F13 Mental disorders and behavioral disorders caused by the use of sedatives or hypnotics
F14 Mental and behavioral disorders caused by cocaine use
F15 Mental and behavioral disorders caused by the use of other stimulants, including caffeine
F16 Mental and behavioral disorders caused by the use of hallucinogens
F17 Mental and behavioral disorders caused by tobacco use
F18 Mental and behavioral disorders caused by the use of volatile solvents
F19 Mental and behavioral disorders caused by the use of multiple drugs and other psychoactive substances *
* Use this item if it is known that two or more psychoactive substances have been used, but it is not possible to decide which substance contributes the most to the disorder. This item should also be used when the identification of some or all of the psychoactive substances used is uncertain or unknown. Many users of multiple types of drugs often do not even know exactly what they are taking..

For the fourth character of the code (e.g. F10.0 - acute alcohol intoxication), the rules stated in this article apply .

General properties of addictive substances[edit | edit source]

In order for a substance to be classified as a drug, it must meet at least one of the following properties. However, almost all of them meet several criteria.


A drug is a substance that generally has the ability to remove unpleasant psychological states, or to induce pleasant ones. More generally speaking, to induce feelings of euphoria, an influx of energy, alleviation of anxiety and fear, a psychospiritual experience ( hallucinations ), while the drug here does not mean ordinary food.


Typical properties of drugs



related articles[edit | edit source]

Psychoanaleptics
Hallucinogens
Stimulants
Sedatives
Withdrawal syndrome
Detoxification
Intoxication
Mental disorders and behavioral disorders caused by the use of psychoactive substances

Resources[edit | edit source]

Papežová a kol., Naléhavé stavy v psychiatrii (1.st ed., pp. 430-447). Praha: Maxdorf.

RABOCH, Jiří a Petr ZVOLSKÝ, c2001. Psychiatrie. Praha: Galén. ISBN 80-726-2140-8.

KALINA, Kamil, 2015. Klinická adiktologie 1 - Klinická farmakologie návykových látek. Praha.