The misuse of psychoactive substances

A psychoactive substance is any substance which alters the state of consciousness, mood or behavior.

Because of the interconnectivity of the world, it’s now extremely easy to gain access to any psychoactive substance or drug, whether synthetic or natural. Continuous unmonitored psychoactive substance consumption can lead to a multitude of health issues of which the most notable is substance use disorder and addiction. Because of the many negative effects these substances have, their production and distribution are either illegal, or under strict regulation and control by the government (medicine such as amphetamines or morphine etc.).

Substance use disorder (SUD) is classified as a mental disorder which affects the brain and behavior. It is considered a disorder of the brain because of the significant functional changes it creates in the neural regions associated with reward, stress and self-control. These changes can persist long after the substance use ends.

The main reasons for the start of consumption of psychoactive substances are:

• Feeling good: recreational use of psychoactive substances is often based on the feelings of pleasure and contempt these substances provide. The experience of euphoria and pleasure vary depending on the substance.
• Compensation: people with different problems often find relief and short-term improvement of their mood, anxiety and overall experiences using such substances. Exposure to stress is a common factor that contributes to the start of usage, continuation and later relapse.
• Performance enhancement: some people feel intense pressure to perform better in school, work or sports. Different substances can help in these fields in different ways.
• Curiosity and social pressure: in adolescence people are often vulnerable to the influence and expectations of their peers. Recreational experimentation with psychoactive substances can lead to serious misuse and addiction problems, and social influence is a serious risk factor.

Addiction is considered the most extreme form of substance abuse disorder. It is defined as a chronic, repeating disorder which is characterized by compulsively trying to acquire the substance and use it, despite the knowledge of the negative consequences.

Addiction can have other forms, associated with gambling, video games, internet or other specific behaviors. We here are focusing on addiction in relation to the use of psychoactive substances.

Types of psychoactive substances

One should keep in mind that some psychoactive substances are socially and legally acceptable and that their production and use is considered normal, or even a positive in some situations. This doesn’t mean their misuse isn’t dangerous. The misuse of medicine, coffee, tobacco or alcohol can lead to addiction as well as other serious health issues.

Psychoactive substances are divided into categories by the effects they have on the nervous system:

• Depressors – can have a calming effect, they bring about feelings of relaxation, sleepiness, tranquility, and slow down psychomotor functions. They can also lead to nightmares, anxiety and aggression. Alcohol, sedatives and opiates are in this group.
• Stimulants – increase energy levels, wakefulness, stimulate psychomotor activity, increase confidence and feelings of energy and general happiness. They can increase heart rate and blood pressure. Caffeine, cocaine, amphetamine, cannabis and ecstasy are in this group.
• Hallucinogens – cause hallucinations and changes in perception, feelings of derealization and dissociation from surroundings or feelings of deep insight. LSD, mescaline, peyote, psilocybin fungi are in this group.

Symptoms of substance use disorder

As state by the special hospital for addiction “Drajzerova”, substance addiction the presence of at least three of the following symptoms:

• Longing for the consumption of the substance
• Physical abstinence symptoms when the use of the substance stops
• Developing a tolerance for previously effective doses of the substance
• Preoccupation with the substance
• Neglecting other interests in order to consume the substance
• Spending large amounts of time to acquire and use the substance
• Continuation of consumption even though the person is aware of the detrimental consequences

There are psychological and physiological aspects to substance addiction. Alcohol, sedatives and opiates lead to both, other substances usually lead to psychological addiction which can have very severe symptoms which affect the general psycho-physiological state of the addict.

Many of the more specific symptoms depend on the specific situation and substance.

 Causes and risk factors

Modern science has established that many factors contribute to the development, and maintenance of this disorder.

• Biological factors: research states that genetics, as well as genetic expression influenced by the surroundings (epigenetics), have a significant role in the development of addictive patterns. Also, adolescents and people with other mental disorders have a higher chance of developing this disorder.
• Home and family: a very important factor, especially in early childhood, if parents or other family members display addictive patterns of behavior, the risk for the children drastically increases.
• School and peers: very significant in adolescents, peers can influence those with no other risk factors to try substances. Difficulties in schoolwork or social interactions can worsen the risk.
• Early use: the consumption of substances at any age can lead to addiction, but research shows that the risk is higher the earlier the use starts. This could be connected to the damaging effects of the substances on the development of the brain. Early use can be influenced by different social and biological factors such as inadequate familial stability, abuse, genetics or other mental disorders.
• Ways of consumption: different substances have different effects and different ways of use lead to different consequences. Consuming substances through smoking or injecting into the bloodstream tends to have more serious effects and thus consequences.

People with substance abuse and addiction problems are often stigmatized (“junkies”), but it is important to understand that this is a disorder which comes about because of many different and complex factors and that these people need help and support to overcome these problems.

Treating substance use disorder

There are many ways to treat substance use disorder. Treatments are individualized and vary depending on the specific person and substance.

The treatments require continuity and monitoring.

Because substance use disorder has a high comorbidity and overlapping with other mental disorders, it is often a good idea to treat them simultaneously instead of separately.

It is necessary for the practitioner or diagnostician to give adequate treatment for the specific situation. It is necessary to take into account the specific combination of the disorders, symptoms, age, substance and situation. If you have doubts that you or someone close to you is experiencing problems with substance use, seek advice from a doctor or other qualified healthcare professional that could help you with diagnosing and finding adequate treatment for your specific situation.

It is most common for treatment to combine pharmacotherapy (medicaments) with psychotherapy.

The first step is detoxification which means cleaning the body from the problematic substance. Depending on the intensity of the problem, pharmacotherapy can be prescribed to help relieve the symptoms of the abstinence crisis.

After this, the most common step is psychotherapy, which is most often based on cognitive behavioral therapy (CBT) or other forms of behavioral therapy. These types of therapy are focused on realization of goals and learning healthy behavioral, cognitive and emotional patterns. Their strength is commonly also in the easing of the other mental health problems which are often associated with substance abuse. It is common for the psychotherapy to include the family of the individual, they need help as well, since this problem affects not only the individual but those closest to them also. It is also important that the family learns and understands how they can provide adequate support.

Pharmacotherapy can also be included in the therapeutic plan, as a way to regulate the chemical imbalance in the brain, ease the longing for the substance, as well as the symptoms of the abstinence crisis.

The specific pharmacotherapy in a big way is dependent on the specific substance in question.

Written by: Bachelor of Psychology, Aleksa Holcer.

Drug Misuse and Addiction | National Institute on Drug Abuse. (2024, January 5). National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

Fletcher, J. (2023, November 15). What to know about the different types of psychoactive drugs. https://www.medicalnewstoday.com/articles/types-of-psychoactive-drugs#types

Substance use and Co-Occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

Šta treba znati o drogama? (n.d.). Drajzerova. https://www.drajzerova.org.rs/saveti/%C5%A1ta-treba-znati-o-drogama

*This text is intended for informational purposes only. If you experience any symptoms, it is recommended that you seek advice from your doctor or a qualified healthcare professional.*

*Image taken from the site: https://unsplash.com/photos/vhite-labeled-jar-on-top-of-cube-ball-on-blue-tektile-ap5KpBcguAK*