Drug

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Uncoated aspirin tablets, consisting of about 90% acetylsalicylic acid, along with a minor amount of inert fillers and binders. Aspirin is a pharmaceutical drug often used to treat pain, fever, and inflammation. Aspirine macro shot.jpg
Uncoated aspirin tablets, consisting of about 90% acetylsalicylic acid, along with a minor amount of inert fillers and binders. Aspirin is a pharmaceutical drug often used to treat pain, fever, and inflammation.

A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. [1] Consumption of drugs can be via inhalation, injection, smoking, ingestion, absorption via a patch on the skin, suppository, or dissolution under the tongue.

Contents

In pharmacology, a drug is a chemical substance, typically of known structure, which, when administered to a living organism, produces a biological effect. [2] A pharmaceutical drug, also called a medication or medicine, is a chemical substance used to treat, cure, prevent, or diagnose a disease or to promote well-being. [3] Traditionally drugs were obtained through extraction from medicinal plants, but more recently also by organic synthesis. [4] Pharmaceutical drugs may be used for a limited duration, or on a regular basis for chronic disorders. [3]

Classification

Pharmaceutical drugs are often classified into drug classes—groups of related drugs that have similar chemical structures, the same mechanism of action (binding to the same biological target), a related mode of action, and that are used to treat the same disease. [5] [6] The Anatomical Therapeutic Chemical Classification System (ATC), the most widely used drug classification system, assigns drugs a unique ATC code, which is an alphanumeric code that assigns it to specific drug classes within the ATC system. Another major classification system is the Biopharmaceutics Classification System. This classifies drugs according to their solubility and permeability or absorption properties. [7]

Psychoactive drugs are substances that affect the function of the central nervous system, altering perception, mood or consciousness. [8] These drugs are divided into different groups like: stimulants, depressants, antidepressants, anxiolytics, antipsychotics, and hallucinogens. These psychoactive drugs have been proven useful in treating wide range of medical conditions including mental disorders around the world. The most widely used drugs in the world include caffeine, nicotine and alcohol, [9] which are also considered recreational drugs, since they are used for pleasure rather than medicinal purposes. [10] All drugs can have potential side effects. [11] Abuse of several psychoactive drugs can cause addiction and/or physical dependence. [12] Excessive use of stimulants can promote stimulant psychosis. Many recreational drugs are illicit; international treaties such as the Single Convention on Narcotic Drugs exist for the purpose of their prohibition.

Etymology

In English, the noun "drug" is thought to originate from Old French "drogue", possibly deriving from "droge (vate)" from Middle Dutch meaning "dry (barrels)", referring to medicinal plants preserved as dry matter in barrels. [13] [14]

In the 1990s however, Spanish lexicographer Federico Corriente Córdoba documented the possible origin of the word in {ḥṭr} [15] an early romanized form of Al-Andalus language from Northwestern part of the Iberian peninsula. [16] The term could approximately be transcribed as حطروكة or hatruka. [17]

The term "drug" has become a skunked term with negative connotation, being used as a synonym for illegal substances like cocaine or heroin or for drugs used recreationally. In other contexts the terms "drug" and "medicine" are used interchangeably. [18]

Efficacy

Drug action is highly specific and their effects may only be detected in certain individuals. For instance, the 10 highest-grossing drugs in the US may help only 4-25% of people. [19] Often, the activity of a drug depends on the genotype of a patient. For example, Erbitux (cetuximab) increases the survival rate of colorectal cancer patients if they carry a particular mutation in the EGFR gene. [19] Some drugs are specifically approved for certain genotypes. Vemurafenib is such a case which is used for melanoma patients who carry a mutation in BRAF gene. [19] The number of people who benefit from a drug determines if drug trials are worth carrying out, given that phase III trials may cost between $100 million and $700 million per drug. This is the motivation behind personalized medicine, that is, to develop drugs that are adapted to individual patients. [19]

Medication

Nexium (Esomeprazole) is a proton-pump inhibitor. It is used to reduce the production of stomach acid. Nexium (esomeprazole magnesium) pills.JPG
Nexium (Esomeprazole) is a proton-pump inhibitor. It is used to reduce the production of stomach acid.

A medication or medicine is a drug taken to cure or ameliorate any symptoms of an illness or medical condition. The use may also be as preventive medicine that has future benefits but does not treat any existing or pre-existing diseases or symptoms. Dispensing of medication is often regulated by governments into three categories— over-the-counter medications, which are available in pharmacies and supermarkets without special restrictions; behind-the-counter medicines, which are dispensed by a pharmacist without needing a doctor's prescription, and prescription only medicines , which must be prescribed by a licensed medical professional, usually a physician. [20]

In the United Kingdom, behind-the-counter medicines are called pharmacy medicines which can only be sold in registered pharmacies, by or under the supervision of a pharmacist. These medications are designated by the letter P on the label. [21] The range of medicines available without a prescription varies from country to country. Medications are typically produced by pharmaceutical companies and are often patented to give the developer exclusive rights to produce them. Those that are not patented (or with expired patents) are called generic drugs since they can be produced by other companies without restrictions or licenses from the patent holder. [22]

Pharmaceutical drugs are usually categorised into drug classes. A group of drugs will share a similar chemical structure, or have the same mechanism of action, the same related mode of action or target the same illness or related illnesses. [5] [6] The Anatomical Therapeutic Chemical Classification System (ATC), the most widely used drug classification system, assigns drugs a unique ATC code, which is an alphanumeric code that assigns it to specific drug classes within the ATC system. Another major classification system is the Biopharmaceutics Classification System. This groups drugs according to their solubility and permeability or absorption properties. [7]

Spiritual and religious use

An Amazonian shaman Chaman Amazonie 5 06.jpg
An Amazonian shaman
San Pedro, a psychoactive cactus Flowering San Pedro cactus.jpg
San Pedro, a psychoactive cactus

Some religions, particularly ethnic religions, are based completely on the use of certain drugs, known as entheogens, which are mostly hallucinogens,—psychedelics, dissociatives, or deliriants. Some entheogens include kava which can act as a stimulant, a sedative, a euphoriant and an anesthetic. The roots of the kava plant are used to produce a drink consumed throughout the cultures of the Pacific Ocean.

Some shamans from different cultures use entheogens, defined as "generating the divine within," [23] to achieve religious ecstasy. Amazonian shamans use ayahuasca (yagé), a hallucinogenic brew, for this purpose. Mazatec shamans have a long and continuous tradition of religious use of Salvia divinorum , a psychoactive plant. Its use is to facilitate visionary states of consciousness during spiritual healing sessions. [24]

Silene undulata is regarded by the Xhosa people as a sacred plant and used as an entheogen. Its roots are traditionally used to induce vivid (and according to the Xhosa, prophetic) lucid dreams during the initiation process of shamans, classifying it a naturally occurring oneirogen similar to the more well-known dream herb Calea ternifolia . [25]

Peyote, a small spineless cactus, has been a major source of psychedelic mescaline and has probably been used by Native Americans for at least five thousand years. [26] [27] Most mescaline is now obtained from a few species of columnar cacti in particular from San Pedro and not from the vulnerable peyote. [28]

The entheogenic use of cannabis has also been widely practised [29] for centuries. [30] Rastafari use marijuana (ganja) as a sacrament in their religious ceremonies.

Psychedelic mushrooms (psilocybin mushrooms), commonly called magic mushrooms or shrooms have also long been used as entheogens.

Smart drugs and designer drugs

Nootropics, also commonly referred to as "smart drugs", are drugs that are claimed to improve human cognitive abilities. Nootropics are used to improve memory, concentration, thought, mood, and learning. An increasingly used nootropic among students, also known as a study drug, is methylphenidate branded commonly as Ritalin and used for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. [31] At high doses methylphenidate can become highly addictive. [32] Serious addiction can lead to psychosis, anxiety and heart problems, and the use of this drug is related to a rise in suicides, and overdoses. Evidence for use outside of student settings is limited but suggests that it is commonplace. [31] [32] Intravenous use of methylphenidate can lead to emphysematous damage to the lungs, known as Ritalin lung . [33]

Other drugs known as designer drugs are produced. An early example of what today would be labelled a 'designer drug' was LSD, which was synthesised from ergot. [34] Other examples include analogs of performance-enhancing drugs such as designer steroids taken to improve physical capabilities; these are sometimes used (legally or not) for this purpose, often by professional athletes. [35] Other designer drugs mimic the effects of psychoactive drugs. Since the late 1990s there has been the identification of many of these synthesised drugs. In Japan and the United Kingdom this has spurred the addition of many designer drugs into a newer class of controlled substances known as a temporary class drug.

Synthetic cannabinoids have been produced for a longer period of time and are used in the designer drug synthetic cannabis.

Recreational drug use

Cannabis is a commonly used recreational drug. Macro cannabis bud.jpg
Cannabis is a commonly used recreational drug.

Recreational drug use is the use of a drug (legal, controlled, or illegal) with the primary intention of altering the state of consciousness through alteration of the central nervous system in order to create positive emotions and feelings. The hallucinogen LSD is a psychoactive drug commonly used as a recreational drug. [37]

Ketamine is a drug used for anesthesia, and is also used as a recreational drug, both in powder and liquid form, for its hallucinogenic and dissociative effects. [38]

Some national laws prohibit the use of different recreational drugs; medicinal drugs that have the potential for recreational use are often heavily regulated. However, there are many recreational drugs that are legal in many jurisdictions and widely culturally accepted. Cannabis is the most commonly consumed controlled recreational drug in the world (as of 2012). [39] Its use in many countries is illegal but is legally used in several countries usually with the proviso that it can only be used for personal use. It can be used in the leaf form of marijuana (grass), or in the resin form of hashish. Marijuana is a more mild form of cannabis than hashish.

There may be an age restriction on the consumption and purchase of legal recreational drugs. Some recreational drugs that are legal and accepted in many places include alcohol, tobacco, betel nut, and caffeine products, and in some areas of the world the legal use of drugs such as khat is common. [40]

There are a number of legal intoxicants commonly called legal highs that are used recreationally. The most widely used of these is alcohol.

Administration of drugs

All drugs have a route of administration, and many can be administered by more than one.

A bolus is the administration of a medication, drug or other compound that is given to raise its concentration in blood rapdily to an effective level, regardless of the route of administration

Control of drugs

Numerous governmental offices in many countries deal with the control and supervision of drug manufacture and use, and the implementation of various drug laws. The Single Convention on Narcotic Drugs is an international treaty brought about in 1961 to prohibit the use of narcotics save for those used in medical research and treatment. In 1971, a second treaty the Convention on Psychotropic Substances had to be introduced to deal with newer recreational psychoactive and psychedelic drugs.

The legal status of Salvia divinorum varies in many countries and even in states within the United States. Where it is legislated against, the degree of prohibition also varies.

The Food and Drug Administration (FDA) in the United States is a federal agency responsible for protecting and promoting public health through the regulation and supervision of food safety, tobacco products, dietary supplements, prescription and over-the-counter medications, vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices, cosmetics, animal foods [42] and veterinary drugs.

In India, the Narcotics Control Bureau (NCB), an Indian federal law enforcement and intelligence agency under the Ministry of Home Affairs, is tasked with combating drug trafficking and assisting international use of illegal substances under the provisions of Narcotic Drugs and Psychotropic Substances Act. [43]

See also

Lists of drugs

Related Research Articles

<span class="mw-page-title-main">Controlled Substances Act</span> United States drug-regulating law

The Controlled Substances Act (CSA) is the statute establishing federal U.S. drug policy under which the manufacture, importation, possession, use, and distribution of certain substances is regulated. It was passed by the 91st United States Congress as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970 and signed into law by President Richard Nixon. The Act also served as the national implementing legislation for the Single Convention on Narcotic Drugs.

<span class="mw-page-title-main">Recreational use of dextromethorphan</span> Cough suppressant drug susceptible to misuse.

Dextromethorphan, or DXM, a common active ingredient found in many over-the-counter cough suppressant cold medicines, is used as a recreational drug and entheogen for its dissociative effects. Street names include Brownies, Dextro, Drix, Gel, Groove, Lean, Mega-perls, Poor man's ecstasy, Poor man's PCP, Red devils, Robo, Rojo, Rome, Skittles, Sizzurp, Triple Cs, Sky and Velvet.

<span class="mw-page-title-main">Pharmacology</span> Science of drugs and medications and their effects

Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals.

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Recreational drugs are commonly divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">Narcotic</span> Chemical substance with psycho-active properties

The term narcotic originally referred medically to any psychoactive compound with numbing or paralyzing properties. In the United States, it has since become associated with opiates and opioids, commonly morphine and heroin, as well as derivatives of many of the compounds found within raw opium latex. The primary three are morphine, codeine, and thebaine.

<span class="mw-page-title-main">Psychopharmacology</span> Study of the effects of psychoactive drugs

Psychopharmacology is the scientific study of the effects drugs have on mood, sensation, thinking, behavior, judgment and evaluation, and memory. It is distinguished from neuropsychopharmacology, which emphasizes the correlation between drug-induced changes in the functioning of cells in the nervous system and changes in consciousness and behavior.

α-Methyltryptamine Chemical compound

α-Methyltryptamine is a psychedelic, stimulant, and entactogen drug of the tryptamine family. It was originally developed as an antidepressant at Upjohn in the 1960s, and was used briefly as an antidepressant in the Soviet Union under the brand name Indopan or Indopane before being discontinued.

<span class="mw-page-title-main">Stimulant</span> Drug that increases activity of central nervous system

Stimulants are a class of drugs that increase the activity of the brain. They are used for various purposes, such as enhancing alertness, attention, motivation, cognition, mood, and physical performance. Some of the most common stimulants are caffeine, nicotine, amphetamines, cocaine, methylphenidate, and modafinil.

<span class="mw-page-title-main">Medication</span> Substance used to diagnose, cure, treat, or prevent disease

A medication is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management.

<span class="mw-page-title-main">Entheogen</span> Psychoactive substances that induce spiritual experiences

Entheogens are psychoactive substances, including psychedelic drugs used throughout history in sacred contexts.

A designer drug is a structural or functional analog of a controlled substance that has been designed to mimic the pharmacological effects of the original drug, while avoiding classification as illegal and/or detection in standard drug tests. Designer drugs include psychoactive substances that have been designated by the European Union, Australia, and New Zealand, as new psychoactive substances (NPS) as well as analogs of performance-enhancing drugs such as designer steroids.

<span class="mw-page-title-main">Armodafinil</span> Eugeroic medication

Armodafinil, sold under the brand name Nuvigil, is a wakefulness-promoting medication which is used to treat excessive daytime sleepiness associated with obstructive sleep apnea, narcolepsy, and shift work disorder. It is also used off-label for certain other indications. The drug is taken by mouth.

<span class="mw-page-title-main">Phenibut</span> CNS depressant medication

Phenibut, sold under the brand name Anvifen among others, is a central nervous system (CNS) depressant with anxiolytic effects, and is used to treat anxiety, insomnia, and for a variety of other indications. It is usually taken orally, but may be given intravenously.

<span class="mw-page-title-main">Convention on Psychotropic Substances</span> 1971 UN treaty to regulate recreational drugs

The Convention on Psychotropic Substances of 1971 is a United Nations treaty designed to control psychoactive drugs such as amphetamine-type stimulants, barbiturates, benzodiazepines, and psychedelics signed in Vienna, Austria on 21 February 1971. The Single Convention on Narcotic Drugs of 1961 did not ban the many newly discovered psychotropics, since its scope was limited to drugs with cannabis, coca and opium-like effects.

Substituted amphetamines, or simply amphetamines, are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents. The compounds in this class span a variety of pharmacological subclasses, including stimulants, empathogens, and hallucinogens, among others. Examples of substituted amphetamines are amphetamine (itself), methamphetamine, ephedrine, cathinone, phentermine, mephentermine, tranylcypromine, bupropion, methoxyphenamine, selegiline, amfepramone (diethylpropion), pyrovalerone, MDMA (ecstasy), and DOM (STP).

<span class="mw-page-title-main">Dronabinol</span> Generic name of Δ9-THC in medicine

Dronabinol, sold under the brand names Marinol and Syndros, is the generic name for the molecule of (−)-trans-Δ9-tetrahydrocannabinol (THC) in the pharmaceutical context. It has indications as an appetite stimulant, antiemetic, and sleep apnea reliever and is approved by the U.S. Food and Drug Administration (FDA) as safe and effective for HIV/AIDS-induced anorexia and chemotherapy-induced nausea and vomiting.

<span class="mw-page-title-main">Psychoactive drug</span> Chemical substance that alters brain function

A psychoactive drug, mind-altering drug, or consciousness-altering drug is a chemical substance that changes brain function and results in alterations in perception, mood, consciousness, cognition, or behavior. The term psychotropic drug is often used interchangeably, while some sources present narrower definitions. These substances may be used medically; recreationally; to purposefully improve performance or alter consciousness; as entheogens for ritual, spiritual, or shamanic purposes; or for research, including psychedelic therapy. Physicians and other healthcare practitioners prescribe psychoactive drugs from several categories for therapeutic purposes. These include anesthetics, analgesics, anticonvulsant and antiparkinsonian drugs as well as medications used to treat neuropsychiatric disorders, such as antidepressants, anxiolytics, antipsychotics, and stimulants. Some psychoactive substances may be used in detoxification and rehabilitation programs for persons dependent on or addicted to other psychoactive drugs.

Stimulant use disorder is a type of substance use disorder where the use of stimulants caused clinically significant impairment or distress. It is defined in the DSM-5 as "the continued use of amphetamine-type substances, cocaine, or other stimulants leading to clinically significant impairment or distress, from mild to severe". These psychoactive drugs, known as stimulants, are among the most widely used drugs in the world today, although not all stimulants can induce addiction. As of 1993, Approximately 200 million Americans have used some type of stimulant in the past year alone.

<span class="mw-page-title-main">25G-NBOMe</span> Chemical compound

25G-NBOMe (NBOMe-2C-G) is a derivative of the phenethylamine hallucinogen 2C-G, which acts as a highly potent agonist for the human 5-HT2A receptor.

<span class="mw-page-title-main">Prescription drug addiction</span> Medical condition

Prescription drug addiction is the chronic, repeated use of a prescription drug in ways other than prescribed for, including using someone else’s prescription. A prescription drug is a pharmaceutical drug that may not be dispensed without a legal medical prescription. Drugs in this category are supervised due to their potential for misuse and substance use disorder. The classes of medications most commonly abused are opioids, central nervous system (CNS) depressants and central nervous stimulants. In particular, prescription opioid is most commonly abused in the form of prescription analgesics.

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