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Lecture 1What is addiction?
WHO: Repeated use of a psychoactive substance or substances, to the extent that the user (referred to
as an addict)
- is periodically or chronically intoxicated
- shows a compulsion to take the preferred substance(s)
- has great difficulty in voluntarily stopping substance use
- exhibits determination to obtain psychoactive substances
Tolerance is prominent and a withdrawal syndrome frequently occurs when substance use is
interrupted
The life of the addict is dominated by substance use to the exclusion of all other activities and
responsibilities
Central to the definition of addiction:
- addictive substances
- getting high
- severe negative consequences (individual/social)
- compulsion
- loss of control, unable to stop
Three central elements
1. using substances
2. keep using substances despite negative consequences
3. loss of control
What are addictive substances?
- Substances with a rewarding effect, i.e., substances that will make you feel good (euphoria)
Different substances, three main categories:
Psycholeptica
- Substances that suppress CNS
- Alcohol, heroin, GHB, benzodiazepines
Pyshcoanaleptica
- Substances that stimulate CNS
- Nicotine, coffee, cocaine, XTC, speed
Psychodysleptica
- Substances that cause hallucinations
- LSD, paddo’s, cannabis
These are rewarding effects and the reason people start using these drugs. This is the positive effect,
the first part of the ‘addictive substances, getting high’.
,There are different types of harm when speaking of addiction, shown here:
Individual harm
Harm on a population level
Social damage is a collection of different consequences that are related to crime, health care, social
dysfunction, traffic, etc.
How many people are currently, in the Netherlands, are seeking treatment or are addicted?
,There’s a clear difference between the age group.
Conclusion: we see that addiction has a high prevalence, it’s a very big patient group. We see a lot of
people who are seeking treatment for legal drugs. If you combine that with the previous figures, it’s
not a surprise that the drugs with the most harm are more prevalence.
, Individual/social harm combined
Central to definition of addiction:
- addictive substances
- getting high
- severe negative consequences
individual
social
- compulsion
- loss of control, unable to stop
Despite of the negative consequences, people will not stop. This is stated by the last two components
of addiction, that makes people unable to quit their addiction.
Psycholeptica
substances that suppress CNS
alcohol, benzodiazepines, GHB, opiates
Psychoanaleptica
substances that stimulate CNS
nicotine, coffee, cocaine, amphetamine, XTC
Psychodysleptica
substances that cause hallucinations (“tripping”)
LSD, paddo’s, cannabis
What are addictive substances?
- substances with a rewarding effect, for example substances that will make you feel good
(EUPHORIA)
- substances that make some people think about it and long for it and long after they used it
(CRAVING)
- substances that make some people lose control
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