Psychoactive drug

A psychoactive drug, psychopharmaceutical,

psychoactive agent, or psychotropic drug, is a
chemical substance that changes functions of the
nervous system and results in alterations in perception,
mood, consciousness, cognition or behavior.[1] These
substances may be used medically, recreationally, or
spiritually; to purposefully improve performance or
alter one's consciousness; as entheogens for ritual,
spiritual, or shamanic purposes, or for research. Some
categories of psychoactive drugs, which have
therapeutic value, are prescribed by physicians and
other healthcare practitioners. Examples include
anesthetics, analgesics, anticonvulsants, and
antiparkinsonian drugs, as well as medications used to
treat neuropsychiatric disorders, such as An assortment of psychoactive drugs, including
antidepressants, anxiolytics, antipsychotics, and both street drugs and medications:
stimulant medications. Some psychoactive substances
may be used in the detoxification and rehabilitation 1. caffeine
programs for persons dependent on or addicted to 2. crack cocaine
other psychoactive drugs. 3. methylphenidate (Ritalin)
Psychoactive substances often bring about subjective 4. ephedrine
(although these may be objectively observed) changes 5. MDMA (ecstasy)
in consciousness and mood that the user may find 6. peyote (mescaline)
rewarding and pleasant (e.g., euphoria or a sense of 7. LSD blotter
relaxation) or advantageous in an objectively 8. psilocybin mushroom (Psilocybe
observable or measurable way (e.g. increased cubensis)
alertness). Substances which are rewarding, and thus
9. Salvia divinorum
positively reinforcing, have the potential to induce a
state of addiction – compulsive drug use despite 10. diphenhydramine (Benadryl)
negative consequences. In addition, sustained use of 11. Amanita muscaria mushroom
some substances may produce physical or 12. Tylenol 3 (contains codeine)
psychological dependence, or both, associated with 13. codeine with muscle relaxant
somatic or psychological-emotional withdrawal states
14. pipe tobacco
respectively. Drug rehabilitation attempts to reduce
15. bupropion (Zyban)
addiction, through a combination of psychotherapy,
support groups, and other psychoactive substances. 16. cannabis
Conversely, certain psychoactive drugs may be so 17. hashish
unpleasant, that the person will never use the
substance again. This is especially true of certain
deliriants (e.g. Jimson weed), powerful dissociatives (e.g. PCP, ketamine), and classic psychedelics (e.g.
LSD, psilocybin), in the form of a "bad trip". But a bad LSD or psilocybin trip is not necessarily bad in the
sense that the person can introspectively understand elements of their life, and after this bad trip, understand
that this experience was necessary but temporary and that it was beneficial to them. Delirants like DPH are
necessarily more or less dysphoric in their manifestation, and therefore much more often unpleasant, with
LSD and other psychedelics, the mindset&setting can avoid a bad experience and an anxiolytic can
improve the current condition of the person currently suffering from it.

Psychoactive drug misuse, dependence, and addiction have resulted in legal measures and moral debate.
Governmental controls on manufacture, supply, and prescription attempt to reduce problematic medical
drug use. Ethical concerns have also been raised about over-use of these drugs clinically, and about their
marketing by manufacturers. Popular campaigns to decriminalize or legalize the recreational use of certain
drugs (e.g. cannabis) are also ongoing.

Contents
History
Purposes
Uses
Anesthesia
Pain management
Mental disorders
Recreation
Ritual and spiritual
Military
Route of administration
Determinants of effects
Effects
Affected neurotransmitter systems
Addiction and dependence
Legality
Effect on animals
Widely used psychoactive drugs
See also
References
External links

History
Psychoactive drug use can be traced to prehistory. There is archaeological evidence of the use of
psychoactive substances, mostly plants, dating back at least 10,000 years, and historical evidence of cultural
use over the past 5,000 years.[4] The chewing of coca leaves, for example, dates back over 8,000 years ago
in Peruvian society.[5][6]

Medicinal use is one important facet of psychoactive drug usage. However, some have postulated that the
urge to alter one's consciousness is as primary as the drive to satiate thirst, hunger, or sexual desire.[7]
Supporters of this belief contend that the history of drug use, and even children's desire for spinning,
swinging, or sliding indicate that the drive to alter one's state of mind is universal.[8]
One of the first people to articulate this point of view,
set aside from a medicinal context, was American
author Fitz Hugh Ludlow (1836–1870) in his book
The Hasheesh Eater (1857):

[D]rugs are able to bring humans into the

neighborhood of divine experience and
can thus carry us up from our personal
fate and the everyday circumstances of
our life into a higher form of reality. It is,
however, necessary to understand
precisely what is meant by the use of
drugs. We do not mean the purely Alcohol is a widely used and abused psychoactive
physical craving...That of which we drug. The global alcoholic drinks market was
speak is something much higher, namely expected to exceed $1 trillion in 2013.[2] Beer is
the third-most popular drink overall, after water and
the knowledge of the possibility of the
soul to enter into a lighter being, and to tea.[3]
catch a glimpse of deeper insights and
more magnificent visions of the beauty,
truth, and the divine than we are normally
able to spy through the cracks in our
prison cell. But there are not many drugs
which have the power of stilling such
craving. The entire catalog, at least to the
extent that research has thus far written it,
may include only opium, hashish, and in
rarer cases alcohol, which has
enlightening effects only upon very
particular characters.[9]

During the 20th century, many governments across the world initially responded to the use of recreational
drugs by banning them, and making their use, supply, or trade a criminal offense. A notable example of this
was Prohibition in the United States, where alcohol was made illegal for 13 years. However, many
governments, government officials, and persons in law enforcement have concluded that illicit drug use
cannot be sufficiently stopped through criminalization. Organizations such as Law Enforcement Against
Prohibition (LEAP) have come to such a conclusion, believing:

[T]he existing drug policies have failed in their intended goals of addressing the problems of
crime, drug abuse, addiction, juvenile drug use, stopping the flow of illegal drugs into this
country and the internal sale and use of illegal drugs. By fighting a war on drugs the
government has increased the problems of society and made them far worse. A system of
regulation rather than prohibition is a less harmful, more ethical and a more effective public
policy.[10]

In some countries, there has been a move toward harm reduction by health services, where the use of illicit
drugs is neither condoned nor promoted, but services and support are provided to ensure users have
adequate factual information readily available, and that the negative effects of their use be minimized. Such
is the case of the Portuguese drug policy of decriminalization, which achieved its primary goal of reducing
the adverse health effects of drug abuse.[11]
Purposes
Psychoactive substances are used by humans for a number of different purposes, and these uses vary
widely between cultures. Some substances may have controlled or illegal uses, some may have shamanic
purposes, and some others are used medicinally. Other examples would be social drinking, nootropic, or
sleep aids. Caffeine is the world's most widely consumed psychoactive substance, but unlike many others,
it is legal and unregulated in nearly all jurisdictions. In North America, 90% of adults consume caffeine
daily.[12]

Psychoactive drugs are divided into different groups according to their pharmacological effects. Commonly
used psychoactive drugs and groups:

Anxiolytics. Used to reduce symptoms of anxiety and panic.

Example: benzodiazepines such as Xanax and Valium, barbiturates

Empathogen–entactogens

Example: MDMA (ecstasy), MDA, 6-APB, AMT

Stimulants ("uppers"). This category comprises substances that increase wakefulness and
productivity, stimulate the mind, and may cause euphoria, but do not affect vision.

Examples: amphetamine, caffeine, cocaine, nicotine, modafinil

Depressants ("downers"), including sedatives, hypnotics, and opioids. This category

includes all of the calmative, sleep-inducing, anesthetizing substances, which sometimes
induce perceptual changes, such as dream images, and often evoke feelings of euphoria.

Examples: Ethanol (alcohol), opioids such as morphine, fentanyl, and codeine,

cannabis, barbiturates, benzodiazepines.

Hallucinogens, including psychedelics, dissociatives, and deliriants. This category

encompasses all substances that produce distinct alterations in perception, sensation of
space and time, and emotional states[13]

Examples: psilocybin, LSD, DMT (N,N-Dimethyltryptamine)/ayahuasca, mescaline,

Salvia divinorum, Nitrous oxide, and Scopolamine

Uses

Anesthesia

General anesthetics are a class of psychoactive drug used on people to block physical pain and other
sensations. Most anesthetics induce unconsciousness, allowing the person to undergo medical procedures
like surgery, without the feelings of physical pain or emotional trauma.[14] To induce unconsciousness,
anesthetics affect the GABA and NMDA systems. For example, propofol is a GABA agonist,[15] and
ketamine is an NMDA receptor antagonist.[16]

Pain management
Psychoactive drugs are often prescribed to manage pain. The subjective experience of pain is primarily
regulated by endogenous opioid peptides. Thus, pain can often be managed using psychoactives that
operate on this neurotransmitter system, also known as opioid receptor agonists. This class of drugs can be
highly addictive, and includes opiate narcotics, like morphine and codeine.[17] NSAIDs, such as aspirin
and ibuprofen, are also analgesics. These agents also reduce eicosanoid-mediated inflammation by
inhibiting the enzyme cyclooxygenase.

Mental disorders

Psychiatric medications are psychoactive drugs prescribed for

the management of mental and emotional disorders, or to aid in
overcoming challenging behavior.[18] There are six major
classes of psychiatric medications:

Antidepressants treat disorders such as clinical

depression, dysthymia, anxiety, eating disorders and
borderline personality disorder.[19]
Stimulants, used to treat disorders such as attention
deficit hyperactivity disorder and narcolepsy, and for
weight reduction.
Antipsychotics, used to treat psychotic symptoms, Zoloft (sertraline) is an SSRI
such as those associated with schizophrenia or antidepressant.
severe mania, or as adjuncts to relieve clinical
depression.
Mood stabilizers, used to treat bipolar disorder and schizoaffective disorder.
Anxiolytics, used to treat anxiety disorders.
Depressants, used as hypnotics, sedatives, and anesthetics, depending upon dosage.

In addition, several psychoactive substances are currently employed to treat various addictions. These
include acamprosate or naltrexone in the treatment of alcoholism, or methadone or buprenorphine
maintenance therapy in the case of opioid addiction.[20]

Exposure to psychoactive drugs can cause changes to the brain that counteract or augment some of their
effects; these changes may be beneficial or harmful. However, there is a significant amount of evidence that
the relapse rate of mental disorders negatively corresponds with the length of properly followed treatment
regimens (that is, relapse rate substantially declines over time), and to a much greater degree than
placebo.[21]

Recreation

Many psychoactive substances are used for their mood and perception altering effects, including those with
accepted uses in medicine and psychiatry. Examples of psychoactive substances include caffeine, alcohol,
cocaine, LSD, nicotine and cannabis.[22] Classes of drugs frequently used recreationally include:

Stimulants, which activate the central nervous system. These are used recreationally for
their euphoric effects.
Hallucinogens (psychedelics, dissociatives and deliriants), which induce perceptual and
cognitive alterations.
Hypnotics, which depress the central nervous system.
 Opioid analgesics, which also depress the central nervous system. These are used
recreationally because of their euphoric effects.
Inhalants, in the forms of gas aerosols, or solvents, which are inhaled as a vapor because of
their stupefying effects. Many inhalants also fall into the above categories (such as nitrous
oxide which is also an analgesic).

In some modern and ancient cultures, drug usage is seen as a status symbol. Recreational drugs are seen as
status symbols in settings such as at nightclubs and parties.[23] For example, in ancient Egypt, gods were
commonly pictured holding hallucinogenic plants.[24]

Because there is controversy about regulation of recreational drugs, there is an ongoing debate about drug
prohibition. Critics of prohibition believe that regulation of recreational drug use is a violation of personal
autonomy and freedom.[25] In the United States, critics have noted that prohibition or regulation of
recreational and spiritual drug use might be unconstitutional, and causing more harm than is prevented.[26]

Some people who take psychoactive drugs experience drug or substance induced psychosis. A 2019
systematic review and meta-analysis by Murrie et al. found that the pooled proportion of transition from
substance-induced psychosis to schizophrenia was 25% (95% CI 18%–35%), compared with 36% (95% CI
30%–43%) for brief, atypical and not otherwise specified psychoses.[27] Type of substance was the primary
predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with
cannabis (6 studies, 34%, CI 25%–46%), hallucinogens (3 studies, 26%, CI 14%–43%) and amphetamines
(5 studies, 22%, CI 14%–34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative
(9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex,
country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration
of follow-up.[27]

Ritual and spiritual

Certain psychoactives, particularly hallucinogens, have been used for

religious purposes since prehistoric times. Native Americans have used
peyote cacti containing mescaline for religious ceremonies for as long as
5700 years.[28] The muscimol-containing Amanita muscaria mushroom
was used for ritual purposes throughout prehistoric Europe.[29]

The use of entheogens for religious purposes resurfaced in the West during
the counterculture movements of the 1960s and 70s. Under the leadership
of Timothy Leary, new spiritual and intention-based movements began to
use LSD and other hallucinogens as tools to access deeper inner
exploration. In the United States, the use of peyote for ritual purposes is
protected only for members of the Native American Church, which is Timothy Leary was a leading
allowed to cultivate and distribute peyote. However, the genuine religious proponent of spiritual
use of peyote, regardless of one's personal ancestry, is protected in hallucinogen use.
Colorado, Arizona, New Mexico, Nevada, and Oregon.[30]

Military

Psychoactive drugs have been used in military applications as non-lethal weapons.

Both military and civilian American intelligence officials are known to have used psychoactive drugs while
interrogating captives apprehended in its "war on terror". In July 2012 Jason Leopold and Jeffrey Kaye,
psychologists and human rights workers, had a Freedom of Information Act request fulfilled that confirmed
that the use of psychoactive drugs during interrogation was a long-standing practice.[31][32] Captives and
former captives had been reporting medical staff collaborating with interrogators to drug captives with
powerful psychoactive drugs prior to interrogation since the very first captives release.[33][34] In May 2003
recently released Pakistani captive Sha Mohammed Alikhel described the routine use of psychoactive
drugs. He said that Jihan Wali, a captive kept in a nearby cell, was rendered catatonic through the use of
these drugs.

Additionally, militaries worldwide have used or are using various psychoactive drugs to improve
performance of soldiers by suppressing hunger, increasing the ability to sustain effort without food,
increasing and lengthening wakefulness and concentration, suppressing fear, reducing empathy, and
improving reflexes and memory-recall among other things.[35][36]

The first documented case of a soldier overdosing on methamphetamine during combat, was the Finnish
corporal Aimo Koivunen, a soldier who fought in the Winter War and the Continuation War.[37][38]

Route of administration
Psychoactive drugs are administered via oral ingestion as a tablet, capsule, powder, liquid, and beverage;
via injection by subcutaneous, intramuscular, and intravenous route; via rectum by suppository and enema;
and via inhalation by smoking, vaporizing, and snorting. The efficiency of each method of administration
varies from drug to drug.[39]

The psychiatric drugs fluoxetine, quetiapine, and lorazepam are ingested orally in tablet or capsule form.
Alcohol and caffeine are ingested in beverage form; nicotine and cannabis are smoked or vaporized; peyote
and psilocybin mushrooms are ingested in botanical form or dried; and crystalline drugs such as cocaine
and methamphetamine are usually inhaled or snorted.

Determinants of effects
The theory of dosage, set, and setting is a useful model in dealing with the effects of psychoactive
substances, especially in a controlled therapeutic setting as well as in recreational use. Dr. Timothy Leary,
based on his own experiences and systematic observations on psychedelics, developed this theory along
with his colleagues Ralph Metzner, and Richard Alpert (Ram Dass) in the 1960s.[40]

Dosage

The first factor, dosage, has been a truism since ancient times, or at least since Paracelsus who said, "Dose
makes the poison." Some compounds are beneficial or pleasurable when consumed in small amounts, but
harmful, deadly, or evoke discomfort in higher doses.

Set

The set is the internal attitudes and constitution of the person, including their expectations, wishes, fears,
and sensitivity to the drug. This factor is especially important for the hallucinogens, which have the ability
to make conscious experiences out of the unconscious. In traditional cultures, set is shaped primarily by the
worldview, health and genetic characteristics that all the members of the culture share.

Setting
The third aspect is setting, which pertains to the surroundings, the place, and the time in which the
experiences transpire.

This theory clearly states that the effects are equally the result of chemical, pharmacological, psychological,
and physical influences. The model that Timothy Leary proposed applied to the psychedelics, although it
also applies to other psychoactives.[41]

Effects
Psychoactive drugs operate by temporarily affecting a
person's neurochemistry, which in turn causes changes
in a person's mood, cognition, perception and
behavior. There are many ways in which psychoactive
drugs can affect the brain. Each drug has a specific
action on one or more neurotransmitter or
neuroreceptor in the brain.

Drugs that increase activity in particular

Illustration of the major elements of
neurotransmitter systems are called agonists. They act
neurotransmission. Depending on its method of
by increasing the synthesis of one or more
action, a psychoactive substance may block the
neurotransmitters, by reducing its reuptake from the
receptors on the post-synaptic neuron (dendrite), or
synapses, or by mimicking the action by binding
block reuptake or affect neurotransmitter synthesis
directly to the postsynaptic receptor. Drugs that reduce
in the pre-synaptic neuron (axon).
neurotransmitter activity are called antagonists, and
operate by interfering with synthesis or blocking
postsynaptic receptors so that neurotransmitters cannot bind to them.[42]

Exposure to a psychoactive substance can cause changes in the structure and functioning of neurons, as the
nervous system tries to re-establish the homeostasis disrupted by the presence of the drug (see also,
neuroplasticity). Exposure to antagonists for a particular neurotransmitter can increase the number of
receptors for that neurotransmitter or the receptors themselves may become more responsive to
neurotransmitters; this is called sensitization. Conversely, overstimulation of receptors for a particular
neurotransmitter may cause a decrease in both number and sensitivity of these receptors, a process called
desensitization or tolerance. Sensitization and desensitization are more likely to occur with long-term
exposure, although they may occur after only a single exposure. These processes are thought to play a role
in drug dependence and addiction.[43] Physical dependence on antidepressants or anxiolytics may result in
worse depression or anxiety, respectively, as withdrawal symptoms. Unfortunately, because clinical
depression (also called major depressive disorder) is often referred to simply as depression, antidepressants
are often requested by and prescribed for patients who are depressed, but not clinically depressed.

Affected neurotransmitter systems

The following is a brief table of notable drugs and their primary neurotransmitter, receptor or method of
action. Many drugs act on more than one transmitter or receptor in the brain.[44]
Neurotransmitter/receptor Classification Examples
Cholinergics
(acetylcholine
arecoline, nicotine, piracetam
receptor
agonists)
Muscarinic
antagonists
scopolamine, benzatropine, dimenhydrinate, diphenhydramine,
(acetylcholine
doxylamine, atropine, quetiapine, olanzapine, most tricyclics
receptor
antagonists)
Acetylcholine
Nicotinic
antagonists
(acetylcholine memantine, bupropion
receptor
antagonists)

Adenosine
receptor caffeine, theobromine, theophylline
antagonists[45]

Adenosine
Dopamine cocaine, bupropion, methylphenidate, St John's wort, and certain
reuptake TAAR1 agonists like amphetamine, phenethylamine, and
inhibitors methamphetamine
Dopamine
Cavendish bananas,[46] TAAR1 agonists like amphetamine,
releasing
phenethylamine, and methamphetamine
agents
Dopamine
pramipexole, Ropinirole, L-DOPA (prodrug), memantine
agonists
Dopamine
Dopamine haloperidol, droperidol, many antipsychotics (e.g., risperidone,
antagonists olanzapine, quetiapine)
Dopamine
partial LSD, aripiprazole
agonists
GABA
reuptake tiagabine, St John's wort, vigabatrin, deramciclane
inhibitors
gamma-Aminobutyric acid
GABAA ethanol, niacin,[47] barbiturates, diazepam, clonazepam,
(GABA)
receptor lorazepam, temazepam, alprazolam and other benzodiazepines,
agonists zolpidem, eszopiclone, zaleplon and other nonbenzodiazepines,
muscimol, phenibut
GABAA
receptor
positive
allosteric
modulators
GABA
receptor thujone, bicuculline
antagonists
GABAA
receptor
negative
 allosteric
modulators

St John's wort,[48] most non-SSRI antidepressants such as

Norepinephrine amoxapine, atomoxetine, bupropion, venlafaxine, quetiapine, the
reuptake tricyclics, methylphenidate, SNRIs such as duloxetine,
inhibitors venlafaxine, cocaine, tramadol, and certain TAAR1 agonists like
amphetamine, phenethylamine, methamphetamine.
Norepinephrine
ephedrine, PPA, pseudoephedrine, amphetamine,
releasing
phenethylamine, methamphetamine
agents

Norepinephrine Adrenergic
clonidine, guanfacine, phenylephrine
agonists
Adrenergic carvedilol, metoprolol, mianserin, prazosin, propranolol,
antagonists trazodone, yohimbine, olanzapine
Serotonin triptans (e.g. sumatriptan, eletriptan), psychedelics (e.g. lysergic
receptor acid diethylamide, psilocybin, mescaline), ergolines (e.g. lisuride,
agonists bromocriptine)
Serotonin most antidepressants including St John's wort, tricyclics such as
reuptake imipramine, SSRIs (e.g. fluoxetine, sertraline, escitalopram),
inhibitors SNRIs (e.g. duloxetine, venlafaxine)
Serotonin
releasing fenfluramine, MDMA (ecstasy), tryptamine
agents
Serotonin
Serotonin ritanserin, mirtazapine, mianserin, trazodone, cyproheptadine,
receptor memantine, atypical antipsychotics (e.g., risperidone, olanzapine,
antagonists quetiapine)
AMPA
receptor
positive aniracetam, CX717, piracetam
allosteric
modulators
AMPA
receptor kynurenic acid, NBQX, topiramate
AMPA receptor antagonists
Cannabinoid
receptor JWH-018
agonists
Cannabinoid
receptor partial Anandamide, THC, cannabidiol, cannabinol
agonists
Cannabinoid
receptor
Rimonabant
inverse
agonists
Cannabinoid
Anandamide
reuptake LY 2183240, VDM 11, AM 404
inhibitors[49]
FAAH enzyme
MAFP, URB597, N-Arachidonylglycine
inhibitors
NMDA
ethanol, ketamine, deschloroketamine, 2-
NMDA receptor receptor
Fluorodeschloroketamine, PCP, DXM, Nitrous Oxide, memantine
antagonists
GHB receptor GHB receptor GHB, T-HCA
agonists
 Sigma-1
cocaine, DMT, DXM, fluvoxamine, ibogaine, opipramol, PCP,
receptor
methamphetamine
agonists
Sigma receptor
Sigma-2
receptor methamphetamine
agonists
μ-opioid
Narcotic opioids (e.g. codeine, morphine, hydrocodone,
receptor
hydromorphone, oxycodone, oxymorphone, heroin, fentanyl)
agonists
μ-opioid
receptor partial buprenorphine
agonists
μ-opioid
receptor
naloxone
inverse
Opioid receptor agonists
μ-opioid
receptor naltrexone
antagonists
κ-opioid
receptor salvinorin A, butorphanol, nalbuphine, pentazocine, ibogaine[50]
agonists
κ-opioid
receptor buprenorphine
antagonists
H1 receptor diphenhydramine, doxylamine, mirtazapine, mianserin,
antagonists quetiapine, olanzapine, meclozine, most tricyclics

H3 receptor
pitolisant
Histamine receptor antagonists
Indirect
histamine
modafinil[51]
receptor
agonists
Monoamine phenelzine, iproniazid, tranylcypromine, selegiline, rasagiline,
oxidase moclobemide, isocarboxazid, Linezolid, benmoxin, St John's
Monoamine oxidase
inhibitors
wort, coffee,[52] garlic[53]
(MAOIs)
Melatonin
Melatonin receptor receptor agomelatine, melatonin, ramelteon, tasimelteon
agonists
Imidazoline
Imidazoline receptor receptor apraclonidine, clonidine, moxonidine, rilmenidine
agonists
Inderict Orexin
receptor modafinil[54]
agonists
Orexin receptor
Orexin
receptor SB-334,867, SB-408,124, TCS-OX2-29, suvorexant
antagonists

Addiction and dependence

Psychoactive drugs are often associated with addiction or drug Addiction and dependence
dependence. Dependence can be divided into two types: glossary[55][56][57][58]
psychological dependence, by which a user experiences negative
psychological or emotional withdrawal symptoms (e.g., addiction – a biopsychosocial
depression) and physical dependence, by which a user must use a disorder characterized by
drug to avoid physically uncomfortable or even medically harmful
persistent use of drugs (including
physical withdrawal symptoms.[60] Drugs that are both rewarding
alcohol) despite substantial harm
and reinforcing are addictive; these properties of a drug are
and adverse consequences
mediated through activation of the mesolimbic dopamine pathway,
particularly the nucleus accumbens. Not all addictive drugs are addictive drug – psychoactive
associated with physical dependence, e.g., amphetamine, and not substances that with repeated
all drugs that produce physical dependence are addictive drugs, use are associated with
e.g., caffeine. significantly higher rates of
substance use disorders, due in
Many professionals, self-help groups, and businesses specialize in
large part to the drug's effect on
drug rehabilitation, with varying degrees of success, and many
parents attempt to influence the actions and choices of their brain reward systems
children regarding psychoactives.[61] dependence – an adaptive state
associated with a withdrawal
Common forms of rehabilitation include psychotherapy, support syndrome upon cessation of
groups and pharmacotherapy, which uses psychoactive substances repeated exposure to a stimulus
to reduce cravings and physiological withdrawal symptoms while
(e.g., drug intake)
a user is going through detox. Methadone, itself an opioid and a
psychoactive substance, is a common treatment for heroin drug sensitization or reverse
addiction, as is another opioid, buprenorphine. Recent research on tolerance – the escalating effect
addiction has shown some promise in using psychedelics such as of a drug resulting from repeated
ibogaine to treat and even cure drug addictions, although this has administration at a given dose
yet to become a widely accepted practice.[62][63] drug withdrawal – symptoms
that occur upon cessation of
Legality repeated drug use
physical dependence –
The legality of psychoactive drugs has been controversial through dependence that involves
most of recent history; the Second Opium War and Prohibition are
persistent physical–somatic
two historical examples of legal controversy surrounding
withdrawal symptoms (e.g.,
psychoactive drugs. However, in recent years, the most influential
fatigue and delirium tremens)
document regarding the legality of psychoactive drugs is the Single
Convention on Narcotic Drugs, an international treaty signed in psychological dependence –
1961 as an Act of the United Nations. Signed by 73 nations dependence that involves
including the United States, the USSR, Pakistan, India, and the emotional–motivational
United Kingdom, the Single Convention on Narcotic Drugs withdrawal symptoms (e.g.,
established Schedules for the legality of each drug and laid out an dysphoria and anhedonia)
international agreement to fight addiction to recreational drugs by
reinforcing stimuli – stimuli that
combatting the sale, trafficking, and use of scheduled drugs.[64]
All countries that signed the treaty passed laws to implement these increase the probability of
rules within their borders. However, some countries that signed the repeating behaviors paired with
Single Convention on Narcotic Drugs, such as the Netherlands, them
are more lenient with their enforcement of these laws.[65] rewarding stimuli – stimuli that
the brain interprets as
In the United States, the Food and Drug Administration (FDA) has
intrinsically positive and
authority over all drugs, including psychoactive drugs. The FDA
desirable or as something to
regulates which psychoactive drugs are over the counter and
approach
which are only available with a prescription.[66] However, certain sensitization – an amplified
psychoactive drugs, like alcohol, tobacco, and drugs listed in the response to a stimulus resulting
Single Convention on Narcotic Drugs are subject to criminal laws. from repeated exposure to it
The Controlled Substances Act of 1970 regulates the recreational
substance use disorder – a
drugs outlined in the Single Convention on Narcotic Drugs.[67]
Alcohol is regulated by state governments, but the federal National condition in which the use of
Minimum Drinking Age Act penalizes states for not following a substances leads to clinically and
national drinking age.[68] Tobacco is also regulated by all fifty functionally significant
state governments.[69] Most people accept such restrictions and impairment or distress
prohibitions of certain drugs, especially the "hard" drugs, which tolerance – the diminishing
are illegal in most countries.[70][71][72] effect of a drug resulting from
repeated administration at a
In the medical context, psychoactive drugs as a treatment for
illness is widespread and generally accepted. Little controversy given dose
exists concerning over the
counter psychoactive
medications in antiemetics
and antitussives.
Psychoactive drugs are
commonly prescribed to
patients with psychiatric
disorders. However,
certain critics believe that
certain prescription
psychoactives, such as
antidepressants and
stimulants, are
Historical image of legal
overprescribed and
heroin bottle
threaten patients'
judgement and
autonomy. [73][74]
Comparison of the perceived harm for various
psychoactive drugs from a poll among medical
Effect on animals psychiatrists specialized in addiction treatment
(David Nutt et al. 2007).[59]
A number of animals consume different psychoactive
plants, animals, berries and even fermented fruit,
becoming intoxicated, such as cats after consuming catnip. Traditional legends of sacred plants often
contain references to animals that introduced humankind to their use.[75] Animals and psychoactive plants
appear to have co-evolved, possibly explaining why these chemicals and their receptors exist within the
nervous system.[76]

Widely used psychoactive drugs

This is a list of commonly used drugs that contain psychoactive ingredients. Please note that the following
lists contains legal and illegal drugs (based on the country's laws).

Alcohol
Benzodiazepines
Caffeine
Cannabis
 Cocaine
Heroin
LSD
Methamphetamine
Ecstasy
Nicotine
Opioids
Psilocybin mushrooms

See also
Contact high
Counterculture of the 1960s
Demand reduction
Designer drug
Drug
Drug addiction
Drug checking
Drug rehabilitation
Hamilton's Pharmacopeia
Hard and soft drugs
Harm reduction
Neuropsychopharmacology
Psychopharmacology
Poly drug use
Project MKULTRA
Psychedelic plants
Psychoactive fish
Recreational drug use
Responsible drug use
Self-medication

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External links
Neuroscience of Psychoactive Substance Use and Dependence (https://www.who.int/substa
nce_abuse/publications/en/Neuroscience_E.pdf) by the WHO

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