Medications and other substances, whether used for legitimate medical purposes, as a habit (for example, drinking coffee for the caffeine), or recreationally, are an integral part of everyday life for many people (see table Medications and other substances, whether used for legitimate medical purposes, as a habit (for example, drinking coffee for the caffeine), or recreationally, are an integral part of everyday life for many people (see tableMedications With Both Medical and Illicit Uses).
Substance misuse and other substance-related disorders can arise when drugs that directly activate the brain's reward system are taken by a person with the goal of experiencing the feelings of pleasure caused by the drug. The pleasurable sensations vary with the drug. Drugs that are involved in substance use disorders are divided into 10 different classes based on the different effects they produce in the mind and body.
Ten Drug Classes Commonly Associated With Substance-Related Disorders
CaffeineCaffeine |
Cannabis (including marijuana and synthetic cannabinoids) |
Hallucinogens (including LSD, phencyclidine, psilocybin, 3,4-methylenedioxymethamphetamine [MDMA])(including LSD, phencyclidine, psilocybin, 3,4-methylenedioxymethamphetamine [MDMA]) |
Inhalants (such as paint thinner and certain glues) |
Opioids (including fentanyl, morphine, and oxycodone)(including fentanyl, morphine, and oxycodone) |
Stimulants (including amphetamines and cocaine) |
Other (including anabolic steroids and other commonly abused substances) |
Substance-related disorders can develop whether or not a drug is legal, is socially acceptable, or has an accepted medical use (with or without a prescription).
In discussions about controlled substances and drug use, the term "narcotics" is often used. This term refers to drugs that cause loss of feeling, a sense of numbness, and drowsiness, specifically opioids (drugs that bind to opiate receptors on cells). However, the term "narcotics" is also used in a broader (but technically inaccurate) sense to include any drug that is illicit or used illegitimately.
Medications With Both Medical and Illicit Uses
Drug | Medical Use |
|---|---|
CaffeineCaffeine | As an ingredient in some pain relief medications |
Cannabis | To manage chronic pain To manage symptoms associated with chemotherapy (for example, nausea, vomiting, lack of appetite) To treat certain types of childhood seizures |
Medications similar to cocaine (but not cocaine itself) are used as to numb surfaces of the body (as topical and local anesthetics; lidocaine is one such me)Medications similar to cocaine (but not cocaine itself) are used as to numb surfaces of the body (as topical and local anesthetics; lidocaine is one such me) | |
To provide anesthesia To treat depression that has not responded to other treatments | |
To relieve pain and provide anesthesia |
Substance use disorders generally involve behavior patterns in which people continue to use a substance despite having problems caused by its use. There may also be physiologic manifestations, including changes in brain circuitry. The term "substance use disorder" is more accurate, clearly defined, and has fewer negative connotations than "addiction," "abuse," or "dependence."
Drugs in the 10 classes vary in how likely they are to cause a substance use disorder. The potential for misuse of these drugs depends upon a combination of factors, including the following:
How the drug is used
How strongly the drug stimulates the brain's reward pathway
How quickly the drug works
The drug's ability to induce tolerance and/or symptoms of withdrawal
Scheduled Drugs (Controlled Substances)
In the United States, medications classified as controlled substances are regulated by the Drug Enforcement Administration. (See table Some Examples of Controlled Substances). Controlled substances are divided into 5 schedules (or classes) on the basis of their potential for promoting a substance use disorder, whether there is an accepted medical use, and their ability to be used safely under medical supervision (see also U.S. Drug Enforcement Administration Drug Schedules).
Some Examples of Controlled Substances
Schedule | Examples |
|---|---|
I* | Cathinone (khat) and methcathinone, GHB, heroin (and some other opioids), LSD, marijuana, MDMA, psilocybin, synthetic cannabinoids |
II | Amphetamines, barbiturates (short-acting), cocaine, hydrocodone (including hydrocodone combination products), hydromorphone, methadone, methylphenidate, morphine and other strong opioid agonists, oxycodone, hydrocodone, , hydrocodone (including hydrocodone combination products), hydromorphone, methadone, methylphenidate, morphine and other strong opioid agonists, oxycodone, hydrocodone,phencyclidine |
III | Anabolic steroids, barbiturates (intermediate-acting), buprenorphine, dihydrocodeine, dronabinol, , barbiturates (intermediate-acting), buprenorphine, dihydrocodeine, dronabinol,ketamine, paregoric |
IV | Barbiturates (long-acting), benzodiazepines, chloral hydrate, modafinil, meprobamate, pentazocine, propoxyphene, zolpidemBarbiturates (long-acting), benzodiazepines, chloral hydrate, modafinil, meprobamate, pentazocine, propoxyphene, zolpidem |
V | Cough suppressants containing small amounts of codeine, pregabalinCough suppressants containing small amounts of codeine, pregabalin |
* Cannot be prescribed. GHB = gamma hydroxybutyrate; LSD = lysergic acid diethylamide; MDMA = methylenedioxymethamphetamine. | |
Drugs Mentioned In This Article
