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14. PATHOPHYSIOLOGY OF TOXICOMANIA, ALCOHOLISM, DRUG ADDICTION

Toxicomania is a pathological state characterized by anomalous drive to consume certain substances or medicines other than narcotic drugs, and development of psychological or physical dependence. The most prevalent form of toxicomania is alcoholism, which can be also called ethylism.

Drug addiction is a pathological drive to take narcotic drugs.

Psychological dependence is a need to use substance of abuse to improve mood, releive depression or anxiety, increase mental well-being. Physical dependence is manifested by drug or alcohol withdrawal syndrome.

Common stages can be distinguished in the course of drug addiction and alcoholism (fig. 14).

Fig. 14. Common stages in the development of drug addiction and alcoholism

In the absence of dependence, an individual can be given a diagnosis of drug or alcohol abuse if he or she demonstrates repetitive problems with a substance of abuse in any one of four life areas, including:

 an inability to fulfill major obligations;

 use in hazardous situations such as driving;

 legal problems, or use despite social or interpersonal difficulties.

Pharmacological classes of drugs (narcotics) that are usually abused include:

 sedative-hypnotics (e.g. benzodiazepines);

 central nervous system stimulants (e.g. cocaine, marijuana);

 phencyclidine (dissociative anesthetic);

 hallucinogens (e.g. LSD - lysergic acid diethylamine; psilocybin, mescaline);

 opiates (e.g. heroin, morphine).

Stages of alcoholism

I stage

Psychological dependence.

In its first stage alcoholism is characterized by psychological dependence on alcohol. This implies that an individuum drinks alcoholic beverages to reach psychological comfort which is difficult to achieve in the sober state. The alcohol use and associated activity dominate in the alcoholic's consciousness.

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