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Knowing Drug Classifications Can Be Very Helpful
The Controlled Substances Act (CSA)
regulates five classes of drugs:
Each class has distinguishing properties,
and drugs within each class often produce similar effects. However, all
controlled substances, regardless of class, share a number of common features.
It is the purpose of this introduction to familiarize the reader with some of
these shared features and to give definition to terms (printed in bold)
frequently associated with these drugs.
With the exception of anabolic steroids,
drugs in the other classes are utilized to alter mood, thought, and feeling
through their actions on the central nervous system (brain and spinal cord). For
example, some of these drugs alleviate pain, anxiety, or depression. Some induce
sleep and others energize. Though therapeutically useful, the "feel good"
effects of these drugs contribute to their abuse. The extent to which a
substance is reliably capable of producing intensely pleasurable feelings
(euphoria) increases the likelihood of that substance being abused.
When drugs are used in a manner or amount
inconsistent with the medical or social patterns of a culture, it is called drug
abuse. In legal terms, the non-sanctioned use of substances controlled in
Schedules I through V of the CSA is considered drug abuse. While legal
pharmaceuticals placed under control in the CSA are prescribed and used by
patients for medical treatment, the use of these same pharmaceuticals outside
the scope of Sound medical practice is drug abuse.
In addition to having abuse potential, most
controlled substances are capable of producing dependence, either physical or
psychological. Physical dependence refers to the changes that have occurred in
the body after repeated use of a drug that necessitates the continued
administration of the drug to prevent a withdrawal syndrome. This withdrawal
syndrome can range from mildly unpleasant to life-threatening and is dependent
on a number of factors. The type of withdrawal experienced is related to the
drug being used; the dose and route of administration; concurrent use of other
drugs; frequency and duration of drug use; and the age, sex, health, and genetic
makeup of the user. Psychological dependence refers to the perceived "need" or
"craving" for a drug. Individuals who are psychologically dependent on a
particular substance often feel that they cannot function without continued use
of that substance. While physical dependence disappears within days or weeks
after drug use stops, psychological dependence can last much longer and is one
of the primary reasons for relapse/initiation of drug use after a period of
abstinence).
Contrary to common belief, physical
dependence is not addiction. While addicts are usually physically dependent on
the drug they are abusing, physical dependence can exist without addiction. For
example, patients who take narcotics for chronic pain management or
benzodiazepines to treat anxiety as compulsive drug-seeking behavior where
acquiring and using a drug becomes the most important activity in the user's
life. This definition implies a loss of control regarding drug use, and the
addict will continue to use a drug despite serious medical and/or social
consequences. The National Institute on Drug Abuse (NIDA) estimates that about
five million Americans suffer from drug addiction.
Individuals that abuse drugs often have a
preferred drug that they use, but may substitute other drugs that produce
similar effects (often found in the same drug class) when they have difficulty
obtaining their drug of choice. Drugs within a class are often compared with
each other with terms like potency and efficacy. Potency refers to the amount of
a drug that must be taken to produce a certain effect, while efficacy refers to
whether or not a drug is capable of producing a given effect regardless of dose.
Both the strength and the ability of a substance to produce certain effects play
a role in whether that drug is selected by the drug abuser.
It is important to keep in mind that the
effects produced by any drug can vary significantly and is largely dependent on
the dose and route of administration. Concurrent use of other drugs can enhance
or block an effect and substance abusers often take more than one drug to boost
the desired effects or counter unwanted side effects. This means that the risks
associated with drug abuse cannot be accurately predicted because each user has
his/her own unique sensitivity to a drug. There are a number of theories that
attempt to explain these differences, and it is clear that a genetic component
may predispose an individual to certain toxicities or even addictive behavior.
Youths are especially vulnerable to drug
abuse. According to N IDA, young Americans engaged in extraordinary levels of
illicit drug use in the last third of the twentieth century. Today, the majority
of young people (about 55 percent) have used an illicit drug by the time they
leave high school and about 25 percent of all seniors are current (within the
past month) users. The behaviors associated with teen and preteen drug use often
result in tragic consequences with untold harm to others, themselves, and their
families. For example, an analysis of data from the National Household Survey on
Drug Abuse indicates that youngsters between the ages of 12 and 17 who have
smoked marijuana within the past year are more than twice as likely to cut
class, steal, attack people, and destroy property than are those who did not
smoke marijuana. The more frequently a youth smokes marijuana, the more likely
he or she is to engage in these antisocial behaviors.
In the sections that follow, each of the five classes of drugs is
reviewed and various drugs within each class are profiled. Although marijuana is
classified in the CSA as a hallucinogen, a separate section is dedicated to that
topic. There are also a number of substances that are abused but not regulated
under the CSA. Alcohol and tobacco, for example, are specifically exempt from
control by the CSA. In addition, a whole group of substances called inhalants
are commonly available and widely abused by children. Control of these
substances under the CSA would not only impede legitimate commerce, but would
likely have little effect on the abuse of these substances by youngsters. An
energetic campaign aimed at educating both adults and youth about inhalants is
more likely to prevent their abuse. To that end, a section is dedicated to
providing information on inhalants. The last section in this publication is
entitled, U.S. Chemical Control. In recent years, a significant effort has been
initiated by the United States to reduce the availability of clandestinely
produced drugs by limiting the availability of chemicals and equipment needed to
produce them. This section provides information on chemical control and
specifically lists those chemicals that are currently regulated under the CSA.
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