Thomas Sydenham, the renounced English physician of seventeenth century, once said, “Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.” Opium, as one significant example of addictive drugs, was in medicinal use since the Stone Age. Like opium, many other currently illicit substances were once accepted therapeutic agents. Addiction as a self-awarding behavior was first connected to compulsive indulging of habit-forming substance in the early twentieth century. Modern physicians no longer warship opium in the manner Sydenham did, as they understand a quick and powerful relief of suffering alone, without balancing other aspects of health, is not the destination of medicine.

The phenomenon of addiction subjected to extensive scientific investigation. At this time the biological mechanisms of addiction are not yet completely elicited. Key structural elements likely include amygdala, nucleus accumbens, pontine nuclei, arcuate, ventral tegmental area (VTA), prefrontal cortex, thalamus, and pallidum. Neurotransmitters, dopamine, and norepinephrine are most closely involved.

DSM-IV-TR allows fourteen diagnoses of substance-related disorders:

1. ▶ Substance dependence

2. ▶ Substance abuse

3. ▶ Substance intoxication

4. ▶ Substance withdrawal

5. ▶ Substance intoxication delirium

6. ▶ Substance withdrawal delirium

7. ▶ Substance-induced persisting dementia

8. ▶ Substance-induced persisting amnestic disorder

9. ▶ Substance-induced psychotic disorder (including hallucinogen persisting perception disorder)

10. ▶ Substance-induced mood disorder

11. ▶ Substance-induced anxiety disorder

12. ▶ Substance-induced sexual dysfunction

13. ▶ Substance-induced sleep disorder

14. ▶ Substance-related disorder not otherwise specified (NOS)

Abuse vs. dependence

1. ▶ Abuse implies failure to fulfill role – failure of any one of these role meets the criteria of abuse

1. ▶ As a worker (repeated absences, poor work performance)

2. ▶ As a student (suspensions, expulsions from school)

3. […]