By Avram Goldstein
Content material: medicines and the mind. Neurotransmitters : the brain's personal medicines -- Receptors : locks for the addictive keys -- Addictive habit -- ache and enjoyment -- The seesaw mind : "highs" and variations -- Are addicts born or made? the medicine and the addicts. Nicotine -- Alcohol and similar medications -- Heroin, morphine, and different opiates -- Cocaine and amphetamines -- hashish (Marijuana) -- Caffeine -- Hallucinogens. medications and society. Prevention : simply say no? -- Treating dependancy, fighting relapse -- 3 classes from the road -- 3 classes from in a foreign country -- Prohibition vs. legalization : a fake dichotomy -- New ideas for rational drug coverage
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Extra info for Addiction : from biology to drug policy
Apparently without biologic activity of its own, it nevertheless blocked the many actions of morphine. Because of this powerful antagonist effect, it came into clinical use for reviving victims of heroin or morphine overdose. Nothing in medical practice is quite so dramatic as a naloxone injection in the emergency room. A person is carried in, barely breathing, blue, and moribund; instantly after naloxone, the patient takes a deep breath, sits up, and wants to go home. Not only is naloxone highly effective in blocking the opioid receptors (see chapter 3), it does so in a specific manner, it fits those receptors and no others.
Addiction is a behavior, and all human behavior has a biologic basis in the workings of the brain. The "hardware" of the brain consists of a thousand billion neurons with their complex network of interconnections, the neurotransmitters they manufacture, and the specialized receptors on which the neurotransmitters act. All this hardware develops initially according to the blueprints in the DNA of our genes, but it is also modified by experience. The "software" consists of the memories, learning, and conditioning that reflect inputs from the environment.
In this way, a "message" is transmitted across the synapse to the second neuron. Sometimes, if the right receptor is present on the nerve ending, a neurotransmitter can act back on the same nerve cell from which it was released, in a kind of feedback loop. Nicotinic and muscarinic acetylcholine receptors are found in many regions of the brain, and acetylcholine is one of the brain's most abundant neurotransmitters. Nicotine, when delivered to the brain in a smoker's blood, combines with certain nicotinic receptors, mimicking the actions of acetylcholine.
Addiction : from biology to drug policy by Avram Goldstein