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Various psychoactive substances

The word drug also colloquially referred to since the mid-20th century intoxicating convincing substances ( illicit drugs , intoxicants or drugs ). These are psychotropic substances and their preparations, which can have both an effect that changes physical conditions and an effect that changes consciousness and perception . In scientific parlance, however, the term actually stands for dried parts of plants, fungi, animals or microorganisms that are used to manufacture drugs (see medicinal drug ).

Some psychoactive drugs have traditionally been viewed as stimulants in parts of the world and are consumed by broad sections of society. These include alcohol (e.g. in the form of beer , wine or schnapps ; see alcohol consumption ), nicotine ( tobacco , see smoking ), caffeine ( coffee , tea ), cannabis ( marijuana , hashish ), cocaine ( coca leaves ), Betel and Kath . Many luxury foods can lead to an altered state of consciousness with the appropriate dosage and can be associated with harmful consequences, including addiction and death.

There is no general agreement on whether and to what extent drug use is socially and economically appropriate and tolerable. The debate about this is predominantly colored ideologically and conducted irrationally. The trade, circulation and consumption of psychotropic substances are largely regulated and restricted by national legislation and international agreements. Thus, in 1971 by the leading United Nations adopted the Convention on Psychotropic Substances to the global ban on almost all then known drugs; The only exceptions were a few (mostly in the western world) already established drugs such as alcohol, nicotine and caffeine. In fact, due to the high demand for other drugs, a global shadow economy has emerged.

Legal Aspects

" Narcotics " is a collective term in Germany for substances of different origin, composition and effect, the cultivation, manufacture, import and export, distribution, acquisition, possession and trade of which are punishable if the Federal Institute for Drugs and Medical Devices does not have a permit . The colloquial terms “drug” or “drug” are not mentioned in the Narcotics Act . The more modern designer drugs, on the other hand, aim exclusively at intoxicating and addictive effects.

While many intoxicants are banned or strictly regulated by law in most countries, others are traditionally widely used folk drugs , including coffee , alcohol (see alcohol consumption ) and tobacco (see smoking ) in particular .

To the subject

The German colloquial use of the term drug differs from that in English-speaking countries: Because there, drug is mostly used in the sense of medicinal drug and stands for medicinal substances in general. Recreational drugs, on the other hand, are those psychoactive substances that are taken for recreational purposes instead of for therapeutic purposes. This term therefore corresponds most closely to the German drug or intoxicating drug.

The term drug is etymologically derived from the Dutch droog for dry (cf. also the originally Low German and largely synonymous word dröge ). That in turn was adopted as drogue in French and from there around 1600 as a loan word in German. The further development of meaning proceeded via the (Central) Dutch or (Central) Low German phrase drug vaten , which literally means dry barrels and denotes containers for dry goods. In the further course the adjective drug or later droog was gradually used as a substitute for the phrase and finally only referred to the contents of such containers. During the times of Dutch colonial rule, these were in particular dried plant products such as tea and spices . From this meaning, via the detour via French, both today's German meaning of the word drug and the English drug , which is also (and above all) used in the sense of drug, arose; See also the German word drug store and the article drug (pharmacy) .

History of intoxicating drug use

Cultic mushroom statuettes from Central America

The use of psychoactive substances and drugs can be proven as early as the Neolithic . Already around 6000 BC Chr. Was viticulture operated in western Central Asia, and no later than 3000 BC. In ancient Egypt and Mesopotamia beer was brewed. The use of hemp as a fiber plant is for the 3rd millennium BC. Occupied; by the Assyrians was cannabis already in pre-Christian times as incense used and the intoxicating effect is also in the Indian Vedas mentioned. In the 4th millennium BC The cultivation of the opium poppy began in the Middle East , from where it spread in the Mediterranean region and in Asia to China. Its use as an analgesic and sleep-inducing agent is for 1300 BC. Proven.

On the basis of linguistic analyzes, there are indications that the effects of the fly agaric in Siberia were known more than 5000 years ago; to 1000 to 2000 BC Petroglyphs dated to BC show figures with mushroom-like heads. References to the use of mushrooms containing psilocybin are dated around 5000 BC. Dated. Petroglyphs depicting mushroom-shaped deities have been discovered in the Tassi Valley in Algeria. In Central and South America, so-called mushroom stones can be found, which date back to 1000 to 500 BC. To be dated.

Around 300 BC . Chr described Theophrastus the psychoactive properties of datura ; Tobacco use is documented on the American continent around the same time .

Drug use in a social context

Ritual and religious use

An Indian sadhu smoking charas ( hashish ) as an offering to Shiva

A number of naturally occurring drugs called entheogens are traditionally used in a cultic or shamanic context, such as the fly agaric in Siberia, psilocybin-containing mushrooms by native people of southwestern Mexico, and ayahuasca by the Amazon Indians . There are some officially recognized communities in which the regulated use of hallucinogenic substances plays a central role, such as the Santo Daime Church and the Native American Church . In Hinduism the entheogenic use is cannabis common practice; Psychoactive hemp preparations are consumed at religious festivals in honor of the god Shiva , who is said to have brought the hemp plant to mankind.

Use for pleasure and intoxication purposes

Beer is a generally accepted intoxicating drink in western culture

Legal and illegal drugs are used in large parts of the population for non-cultic and non-medical purposes. In most cases, an intensification or change of the experience, sometimes also a state of intoxication, is aimed for. In many countries, the consumption of intoxicating drugs is considered a cultural tradition, in the western world, for example, drinking alcohol . In the opinion of some, the inclusion of the drug in society should reduce the risk of dependency , which could otherwise develop unnoticed by the environment. However, this view is controversial in view of the approximately 1.5 to 2.5 million alcoholics in Germany .

The greatest likelihood of first exposure to drugs is in adolescence, with alcohol, tobacco and cannabis being by far the most common. Only a small proportion of first-time users switch to regular consumption. Around a quarter of adult Germans and Europeans in general have used at least one illegal drug in their lifetime, with one-off or infrequent use also being the rule.

In regions with significant drug consumption, the substances can be detected in municipal wastewater .

Medical use

LSD made for research purposes

Many psychotropic drugs are marketable drugs, such as benzodiazepines , antidepressants, and some opioids . If these are not used as intended, e.g. B. chronically overdosed, or taken without indication , one speaks of a harmful use (colloquial: drug abuse ). Drug use often also occurs as an attempt at self-medication , especially in the case of an existing or emerging mental illness.

Some drugs have significant medicinal effects, such as the treatment of cluster headaches . The possible uses of LSD , psilocybin and MDMA in psychotherapy are also currently being researched. Cannabis is now approved as a medicinal product in many countries, including Germany . Attempts to establish Ayahuasca in a therapeutic-ritual framework in Europe have failed, as the widespread rejection of spirituality within Western culture promotes a purely enjoyable , consuming use of substances. As a result, participants in ayahuasca ceremonies almost always felt overwhelmed.

Other social functions

In his book High Society, the cultural historian Mike Jay names various functions of drugs in contemporary and historical societies. With the Incas, only aristocrats were allowed to chew coca leaves, which made them stand out from the general population . In many societies, certain drugs are or have represented a status symbol as an expensive luxury product ; in this case there is often a demonstrative component inherent in consumption ( validity consumption ). As a result, drugs with status are not only consumed in the immediate private sphere, but also in public at venues such as clubs and restaurants as well as during social celebrations. If drug use is also ritualized , the community that implements the drug use can be strengthened.


Classification of common drugs according to substance class and mode of action

Since psychoactive substances have complex, completely different mechanisms of action and effects, several forms of classification are possible, whereby each classification can only consider certain aspects of a substance. In order to assess the general effects and possible risks of a substance, it is therefore usually necessary to consider its classification within several classifications. In the following, particularly common or known substances are listed as examples. More detailed information can be found in the corresponding sub-articles.

Classification according to substance class

Structural formulas
Psilocybin Structural Formulas V.1.svg
Cocaine - Cocaine.svg
Heroin - Heroine.svg
Diacetylmorphine ( heroin )
Nicotine - Nicotine.svg

Due to their chemical structure, drugs can be assigned to different substance classes . Many drugs can be assigned to the alkaloids (nitrogen-containing organic compounds) or the terpenoids (oxygen-containing derivatives of isoprene ). Within a substance class, psychoactive substances often have a common aspect of the effect; For example, all amphetamines are stimulatory and most tryptamines are hallucinogenic.

Substance class structure Examples
Benzodiazepines Benzodiazepine Structural Formula V1.svg Alprazolam , diazepam , lorazepam
Thienodiazepines Thienodiazepine General Formula V1.svg Bentazepam , Brotizolam , Etizolam
Indole alkaloids Indole2.svg Ibogaine , mitragynine
Ergolines and ergot alkaloids
Ergoline Structural Formulas V.1.svg
Harman alkaloids
Beta-Carboline.svg Harmaline , Harmalol , Harmine , Tetrahydroharmine
Tryptamine.svg 4-HO-MET , 5-MeO-DALT , psilocin , psilocybin ; endogenous: DMT , melatonin , serotonin
Opioids Morphine - Morphine.svg
Arylcyclohexylamines Acha markush.png
Phenylethylamines Phenethylamine - Phenethylamine.svg
D-amphetamine Amphetamine , DOM , 4-FA , MDMA , methylamphetamine
Cathinon Structural Formulas V.1.svg Cathinone , MDMC , mephedrone , methcathinone , 4-methylethcathinone
L-tyrosine Adrenaline , dopamine , noradrenaline (all produced by the body)
Tropane alkaloids Tropane - Tropane.svg Hyoscyamine , cocaine , scopolamine
Xanthines Xanthine - Xanthine.svg Caffeine , theobromine , theophylline
Others Arecoline , Muscimol , Nicotine
Substance class structure Examples
Cannabinoids Tetrahydrocannabinol.svg Cannabidiol (CBD), Δ 9 -THC
Salvinorine Salvinorin AB.svg Salvinorin A

Classification according to effect

Ecstasy is mainly used for its entactogenic and stimulating effects

Drugs can be classified according to their pharmacological classification according to their psychological effects, with some drugs belonging to several groups. This classification is the most general and widely used among drug users; The substance class can be used for a more precise assessment of the expected effect.

group Main effect Examples
Dissociatives Decoupling of mental processes from consciousness through dissociation DXM , ketamine , nitrous oxide
Delirium Dissociative; Disorientation, sometimes hallucinations Alcohol , DPH , hyoscyamine , muscimol , scopolamine
Empathogens and Entactogens Intensification of feelings, often also increased emotional opening towards others 2C-B , 2C-I , GBL , MDMA , MDMC
Narcotics Dissociative; in high doses, complete anesthesia , e.g. Some also have a psychedelic effect Barbiturates , ketamine
Psychedelics Psychotomimetic and pseudo-hallucinogenic , it leads to a psychedelic high (coll .:  trip ) AL-LAD , DMT , 25I-NBOMe , LSA , LSD , mescaline , psilocin , psilocybin ; DXM and ketamine have a dissociative effect at the same time
Sedatives and hypnotics Central damping , whereby the distinction between the two groups is purely quantitative Benzodiazepines , (low dose) cannabis , mitragynine ( kratom ), neuroleptics ; Alcohol , DPH and opiates have a dissociative effect at the same time
Stimulants Stimulation of the organism Caffeine , cocaine , nicotine , amphetamines

A very simplified approach divides drugs into upper (stimulating substances), downers (depressant substances) and hallucinogens (mind-altering substances), whereby the transitions can be fluid depending on the substance and dosage.

Classification by origin

Drugs can be obtained directly from living beings as natural substances, synthesized on the basis of such natural substances, and also produced fully synthetically. Some drug users show a strong preference to consume only natural or synthetic drugs, although comparable substances in both groups do not necessarily differ in their pharmacological potency and mode of action.

Overall, however, there is a trend towards the consumption of synthetic drugs (especially amphetamine-like stimulants) and drug abuse (especially opioids and benzodiazepines). This is a direct result of the global decline in coca and opium cultivation. On the other hand, there are no reliable data on the spread of hallucinogenic substances. It is very likely that the number of users is relatively small compared to users of pure upper and downers, since habitual long-term consumption can be as good as ruled out due to the intensive mind-altering effects. However, the availability of psychoactive mushrooms, Salvia divinorum and other psychedelics in smart shops since the late 1990s may well have led to a popularization.

Biogenic Herbal Drugs

Aztec sage ( Salvia divinorum )
Preparation of ayahuasca in the Napo region of Ecuador
Flowering female hemp plant

Most of the traditionally used drugs are of plant origin. Almost all psychoactive plants or plants used in psychoactive preparations are specifically bred and cultivated. Most of the time, parts of plants are consumed directly (by consumption, smoking or making an infusion ) or used as an effective component of a preparation. In the case of some biogenic drugs, in order to achieve a state of intoxication, it is customary to extract the main active ingredient for the purpose of enhancing the effect or making it easier to dose . This can be done by converting it into a solution and then separating it, or by directly evaporating the active ingredient in a vaporizer . Despite the rather high acquisition costs, vaporizers are used by some users of biogenic drugs for consumption, mainly because they refuse to smoke parts of plants for health reasons.

drug Main effect Occurrence
alcohol Delirium by yeasts or bacteria fermented sugar - or starch-containing plant parts
Cathine , cathinone stimulant Cath shrub ( Catha edulis )
DMT Psychedelic Ayahuasca , the tropical red plant Psychotria viridis , various acacia and mimosa species , reed grass
Ephedrine , pseudoephedrine stimulant Plants of the genus Ephedra (e.g. Ephedra sinica )
Harmaline , harmine MAOIs , Oneirogen Ayahuasca , the tropical vine, Banisteriopsis caapi , rue , passion flower
caffeine stimulant Guaraná , coffee , cocoa , tea
cocaine stimulant Coca bush ( Erythroxylum coca )
LSA Psychedelic Hawaiian woodrose , seeds of the bindweed family Turbina corymbosa or Ipomoea violacea ( Ololiuqui )
LSH Psychedelic Ololiuqui
Mescaline Psychedelic Peyote cactus ( Lophophora williamsii ), various cacti of the genus Echinopsis , e.g. B. ( Echinopsis pachanoi , Echinopsis peruviana )
Mitragynine sedative Kratom tree ( Mitragyna speciosa )
nicotine stimulant tobacco
Opiates ( codeine , morphine ) Hypnotic Seed pods of the opium poppy ( Papaver somniferum ), from which opium ( natural opiates is obtained)
Salvinorin A Dissociative Aztec sage ( Salvia divinorum )
Scopolamine Delirium Henbane , angel's trumpets , thorn apple , deadly nightshade
Tetrahydrocannabinol sedative Hemp ( cannabis )

Biogenic drugs from mushrooms

Mushroom drugs are among the oldest drugs known to man and were used in shamanic and religious contexts as early as the Neolithic period due to their predominantly psychedelic effects . Psychoactive mushrooms are often collected in nature, but sometimes also grown on a small scale. The fruit bodies are almost always consumed directly, sometimes the sclerotia as well .

drug Main effect Occurrence
Muscimol Delirium Fly agaric , panther mushroom
Psilocybin Psychedelic Different types of bald heads (e.g. Cuban bald head , pointed conical bald head , stately bald head ) and fertilizers (e.g. blue fertilizer )

Semi-synthetic drugs

LSD Blotter

Some psychoactive substances are synthesized from natural substances. Some intrinsically biogenic drugs (e.g. cocaine) can also be produced from natural precursors through partial synthesis . This requires at least a basic chemical laboratory as well as access to starting chemicals , which in turn can be regulated by law due to the possibility of producing illegal drugs. Despite these obstacles, numerous hidden laboratories, sometimes known colloquially as drug kitchens , serve the demand for illegal semi-synthetic and fully synthetic drugs.

drug Main effect Raw material
LSD , 1P-LSD , ETH-LAD , AL-LAD Psychedelics Ergot alkaloids
Some opioids like buprenorphine , heroin, and oxycodone Hypnotic, analgesic Opium (opium poppy)

Synthetic drugs

Diazepam (Valium)
One 2C-I tablet
Methylphenidate preparations from various manufacturers

Many drugs are manufactured fully synthetically without the aid of a natural starting material. Many substances originally designed as drugs and most marketable drugs, but also so-called designer drugs or research chemicals , which were specifically designed to induce intoxication and / or to circumvent existing substance legislation , fall into this category . It is usually taken orally , often through the nose ( sniffing , pulling ).

drug Main effect
amphetamine stimulant
Arylcyclohexylamines , e.g. B. ketamine , methoxetamine , phencyclidine or 3-MeO-PCP Dissociative, psychedelic
Benzodiazepines , e.g. B. diazepam , flunitrazepam or lorazepam Hypnotic
γ-butyrolactone (GBL) Entactogen
Dextromethorphan (DXM) Dissociative
Dimethoxyamphetamines , e.g. B. DOB , DOI or DOM Psychedelic
Dimethoxyphenylethylamines , e.g. B. the substances of the 2C group or 25I-NBOMe Psychedelic
Diphenhydramine (DPH) Delirium
Laughing gas Dissociative
Solvents ( inhalants ) Dissociative
Methylenedioxyamphetamines , e.g. B. MDA , MDMC or MDMA ( Ecstasy ) Entactogen
Many opioids , e.g. B. fentanyl , methadone , tilidine or tramadol Hypnotic, analgesic
Poppers Tonic , aphrodisiac
Synthetic cannabinoids , e.g. B. JWH-018 , JWH-073 or AM-2201 Cannabinoid mimetic

Classification according to hard and soft

The distinction between hard and soft represents an attempt to depict the hazard potential of certain drugs, especially with regard to their legal classification, in a two-pronged scheme. This approach is controversial.

This classification became popular primarily through the public discussion and media coverage from the judicial environment. The subdivision is found in the Dutch Opium Act (Dutch: Opiumwet ), see Soft Drug (Dutch law), for its origin and specific application .

Classification according to damage potential

Harm potential of common drugs
according to Nutt, 2010
rank drug Point value
1 alcohol 72
2 heroin 55
3 Crack 54
4th Methamphetamine 33
5 cocaine 27
6th tobacco 26th
7th amphetamine 23
8th cannabis 20th
9 GHB 19th
10 Benzodiazepines 15th
11 Ketamine 15th
12 Methadone 14th
13 Mephedrone 13
14th butane 11
15th Khat 9
16 Anabolic steroids 10
17th Ecstasy 9
18th LSD 7th
19th Buprenorphine 7th
20th Mushrooms containing psilocybin 6th
Note: The higher the point value, the higher the damage potential

Risk assessment based on evidence-based methods is difficult.

A possible starting point is the comparison of deaths and consumption units. According to the federal government, around 74,000 people die every year in Germany as a result of the direct and indirect consequences of alcohol abuse. At the same time, an annual per capita consumption of ten liters of pure alcohol per person (in the population aged 14 and over) is assumed, which corresponds to a death per approx. 9,000 to 10,000 liters of pure alcohol consumed. Assuming an alcohol content of 4.8 percent, in Germany - arithmetically - almost 600,000 small beers (0.33 L) cause a fatality. In contrast, one fatality is compared to the consumption of 1,000,000 to 17,000,000 ecstasy pills, depending on the study. The problem with this approach is that although the number of drug-related deaths is known, the number of users is not always known.

In March 2007, a study carried out by a research team led by David Nutt was published in the renowned medical journal The Lancet . It defined three main factors that make up the harm potential of using a drug:

  • the physical harm (physical and health) to the individual that the drug can cause;
  • the potential extent of the individual's dependence on the drug;
  • the possible effects of drug use on the family, community and society in which the drug user lives, i.e. the social harm .

Each of these categories is in turn divided into three sub-categories. Psychiatrists and independent experts gave 0 to 3 points in each sub-category for all substances. The averaged ratings of all categories were added for each substance in order to obtain a value for the general potential for harm.

It is noteworthy that, as a result, the legal drugs alcohol and tobacco are to be found among the ten most harmful drugs. For this reason, Nutt, the British government's drug commissioner at the time, criticized drug policy as "contradicting the findings of research," whereupon he was removed from office.

In November 2010, a follow-up study based on improved methodology was published in the Lancet . The damage potential was now made up of 16 weighted individual factors, which are distributed among the groups of physical, psychological and social damage within the dimensions of self-harm and harm to others . As the drug with the greatest harm potential overall, alcohol was identified with a rating of 72 out of 100 points, followed by heroin (55) and crack (54). The high potential for harm from alcohol, especially in terms of external harm , can probably be partly explained by its easy availability and the widespread and socially tolerated consumption. On the other hand, other drugs with an overall high risk assessment have a higher absolute potential for self-harm. This is likely to be due primarily to the pronounced risk of rapid addiction development with these drugs.

Health aspects


While responsible drug consumption is generally possible with moderate dosage and frequency of use, with some drugs, on the other hand, the use of normal amounts, even when taken once, can lead to health problems. In particular, habitual high-dose consumption of such drugs can damage the body, cause secondary diseases and reduce life expectancy.

So z. B. an overdose of heroin or other opioids can be acutely life-threatening, even in people who are physically used to the substance through regular consumption and corresponding development of opioid tolerance . Even a relatively small dose can have dangerous physical effects without trained tolerance. Drug users who consume opioids again after a long period of abstinence are also at risk.

There is also a risk when intoxicants are “diluted” by diluents in order to increase profit and the diluents are harmful substances with (side) effects unknown to the consumer, for example phenacetin , levamisole and lidocaine in cocaine . Since every intermediate seller can use different diluents, they also serve as indicators and can thus make the transport route of the drugs traceable.

Even legal drugs accepted as stimulants are not free from risks and are by no means to be regarded as harmless. The consumption of large amounts of alcohol can lead to dangerous, in the worst case fatal, alcohol intoxication; Chronic alcohol abuse can cause severe liver damage, brain damage ( Korsakoff syndrome ), as well as various cancers and forms of alcohol psychosis , such as B. the alcohol hallucinosis (ICD-10 F10.52). Tobacco smoke contains more than 4000 z. Substances that are partially damaging to cells, genes and carcinogens. Furthermore, smoking can directly or indirectly damage all of the body's organ systems and is the leading cause of lung cancer .

Psychedelics such as LSD or mushrooms containing psilocybin are largely free of physical and psychological risks due to their mode of action and the scarcely existing abuse potential. However, it cannot be ruled out that, with the appropriate assessment, u. U. a substance-induced psychosis or an already established schizophrenia is triggered. With cannabis products, the health risks are also relatively low. When cannabis is smoked, carcinogenic substances are produced when it is burned, similar to tobacco , but - unlike tobacco smoke - there is no evidence that cannabis smoke (without tobacco smoke) can cause cancer. Currently (as of 2019) research assumes that it appears that cannabis smoke is non-carcinogenic, even though it contains carcinogens . The World Health Organization cites epidemiological evidence that cannabis use does not increase the risk of lung, head and neck cancer. However, if cannabis is smoked together with tobacco , the user basically exposes himself to the same or even greater risks than when smoking tobacco. For this reason, tobacco-free joints and vaporizers are enjoying increasing popularity among cannabis users.

Mixed consumption

The simultaneous consumption of several drugs can represent a major acute health risk because, depending on the combination and dosage, it can result in a significant burden on the organism. Interactions can also occur with ingested medication during mixed consumption . In the worst case, a medical emergency is the result. However, such risks can be reduced considerably by generally avoiding particularly risky mixed consumption or at least only taking a fraction of the otherwise usual dosage of the individual substances.

Selection of potentially dangerous combinations
Drug / drug combined with Risks
alcohol MAO inhibitors (also ayahuasca ) Tyramine poisoning , hypertensive crisis
Opioids (heroin, methadone, tramadol, fentanyl), benzodiazepines ( alprazolam , diazepam , lorazepam ), GBL Respiratory depression , respiratory failure , coma
Amphetamine, cocaine, MDMA Dehydration , circulatory collapse
Antidepressants ; both tricyclic ( amitriptyline , doxepin , clomipramine ) and SSRIs ( sertraline , citalopram ) and SNRIs ( venlafaxine , duloxetine ) MAOIs, DXM , tramadol, 2C-T psychedelics Serotonin syndrome
Anti-epileptic drugs ; especially lithium Serotonergic psychedelics ( tryptamines , phenylethylamines , ergot alkaloids ) Seizures
Beta blockers ( metoprolol , propranolol ) Amphetamine, cocaine, MDMA, nightshade family High blood pressure , hypertensive crisis
MAO inhibitors ( moclobemide , selegiline , rue , 2C-T psychedelics) Antidepressants, DXM, MDMA, Tramadol, 2C psychedelics Serotonin syndrome
Opioids ( heroin , methadone , tramadol , fentanyl ) Alcohol, benzodiazepines (alprazolam, diazepam, lorazepam), GBL Respiratory depression, respiratory failure, coma
Vasodilators ( Viagra , poppers ) Amphetamine, cocaine, MDMA Circulatory lapse with hypertensive crisis or hypotension

Every year around 1000 people die in Germany as a result of drug consumption, not including alcohol and tobacco. Much of the drug-related deaths are due to mixed use, the vast majority of which are associated with opioids such as heroin. This is offset by an estimated 74,000 deaths from alcohol and up to 120,000 deaths per year due to the consequences of tobacco smoking.

Drugs in Pregnancy

Drug use during pregnancy, including drinking alcohol, can result in fruit damage, even miscarriage or lifelong health problems for the child. Alcohol consumption during pregnancy is the most common non-genetic cause of intellectual disability, such as fetal alcohol syndrome .

However, substance withdrawal during pregnancy can also be dangerous for the mother and the unborn child, so medical care is required in any case. Under certain circumstances, complete discontinuation of drugs - including alcohol - is contraindicated and the mother-to-be must be substituted instead . Children of drug-addicted mothers are often born with withdrawal symptoms.

Harmful use and addiction

Tobacco smoke has a high potential for dependence

Under suitable conditions, many drugs can cause psychological or neurochemical dependence , which is often colloquially referred to as addiction . Various factors have an influence on whether and how quickly a dependency arises. With crack, the short duration of action of approx. 10 minutes with simultaneous stimulation of the reward center plays a decisive role in the development of addiction. The individual personality structure and life situation are of particular importance in each case; In principle, however, with a corresponding personal predisposition, almost any substance that causes intoxication can be used to the extent that it leads to psychological dependence or habit formation . Heroin, tobacco and crack are some of the most addictive substances, and even a few doses can lead to very strong addiction.

Depending on the neurochemical mode of action and the duration of use, discontinuing certain drugs can lead to a mental or physical withdrawal syndrome . These include drugs that primarily affect the dopamine system and especially the reward center (e.g. cocaine , crack and amphetamine ), agonists on the µ-opioid receptor (e.g. heroin , codeine and tramadol ), agonists am Nicotinic acetylcholine receptor ( alcohol and nicotine ), as well as agonists on the GABA receptor ( benzodiazepines , barbiturates and GBL ).

In the event of unavailability or self-withdrawal of a drug on which there is a dependency, there may be a switch to another drug and thus a shift in dependency . Simultaneous dependence on several drugs is also possible and is known as polytoxicomania .

Those affected by addiction have the option of seeking drug counseling or self-help groups such as B. Narcotics Anonymous or Alcoholics Anonymous . In severe cases, withdrawal therapy or substitution therapy , usually as part of drug therapy , can be undertaken.

Drug emergencies: Endangering yourself and others can occur. Unconsciousness after drug use is dangerous, especially unconsciousness in a coma.

Prevention and Safer Use

Prohibitive approach to prevention: the motto “Life without drugs” on a postage stamp

In connection with the use of drugs, the term prevention includes all measures to avoid harm. For this purpose, the official side almost always propagates a complete renunciation of consumption, which, however, is often not a desired or possible option. Therefore, there are various other approaches to minimize potential risks of drug use and the occurrence of risky patterns of use.

A chemical analysis of a drug ( drug checking ) can be used to determine whether it actually contains the substance that a potential consumer would expect. The testing of drugs that are only available on the black market is a measure to reduce harm, since consumers can be warned of particularly dangerous active ingredients , possible harmful admixtures or preparations that are too high. Drug checking is possible both as a rapid test with limited informative value and as a high-quality laboratory test. However, all state laboratories in Germany are instructed not to accept samples from civil organizations.

Under safer use measures be understood that minimize avoidable damage in drug use. For example, nasal consumption or intravenous use of a drug ( slamming ) entails the risk of infection via the mucous membranes or the bloodstream. Consumers are therefore given the opportunity to exchange syringes and obtain clean snuff tubes at parties.

Health information on the consumption of drugs, e.g. B. Dosage instructions or information on possible harmful interactions with mixed consumption are also referred to as safer use. The education with regard to risk-minimizing use is often criticized as a call for drug use, on the other hand, safer use organizations refer to the use taking place despite legal restrictions, and that one closes a dangerous information gap resulting from the illegality of the substances and the consequent tabooing .

Drug crime

Illegal drugs

Colloquially in Germany, illegal drugs are substances that are listed as not marketable in Appendix I of the Narcotics Act (BtMG), the trade and distribution of which is therefore generally punishable. Dealing with substances from Annex II BtMG ( marketable but not prescription narcotics ) without the permission of the Federal Opium Agency is also a criminal offense. The offenses are regulated according to § 29 , § 29a , § 30 , § 30a , § 30b BtMG

Other drugs are said to be legal even if there are restrictions on trade or distribution, such as: B. marketable and prescription narcotics of Annex III of the BtMG. Apart from the explicit listing as not marketable in the annexes of the BtMG, the manufacture and placing on the market of psychoactive substances or preparations can be subject to the regulations of the Medicines Act (AMG) , provided that they correspond to the definition of the term medicinal product .

Legal drugs

According to the judgment of the European Court of Justice and confirmed by the Federal Court of Justice , so-called new psychoactive substances (legal highs), which are not listed in Annex I – III of the BtMG, are included. Some of them are expressly marketed as a legal substitute for cannabis and have no direct health benefit, not under the term medicinal product. In its judgment, the European Court of Justice concluded:

"Art. 1 No. 2 letter b of Directive 2001/83 / EC of the European Parliament and of the Council of 6 November 2001 on the creation of a Community code for medicinal products for human use in the scope of Directive 2004/27 / EC of the European Parliament and of the Council of 31 March 2004, as amended, is to be interpreted as meaning that it does not cover substances such as those at issue in the main proceedings, the effects of which are limited to a simple influencing of the physiological functions without being suitable for being directly or indirectly beneficial to human health which are only consumed to induce a state of intoxication and which are harmful to health. "

- JUDGMENT OF THE COURT OF JUSTICE (Fourth Chamber) of 10 July 2014: “Medicinal products for human use - Directive 2001/83 / EC - Scope - Interpretation of the term 'medicinal product' - Meaning of the criterion of ability to influence physiological functions - Products based on Herbs and Cannabinoids - Exclusion "

In return, the Federal Cabinet presented the draft law on May 4, 2016 to combat the spread of new psychoactive substances ( NpSG ). Passing it on is now a punishable offense. In addition to the individual substance approach of the Narcotics Act, the NpSG contains a substance group regulation in order to be able to counter NPS more effectively in future. Critics of a legal high ban, however, see the risk that illegal drug trafficking on the street and drug-related crime will increase, and that legal highs will be supplemented with excipients, similar to illegal drugs. According to the Munich Public Prosecutor Susanne Wosylus, the NpS law causes “great difficulties in practical application” , since Section 4 (1) NpSG only deals with the trading, placing on the market and administering, but not the possession , acquisition or consumption of new psychoactive substances Criminalises substances.

The two groups of substances of NPS that are subject to the ban are listed in the annex to the law:

Possession of small quantities

A personal use amount of marijuana

The possession of a (legally defined) small amount of an illegal drug (colloquially: personal use ) does not necessarily lead to a charge or criminal prosecution, provided the drug is intended for personal consumption and there is no danger to others . In such a case, a public interest in criminal prosecution cannot be assumed and an indictment can be dispensed with or an ongoing procedure can be terminated. In any case, the drug will be confiscated because the amount of active ingredient it contains has to be determined in a laboratory. Possession in large quantities is prosecuted as a crime .

Evidence of drugs

Rapid cocaine test

If drug use is suspected, especially during a traffic stop , the police can verify the initial suspicion by means of an alcohol test or a drug wipe test . Since the rapid tests are subject to a certain degree of uncertainty, a blood or urine sample is also required for a legally binding result. As part of an MPU , but also if illegal drugs are taken on record, a so-called screening can be ordered after a positive result , with several urine samples or hair analyzes being carried out over a period of half a year to a year as evidence of abstinence . The dates are set at short notice so that any substances that may have been consumed can be detected with a high degree of certainty.

Political situation

Drug policy

In the 2014 report of the national REITOX hub of the German Monitoring Center for Drugs and Drug Addiction to the European Monitoring Center for Drugs and Drug Addiction , the term drug policy for Germany is defined as follows:

“Until the end of the last century, the term 'drug policy' only applied to illegal drugs that were the focus of political interest. There was no comparable concept for an alcohol or tobacco policy or for a cross-substance 'addiction' policy. For some years now, there have been disorders caused by legal psychotropic substances (e.g. alcohol, tobacco and drug abuse) and cross-substance aspects (e.g. in universal prevention or in patients with multiple abuse) as well as for some time non-substance-related addictions (e.g. pathological gambling) more at the center of political interest. For this reason, the terms 'drug and addiction policy' or 'addiction policy' are increasingly being used instead of 'drug policy'. Because of the differences in political goals and strategies with regard to legal and illegal substances, the term 'drug and addiction policy' is preferred in Germany. In addition, the field of vision has expanded from the original main interest in substance addiction to risky and harmful consumer behavior and thus to a more extensive understanding of health policy for substance-related disorders and risks. However, the German language does not have a short term for this, so that the (inadequate) term 'addiction policy' continues to be used. For the annual reports of the German Monitoring Center for Drugs and Drug Addiction (DBDD), this means that legal substances and common strategies for legal and illegal substances have to be discussed in some cases. A separation is no longer possible in many places due to the technical and political development. "

- Tim Pfeiffer-Gerschel, Lisa Jakob, Daniela Stumpf IFT Institute for Therapy Research, Axel Budde, Federal Center for Health Education, Christina Rummel, German Central Office for Addiction Issues: 2014 report from the national REITOX hub to the EMCDDA 1.1.1 Definition of terms, p. 33

Intergovernmental Agreements

Confiscated cannabis plantation in the UK

As a result of the International Opium Conferences of 1912 and 1925, which took place on the initiative of the USA , strict control of the production and trade of morphine and cocaine was initially decided, later the latter, as well as heroin , was placed completely under prohibition . The export and import of cannabis for medical and scientific purposes remained partially permitted.

The 1961 standard agreement on narcotics finally laid the basis for the worldwide control of certain drugs that is still in place today. In addition to synthetic opioids were in 1971 in the Convention on Psychotropic Substances and psychedelics , barbiturates and benzodiazepines regulated. In 1988 the United Nations Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances was passed, which obliges the signatory states to take criminal action against the illicit production and trade in so-called narcotic drugs .

The cultivation of opium poppies for opium production is now legally possible in three Indian states. From the raw opium to morphine and codeine produced for export to Western countries. Despite the strict requirements and controls, some of the opium ends up on the black market , mainly for the synthesis of heroin for the European and Russian markets. Legalization of opium cultivation is still being considered for Afghanistan, as this represents an important branch of the country's economy and a repressive approach would deprive many farmers of their livelihood.

Government action on consumption and illicit trafficking

Mexican military on duty against drug cartels

Apart from generally accepted popular drugs , many states pursue a repressive prohibition policy out of economic or political self-interest, but also with reference to international agreements . In most western countries, the production, possession and trafficking of illegal drugs are generally punishable. B. in the Netherlands or Germany if the possession of a small amount of illegal drugs, usually cannabis, can be refrained from prosecution or the proceedings are terminated at the discretion of the judge.

As part of the War on Drugs, the USA continues to pursue a very repressive drug policy that also acts on foreign policy; In particular, there were repeated military interventions in the Andean states because of the coca cultivation there and the smuggling of large quantities of cocaine. Since the 1990s, a real war has been raging in Mexico between drug cartels , the military and the police, the end of which is nowhere in sight.

Overall, it can be said that even large-scale and harsh measures to curb illegal drug trafficking and consumption have remained largely unsuccessful.

Legalization of illegal drugs

Initiative to legalize cannabis in Zurich
Demonstrators with legalization banners at the 2008 Hemp Parade

The possibility of controlled legalization of the possession, production and distribution of illegal drugs is hotly debated, with the focus being primarily on cannabis. The debate is predominantly ideological , which makes it very difficult to find a solution; even moderate positions are sometimes violently attacked. Arguments are sometimes difficult to verify or refute, as scientific research on illegal drugs is made difficult by the legal situation, or research results are ignored or interpreted exclusively in their own interests .

Nevertheless, since the 1990s, experimental projects aimed at at least partially decriminalizing the possession of illegal drugs have been implemented in some countries . The most permissive legislation in Europe is currently in Portugal , where the government in 2001 completely decriminalized possession of all illegal drugs, including those with high addiction potential; the possession of quantities customary for consumption is now exclusively an administrative offense . According to several studies carried out in the following years, the consumption of illegal drugs in Portugal has neither increased nor decreased noticeably since then, nor has drug tourism started . However, the consumption of particularly addictive drugs has decreased significantly, while cannabis use has increased. In addition, treatment offers are more likely to be used. The extent to which these results can be transferred to other European countries is still being investigated.

In New Zealand, a revised version of the Psychoactive Substances Act came into force in July 2013 , which now also regulates designer drugs and legal highs on the basis of scientific evidence. This type of drug particularly dominates the market in New Zealand, as the country is not significantly involved in the international trade in established drugs due to its remote location and small population. New synthetic drugs, like drugs, have to undergo extensive toxicity and safety tests before they can be approved and legally sold. This move has been noted with some interest globally as the increasing pace at which new designer drugs are constantly appearing on the market poses a serious challenge to legislators.

Uruguay became the first country in the world to fully regulate the production and distribution of cannabis since May 2014. Registered users can purchase up to 40 grams of marijuana per month from pharmacies; It is also legally possible to grow up to six hemp plants yourself. The South American country hopes that this will lead to more efficient action against drug cartels, as legal marijuana can be offered at a fraction of the black market price.

As early as the 1990s, medical marijuana has been legally prescribable in an increasing number of US states as an alternative to synthetic THC supplements, and in 2014, distribution for non-medical purposes was finally legalized in the states of Colorado and Washington .

Prominent personalities are also increasingly joining the legalization debate. Former US President Jimmy Carter spoke out against the drug war in the New York Times after the first report of the Global Commission on Drug Policy , founded a few months earlier by former politicians and human rights activists, had appeared. This refers to the effective ineffectiveness of repressive political measures, which in the first place in no way lead to a reduction in consumption, but to the exclusion and stigmatization of non-externally harmful consumers. At the same time, the training of organized criminal structures is favored, while the production, trade and consumption of illegal drugs have increased continuously. A detailed analysis of a high-profile committee of experts from the London School of Economics and Political Science comes to similar conclusions, although it is also noted that, despite prohibition, the street price of illegal drugs has fallen and purity has increased. Political destabilization of entire states, corruption , rampant violence, armed conflicts, massive human rights violations, global shortages of painkillers and HIV epidemics are named as consequences of repressive drug policy .

Cultivation, manufacture and trafficking of illicit drugs

Opium cultivation in Afghanistan

Many drugs (primarily marijuana and stimulants such as amphetamines and ecstasy ) are predominantly and increasingly produced in the country in which they are consumed and thus do not make a significant contribution to the international drug trade. The situation is different for drugs, whose global production is concentrated in a few countries or regions; here in particular are out of the opium produced heroin and the cocaine significant.

By far the most important opium producer worldwide is Afghanistan , followed by Myanmar , Mexico and Colombia . The main buyers of heroin are Western Europe, where the drug reaches via Iran, Turkey and the Balkans, and Russia. Cocaine is mainly produced in the Andean countries , with Colombia, Peru and Bolivia being the largest producers. The cocaine is smuggled through transit countries in Central America and the Caribbean to the main buyers in North America and Europe.

Illegal drugs mostly reach the end consumer in the traditional street trade via small dealers . The drug trade on the Internet is playing an increasing role ; Darknet markets that can be reached via encrypted networks such as Tor represent an anonymous platform for this.

See also

Portal: Drugs  - Overview of Wikipedia content on drugs
Portal: Mind and Brain  - Overview of Wikipedia content on Mind and Brain
Portal: Psychology  - Overview of Wikipedia content on the subject of psychology






Web links

Commons : Drugs  - Collection of pictures, videos and audio files
Wiktionary: drug  - explanations of meanings, word origins, synonyms, translations
Wikiquote: Drug  Quotes

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