drug
Since the middle of the 20th century, the word drug has also colloquially referred to intoxicating substances ( intoxicating drugs , intoxicants or narcotics ). These are psychotropic substances and preparations from them, which can cause both a physical condition -changing effect and a consciousness- and perception -changing effect. In pharmacological and pharmaceutical usage, however, the term stands for dried parts of plants, fungi, animals or microorganisms that are used to produce medicines (see medicinal drug).
Some psychoactive drugs are traditionally considered recreational in parts of the world and used 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 as well as cat . When dosed appropriately, many stimulants can lead to an altered state of consciousness and be associated with harmful consequences, including dependence and death.
There is no general agreement as to whether and to what extent drug use is socially and economically appropriate and tolerable. Trade, circulation and use of psychotropic substances are largely regulated and restricted by national legislation and international agreements. The Convention on Psychotropic Substances adopted by the United Nations in 1971 led to the global ban on almost all drugs known at the time; The only exceptions were a few, mostly in the western world, already established drugs such as alcohol, nicotine and caffeine. In fact, however, due to the high demand for other psychotropic drugs, a worldwide informal economy has emerged.
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 rather than for therapeutic purposes. This term therefore corresponds most closely to the German drug or intoxicating drug.
The term drug comes etymologically from the Dutch droog for dry (cf. also the originally Low German word dröge , which largely has the same meaning ). This in turn was adopted into French as drogue and from there came into German as a loan word around 1600 . The further development of the meaning went through the (Central) Dutch or (Central) Dutch phrase droge vaten , which literally meant dry barrels and containers for dry goods. Later on, the adjective droge or later droog was gradually used as a substitute for the phrase and eventually only referred to the contents of such containers. In the days 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 as well as the English drug , which is also (and above all) used in the sense of drug ; see also the German word Drogerie and the article drug (pharmacy) .
In Germany, " narcotics " is a collective term for substances of different origin, composition and effect, the cultivation, manufacture, import and export, distribution, acquisition, possession and trade of which are punishable by law if there is no permit from the Federal Institute for Drugs and Medical Devices . The colloquial terms "drug" or "drug" are not mentioned in the Narcotics Act .
Drug use in prehistory and early history
The use of psychoactive substances and drugs can be proven as early as the Neolithic Age . Already around 6000 BC. Viticulture was practiced in western Central Asia, and no later than 3000 BC . Beer was brewed in ancient Egypt and Mesopotamia . The use of hemp as a fiber crop dates back to the 3rd millennium BC. attested; the Assyrians used cannabis as an incense in pre-Christian times and the intoxicating effect is also mentioned in the Indian Vedas . In the 4th millennium BC The cultivation of the opium poppy began in the Near East in the Middle East , from where it spread to the Mediterranean region and Asia, all the way to China. Its use as an analgesic and sleep-inducing agent is dated back to 1300 BC. proven.
Based on linguistic analyses, there are indications that the effect of the fly agaric in Siberia was known more than 5000 years ago; to 1000 to 2000 BC. Rock carvings dated to BC show figures with mushroom-like heads. References to the use of mushrooms containing psilocybin are dated to around 5000 BC. dated. Rock carvings depicting mushroom-shaped deities have been discovered in the Tassili Plains in Algeria. So-called mushroom stones can be found in Central and South America, which date back to 1000 to 500 BC. be dated.
Around 300 BC Theophrastus of Eresos described the psychoactive properties of thorn- apple ; Tobacco use on the American continent is documented for about the same time .
Drug use in the social context
Ritual and religious use
A number of naturally occurring drugs, called entheogens, have traditionally been used in a cultic or shamanic context, such as fly agaric in Siberia, psilocybin mushrooms by native peoples of southwestern Mexico, and ayahuasca by the Amazon Indians. There are some officially recognized communities in which the regulated use of hallucinogenic substances is central, such as the Santo Daime Church and the Native American Church . In Hinduism , the entheogenic use of cannabis is common; Psychoactive hemp preparations are consumed, among other things, 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
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Legal and illegal drugs are used by large sections of the population for non-cult and non-medical purposes. The aim here is usually an intensification or change of experience, sometimes also a state of intoxication . In many countries, the consumption of intoxicating drugs is considered a cultural tradition, such as drinking alcohol in the western world . The incorporation of the drug into society is believed by some to reduce the risk of addiction , which could otherwise develop unnoticed by those around you. However, this view is disputed 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 lives, with single or infrequent use also being the rule.
In regions with significant drug consumption, the substances can be detected in municipal sewage .
Medical use
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 (colloquially: drug abuse ). Drug use often occurs as an attempt at self-medication , particularly in the case of an existing or emerging mental illness.
Some drugs have a significant medicinal spectrum of effects, such as in the treatment of cluster headaches . Possibilities of using LSD , psilocybin and MDMA in psychotherapy are also currently being researched (see Psycholytic Psychotherapy ). 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, since the widespread rejection of spirituality within Western culture promotes a purely pleasurable , consuming use of substances. Participants in Ayahuasca ceremonies almost always felt overwhelmed.
Other social functions
In his book High Society , cultural historian Mike Jay lists various functions of drugs in contemporary and historical societies. For example, among the Incas , only aristocrats were allowed to chew coca leaves, which set them apart from the general population . In many societies, certain drugs are or have been status symbols as an expensive luxury product ; in this case, consumption often has a demonstrative component ( conspicuous consumption ). Consequently, status drugs are used not only in the immediate private environment but also in public places such as clubs and restaurants and during social celebrations. If drug use is also ritualized , the community that carries out the use can be strengthened.
classification
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 effect and possible risks of a substance, it is therefore usually necessary to consider its classification within several classifications. Substances that are particularly common or known are listed below by way of example. More detailed information can be found in the relevant sub-articles.
Classification by substance class
Drugs can be assigned to different classes of substances based on their chemical structure . Many drugs can be classified as alkaloids (nitrogen-containing organic compounds) or terpenoids (oxygenated derivatives of isoprene ). Within a class of substances, psychoactive substances often share a common aspect of effects; for example, all amphetamines are stimulants, among other things, and most tryptamines are hallucinogenic.
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Classification by Effect
Drugs can be classified based on their pharmacological classification according to their psychological mode of action, with some drugs belonging to several groups. This classification is the most general and used among intoxicating drug users; The substance class can be consulted for a more precise assessment of the expected effect.
| group | main effect | examples |
|---|---|---|
| dissociatives | Decoupling mental processes from consciousness through dissociation | DXM , Ketamine , Nitrous Oxide |
| delirium | dissociative; Disorientation, sometimes also hallucinations | Alcohol , DPH , Hyoscyamine , Muscimol , Scopolamine |
| Empathogens and entactogens | Intensification of feelings, often also increased emotional opening towards others | 2C-B , 2C-E , 2C-I , GBL , MDMA , MDMC |
| narcotics | dissociative; in high doses, complete anesthesia , e.g. T. also psychedelic effect | barbiturates , ketamine |
| psychedelics | Psychotomimetic and pseudohallucinogenic , it comes to a psychedelic intoxication (coll.: trip ) | DMT , 25I-NBOMe , lysergic acid amides such as LSD and analogues , mescaline , psilocin , psilocybin ; DXM and ketamine also have a dissociative effect |
| sedatives and hypnotics | Centrally dampening , the distinction between the two groups being purely quantitative | benzodiazepines , medicinal cannabis , mitragynine ( kratom ), neuroleptics ; Alcohol , DPH and opiates all have a dissociative effect |
| stimulants | stimulation of the organism | Caffeine , Cocaine , Nicotine , Amphetamines |
A greatly simplified approach divides drugs into upper (stimulating substances), downer (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, or produced fully synthetically. Some drug users show a strong preference to use only natural or synthetic drugs, although comparable substances from both groups do not necessarily differ in their pharmacological potency and mode of action.
Overall, however, a trend towards the consumption of synthetic drugs (especially amphetamine-type stimulants) and drug abuse (especially opioids and benzodiazepines) can be observed. This is a direct result of the global decline in coca and opium cultivation. On the other hand, there is 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 uppers and downers, since habitual long-term use is all but impossible due to the intense mind-altering effects. However, it may well have been popularized with the availability of psychoactive mushrooms, Salvia divinorum , and other psychedelics in smart shops since the late 1990s.
Biogenic herbal drugs
Most traditionally used drugs are of plant origin. Almost all psychoactive plants or plants used in psychoactive preparations are deliberately bred and cultivated. Plant parts are usually consumed directly (by eating, smoking or preparing an infusion ) or used as an active ingredient in a preparation. With some biogenic drugs, it is common to extract the main active ingredient in order to increase the effect or better dosing in order to achieve a state of intoxication . This can be done by converting it into a solution and then separating it, or by evaporating the active ingredient directly in a vaporizer . Despite the fairly high acquisition costs, vaporizers are used by some users of biogenic drugs for consumption, mainly because smoking plant parts is rejected for health reasons.
| drug | main effect | Happen |
|---|---|---|
| alcohol | delirium | Plant parts containing sugar or starch fermented by yeast or bacteria |
| Cathin , Cathinon | stimulant | Kath shrub ( Catha edulis ) |
| DMT | psychedelic | Ayahuasca , the tropical blush plant Psychotria viridis , various types of acacia and mimosa , canary grass |
| ephedrine , pseudoephedrine | stimulant | Plants of the genus Ephedra (e.g. Ephedra sinica ) |
| harmaline , harmine | MAO inhibitors , oneirogen | Ayahuasca , the tropical liana Banisteriopsis caapi , rue , passion flower |
| caffeine | stimulant | Guarana , coffee , cocoa , tea |
| cocaine | stimulant | Coca bush ( Erythroxylum coca ) |
| LSA | psychedelic | Hawaiian baby woodrose , seeds of the morning glory plants 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 fungi
Mushroom drugs are among the oldest drugs known to mankind 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 from nature, but some are also cultivated on a small scale. The fruiting bodies are almost always eaten directly, sometimes the sclerotia as well .
| drug | main effect | Happen |
|---|---|---|
| muscimol | delirium | Fly Agaric , Panther Mushroom |
| psilocybin | psychedelic | Different types of baldheads (e.g. Cuban baldhead , pointed cone baldhead , stately baldhead ) and manurelings (e.g. blue manureling ) |
semi-synthetic drugs
Some psychoactive substances are synthesized from natural products. Some intrinsically biogenic drugs (e.g. cocaine) can also be produced by partial synthesis from natural precursors . This requires at least a basic chemical laboratory and access to the starting chemicals, which in turn may be regulated by law due to the possibility of illegal drug production. Despite these obstacles, numerous clandestine laboratories, sometimes referred to colloquially as drug labs, serve the demand for illicit semi- and synthetic drugs.
| drug | main effect | raw material |
|---|---|---|
| LSD and LSD analogues | psychedelic | ergot alkaloids |
| Some opioids such as buprenorphine , heroin and oxycodone | hypnotic, analgesic | opium (opium poppy) |
Synthetic Drugs
A large number of drugs are produced fully synthetically without the aid of a natural starting material. This category includes many substances originally designed as medicines and most marketable medicines, but also so-called designer drugs or research chemicals , which were designed specifically to have an intoxicating effect and/or to circumvent existing substance legislation. It is usually taken orally , often through the nose ( sniffing , pulling ).
| drug | main effect |
|---|---|
| amphetamine | stimulant |
| arylcyclohexylamines , e.g. ketamine , methoxetamine , phencyclidine , or 3-MeO-PCP | dissociative, psychedelic |
| benzodiazepines , e.g. B. diazepam , flunitrazepam or lorazepam | hypnotic |
| γ-butyrolactone (GBL), 1,4-butanediol (BDO) | entactogen |
| Dextromethorphan (DXM) | dissociative |
| dimethoxyamphetamines , e.g. e.g. DOB , DOI or DOM | psychedelic |
| dimethoxyphenylethylamines e.g. B. the substances of the 2C group | psychedelic |
| Diphenhydramine (DPH) | delirium |
| laughing gas | dissociative |
| Solvents ( inhalants ) | dissociative |
| methylenedioxyamphetamines , e.g. B. MDA , MDMC or MDMA ( Ecstasy ) | entactogen |
| Many opioids , e.g. 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 map the risk potential of certain drugs, especially with regard to legal classification, in a two-part scheme. This approach is controversial.
This classification became popular primarily through public discussion and media reporting from the judicial environment. The subdivision finds its origin and concrete application in the Dutch Opium Act (Dutch: Opiumwet ), see Soft drug (Dutch law) .
Classification according to damage potential
| rank | drug | point value |
|---|---|---|
| 1 | alcohol | 72 |
| 2 | heroin | 55 |
| 3 | crack | 54 |
| 4 | methamphetamine | 33 |
| 5 | cocaine | 27 |
| 6 | tobacco | 26 |
| 7 | amphetamine e | 23 |
| 8th | cannabis | 20 |
| 9 | GHB | 19 |
| 10 | benzodiazepines | 15 |
| 11 | ketamine | 15 |
| 12 | methadone | 14 |
| 13 | mephedrone | 13 |
| 14 | butane | 11 |
| 15 | anabolic steroids | 10 |
| 16 | khat | 9 |
| 17 | ecstasy | 9 |
| 18 | buprenorphine | 7 |
| 19 | LSD | 7 |
| 20 | mushrooms | 6 |
| 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 in Germany every year from 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 one fatality for around 9,000 to 10,000 liters of pure alcohol consumed. Assuming an alcohol content of 4.8 percent, this means that in Germany – arithmetically – every almost 600,000 small beers (0.33 l) claim one fatality. In contrast, one fatality is compared to the consumption of - depending on the study - 1,000,000 to 17,000,000 ecstasy pills. The problem with this approach is that although the number of drug-related deaths is known, the number of users is not always known. (See also the Drug Death section below).
In March 2007, a study conducted by a research team led by David Nutt was published in the renowned medical journal The Lancet . It defined three main factors that account for 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 potential impact 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 subcategories. Psychiatrists and independent experts gave all substances 0 to 3 points in each subcategory. The average ratings of all categories were added for each substance to obtain a value for the overall harm potential.
It is noteworthy that, as a result, the legal drugs alcohol and tobacco are among the ten most harmful drugs. For this reason, Nutt, the British government's drug commissioner at the time, criticized the drug policy as "contradicting the findings of research", whereupon he was relieved of his office. In Germany, these two drugs alone cause more than 99 percent of drug-related deaths. (See Drug Death section below).
A follow-up study based on improved methodology was published in the Lancet in November 2010 . The damage potential now consists of 16 weighted individual factors, which are divided into the groups of physical, psychological and social damage within the dimensions self-harm and damage to others . Alcohol was identified as the drug with the greatest potential for harm overall, with a score of 72 out of 100, followed by heroin (55) and crack (54). The high harm potential of alcohol, especially in the dimension of harm to others , can probably be partly explained by its ready availability and widespread and socially tolerated consumption. Other drugs with an overall high risk assessment, on the other hand, have a higher absolute self-harm potential. This is likely to be primarily due to the high risk of rapid dependence developing with these drugs.
- results of the studies
Visualized results of the original study
Ratio of usual to harmful doses of various drugs
Harm potential of common drugs (follow-up study).
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Health risks
Harmful Use and Addiction
Under the right conditions, many drugs can cause psychological or neurochemical dependency , which is often referred to colloquially as addiction . Various factors have an impact on whether and how quickly a dependency develops. In the case of crack, for example, the short duration of action of approx. 10 minutes, with simultaneous stimulation of the reward center , plays a decisive role in the development of dependency. The individual personality structure and life situation are of particular importance in each case; In principle, however, with a corresponding personal predisposition , almost any intoxicating substance can be used to the effect that psychological dependence or habit formation occurs. Heroin, tobacco and crack are among the most addictive substances, and even a few doses can result in a very strong dependency.
Depending on the neurochemical mode of action and the duration of use, stopping certain drugs can lead to a mental or physical withdrawal syndrome . These include drugs that primarily affect the dopamine system and there in particular the reward center (e.g. cocaine , crack and amphetamine ), also agonists at the µ-opioid receptor (e.g. heroin , codeine and tramadol ), agonists at the Nicotinic acetylcholine receptor ( alcohol and nicotine ), as well as agonists at the GABA receptor ( benzodiazepines , barbiturates and GBL ).
If a drug is not available or you withdraw yourself from it, you may switch to another drug and thus shift your dependency . Simultaneous dependence on several drugs is also possible and is referred to as polydrug addiction .
Those affected by addiction have the option of using drug counseling or self-help groups such as B. Visit Narcotics Anonymous or Alcoholics Anonymous . In severe cases, withdrawal treatment or substitution therapy , usually as part of drug therapy , can be undertaken.
In drug emergencies, self-harm and harm to others can occur. Here, unconsciousness after drug use is a danger for the user. Furthermore, "diluting" intoxicants with cutting agents to increase profits poses a health risk when the cutting agents are harmful substances with (side) effects unknown to users, such as phenacetin , levamisole and lidocaine in cocaine . Since each intermediate seller can use different extenders, these can also act as an indicator and possibly make the transport route of the drugs traceable.
For substance
Even legal drugs that are accepted as stimulants are not free of risks and should by no means be regarded as harmless. Consuming large amounts of alcohol can lead to dangerous, and in the worst case fatal , alcohol poisoning ; Chronic alcohol abuse can, under certain circumstances, cause severe liver damage, brain damage ( Korsakoff syndrome ), as well as various cancers and forms of alcohol psychosis , such as e.g. B. cause alcohol hallucinosis (ICD-10 F10.52). Tobacco smoke contains more than 4000 z. T. cell and mutagenic and carcinogenic substances. Furthermore, smoking can directly or indirectly damage all organ systems of the body and is the main cause of lung cancer .
Psychedelics such as LSD or psilocybin-containing mushrooms are largely free of physical and psychological risks due to their mode of action and the almost non-existent potential for abuse. However, it cannot be ruled out that a substance-induced psychosis or schizophrenia that has already developed can be triggered with a corresponding predisposition . In the case of cannabis products, the health risks are also relatively low. Smoking cannabis produces carcinogenic substances similar to tobacco when burned , but unlike tobacco smoke, there is no evidence that cannabis smoke (other than tobacco smoke) can cause cancer. 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 consumer is exposed to the same or possibly even increased risks as with tobacco smoking. For this reason, tobacco-free joints and vaporizers are gaining popularity among cannabis users.
- Physical and psychological risks of psychotropic substances
Number of inpatient hospital treatments in Germany due to drug problems. Average data from 2009-2012. 2014 report of the REITOX national focal point to the EMCDDA . New developments and trends. Drug situation 2013/2014.
Comparison of dependency potential and ratio between usual and lethal dose of various psychotropic substances according to RS Gable .
In the case of individual drugs, on the other hand, the use of normal amounts, even if taken once, can lead to health impairments. In particular, habitual high-dose use of such drugs can damage the body, cause secondary diseases and reduce life expectancy. So e.g. For example, an overdose of heroin or other opioids can be life-threatening, even in people who are physically accustomed to the substance through regular consumption and the corresponding development of an opioid tolerance . Even a relatively small dose can have dangerous physical effects if left untrained. Drug users who use opioids again after a long period of abstinence are also at risk.
mixed use
The simultaneous consumption of several drugs can pose a major acute health risk because, depending on the combination and dosage, it can result in significant stress on the organism. Interactions can also occur with medication taken during mixed consumption . In the worst case, a medical emergency can result. However, such risks can be significantly reduced by generally refraining from particularly risky mixed consumption or at least taking only a fraction of the usual dosage of the individual substances.
| drug/medication | 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 arrest , coma | |
| Amphetamine, Cocaine, MDMA | dehydration , circulatory collapse | |
| antidepressants ; both tricyclic ( amitriptyline , doxepin , clomipramine ), SSRI ( sertraline , citalopram ) and SNRI ( venlafaxine , duloxetine ) | MAOIs, DXM , Tramadol, 2C-T Psychedelics | serotonin syndrome |
| antiepileptics ; especially lithium | Serotonergic psychedelics ( tryptamines , phenylethylamines , ergot alkaloids ) | seizures |
| Beta blockers ( metoprolol , propranolol ) | Amphetamine, cocaine, MDMA, nightshades | Hypertension , hypertensive crisis |
| MAOIs ( 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 arrest, coma |
| Vasodilators ( Viagra , poppers ) | Amphetamine, Cocaine, MDMA | Circulatory failure with hypertensive crisis or hypotension |
| Sources: | ||
drugs during pregnancy
Drug use during pregnancy, including drinking alcohol, can result in fetal damage, including a miscarriage or lifelong health problems for the child. Alcohol consumption during pregnancy is the most common non-genetic cause of intellectual disabilities, such as fetal alcohol syndrome .
However, withdrawal from a substance during pregnancy can also be dangerous for the mother and the unborn child, so medical attention is always required. It may be contraindicated that the drugs – including alcohol – should be completely stopped and the mother-to-be must be substituted instead . Children of drug-addicted mothers are often born with withdrawal symptoms.
drug death
An estimated 121,000 people die every year in Germany from the effects of tobacco consumption and 74,000 from the effects of alcohol consumption. This contrasts with the lower number of around 1,000 people who die each year as a result of the use of illegal drugs.
drug crime
Illegal drugs
Colloquially, illegal drugs in Germany are substances that are listed as not marketable in Appendix I of the Narcotics Act (BtMG), the trade and sale of which is therefore fundamentally punishable. Dealing with substances from Appendix II of the BtMG ( marketable but non-prescription narcotics ) without permission from the Federal Opium Agency is also a punishable offence. The criminal offenses are regulated according to § 29 , § 29a , § 30 , § 30a , § 30b BtMG.
Other drugs are considered legal even if they are subject to restrictions on sale or distribution, such as B. marketable and prescription-capable narcotics of Appendix III of the BtMG. Apart from the explicit listing as not marketable in the appendices 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 (Arzneimittelgesetz, AMG) , provided 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) that are not listed in Appendix I–III of the BtMG, e.g. T. are expressly marketed as a legal substitute for cannabis and have no immediate health benefit, not under the definition of medicinal products. In its judgment, the European Court of Justice finally ruled:
"Art. 1 No. 2 letter b of Directive 2001/83/EC of the European Parliament and of the Council of November 6, 2001 on the creation of a Community code for medicinal products for human use in the area defined by Directive 2004/27/EC of the European Parliament and of the Council of November 31, 2001. The amended version of March 2004 is to be interpreted in such a way that it does not cover substances such as those at issue in the main proceedings, the effects of which are limited to simply influencing physiological functions without being suitable for directly or indirectly benefiting human health which are only consumed to induce intoxication and which are harmful to health when doing so.”
In return, on May 4, 2016, the federal cabinet presented the draft law to combat the spread of new psychoactive substances ( NpSG ). Passing it on is now a punishable offence. In addition to the individual substance approach of the Narcotics Act, the NpSG contains a substance group regulation in order to be able to deal with NPS legally more effectively in the future. However, critics of a ban on legal highs see the danger that illegal drug trafficking on the open street and drug-related crime will increase, and that legal highs, like illegal drugs, will be supplemented with fillers. According to the Munich senior public prosecutor, Susanne Wosylus, the NpS law “poses great difficulties in its practical application” , since Section 4 (1) NpSG only covers trading, placing on the market and administering, but not the possession , acquisition or consumption of new psychoactive substances criminalizes substances.
The two substance groups of NPS that are subject to the ban are listed in the appendix to the law:
- Compounds derived from 2-phenylethylamine (i.e. substances related to amphetamine , including cathinones )
- Cannabinoid mimetics / synthetic cannabinoids (i.e. substances that mimic the effects of cannabis )
possession of small amounts
Possession of a (legally defined) small amount of an illegal drug (colloquially: personal use ) does not necessarily result in a charge or criminal prosecution, provided the drug is intended for personal use and does not pose a threat to others . In such a case, it cannot be assumed that there is a public interest in criminal prosecution and charges can be waived or ongoing proceedings can be discontinued. In any case, the drug will be confiscated because the amount of active ingredient it contains has to be determined in a laboratory. Possession of larger amounts will be prosecuted as a crime .
detection of drugs
If drug use is suspected, especially during a traffic stop , the police can verify the initial suspicion by means of an alcohol test or 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 in the case of mere documented use of illegal drugs, a so-called screening can be ordered after a positive result, whereby several urine samples or hair analyzes are carried out over a period of six months to a year as proof of abstinence. The appointments are scheduled 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 node 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:
“Up until the end of the last century, the term 'drug policy' only referred to illegal drugs, which were the focus of political interest. There was no comparable conception for an alcohol or tobacco policy or for a cross-substance 'addiction' policy. For a number of years, disorders caused by legal psychotropic substances (e.g. alcohol, tobacco and drug abuse) and substance-related aspects (e.g. in universal prevention or in patients with multiple abuse) and, for some time now, also non-substance-related addictions (e.g. pathological gambling) more in the focus 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 preferably used in Germany. In addition, the field of vision has expanded from the original main interest in substance dependence to include risky and harmful consumption behavior and thus to a more extensive understanding of health policy for substance-related disorders and risks. However, the German language does not have an abbreviation 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 joint strategies for legal and illegal substances also have to be dealt with in some cases. A separation is no longer possible in many places due to technical and political developments.”
Intergovernmental Agreements
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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 , were placed under complete prohibition . The export and import of cannabis for medical and scientific purposes remained partially permitted.
Finally, the Single Convention on Narcotics of 1961 laid the basis for the worldwide control of certain drugs that still exists today. In addition to synthetic opioids , psychedelics , barbiturates and benzodiazepines were also regulated in the 1971 Convention on Psychotropic Substances . In 1988 the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances was passed, which obliges the signatory states to take criminal action against the illicit production and illicit trade in so-called narcotics .
The cultivation of opium poppies for opium production is now legal in three Indian states. Morphine and codeine are extracted from raw opium for export to western countries. Despite the strict regulations and controls, some opium ends up on the black market , mainly for the synthesis of heroin for the European and Russian markets. However, legalization of opium cultivation is also being considered for Afghanistan, as this is an important branch of the country's economy and repressive action would deprive many farmers of their livelihoods.
Government measures regarding consumption and illegal trade
Apart from generally accepted folk drugs , many states pursue repressive prohibition policies . In most Western countries, production, possession and trafficking in illegal drugs are generally punishable, but e.g. For example, in the Netherlands or Germany, possession of a small quantity of illegal drugs, usually cannabis, means that criminal prosecution can be waived or the case dismissed 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 affects foreign policy; in particular, there were repeated military interventions in the Andean countries 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 among and between drug cartels , the military and the police, with no end in sight.
Overall, it can be stated that even large-scale and vigorously implemented measures to curb illegal drug trafficking and consumption have largely remained unsuccessful.
Legalization of intoxicating drugs
The possibility of a controlled legalization of the possession, production and distribution of hitherto illegal intoxicating drugs is discussed, with the main focus being on cannabis. The debate is predominantly ideologically colored, which makes it very difficult to find a solution; even moderate positions are sometimes violently attacked. Arguments are sometimes difficult to verify or refute, since scientific research on illegal drugs is made more difficult by the legal situation, or research results are ignored or interpreted exclusively in their own interest .
Nevertheless, since the 1990s, some countries have implemented experimental projects to at least partially decriminalize the possession of illegal drugs. The most permissive legislation in Europe is currently in Portugal , where the government completely decriminalized the possession of all illegal drugs, including those with a high potential for addiction, in 2001; the possession of quantities customary for consumption is now exclusively an administrative offence . According to several studies carried out in the following years, the consumption of illegal drugs in Portugal has neither increased nor decreased significantly, nor has drug tourism started . However, the use of particularly addictive drugs has decreased significantly, while the use of cannabis 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.
A revised version of the Psychoactive Substances Act came into force in New Zealand in July 2013, which now also regulates designer drugs and legal highs on the basis of scientific evidence. This type of drug dominates the market in New Zealand in particular, as the country is not significantly involved in the international trade in established drugs due to its remote location and small population. Similar to medicines, new synthetic drugs have to undergo extensive toxicity and harmlessness tests before they can be approved and legally sold. This move has been noted with some interest globally, as the increasing speed at which new designer drugs are constantly appearing on the market poses a serious challenge for legislators.
Since May 2014, Uruguay is the first country in the world to fully regulate the production and distribution of cannabis. Registered users can obtain up to 40 grams of marijuana per month from dispensaries; 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, since legal marijuana can be offered at a fraction of the price on the black market.
Medical cannabis is currently (2022) legal in 37 US states and the Federal District of Washington, DC . Recreational cannabis is currently (2021) legal in 18 US states and Washington, DC. Legalization of cannabis began in California in 1996 with medicinal use. Recreational cannabis was first legalized in 2012 (states of Colorado and Washington ).
Recreational cannabis was legalized in Canada in 2018.
In September 2018, South Africa 's Constitutional Court legalized the cultivation of cannabis for personal use and the use of cannabis outside of public spaces.
EU countries are also currently working on the legalization of cannabis. Possession and cultivation of cannabis for personal use was legalized in Malta in December 2021. In its coalition agreement published on November 24, 2021, the traffic light coalition that formed after the 2021 federal election in Germany stipulated that the controlled sale of cannabis to adults for recreational purposes in licensed shops will be legalized. In Italy , a bill is in the works that would legalize the cultivation of up to four cannabis plants.
In Mexico , the cultivation of cannabis was approved by the constitutional court in 2021 - but a regulation by the legislator is still pending.
In Israel , the Knesset will vote on legalizing cannabis in 2021 . The bill narrowly missed a majority.
Prominent personalities are also becoming increasingly involved in 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, was published. In this, the effective ineffectiveness of repressive political measures is pointed out, which primarily do not lead to a reduction in consumption, but to an exclusion and stigmatization of consumers who do not harm others . At the same time, the formation of organized criminal structures is favored, while the production, trade and consumption of illegal drugs have increased continuously. The detailed analysis by a high-profile panel of experts from the London School of Economics and Political Science comes to similar conclusions, noting that despite Prohibition, the street price of illicit drugs has fallen and purity has risen. Political destabilization of entire states, corruption , escalating violence, armed conflicts, mass violations of human rights, a global shortage of painkillers and HIV epidemics are named as the consequences of repressive drug policies.
Cultivation, manufacture and trafficking of illegal drugs
Many drugs (principally marijuana and stimulants such as amphetamine and ecstasy ) are predominantly and increasingly produced in the country where they are consumed, and thus do not contribute significantly to the international drug trade. This is different for drugs whose global production is concentrated in a few countries or regions; heroin , which is made from opium , and cocaine are particularly important here.
By far the world's most important opium producer is Afghanistan , followed by Myanmar , Mexico and Colombia . The main buyers of heroin are Western Europe, where the drug enters 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 via transit countries in Central America and the Caribbean to the main customers in North America and Europe.
Illegal drugs usually reach the end consumer in the classic street trade via small dealers . Drug trafficking is playing an increasing role on the Internet ; Darknet markets accessible via encrypted networks such as Tor represent an anonymous platform for this.
Prevention and Safer Use
In connection with the use of drugs, the term prevention includes any harm avoidance measures. 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 possible risks of drug use and the occurrence of risky consumption patterns.
The chemical analysis of a drug ( drug checking ) can be used to determine whether it actually contains the substance that a potential user expects. Testing drugs that are only available on the black market is a harm reduction measure, as consumers can be warned about particularly dangerous active ingredients , possible harmful additives or preparations that are in excessive doses. Drug checking is possible both as a rapid test with limited significance and as a high-quality laboratory test. However, all state laboratories in Germany are instructed not to accept samples from civil organizations.
Safer use means measures that minimize the avoidable harm of drug use. In the case of nasal consumption or intravenous use of a drug ( slamming ), there is a risk of infection via the mucous membranes or the bloodstream. Consumers are therefore given the opportunity to exchange syringes and get clean snuff tubes at parties.
Health information about the use of drugs, e.g. B. dosage instructions or information on possible harmful interactions with mixed consumption are also referred to as safer use. Education with regard to risk-minimising consumption is often criticized as a call to take drugs. On the other hand, safer-use organizations refer to consumption taking place despite legal restrictions, and that a dangerous information gap that has arisen due to the illegality of the substances and the resulting taboos is being closed .
See also
General
- health
political
Legal
literature
- Alfred Hasterlik: From stimulants and intoxicants Our most important stimulants according to composition, extraction and quantities , Franckh'sche Verlagshandlung, Stuttgart 1918, DNB link
- Maximilian von Heyden: Handbook of Psychoactive Substances. Springer Berlin Heidelberg, 2017, ISBN 978-3-642-55124-6 ( limited preview in Google book search).
- Richard J. Miller: Drugged: The Science and Culture Behind Psychotropic Drugs. Oxford University Press, 2014, ISBN 978-0-19-995797-2 .
- Thomas Gewinde: Intoxicating drugs: market forms and modes of action. Springer, 7th fully revised & advanced. Edition 2013, ISBN 978-3-642-30162-9 [Print]; ISBN 978-3-642-30163-6 [eBook]
- Mike JayHigh Society. A cultural history of drugs. Primus Verlag, Darmstadt 2011, ISBN 978-3-89678-858-0 .
- Markus Berger : Handbook for drug emergencies - the most important things about potential dangers, overdoses and dependencies. Nightshade Publishers 2004, ISBN 3-03788-125-9 .
- Wolfgang Schmidbauer , Jürgen from Scheidt, Monika Schulenberg: Handbook of intoxicating drugs. Fischer Verlag, Frankfurt am Main (1989) 2004, ISBN 3-596-16277-7 .
- Günter Amendt , Wolfgang Neskovic: No Drugs No Future. Two thousand ones publisher, 2004, ISBN 3-86150-625-4 .
- Bernhard van Treeck : drug and addiction dictionary. Lexicon-Imprint-Verlag, Berlin 2003, ISBN 3-89602-221-0 .
- Christian Rätsch : Encyclopedia of psychoactive plants. Botany, ethnopharmacology and application. Stuttgart 1998; AT-Verlag 2002, ISBN 3-85502-570-3 .
- Giulia Sissa : Lust and evil desire. A philosophy of drugs. Translated from the French by Christine Schmutz. Klett-Cotta, Stuttgart 1999, ISBN 3-608-91917-1 .
- Sebastian Scheerer , Irmgard Vogt: Drugs and Drug Policy. A manual. Frankfurt am Main 1989, ISBN 3-593-33675-8 .
- Kurt Karl Ferdinand Pohlisch : Drugs and the Constitution. Publishing house "Auf der Wacht", Berlin-Dahlem 1932.
- Drug and Addiction Report 2013 (PDF), 2014 (PDF) and 2015 (PDF) of the Federal Government
web links
- Erowid - Very extensive English language database on drugs, society and spirituality
- Lycæum ( Memento of 26 June 2018 at Internet Archive ) Another major English-language database on drugs
- Drugtext – International Substance Use Library ( Memento from 16 June 2014 in the Internet Archive ) Extensive English-language literature archive on the subject
- The Deoxyribonucleic Hyperdimension – Collection of Articles and Thoughts on Drug, Mind and Society Related Issues
- Drug Scouts - Drug Encyclopedia
- Psychotropicon - Encyclopedia of Psychoactives
- PSI-TV media project – video presentations on the subject of drugs
- MAPS – Multidisciplinary Association for Psychedelic Studies, funding medical studies on psychedelics and cannabis
itemizations
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- ↑ In Italy, cannabis will soon be allowed to be grown on the balcony. Redaktionsnetzwerk Deutschland, September 9, 2021, retrieved February 4, 2022 (German).
- ↑ How Mexico Has Legalized But Still Not Regulated Cannabis. In: Filters. 30 July 2021, retrieved 20 September 2021 (American English).
- ↑ Cannabis decriminalization bill fails to get Knesset majority. The Jerusalem Post, July 28, 2021, retrieved September 20, 2021 (American English).
- ↑ Call Off the Global Drug War . In: New York Times
- ↑ Peter Mühlbauer: Jimmy Carter sees "War on Drugs" as a failure. In: Telepolis . 21 June 2011, retrieved 26 December 2014 .
- ↑ Reports by the Global Commission on Drug Policy . January 9, 2012.
- ↑ Swiss Radio and Television (SRF) . In: www.srf.ch .
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- ↑ Global drugs was a 'billion-dollar failure' . In: www.aljazeera.com .
- ↑ War on drugs a global failure, London School of Economics says . CBC News
- ↑ Abby Haglage: Economists Slam the War on Drugs in a New London School of Economics Report . May 6, 2014.
- ↑ World Drug Report 2010 (PDF; 14.6 MB). United Nations Office on Drugs and Crime ( UNODC )
- ↑ Judith Aldridge, David Décary-Hétu: Not an 'Ebay for Drugs': The Cryptomarket 'Silk Road' as a Paradigm Shifting Criminal Innovation. In: SSRN Electronic Journal. doi:10.2139/ssrn.2436643 .
- ↑ Slamming - Reduce risks when spraying chems . German AIDS Aid
