Psychoactive drug#Subjective and behavioral effects

{{main|History of alcoholic drinks|Prohibition of drugs}}

Psychoactive drug use can be traced to prehistory. Archaeological evidence of the use of psychoactive substances, mostly plants, dates back at least 10,000 years; historical evidence indicates cultural use 5,000 years ago.{{cite journal | author=Merlin, M.D. | title=Archaeological Evidence for the Tradition of Psychoactive Plant Use in the Old World | journal=Economic Botany | volume=57 | issue=3 | pages= 295–323 | doi=10.1663/0013-0001(2003)057[0295:AEFTTO]2.0.CO;2 | year=2003 | s2cid=30297486 }} There is evidence of the chewing of coca leaves, for example, in Peruvian society 8,000 years ago.Early Holocene coca chewing in northern Peru Volume: 84 Number: 326 Page: 939–953{{cite news | url=https://www.bbc.co.uk/news/science-environment-11878241 | work=BBC News | title=Coca leaves first chewed 8,000 years ago, says research | date=December 2, 2010 | url-status=live | archive-url=https://web.archive.org/web/20140523140912/http://www.bbc.co.uk/news/science-environment-11878241 | archive-date=May 23, 2014 }}

Psychoactive substances have been used medicinally and to alter consciousness. Consciousness altering may be a primary drive, akin to the need to satiate thirst, hunger, or sexual desire.{{cite book | author=Siegel, Ronald K| title=Intoxication: The Universal Drive for Mind-Altering Substances| publisher=Park Street Press, Rochester, Vermont | year=2005 | isbn=1-59477-069-7}} This may be manifest in the long history of drug use, and even in children's desire for spinning, swinging, or sliding, suggesting that the drive to alter one's state of mind is universal.{{cite book | last=Weil | first=Andrew | year=2004 | title=The Natural Mind: A Revolutionary Approach to the Drug Problem | page=15 | publisher=Houghton Mifflin | isbn=0-618-46513-8| edition=Revised }}

In The Hasheesh Eater (1857), American author Fitz Hugh Ludlow was one of the first to describe in modern terms the desire to change one's consciousness through drug use:{{blockquote|[D]rugs are able to bring humans into the neighborhood of divine experience and can thus carry us up from our personal fate and the everyday circumstances of our life into a higher form of reality. It is, however, necessary to understand precisely what is meant by the use of drugs. We do not mean the purely physical craving ... That of which we speak is something much higher, namely the knowledge of the possibility of the soul to enter into a lighter being, and to catch a glimpse of deeper insights and more magnificent visions of the beauty, truth, and the divine than we are normally able to spy through the cracks in our prison cell. But there are not many drugs which have the power of stilling such craving. The entire catalog, at least to the extent that research has thus far written it, may include only opium, hashish, and in rarer cases alcohol, which has enlightening effects only upon very particular characters.The Hashish Eater (1857) pg. 181}}

During the 20th century, the majority of countries initially responded to the use of recreational drugs by prohibiting production, distribution, or use through criminalization.{{Citation needed|date=July 2024}} A notable example occurred with Prohibition in the United States, where early in the century alcohol was made illegal for 13 years. In recent decades, an emerging perspective among governments and law enforcement holds that illicit drug use cannot be stopped through prohibition.{{Citation needed|date=July 2024}} One organization holding that view, Law Enforcement Against Prohibition (LEAP), concluded that "[in] fighting a war on drugs the government has increased the problems of society and made them far worse. A system of regulation rather than prohibition is a less harmful, more ethical and a more effective public policy."{{cite web |title=LEAP's Mission Statement |url=http://www.leap.cc/cms/index.php?name=Content&pid=5 |url-status=dead |archive-url=https://web.archive.org/web/20080913235116/http://www.leap.cc/cms/index.php?name=Content&pid=5 |archive-date=2008-09-13 |access-date=2013-05-30 |publisher=Law Enforcement Against Prohibition}}{{Failed verification|date=May 2013}}

In some countries, there has been a move toward harm reduction, where the use of illicit drugs is neither condoned nor promoted, but services and support are provided to ensure users have adequate factual information readily available, and that the negative effects of their use be minimized. Such is the case with Portugal's drug policy of decriminalization, with a primary goal of reducing the adverse health effects of drug use.{{cite web |url=http://www.scientificamerican.com/article.cfm?id=portugal-drug-decriminalization |title=5 Years After: Portugal's Drug Decriminalization Policy Shows Positive Results |publisher=Scientific American |access-date=2013-05-30 |url-status=live |archive-url=https://web.archive.org/web/20130815160507/http://www.scientificamerican.com/article.cfm?id=portugal-drug-decriminalization |archive-date=2013-08-15 }}

Psychoactive and psychotropic are often used interchangeably in general and academic sources, to describe substances that act on the brain to alter cognition and perception; some sources make a distinction between the terms. One narrower definition of psychotropic refers to drugs used to treat mental disorders, such as anxiolytic sedatives, antidepressants, antimanic agents, and neuroleptics. Another usage of psychotropic refers to substances determined to pose "high abuse liability", including stimulants, hallucinogens, opioids, and sedatives/hypnotics including alcohol. In international drug control, psychotropic substances refers to the substances specified in the Convention on Psychotropic Substances, which does not include narcotics.{{Cite web |date=2024 |title=HRB National Drugs Library: Psychoactive drug or substance |url=https://www.drugsandalcohol.ie/glossary/search?search_string=psychoactive+drug&search_fields=title&order_by=none&submit=Search |access-date=Jul 30, 2024 |website=Health Research Board}}

The term "drug" has become a skunked term. "Drugs" can have a negative connotation, often associated with illegal substances like cocaine or heroin, despite the fact that the terms "drug" and "medicine" are sometimes used interchangeably.{{cite book |pmc=7120710 |date=2011 |title=The Science and Business of Drug Discovery |pages=11–27 |doi=10.1007/978-1-4419-9902-3_2 | vauthors = Zanders ED |chapter=Introduction to Drugs and Drug Targets |isbn=978-1-4419-9901-6 }}

Novel psychoactive substances (NPS){{NoteTag|"New Psychoactive Substance", and "Novel Psychoactive Substance" (NPS) are often used interchangeably.|name=other names}}, also known as "designer drugs" are a category of psychoactive drugs (substances) that are designed to mimic the effects of often illegal drugs, usually in efforts to circumvent existing drug laws.{{Cite web |title=New psychoactive substances (NPS) {{!}} www.emcdda.europa.eu |url=https://www.emcdda.europa.eu/topics/nps_en |access-date=2024-06-09 |website=www.emcdda.europa.eu}}

Psychoactive drugs are divided according to their pharmacological effects. Common subtypes include:

• Anxiolytics are medicinally used to reduce the symptoms of anxiety, and sometimes insomnia.

::Example: benzodiazepines such as Xanax and Valium; barbiturates

• Empathogen–entactogens alter emotional state, often resulting in an increased sense of empathy, closeness, and emotional communication.

::Example: MDMA (ecstasy), MDA, 6-APB, AMT

• Stimulants increase activity, or arousal, of the central nervous system. They can enhance alertness, attention, cognition, mood and physical performance. Some stimulants are used medicinally to treat individuals with ADHD and narcolepsy.

::Examples: amphetamines, caffeine, cocaine, nicotine

• Depressants reduce, or depress, activity and stimulation in the central nervous system. This category encompasses a spectrum of substances with sedative, soporific, and anesthetic properties, and include sedatives, hypnotics, and opioids.

:: Examples: ethanol (alcohol), opioids such as morphine, fentanyl, and codeine, barbiturates, and benzodiazepines

• Hallucinogens, including psychedelics, dissociatives and deliriants, encompass substances that produce distinct alterations in perception, sensation of space and time, and emotional state.{{cite journal |vauthors=Bersani FS, Corazza O, Simonato P, Mylokosta A, Levari E, Lovaste R, Schifano F |year=2013 |title=Drops of madness? Recreational misuse of tropicamide collyrium; early warning alerts from Russia and Italy |journal=General Hospital Psychiatry |volume=35 |issue=5 |pages=571–3 |doi=10.1016/j.genhosppsych.2013.04.013 |pmid=23706777}}

::Examples, psychedelics: Psilocybin, LSD, DMT (N,N-Dimethyltryptamine), mescaline, cannabis

::Examples, dissociatives: Dextromethorphan, Salvia divinorum

::Examples, deliriants: Datura, scopolamine

File:Drug use triangle.png

The ways in which psychoactive substances are used vary widely between cultures. Some substances may have controlled or illegal uses, others may have shamanic purposes, and others are used medicinally. Examples would be social drinking, nootropic supplements, and sleep aids. Caffeine is the world's most widely consumed psychoactive substance, and is legal and unregulated in nearly all jurisdictions; in North America, 90% of adults consume caffeine daily.{{cite journal |last=Lovett |first=Richard |date=24 September 2005 |title=Coffee: The demon drink? |url=https://www.newscientist.com/article.ns?id=mg18725181.700 |url-status=live |format=fee required |journal=New Scientist |issue=2518 |archive-url=https://web.archive.org/web/20071024030810/http://www.newscientist.com/article.ns?id=mg18725181.700 |archive-date=24 October 2007 |access-date=2007-11-19}}

{{Main| Psychiatric medications}}

File:Zoloft bottles.jpg) is an SSRI antidepressant.]]

Psychiatric medications are psychoactive drugs prescribed for the management of mental and emotional disorders, or to aid in overcoming challenging behavior.{{cite journal |last1=Matson |first1=Johnny L. |last2=Neal |first2=Daniene |title=Psychotropic medication use for challenging behaviors in persons with intellectual disabilities: An overview |journal=Research in Developmental Disabilities |volume=30 |issue=3 |pages=572–86 |year=2009 |pmid=18845418 |doi=10.1016/j.ridd.2008.08.007 }} There are six major classes of psychiatric medications:

• Antidepressants treat disorders such as clinical depression, dysthymia, anxiety, eating disorders, and borderline personality disorder.{{cite journal | vauthors = Schatzberg AF | title = New indications for antidepressants | journal = The Journal of Clinical Psychiatry | volume = 61 | issue = 11 | pages = 9–17 | year = 2000 | pmid = 10926050 }}
• Stimulants, used to treat disorders such as attention deficit hyperactivity disorder and narcolepsy, and for weight reduction.
• Antipsychotics, used to treat psychotic symptoms, such as those associated with schizophrenia or severe mania, or as adjuncts to relieve clinical depression.
• Mood stabilizers, used to treat bipolar disorder and schizoaffective disorder.
• Anxiolytics, used to treat anxiety disorders.
• Depressants, used as hypnotics, sedatives, and anesthetics, depending upon dosage.

In addition, several psychoactive substances are currently employed to treat various addictions. These include acamprosate or naltrexone in the treatment of alcoholism, or methadone or buprenorphine maintenance therapy in the case of opioid addiction.{{Cite book|chapter-url=https://books.google.com/books?id=_MySDAAAQBAJ&pg=PA606|title=The Oxford Handbook of Substance Use and Substance Use Disorders|vauthors=Swift RM|publisher=Oxford University Press|year=2016|isbn=978-0-19-938170-8|veditors=Sher KJ|pages=601–603, 606|language=en|chapter=Pharmacotherapy of Substance Use, Craving, and Acute Abstinence Syndromes|url-status=live|archive-url=https://web.archive.org/web/20180509181047/https://books.google.com/books?id=_MySDAAAQBAJ&pg=PA606|archive-date=2018-05-09}}

Exposure to psychoactive drugs can cause changes to the brain that counteract or augment some of their effects; these changes may be beneficial or harmful. However, there is a significant amount of evidence that the relapse rate of mental disorders negatively corresponds with the length of properly followed treatment regimens (that is, relapse rate substantially declines over time), and to a much greater degree than placebo.{{cite journal |doi=10.1192/bjp.179.42.s4|doi-access=free |pmid=11532820 |title=Clinical importance of long-term antidepressant treatment |journal=The British Journal of Psychiatry |volume=179 |issue=42 |pages=S4–8 |year=2001 |last1=Hirschfeld |first1=Robert M. A. }}

File:Victory show Cosby Leicestershire UK 2013-09-07 zaphad1 Victory show 529 WWII military equipment orginals replicas reenactment etc German Luftwaffe pilot's personal items guns badges goggles knives etc.jpgs, located in the left-center, are featured in the military equipment used as emergency sustenance by the Luftwaffe, which was the air force of Nazi Germany during World War II.]]

{{Main|List of drugs used by militaries}}

Militaries worldwide have used or are using various psychoactive drugs to treat pain and to improve performance of soldiers by suppressing hunger, increasing the ability to sustain effort without food, increasing and lengthening wakefulness and concentration, suppressing fear, reducing empathy, and improving reflexes and memory-recall among other things.{{cite news |last1=Stoker |first1=Liam |date=14 April 2013 |title=Analysis Creating Supermen: battlefield performance enhancing drugs |url=https://www.army-technology.com/features/featurecreating-supermen-battlefield-performance-enhancing-drugs/ |access-date=22 June 2018 |website=Army Technology |publisher=Verdict Media Limited}}{{cite web |last1=Kamienski |first1=Lukasz |date=2016-04-08 |title=The Drugs That Built a Super Soldier |url=https://www.theatlantic.com/health/archive/2016/04/the-drugs-that-built-a-super-soldier/477183/ |access-date=22 June 2018 |publisher=The Atlantic}}

Both military and civilian American intelligence officials are known to have used psychoactive drugs while interrogating captives apprehended in its "war on terror". In July 2012 Jason Leopold and Jeffrey Kaye, psychologists and human rights workers, had a Freedom of Information Act request fulfilled that confirmed that the use of psychoactive drugs during interrogation was a long-standing

practice. Captives and former captives had been reporting medical staff collaborating with interrogators to drug captives with powerful psychoactive drugs prior to interrogation since the very first captives release.

In May 2003 recently released Pakistani captive Sha Mohammed Alikhel described the routine use of psychoactive drugs. He said that Jihan Wali, a captive kept in a nearby cell, was rendered catatonic through the use of these drugs.{{citation needed|date=October 2022}}

Alcohol has a long association of military use, and has been called "liquid courage" for its role in preparing troops for battle, anaesthetize injured soldiers, and celebrate military victories. It has also served as a coping mechanism for combat stress reactions and a means of decompression from combat to everyday life. However, this reliance on alcohol can have negative consequences for physical and mental health.{{cite journal |vauthors=Jones E, Fear NT |date=April 2011 |title=Alcohol use and misuse within the military: a review |journal=International Review of Psychiatry |volume=23 |issue=2 |pages=166–172 |doi=10.3109/09540261.2010.550868 |pmid=21521086}}

The first documented case of a soldier overdosing on methamphetamine during combat, was the Finnish corporal Aimo Koivunen, a soldier who fought in the Winter War and the Continuation War.{{cite web |url= https://www.sotapolku.fi/henkilot/koivunen_aimo-allan_1917-11-14_alastaro/|title= Aimo Allan Koivunen|author= |date= 2016|website= www.sotapolku.fi|publisher= |access-date= January 17, 2022|language=fi}}{{cite web |url= http://www.mapinc.org/drugnews/v02/n1001/a05.html?5235|title= Finland: History: Amphetamine Overdose In Heat Of Combat|last= Rantanen|first= Miska|date= 28 May 2002|website= www.mapinc.org|publisher= Helsingin Sanomat|access-date= January 17, 2022|quote=}}

{{main|Psychochemical warfare}}

Psychoactive drugs have been used in military applications as non-lethal weapons.

{{Main| Analgesics}}

Psychoactive drugs are often prescribed to manage pain. The subjective experience of pain is primarily regulated by endogenous opioid peptides. Thus, pain can often be managed using psychoactives that operate on this neurotransmitter system, also known as opioid receptor agonists. This class of drugs can be highly addictive, and includes opiate narcotics, like morphine and codeine.{{cite journal | vauthors = Quiding H, Lundqvist G, Boréus LO, Bondesson U, Ohrvik J | title = Analgesic effect and plasma concentrations of codeine and morphine after two dose levels of codeine following oral surgery | journal = European Journal of Clinical Pharmacology | volume = 44 | issue = 4 | pages = 319–23 | year = 1993 | pmid = 8513842 | doi = 10.1007/BF00316466 | s2cid = 37268044 }} NSAIDs, such as aspirin and ibuprofen, are also analgesics. These agents also reduce eicosanoid-mediated inflammation by inhibiting the enzyme cyclooxygenase.

{{Main| Anesthesia}}

General anesthetics are a class of psychoactive drug used on people to block physical pain and other sensations. Most anesthetics induce unconsciousness, allowing the person to undergo medical procedures like surgery, without the feelings of physical pain or emotional trauma.Medline Plus. [https://www.nlm.nih.gov/medlineplus/anesthesia.html Anesthesia.] {{webarchive|url=https://web.archive.org/web/20160704221735/https://www.nlm.nih.gov/medlineplus/anesthesia.html |date=2016-07-04 }} Accessed on July 16, 2007. To induce unconsciousness, anesthetics affect the GABA and NMDA systems. For example, Propofol is a GABA agonist,{{cite journal | vauthors = Li X, Pearce RA | title = Effects of halothane on GABA(A) receptor kinetics: evidence for slowed agonist unbinding | journal = The Journal of Neuroscience | volume = 20 | issue = 3 | pages = 899–907 | year = 2000 | pmid = 10648694 | doi = 10.1523/JNEUROSCI.20-03-00899.2000 | doi-access = free | pmc = 6774186 }} and ketamine is an NMDA receptor antagonist.{{cite journal | vauthors = Harrison NL, Simmonds MA | title = Quantitative studies on some antagonists of N-methyl D-aspartate in slices of rat cerebral cortex | journal = British Journal of Pharmacology | volume = 84 | issue = 2 | pages = 381–91 | year = 1985 | pmid = 2858237 | pmc = 1987274 | doi = 10.1111/j.1476-5381.1985.tb12922.x }}

{{main|Performance-enhancing substance}}

Performance-enhancing substances, also known as performance-enhancing drugs (PEDs),{{Cite web | url=http://www.usada.org/substances/effects-of-performance-enhancing-drugs/ | title=Effects of Performance-Enhancing Drugs | USADA| date=May 2019}} are substances that are used to improve any form of activity performance in humans. A well-known example of cheating in sports involves doping in sport, where banned physical performance-enhancing drugs are used by athletes and bodybuilders. Athletic performance-enhancing substances are sometimes referred as ergogenic aids.{{cite journal |vauthors=Pesta DH, Angadi SS, Burtscher M, Roberts CK |date=December 2013 |title=The effects of caffeine, nicotine, ethanol, and tetrahydrocannabinol on exercise performance |journal=Nutrition & Metabolism |volume=10 |issue=1 |pages=71 |doi=10.1186/1743-7075-10-71 |pmc=3878772 |pmid=24330705 |doi-access=free }}{{cite journal |vauthors=Liddle DG, Connor DJ |date=June 2013 |title=Nutritional supplements and ergogenic AIDS |journal=Primary Care |volume=40 |issue=2 |pages=487–505 |doi=10.1016/j.pop.2013.02.009 |pmid=23668655 |quote=Amphetamines and caffeine are stimulants that increase alertness, improve focus, decrease reaction time, and delay fatigue, allowing for an increased intensity and duration of training ...
Physiologic and performance effects [of amphetamines]
{{•}}Amphetamines increase dopamine/norepinephrine release and inhibit their reuptake, leading to central nervous system (CNS) stimulation
{{•}}Amphetamines seem to enhance athletic performance in anaerobic conditions 39 40
{{•}}Improved reaction time
{{•}}Increased muscle strength and delayed muscle fatigue
{{•}}Increased acceleration
{{•}}Increased alertness and attention to task}} Cognitive performance-enhancing drugs, commonly called nootropics,{{cite journal | vauthors = Frati P, Kyriakou C, Del Rio A, Marinelli E, Vergallo GM, Zaami S, Busardò FP | title = Smart drugs and synthetic androgens for cognitive and physical enhancement: revolving doors of cosmetic neurology | journal = Current Neuropharmacology | volume = 13 | issue = 1 | pages = 5–11 | date = January 2015 | pmid = 26074739 | pmc = 4462043 | doi = 10.2174/1570159X13666141210221750 | quote = Cognitive enhancement can be defined as the use of drugs and/or other means with the aim to improve the cognitive functions of healthy subjects in particular memory, attention, creativity and intelligence in the absence of any medical indication. ... The first aim of this paper was to review current trends in the misuse of smart drugs (also known as Nootropics) presently available on the market focusing in detail on methylphenidate, trying to evaluate the potential risk in healthy individuals, especially teenagers and young adults. }} are sometimes used by students to improve academic performance. Performance-enhancing substances are also used by military personnel to enhance combat performance.{{cite report |title=Better Fighting Through Chemistry? The Role of FDA Regulation in Crafting the Warrior of the Future |url=https://dash.harvard.edu/handle/1/8848246 |archive-url=https://web.archive.org/web/20160203110733/https://dash.harvard.edu/handle/1/8848246 |archive-date=3 February 2016 |date=8 March 2004 }}

{{Main|Recreational drug use}}

{{also|Clubbing (subculture)}}

File:Alcohol consumption per capita (Per capita alcohol consumption in high-income countries), OWID.svg

Many psychoactive substances are used for their mood and perception altering effects, including those with accepted uses in medicine and psychiatry. Examples of psychoactive substances include caffeine, alcohol, cocaine, LSD, nicotine, cannabis, and dextromethorphan.[https://www.who.int/substance_abuse/publications/en/Neuroscience_E.pdf Neuroscience of Psychoactive Substance Use and Dependence] {{webarchive|url=https://web.archive.org/web/20061003085309/http://www.who.int/substance_abuse/publications/en/Neuroscience_E.pdf |date=2006-10-03 }} by the World Health Organization. Retrieved 5 July 2007. Classes of drugs frequently used recreationally include:

• Stimulants, which activate the central nervous system. These are used recreationally for their euphoric effects.
• Hallucinogens (psychedelics, dissociatives and deliriants), which induce perceptual and cognitive alterations.
• Hypnotics, which depress the central nervous system.
• Opioid analgesics, which also depress the central nervous system. These are used recreationally because of their euphoric effects.
• Inhalants, in the forms of gas aerosols, or solvents, which are inhaled as a vapor because of their stupefying effects. Many inhalants also fall into the above categories (such as nitrous oxide which is also an analgesic).

In some modern and ancient cultures, drug usage is seen as a status symbol. Recreational drugs are seen as status symbols in settings such as at nightclubs and parties.{{cite journal | vauthors = Anderson TL | title = Drug identity change processes, race, and gender. III. Macrolevel opportunity concepts | journal = Substance Use & Misuse | volume = 33 | issue = 14 | pages = 2721–35 | year = 1998 | pmid = 9869440 | doi = 10.3109/10826089809059347 }} For example, in ancient Egypt, gods were commonly pictured holding hallucinogenic plants.{{cite journal | vauthors = Bertol E, Fineschi V, Karch SB, Mari F, Riezzo I | title = Nymphaea cults in ancient Egypt and the New World: a lesson in empirical pharmacology | journal = Journal of the Royal Society of Medicine | volume = 97 | issue = 2 | pages = 84–5 | year = 2004 | pmid = 14749409 | pmc = 1079300 | doi = 10.1177/014107680409700214 }}

Because there is controversy about regulation of recreational drugs, there is an ongoing debate about drug prohibition. Critics of prohibition believe that regulation of recreational drug use is a violation of personal autonomy and freedom.{{cite journal | vauthors = Hayry M | title = Prescribing cannabis: freedom, autonomy, and values | journal = Journal of Medical Ethics | volume = 30 | issue = 4 | pages = 333–6 | year = 2004 | pmid = 15289511 | pmc = 1733898 | doi = 10.1136/jme.2002.001347 }} In the United States, critics have noted that prohibition or regulation of recreational and spiritual drug use might be unconstitutional, and causing more harm than is prevented.Barnett, Randy E. [http://law.wustl.edu/Journal/22/p29Barnett.pdf "The Presumption of Liberty and the Public Interest: Medical Marijuana and Fundamental Rights"] {{webarchive|url=https://web.archive.org/web/20070711001509/http://law.wustl.edu/Journal/22/p29Barnett.pdf |date=2007-07-11 }}. Retrieved 4 July 2007.

Some people who take psychoactive drugs experience drug or substance induced psychosis. A 2019 systematic review and meta-analysis by Murrie et al. found that the pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%–35%), compared with 36% (95% CI 30%–43%) for brief, atypical and not otherwise specified psychoses.{{cite journal |last1=Murrie |first1=Benjamin |last2=Lappin |first2=Julia |last3=Large |first3=Matthew |last4=Sara |first4=Grant |title=Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis |journal=Schizophrenia Bulletin |date=16 October 2019 |volume=46 |issue=3 |pages=505–516 |doi=10.1093/schbul/sbz102 |pmid=31618428 |pmc=7147575 |doi-access=free }} Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%–46%), hallucinogens (3 studies, 26%, CI 14%–43%) and amphetamines (5 studies, 22%, CI 14%–34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up.

Alcohol and tobacco (nicotine) have been and are used as offerings in various religions and spiritual practices.{{Citation needed|date=August 2024}} Coca leaves have been used as offerings in rituals.{{Cite book |last=Quilter |first=Jeffrey |title=The Ancient Central Andes |publisher=Routledge World Archaeology |year=2022 |isbn=978-0-367-48151-3 |edition=2nd |location=New York, NY |pages=38–39, 279 |language=English}}

{{main|Religion and alcohol}}

According to the Catholic Church, the sacramental wine used in the Eucharist must contain alcohol. Canon 924 of the present Code of Canon Law (1983) states:

§3 The wine must be natural, made from grapes of the vine, and not corrupt.[http://www.deacons.net/Canon_Law/cci.htm Code of Canon Law, 1983] {{webarchive|url=https://web.archive.org/web/20060619055307/http://www.deacons.net/Canon_Law/cci.htm |date=19 June 2006 }}

{{also|Entheogen|List of substances used in rituals}}

File:Timothy-Leary-Los-Angeles-1989.jpg was a leading proponent of spiritual hallucinogen use.]]

Certain psychoactives, particularly hallucinogens, have been used for religious purposes since prehistoric times. Native Americans have used peyote cacti containing mescaline for religious ceremonies for as long as 5700 years.{{cite journal | vauthors = El-Seedi HR, De Smet PA, Beck O, Possnert G, Bruhn JG | title = Prehistoric peyote use: alkaloid analysis and radiocarbon dating of archaeological specimens of Lophophora from Texas | journal = Journal of Ethnopharmacology | volume = 101 | issue = 1–3 | pages = 238–42 | year = 2005 | pmid = 15990261 | doi = 10.1016/j.jep.2005.04.022 }} The muscimol-containing Amanita muscaria mushroom was used for ritual purposes throughout prehistoric Europe.{{cite journal | vauthors = Vetulani J | title = Drug addiction. Part I. Psychoactive substances in the past and presence | journal = Polish Journal of Pharmacology | volume = 53 | issue = 3 | pages = 201–14 | year = 2001 | pmid = 11785921 }}

The use of entheogens for religious purposes resurfaced in the West during the counterculture movements of the 1960s and 70s. Under the leadership of Timothy Leary, new spiritual and intention-based movements began to use LSD and other hallucinogens as tools to access deeper inner exploration. In the United States, the use of peyote for ritual purposes is protected only for members of the Native American Church, which is allowed to cultivate and distribute peyote. However, the genuine religious use of peyote, regardless of one's personal ancestry, is protected in Colorado, Arizona, New Mexico, Nevada, and Oregon.{{cite journal | vauthors = Bullis RK | title = Swallowing the scroll: legal implications of the recent Supreme Court peyote cases | journal = Journal of Psychoactive Drugs | volume = 22 | issue = 3 | pages = 325–32 | year = 1990 | pmid = 2286866 | doi = 10.1080/02791072.1990.10472556}}

{{main|Psychedelic therapy}}

Psychedelic therapy (or psychedelic-assisted therapy) refers to the proposed use of psychedelic drugs, such as psilocybin, MDMA,{{refn|MDMA and Ketamine are not a classical psychedelics but are sometimes discussed alongside classical psychedelics due to similarities in their psychoactive and potentially therapeutic effects.{{cite journal | vauthors = Nutt D | title = Psychedelic drugs-a new era in psychiatry? | journal = Dialogues in Clinical Neuroscience | volume = 21 | issue = 2 | pages = 139–147 | date = 2019 | pmid = 31636488 | pmc = 6787540 | doi = 10.31887/DCNS.2019.21.2/dnutt }}|group=note}} LSD, and ayahuasca, to treat mental disorders.{{cite journal | vauthors = Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM | display-authors = 6 | title = Psychedelics and Psychedelic-Assisted Psychotherapy | journal = The American Journal of Psychiatry | volume = 177 | issue = 5 | pages = 391–410 | date = May 2020 | pmid = 32098487 | doi = 10.1176/appi.ajp.2019.19010035 | s2cid = 211524704 }}{{cite journal | vauthors = Marks M, Cohen IG | title = Psychedelic therapy: a roadmap for wider acceptance and utilization | journal = Nature Medicine | volume = 27 | issue = 10 | pages = 1669–1671 | date = October 2021 | pmid = 34608331 | doi = 10.1038/s41591-021-01530-3 | s2cid = 238355863 | doi-access = free }} As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.{{cite journal | vauthors = Pilecki B, Luoma JB, Bathje GJ, Rhea J, Narloch VF | title = Ethical and legal issues in psychedelic harm reduction and integration therapy | journal = Harm Reduction Journal | volume = 18 | issue = 1 | pages = 40 | date = April 2021 | pmid = 33827588 | pmc = 8028769 | doi = 10.1186/s12954-021-00489-1 | doi-access = free }}

{{main|Psychonautics}}

The aims and methods of psychonautics, when state-altering substances are involved, is commonly distinguished from recreational drug use by research sources.{{cite book |last=Blom |first=Jan Dirk |title=A Dictionary of Hallucinations |page=434 |url=https://books.google.com/books?id=qbF44AEMGdcC&pg=PA434 |access-date=2010-03-05 | isbn=978-1-4419-1222-0 | year=2009 | publisher=Springer}} Psychonautics as a means of exploration need not involve drugs, and may take place in a religious context with an established history. Cohen considers psychonautics closer in association to wisdom traditions and other transpersonal and integral movements.UK Institute of Psychonautics and Somanautics [http://www.transpersonalacademy.co.uk/psychonautics.htm page] {{webarchive|url=https://web.archive.org/web/20101110073128/http://www.transpersonalacademy.co.uk/psychonautics.htm |date=10 November 2010 }} at his {{cite web |url=http://www.transpersonalacademy.co.uk |title=Academy for Transpersonal Studies |access-date=10 March 2010 |archive-url=https://web.archive.org/web/20100923100000/http://www.transpersonalacademy.co.uk/ |archive-date=23 September 2010}}

{{main|Self-medication}}

Self-medication, sometime called do-it-yourself (DIY) medicine, is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions, for example headaches or fatigue.

The substances most widely used in self-medication are over-the-counter drugs and dietary supplements, which are used to treat common health issues at home. These do not require a doctor's prescription to obtain and, in some countries, are available in supermarkets and convenience stores.{{cite web|title=What is self-Medication? |url=http://www.wsmi.org/about-self-care-and-self-medication/what-is-self-medication/ |publisher=World Self-Medication Industry |access-date=25 May 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160605074727/http://www.wsmi.org/about-self-care-and-self-medication/what-is-self-medication/ |archive-date= Jun 5, 2016 }}

{{main|Sex and drugs}}

Sex and drugs date back to ancient humans and have been interlocked throughout human history. Both legal and illegal, the consumption of drugs and their effects on the human body encompasses all aspects of sex, including desire, performance, pleasure, conception, gestation, and disease.

There are many different types of drugs that are commonly associated with their effects on sex, including alcohol, cannabis, cocaine, MDMA, GHB, amphetamines, opioids, antidepressants, and many others.

In the US, NORML (National Organization for the Reform of Marijuana Laws) has led since the 1970s a movement to legalize cannabis nationally.Joshua Clark Davis. (November 6, 2014). [http://www.huffingtonpost.com/joshua-clark-davis/the-long-marijuana-rights_b_6113894.html The Long Marijuana-Rights Movement.] {{webarchive|url=https://web.archive.org/web/20160911130717/http://www.huffingtonpost.com/joshua-clark-davis/the-long-marijuana-rights_b_6113894.html|date=September 11, 2016}} The Huffington Post. Retrieved August 3, 2016. The so-called "420 movement" is the global association of the number 420 with cannabis consumption: April 20th – fourth month, twentieth day – has become an international counterculture holiday based on the celebration and consumption of cannabis;{{cite web |last=King |first=Matt |date=April 24, 2007 |title=Thousands at UCSC burn one to mark cannabis holiday |url=http://www.santacruzsentinel.com/archive/2007/April/24/local/stories/08local.htm |archive-url=https://web.archive.org/web/20070426081319/http://www.santacruzsentinel.com/archive/2007/April/24/local/stories/08local.htm |archive-date=April 26, 2007 |work=Santa Cruz Sentinel}}{{cite web |last1=Halnon |first1=Karen Bettez |date=April 11, 2005 |title=The power of 420 |url=http://hightimes.com/read/power-420 |archive-url=https://web.archive.org/web/20130513011500/http://hightimes.com/read/power-420 |archive-date=May 13, 2013}}{{cite web |title=420 event lists |url=http://cannabis.shoutwiki.com/wiki/420_event_lists}} 4:20 pm on any day is a time to consume cannabis.{{cite web |last=King |first=Matt |date=April 24, 2007 |title=Thousands at UCSC burn one to mark cannabis holiday |url=http://www.santacruzsentinel.com/archive/2007/April/24/local/stories/08local.htm |archive-url=https://web.archive.org/web/20070426081319/http://www.santacruzsentinel.com/archive/2007/April/24/local/stories/08local.htm |archive-date=April 26, 2007 |work=Santa Cruz Sentinel}}{{cite news |last=McCoy |first=Terrence |date=2014-04-18 |title=The strange story of how the pot holiday '4/20' got its name |url=https://www.washingtonpost.com/news/morning-mix/wp/2014/04/18/the-strange-story-of-how-the-pot-holiday-420-got-its-name/ |access-date=2020-04-18 |newspaper=The Washington Post}}

{{main|Operation Overgrow}}

Operation Overgrow is the name, given by cannabis activists, of an "operation" to spread marijuana seeds wildly "so it grows like weed".{{cite news|title=Cannabis i Malmös blomlådor – igen|trans-title=Cannabis in Malmö flower boxes – again|author=Karl Grauers|date=May 18, 2009|newspaper=Metro|location=Stockholm, Sweden|url=http://www.metro.se/nyheter/cannabis-i-malmos-blomlador-igen/Objier!29735/|archive-url=https://web.archive.org/web/20170511202511/http://www.metro.se/artikel/cannabis-i-malm%C3%B6s-bloml%C3%A5dor-igen-xr|archive-date=May 11, 2017}} The thought behind the operation is to draw attention to the debate about legalization/decriminalization of marijuana.

{{also|Suicide methods#Drug_overdose|suicide pill}}

A drug overdose involves taking a dose of a drug that exceeds safe levels. In the UK (England and Wales) until 2013, a drug overdose was the most common suicide method in females.{{cite web |title=Suicides in England and Wales – Office for National Statistics |url=https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations |website=www.ons.gov.uk}} In 2019 in males the percentage is 16%. Self-poisoning accounts for the highest number of non-fatal suicide attempts. In the United States about 60% of suicide attempts and 14% of suicide deaths involve drug overdoses.{{cite journal |last1=Conner |first1=Andrew |last2=Azrael |first2=Deborah |last3=Miller |first3=Matthew |title=Suicide Case-Fatality Rates in the United States, 2007 to 2014 |journal=Annals of Internal Medicine |date=3 December 2019 |doi=10.7326/M19-1324|pmid=31791066 |volume=171 |issue=12 |pages=885–895 |s2cid=208611916 }} The risk of death in suicide attempts involving overdose is about 2%.{{Verification needed|date=June 2021|reason=Two percent, or twenty?}}

Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide,{{cite journal | vauthors = Youssef NA, Rich CL | title = Does acute treatment with sedatives/hypnotics for anxiety in depressed patients affect suicide risk? A literature review | journal = Annals of Clinical Psychiatry | volume = 20 | issue = 3 | pages = 157–169 | year = 2008 | pmid = 18633742 | doi = 10.1080/10401230802177698 }} with alcoholism present in between 15% and 61% of cases.{{cite journal | vauthors = Vijayakumar L, Kumar MS, Vijayakumar V | title = Substance use and suicide | journal = Current Opinion in Psychiatry | volume = 24 | issue = 3 | pages = 197–202 | date = May 2011 | pmid = 21430536 | doi = 10.1097/YCO.0b013e3283459242 | s2cid = 206143129 }} Countries that have higher rates of alcohol use and a greater density of bars generally also have higher rates of suicide.{{cite journal | vauthors = Sher L | title = Alcohol consumption and suicide | journal = QJM | volume = 99 | issue = 1 | pages = 57–61 | date = January 2006 | pmid = 16287907 | doi = 10.1093/qjmed/hci146 | doi-access = free }} About 2.2–3.4% of those who have been treated for alcoholism at some point in their life die by suicide. Alcoholics who attempt suicide are usually male, older, and have tried to take their own lives in the past. In adolescents who misuse alcohol, neurological and psychological dysfunctions may contribute to the increased risk of suicide.{{cite journal | vauthors = Sher L | title = Functional magnetic resonance imaging in studies of the neurobiology of suicidal behavior in adolescents with alcohol use disorders | journal = International Journal of Adolescent Medicine and Health | volume = 19 | issue = 1 | pages = 11–18 | year = 2007 | pmid = 17458319 | doi = 10.1515/ijamh.2007.19.1.11 | s2cid = 42672912 }}

Overdose attempts using painkillers are among the most common, due to their easy availability over-the-counter.{{cite journal |last =Brock |first =Anita |author2=Sini Dominy |author3=Clare Griffiths |date=6 November 2003 |title = Trends in suicide by method in England and Wales, 1979 to 2001 |journal = Health Statistics Quarterly |volume = 20 |pages = 7–18 |issn = 1465-1645 |url=http://www.statistics.gov.uk/CCI/article.asp?ID=1538&Pos=4&ColRank=1&Rank=176 |access-date = 2007-06-25 }}

{{main|Route of administration}}

Psychoactive drugs are administered via oral ingestion as a tablet, capsule, powder, liquid, and beverage; via injection by subcutaneous, intramuscular, and intravenous route; via rectum by suppository and enema; and via inhalation by smoking, vaporizing, and snorting. The efficiency of each method of administration varies from drug to drug.United States Food and Drug Administration. [https://www.fda.gov/cder/dsm/DRG/drg00301.htm CDER Data Standards Manual] {{webarchive|url=https://web.archive.org/web/20060103175139/https://www.fda.gov/cder/dsm/DRG/drg00301.htm |date=2006-01-03 }}. Retrieved on May 15, 2007.

The psychiatric drugs fluoxetine, quetiapine, and lorazepam are ingested orally in tablet or capsule form. Alcohol and caffeine are ingested in beverage form; nicotine and cannabis are smoked or vaporized; peyote and psilocybin mushrooms are ingested in botanical form or dried; and crystalline drugs such as cocaine and methamphetamine are usually inhaled or snorted.

The theory of dosage, set, and setting is a useful model in dealing with the effects of psychoactive substances, especially in a controlled therapeutic setting as well as in recreational use. Dr. Timothy Leary, based on his own experiences and systematic observations on psychedelics, developed this theory along with his colleagues Ralph Metzner, and Richard Alpert (Ram Dass) in the 1960s.Timothy Leary; Ralph Metzner; Richard Alpert. The Psychedelic Experience. New York: University Books. 1964

; Dosage

The first factor, dosage, has been a truism since ancient times, or at least since Paracelsus who said, "Dose makes the poison." Some compounds are beneficial or pleasurable when consumed in small amounts, but harmful, deadly, or evoke discomfort in higher doses.

; Set

The set is the internal attitudes and constitution of the person, including their expectations, wishes, fears, and sensitivity to the drug. This factor is especially important for the hallucinogens, which have the ability to make conscious experiences out of the unconscious. In traditional cultures, set is shaped primarily by the worldview, health and genetic characteristics that all the members of the culture share.

; Setting

The third aspect is setting, which pertains to the surroundings, the place, and the time in which the experiences transpire.

This theory clearly states that the effects are equally the result of chemical, pharmacological, psychological, and physical influences. The model that Timothy Leary proposed applied to the psychedelics, although it also applies to other psychoactives.{{cite book | title=The Encyclopedia of Psychoactive Plants | publisher=Park Street Press | author=Ratsch, Christian | author-link=Christian Rätsch| date=May 5, 2005 | page=944 | isbn=0-89281-978-2}}

{{Main| Neuropsychopharmacology}}

File:SynapseSchematic en.svg. Depending on its method of action, a psychoactive substance may block the receptors on the post-synaptic neuron (dendrite), or block reuptake or affect neurotransmitter synthesis in the pre-synaptic neuron (axon).]]

Psychoactive drugs operate by temporarily affecting a person's neurochemistry, which in turn causes changes in a person's mood, cognition, perception and behavior. There are many ways in which psychoactive drugs can affect the brain. Each drug has a specific action on one or more neurotransmitter or neuroreceptor in the brain.

Drugs that increase activity in particular neurotransmitter systems are called agonists. They act by increasing the synthesis of one or more neurotransmitters, by reducing its reuptake from the synapses, or by mimicking the action by binding directly to the postsynaptic receptor. Drugs that reduce neurotransmitter activity are called antagonists, and operate by interfering with synthesis or blocking postsynaptic receptors so that neurotransmitters cannot bind to them.{{cite book| last = Seligma| first = Martin E.P.| title = Abnormal Psychology| publisher = W. W. Norton & Company|year=1984| isbn = 0-393-94459-X| chapter = 4 }}

Exposure to a psychoactive substance can cause changes in the structure and functioning of neurons, as the nervous system tries to re-establish the homeostasis disrupted by the presence of the drug (see also, neuroplasticity). Exposure to antagonists for a particular neurotransmitter can increase the number of receptors for that neurotransmitter or the receptors themselves may become more responsive to neurotransmitters; this is called sensitization. Conversely, overstimulation of receptors for a particular neurotransmitter may cause a decrease in both number and sensitivity of these receptors, a process called desensitization or tolerance. Sensitization and desensitization are more likely to occur with long-term exposure, although they may occur after only a single exposure. These processes are thought to play a role in drug dependence and addiction.{{cite web | title=University of Texas, Addiction Science Research and Education Center | url=http://www.utexas.edu/research/asrec/dopamine.html | access-date=May 14, 2007 | url-status=dead | archive-url=https://web.archive.org/web/20110814130859/http://www.utexas.edu/research/asrec/dopamine.html | archive-date=August 14, 2011 }} Physical dependence on antidepressants or anxiolytics may result in worse depression or anxiety, respectively, as withdrawal symptoms. Unfortunately, because clinical depression (also called major depressive disorder) is often referred to simply as depression, antidepressants are often requested by and prescribed for patients who are depressed, but not clinically depressed.

The following is a brief table of notable drugs and their primary neurotransmitter, receptor or method of action. Many drugs act on more than one transmitter or receptor in the brain.{{cite journal | vauthors = Lüscher C, Ungless MA | title = The mechanistic classification of addictive drugs | journal = PLOS Medicine | volume = 3 | issue = 11 | pages = e437 | year = 2006 | pmid = 17105338 | pmc = 1635740 | doi = 10.1371/journal.pmed.0030437 | doi-access = free }}

{{Main|Addiction|ΔFosB}}

{{Addiction glossary|collapse=yes|width=30em}}

File:Development of a rational scale to assess the harm of drugs of potential misuse (physical harm and dependence, NA free means).svg et al. 2007){{Cite journal | journal = The Lancet | first4 = C. | last4 = Blakemore | author-link4 = Colin Blakemore| author-link1 = David Nutt| volume = 369 | issue = 9566| pmid=17382831 | pages = 1047–1053 | first3 = W. | last3 = Saulsbury | year = 2007 | title = Development of a rational scale to assess the harm of drugs of potential misuse | last1 = Nutt | first1 = D. | first2 = L. A. | last2 = King | doi = 10.1016/S0140-6736(07)60464-4| s2cid = 5903121 }}]]

Psychoactive drugs are often associated with addiction or drug dependence. Dependence can be divided into two types: psychological dependence, by which a user experiences negative psychological or emotional withdrawal symptoms (e.g., depression) and physical dependence, by which a user must use a drug to avoid physically uncomfortable or even medically harmful physical withdrawal symptoms.{{cite journal |last1=Johnson |first1=B |title=Psychological Addiction, Physical Addiction, Addictive Character, and Addictive Personality Disorder: A Nosology of Addictive Disorders |journal=Canadian Journal of Psychoanalysis |volume=11 |issue=1 |year=2003 |pages=135–60 |oclc=208052223 }} Drugs that are both rewarding and reinforcing are addictive; these properties of a drug are mediated through activation of the mesolimbic dopamine pathway, particularly the nucleus accumbens. Not all addictive drugs are associated with physical dependence, e.g., amphetamine, and not all drugs that produce physical dependence are addictive drugs, e.g., oxymetazoline.

Globally, as of 2016, alcohol use disorders were the most prevalent of all substance use disorders (SUD) worldwide; cannabis dependence and opioid dependence were the next most prevalent SUDs.{{cite journal |vauthors=Degenhardt L |collaboration=GBD 2016 Alcohol and Drug Use Collaborators |date=December 2018 |title=The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. |journal=The Lancet. Psychiatry |volume=5 |issue=12 |pages=987-1012 |doi=10.1016/S2215-0366(18)30337-7 |doi-access=free |pmc=6251968 |pmid=30392731}}

Many professionals, self-help groups, and businesses specialize in drug rehabilitation, with varying degrees of success, and many parents attempt to influence the actions and choices of their children regarding psychoactives.{{cite journal |doi=10.3109/00952999009001586 |pmid=2288323 |title=Parent-Adolescent Problem-Solving Interactions and Drug Use |journal=The American Journal of Drug and Alcohol Abuse |volume=16 |issue=3–4 |pages=239–58 |year=2009 |last1=Hops |first1=Hyman |last2=Tildesley |first2=Elizabeth |last3=Lichtenstein |first3=Edward |last4=Ary |first4=Dennis |last5=Sherman |first5=Linda }}

Common forms of rehabilitation include psychotherapy, support groups and pharmacotherapy, which uses psychoactive substances to reduce cravings and physiological withdrawal symptoms while a user is going through detox. Methadone, itself an opioid and a psychoactive substance, is a common treatment for heroin addiction, as is another opioid, buprenorphine. Recent research on addiction has shown some promise in using psychedelics such as ibogaine to treat and even cure drug addictions, although this has yet to become a widely accepted practice.{{cite web | title=Psychedelics Could Treat Addiction Says Vancouver Official | url=https://thetyee.ca/News/2006/08/09/Psychedelics/ | access-date=March 26, 2007 | url-status=live | archive-url=https://web.archive.org/web/20061202185112/http://thetyee.ca/News/2006/08/09/Psychedelics/ | archive-date=December 2, 2006 | date=2006-08-09 }}{{cite web | title=Ibogaine research to treat alcohol and drug addiction | url=http://www.maps.org/ibogaine/ | access-date=March 26, 2007 | url-status=live | archive-url=https://web.archive.org/web/20070422174952/http://www.maps.org/ibogaine/ | archive-date=April 22, 2007 }}

{{Main|Prohibition of drugs}}

File:Bayer Heroin bottle.jpg bottle]]

The legality of psychoactive drugs has been controversial through most of recent history; the Second Opium War and Prohibition are two historical examples of legal controversy surrounding psychoactive drugs. However, in recent years, the most influential document regarding the legality of psychoactive drugs is the Single Convention on Narcotic Drugs, an international treaty signed in 1961 as an Act of the United Nations. Signed by 73 nations including the United States, the USSR, Pakistan, India, and the United Kingdom, the Single Convention on Narcotic Drugs established Schedules for the legality of each drug and laid out an international agreement to fight addiction to recreational drugs by combatting the sale, trafficking, and use of scheduled drugs.[http://www.unodc.org/pdf/convention_1961_en.pdf United Nations Single Convention on Narcotic Drugs.] {{webarchive|url=https://web.archive.org/web/20080510121002/http://www.unodc.org/pdf/convention_1961_en.pdf |date=2008-05-10 }} Retrieved on June 20, 2007. All countries that signed the treaty passed laws to implement these rules within their borders. However, some countries that signed the Single Convention on Narcotic Drugs, such as the Netherlands, are more lenient with their enforcement of these laws.{{cite journal |doi=10.1126/science.278.5335.47 |pmid=9311925 |title=Interpreting Dutch Cannabis Policy: Reasoning by Analogy in the Legalization Debate |journal=Science |volume=278 |issue=5335 |pages=47–52 |year=1997 |last1=MacCoun |first1=R |last2=Reuter |first2=P }}

In the United States, the Food and Drug Administration (FDA) has authority over all drugs, including psychoactive drugs. The FDA regulates which psychoactive drugs are over the counter and which are only available with a prescription.History of the Food and Drug Administration. Retrieved at [https://www.fda.gov/oc/history/historyoffda/section1.html FDA's website] {{webarchive|url=https://web.archive.org/web/20090119132328/https://www.fda.gov/oc/history/historyoffda/section1.html |date=2009-01-19 }} on June 23, 2007. However, certain psychoactive drugs, like alcohol, tobacco, and drugs listed in the Single Convention on Narcotic Drugs are subject to criminal laws. The Controlled Substances Act of 1970 regulates the recreational drugs outlined in the Single Convention on Narcotic Drugs.United States Controlled Substances Act of 1970. Retrieved from the [http://www.usdoj.gov/dea/pubs/csa.html DEA's website] {{webarchive|url=https://web.archive.org/web/20090508010906/http://www.usdoj.gov/dea/pubs/csa.html |date=2009-05-08 }} on June 20, 2007. Alcohol is regulated by state governments, but the federal National Minimum Drinking Age Act penalizes states for not following a national drinking age.[http://epw.senate.gov/title23.pdf Title 23 of the United States Code, Highways.] {{webarchive|url=https://web.archive.org/web/20070614002534/http://epw.senate.gov/title23.pdf |date=2007-06-14 }} Retrieved on June 20, 2007. Tobacco is also regulated by all fifty state governments.Taxadmin.org. [http://www.taxadmin.org/FTA/rate/cigarett.html State Excise Tax Rates on Cigarettes.] {{webarchive|url=https://web.archive.org/web/20091109195142/http://www.taxadmin.org/FTA/rate/cigarett.html |date=2009-11-09 }} Retrieved on June 20, 2007. Most people accept such restrictions and prohibitions of certain drugs, especially the "hard" drugs, which are illegal in most countries.{{cite web |title=What's your poison? |work=Caffeine |url=http://www.abc.net.au/quantum/poison/caffeine/caffeine.htm |access-date=July 12, 2006 |url-status=live |archive-url=https://web.archive.org/web/20090726194701/http://www.abc.net.au/quantum/poison/caffeine/caffeine.htm |archive-date=July 26, 2009 }}

{{cite book |last=Griffiths |first=RR |year=1995 |title=Psychopharmacology: The Fourth Generation of Progress |edition=4th |page=2002 |publisher=Lippincott Williams & Wilkins | isbn=0-7817-0166-X}}{{cite book |last=Edwards | first=Griffith |year=2005 |title=Matters of Substance: Drugs—and Why Everyone's a User |page=352 |publisher=Thomas Dunne Books | isbn=0-312-33883-X}}

In the medical context, psychoactive drugs as a treatment for illness is widespread and generally accepted. Little controversy exists concerning over the counter psychoactive medications in antiemetics and antitussives. Psychoactive drugs are commonly prescribed to patients with psychiatric disorders. However, certain critics {{who|date=July 2021}} believe that certain prescription psychoactives, such as antidepressants and stimulants, are overprescribed and threaten patients' judgement and autonomy.Dworkin, Ronald. Artificial Happiness. New York: Carroll & Graf, 2006. pp.2–6. {{ISBN|0-7867-1933-8}}{{cite journal |doi=10.1136/jme.2005.013540 |pmid=16446415 |pmc=2563334 |title=Medicating the mind: A Kantian analysis of overprescribing psychoactive drugs |journal=Journal of Medical Ethics |volume=32 |issue=2 |pages=100–5 |year=2006 |last1=Manninen |first1=BA }}

{{Further|Effect of psychoactive drugs on animals|Recreational drug use in animals|Zoopharmacognosy}}

A number of animals consume different psychoactive plants, animals, berries and even fermented fruit, becoming intoxicated. An example of this is cats after consuming catnip. Traditional legends of sacred plants often contain references to animals that introduced humankind to their use.{{cite book | last=Samorini | first=Giorgio | year=2002 | title=Animals And Psychedelics: The Natural World & The Instinct To Alter Consciousness | publisher=Park Street Press | isbn=0-89281-986-3 }} Animals and psychoactive plants appear to have co-evolved, possibly explaining why these chemicals and their receptors exist within the nervous system.{{cite web | author=Albert, David Bruce Jr. |date=1993 | title=Event Horizons of the Psyche | url=http://www.csp.org/chrestomathy/event_horizons.html | access-date=February 2, 2006 | url-status=dead | archive-url=https://web.archive.org/web/20060927063611/http://www.csp.org/chrestomathy/event_horizons.html | archive-date=September 27, 2006 }}

This is a list of commonly used drugs that contain psychoactive ingredients. Please note that the following lists contains legal and illegal drugs (based on the country's laws).

The most widely consumed psychotropic drugs worldwide are:{{cite journal | vauthors = Crocq MA | title = Alcohol, nicotine, caffeine, and mental disorders | journal = Dialogues in Clinical Neuroscience | volume = 5 | issue = 2 | pages = 175–185 | date = June 2003 | pmid = 22033899 | pmc = 3181622 | doi = 10.31887/DCNS.2003.5.2/macrocq }}

• Caffeine
• Alcohol
• Nicotine

• Benzodiazepines
• Cannabis
• Opioids
• Amphetamines
• SSRIs

{{div col|colwidth=15em}}

• Cocaine
• Heroin
• LSD
• Methamphetamine
• Ecstasy
• Psilocybin mushrooms
• Benzodiazepines
• Pharmaceutical drugs
• Stimulants

{{div col end}}

{{div col|colwidth=15em}}

• Contact high
• Counterculture of the 1960s
• Demand reduction
• Designer drug
• Drug
• Drug addiction
• Drug checking
• Drug rehabilitation
• Hamilton's Pharmacopeia
• Hard and soft drugs
• Harm reduction
• Neuropsychopharmacology
• Psychopharmacology
• Poly drug use
• Project MKULTRA
• Psychedelic plants
• Psychoactive fish
• Recreational drug use
• Responsible drug use
• Self-medication

{{div col end}}

{{reflist|group=note}}

{{Reflist|30em|refs=

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| archive-url = https://web.archive.org/web/20121031015328/http://news.bbc.co.uk/2/hi/south_asia/3051501.stm

| url-status = live

| quote = Mr Shah alleged that the Americans had given him injections and tablets prior to interrogations. "They used to tell me I was mad," the 23-year-old told the BBC in his native village in Dir district near the Afghan border. I was given injections at least four or five times as well as different tablets. I don't know what they were meant for."

}}

{{cite news

| url = http://www.guardian.co.uk/guantanamo/story/0,13743,1098604,00.html

| title = People the law forgot

| work = The Guardian

| date = 2003-12-03

| access-date = 2012-07-14

| archive-date = 2013-08-27

| archive-url = https://web.archive.org/web/20130827191607/https://www.theguardian.com/world/2003/dec/03/guantanamo.usa1

| url-status = live

| quote = The biggest damage is to my brain. My physical and mental state isn't right. I'm a changed person. I don't laugh or enjoy myself much.

}}

{{cite news

| url = http://truth-out.org/news/item/10248-exclusive-department-of-defense-declassifies-report-on-alleged-drugging-of-detainees

| title = EXCLUSIVE: DoD Report Reveals Some Detainees Interrogated While Drugged, Others "Chemically Restrained"

| publisher = Truthout

| author1 = Jason Leopold |author2=Jeffrey Kaye

| date = 2011-07-11

| archive-date = 2020-03-28

| archive-url = https://web.archive.org/web/20200328062203/https://truthout.org/articles/exclusive-department-of-defense-declassifies-report-on-alleged-drugging-of-detainees/

| url-status = live

| quote = Truthout obtained a copy of the report - "Investigation of Allegations of the Use of Mind-Altering Drugs to Facilitate Interrogations of Detainees" - prepared by the DoD's deputy inspector general for intelligence in September 2009, under a Freedom of Information Act (FOIA) request we filed nearly two years ago.

}}

{{cite news

| url = http://www.wired.com/dangerroom/2012/07/gitmo/

| title = U.S. Injected Gitmo Detainees With 'Mind Altering' Drugs

| publisher = Wired magazine

| author = Robert Beckhusen

| date = 2012-07-11

| access-date = 2012-07-14

| archive-date = 2012-07-13

| archive-url = https://web.archive.org/web/20120713233900/https://www.wired.com/dangerroom/2012/07/gitmo/

| url-status = live

| quote = That's according to a recently declassified report (.pdf) from the Pentagon's inspector general, obtained by Truthout's Jeffrey Kaye and Jason Leopold after a Freedom of Information Act Request. In it, the inspector general concludes that 'certain detainees, diagnosed as having serious mental health conditions being treated with psychoactive medications on a continuing basis, were interrogated.' The report does not conclude, though, that anti-psychotic drugs were used specifically for interrogation purposes.

}}

}}

• [https://www.who.int/substance_abuse/publications/en/Neuroscience_E.pdf Neuroscience of Psychoactive Substance Use and Dependence] by the WHO

{{Major drug groups}}

{{Drug use}}

{{Chemical classes of psychoactive drugs}}

{{Unnecessary health care}}

{{Mental health law}}

{{Authority control}}

fi:Psykoaktiivinen aine