Definition
The World Health Organization defines psychoactive substances as chemicals that affect a person’s mental or psychological state, including perception, mood, and behavior. These substances are generally classified into three main categories:
- Stimulants
- Depressants
- Hallucinogens
How do psychoactive substances affect mental state and brain function?
Most psychoactive substances act on the brain reward system, which is responsible for feelings of pleasure and motivation. They do this by increasing levels of dopamine, a key chemical involved in experiencing pleasure.
When the reward system is flooded with dopamine, it produces an intense and unnatural sense of euphoria. This reinforces repeated use, as the brain begins to associate the substance with pleasure.
Over time, the brain adapts to these elevated dopamine levels, reducing its natural response. As a result, the person experiences less pleasure from the same amount of the
substance. This effect is known as tolerance.
Tolerance can lead to:
- Dependency and the need for higher doses to achieve the same effect
- Loss of control over substance use
- Increased risk of overdose, which may be life-threatening
Understanding these effects is essential for prevention and treatment, as managing substance use disorders typically requires medical supervision and comprehensive care to support safe and sustained recovery.
Depressants & Drugs
These are substances that suppress the central nervous system and reduce the signals transmitted to and from the brain, leading to a decrease in heart rate and breathing. The most important types include:
Alcoholic Beverages:
Short-term alcohol consumption may lead to several problems, such as:
• Nausea
• Impaired coordination and reaction time
• Blurred vision
• Slurred speech
• Vomiting
• Headache
• Loss of consciousness
In the long term, excessive alcohol consumption may cause serious health problems, including:
• Digestive disorders
• Increased risk of pancreatitis and ulcers
• Severe liver damage
• Damage to the brain and nervous system
• Impaired thinking and memory loss
• Hormonal disturbances
• Increased risk of heart disease and stroke
• Increased risk of cancers of the digestive system, pharynx, esophagus, and liver, as well as breast cancer in women
On the psychological and social level, excessive alcohol use may increase anxiety, anger, and depression, and negatively affect social, family, and work performance.
Alcohol addiction should be treated in specialized centers under medical supervision to manage withdrawal symptoms safely.
The patient should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help achieve recovery and return to a healthy and normal life.
Opioids (Heroin, Morphine, Codeine, and Others):
Heroin:
Heroin is considered one of the most addictive opioid substances. It affects the brain by stimulating the release of chemicals that create feelings of euphoria, happiness, and relaxation. Like other opioids, heroin significantly reduces the sensation of pain.
Heroin causes many harmful effects on the body, both in the short and long term.
Short-term side effects include:
• Shortness of breath
• Poor concentration
• Reduced sensation of physical and emotional pain
• Persistent itching that is difficult to control
Long-term complications include:
• Heart disease
• Transmission of infections through needle use, especially HIV/AIDS and Hepatitis C
• Pneumonia
• Blood clots
• Liver disease
• Seizures
• Risk of death due to overdose
Heroin addiction should be treated in specialized centers under medical supervision to manage withdrawal symptoms safely.
The patient should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help achieve recovery and return to a healthy and normal life.
Opioid-like Substances (Tramadol / Tramal):
Tramadol:
Tramadol is used to relieve moderate to severe pain. It is similar to codeine in its pain-relieving effect, but the risk of addiction and respiratory depression is generally lower compared to codeine.
It is also used in cancer pain management; however, after several weeks of treatment, stronger opioid pain relievers may sometimes be required.
Misuse of tramadol in high doses and for prolonged periods without medical supervision can lead to addiction. Tramadol addiction is considered one of the most common forms of drug addiction worldwide.
Common symptoms of tramadol addiction include:
• Constricted pupils
• Changes in appetite
• Poor concentration
• Slow speech
• Insomnia and sleep disturbances
One serious symptom is:
Seizures occurring in individuals with no prior history of epilepsy, due to tramadol’s effect on serotonin and noradrenaline receptors and increased neurotransmitter release.
Tramadol addiction should be treated in specialized centers under medical supervision to manage withdrawal symptoms safely.
The patient should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help achieve recovery and return to a healthy and normal life.
Inhalants and Volatile Substances (Glue, Gasoline, Paints):
Young people are often vulnerable to addiction to these substances due to a lack of awareness about their toxicity and dangers, as well as their easy availability and common everyday use.
Some individuals begin inhaling these substances recreationally and may develop addiction without realizing the severe toxicity and serious harm they can cause to the body, brain, and nervous system.
Stimulants
Stimulants work by stimulating the central nervous system, leading to an increase in major vital functions such as heart rate, body temperature, and blood pressure.
Their harmful effects include a wide range of physical symptoms (such as loss of appetite) as well as neurological and psychological symptoms (such as anxiety, seizures, and hallucinations). Common types include:
• Khat (Cathinone)
• Cocaine and crack cocaine
• Amphetamines (Captagon) and methamphetamine (crystal meth)
Among their most dangerous complications are severe addiction (which may occur even after the first dose), increased risk of heart attacks, strokes, epileptic seizures, and psychotic episodes.
Treatment for stimulant addiction should be provided in specialized centers under medical supervision because of the serious withdrawal symptoms associated with these substances.
Patients should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help them recover, regain stability, and return to a healthy and normal life.
Hallucinogens
Hallucinogens are substances that cause hallucinations.
Hallucinations are distorted sensory perceptions that may be:
• Auditory (hearing sounds or voices)
• Visual (seeing things that are not present)
• Sensory or tactile (feeling sensations that are not real)
Common hallucinogenic substances include:
• LSD (Lysergic Acid Diethylamide)
• Mescaline
• Cannabis (Marijuana / Hashish)
Cannabis (Marijuana / Hashish):
Hashish and marijuana are both derived from the cannabis plant, but they differ in the method of extraction, appearance, color, and concentration of the active substance.
Hashish:
A resinous substance extracted from the cannabis plant.
Marijuana:
Derived from the flowers and upper leaves of the cannabis plant. The plant material is harvested, dried, cleaned of seeds and stems, and then ground. Marijuana is usually green or gray in color.
Methods of Use:
• Hashish: Commonly smoked by mixing it with tobacco. It may also be chewed or added to certain foods.
• Marijuana: Usually smoked, including through water pipes, and may also be boiled in hot water to prepare tea.
Common Names:
• Hashish is commonly known by the same Arabic term among users.
• Marijuana may also be referred to as “Ganja,” “Weed,” or “Mary Jane.”
Geographical Spread:
Hashish is more commonly used in Arab countries, the Middle East, and Afghanistan. China and India are among the major producers of hashish, although its use and trade are illegal in many countries.
Marijuana is more commonly found in European countries and parts of the Americas. Uruguay, the United States, Spain, and the Netherlands are among the countries where cultivation may be permitted under specific regulations. Some U.S. states allow both cultivation and use under local laws.
Side Effects:
Both hashish and marijuana can produce similar harmful effects on general health. The psychoactive substance THC affects cannabinoid receptors in the brain, altering nervous system functions. These effects may appear within minutes of use.
Marijuana smoking may also cause tar accumulation in the lungs, increasing the risk of lung disease and lung cancer.
Common symptoms include:
• Apathy and reduced motivation
• Increased appetite
• Impaired perception of distance and time
• Lung and breathing problems
• Irregular heart rate
• Poor concentration and memory
• Anxiety
• Heightened sensory perception
Long-term use of hashish and marijuana may contribute to:
• Schizophrenia
• Depression
• Hallucinations
• Paranoia
Risks:
Hashish is generally considered more potent than marijuana due to its higher concentration of THC and the presence of numerous chemical compounds. THC concentration in hashish may range from 20% to 60%.
Marijuana typically contains lower THC concentrations ranging from 10% to 20%, and its addictive effects are generally considered less intense than hashish.
Treatment for hashish or marijuana addiction should take place in specialized centers under medical supervision due to withdrawal symptoms and possible psychological complications.
Patients should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help them recover and return to a healthy and stable life.
Magic Mushrooms (Psilocybin Mushrooms):
Hallucinogen addiction should be treated in specialized centers under medical supervision because these substances may cause serious psychological complications and withdrawal-related symptoms.
Patients should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help them recover and return to normal life.
Controlled Prescription drugs
These are medications used for medical purposes in specific doses and under medical supervision. However, misuse of these medications may cause psychological effects, addiction, and serious health complications.
Using these medications without a prescription or for non-medical purposes is considered a legal offense punishable by law.
The most important types include:
• Analgesic / narcotic medications (such as morphine and codeine)
• Sedative / psychiatric medications (such as Xanax and Rivotril)
• Neurological medications (such as Kemadrin, Lyrica, and Neurontin)
• Stimulant medications (such as Ritalin and Adderall)
Addiction to prescription medications should be treated in specialized centers under medical supervision because of the serious withdrawal symptoms they may cause.
Patients should undergo a comprehensive treatment program, follow medical advice, and receive support from family and friends to help them recover and return to a healthy and stable life.
New Drugs / Synthetic and Designer Drugs:
In recent years, there has been a noticeable change in patterns of substance abuse among young people and adolescents, with increasing use of various types of drugs and new psychoactive substances.
According to sources from the United Nations Office on Drugs and Crime (UNODC), the emergence of new psychoactive substances has increased significantly, with 483 new substances registered by the end of 2015.
These substances are narcotic drugs or psychoactive compounds produced in pure or laboratory-prepared forms. They are not controlled under the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, yet they pose a serious threat to public health.
The term “new” does not necessarily mean recently invented. Some of these substances were discovered more than 40 years ago but have recently reappeared and spread in global markets under new forms and names.
Major categories of new psychoactive substances include:
• Synthetic cathinones
• Synthetic and semi-synthetic cannabinoids (such as Spice, K2, and Chronic)
• Ketamine and phencyclidine (PCP)
• Plant-based substances (such as Kratom)
According to the United Nations Office on Drugs and Crime, the threat of new psychoactive substances has become a global phenomenon affecting more than 90 countries.
New types of these substances continue to emerge regularly. Therefore, it is important to avoid using medications or products with unknown ingredients or without medical advice.
It is important to note that even substances marketed as herbal remedies or natural pain relievers should not be used unless they have been examined and approved by the appropriate health authorities.
Tobacco and Electronic Smoking Products
Smoking is considered one of the leading causes of disease, death, and poverty worldwide. According to the World Health Organization, smoking causes approximately 7 million deaths annually due to direct tobacco use and around 1.2 million deaths due to secondhand smoke exposure.
Smoking is also considered a gateway to addiction. Studies have shown that adolescent smokers are three times more likely to use psychoactive substances compared to non-smokers, according to the World Health Organization.
Electronic cigarettes and similar vaping devices are also harmful, much like traditional cigarettes, because they contain nicotine — the same addictive substance found in conventional tobacco products. Nicotine has direct harmful effects on the heart, brain, and blood vessels and can lead to addiction.
In addition, the use of electronic smoking products may encourage addictive behavior and increase the likelihood that non-smokers will experiment with them under the mistaken belief that they are less harmful than traditional smoking.
