research paper topics about drugs

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• A Research Guide
• Research Paper Topics
• 40 Drug Abuse & Addiction Research Paper Topics

40 Drug Abuse & Addiction Research Paper Topics

Drug Abuse and Sociology

Drug abuse and medicine, drug abuse and psychology.

• Drug abuse and the degradation of neuron cells
• The social aspects of the drug abuse. The most vulnerable categories of people
• Drugs and religion. Drug abuse as the part of the sacred rituals
• Chronic Lymphocytic Leukemia
• Drug abuse as the part of human trafficking and as psychological defence of victims
• Reversible and irreversible consequences of drug abuse
• Drug abuse and minors
• Ethnic and cultural traditions that may lead to drug abuse
• Medical marijuana. Can legalizing it lead to drug abuse?
• The ethical questions of abusing painkiller drugs or other drugs that ease the state of a person
• The “club culture”. May it enhance the danger of drug abuse?
• Preventing drug abuse. Mandatory examination or voluntary learning: what will help most?
• The abstinence after the drug abuse. Rehabilitation and resocialization of the victims of it
• The harm done by drug abuse to the family and social relations
• The types of drugs and the impact of their abuse to the human body
• The positive effects of drugs. May they be reached without drawbacks of drug abuse?
• Alcoholics Anonymous, similar organisations and their role in overcoming the dependency
• Is constant smoking a drug abuse? Quitting smoking: government and social decisions
• Exotic addictions: game addiction, porn addiction etc. Do they have the effects similar to drug abuse?
• Substance abuse during pregnancy and before conceiving. What additional harm it causes?
• The correlation between drugs and spreading of HIV/AIDS
• Drug abuse and crime rates
• History of drug abuse. Opium houses, heroin cough syrup and others
• Drunk driving and drunk violence. The indirect victims of alcohol abuse
• The social rejection of the former drug abusers and the way to overcome it
• The main causes of drug abuse in the different social groups
• Drug abuse and mental health
• LGBTQ+ and drug abuse
• The development of drug testing. The governmental implementation of it
• Geniuses and drug abuse. Did drugs really helped them to create their masterpieces?
• Shall the laws about drug abuse be changed?
• Health Care Information Technology
• Drug abuse and global health throughout the 20-21 centuries
• Personal freedom or the safety of society: can drugs be allowed for personal use?
• Legal drinking age in different countries and its connection to the cultural diversity
• The different attitude to drugs and drug abuse in the different countries. Why it differs so much?
• Teenage and college culture. Why substance abuse is considered to be cool?
• Drugs, rape and robbery. Drugging people intentionally as the way to prevent them defending themselves
• 12-Step Programs and their impact on healing the drug addiction
• Alcohol, tobacco and sleeping pills advertising. Can it lead to more drug abuse?

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Drug Topics For School Projects And Academic Research

Research papers and essays on drug topics address sociology, pharmacology, medicine, psychology, statistics, history, and criminology issues. Drug abuse is a serious problem in modern society. It’s a serious issue that different countries are trying to combat. As such, educators ask learners to write academic papers and essays on drug abuse topics to understand this subject better.

Many countries have spent billions of dollars fighting addiction and treating drug addicts. Countless lives have been lost to drug addiction. The increasing crime rates in many countries have also been attributed to drug abuse and addiction. What’s more, people in different social groups gave initiated campaigns against drug use and trade. It’s, therefore, reasonable for educators to ask learners to write about drug and alcohol topics.

Choosing Drug Research Topics

• Interesting Drug Topics for Papers and Essays
• Effects of Drug Addiction Topics

Argumentative Research Topics about Drug Use

Drug and alcohol group topics, drug legislation research essay topics.

As students write academic papers on drug related research topics, they engage in research that helps them come to terms with the extent of this problem. They also learn how illicit drug use affects human life. War on drugs research topics helps learners to know the number of resources their governments are spending trying to deal with this problem. Such knowledge can help learners avoid addictive drugs.

But, choosing the drug research topics to write about is not easy. That’s because learners should choose interesting topics for which they can find adequate information to write about. If struggling to pick topics on drug abuse for your academic papers and essays, here are 100 great ideas from our assignment service .

Interesting Drug Topics for Papers and Essays

• The government should legalize marijuana use
• Drug users should go to rehabs, not jail
• The government should eliminate cash bail and legalize marijuana
• How illicit drugs benefit society
• Interesting medical uses of cannabis
• Effects of illicit drugs on society
• Why teens abuse drugs
• Possible solutions to the drug abuse problem among teenagers
• What are the effects of early drug abuse?
• Health benefits of marijuana
• Why athletes need marijuana
• Discuss the long-term effects of illicit drug use
• History of drug abuse
• What prompts a person to abuse drugs?
• Is the war against drug abuse necessary?
• Can the government win the war against illicit drugs?
• Can technology be used to fight drug abuse and addiction?
• How do movies promote drug abuse?
• Are modern celebrities promoting drug abuse?
• How can the government deal with prescription drug abuse?

These are interesting ideas for research papers and essays, especially for learners that want to write about controversial drug topics. Nevertheless, be ready to invest time and effort in research, analysis, and writing if you pick any of these research paper topics on drug abuse.

Effects of Drug Addiction Topics

Some people want to know how drug addiction affects a person’s life. As such, this category comprises some of the most interesting drug related topics for learners. Here are some of the best drug addiction research topics to consider if interested in the consequences of addictive substances.

• Does the amount of abused drugs affect its impact?
• Why are some people more addicted to drugs than others?
• How does drug addiction differ between men and women?
• Why are there differences in drug addiction levels between men and women?
• What influences the effects of illicit drugs?
• Why do different drugs affect humans differently?
• What are the major signs of alcoholism?
• What are the effects of abusing marijuana?
• What are the effects of psychoactive substances on the human brain?
• Explain the main social issues caused by alcohol abuse
• How does drug abuse affect the social life of a person?
• How do addicts try to hide the effects of addictive substances?
• Can family members help an addict deal with the effects of an illicit drug?
• Can a person deal with the effects of illicit drug abuse alone?
• Why is rehab necessary when dealing with the effects of illicit drugs?
• Is withdrawal syndrome an effect of illicit drug addiction
• Can abusing alcohol affect the judgment of a person?
• Why is it not advisable to drink alcohol and operate machinery or drive?
• Common myths about the effects of alcohol
• Common myths about the effects of marijuana

Choose any of these drug research paper topics if interested in learning how illicit substances affect the users. Nevertheless, be prepared to research extensively to come up with a solid paper about any of these essay topics on drug addiction.

Maybe you hold a certain perspective about drug use. Some people may not agree with you but you would like to persuade them. In that case, you might consider argumentative essay topics drug addiction ideas. That way, you can express your views on the topic professionally. Here are some of the best persuasive essay topics about drugs to consider.

• Addiction is a disease
• The genetic makeup of a person can prompt them to abuse drugs
• The environment of a person can influence them to abuse drugs
• Social and cultural factors play a role in drug addiction
• Drug abuse does not always lead to bad behaviors
• Mass media can encourage drug abuse and addiction
• Celebrities can influence drug abuse among teenagers
• Drug addiction treatments should focus on inner motivations
• Imprisonment does not help a drug addict
• Interactions with drug addicts can have a negative influence on kids
• The environment is not to blame for drug addiction
• Schools can help prevent drug abuse among the teens
• The perceived correlation between delinquency and drug abuse is wrong
• The effect of drugs on a person’s perception is not always negative
• Parents are partly to blame for drug abuse by teens
• A person who has never had an addiction can’t understand how it feels to battle drug addiction
• Drug addiction takes control over a person
• Behavioral and cognitive problems can also affect the academic performance of students that abuse drugs and alcohol
• Isolating drug addicts will only escalate their addiction
• Family members should play a role in the treatment of drug addicts

Pick a topic on drug addiction from this category if ready to research extensively and come up with strong points to support your argument. That’s because you must convince readers to support your position in your argument.

Perhaps, you’re looking for drug project ideas that touch on group mentality or perception. In that case, this category has some of the best academic papers and essay topics for drug abuse that you should consider.

• What are the major social aspects of drug addiction?
• Which are the most vulnerable social groups when it comes to drug addiction?
• Is drug abuse part of sacred rituals in some religions?
• Minors and drug abuse
• Irreversible effects of drug abuse among teens
• What is the psychological defense of drug abuse by human trafficking victims
• Cultural and ethnic traditions that compel some social groups to abuse drugs
• Can legalizing marijuana make some social groups abuse it more?
• Why do most women abuse painkiller drugs?
• How does the “club culture” enhance drug abuse?
• Who can benefit from the mandatory examination for drug abuse?
• How drug abuse affects social relations
• Can a family be affected negatively by substance abuse by one of its members?
• Drug abuse among the LGBTQ
• Why drug abuse is considered cool among teenagers
• How college culture enhances drug abuse
• How does attitude towards drugs differ among social groups?
• How does the legal drinking age differ based on cultural diversity?
• Should countries have similar laws on drug abuse?
• What are the main causes of drug abuse in various social groups?

These are also great drug debate topics for students in different study levels. However, they also require extensive research to come up with good papers and essays.

If you decide to write about topics for a paper on drug war, you may want to talk about policies, laws, and regulations that touch on different illicit substances. This category has research paper topics drugs ideas that may also focus on legislation.

• Common substance abuse laws in most countries
• Effects of drug abuse policies
• How some legislations compel people to abuse drugs
• How substance abuse laws can help in the war against the drug trade
• Top drug laws in the U.S
• Explain the confidentiality of drug and alcohol abuse patients’ records
• Explain the disparity in drug law among people of different races
• How governments can use legislation to fight drug abuse
• Should the government legalize marijuana?
• Scaling up the war against drug abuse through legislation
• Important legislations for enhancing the war against drugs
• Legislations for preventing underage alcohol consumption
• How can the government use legislation to fight drug abuse without infringing on human rights?
• Legislation to channel more resources to the war on drug abuse
• Causes of illegal drug use among women
• Vaping legislation to prevent drug abuse
• Important legislation to prevent prescription drug abuse
• Legislations to curb military populations’ drug abuse
• Enforcing law to curb college drug abuse
• Addressing the increasing cases of people drinking under the influence of alcohol

Drug abuse is a broad subject. Pick some of these drugs essay topics and then research them extensively to come up with papers that will earn you the top scores. Also, you can take a look at these health topics .

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• April 01, 2024 | VOL. 181, NO. 4 CURRENT ISSUE pp.255-346
• March 01, 2024 | VOL. 181, NO. 3 pp.171-254
• February 01, 2024 | VOL. 181, NO. 2 pp.83-170
• January 01, 2024 | VOL. 181, NO. 1 pp.1-82

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Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications

• Ned H. Kalin , M.D.

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The numbers for substance use disorders are large, and we need to pay attention to them. Data from the 2018 National Survey on Drug Use and Health ( 1 ) suggest that, over the preceding year, 20.3 million people age 12 or older had substance use disorders, and 14.8 million of these cases were attributed to alcohol. When considering other substances, the report estimated that 4.4 million individuals had a marijuana use disorder and that 2 million people suffered from an opiate use disorder. It is well known that stress is associated with an increase in the use of alcohol and other substances, and this is particularly relevant today in relation to the chronic uncertainty and distress associated with the COVID-19 pandemic along with the traumatic effects of racism and social injustice. In part related to stress, substance use disorders are highly comorbid with other psychiatric illnesses: 9.2 million adults were estimated to have a 1-year prevalence of both a mental illness and at least one substance use disorder. Although they may not necessarily meet criteria for a substance use disorder, it is well known that psychiatric patients have increased usage of alcohol, cigarettes, and other illicit substances. As an example, the survey estimated that over the preceding month, 37.2% of individuals with serious mental illnesses were cigarette smokers, compared with 16.3% of individuals without mental illnesses. Substance use frequently accompanies suicide and suicide attempts, and substance use disorders are associated with a long-term increased risk of suicide.

Addiction is the key process that underlies substance use disorders, and research using animal models and humans has revealed important insights into the neural circuits and molecules that mediate addiction. More specifically, research has shed light onto mechanisms underlying the critical components of addiction and relapse: reinforcement and reward, tolerance, withdrawal, negative affect, craving, and stress sensitization. In addition, clinical research has been instrumental in developing an evidence base for the use of pharmacological agents in the treatment of substance use disorders, which, in combination with psychosocial approaches, can provide effective treatments. However, despite the existence of therapeutic tools, relapse is common, and substance use disorders remain grossly undertreated. For example, whether at an inpatient hospital treatment facility or at a drug or alcohol rehabilitation program, it was estimated that only 11% of individuals needing treatment for substance use received appropriate care in 2018. Additionally, it is worth emphasizing that current practice frequently does not effectively integrate dual diagnosis treatment approaches, which is important because psychiatric and substance use disorders are highly comorbid. The barriers to receiving treatment are numerous and directly interact with existing health care inequities. It is imperative that as a field we overcome the obstacles to treatment, including the lack of resources at the individual level, a dearth of trained providers and appropriate treatment facilities, racial biases, and the marked stigmatization that is focused on individuals with addictions.

This issue of the Journal is focused on understanding factors contributing to substance use disorders and their comorbidity with psychiatric disorders, the effects of prenatal alcohol use on preadolescents, and brain mechanisms that are associated with addiction and relapse. An important theme that emerges from this issue is the necessity for understanding maladaptive substance use and its treatment in relation to health care inequities. This highlights the imperative to focus resources and treatment efforts on underprivileged and marginalized populations. The centerpiece of this issue is an overview on addiction written by Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and coauthors Drs. Patricia Powell (NIAAA deputy director) and Aaron White ( 2 ). This outstanding article will serve as a foundational knowledge base for those interested in understanding the complex factors that mediate drug addiction. Of particular interest to the practice of psychiatry is the emphasis on the negative affect state “hyperkatifeia” as a major driver of addictive behavior and relapse. This places the dysphoria and psychological distress that are associated with prolonged withdrawal at the heart of treatment and underscores the importance of treating not only maladaptive drug-related behaviors but also the prolonged dysphoria and negative affect associated with addiction. It also speaks to why it is crucial to concurrently treat psychiatric comorbidities that commonly accompany substance use disorders.

Insights Into Mechanisms Related to Cocaine Addiction Using a Novel Imaging Method for Dopamine Neurons

Cassidy et al. ( 3 ) introduce a relatively new imaging technique that allows for an estimation of dopamine integrity and function in the substantia nigra, the site of origin of dopamine neurons that project to the striatum. Capitalizing on the high levels of neuromelanin that are found in substantia nigra dopamine neurons and the interaction between neuromelanin and intracellular iron, this MRI technique, termed neuromelanin-sensitive MRI (NM-MRI), shows promise in studying the involvement of substantia nigra dopamine neurons in neurodegenerative diseases and psychiatric illnesses. The authors used this technique to assess dopamine function in active cocaine users with the aim of exploring the hypothesis that cocaine use disorder is associated with blunted presynaptic striatal dopamine function that would be reflected in decreased “integrity” of the substantia nigra dopamine system. Surprisingly, NM-MRI revealed evidence for increased dopamine in the substantia nigra of individuals using cocaine. The authors suggest that this finding, in conjunction with prior work suggesting a blunted dopamine response, points to the possibility that cocaine use is associated with an altered intracellular distribution of dopamine. Specifically, the idea is that dopamine is shifted from being concentrated in releasable, functional vesicles at the synapse to a nonreleasable cytosolic pool. In addition to providing an intriguing alternative hypothesis underlying the cocaine-related alterations observed in substantia nigra dopamine function, this article highlights an innovative imaging method that can be used in further investigations involving the role of substantia nigra dopamine systems in neuropsychiatric disorders. Dr. Charles Bradberry, chief of the Preclinical Pharmacology Section at the National Institute on Drug Abuse, contributes an editorial that further explains the use of NM-MRI and discusses the theoretical implications of these unexpected findings in relation to cocaine use ( 4 ).

Treatment Implications of Understanding Brain Function During Early Abstinence in Patients With Alcohol Use Disorder

Developing a better understanding of the neural processes that are associated with substance use disorders is critical for conceptualizing improved treatment approaches. Blaine et al. ( 5 ) present neuroimaging data collected during early abstinence in patients with alcohol use disorder and link these data to relapses occurring during treatment. Of note, the findings from this study dovetail with the neural circuit schema Koob et al. provide in this issue’s overview on addiction ( 2 ). The first study in the Blaine et al. article uses 44 patients and 43 control subjects to demonstrate that patients with alcohol use disorder have a blunted neural response to the presentation of stress- and alcohol-related cues. This blunting was observed mainly in the ventromedial prefrontal cortex, a key prefrontal regulatory region, as well as in subcortical regions associated with reward processing, specifically the ventral striatum. Importantly, this finding was replicated in a second study in which 69 patients were studied in relation to their length of abstinence prior to treatment and treatment outcomes. The results demonstrated that individuals with the shortest abstinence times had greater alterations in neural responses to stress and alcohol cues. The authors also found that an individual’s length of abstinence prior to treatment, independent of the number of days of abstinence, was a predictor of relapse and that the magnitude of an individual’s neural alterations predicted the amount of heavy drinking occurring early in treatment. Although relapse is an all too common outcome in patients with substance use disorders, this study highlights an approach that has the potential to refine and develop new treatments that are based on addiction- and abstinence-related brain changes. In her thoughtful editorial, Dr. Edith Sullivan from Stanford University comments on the details of the study, the value of studying patients during early abstinence, and the implications of these findings for new treatment development ( 6 ).

Relatively Low Amounts of Alcohol Intake During Pregnancy Are Associated With Subtle Neurodevelopmental Effects in Preadolescent Offspring

Excessive substance use not only affects the user and their immediate family but also has transgenerational effects that can be mediated in utero. Lees et al. ( 7 ) present data suggesting that even the consumption of relatively low amounts of alcohol by expectant mothers can affect brain development, cognition, and emotion in their offspring. The researchers used data from the Adolescent Brain Cognitive Development Study, a large national community-based study, which allowed them to assess brain structure and function as well as behavioral, cognitive, and psychological outcomes in 9,719 preadolescents. The mothers of 2,518 of the subjects in this study reported some alcohol use during pregnancy, albeit at relatively low levels (0 to 80 drinks throughout pregnancy). Interestingly, and opposite of that expected in relation to data from individuals with fetal alcohol spectrum disorders, increases in brain volume and surface area were found in offspring of mothers who consumed the relatively low amounts of alcohol. Notably, any prenatal alcohol exposure was associated with small but significant increases in psychological problems that included increases in separation anxiety disorder and oppositional defiant disorder. Additionally, a dose-response effect was found for internalizing psychopathology, somatic complaints, and attentional deficits. While subtle, these findings point to neurodevelopmental alterations that may be mediated by even small amounts of prenatal alcohol consumption. Drs. Clare McCormack and Catherine Monk from Columbia University contribute an editorial that provides an in-depth assessment of these findings in relation to other studies, including those assessing severe deficits in individuals with fetal alcohol syndrome ( 8 ). McCormack and Monk emphasize that the behavioral and psychological effects reported in the Lees et al. article would not be clinically meaningful. However, it is feasible that the influences of these low amounts of alcohol could interact with other predisposing factors that might lead to more substantial negative outcomes.

Increased Comorbidity Between Substance Use and Psychiatric Disorders in Sexual Identity Minorities

There is no question that victims of societal marginalization experience disproportionate adversity and stress. Evans-Polce et al. ( 9 ) focus on this concern in relation to individuals who identify as sexual minorities by comparing their incidence of comorbid substance use and psychiatric disorders with that of individuals who identify as heterosexual. By using 2012−2013 data from 36,309 participants in the National Epidemiologic Study on Alcohol and Related Conditions–III, the authors examine the incidence of comorbid alcohol and tobacco use disorders with anxiety, mood disorders, and posttraumatic stress disorder (PTSD). The findings demonstrate increased incidences of substance use and psychiatric disorders in individuals who identified as bisexual or as gay or lesbian compared with those who identified as heterosexual. For example, a fourfold increase in the prevalence of PTSD was found in bisexual individuals compared with heterosexual individuals. In addition, the authors found an increased prevalence of substance use and psychiatric comorbidities in individuals who identified as bisexual and as gay or lesbian compared with individuals who identified as heterosexual. This was most prominent in women who identified as bisexual. For example, of the bisexual women who had an alcohol use disorder, 60.5% also had a psychiatric comorbidity, compared with 44.6% of heterosexual women. Additionally, the amount of reported sexual orientation discrimination and number of lifetime stressful events were associated with a greater likelihood of having comorbid substance use and psychiatric disorders. These findings are important but not surprising, as sexual minority individuals have a history of increased early-life trauma and throughout their lives may experience the painful and unwarranted consequences of bias and denigration. Nonetheless, these findings underscore the strong negative societal impacts experienced by minority groups and should sensitize providers to the additional needs of these individuals.

Trends in Nicotine Use and Dependence From 2001–2002 to 2012–2013

Although considerable efforts over earlier years have curbed the use of tobacco and nicotine, the use of these substances continues to be a significant public health problem. As noted above, individuals with psychiatric disorders are particularly vulnerable. Grant et al. ( 10 ) use data from the National Epidemiologic Survey on Alcohol and Related Conditions collected from a very large cohort to characterize trends in nicotine use and dependence over time. Results from their analysis support the so-called hardening hypothesis, which posits that although intervention-related reductions in nicotine use may have occurred over time, the impact of these interventions is less potent in individuals with more severe addictive behavior (i.e., nicotine dependence). When adjusted for sociodemographic factors, the results demonstrated a small but significant increase in nicotine use from 2001–2002 to 2012–2013. However, a much greater increase in nicotine dependence (46.1% to 52%) was observed over this time frame in individuals who had used nicotine during the preceding 12 months. The increases in nicotine use and dependence were associated with factors related to socioeconomic status, such as lower income and lower educational attainment. The authors interpret these findings as evidence for the hardening hypothesis, suggesting that despite the impression that nicotine use has plateaued, there is a growing number of highly dependent nicotine users who would benefit from nicotine dependence intervention programs. Dr. Kathleen Brady, from the Medical University of South Carolina, provides an editorial ( 11 ) that reviews the consequences of tobacco use and the history of the public measures that were initially taken to combat its use. Importantly, her editorial emphasizes the need to address health care inequity issues that affect individuals of lower socioeconomic status by devoting resources to develop and deploy effective smoking cessation interventions for at-risk and underresourced populations.

Conclusions

Maladaptive substance use and substance use disorders are highly prevalent and are among the most significant public health problems. Substance use is commonly comorbid with psychiatric disorders, and treatment efforts need to concurrently address both. The papers in this issue highlight new findings that are directly relevant to understanding, treating, and developing policies to better serve those afflicted with addictions. While treatments exist, the need for more effective treatments is clear, especially those focused on decreasing relapse rates. The negative affective state, hyperkatifeia, that accompanies longer-term abstinence is an important treatment target that should be emphasized in current practice as well as in new treatment development. In addition to developing a better understanding of the neurobiology of addictions and abstinence, it is necessary to ensure that there is equitable access to currently available treatments and treatment programs. Additional resources must be allocated to this cause. This depends on the recognition that health care inequities and societal barriers are major contributors to the continued high prevalence of substance use disorders, the individual suffering they inflict, and the huge toll that they incur at a societal level.

Disclosures of Editors’ financial relationships appear in the April 2020 issue of the Journal .

1 US Department of Health and Human Services: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality: National Survey on Drug Use and Health 2018. Rockville, Md, SAMHSA, 2019 ( https://www.samhsa.gov/data/nsduh/reports-detailed-tables-2018-NSDUH ) Google Scholar

2 Koob GF, Powell P, White A : Addiction as a coping response: hyperkatifeia, deaths of despair, and COVID-19 . Am J Psychiatry 2020 ; 177:1031–1037 Link ,  Google Scholar

3 Cassidy CM, Carpenter KM, Konova AB, et al. : Evidence for dopamine abnormalities in the substantia nigra in cocaine addiction revealed by neuromelanin-sensitive MRI . Am J Psychiatry 2020 ; 177:1038–1047 Link ,  Google Scholar

4 Bradberry CW : Neuromelanin MRI: dark substance shines a light on dopamine dysfunction and cocaine use (editorial). Am J Psychiatry 2020 ; 177:1019–1021 Abstract ,  Google Scholar

5 Blaine SK, Wemm S, Fogelman N, et al. : Association of prefrontal-striatal functional pathology with alcohol abstinence days at treatment initiation and heavy drinking after treatment initiation . Am J Psychiatry 2020 ; 177:1048–1059 Link ,  Google Scholar

6 Sullivan EV : Why timing matters in alcohol use disorder recovery (editorial). Am J Psychiatry 2020 ; 177:1022–1024 Abstract ,  Google Scholar

7 Lees B, Mewton L, Jacobus J, et al. : Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the Adolescent Brain Cognitive Development Study . Am J Psychiatry 2020 ; 177:1060–1072 Link ,  Google Scholar

8 McCormack C, Monk C : Considering prenatal alcohol exposure in a developmental origins of health and disease framework (editorial). Am J Psychiatry 2020 ; 177:1025–1028 Abstract ,  Google Scholar

9 Evans-Polce RJ, Kcomt L, Veliz PT, et al. : Alcohol, tobacco, and comorbid psychiatric disorders and associations with sexual identity and stress-related correlates . Am J Psychiatry 2020 ; 177:1073–1081 Abstract ,  Google Scholar

10 Grant BF, Shmulewitz D, Compton WM : Nicotine use and DSM-IV nicotine dependence in the United States, 2001–2002 and 2012–2013 . Am J Psychiatry 2020 ; 177:1082–1090 Link ,  Google Scholar

11 Brady KT : Social determinants of health and smoking cessation: a challenge (editorial). Am J Psychiatry 2020 ; 177:1029–1030 Abstract ,  Google Scholar

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• Substance-Related and Addictive Disorders
• Addiction Psychiatry
• Transgender (LGBT) Issues

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Research articles

Unexplored therapeutic opportunities in the human genome

In 2014, the Illuminating the Druggable Genome programme was launched to promote the exploration of currently understudied but potentially druggable proteins. This article discusses how the systematic collection and processing of a wide array of biological and chemical data as part of this programme has enabled the development of evidence-based criteria for tracking the target development level of human proteins, which indicates a substantial knowledge deficit for approximately one out of three proteins in the human proteome. It also highlights the nature of the unexplored therapeutic opportunities for major protein families.

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Drug discovery effectiveness from the standpoint of therapeutic mechanisms and indications

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Trends in GPCR drug discovery: new agents, targets and indications

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A comprehensive map of molecular drug targets

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An analysis of the attrition of drug candidates from four major pharmaceutical companies

Attempts to reduce the number of efficacy- and safety-related failures that may be linked to the physicochemical properties of small-molecule drug candidates have been inconclusive owing to the limited size of data sets from individual companies. Waring and colleagues analyse the largest data set compiled so far on the causes of attrition for oral, small-molecule drug candidates, derived from a pioneering data-sharing effort by AstraZeneca, Eli Lilly and Company, GlaxoSmithKline and Pfizer.

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The discovery of first-in-class drugs: origins and evolution

Previous analyses of new drug approvals have suggested that phenotypic screening strategies have been more productive than target-based approaches in the discovery of first-in-class small-molecule drugs. Eder and colleagues analysed the origins of the first-in-class drugs approved by the US Food and Drug Administration from 1999 to 2013, and found that target-based approaches have had a substantial impact in more recent years. They discuss the implications for drug discovery strategies, including viewing phenotypic screening as a novel discipline rather than as a neoclassical approach.

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Phenotypic screening in cancer drug discovery — past, present and future

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The role of ligand efficiency metrics in drug discovery

Ligand efficiency metrics quantify the molecular properties required to gain binding affinity for a drug target. This article discusses the application of such metrics in the selection and optimization of fragments, hits and leads, highlighting how optimizing ligand efficiency metrics based on both molecular mass and lipophilicity, when set in the context of the specific target, has the potential to increase the quality of drug candidates.

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• Neuropsychopharmacology
• v.46(10); 2021 Sep

Addiction as a brain disease revised: why it still matters, and the need for consilience

Markus heilig.

1 Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden

James MacKillop

2 Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada

3 Homewood Research Institute, Guelph, ON Canada

Diana Martinez

4 New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY USA

Jürgen Rehm

5 Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON Canada

6 Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto (UofT), Toronto, ON Canada

7 Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany

8 Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Lorenzo Leggio

9 Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD USA

Louk J. M. J. Vanderschuren

10 Department of Population Health Sciences, Unit Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands

The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. These criticisms state that the brain disease view is deterministic, fails to account for heterogeneity in remission and recovery, places too much emphasis on a compulsive dimension of addiction, and that a specific neural signature of addiction has not been identified. We acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. We also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic. Here, we therefore address these criticisms, and in doing so provide a contemporary update of the brain disease view of addiction. We provide arguments to support this view, discuss why apparently spontaneous remission does not negate it, and how seemingly compulsive behaviors can co-exist with the sensitivity to alternative reinforcement in addiction. Most importantly, we argue that the brain is the biological substrate from which both addiction and the capacity for behavior change arise, arguing for an intensified neuroscientific study of recovery. More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.

Introduction

Close to a quarter of a century ago, then director of the US National Institute on Drug Abuse Alan Leshner famously asserted that “addiction is a brain disease”, articulated a set of implications of this position, and outlined an agenda for realizing its promise [ 1 ]. The paper, now cited almost 2000 times, put forward a position that has been highly influential in guiding the efforts of researchers, and resource allocation by funding agencies. A subsequent 2000 paper by McLellan et al. [ 2 ] examined whether data justify distinguishing addiction from other conditions for which a disease label is rarely questioned, such as diabetes, hypertension or asthma. It concluded that neither genetic risk, the role of personal choices, nor the influence of environmental factors differentiated addiction in a manner that would warrant viewing it differently; neither did relapse rates, nor compliance with treatment. The authors outlined an agenda closely related to that put forward by Leshner, but with a more clinical focus. Their conclusion was that addiction should be insured, treated, and evaluated like other diseases. This paper, too, has been exceptionally influential by academic standards, as witnessed by its ~3000 citations to date. What may be less appreciated among scientists is that its impact in the real world of addiction treatment has remained more limited, with large numbers of patients still not receiving evidence-based treatments.

In recent years, the conceptualization of addiction as a brain disease has come under increasing criticism. When first put forward, the brain disease view was mainly an attempt to articulate an effective response to prevailing nonscientific, moralizing, and stigmatizing attitudes to addiction. According to these attitudes, addiction was simply the result of a person’s moral failing or weakness of character, rather than a “real” disease [ 3 ]. These attitudes created barriers for people with substance use problems to access evidence-based treatments, both those available at the time, such as opioid agonist maintenance, cognitive behavioral therapy-based relapse prevention, community reinforcement or contingency management, and those that could result from research. To promote patient access to treatments, scientists needed to argue that there is a biological basis beneath the challenging behaviors of individuals suffering from addiction. This argument was particularly targeted to the public, policymakers and health care professionals, many of whom held that since addiction was a misery people brought upon themselves, it fell beyond the scope of medicine, and was neither amenable to treatment, nor warranted the use of taxpayer money.

Present-day criticism directed at the conceptualization of addiction as a brain disease is of a very different nature. It originates from within the scientific community itself, and asserts that this conceptualization is neither supported by data, nor helpful for people with substance use problems [ 4 – 8 ]. Addressing these critiques requires a very different perspective, and is the objective of our paper. We readily acknowledge that in some cases, recent critiques of the notion of addiction as a brain disease as postulated originally have merit, and that those critiques require the postulates to be re-assessed and refined. In other cases, we believe the arguments have less validity, but still provide an opportunity to update the position of addiction as a brain disease. Our overarching concern is that questionable arguments against the notion of addiction as a brain disease may harm patients, by impeding access to care, and slowing development of novel treatments.

A premise of our argument is that any useful conceptualization of addiction requires an understanding both of the brains involved, and of environmental factors that interact with those brains [ 9 ]. These environmental factors critically include availability of drugs, but also of healthy alternative rewards and opportunities. As we will show, stating that brain mechanisms are critical for understanding and treating addiction in no way negates the role of psychological, social and socioeconomic processes as both causes and consequences of substance use. To reflect this complex nature of addiction, we have assembled a team with expertise that spans from molecular neuroscience, through animal models of addiction, human brain imaging, clinical addiction medicine, to epidemiology. What brings us together is a passionate commitment to improving the lives of people with substance use problems through science and science-based treatments, with empirical evidence as the guiding principle.

To achieve this goal, we first discuss the nature of the disease concept itself, and why we believe it is important for the science and treatment of addiction. This is followed by a discussion of the main points raised when the notion of addiction as a brain disease has come under criticism. Key among those are claims that spontaneous remission rates are high; that a specific brain pathology is lacking; and that people suffering from addiction, rather than behaving “compulsively”, in fact show a preserved ability to make informed and advantageous choices. In the process of discussing these issues, we also address the common criticism that viewing addiction as a brain disease is a fully deterministic theory of addiction. For our argument, we use the term “addiction” as originally used by Leshner [ 1 ]; in Box  1 , we map out and discuss how this construct may relate to the current diagnostic categories, such as Substance Use Disorder (SUD) and its different levels of severity (Fig.  1) .

Risky (hazardous) substance use refers to quantity/frequency indicators of consumption; SUD refers to individuals who meet criteria for a DSM-5 diagnosis (mild, moderate, or severe); and addiction refers to individuals who exhibit persistent difficulties with self-regulation of drug consumption. Among high-risk individuals, a subgroup will meet criteria for SUD and, among those who have an SUD, a further subgroup would be considered to be addicted to the drug. However, the boundary for addiction is intentionally blurred to reflect that the dividing line for defining addiction within the category of SUD remains an open empirical question.

Box 1 What’s in a name? Differentiating hazardous use, substance use disorder, and addiction

Although our principal focus is on the brain disease model of addiction, the definition of addiction itself is a source of ambiguity. Here, we provide a perspective on the major forms of terminology in the field.

Hazardous Substance Use

Hazardous (risky) substance use refers to quantitative levels of consumption that increase an individual’s risk for adverse health consequences. In practice, this pertains to alcohol use [ 110 , 111 ]. Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care [ 112 ]. More recently, a reduction in these quantitative levels has been validated as treatment endpoints [ 113 ].

Substance Use Disorder

SUD refers to the DSM-5 diagnosis category that encompasses significant impairment or distress resulting from specific categories of psychoactive drug use. The diagnosis of SUD is operationalized as 2 or more of 11 symptoms over the past year. As a result, the diagnosis is heterogenous, with more than 1100 symptom permutations possible. The diagnosis in DSM-5 is the result of combining two diagnoses from the DSM-IV, abuse and dependence, which proved to be less valid than a single dimensional approach [ 114 ]. Critically, SUD includes three levels of severity: mild (2–3 symptoms), moderate (4–5 symptoms), and severe (6+ symptoms). The International Classification of Diseases (ICD) system retains two diagnoses, harmful use (lower severity) and substance dependence (higher severity).

Addiction is a natural language concept, etymologically meaning enslavement, with the contemporary meaning traceable to the Middle and Late Roman Republic periods [ 115 ]. As a scientific construct, drug addiction can be defined as a state in which an individual exhibits an inability to self-regulate consumption of a substance, although it does not have an operational definition. Regarding clinical diagnosis, as it is typically used in scientific and clinical parlance, addiction is not synonymous with the simple presence of SUD. Nowhere in DSM-5 is it articulated that the diagnostic threshold (or any specific number/type of symptoms) should be interpreted as reflecting addiction, which inherently connotes a high degree of severity. Indeed, concerns were raised about setting the diagnostic standard too low because of the issue of potentially conflating a low-severity SUD with addiction [ 116 ]. In scientific and clinical usage, addiction typically refers to individuals at a moderate or high severity of SUD. This is consistent with the fact that moderate-to-severe SUD has the closest correspondence with the more severe diagnosis in ICD [ 117 – 119 ]. Nonetheless, akin to the undefined overlap between hazardous use and SUD, the field has not identified the exact thresholds of SUD symptoms above which addiction would be definitively present.

Integration

The ambiguous relationships among these terms contribute to misunderstandings and disagreements. Figure 1 provides a simple working model of how these terms overlap. Fundamentally, we consider that these terms represent successive dimensions of severity, clinical “nesting dolls”. Not all individuals consuming substances at hazardous levels have an SUD, but a subgroup do. Not all individuals with a SUD are addicted to the drug in question, but a subgroup are. At the severe end of the spectrum, these domains converge (heavy consumption, numerous symptoms, the unambiguous presence of addiction), but at low severity, the overlap is more modest. The exact mapping of addiction onto SUD is an open empirical question, warranting systematic study among scientists, clinicians, and patients with lived experience. No less important will be future research situating our definition of SUD using more objective indicators (e.g., [ 55 , 120 ]), brain-based and otherwise, and more precisely in relation to clinical needs [ 121 ]. Finally, such work should ultimately be codified in both the DSM and ICD systems to demarcate clearly where the attribution of addiction belongs within the clinical nosology, and to foster greater clarity and specificity in scientific discourse.

What is a disease?

In his classic 1960 book “The Disease Concept of Alcoholism”, Jellinek noted that in the alcohol field, the debate over the disease concept was plagued by too many definitions of “alcoholism” and too few definitions of “disease” [ 10 ]. He suggested that the addiction field needed to follow the rest of medicine in moving away from viewing disease as an “entity”, i.e., something that has “its own independent existence, apart from other things” [ 11 ]. To modern medicine, he pointed out, a disease is simply a label that is agreed upon to describe a cluster of substantial, deteriorating changes in the structure or function of the human body, and the accompanying deterioration in biopsychosocial functioning. Thus, he concluded that alcoholism can simply be defined as changes in structure or function of the body due to drinking that cause disability or death. A disease label is useful to identify groups of people with commonly co-occurring constellations of problems—syndromes—that significantly impair function, and that lead to clinically significant distress, harm, or both. This convention allows a systematic study of the condition, and of whether group members benefit from a specific intervention.

It is not trivial to delineate the exact category of harmful substance use for which a label such as addiction is warranted (See Box  1 ). Challenges to diagnostic categorization are not unique to addiction, however. Throughout clinical medicine, diagnostic cut-offs are set by consensus, commonly based on an evolving understanding of thresholds above which people tend to benefit from available interventions. Because assessing benefits in large patient groups over time is difficult, diagnostic thresholds are always subject to debate and adjustments. It can be debated whether diagnostic thresholds “merely” capture the extreme of a single underlying population, or actually identify a subpopulation that is at some level distinct. Resolving this issue remains challenging in addiction, but once again, this is not different from other areas of medicine [see e.g., [ 12 ] for type 2 diabetes]. Longitudinal studies that track patient trajectories over time may have a better ability to identify subpopulations than cross-sectional assessments [ 13 ].

By this pragmatic, clinical understanding of the disease concept, it is difficult to argue that “addiction” is unjustified as a disease label. Among people who use drugs or alcohol, some progress to using with a quantity and frequency that results in impaired function and often death, making substance use a major cause of global disease burden [ 14 ]. In these people, use occurs with a pattern that in milder forms may be challenging to capture by current diagnostic criteria (See Box  1 ), but is readily recognized by patients, their families and treatment providers when it reaches a severity that is clinically significant [see [ 15 ] for a classical discussion]. In some cases, such as opioid addiction, those who receive the diagnosis stand to obtain some of the greatest benefits from medical treatments in all of clinical medicine [ 16 , 17 ]. Although effect sizes of available treatments are more modest in nicotine [ 18 ] and alcohol addiction [ 19 ], the evidence supporting their efficacy is also indisputable. A view of addiction as a disease is justified, because it is beneficial: a failure to diagnose addiction drastically increases the risk of a failure to treat it [ 20 ].

Of course, establishing a diagnosis is not a requirement for interventions to be meaningful. People with hazardous or harmful substance use who have not (yet) developed addiction should also be identified, and interventions should be initiated to address their substance-related risks. This is particularly relevant for alcohol, where even in the absence of addiction, use is frequently associated with risks or harm to self, e.g., through cardiovascular disease, liver disease or cancer, and to others, e.g., through accidents or violence [ 21 ]. Interventions to reduce hazardous or harmful substance use in people who have not developed addiction are in fact particularly appealing. In these individuals, limited interventions are able to achieve robust and meaningful benefits [ 22 ], presumably because patterns of misuse have not yet become entrenched.

Thus, as originally pointed out by McLellan and colleagues, most of the criticisms of addiction as a disease could equally be applied to other medical conditions [ 2 ]. This type of criticism could also be applied to other psychiatric disorders, and that has indeed been the case historically [ 23 , 24 ]. Today, there is broad consensus that those criticisms were misguided. Few, if any healthcare professionals continue to maintain that schizophrenia, rather than being a disease, is a normal response to societal conditions. Why, then, do people continue to question if addiction is a disease, but not whether schizophrenia, major depressive disorder or post-traumatic stress disorder are diseases? This is particularly troubling given the decades of data showing high co-morbidity of addiction with these conditions [ 25 , 26 ]. We argue that it comes down to stigma. Dysregulated substance use continues to be perceived as a self-inflicted condition characterized by a lack of willpower, thus falling outside the scope of medicine and into that of morality [ 3 ].

Chronic and relapsing, developmentally-limited, or spontaneously remitting?

Much of the critique targeted at the conceptualization of addiction as a brain disease focuses on its original assertion that addiction is a chronic and relapsing condition. Epidemiological data are cited in support of the notion that large proportions of individuals achieve remission [ 27 ], frequently without any formal treatment [ 28 , 29 ] and in some cases resuming low risk substance use [ 30 ]. For instance, based on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study [ 27 ], it has been pointed out that a significant proportion of people with an addictive disorder quit each year, and that most afflicted individuals ultimately remit. These spontaneous remission rates are argued to invalidate the concept of a chronic, relapsing disease [ 4 ].

Interpreting these and similar data is complicated by several methodological and conceptual issues. First, people may appear to remit spontaneously because they actually do, but also because of limited test–retest reliability of the diagnosis [ 31 ]. For instance, using a validated diagnostic interview and trained interviewers, the Collaborative Studies on Genetics of Alcoholism examined the likelihood that an individual diagnosed with a lifetime history of substance dependence would retain this classification after 5 years. This is obviously a diagnosis that, once met, by definition cannot truly remit. Lifetime alcohol dependence was indeed stable in individuals recruited from addiction treatment units, ~90% for women, and 95% for men. In contrast, in a community-based sample similar to that used in the NESARC [ 27 ], stability was only ~30% and 65% for women and men, respectively. The most important characteristic that determined diagnostic stability was severity. Diagnosis was stable in severe, treatment-seeking cases, but not in general population cases of alcohol dependence.

These data suggest that commonly used diagnostic criteria alone are simply over-inclusive for a reliable, clinically meaningful diagnosis of addiction. They do identify a core group of treatment seeking individuals with a reliable diagnosis, but, if applied to nonclinical populations, also flag as “cases” a considerable halo of individuals for whom the diagnostic categorization is unreliable. Any meaningful discussion of remission rates needs to take this into account, and specify which of these two populations that is being discussed. Unfortunately, the DSM-5 has not made this task easier. With only 2 out of 11 symptoms being sufficient for a diagnosis of SUD, it captures under a single diagnostic label individuals in a “mild” category, whose diagnosis is likely to have very low test–retest reliability, and who are unlikely to exhibit a chronic relapsing course, together with people at the severe end of the spectrum, whose diagnosis is reliable, many of whom do show a chronic relapsing course.

The NESARC data nevertheless show that close to 10% of people in the general population who are diagnosed with alcohol addiction (here equated with DSM-IV “dependence” used in the NESARC study) never remitted throughout their participation in the survey. The base life-time prevalence of alcohol dependence in NESARC was 12.5% [ 32 ]. Thus, the data cited against the concept of addiction as a chronic relapsing disease in fact indicate that over 1% of the US population develops an alcohol-related condition that is associated with high morbidity and mortality, and whose chronic and/or relapsing nature cannot be disputed, since it does not remit.

Secondly, the analysis of NESARC data [ 4 , 27 ] omits opioid addiction, which, together with alcohol and tobacco, is the largest addiction-related public health problem in the US [ 33 ]. This is probably the addictive condition where an analysis of cumulative evidence most strikingly supports the notion of a chronic disorder with frequent relapses in a large proportion of people affected [ 34 ]. Of course, a large number of people with opioid addiction are unable to express the chronic, relapsing course of their disease, because over the long term, their mortality rate is about 15 times greater than that of the general population [ 35 ]. However, even among those who remain alive, the prevalence of stable abstinence from opioid use after 10–30 years of observation is <30%. Remission may not always require abstinence, for instance in the case of alcohol addiction, but is a reasonable proxy for remission with opioids, where return to controlled use is rare. Embedded in these data is a message of literally vital importance: when opioid addiction is diagnosed and treated as a chronic relapsing disease, outcomes are markedly improved, and retention in treatment is associated with a greater likelihood of abstinence.

The fact that significant numbers of individuals exhibit a chronic relapsing course does not negate that even larger numbers of individuals with SUD according to current diagnostic criteria do not. For instance, in many countries, the highest prevalence of substance use problems is found among young adults, aged 18–25 [ 36 ], and a majority of these ‘age out’ of excessive substance use [ 37 ]. It is also well documented that many individuals with SUD achieve longstanding remission, in many cases without any formal treatment (see e.g., [ 27 , 30 , 38 ]).

Collectively, the data show that the course of SUD, as defined by current diagnostic criteria, is highly heterogeneous. Accordingly, we do not maintain that a chronic relapsing course is a defining feature of SUD. When present in a patient, however, such as course is of clinical significance, because it identifies a need for long-term disease management [ 2 ], rather than expectations of a recovery that may not be within the individual’s reach [ 39 ]. From a conceptual standpoint, however, a chronic relapsing course is neither necessary nor implied in a view that addiction is a brain disease. This view also does not mean that it is irreversible and hopeless. Human neuroscience documents restoration of functioning after abstinence [ 40 , 41 ] and reveals predictors of clinical success [ 42 ]. If anything, this evidence suggests a need to increase efforts devoted to neuroscientific research on addiction recovery [ 40 , 43 ].

Lessons from genetics

For alcohol addiction, meta-analysis of twin and adoption studies has estimated heritability at ~50%, while estimates for opioid addiction are even higher [ 44 , 45 ]. Genetic risk factors are to a large extent shared across substances [ 46 ]. It has been argued that a genetic contribution cannot support a disease view of a behavior, because most behavioral traits, including religious and political inclinations, have a genetic contribution [ 4 ]. This statement, while correct in pointing out broad heritability of behavioral traits, misses a fundamental point. Genetic architecture is much like organ structure. The fact that normal anatomy shapes healthy organ function does not negate that an altered structure can contribute to pathophysiology of disease. The structure of the genetic landscape is no different. Critics further state that a “genetic predisposition is not a recipe for compulsion”, but no neuroscientist or geneticist would claim that genetic risk is “a recipe for compulsion”. Genetic risk is probabilistic, not deterministic. However, as we will see below, in the case of addiction, it contributes to large, consistent probability shifts towards maladaptive behavior.

In dismissing the relevance of genetic risk for addiction, Hall writes that “a large number of alleles are involved in the genetic susceptibility to addiction and individually these alleles might very weakly predict a risk of addiction”. He goes on to conclude that “generally, genetic prediction of the risk of disease (even with whole-genome sequencing data) is unlikely to be informative for most people who have a so-called average risk of developing an addiction disorder” [ 7 ]. This reflects a fundamental misunderstanding of polygenic risk. It is true that a large number of risk alleles are involved, and that the explanatory power of currently available polygenic risk scores for addictive disorders lags behind those for e.g., schizophrenia or major depression [ 47 , 48 ]. The only implication of this, however, is that low average effect sizes of risk alleles in addiction necessitate larger study samples to construct polygenic scores that account for a large proportion of the known heritability.

However, a heritability of addiction of ~50% indicates that DNA sequence variation accounts for 50% of the risk for this condition. Once whole genome sequencing is readily available, it is likely that it will be possible to identify most of that DNA variation. For clinical purposes, those polygenic scores will of course not replace an understanding of the intricate web of biological and social factors that promote or prevent expression of addiction in an individual case; rather, they will add to it [ 49 ]. Meanwhile, however, genome-wide association studies in addiction have already provided important information. For instance, they have established that the genetic underpinnings of alcohol addiction only partially overlap with those for alcohol consumption, underscoring the genetic distinction between pathological and nonpathological drinking behaviors [ 50 ].

It thus seems that, rather than negating a rationale for a disease view of addiction, the important implication of the polygenic nature of addiction risk is a very different one. Genome-wide association studies of complex traits have largely confirmed the century old “infinitisemal model” in which Fisher reconciled Mendelian and polygenic traits [ 51 ]. A key implication of this model is that genetic susceptibility for a complex, polygenic trait is continuously distributed in the population. This may seem antithetical to a view of addiction as a distinct disease category, but the contradiction is only apparent, and one that has long been familiar to quantitative genetics. Viewing addiction susceptibility as a polygenic quantitative trait, and addiction as a disease category is entirely in line with Falconer’s theorem, according to which, in a given set of environmental conditions, a certain level of genetic susceptibility will determine a threshold above which disease will arise.

A brain disease? Then show me the brain lesion!

The notion of addiction as a brain disease is commonly criticized with the argument that a specific pathognomonic brain lesion has not been identified. Indeed, brain imaging findings in addiction (perhaps with the exception of extensive neurotoxic gray matter loss in advanced alcohol addiction) are nowhere near the level of specificity and sensitivity required of clinical diagnostic tests. However, this criticism neglects the fact that neuroimaging is not used to diagnose many neurologic and psychiatric disorders, including epilepsy, ALS, migraine, Huntington’s disease, bipolar disorder, or schizophrenia. Even among conditions where signs of disease can be detected using brain imaging, such as Alzheimer’s and Parkinson’s disease, a scan is best used in conjunction with clinical acumen when making the diagnosis. Thus, the requirement that addiction be detectable with a brain scan in order to be classified as a disease does not recognize the role of neuroimaging in the clinic.

For the foreseeable future, the main objective of imaging in addiction research is not to diagnose addiction, but rather to improve our understanding of mechanisms that underlie it. The hope is that mechanistic insights will help bring forward new treatments, by identifying candidate targets for them, by pointing to treatment-responsive biomarkers, or both [ 52 ]. Developing innovative treatments is essential to address unmet treatment needs, in particular in stimulant and cannabis addiction, where no approved medications are currently available. Although the task to develop novel treatments is challenging, promising candidates await evaluation [ 53 ]. A particular opportunity for imaging-based research is related to the complex and heterogeneous nature of addictive disorders. Imaging-based biomarkers hold the promise of allowing this complexity to be deconstructed into specific functional domains, as proposed by the RDoC initiative [ 54 ] and its application to addiction [ 55 , 56 ]. This can ultimately guide the development of personalized medicine strategies to addiction treatment.

Countless imaging studies have reported differences in brain structure and function between people with addictive disorders and those without them. Meta-analyses of structural data show that alcohol addiction is associated with gray matter losses in the prefrontal cortex, dorsal striatum, insula, and posterior cingulate cortex [ 57 ], and similar results have been obtained in stimulant-addicted individuals [ 58 ]. Meta-analysis of functional imaging studies has demonstrated common alterations in dorsal striatal, and frontal circuits engaged in reward and salience processing, habit formation, and executive control, across different substances and task-paradigms [ 59 ]. Molecular imaging studies have shown that large and fast increases in dopamine are associated with the reinforcing effects of drugs of abuse, but that after chronic drug use and during withdrawal, brain dopamine function is markedly decreased and that these decreases are associated with dysfunction of prefrontal regions [ 60 ]. Collectively, these findings have given rise to a widely held view of addiction as a disorder of fronto-striatal circuitry that mediates top-down regulation of behavior [ 61 ].

Critics reply that none of the brain imaging findings are sufficiently specific to distinguish between addiction and its absence, and that they are typically obtained in cross-sectional studies that can at best establish correlative rather than causal links. In this, they are largely right, and an updated version of a conceptualization of addiction as a brain disease needs to acknowledge this. Many of the structural brain findings reported are not specific for addiction, but rather shared across psychiatric disorders [ 62 ]. Also, for now, the most sophisticated tools of human brain imaging remain crude in face of complex neural circuit function. Importantly however, a vast literature from animal studies also documents functional changes in fronto-striatal circuits, as well their limbic and midbrain inputs, associated with addictive behaviors [ 63 – 68 ]. These are circuits akin to those identified by neuroimaging studies in humans, implicated in positive and negative emotions, learning processes and executive functions, altered function of which is thought to underlie addiction. These animal studies, by virtue of their cellular and molecular level resolution, and their ability to establish causality under experimental control, are therefore an important complement to human neuroimaging work.

Nevertheless, factors that seem remote from the activity of brain circuits, such as policies, substance availability and cost, as well as socioeconomic factors, also are critically important determinants of substance use. In this complex landscape, is the brain really a defensible focal point for research and treatment? The answer is “yes”. As powerfully articulated by Francis Crick [ 69 ], “You, your joys and your sorrows, your memories and your ambitions, your sense of personal identity and free will, are in fact no more than the behavior of a vast assembly of nerve cells and their associated molecules”. Social and interpersonal factors are critically important in addiction, but they can only exert their influences by impacting neural processes. They must be encoded as sensory data, represented together with memories of the past and predictions about the future, and combined with representations of interoceptive and other influences to provide inputs to the valuation machinery of the brain. Collectively, these inputs drive action selection and execution of behavior—say, to drink or not to drink, and then, within an episode, to stop drinking or keep drinking. Stating that the pathophysiology of addiction is largely about the brain does not ignore the role of other influences. It is just the opposite: it is attempting to understand how those important influences contribute to drug seeking and taking in the context of the brain, and vice versa.

But if the criticism is one of emphasis rather than of principle—i.e., too much brain, too little social and environmental factors – then neuroscientists need to acknowledge that they are in part guilty as charged. Brain-centric accounts of addiction have for a long time failed to pay enough attention to the inputs that social factors provide to neural processing behind drug seeking and taking [ 9 ]. This landscape is, however, rapidly changing. For instance, using animal models, scientists are finding that lack of social play early in life increases the motivation to take addictive substances in adulthood [ 70 ]. Others find that the opportunity to interact with a fellow rat is protective against addiction-like behaviors [ 71 ]. In humans, a relationship has been found between perceived social support, socioeconomic status, and the availability of dopamine D2 receptors [ 72 , 73 ], a biological marker of addiction vulnerability. Those findings in turn provided translation of data from nonhuman primates, which showed that D2 receptor availability can be altered by changes in social hierarchy, and that these changes are associated with the motivation to obtain cocaine [ 74 ].

Epidemiologically, it is well established that social determinants of health, including major racial and ethnic disparities, play a significant role in the risk for addiction [ 75 , 76 ]. Contemporary neuroscience is illuminating how those factors penetrate the brain [ 77 ] and, in some cases, reveals pathways of resilience [ 78 ] and how evidence-based prevention can interrupt those adverse consequences [ 79 , 80 ]. In other words, from our perspective, viewing addiction as a brain disease in no way negates the importance of social determinants of health or societal inequalities as critical influences. In fact, as shown by the studies correlating dopamine receptors with social experience, imaging is capable of capturing the impact of the social environment on brain function. This provides a platform for understanding how those influences become embedded in the biology of the brain, which provides a biological roadmap for prevention and intervention.

We therefore argue that a contemporary view of addiction as a brain disease does not deny the influence of social, environmental, developmental, or socioeconomic processes, but rather proposes that the brain is the underlying material substrate upon which those factors impinge and from which the responses originate. Because of this, neurobiology is a critical level of analysis for understanding addiction, although certainly not the only one. It is recognized throughout modern medicine that a host of biological and non-biological factors give rise to disease; understanding the biological pathophysiology is critical for understanding etiology and informing treatment.

Is a view of addiction as a brain disease deterministic?

A common criticism of the notion that addiction is a brain disease is that it is reductionist and in the end therefore deterministic [ 81 , 82 ]. This is a fundamental misrepresentation. As indicated above, viewing addiction as a brain disease simply states that neurobiology is an undeniable component of addiction. A reason for deterministic interpretations may be that modern neuroscience emphasizes an understanding of proximal causality within research designs (e.g., whether an observed link between biological processes is mediated by a specific mechanism). That does not in any way reflect a superordinate assumption that neuroscience will achieve global causality. On the contrary, since we realize that addiction involves interactions between biology, environment and society, ultimate (complete) prediction of behavior based on an understanding of neural processes alone is neither expected, nor a goal.

A fairer representation of a contemporary neuroscience view is that it believes insights from neurobiology allow useful probabilistic models to be developed of the inherently stochastic processes involved in behavior [see [ 83 ] for an elegant recent example]. Changes in brain function and structure in addiction exert a powerful probabilistic influence over a person’s behavior, but one that is highly multifactorial, variable, and thus stochastic. Philosophically, this is best understood as being aligned with indeterminism, a perspective that has a deep history in philosophy and psychology [ 84 ]. In modern neuroscience, it refers to the position that the dynamic complexity of the brain, given the probabilistic threshold-gated nature of its biology (e.g., action potential depolarization, ion channel gating), means that behavior cannot be definitively predicted in any individual instance [ 85 , 86 ].

Driven by compulsion, or free to choose?

A major criticism of the brain disease view of addiction, and one that is related to the issue of determinism vs indeterminism, centers around the term “compulsivity” [ 6 , 87 – 90 ] and the different meanings it is given. Prominent addiction theories state that addiction is characterized by a transition from controlled to “compulsive” drug seeking and taking [ 91 – 95 ], but allocate somewhat different meanings to “compulsivity”. By some accounts, compulsive substance use is habitual and insensitive to its outcomes [ 92 , 94 , 96 ]. Others refer to compulsive use as a result of increasing incentive value of drug associated cues [ 97 ], while others view it as driven by a recruitment of systems that encode negative affective states [ 95 , 98 ].

The prototype for compulsive behavior is provided by obsessive-compulsive disorder (OCD), where compulsion refers to repeatedly and stereotypically carrying out actions that in themselves may be meaningful, but lose their purpose and become harmful when performed in excess, such as persistent handwashing until skin injuries result. Crucially, this happens despite a conscious desire to do otherwise. Attempts to resist these compulsions result in increasing and ultimately intractable anxiety [ 99 ]. This is in important ways different from the meaning of compulsivity as commonly used in addiction theories. In the addiction field, compulsive drug use typically refers to inflexible, drug-centered behavior in which substance use is insensitive to adverse consequences [ 100 ]. Although this phenomenon is not necessarily present in every patient, it reflects important symptoms of clinical addiction, and is captured by several DSM-5 criteria for SUD [ 101 ]. Examples are needle-sharing despite knowledge of a risk to contract HIV or Hepatitis C, drinking despite a knowledge of having liver cirrhosis, but also the neglect of social and professional activities that previously were more important than substance use. While these behaviors do show similarities with the compulsions of OCD, there are also important differences. For example, “compulsive” substance use is not necessarily accompanied by a conscious desire to withhold the behavior, nor is addictive behavior consistently impervious to change.

Critics question the existence of compulsivity in addiction altogether [ 5 – 7 , 89 ], typically using a literal interpretation, i.e., that a person who uses alcohol or drugs simply can not do otherwise. Were that the intended meaning in theories of addiction—which it is not—it would clearly be invalidated by observations of preserved sensitivity of behavior to contingencies in addiction. Indeed, substance use is influenced both by the availability of alternative reinforcers, and the state of the organism. The roots of this insight date back to 1940, when Spragg found that chimpanzees would normally choose a banana over morphine. However, when physically dependent and in a state of withdrawal, their choice preference would reverse [ 102 ]. The critical role of alternative reinforcers was elegantly brought into modern neuroscience by Ahmed et al., who showed that rats extensively trained to self-administer cocaine would readily forego the drug if offered a sweet solution as an alternative [ 103 ]. This was later also found to be the case for heroin [ 103 ], methamphetamine [ 104 ] and alcohol [ 105 ]. Early residential laboratory studies on alcohol use disorder indeed revealed orderly operant control over alcohol consumption [ 106 ]. Furthermore, efficacy of treatment approaches such as contingency management, which provides systematic incentives for abstinence [ 107 ], supports the notion that behavioral choices in patients with addictions remain sensitive to reward contingencies.

Evidence that a capacity for choosing advantageously is preserved in addiction provides a valid argument against a narrow concept of “compulsivity” as rigid, immutable behavior that applies to all patients. It does not, however, provide an argument against addiction as a brain disease. If not from the brain, from where do the healthy and unhealthy choices people make originate? The critical question is whether addictive behaviors—for the most part—result from healthy brains responding normally to externally determined contingencies; or rather from a pathology of brain circuits that, through probabilistic shifts, promotes the likelihood of maladaptive choices even when reward contingencies are within a normal range. To resolve this question, it is critical to understand that the ability to choose advantageously is not an all-or-nothing phenomenon, but rather is about probabilities and their shifts, multiple faculties within human cognition, and their interaction. Yes, it is clear that most people whom we would consider to suffer from addiction remain able to choose advantageously much, if not most, of the time. However, it is also clear that the probability of them choosing to their own disadvantage, even when more salutary options are available and sometimes at the expense of losing their life, is systematically and quantifiably increased. There is a freedom of choice, yet there is a shift of prevailing choices that nevertheless can kill.

Synthesized, the notion of addiction as a disease of choice and addiction as a brain disease can be understood as two sides of the same coin. Both of these perspectives are informative, and they are complementary. Viewed this way, addiction is a brain disease in which a person’s choice faculties become profoundly compromised. To articulate it more specifically, embedded in and principally executed by the central nervous system, addiction can be understood as a disorder of choice preferences, preferences that overvalue immediate reinforcement (both positive and negative), preferences for drug-reinforcement in spite of costs, and preferences that are unstable ( “I’ll never drink like that again;” “this will be my last cigarette” ), prone to reversals in the form of lapses and relapse. From a contemporary neuroscience perspective, pre-existing vulnerabilities and persistent drug use lead to a vicious circle of substantive disruptions in the brain that impair and undermine choice capacities for adaptive behavior, but do not annihilate them. Evidence of generally intact decision making does not fundamentally contradict addiction as a brain disease.

Conclusions

The present paper is a response to the increasing number of criticisms of the view that addiction is a chronic relapsing brain disease. In many cases, we show that those criticisms target tenets that are neither needed nor held by a contemporary version of this view. Common themes are that viewing addiction as a brain disease is criticized for being both too narrow (addiction is only a brain disease; no other perspectives or factors are important) or too far reaching (it purports to discover the final causes of addiction). With regard to disease course, we propose that viewing addiction as a chronic relapsing disease is appropriate for some populations, and much less so for others, simply necessitating better ways of delineating the populations being discussed. We argue that when considering addiction as a disease, the lens of neurobiology is valuable to use. It is not the only lens, and it does not have supremacy over other scientific approaches. We agree that critiques of neuroscience are warranted [ 108 ] and that critical thinking is essential to avoid deterministic language and scientific overreach.

Beyond making the case for a view of addiction as a brain disease, perhaps the more important question is when a specific level of analysis is most useful. For understanding the biology of addiction and designing biological interventions, a neurobiological view is almost certainly the most appropriate level of analysis, in particular when informed by an understanding of the behavioral manifestations. In contrast, for understanding the psychology of addiction and designing psychological interventions, behavioral science is the natural realm, but one that can often benefit from an understanding of the underlying neurobiology. For designing policies, such as taxation and regulation of access, economics and public administration provide the most pertinent perspectives, but these also benefit from biological and behavioral science insights.

Finally, we argue that progress would come from integration of these scientific perspectives and traditions. E.O. Wilson has argued more broadly for greater consilience [ 109 ], unity of knowledge, in science. We believe that addiction is among the areas where consilience is most needed. A plurality of disciplines brings important and trenchant insights to bear on this condition; it is the exclusive remit of no single perspective or field. Addiction inherently and necessarily requires multidisciplinary examination. Moreover, those who suffer from addiction will benefit most from the application of the full armamentarium of scientific perspectives.

Funding and disclosures

Supported by the Swedish Research Council grants 2013-07434, 2019-01138 (MH); Netherlands Organisation for Health Research and Development (ZonMw) under project number 912.14.093 (LJMJV); NIDA and NIAAA intramural research programs (LL; the content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health); the Peter Boris Chair in Addictions Research, Homewood Research Institute, and the National Institute on Alcohol Abuse and Alcoholism grants AA025911, AA024930, AA025849, AA027679 (JM; the content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health).

MH has received consulting fees, research support or other compensation from Indivior, Camurus, BrainsWay, Aelis Farma, and Janssen Pharmaceuticals. JM is a Principal and Senior Scientist at BEAM Diagnostics, Inc. DM, JR, LL, and LJMJV declare no conflict of interest.

Acknowledgements

The authors want to acknowledge comments by Drs. David Epstein, Kenneth Kendler and Naomi Wray.

Author contributions

All authors jointly drafted the paper.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Understanding reasons for drug use amongst young people: a functional perspective

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Annabel Boys, John Marsden, John Strang, Understanding reasons for drug use amongst young people: a functional perspective, Health Education Research , Volume 16, Issue 4, August 2001, Pages 457–469, https://doi.org/10.1093/her/16.4.457

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This study uses a functional perspective to examine the reasons young people cite for using psychoactive substances. The study sample comprised 364 young poly-drug users recruited using snowball-sampling methods. Data on lifetime and recent frequency and intensity of use for alcohol, cannabis, amphetamines, ecstasy, LSD and cocaine are presented. A majority of the participants had used at least one of these six drugs to fulfil 11 of 18 measured substance use functions. The most popular functions for use were using to: relax (96.7%), become intoxicated (96.4%), keep awake at night while socializing (95.9%), enhance an activity (88.5%) and alleviate depressed mood (86.8%). Substance use functions were found to differ by age and gender. Recognition of the functions fulfilled by substance use should help health educators and prevention strategists to make health messages about drugs more relevant and appropriate to general and specific audiences. Targeting substances that are perceived to fulfil similar functions and addressing issues concerning the substitution of one substance for another may also strengthen education and prevention efforts.

The use of illicit psychoactive substances is not a minority activity amongst young people in the UK. Results from the most recent British Crime Survey show that some 50% of young people between the ages of 16 and 24 years have used an illicit drug on at least one occasion in their lives (lifetime prevalence) ( Ramsay and Partridge, 1999 ). Amongst 16–19 and 20–24 year olds the most prevalent drug is cannabis (used by 40% of 16–19 year olds and 47% of 20–24 year olds), followed by amphetamine sulphate (18 and 24% of the two age groups respectively), LSD (10 and 13%) and ecstasy (8 and 12%). The lifetime prevalence for cocaine hydrochloride (powder cocaine) use amongst the two age groups is 3 and 9%, respectively. Collectively, these estimates are generally comparable with other European countries ( European Monitoring Centre for Drugs and Drug Addiction, 1998 ) and the US ( Johnston et al ., 1997 , 2000 ).

The widespread concern about the use of illicit drugs is reflected by its high status on health, educational and political agendas in many countries. The UK Government's 10-year national strategy on drug misuse identifies young people as a critical priority group for prevention and treatment interventions ( Tackling Drugs to Build a Better Britain 1998 ). If strategies to reduce the use of drugs and associated harms amongst the younger population are to be developed, particularly within the health education arena, it is vital that we improve our understanding of the roles that both licit and illicit substances play in the lives of young people. The tendency for educators, practitioners and policy makers to address licit drugs (such as alcohol) separately from illegal drugs may be unhelpful. This is partly because young illicit drug users frequently drink alcohol, and may have little regard for the illicit and licit distinction established by the law. To understand the roles that drug and alcohol use play in contemporary youth culture, it is necessary to examine the most frequently used psychoactive substances as a set.

It is commonplace for young drug users to use several different psychoactive substances. The terms `poly-drug' or `multiple drug' use have been used to describe this behaviour although their exact definitions vary. The term `poly-drug use' is often used to describe the use of two or more drugs during a particular time period (e.g. over the last month or year). This is the definition used within the current paper. However, poly-drug use could also characterize the use of two or more psychoactive substances so that their effects are experienced simultaneously. We have used the term `concurrent drug use' to denote this pattern of potentially more risky and harmful drug use ( Boys et al. 2000a ). Previous studies have reported that users often use drugs concurrently to improve the effects of another drug or to help manage its negative effects [e.g. ( Power et al ., 1996 ; Boys et al. 2000a ; Wibberley and Price, 2000 )].

The most recent British Crime Survey found that 5% of 16–29 year olds had used more than one drug in the last month ( Ramsay and Partridge, 1999 ). Given that 16% of this age band reported drug use in the month prior to interview, this suggests that just under a third of these individuals had used more than one illicit substance during this time period. With alcohol included, the prevalence of poly-drug use is likely to be much higher.

There is a substantial body of literature on the reasons or motivations that people cite for using alcohol, particularly amongst adult populations. For example, research on heavy drinkers suggested that alcohol use is related to multiple functions for use ( Edwards et al ., 1972 ; Sadava, 1975 ). Similarly, research with a focus on young people has sought to identify motives for illicit drug use. There is evidence that for many young people, the decision to use a drug is based on a rational appraisal process, rather than a passive reaction to the context in which a substance is available ( Boys et al. 2000a ; Wibberley and Price, 2000 ). Reported reasons vary from quite broad statements (e.g. to feel better) to more specific functions for use (e.g. to increase self-confidence). However, much of this literature focuses on `drugs' as a generic concept and makes little distinction between different types of illicit substances [e.g. ( Carman, 1979 ; Butler et al ., 1981 ; Newcomb et al ., 1988 ; Cato, 1992 ; McKay et al ., 1992 )]. Given the diverse effects that different drugs have on the user, it might be proposed that reasons for use will closely mirror these differences. Thus stimulant drugs (such as amphetamines, ecstasy or cocaine) will be used for reasons relating to increased nervous system arousal and drugs with sedative effects (such as alcohol or cannabis), with nervous system depression. The present study therefore selected a range of drugs commonly used by young people with stimulant, sedative or hallucinogenic effects to examine this issue further.

The phrase `instrumental drug use' has been used to denote drug use for reasons specifically linked to a drug's effects ( WHO, 1997 ). Examples of the instrumental use of amphetamine-type stimulants include vehicle drivers who report using to improve concentration and relieve tiredness, and people who want to lose weight (particularly young women), using these drugs to curb their appetite. However, the term `instrumental substance use' seems to be used when specific physical effects of a drug are exploited and does not encompass use for more subtle social or psychological purposes which may also be cited by users. In recent reports we have described a `drug use functions' model to help understand poly-substance use phenomenology amongst young people and how decisions are made about patterns of consumption ( Boys et al ., 1999a , b , 2000a ). The term `function' is intended to characterize the primary or multiple reasons for, or purpose served by, the use of a particular substance in terms of the actual gains that the user perceives that they will attain. In the early, 1970s Sadava suggested that functions were a useful means of understanding how personality and environmental variables impacted on patterns of drug use ( Sadava, 1975 ). This work was confined to functions for cannabis and `psychedelic drugs' amongst a sample of college students. To date there has been little research that has examined the different functions associated with the range of psychoactive substances commonly used by young poly-drug users. It is unclear if all drugs with similar physical effects are used for similar purposes, or if other more subtle social or psychological dimensions to use are influential. Work in this area will help to increase understanding of the different roles played by psychoactive substances in the lives of young people, and thus facilitate health, educational and policy responses to this issue.

Previous work has suggested that the perceived functions served by the use of a drug predict the likelihood of future consumption ( Boys et al ., 1999a ). The present study aims to develop this work further by examining the functional profiles of six substances commonly used by young people in the UK.

Patterns of cannabis, amphetamine, ecstasy, LSD, cocaine hydrochloride and alcohol use were examined amongst a sample of young poly-drug users. Tobacco use was not addressed in the present research.

Sampling and recruitment

A snowball-sampling approach was employed for recruitment of participants. Snowball sampling is an effective way of generating a large sample from a hidden population where no formal sampling frame is available ( Van Meter, 1990 ). A team of peer interviewers was trained to recruit and interview participants for the study. We have described this procedure in detail elsewhere and only essential features are described here ( Boys et al. 2000b ). Using current or ex-drug users to gather data from hidden populations of drug using adults has been found to be successful ( Griffiths et al ., 1993 ; Power, 1995 ).

Study participants

Study participants were current poly-substance users with no history of treatment for substance-related disorders. We excluded people with a treatment history on the assumption that young people who have had substance-related problems requiring treatment represent a different group from the general population of young drug users. Inclusion criteria were: aged 16–22 years and having used two or more illegal substances during the past 90 days. During data collection, the age, gender and current occupation of participants were recorded and monitored to ensure that sufficient individuals were recruited to the groups to permit subgroup analyses. If an imbalance was observed in one of these variables, the interviewers were instructed to target participants with specific characteristics (e.g. females under the age of 18) to redress this imbalance.

Study measures

Data were collected using a structured interviewer-administered questionnaire developed specifically for the study. In addition to recording lifetime substance use, questions profiled consumption patterns of six substances in detail. Data were collected between August and November 1998. Interviews were audiotaped with the interviewee's consent. This enabled research staff to verify that answers had been accurately recorded on the questionnaire and that the interview had been conducted in accordance with the research protocol. Research staff also checked for consistency across different question items (e.g. the total number of days of drug use in the past 90 days should equal or exceed the number of days of cannabis use during the same time period). On the few occasions where inconsistencies were identified that could not be corrected from the tape, the interviewer was asked to re-contact the interviewee to verify the data.

Measures of lifetime use, consumption in the past year and past 90 days were based on procedures developed by Marsden et al . ( Marsden et al ., 1998 ). Estimated intensity of consumption (amount used on a typical using day) was recorded verbatim and then translated into standardized units at the data entry stage.

Functions for substance use scale

The questionnaire included a 17-item scale designed to measure perceived functions for substance use. This scale consisted of items developed in previous work ( Boys et al ., 1999a ) in addition to functions derived from qualitative interviews ( Boys et al ., 1999b ), new literature and informal discussions with young drug users. Items were drawn from five domains (Table I ).

Participants were asked if they had ever used a particular drug in order to fulfil each specific function. Those who endorsed the item were then invited to rate how frequently they had used it for this purpose over the past year, using a five-point Likert-type scale (`never' to `always'; coded 0–4). One item differed between the function scales used for the stimulant drugs and for alcohol and cannabis. For the stimulant drugs (amphetamines, cocaine and ecstasy) the item `have you ever used [named drug] to help you to lose weight' was used, for cannabis and alcohol this item was replaced with `have you ever used [drug] to help you to sleep?'. (The items written in full as they appeared in the questionnaire are shown in Table III , together with abbreviations used in this paper.)

Statistical procedures

The internal reliability of the substance use functions scales for each of the six substances was judged using Chronbach's α coefficient. Chronbach's α is a statistic that reflects the extent to which each item in a measurement scale is associated with other items. Technically it is the average of correlations between all possible comparisons of the scale items that are divided into two halves. An α coefficient for a scale can range from 0 (no internal reliability) to 1 (complete reliability). Analyses of categorical variables were performed using χ 2 statistic. Differences in scale means were assessed using t -tests.

The sample consisted of 364 young poly-substance users (205 males; 56.3%) with a mean age of 19.3 years; 69.8% described their ethnic group as White-European, 12.6% as Black and 10.1% were Asian. Just over a quarter (27.5%) were unemployed at the time of interview; a third were in education, 28.8% were in full-time work and the remainder had part-time employment. Estimates of monthly disposable income (any money that was spare after paying for rent, bills and food) ranged from 0 to over £1000 (median = £250).

Substance use history

The drug with the highest lifetime prevalence was cannabis (96.2%). This was followed by amphetamine sulphate (51.6%), cocaine hydrochloride (50.5%) (referred to as cocaine hereafter) and ecstasy (48.6%). Twenty-five percent of the sample had used LSD and this was more common amongst male participants (χ 2 [1] = 9.68, P < 0.01). Other drugs used included crack cocaine (25.5%), heroin (12.6%), tranquillizers (21.7%) and hallucinogenic mushrooms (8.0%). On average, participants had used a total of 5.2 different psychoactive substances in their lives (out of a possible 14) (median = 4.0, mode = 3.0, range 2–14). There was no gender difference in the number of different drugs ever used.

Table II profiles use of the six target drugs over the past year, and the frequency and intensity of use in the 90 days prior to interview.

There were no gender differences in drug use over the past year or in the past 90 days with the exception of amphetamines. For this substance, females who had ever used this drug were more likely to have done so during the past 90 days than males (χ 2 [1] = 4.14, P < 0.05). The mean number of target drugs used over the past 90 days was 3.2 (median = 3.0, mode = 3.0, range 2–6). No gender differences were observed. Few differences were also observed in the frequency and intensity of use. Males reported drinking alcohol more frequently during the three months prior to interview ( t [307] = 2.48, P < 0.05) and using cannabis more intensively on a `typical using day' ( t [337] = 3.56, P < 0.001).

Perceived functions for substance use

There were few differences between the functions endorsed for use of each drug `ever' and those endorsed for use during `the year prior to interview'. This section therefore concentrates on data for the year prior to interview. We considered that in order to use a drug for a specific function, the user must have first hand knowledge of the drug's effects before making this decision. Consequently, functions reported by individuals who had only used a particular substance on one occasion in their lives (i.e. with no prior experience of the drug at the time they made the decision to take it) were excluded from the analyses. Table III summarizes the proportion of the sample who endorsed each of the functions for drugs used in the past year. Roman numerals have been used to indicate the functions with the top five average scores. Table III also shows means for the total number of different items endorsed by individual users and the internal reliability of the function scales for each substance using Chronbach's α coefficients. There were no significant gender differences in the total number of functions endorsed for any of the six substances.

The following sections summarize the top five most popular functions drug-by-drug together with any age or gender differences observed in the items endorsed.

Cannabis use ( n = 345)

Overall the most popular functions for cannabis use were to `RELAX' (endorsed by 96.8% of people who had used the drug in the last year), to become `INTOXICATED' (90.7%) and to `ENHANCE ACTIVITY' (72.8%). Cannabis was also commonly used to `DECREASE BOREDOM' (70.1%) and to `SLEEP' (69.6%) [this item was closely followed by using to help `FEEL BETTER' (69.0%)]. Nine of the 17 function items were endorsed by over half of those who had used cannabis on more than one occasion in the past year. There were no significant gender differences observed, with the exception of using to `KEEP GOING', where male participants were significantly more likely to say that they had used cannabis to fulfil this function in the past year (χ 2 [1] = 6.10, P < 0.05).

There were statistically significant age differences on four of the function variables: cannabis users who reported using this drug in the past year to help feel `ELATED/EUPHORIC' or to help `SLEEP' were significantly older than those who had not used cannabis for these purposes (19.6 versus 19.0; t [343] = 3.32, P < 0.001; 19.4 versus 19.0; t [343] = 2.01, P < 0.05). In contrast, those who had used cannabis to `INCREASE CONFIDENCE' and to `STOP WORRYING' tended to be younger than those who did not (19.0 versus 19.4; t [343] = –2.26, P < 0.05; 19.1 versus 19.5; t [343] = –1.99, P < 0.05).

Amphetamines ( n = 160)

Common functions for amphetamine use were to `KEEP GOING' (95.6%), to `STAY AWAKE' (91.3%) or to `ENHANCE ACTIVITY' (66.2%). Using to help feel `ELATED/EUPHORIC' (60.6%) and to `ENJOY COMPANY' (58.1%) were also frequently mentioned. Seven of the 17 function items were endorsed by over half of participants who had used amphetamines in the past year. As with cannabis, gender differences were uncommon: females were more likely to use amphetamines to help `LOSE WEIGHT' than male participants (χ 2 [1] = 21.67, P < 0.001).

Significant age differences were found on four function variables. Individuals who reported using amphetamines in the past year to feel `ELATED/EUPHORIC' were significantly older than those who did not (19.9 versus 19.0; t [158] = 2.87, P < 0.01). In contrast, participants who used amphetamines to `STOP WORRYING' (18.8 versus 19.8; t [158] = –2.77, P < 0.01), to `DECREASE BOREDOM' (19.2 versus 19.9; t [158] = –2.39, P < 0.05) or to `ENHANCE ACTIVITY' (19.3 versus 20.1; t [158] = –2.88, P < 0.01) were younger than those who had not.

Ecstasy ( n = 157)

The most popular five functions for using ecstasy were similar to those for amphetamines. The drug was used to `KEEP GOING' (91.1%), to `ENHANCE ACTIVITY' (79.6%), to feel `ELATED/EUPHORIC' (77.7%), to `STAY AWAKE' (72.0%) and to get `INTOXICATED' (68.2%). Seven of the 17 function items were endorsed by over half of those who had used ecstasy in the past year. Female users were more likely to use ecstasy to help `LOSE WEIGHT' than male participants (Fishers exact test, P < 0.001).

As with the other drugs discussed above, participants who reported using ecstasy to feel `ELATED/EUPHORIC' were significantly older than those who did not (19.8 versus 18.9; t [155] = 2.61, P < 0.01). In contrast, those who had used ecstasy to `FEEL BETTER' (19.3 versus 20.0; t [155] = –2.29, P < 0.05), to `INCREASE CONFIDENCE' (19.2 versus 19.9; t [155] = –2.22, P < 0.05) and to `STOP WORRYING' (19.0 versus 19.9; t [155] = –2.96, P < 0.01) tended to be younger.

LSD ( n = 58)

Of the six target substances examined in this study, LSD was associated with the least diverse range of functions for use. All but two of the function statements were endorsed by at least some users, but only five were reported by more than 50%. The most common purpose for consuming LSD was to get `INTOXICATED' (77.6%). Other popular functions included to feel `ELATED/EUPHORIC' and to `ENHANCE ACTIVITY' (both endorsed by 72.4%), and to `KEEP GOING' and to `ENJOY COMPANY' (both endorsed by 58.6%). Unlike the other substances examined, no gender or age differences were observed.

Cocaine ( n = 168)

In common with ecstasy and amphetamines, the most widely endorsed functions for cocaine use were to help `KEEP GOING' (84.5%) and to help `STAY AWAKE' (69.0%). Consuming cocaine to `INCREASE CONFIDENCE' and to get `INTOXICATED' (both endorsed by 66.1%) were also popular. However, unlike the other stimulant drugs, 61.9% of the cocaine users reported using to `FEEL BETTER'. Ten of the 17 function items were endorsed by over half of those who had used cocaine in the past year.

Gender differences were more common amongst functions for cocaine use than the other substances surveyed. More males reported using cocaine to `IMPROVE EFFECTS' of other drugs (χ 2 [1] = 4.00, P < 0.05); more females used the drug to help `STAY AWAKE' (χ 2 [1] = 12.21, P < 0.001), to `LOSE INHIBITIONS' (χ 2 [1] = 9.01, P < 0.01), to `STOP WORRYING' (χ 2 [1] = 8.11, P < 0.01) or to `ENJOY COMPANY' of friends (χ 2 [1] = 4.34, P < 0.05). All participants who endorsed using cocaine to help `LOSE WEIGHT' were female.

Those who had used cocaine to `FEEL BETTER' (18.9 versus 19.8; t [166] = –3.06, P < 0.01), to `STOP WORRYING' (18.6 versus 19.7; t [166] = –3.86, P < 0.001) or to `DECREASE BOREDOM' (18.9 versus 19.6; t [166] = –2.52, P < 0.05) were significantly younger than those who did not endorse these functions. Similar to the other drugs, participants who had used cocaine to feel `ELATED/EUPHORIC' in the past year tended to be older than those who had not (19.6 versus 18.7; t [166] = 3.16, P < 0.01).

Alcohol ( n = 312)

The functions for alcohol use were the most diverse of the six substances examined. Like LSD, the most commonly endorsed purpose for drinking was to get `INTOXICATED' (89.1%). Many used alcohol to `RELAX' (82.7%), to `ENJOY COMPANY' (74.0%), to `INCREASE CONFIDENCE' (70.2%) and to `FEEL BETTER' (69.9%). Overall, 11 of the 17 function items were endorsed by over 50% of those who had drunk alcohol in the past year. Male participants were more likely to report using alcohol in combination with other drugs either to `IMPROVE EFFECTS' of other drugs (χ 2 [1] = 4.56, P < 0.05) or to ease the `AFTER EFFECTS' of other substances (χ 2 [1] = 7.07, P < 0.01). More females than males reported that they used alcohol to `DECREASE BOREDOM' (χ 2 [1] = 4.42, P < 0.05).

T -tests revealed significant age differences on four of the function variables: those who drank to feel `ELATED/EUPHORIC' were significantly older (19.7 versus 19.0; t [310] = 3.67, P < 0.001) as were individuals who drank to help them to `LOSE INHIBITIONS' (19.6 versus 19.0; t [310] = 2.36, P < 0.05). In contrast, participants who reported using alcohol just to get `INTOXICATED' (19.2 versus 20.3; t [310] = –3.31, P < 0.001) or to `DECREASE BOREDOM' (19.2 versus 19.6; t [310] = –2.25, P < 0.05) were significantly younger than those who did not.

Combined functional drug use

The substances used by the greatest proportion of participants to `IMPROVE EFFECTS' from other drugs were cannabis (44.3%), alcohol (41.0%) and amphetamines (37.5%). It was also common to use cannabis (64.6%) and to a lesser extent alcohol (35.9%) in combination with other drugs in order to help manage `AFTER EFFECTS'. Amphetamines, ecstasy, LSD and cocaine were also used for these purposes, although to a lesser extent. Participants who endorsed the combination drug use items were asked to list the three main drugs with which they had combined the target substance for these purposes. Table IV summarizes these responses.

Overall functions for drug use

In order to examine which functions were most popular overall, a dichotomous variable was created for each different item to indicate if one or more of the six target substances had been used to fulfil this purpose during the year prior to interview. For example, if an individual reported that they had used cannabis to relax, but their use of ecstasy, amphetamines and alcohol had not fulfilled this function, then the variable for `RELAX' was scored `1'. Similarly if they had used all four of these substances to help them to relax in the past year, the variable would again be scored as `1'. A score of `0' indicates that none of the target substances had been used to fulfil a particular function. Table V summarizes the data from these new variables.

Over three-quarters of the sample had used at least one target substance in the past year for 11 out of the 18 functions listed. The five most common functions for substance use overall were to `RELAX' (96.7%); `INTOXICATED' (96.4%); `KEEP GOING' (95.9%); `ENHANCE ACTIVITY' (88.5%) and `FEEL BETTER' (86.8%). Despite the fact that `SLEEP' was only relevant to two substances (alcohol and cannabis), it was still endorsed by over 70% of the total sample. Using to `LOSE WEIGHT' was only relevant to the stimulant drugs (amphetamines, ecstasy and cocaine), yet was endorsed by 17.3% of the total sample (almost a third of all female participants). Overall, this was the least popular function for recent substance use, followed by `WORK' (32.1%). All other items were endorsed by over 60% of all participants.

Gender differences were identified in six items. Females were significantly more likely to have endorsed the following: using to `INCREASE CONFIDENCE' (χ 2 [1] = 4.41, P < 0.05); `STAY AWAKE' (χ 2 [1] = 5.36, P < 0.05), `LOSE INHIBITIONS' (χ 2 [1] = 4.48, P < 0.05), `ENHANCE SEX' (χ 2 [1] = 5.17, P < 0.05) and `LOSE WEIGHT' (χ 2 [1] = 29.6, P < 0.001). In contrast, males were more likely to use a substance to `IMPROVE EFFECTS' of another drug (χ 2 [1] = 11.18, P < 0.001).

Statistically significant age differences were identified in three of the items. Those who had used at least one of the six target substances in the last year to feel `ELATED/EUPHORIC' (19.5 versus 18.6; t [362] = 4.07, P < 0.001) or to `SLEEP' (19.4 versus 18.9; t [362] = 2.19, P < 0.05) were significantly older than those who had not used for this function. In contrast, participants who had used in order to `STOP WORRYING' tended to be younger (19.1 versus 19.7; t [362] = –2.88, P < 0.01).

This paper has examined psychoactive substance use amongst a sample of young people and focused on the perceived functions for use using a 17-item scale. In terms of the characteristics of the sample, the reported lifetime and recent substance use was directly comparable with other samples of poly-drug users recruited in the UK [e.g. ( Release, 1997 )].

Previous studies which have asked users to give reasons for their `drug use' overall instead of breaking it down by drug type [e.g. ( Carman, 1979 ; Butler et al ., 1981 ; Newcomb et al ., 1988 ; Cato, 1992 ; McKay et al ., 1992 )] may have overlooked the dynamic nature of drug-related decision making. A key finding from the study is that that with the exception of two of the functions for use scale items (using to help sleep or lose weight), all of the six drugs had been used to fulfil all of the functions measured, despite differences in their pharmacological effects. The total number of functions endorsed by individuals for use of a particular drug varied from 0 to 15 for LSD, and up to 17 for cannabis, alcohol and cocaine. The average number ranged from 5.9 (for LSD) to 9.0 (for cannabis). This indicates that substance use served multiple purposes for this sample, but that the functional profiles differed between the six target drugs.

We have previously reported ( Boys et al. 2000b ) that high scores on a cocaine functions scale are strongly predictive of high scores on a cocaine-related problems scale. The current findings support the use of similar function scales for cannabis, amphetamines, LSD and ecstasy. It remains to be seen whether similar associations with problem scores exist. Future developmental work in this area should ensure that respondents are given the opportunity to cite additional functions to those included here so that the scales can be further extended and refined.

Recent campaigns that have targeted young people have tended to assume that hallucinogen and stimulant use is primarily associated with dance events, and so motives for use will relate to this context. Our results support assumptions that these drugs are used to enhance social interactions, but other functions are also evident. For example, about a third of female interviewees had used a stimulant drug to help them to lose weight. Future education and prevention efforts should take this diversity into account when planning interventions for different target groups.

The finding that the same functions are fulfilled by use of different drugs suggests that at least some could be interchangeable. Evidence for substituting alternative drugs to fulfil a function when a preferred drug is unavailable has been found in other studies [e.g. ( Boys et al. 2000a )]. Prevention efforts should perhaps focus on the general motivations behind use rather than trying to discourage use of specific drug types in isolation. For example, it is possible that the focus over the last decade on ecstasy prevention may have contributed inadvertently to the rise in cocaine use amongst young people in the UK ( Boys et al ., 1999c ). It is important that health educators do not overlook this possibility when developing education and prevention initiatives. Considering functions that substance use can fulfil for young people could help us to understand which drugs are likely to be interchangeable. If prevention programmes were designed to target a range of substances that commonly fulfil similar functions, then perhaps this could address the likelihood that some young people will substitute other drugs if deterred from their preferred substance.

There has been considerable concern about the perceived increase in the number of young people who are using cocaine in the UK ( Tackling Drugs to Build a Better Britain 1998 ; Ramsay and Partridge, 1999 ; Boys et al. 2000b ). It has been suggested that, for a number of reasons, cocaine may be replacing ecstasy and amphetamines as the stimulant of choice for some young people ( Boys et al ., 1999c ). The results from this study suggest that motives for cocaine use are indeed similar to those for ecstasy and amphetamine use, e.g. using to `keep going' on a night out with friends, to `enhance an activity', `to help to feel elated or euphoric' or to help `stay awake'. However, in addition to these functions which were shared by all three stimulants, over 60% of cocaine users reported that they had used this drug to `help to feel more confident' in a social situation and to `feel better when down or depressed'. Another finding that sets cocaine aside from ecstasy and amphetamines was the relatively common existence of gender differences in the function items endorsed. Female cocaine users were more likely to use to help `stay awake', `lose inhibitions', `stop worrying', `enjoy company of friends' or to help `lose weight'. This could indicate that women are more inclined to admit to certain functions than their male counterparts. However, the fact that similar gender differences were not observed in the same items for the other five substances, suggests this interpretation is unlikely. Similarly, the lack of gender differences in patterns of cocaine use (both frequency and intensity) suggests that these differences are not due to heavier cocaine use amongst females. If these findings are subsequently confirmed, this could point towards an inclination for young women to use cocaine as a social support, particularly to help feel less inhibited in social situations. If so, young female cocaine users may be more vulnerable to longer-term cocaine-related problems.

Many respondents reported using alcohol or cannabis to help manage effects experienced from another drug. This has implications for the choice of health messages communicated to young people regarding the use of two or more different substances concurrently. Much of the literature aimed at young people warns them to avoid mixing drugs because the interactive effects may be dangerous [e.g. ( HIT, 1996 )]. This `Just say No' type of approach does not take into consideration the motives behind mixing drugs. In most areas, drug education and prevention work has moved on from this form of communication. A more sophisticated approach is required, which considers the functions that concurrent drug use is likely to have for young people and tries to amend messages to make them more relevant and acceptable to this population. Further research is needed to explore the motivations for mixing different combinations of drugs together.

Over three-quarters of the sample reported using at least one of the six target substances to fulfil 11 out of the 18 functions. These findings provide strong evidence that young people use psychoactive drugs for a range of distinct purposes, not purely dependent on the drug's specific effects. Overall, the top five functions were to `help relax', `get intoxicated', `keep going', `enhance activity' and `feel better'. Each of these was endorsed by over 85% of the sample. Whilst all six substances were associated to a greater or lesser degree with each of these items, there were certain drugs that were more commonly associated with each. For example, cannabis and alcohol were popular choices for relaxation or to get intoxicated. In contrast, over 90% of the amphetamine and ecstasy users reported using these drugs within the last year to `keep going'. Using to enhance an activity was a common function amongst users of all six substances, endorsed by over 70% of ecstasy, cannabis and LSD users. Finally, it was mainly alcohol and cannabis (and to a lesser extent cocaine) that were used to `feel better'.

Several gender differences were observed in the combined functions for recent substance use. These findings indicate that young females use other drugs as well as cocaine as social supports. Using for specific physical effects (weight loss, sex or wakefulness) was also more common amongst young women. In contrast, male users were significantly more likely to report using at least one of the target substances to try to improve the effects of another substance. This indicates a greater tendency for young males in this sample to mix drugs than their female counterparts. Age differences were also observed on several function items: participants who had used a drug to `feel elated or euphoric' or to `help sleep' tended to be older and those who used to `stop worrying about a problem' were younger. If future studies confirm these differences, education programmes and interventions might benefit from tailoring their strategies for specific age groups and genders. For example, a focus on stress management strategies and coping skills with a younger target audience might be appropriate.

Some limitations of the study need to be acknowledged. The sample for this study was recruited using a snowball-sampling methodology. Although it does not yield a random sample of research participants, this method has been successfully used to access hidden samples of drug users [e.g. ( Biernacki, 1986 ; Lenton et al ., 1997 )]. Amongst the distinct advantages of this approach are that it allows theories and models to be tested quantitatively on sizeable numbers of subjects who have engaged in a relatively rare behaviour.

Further research is now required to determine whether our observations may be generalized to other populations (such as dependent drug users) and drug types (such as heroin, tranquillizers or tobacco) or if additional function items need to be developed. Future studies should also examine if functions can be categorized into primary and subsidiary reasons and how these relate to changes in patterns of use and drug dependence. Recognition of the functions fulfilled by substance use could help inform education and prevention strategies and make them more relevant and acceptable to the target audiences.

Structure of functions scales

Profile of substance use over the past year and past 90 days ( n = 364)

Proportion (%) of those who have used [substance] more than once, who endorsed each functional statement for their use in the past year

Combined functional substance use reported by the sample over the past year

Percentage of participants who reported having used at least one of the target substances to fulfil each of the different functions over the past year ( n = 364)

We gratefully acknowledge research support from the Health Education Authority (HEA). The views expressed in this paper are those of the authors and do not necessarily reflect those of the HEA. We would also like to thank the anonymous referees for helpful comments and suggestions on an earlier draft of this paper.

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• Alcohol and Drug Abuse in the Workplace Alcohol and drug abuse is one of the major causes of accidents in the workplace. Random alcohol and drug tests would discourage employees of organization from abusing alcohol or drugs.
• The Crisis of Drug Addiction This essay will focus on the crisis of drug addiction in general. It will also include some factors that lead to drug abuse. The paper will cover the dynamics of drug addiction in the USA.
• Classification of Legal and Illegal Drugs The classification of drugs as either legal or illegal provides a baseline foundation for the effect on victims and the attribute of addiction.
• Monopoly Drugs Versus Generic Drugs When a pharmaceutical company creates a new drug it may apply for and be granted a patent that is a legal protection that shelters an invention from being used, copied, or traded without permission.
• Drug Abuse in Homeless Community The number of homeless people is continuously increasing, creating a severe threat to a country’s general well-being.
• Victimless Crimes: Drug Abuse and Sex Work This work’s primary objective is to research and analyze victimless crimes, namely drug abuse and sex work, from the viewpoint of criminology.
• Apis Mellifica as a Homeopathic Drug for Headaches Homeopathy is one of the systems of alternative medicine. The paper investigates the effectiveness of using a homeopathic drug to address headaches.
• Social Problems Related to Alcohol and Drugs The present paper will explain the content of three articles relating to the issue of Alcohol and drug use while also providing a personal reflection on the readings.
• Drug and Substance Abuse: Sociological Causes and Explanations It is normal to think that drug and substance abuse affects only consumers. However, it also affects various aspects of society.
• Alcohol, Tobacco, and Illegal Drugs: Use Consequences Although tobacco, alcohol, and drugs cause severe physical and mental health problems and spoil a person’s social life, the image created for them contributes to harm devaluation.
• Shoppers Drug Mart Corporation’s Retail and Services Shoppers Drug Mart pays significant attention to the development of an efficient retail network that makes the business attractive to customers.
• War on Drugs: Fighting the Way We Are Not Likely to Win The spread of drugs is showing a steady growth trend; its adverse consequences are very multifaceted both for the drug addicts themselves and for the society in which they exist.
• Arguments For and Against Allowing Drug Use in Sports The main argument supporting the drug use in sports is that the drugs are medicines, improving the organism ability to mobilize its potential.
• The Link Between Drug Abuse and Corruption This paper discusses that drug abuse and corruption deserve attention. It introduces causes and reasons for drug abuse and corruption.
• Miami Drug Wars of the 70s and 80s Drug use is a subject that has raised controversies for decades. This paper focuses on the drug wars in Miami outlining their social, political, and economic impacts.
• Drug Dependency: Construction of a Rehabilitation Center Creating a program that would act as a foundation to help drug addicts recover from drug usage would help lessen drug dependency.
• Drug Addiction: A Choice or a Medical Disease? This article examines two opposing points of view on the problem of drug addiction – does a person have a choice to be a drug addict or is drug addiction a medical disease?
• Why Government Needs Drug Control Policy? The use of stopping drugs trafficked to or through the US territory should be evaluated since it usually causes strained relations from the countries where the drugs originate from.
• The Theme of Drug Abuse in Egan’s Book In her novel “A Visit from the Goon Squad”, Jennifer Egan discusses a number of problems of modern society. Among them is the problem of drug abuse.
• Drug Enforcement and War on Drugs “War on Drugs” has both positive and negative impact on criminal justice, creating certain stereotypes and putting pressure on the law enforcement agencies.
• Adolescent Drug Abuse, Their Awareness and Prevention This essay provides a critique of an article written by Chakravarthy, Shah, and Lotfipour about adolescent drug abuse prevention interventions.
• The Use of Performance-Enhancing Drugs The information herein identifies particular risk factors that expose the global community to the objectionable concerns linked with the goods.
• Social Factors of Substance Drug Abuse Substance abuse refers to the pattern of continued use, despite adverse consequences. Socio determinants of substance abuse imply social factors that affect the outcome of drugs.
• Drug Abuse Relation to the Violent Behavior Various groups of drugs greatly vary and relate to violence in different ways. Any person with heavy drug habits may act negatively and involve in violent acts punishable by law.
• Drug Theme in “Sonny’s Blues” by James Baldwin In the story “Sonny’s Blues” by Baldwin, Sonny’s friend felt responsible for what was happening to Sonny because he told him that taking heroine felt great.
• Drug Courts Policy and Its Evaluation Drug courts mark a considerable approach in the struggle to combat drugs. This paper gives a clear description and analysis of the drug court program since the 1980s.
• Drug Abuse and Alcohol-Related Crimes in Adolescents The current paper focuses on the topic of drug abuse and alcohol-related crimes among teenagers, showing that substances remain the most notable factor in juvenile crime.
• How Can Illegal Drugs Be Prevented From Entering Prison?
• Can Economic Aid Make a Difference in the Flow of Drugs?
• Are Novel Drugs Riskier for Patients Than Less Novel Drugs?
• Can the Drugs Problem Be Tackled Primarily Through Legal Enforcement?
• Do Drugs Are Barriers to Our Future?
• Are Anabolic Steroids Really Pernicious Deleterious Drugs?
• How Can Kids Best Be Convinced Not for Do Drugs?
• Have Newer Cardiovascular Drugs Reduced Hospitalization?
• Are Illegal Drugs Inferior Goods in the U.S.?
• How Dangerous Are Drugs?
• Are Psychotherapeutic Drugs Overprescribed for Treating Mental Illness?
• How Dangerous Are Drugs and What Can We Do About the Drug Problem?
• Are Drugs Taking Away the Excitement in Sports?
• How Antidepressant Drugs Work Effect Us?
• Does Medicaid Pay Too Much for Prescription Drugs?
• Are Drugs More Detrimental to Educational Attainment?
• Are Diet Drugs Are Safe for People?
• Can Pharmacogenomics Improve Drugs Safely?
• Does Price Reveal Poor-Quality Drugs?
• How Are Biosimilar Drugs More Extensive Than Those of Generic?
• Are Illegal Drugs Inferior Goods?
• Does Previous Marijuana Use Increase the Use of Other Drugs?
• How Are Drugs and Alcohol Affecting the Teenagers?
• Are Any Drugs Derived From the Ocean Presently Approved?
• Are the More Educated More Likely to Use New Drugs?
• Does Coffee Contain Drugs?
• Has the Time Come to Legalize Drugs?
• How Cost-Effective Are New Cancer Drugs in the U.S.?
• Are Adolescents With Abusive Parents at a Greater Risk of Abusing Drugs?
• Can Production and Trafficking of Illicit Drugs Be Reduced?
• Canadians’ Reaction to Alcohol as a Newly-Invented Illicit Drug The possible reaction of Canadians to alcohol, if it was a newly-invented illicit drug, will differ depending on their personal characteristics and external circumstances.
• Drug Addiction: A Disease or a Choice? Drug addiction remains a serious health concern for contemporary society. The problem of whether drug addiction can be viewed as a disease or a choice remains topical.
• Consumption of Illicit Drugs in the United States Tackling the drug problem in America requires a two-pronged strategy that focuses on the demand and supply side of the problem.
• Cause and Effect of Drug Addiction As a result of drug misuse, there are changes in the functioning of neurological pathways in the human brain, with the associated physical; and mental health deterioration.
• The Effects of Drugs on a Man’s Reproductive System In this article, the author examines the reasons why drug and alcohol abuse negatively affects the reproductive health of men.
• Juvenile Drug Abuse Problems Analysis This essay describes the problem of juvenile drug use and applies the relevant delinquency theory. Additionally, the interventions or programs to fix the issue will be highlighted.
• The Relationship Between Drugs and Addiction to Crime Systemic crime emerges from the arrangement of drug circulation. It includes conflicts over the region in rival drug traders, attacks, and executions committed in involved groups.
• Drug Abuse and Its Effects on Families Because of the lack of control that a substance abuse patient has over their actions, families of the people that develop chemical dependency are under constant threat.
• Drug Interactions Prevention in Nursing Guidelines The Centers for Disease Control and Prevention developed new guidelines to dictate how and when medications should be provided.
• Nurse Practitioner as a Drug Prescriber Nurse Practitioners have a plethora of professional duties in their schedules that they are obliged to follow. This paper presents issues of a nurse practitioner as a prescriber.
• Drugs and Substance Abuse in College: Effects and Treatments The paper will give a review of a treatment approach to drug abuse and describe the effects of substance abuse on a person who is in college.
• Pharmaceutical Industry: Drug Development Drug development is a lengthy process but rightly so since the result should be playing a curative role and not disease inducer.
• How Drugs Influence the Crimes This essay discusses five major questions about ‘Drug and Crimes’, namely, what is the extent to which the drug subculture influences criminal behavior?, etc.
• “Should Drugs Be Legalized?” by William Bennett The war against drugs in the United States has reached a new level. Such an outcome is conditional upon the recent measures that politicians are discussing.
• Drugs in Perspective: Models of Addiction The moral model of addiction is a notion that has very little in common with biological or genetic components of addiction. The disease model of addiction is a lifelong addiction.
• Psychotherapy and Counseling for Drug Abuse Treatment Drugs are the biggest vice of humanity, along with the mental and moral deviations, horrible diseases of modern times, social neglect and abuse it causes and goes along with.
• Performance Enhancing Drugs Legalization in Sports The question that was going to be answered through various arguments in this paper was whether these drugs should be legalized.
• Drugs: Myths and Misconceptions Starting from the very beginning of the twentieth century and ending even today, drugs as a topic have been surrounded by a mass of myths and misconceptions.
• Effects of Drug Use on Society Every society encounters a variety of problems that it needs to address, and one of the most common is drug use among the population.
• Media Misinformation About Drug Use The United States is one of the countries with the strictest policies, rules, and regulations against the peddling and abuse of illicit drugs.
• Causes and Consequences of Alcohol and Drug Addiction Drug addiction is a psychological and physical disorder that affects the brain of an individual. It is caused by dependence on drugs, alcohol, and specific behaviors.
• Therapeutic Drug Monitoring (TDM) Assays Therapeutic drug monitoring (TDM) refers to the measurement of chemical or biochemical parameters in the lab to inform drug prescribing procedures.
• Public Policies Related to Drug Addiction Public policies related to drug addiction need to be enforced in a compassionate manner that pays attention to the unique needs of American society.
• Drugs and Social Life in Iceland The nature of drug use in Iceland can be described as experimental — young people see something new in them and decide to try it out.
• National Association for Alcoholism and Drug Abuse Counselors This paper will consider the fourth principle of the organization’s ethical code, which reads: “Working in a culturally diverse world.”
• Drug Testing in Pharmacology The aim of this paper is to analyze and review drug tests within the population of third-world countries and define whether these trials are ethical.
• The Practice of Nursing Research: Drug Round Tabards The study has several implications for hospitals and nurses involved in medication distribution. It demonstrates that the implementation of drug round tabards is worth attention.
• Carl Hart’s Talk on Racism, Poverty, and Drugs In his TED Talk, Carl Hart, a professor of neuroscience at Columbia University who studies drug addiction, exposes a relationship between racism, poverty, and drugs.
• Drug Testing Problem Reflection The paper discusses a need for the maintenance of a drug test policy. In the present world, this issue is further exacerbated by the legalization of marijuana in all states.
• Criminalizing Drug Usage: Effects and Consequences This paper critically examines the views that criminalization of drug use leads to greater social problems and harms individuals.
• Drugs and Drug Related Crimes Obviously the current strategy of the government isn’t working and it is backfiring. The government needs to do something new.
• Drug Abuse Case: Jenny G This paper present the case of drug abuse. Jenny G., a 48-year-old recovering IV drug abuser, presents with general malaise, anorexia, abdominal pain, and slight jaundice.
• Nurse Misconduct and Drug Diversion as Legal Issue The paper analyzes the case of nurse misconduct associated with drug diversion and identifies improvement strategies to avoid the problem in the future.
• Fear Appeal in Anti-Drug Abuse Public Campaign The problem of prescription drug abuse has become a crucial concern for Florida residents. The public campaign proposes raising awareness about the dangers of prescription drugs.
• Drug-Drug and Food-Drug Interactions Drug-drug interactions occur when a medicine interferes or affects the activity of a second drug when administered together.
• Crisis of Chemical Dependence: Drug Abuse Drug abuse mainly begins during teenage. The first part of this essay discusses social and cultural determinants of substance abuse. The second part focuses on the dynamics of addiction.
• Drug Abuse and Its Impact on Creativity The boosting effect of drugs on creativity is a myth because changes in thinking are a brain reaction to a narcotic that is temporary yet severe.
• Sexually Transmitted Diseases Transmission Involving Drug Use Preventive techniques need to target drug addicts and sex workers to combat the STD epidemic and offer interventions to reduce risky sexual behaviors and drug use.
• Psychotropic Drugs Usage, Effects, Consequences Numerous aspects determine the effectiveness of drug therapy with psychotropic medication, for example, the appropriateness of the choice of pills for the disease.
• Drug Misuse and Its Effects on Children Health and body functioning are negatively affected, and the condition may manifest itself in drug dependence or an array of other harmful and problematic behaviors.
• The legalization of recreational marijuana: pros and cons.
• Should drug users be criminalized or treated?
• Are drug companies liable for the opioid crisis?
• Are safe injection sites effective in preventing drug overdoses?
• The gateway drug theory: reality or a myth?
• Are mandatory minimum sentences for drug offenses justified?
• The impact of zero tolerance drug policies in schools.
• The therapeutic potential of psychedelic substances.
• Why is drug testing essential in the workplace?
• Should drug education programs be mandatory in schools?
• Drug Legalization: Arguments For and Against Some people would say that the U.S. should stop the war on drugs because this war caused enormous imprisonment of small-time drug dealers.
• Analysis of Drug Classification The article argues drug reactions depend considerably on patients and administration methods, that’s why employees must know the basics of drug classification.
• Patient Rights to Experimental Drugs The paper discusses why patients should have the right to decide if they would like to use drugs that have not been proven effective when there are no other treatment options.
• Doctors’ Knowledge on Drug Prescription The reason why doctors have little knowledge of the drugs they prescribe is misplaced priorities during clinical trials.
• Drug Abuse in the United States’ Social Context Drug abuse is one of the problems affecting people in the United States. Society has contributed to the continued misuse of drugs today, through bad parenting or the environment.
• Quality Patient Care: Drug Errors and Nurses The role played by nurses in patient care cannot be underestimated and therefore any idea that can make it even better is something that should be highly encouraged.
• Legalization of Marijuana and Other Illegal Drugs The essay relates both the pros and cons of legalizing drugs, but since there is a solid argument for both sides, a conclusion cannot be reached unless more research is conducted.
• Research Drug Safety Approaches Adverse effects of drugs implemented in certain treatment and care plans began to be noted a long time ago by health care specialists and scientists.
• Criminal Justice System: Drugs and Crime The main objective of the criminal justice system is ensuring delivery of justice for all. It mainly concentrates in detection of crime.
• Mechanism of Action and Clinical Application of Antiviral Drugs Acquired immunodeficiency syndrome was first reported in 1981 by the Centers for Disease Control, with the identification of the HIV-1 as the causative agent.
• Pharmacology: Drug Licensing Opportunity Obtaining a license for a new drug is a very costly and time consuming affair. Any pharmaceutical company would have to weigh all its options before embarking on such a process.
• Criminal Justice Ethics: Police Corruption & Drug Sales The growth of police corruption instances involving drug sales is relatively easy to explain. The financial rewards offered by the sales of illegal drugs are enormous.
• Mandatory Drug Testing for Welfare Recipients Mandatory drug testing should be implemented in the US to ensure that taxpayer money is allocated to the assistance of socially and economically disadvantaged persons.
• War on Drugs Through a Socio-Political Framework Drug addiction is a problem that concerns not only the health of particular members of society suffering from this disease but also the country as a whole.
• Drug Use and Heroin Addiction: Informative Speech The illegality of drugs makes it impossible to research the actual numbers of people using drugs and situations making these persons initiate drug abuse and harm their health.
• The Drug Enforcement Administration Business Model This paper evaluates the business canvas of the Drug Enforcement Administration and provides recommendations for the improvement of cooperation with partners.
• The Phenomenon of The Use of Prescription Drugs The need to have a prescription before the drugs are acquired is usually applied in order to prevent illegal distribution, and effective use of such medicine.
• Drugs and Prison Overcrowding There are a number of significant sign of the impact that the “war on drugs” has had on the communities in the United States.
• Alcohol and Drug Foundation’s Public Relations The campaign conducted by Alcohol and Drug Foundation is a vivid example of how the theories and practices of PR can help alter people’s behavior.
• Drug Misuse, Abuse, and Their Factors Addiction is a recurrent, chronic disorder characterized by compulsive substance seeking and use despite harmful consequences.
• War on Drugs: Causes and Problems Ever since a declaration on the war on drugs was made a few decades ago, arguments have not been far off. Top on the list of these disputes has been the issue of drug legalization.
• Trade and Usage Control: Drug Enforcement Administration The paper looks into the history of the drug enforcement agency, the factors that led to its formation, its goals, and its comparison with the federal bureau of narcotics.
• Reality in Drug Addiction Research: Ethnography Ethnography as a research method is the most suitable for the study of drug use. The method has already has established itself as effective in studies of closed groups.
• Mexican Drug Cartels: A Transnational Threat Mexican drug cartels have grown into a network of efficient and compartmentalized gatekeepers that control the drug trade from Mexico to the United States.
• Drug Addiction Is a Chronic Disease Drug addiction is a disease that can be considered chronic in nature and relies heavily on the influence of hereditability, environmental conditions.
• Violence in the 20th-Century Latin America: Colombian Drug Wars, Dictatorship in Chile, and Undiscovered Personal Tragedies Creating a political environment that is fully devoid of violence is barely possible since there will always be war profiteers who will spur the development of confrontations.
• E-Prescribing Drug Technology in the Healthcare Drug prescriptions are one of the most complex healthcare delivery aspects, vital for the treatment process, and require significant resources to ensure safety.
• Drug Prescription Policy Analysis Prescription drug policy is a highly relevant topic dealing with both clinical practice and public health. The abuse of prescription drugs has reached epidemic levels recently.
• Brain Gain: The Underground World of Neuroenhancing Drugs In “Brain Gain: The Underground World of Neuroenhancing Drugs” published in The New Yorker, Talbot describes the harsh reality of young people in academia who take off-label drugs to keep up with their hectic schedules.
• Eli Lilly and Company: Drug Firm Analysis Eli Lilly and Company is an American drug firm whose head office is situated in Indianapolis. Eli Lilly and Company cares about its clientele by monitoring the benefits and risks of its drugs.
• Drug Addiction among Nurses The United States of America has one of the best healthcare systems in the world. Drug abuse among nurses is a serious problem that threatens the quality care that is offered.
• Drugs and Jazz in James Baldwin’s “Sonny’s Blues” In his short story Sonny’s Blues, James Baldwin uses drugs and jazz music as both literal concepts and metaphorical images to portray the suffering of African Americans.
• The Issue of Misuse of Prescription Drugs The paper discusses the growing problem of prescription drug abuse in the United States, its consequences such as addiction and overdose, and possible solutions.
• Drug Abuse During Pregnancy: Policy Options Heated discussions on whether or not drug abuse during pregnancy should be illegal due to the potential risks to the developing fetus or child persist.
• Disclosure and Nondisclosure in Drugs Prescription The case focuses on the ethical and legal implications of prescribing new medication currently in the development stage for a child under the age of 12.
• Illegal Drug Use in Nurses: Discussion There are reasons why nurses are at risk of developing a drug addiction, which means that there is a high chance for practitioners to work with nurses who illegally use drugs.
• Leadership in Drug Abuse Program Development Within the context of a potential intervention for drug abuse, the roles and competencies of leaders are the primary emphasis of this paper.
• Drugs and Violence Go Hand in Hand From the point of view of American researchers, substance abuse increases the chances of subjects being drawn into conflict relationships.
• Alcohol in the Drugs and Behavior Context It is no secret that alcohol and human health are incompatible things. The most significant influence of alcohol falls on the cerebral cortex.
• Illegal Drugs: Types and Influences Illegal drugs include substances that affect the body and the brain of a person. They are divided into several groups, depending on the method of use and the impact on the brain.
• The war on drugs: the causes of its failures.
• The impact of the war on drugs on minorities.
• The link between the war on drugs and mass incarceration.
• Alternatives to the war on drugs.
• The war on drugs and human rights violations.
• The economic costs of the war on drugs.
• The effects of the war on drugs on drug prices and availability.
• The impact of drug prohibition on drug use patterns.
• The influence of the war on drugs on drug-producing countries.
• Unintended adverse effects of the war on drugs.
• Wellbutrin and Lexapro: Drugs Affecting Neurotransmitters Wellbutrin and Lexapro are effective drugs in the fight against depressive disorder. However, the drugs are addictive.
• Drugs and Behavior: History of Alcohol in America The ordinary colonial American drank roughly twice as much alcohol in 1770 as it does today—about three and a half gallons annually.
• Incretin Mimetic Drugs for Type 2 Diabetes In patients with type 2 diabetes, there is a significant decrease in the incretin effect and a decrease in insulin secretion in response to an oral load.
• Drug Addiction: The Brain Disease Drug addiction acts similarly to neurological diseases. Substances directly affected the brain, with addiction being the most acute phase of substance use disorder.
• Random Drug Testing at the Workplace Employees in law enforcement, public health and safety, and national security should all be subjected to random drug testing.
• Drug Errors: Enhancing Care Quality and Safety Though numerous new technologies have been developed to improve healthcare delivery, drug errors continue to be an issue in the United States.
• Drug Repurposing in Cancer Treatment This article examines the concept of drug repurposing in the context of pharmaceutical companies’ innovation policy: the methods and economic feasibility of repurposing drugs.
• A Right to Experimental Drugs It is necessary to examine whether terminal patients have a moral right to the experimental treatment and suggest possible outcomes for this type of cure.
• Economic Evaluation: Prevention of Suicide and Drug Overdose The economic evaluation of the provided scenario was conducted in four dimensions: cost-of-illness, programmatic, benefit-cost, and cost-effectiveness analyses.
• The War on Drugs in the United States The United States government’s combat with substance abuse is called the “War on Drugs,” addressing the campaign initiated by President Nixon.
• STDs Transmission Involving Drug Use This paper draws a hypothesis suggesting that preventive techniques need to specifically target drug addicts and sex workers to combat the STD epidemic.
• Drug Addiction and Best Treatment Practices This paper will determine the role of treatment in the recovery process and analyze the best evidence-based practices.
• Zero Discrimination for People Who Use Drugs From all of the above, it follows that HIV-infected prisoners should have the same access to timely and high-quality medical care as the population.
• The Drug Abuse Problem in Indiana Drug usage is one of Indiana’s most serious societal problems, affecting the state’s health, economy, behavioral, and criminal elements.
• The Effect of an Antimicrobial Drug on Gene Expression This paper critically evaluates methods and techniques that can be used to assess the effect of an antimicrobial drug on global gene expression.
• Drug Addiction as Moral Failure The paper shows that drug abuse cannot be viewed as a moral failure. Kuhar’s scientific examinations made him come to that conclusion.
• The Ethical Side of Drug Patents In modern times, the property is no longer strictly bound to any physical representation since it can also be intellectual and intangible.
• Overcoming the Drug Abuse Addiction The use of narcotic drugs brings irreparable harm to health and diminishes the quality of life. Opioid abuse is a predominant problem that continues to be a concern.
• The Problems of Drug Misuse and Abuse and Their Management This research aims to determine the best ways to prescript drugs, the importance of drug interactions, and the potential dangers of drug abuse.
• The Anti-Drug Programs in Boston The history of drug abuse across the US has been a challenge for decades. There were various anti-drug programs introduced in Boston to curb the spread of its use in the city.
• Drug Prescription Issues and Abuse This paper aims to determine the best ways to prescript drugs, the importance of drug interactions, and the potential dangers of drug abuse.
• History of Drug Use in Incarceration The history of drug use in prisons go beyond 2008 with some documents indicating a steady rise in drug use between 1980 and 2008.
• Rohypnol and Illegal Drugs in Clinical Trials The current paper discusses Rohypnol. It is a generic drug known as flunitrazepam which contains lorazepam, diazepam, and alprazolam.
• A Spontaneous Reporting System for Drug Safety Surveillance Post-marketing in clinical trials uses a spontaneous reporting system for drug safety surveillance where potential AEs induced by the drugs are detected.
• The Influence of Drugs and Alcohol on Date Rape While drugs can affect mental health and make the victim forget everything, the perpetrators indulge in alcohol abuse to escape the blame and deny non-consensual sex.
• Drug Abuse Demographics in Prisons Drug abuse, including alcohol, is a big problem for the people contained in prisons, both in the United States and worldwide.
• Drug-Resistant Mycobacterium Tuberculosis Strains As with any other infectious disease, TB exhibits specific signs and symptoms that help distinguish it from other illnesses.
• Correlation of HIV, AIDS in White Males Who Are Injection Drug Users The testable hypothesis for this work states that socioeconomic status is correlated with HIV/AIDS in white males who are injection drug users.
• Assessment and Therapeutic Approaches for Drug Addiction Clients The paper uses various drug addiction assessment methods to examine the severity, give clinicians insight into the problem and assist in psychotherapy.
• COVID-19 Epidemic and Alcohol and Drug Addiction The sudden life changes during the COVID-19 epidemic make it difficult for people who suffer from alcohol and drug dependence to fight their addictions.
• High-Level Drug Trafficking in Australia Media articles explain the problem of narcotics trafficking across the Australian border. Australia is an effective participant in international drug trafficking organizations.
• Drug Addiction and Stigmatization The horrifying nature of stigmatization is one of the perplexing factors of drug addiction, so society should understand the role of mental and physical help for such people.
• Drug Addiction: Analysis of Goeders and Guerin Research Goeders & Guerin (1994) point out that anxiety and stress may be involved in drug use and increased risk of dependency, as these are involved in the etiology of cocaine use.
• COVID-19 and Drugs at Schools as Public Health Issues This paper discusses two articles on community and public health issues, specifically, concerning COVID vaccination and drugs at schools.
• Drugs for Neglected Disease Initiative There is a significant unmet need for the treatment of many neglected diseases, as well as for patient groups impacted by these.
• Negative Effects of Drugs on Voice The essay explores the influence of drug intake on the singer’s voice and illustrate the importance of the topic for the singer’s vocal cords maintenance.
• Drug Abuse at the Workplace and a Policy to Address It In this proposal, a policy to address worker substance abuse and addiction, will be discussed, with both its major goals and potential benefits being outlines.
• Act Liability for Price-Fixing of Generic Drugs The United States Department of Justice reported that Apotex Corporation, among other drug manufacturers, paid over $400 to settle violations of the False Claims Act.
• The Emergence of Drug-Resistant Pathogens The drug-resistant pathogens phenomenon has endangered the efficacy of drugs such as antibiotics which have helped transform modern medicine and saved countless lives.
• Non-Performance Enhancing Drugs in Sports The use of drugs is prohibited in professional sports. As for the drugs that do not improve performance, they also require control.
• Forensic Drug Analysis Course: Reflection
• The Adverse Consequences of Substance Use Tool and the Psychoactive Drug History
• Vaccine and Antiviral Drug Supply and Distribution Problem
• Drug Addiction Treatment & Benchmark Program
• The Mexican Drug War and “Queen of the South”
• Improving Drug Administration in Healthcare Facility
• Decriminalizing the Simple Possession of Illegal Drugs
• Law Enforcement of Drug Business on the Demand Side
• Evaluating Harm Reduction Program for Drug Users
• Effects of the War on Drugs on Latinos in the US and the Role of Stereotypes
• Drug Cartels in Mexico: Definition, Background, Mexican War on Drugs
• The Food and Drug Administration (FDA) and Globalization
• Six Stages of Change: Treatment Approaches for Drug Addiction
• Types of Drugs and Types of Domestic Abuse Correlation
• Drug Production During Crisis: The Case of COVID-19
• High U.S. Drug Prices: Health Policy Log
• Why Adolescents Take Drugs: Human Development
• Prescription Drug Abuse Problem
• The Influence of Drugs and Social Media
• Drug War in Border Cities: Causes and Consequences
• Court Decisions on Drug Offenders
• Drug Use and Addiction Correlations
• Support for the Legalization of the Drug Consumption
• Drug and Alcohol Addiction Treatment Program
• Analysis of Drugs in American Society by E. Goode
• Mandatory Drug Tests for Nursing Students
• Male Health Drugs:Overview and Effects
• Alcohol and Other Drug Use Among the Aboriginal and Torres Islander People
• The Problem of Legalizing Drugs
• Anti-Drug Abuse Act of 1986: Crack vs. Cocaine Sentencing Disparity
• The Effect of Prohibition Alcohol and Drug Use
• Escalating Drug Prices: Solution to the Problem
• Drugs and Alcohol Influence on Drivers
• How Liquid Chromatography and Mass Spectrometry is Used in Drug Screening
• Random Drug Testing: Pros and Cons
• Drugs in the Modern Sports
• Drug Issues in Watertown, New York
• Accessory Plus Incorporated’s Drug Abuse Case
• Racism, Racial Profiling and Bias in the War on Drugs
• Children Insecurity in the Context of Mother’s Drug Misuse
• Variables That Impact Sentencing Decision of Judges in Drug Offender Cases
• The Drug Trafficking as Organized Crime
• The Effectiveness of Drugs in Medicine
• Drug Trafficking and Terrorism in the Middle East
• Drugs and Crime Committed Under the Influence
• Combating the Local Drug Distribution in Missouri
• Colombian and Mexican Drug Cartels and Their Impact in the U.S.
• Prescription Drug Abuse as a Community Health Issue
• Crime Trends: Drug Abuse in Adults and Juveniles
• Substance Abuse: Alcohol and Drugs in the Movie “Ray”
• “Addicts Who Survived” by David Courtwright: American Addiction to Narcotics Problem and Anti-drug Policies
• The Interrelationship Among a Bacterial Pathogen and Antimicrobial Drugs
• Should All or Certain Drugs Be Legalized?
• Drug Release: Ethical Dilemma in Pharmaceutics
• Drug Abuse in Correction Facilities
• Distribution of Fake Drugs: Analysis of a Criminal Case
• Medication Safety and Drug Therapy Process
• Reducing the Number of Adverse Drug Events Among Older Adults: An Action Plan
• A Study of Drug Allergy, Iron Poisoning and Abnormal Bone Mineral Metabolism
• Federal Food, Drug, and Cosmetic Act Amendment
• The Role of Forensics in the War on Drugs
• Schizophrenia Treatment With Approved Drug
• Drugs and Crime Description: Federal Drug Statutes
• Patients Receiving Antipsychotic Drugs: Neuroleptic Syndrome
• Reducing Adverse Drug Events Among Older Adults
• The U.S. Drug Prices Assessment
• The Drug Courts: The Question of Drug Abuse
• Judicial Process in Drug Offender Cases: Research Design
• Drugs for Treating Schizophrenia and Mood Disorders
• The Importation of Drugs into the United States
• Drug Courts and Criminal Courts Compared
• Regulation of Drug Compounding
• Americcan College of Radiology Protocol and Cancer Therapy Response to Antiangiogenetic Drug
• Community Health: Prescription Drug Abuse
• The Concept of the “War on Drugs”
• Two Acts on Drug Law Comparison
• Drug Addiction: Elimination of Incarcerations
• Health Issue Analysis: Prescription Drug Abuse
• Juveniles and Drugs in the US
• The Control the Availability of Illicit Drugs
• “Addicts Who Survived” by David Courtwright: Crucial Work on Drug Addiction
• Pharmacogenomics Impact on Individual Drug Effectiveness
• Drug Use and Biological Development in Adolescents
• The Drug Abuse in the U.S. Navy: The Problem Analysis
• The High Cost of Specialty Drugs
• Overmedication of Children With Psychotropic Drugs
• Misguided Perception of Drug Addiction
• International Drug Policy in Russia and the US
• OxyContin as a Legitimate Drug and a Drug of Abuse
• Drug Dealing on College Campuses
• Drug Trade. “Crack” Book by David Farber
• Combating the Local Drug Distribution
• Drug Abuse Factors: Substance Use Disorder
• Prescription Drug Cost Transparency
• Effects of Drugs on the State of Consciousness
• Response to a Journal Article on Drug Control Policy
• A Right to Experimental Drugs
• Ilaris(R)-Drug Usage in U.S. and Australia
• The Problem of Increased Morbidity From Adverse Drug Events in Older Adults
• Drug Abuse and Addiction: Risk Factors
• Bacterial Cells and Chemotherapeutic Drugs
• Detention of a Minor While Using Drugs
• The Relations Between Drug Abuse and Criminal Justice
• Cocaine as a Drug Chosen for Medical Research
• Drug and Alcohol Abuse in Organizations
• Specialty Drugs Costs and Insurance
• Legalization of Marijuana: The Pros and Cons of the Drug
• Drug Abuse: Impaired American Society
• The Issue of Drug Abuse in the Community of Kinsburg
• Caffeine and Performance of Drugs in Adolescents
• Adolescent Drug Abuse: Diagnosis and Cultural Awareness
• Support Services and the Case Review: Drug and Alcohol Addiction
• Health Reform Bill on Drugs in the United States
• Research Design for a New Drug That Reduces Appetite
• The Money Factor in Drug and Alcohol Treatment
• The Problem of Prescription Drug Abuse in the United States
• Performance Enhancing Drugs and the Student Athletes
• A Health Issue Analysis: Prescription Drug Abuse
• Clandestine Drug Laboratory Dangers
• Drug Use, Dealing and Violence
• Global Trends Affecting a Local Drug and Alcohol Rehab Centers
• Drugs to Wipe Out Traumatic Memories
• Information Technology and Mexican Drug Cartels
• Investigating the Issue of Drug Trafficking Through the Points
• Profession of US Drug Enforcement Agent
• Random Drug Test on College Athletes
• Drugs and Society Violent Crime: Public Drunkenness
• Opioid Drug Regulation: Legislative Letter
• American Prohibition and the War Against Drugs
• Drug Abuse and Drug Addiction and Various Policies Related to Drugs
• Drug Abuse and Crime Correlation
• Mandatory Job Drug Test Should Be Allowed
• Drug Addiction: The Problem of Xanax Abuse and Its Consequences
• Physical Privacy and Drug Testing
• Sports Violations: Drug Use in Baseball
• Anti-Drugs, Alcohol and Tobacco Education Programs
• Food and Drug Administration History
• “Blood for Sale” and “Drug Dilemmas”: Articles Reviews
• Legalizing Drugs, an Irrational and Harmful Choice
• Drug Abuse Among Teenagers
• Mifepristone Drug: To Approve or to Disapprove?
• Prescribed Drugs With Complementary and Alternative Medicines
• Current Sources of Evidence-Based Standards and Guidelines for Prescribing Psychiatric Drugs
• Drug Trafficking: Investigation on Frank Lucas
• Law: Drug Treatment and Testing Orders
• Drug Use in the Workplace: The Case of Acme-Antiroadrunner Inc.
• Computerized Provider Order Entry Against Drug Errors
• Drug Monitoring and Florida’s State Strategies
• Prescription Drug Misuse in Elderly Patients
• Improper Drug Administration as a Nursing Practice Issue
• Food and Drug Administration – Regulatory Agency
• Organized Crime and Drug Trafficking Offenders
• Soderbergh’s Traffic and the U.S. War on Drugs
• Public Policy Meeting: Prescription Drug Supply and Cost
• Health Policy: 340B Drug Pricing Program
• Drug-Dealing Organizations in Latin American Politics
• Drugs and Society: Drug Use and Its Impact on Culture and Society
• Random Drug Testing in Schools
• Psychoactive Drugs, Society, and Human Behaviour
• Black Theology and Its Impact on Drug Addiction
• Drug and Alcohol Abuse Treatment Effectiveness
• Drug Trafficking Reduction in the United States
• Undercover Police Investigations in Drug-Related Crimes
• “Adolescent Alcoholism and Drug Addiction” by Choate
• Behind the War on Drugs
• Drug Test on Welfare Recipients
• Nonsteroidal Anti-Inflammatory Drugs and Aspirin
• Drug Abuse Treatment in Nursing
• Pramlintide as Anti-Diabetic Drug
• Antiseizure Medications and Antipsychotic Drugs
• Addressing the Growing Cost of the Prescription Drugs
• Pharmacy and Policy: Inappropriate Prescription of Drugs
• Teenage Drug and Substance Abuse
• Drug Abuse Among Homeless People in Miami
• The Problem of Drug Use and Heroin Addiction in US
• Using Free and Secure Trade to Smuggle Drugs
• Food and Drug Administration Fast-Track Approval
• Computerized Entry of Drug Prescribing Order
• Healthcare Financing and Drug Addiction
• Ethics of Abortion and Over-the-Counter Drugs
• Drug Therapy: Nicotine Interference with Contraceptives
• Drugs Comparison: Montelukast, Flovent and Albuterol
• Prescription Drug Use in the United States
• Drug Safety Approach in Advanced Nursing Practice
• Drug Abuse, HIV/AIDS, and Songs on Social Issues
• Drug War Failure and Associated Problems
• Adverse Drug Events: Evidence-Based Project
• Miami-Dade Community Needs: Alcohol and Drug Addiction
• Can Hospitals Manufacture Drugs in the US?
• Prescription Drugs Prices and Services in Florida
• Female Drug Abuser’s Recovery Care Plan
• Nonmedical Use of Drugs and Negative Sexual Events
• The War on Drugs and the Corrections System
• Drug Dependency and Behavioral Addictions
• Casinos: Occupational Safety and Drug-Free Workplace
• Drug Safety Approach in Administration and Nursing
• Adverse Drug Events and Nurses’ Awareness
• Drug War’s Impact on the US Correction System
• American Drug War and Its Ineffectiveness
• How Mexico Drug Cartels Are Supporting Conflicts?
• Sentencing Policies on Drug Offences
• Drug Dealing Reasons in East Harlem, New York City
• American Great Wall to Reduce the Number of Illegal Immigrants and Illegal Drugs
• Analysis of Extensively Drug-Resistant Tuberculosis: Characteristics, Treatment and Prevention
• Illicit Drug Use Among American Youths
• Minimizing Prescription Drug Abuse in Oklahoma
• Performance Enhancing Drugs and Professional Sport
• Sociology: Prevention of Alcohol and Drug Problem
• Drug’s, Poverty’s and Beauty’s Effects on Health

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StudyCorgi. (2021, September 9). 419 Drugs Essay Topics & Research Questions + Examples. https://studycorgi.com/ideas/drugs-essay-topics/

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StudyCorgi . "419 Drugs Essay Topics & Research Questions + Examples." September 9, 2021. https://studycorgi.com/ideas/drugs-essay-topics/.

StudyCorgi . 2021. "419 Drugs Essay Topics & Research Questions + Examples." September 9, 2021. https://studycorgi.com/ideas/drugs-essay-topics/.

These essay examples and topics on Drugs were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on January 22, 2024 .

98 Research Paper Topics On Drugs You Can Use

Nov 7, 2022

Nov 7, 2022 | Topics

The term drugs refer to any substance that has a physiological effect when ingested or otherwise introduced into the body. Drugs are used for medical purposes, such as pain relief, and they can also use them recreationally. Drugs are a big part of our culture and society. There is a lot of stigma surrounding drug use, but the reality is that most drugs aren’t as dangerous as they are made out to be. Many people use drugs responsibly or even occasionally without causing any harm whatsoever.

Check out this list of research paper topics on drugs to help you get started on your next project. These ideas are based on current research and will help you write a great paper.

Best Research Paper Topics On Drugs

• The Impact of Drugs on Society
• The Psychology of Drug Use
• Drugs and the Brain: How They Work and What Effects They Have
• How Drugs Affect Your Life: A Personal Account
• The Effects of Drugs on the Body
• The Legalization of Marijuana in the United States
• How Parents Can Help Their Children Avoid Drug Use
• Why We Need to Eliminate Drug Trafficking in Our Cities
• The History of Drugs in America
• The Effects of Drugs on the Brain
• Legalizing Marijuana – Pros and Cons
• Prescription Drug Abuse
• Marijuana: What Does Research Say?
• Drugs and the Environment
• Cannabis: The Medical Benefits and Risks
• The History of Drug Use in America
• The Pros and Cons of Legalizing Drugs
• Pros and Cons of Drug Addiction
• The Effects of Drugs On Society
• How To Get A Drug Off Your Resume
• A Study Of The Largest Drug Ring In History
• Addictions: From Marijuana To Methamphetamines
• The Art Of Escaping Your Problems With Drugs

Interesting Research Paper Topics On Drugs

• What Is Addiction?
• The Effects Of Drug Use On Families And Friends
• Marijuana As A Gateway Drug: Fact or Fiction
• How Drugs Are Classified In The United States And Around The World
• The Effects Of Drug Use On The Brain
• How Does Addiction Happen?
• The Pros And Cons Of Legalizing Marijuana
• Why Do So Many People Start Using Drugs?
• What Are The Most Common Types Of Drugs That Are Abused?
• Drug abuse and mental health
• Why substance abuse is dangerous

Simple Research Paper Topics On Drugs

• “The History of Drugs”
• “Drugs and the Modern World”
• “What is Drug Abuse?”
• “Types of Drugs”
• “Effects of Drug Abuse on Society”
• “Drug Abuse and Crime”
• “The Impact of Drug Abuse on Society”
• “Drug Addiction Treatment, Recovery and Relapse Prevention”
• “Drug Addiction Treatment”
• “Recovery and Relapse Prevention”

Controversial Research Paper Topics On Drugs

• The effects of drug addiction on the family
• The impact of drug abuse in high school settings
• The role of social media in the spread of drug use among adolescents
• Why do some teens start using drugs at an early age
• What can parents do to prevent their children from becoming addicted?
• How is addiction treated today?

Research Paper Topics On Drugs for Middle School

• Evaluate the positive and negative aspects of marijuana.
• Compare the effects of alcohol, tobacco, and marijuana on human health.
• Compare the pros and cons of legalizing marijuana for recreational use.
• Analyze what causes people to become addicted to drugs.
• Explain why some people abuse prescription medications while others do not.
• Discuss how drug abuse affects families and communities in America today.
• Analyze how American society views the use of illegal drugs.
• Research different methods for preventing drug abuse.
• Compare the policies of different countries regarding drug use and abuse.
• Discuss how laws regulating marijuana affect users in America today.
• Analyze the reasons why people use illegal drugs.
• Compare and contrast how society views alcohol, tobacco, and marijuana use.
• Discuss what causes people to become addicted to drugs.
• Explain why some people abuse prescription medications.

Research Paper Topics On Drugs for High School

• Discuss the effects of drug abuse in America today.
• Research different ways to prevent children from using drugs.
• Discuss why some people abuse prescription medications.
• Explain how laws regulating marijuana affect users in America today.
• Compare and contrast how society views alcohol, tobacco, and marijuana.
• The history of drugs in America.
• How society views the use and abuse of different types of illegal drugs.
• Discuss why some people become addicted to prescription medications.
• Analyze how illegal drug use affects families, communities, and countries worldwide.
• Explain whether or how law enforcement agencies should regulate prescription drug use.
• The drug war in Mexico.
• The legalization of marijuana in Canada and the U.S.
• The legalization of drugs in Portugal
• How adults and teens alike abuse prescription medications.

Research Paper Topics On Drugs for College

• The legalization of drugs in Colorado, Washington, and Oregon.
• The effects on society when drugs are legalized.
• The effects of prescription medication abuse in America today.
• The legalization of marijuana in the United States.
• The impact that drugs have on families and children in America today.
• The decriminalization of marijuana and its effects on society.
• How marijuana affects the brain.
• The link between drugs and violence.
• The effects of long-term use of illegal substances on users’ health.
• The impact of drug testing in schools on students’ academic performance.
• The effects of drug use on the brain
• How do drugs work in the body?
• What are the long-term side effects of drug use?
• How can we help teens who are using drugs and alcohol?

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As we have seen, there are many different topics that you can choose for your research paper on drugs. You can choose a topic that fits your interests and needs, but keep in mind how much time it will take to complete the project and if there is enough information available online or from your library. As always, when writing any paper, format it accordingly to ensure quality work!

With a passion for education and student empowerment, I create blog content that speaks directly to the needs and interests of students. From study hacks and productivity tips to career exploration and personal development

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Addiction Research

Discover the latest in addiction research, from the neuroscience of substance use disorders to evidence-based treatment practices. reports, updates, case studies and white papers are available to you at hazelden betty ford’s butler center for research..

Why do people become addicted to alcohol and other drugs? How effective is addiction treatment? What makes certain substances so addictive? The Butler Center for Research at the Hazelden Betty Ford Foundation investigates these and other questions and publishes its scientific findings in a variety of alcohol and drug addiction research papers and reports. Research topics include:

• Evidence-based treatment practices
• Addiction treatment outcomes
• Addiction, psychiatry and the brain
• Addictive substances such as prescription opioids and heroin
• Substance abuse in youth/teens, older adults and other demographic groups such as health care or legal professionals

These research queries and findings are presented in the form of updates, white papers and case studies. In addition, the Butler Center for Research collaborates with the Recovery Advocacy team to study special-focus addiction research topics, summarized in monthly  Emerging Drug Trends  reports. Altogether, these studies provide the latest in addiction research for anyone interested in learning more about the neuroscience of addiction and how addiction affects individuals, families and society in general. The research also helps clinicians and health care professionals further understand, diagnose and treat drug and alcohol addiction. Learn more about each of the Butler Center's addiction research studies below.

Research Updates

Written by Butler Center for Research staff, our one-page, topic-specific summaries discuss current research on topics of interest within the drug abuse and addiction treatment field.

View our most recent updates, or view the archive at the bottom of the page.

Patient Outcomes Study Results at Hazelden Betty Ford

Trends and Patterns in Cannabis Use across Different Age Groups

Alcohol and Tobacco Harm Reduction Interventions

Harm Reduction: History and Context

Racial and Ethnic Health Disparities and Addiction

Psychedelics as Therapeutic Treatment

Sexual and Gender Minority Youth and SUDs

Health Care Professionals and Mental Health

Grief and Addiction

Helping Families Cope with Addiction

Emerging Drug Trends Report and National Surveys

Shedding New Light on America’s No. 1 Health Problem

In collaboration with the University of Maryland School of Public Health and with support from the Butler Center for Research, the Recovery Advocacy team routinely issues research reports on emerging drug trends in America. Recovery Advocacy also commissions national surveys on attitudes, behaviors and perspectives related to substance use. From binge drinking and excessive alcohol use on college campuses, to marijuana potency concerns in an age of legalized marijuana, deeper analysis and understanding of emerging drug trends allows for greater opportunities to educate, inform and prevent misuse and deaths.

Each drug trends report explores the topic at hand, documenting the prevalence of the problem, relevant demographics, prevention and treatment options available, as well as providing insight and perspectives from thought leaders throughout the Hazelden Betty Ford Foundation.

View the latest  Emerging Drug Trends  Report:

Pediatricians First Responders for Preventing Substance Use

• Clearing Away the Confusion: Marijuana Is Not a Public Health Solution to the Opioid Crisis
• Does Socioeconomic Advantage Lessen the Risk of Adolescent Substance Use?
• The Collegiate Recovery Movement Is Gaining Strength
• Considerations for Policymakers Regarding Involuntary Commitment for Substance Use Disorders
• Widening the Lens on the Opioid Crisis
• Concerns Rising Over High-Potency Marijuana Use
• Beyond Binging: “High-Intensity Drinking”

View the latest  National Surveys :

• College Administrators See Problems As More Students View Marijuana As Safe

College Parents See Serious Problems From Campus Alcohol Use

• Youth Opioid Study: Attitudes and Usage

About Recovery Advocacy

Our mission is to provide a trusted national voice on all issues related to addiction prevention, treatment and recovery, and to facilitate conversation among those in recovery, those still suffering and society at large. We are committed to smashing stigma, shaping public policy and educating people everywhere about the problems of addiction and the promise of recovery. Learn more about recovery advocacy and how you can make a difference.

Evidence-Based Treatment Series

To help get consumers and clinicians on the same page, the Butler Center for Research has created a series of informational summaries describing:

• Evidence-based addiction treatment modalities
• Distinctive levels of substance use disorder treatment
• Specialized drug and alcohol treatment programs

Each evidence-based treatment series summary includes:

• A definition of the therapeutic approach, level of care or specialized program
• A discussion of applicability, usage and practice
• A description of outcomes and efficacy
• Research citations and related resources for more information

View the latest in this series:

Motivational Interviewing

Cognitive Behavioral Therapy

Case Studies and White Papers

Written by Hazelden Betty Ford Foundation researchers and clinicians, case studies and white papers presented by the Butler Center for Research provide invaluable insight into clinical processes and complex issues related to addiction prevention, treatment and recovery. These in-depth reports examine and chronicle clinical activities, initiatives and developments as a means of informing practitioners and continually improving the quality and delivery of substance use disorder services and related resources and initiatives.

• What does it really mean to be providing medication-assisted treatment for opioid addiction?

Adolescent Motivational Interviewing

Peer Recovery Support: Walking the Path Together

Addiction and Violence During COVID-19

The Brain Disease Model of Addiction

Healthcare Professionals and Compassion Fatigue

Moving to Trauma-Responsive Care

Virtual Intensive Outpatient Outcomes: Preliminary Findings

Driving Under the Influence of Cannabis

Vaping and E-Cigarettes

Using Telehealth for Addiction Treatment

Grandparents Raising Grandchildren

Substance Use Disorders Among Military Populations

Co-Occurring Mental Health and Substance Use Disorders

Women and Alcohol

Prescription Rates of Opioid Analgesics in Medical Treatment Settings

Applications of Positive Psychology to Substance Use Disorder

Substance Use Disorders Among Legal Professionals

Factors Impacting Early Alcohol and Drug Use Among Youths

Animal-Assisted Therapy for Substance Use Disorders

Prevalence of Adolescent Substance Misuse

Problem Drinking Behaviors Among College Students

The Importance of Recovery Management

Substance Use Factors Among LGBTQ individuals

Prescription Opioids and Dependence

Alcohol Abuse Among Law Enforcement Officers

Helping Families Cope with Substance Dependence

The Social Norms Approach to Student Substance Abuse Prevention

Drug Abuse, Dopamine and the Brain's Reward System

Women and Substance Abuse

Substance Use in the Workplace

Health Care Professionals: Addiction and Treatment

Cognitive Improvement and Alcohol Recovery

Drug Use, Misuse and Dependence Among Older Adults

Emerging Drug Trends

Does Socioeconomic Advantage Lessen the Risk of Adolescent Substance Use

The Collegiate Recovery Movement is Gaining Strength

Involuntary Commitment for Substance Use Disorders

Widening the Lens of the Opioid Crisis

Beyond Binge Drinking: High Intensity Drinking

High Potency Marijuana

National Surveys

College Administrators See Problems as More Students View Marijuana as Safe

Risky Opioid Use Among College-Age Youth

Case Studies/ White Papers

What does it really mean to be providing medication-assisted treatment for opioid addiction

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Pharmacology Research Paper Topics

In this page on pharmacology research paper topics , we explore the diverse and dynamic field of pharmacology and provide valuable resources for students who are tasked with writing research papers in this discipline. Pharmacology, as a branch of science, encompasses the study of how drugs interact with biological systems, aiming to understand their mechanisms of action, therapeutic uses, and potential side effects. With the growing importance of pharmacology in healthcare and drug development, it is crucial for students to delve into relevant pharmacology research paper topics that contribute to advancing knowledge and addressing current challenges in the field. Additionally, we highlight iResearchNet’s writing services, offering students the opportunity to order custom pharmacology research papers tailored to their specific needs. Our team of expert writers, equipped with in-depth knowledge of pharmacology and related fields, ensures high-quality, well-researched papers that adhere to the highest academic standards.

In the field of pharmacology, research plays a critical role in advancing our understanding of drugs, their mechanisms of action, and their impact on human health. As students of pharmacology, you may be tasked with writing research papers that explore various aspects of this dynamic discipline. To assist you in your research journey, we have curated a comprehensive list of pharmacology research paper topics that cover a wide range of subfields and emerging areas of interest. Whether you are interested in drug discovery, clinical pharmacology, pharmacogenomics, or drug safety, this list provides a wealth of ideas to inspire and guide your research endeavors.

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Drug Discovery and Development

• Role of Artificial Intelligence in Drug Discovery
• Personalized Medicine: Tailoring Drug Therapy to Individual Patients
• Drug Repurposing: Exploring New Indications for Existing Drugs
• Pharmacogenomics and Drug Response Prediction
• Nanomedicine: Applications in Drug Delivery and Targeting
• Innovative Approaches for Drug Formulation and Delivery
• Drug Combinations: Synergistic Effects and Therapeutic Opportunities
• Natural Products as Sources of Novel Therapeutic Agents
• Virtual Screening and Molecular Docking in Drug Design
• Pharmacokinetics and Pharmacodynamics of New Drug Entities

Clinical Pharmacology

• Precision Dosing: Optimizing Drug Therapy for Individual Patients
• Pharmacokinetic Variability in Special Populations (Pediatrics, Geriatrics, Pregnant Women)
• Drug-Drug Interactions: Mechanisms and Clinical Implications
• Adverse Drug Reactions: Identification, Prevention, and Management
• Pharmacovigilance and Drug Safety Monitoring
• Therapeutic Drug Monitoring: Rationale and Practical Considerations
• Clinical Trials in Pharmacology: Design, Implementation, and Analysis
• Drug Development and Regulatory Approval Processes
• Pharmacoeconomics: Evaluating the Cost-Effectiveness of Drug Therapy
• Ethical Considerations in Clinical Pharmacology Research

Neuropharmacology and Psychopharmacology

• Mechanisms of Action and Therapeutic Applications of Antidepressant Drugs
• Neurotransmitter Systems and Their Role in Mental Health Disorders
• Psychotropic Drugs and Their Impact on Cognitive Functioning
• Novel Approaches for Targeting Neurodegenerative Disorders
• Pharmacological Management of Substance Use Disorders
• Pharmacogenetics in Psychiatry: Implications for Individualized Treatment
• Role of Neuroinflammation in Neurological and Psychiatric Disorders
• Neuropharmacology of Sleep and Wakefulness
• Pharmacotherapy for Schizophrenia: Current Trends and Future Directions
• Novel Treatments for Anxiety and Mood Disorders

Pharmacokinetics and Drug Metabolism

• Drug Transporters and Their Role in Drug Disposition
• Pharmacogenetics and Personalized Drug Therapy
• Pharmacokinetic Variability and Its Impact on Drug Response
• Drug Metabolism Pathways and Enzyme Polymorphisms
• Drug-Drug Interactions: Mechanisms and Clinical Significance
• Predictive Modeling in Pharmacokinetics and Dose Optimization
• Pharmacokinetics in Special Populations: Pediatrics and Geriatrics
• Impact of Genetic Variation on Drug Clearance and Toxicity
• Role of Pharmacokinetics in Individualizing Drug Dosage
• Strategies for Improving Oral Bioavailability of Drugs

Pharmacology of Infectious Diseases

• Antimicrobial Resistance: Mechanisms, Epidemiology, and Strategies
• Development of Novel Antiviral Agents: Challenges and Opportunities
• Pharmacotherapy for Bacterial Infections: Current Approaches and Future Directions
• Antifungal Drugs: Mechanisms of Action and Resistance
• Host-Pathogen Interactions and Their Implications for Drug Development
• Pharmacokinetic Considerations in the Treatment of Viral Infections
• Targeting Virulence Factors in Bacterial Pathogens
• Drug Combination Therapy for Multidrug-Resistant Infections
• Pharmacogenomics of Antimicrobial Agents
• New Approaches for Antiparasitic Drug Development

Cardiovascular Pharmacology

• Novel Antiplatelet Agents: Mechanisms and Clinical Applications
• Antihypertensive Therapy: Current Strategies and Future Perspectives
• Pharmacotherapy for Heart Failure: Advancements and Challenges
• Role of Pharmacogenomics in Cardiovascular Drug Therapy
• Therapeutic Potential of Antiarrhythmic Agents
• Pharmacological Management of Dyslipidemia and Atherosclerosis
• Emerging Therapies for Pulmonary Hypertension
• Pharmacological Approaches to Preventing Thromboembolic Disorders
• Cardiotoxicity of Chemotherapeutic Agents: Mechanisms and Cardioprotective Strategies
• Targeting Inflammatory Pathways in Cardiovascular Disease

Pharmacology and Aging

• Geriatric Pharmacotherapy: Challenges and Approaches
• Age-Related Changes in Pharmacokinetics and Pharmacodynamics
• Polypharmacy and Its Impact on Older Adults
• Adverse Drug Reactions in the Elderly: Recognition and Prevention
• Pharmacological Management of Age-Related Neurodegenerative Disorders
• Geriatric Pharmacogenomics: Implications for Personalized Medicine
• Drug-Related Falls and Fractures in the Elderly: Prevention and Intervention
• Medication Adherence in Older Adults: Barriers and Strategies
• Geriatric Pain Management: Balancing Efficacy and Safety
• Optimizing Drug Therapy in Older Adults with Multiple Comorbidities

Pharmacology of Cancer

• Targeted Therapies for Solid Tumors: Recent Advances and Future Directions
• Immunotherapy in Cancer Treatment: Current Approaches and Challenges
• Pharmacogenomics of Chemotherapy: Implications for Personalized Treatment
• Drug Resistance in Cancer: Mechanisms and Strategies for Overcoming Resistance
• Pharmacokinetics and Pharmacodynamics of Anticancer Agents
• Combination Therapies in Oncology: Rationale and Clinical Outcomes
• Oncolytic Viruses: Exploiting Viral Infections for Cancer Treatment
• Cancer Stem Cells: Targeting Tumor Initiation and Progression
• Development of Novel Imaging Agents for Cancer Diagnosis and Monitoring
• Pharmacological Interventions for Cancer-Associated Pain Management

Pharmacology and Immunology

• Immune Checkpoint Inhibitors in Cancer Immunotherapy
• Autoimmune Diseases: Novel Pharmacological Approaches and Therapies
• Immunomodulatory Effects of Drugs: Implications for Therapeutic Interventions
• Role of Pharmacogenomics in Immunomodulatory Drug Therapy
• Immunopharmacology of Allergic Reactions: Mechanisms and Treatment Strategies
• Immunosuppressive Drugs in Transplantation: Balancing Efficacy and Safety
• Targeting Inflammatory Pathways in Autoimmune Disorders
• Immunopharmacological Interventions for Infectious Diseases
• Pharmacological Modulation of Cytokines in Inflammatory Disorders
• Vaccines: Advancements in Development and Delivery

Pharmacovigilance and Drug Safety

• Post-Marketing Surveillance: Detecting and Evaluating Adverse Drug Reactions
• Signal Detection in Pharmacovigilance: Methods and Applications
• Risk Management Strategies in Drug Development and Marketing
• Pharmacogenomic Biomarkers for Predicting Drug Safety
• Pharmacovigilance in Special Populations: Pregnant Women and Pediatrics
• Drug Safety Communication: Enhancing Patient Awareness and Education
• Role of Pharmacovigilance in Drug Regulatory Affairs
• Pharmacovigilance Data Mining: Leveraging Big Data for Drug Safety
• Pharmacovigilance Systems and Reporting Structures
• Pharmacogenetic Testing in Drug Safety Assessment

This comprehensive list of pharmacology research paper topics provides a broad range of ideas and areas to explore within the field of pharmacology. From drug discovery and development to clinical pharmacology, neuropharmacology, and pharmacokinetics, each category offers multiple topics for students to delve into and contribute to the advancement of pharmacological knowledge. Whether you are interested in the impact of pharmacogenomics on drug therapy, exploring novel treatment strategies, or investigating drug safety and pharmacovigilance, there is a wealth of research possibilities awaiting exploration. By selecting a topic of interest and following the expert advice on topic selection and research paper writing, students can embark on an enriching journey of discovery and make meaningful contributions to the field of pharmacology.

Pharmacology: Exploring the Range of Research Paper Topics

Pharmacology is a captivating and dynamic scientific discipline that focuses on the study of drugs and their effects on living organisms. It plays a crucial role in improving human health by advancing our understanding of how medications interact with biological systems. Within the field of pharmacology, there is a vast array of pharmacology research paper topics that offer students an opportunity to delve into various aspects of drug discovery, development, clinical application, and safety. In this article, we will explore the breadth and depth of pharmacology as a scientific field, highlighting the range of research paper topics it encompasses.

Drug Discovery and Development:  One exciting area of pharmacology research is drug discovery and development. This field involves the identification and development of new therapeutic agents to treat a wide range of diseases. Students interested in this area can explore topics such as the exploration of novel drug targets and therapeutic approaches, investigating natural products for drug development, advancements in targeted drug delivery systems, pharmacokinetics and pharmacodynamics of new drug entities, and understanding and overcoming drug resistance mechanisms.

Clinical Pharmacology:  Clinical pharmacology focuses on the application of pharmacological principles in the clinical setting. It plays a vital role in optimizing drug therapy and ensuring patient safety. Pharmacology research paper topics in this area may include pharmacogenomics, which explores the relationship between an individual’s genetic makeup and their response to medication. Other topics of interest include the identification, prevention, and management of adverse drug reactions, the design and ethical considerations in clinical trials, pharmacovigilance, and optimizing drug regimens for special populations such as pediatrics, geriatrics, and pregnant women.

Neuropharmacology and Psychopharmacology:  The field of neuropharmacology examines how drugs interact with the central nervous system and influence brain function. Pharmacology research paper topics in this area may involve investigating the mechanisms of action and therapeutic applications of psychotropic drugs, exploring neurotransmitter systems and their role in neurological disorders, pharmacological interventions for Alzheimer’s disease and other neurodegenerative disorders, the psychopharmacology of substance use disorders, and the pharmacological management of mental health disorders.

Pharmacokinetics and Drug Metabolism:  Pharmacokinetics and drug metabolism focus on understanding how drugs are absorbed, distributed, metabolized, and eliminated by the body. Pharmacology research paper topics in this area may include studying drug interactions, such as the mechanisms, predictions, and clinical implications of drug-drug interactions. Other topics of interest include pharmacogenetics and individual variations in drug response, the role of drug transporters in drug disposition, drug metabolism and its impact on drug-drug interactions, and the use of predictive modeling in pharmacokinetics and dosing optimization.

Pharmacology of Infectious Diseases:  The pharmacology of infectious diseases involves studying how drugs can effectively treat and prevent infections. Research topics in this area may include exploring antimicrobial resistance, including its mechanisms, epidemiology, and strategies to combat it. Additionally, students may investigate the development of new antiviral agents, the pharmacological management of bacterial infections, host-pathogen interactions, and the pharmacokinetic considerations in the treatment of infectious diseases.

Cardiovascular Pharmacology:  Cardiovascular pharmacology focuses on understanding the effects of drugs on the cardiovascular system. Research topics in this area may include exploring drug therapy for hypertension and current guidelines for treatment, novel anticoagulants in the prevention and treatment of thromboembolic disorders, pharmacological approaches to managing heart failure, drug-induced cardiotoxicity and strategies for prevention, and emerging pharmacotherapies for atherosclerosis and coronary artery disease.

Pharmacology and Aging:  Pharmacology and aging is a specialized field that investigates how drug therapy can be optimized in older adults. Research topics in this area may include exploring geriatric pharmacotherapy, age-related changes in pharmacokinetics and pharmacodynamics, the impact of polypharmacy on older adults, the recognition and prevention of adverse drug reactions, pharmacological management of age-related neurodegenerative disorders, and strategies for improving medication adherence in the elderly.

The field of pharmacology offers a wide range of exciting research paper topics that span from drug discovery and development to clinical pharmacology, neuropharmacology, pharmacokinetics, and beyond. By exploring these topics, students can contribute to the advancement of pharmacological knowledge and make meaningful contributions to the field. Remember to choose a research topic that aligns with your interests and career aspirations, and be sure to consult with your instructors or mentors for guidance throughout your research journey. With dedication, curiosity, and a passion for improving patient care, you have the opportunity to shape the future of pharmacology research.

How to Choose a Pharmacology Research Topic

Choosing the right research paper topic is crucial for a successful academic journey in pharmacology. It allows you to explore your interests, contribute to the field, and showcase your knowledge and skills. However, with the vast scope of pharmacology, selecting a research topic can be a daunting task. In this section, we will provide you with expert advice on how to choose pharmacology research paper topics that are engaging, relevant, and have the potential for significant contribution.

• Identify Your Interests : Start by identifying your areas of interest within pharmacology. Reflect on the topics that have captivated your attention during your coursework or sparked your curiosity. Consider whether you are more inclined towards drug discovery, clinical applications, pharmacokinetics, neuropharmacology, or any other subfield of pharmacology. This self-reflection will help you narrow down your options and select a topic that resonates with your passion.
• Stay Updated with Current Research : To choose a compelling research topic, it is essential to stay updated with the latest advancements and trends in pharmacology. Follow reputable scientific journals, attend conferences, and engage with the pharmacological community to gain insights into the ongoing research and emerging areas of interest. This will help you identify gaps in the current knowledge and select a topic that offers the potential for novel discoveries or addressing existing challenges.
• Consult with Faculty and Experts : Seek guidance from your faculty members, mentors, or experts in the field of pharmacology. They can provide valuable insights and suggest potential research areas based on their expertise and experience. Discuss your interests, goals, and research aspirations with them, and they can help you refine your research topic, provide relevant literature references, and offer valuable advice on the feasibility and scope of your chosen topic.
• Consider Practicality and Resources : When selecting a research topic, consider the practicality and availability of resources. Assess whether the necessary laboratory facilities, equipment, or access to clinical data are readily accessible to conduct your research. Additionally, consider the time and resources required to complete the research within the given timeframe. Choosing a topic that aligns with the available resources will enhance the feasibility and success of your research endeavor.
• Address Current Challenges or Gaps : Pharmacology is a field that constantly evolves, presenting new challenges and unanswered questions. Consider selecting a research topic that addresses current challenges or explores gaps in the existing knowledge. This could involve investigating the mechanisms of drug resistance, exploring novel drug targets, or optimizing drug regimens for specific patient populations. By tackling these challenges, you can contribute to the advancement of pharmacological science and make a meaningful impact.
• Collaborate with Peers : Consider collaborating with fellow students or researchers who share similar research interests. Collaborative research projects can provide a broader perspective, foster knowledge sharing, and enhance the overall quality of your research. Collaborating with peers also allows you to divide the workload, share resources, and receive feedback and support throughout the research process.
• Seek Ethical Considerations : When selecting a pharmacology research topic, it is essential to consider ethical considerations and adhere to the principles of research ethics. Ensure that your chosen topic respects patient confidentiality, follows the guidelines for the ethical use of animal subjects (if applicable), and aligns with the ethical principles outlined by regulatory bodies. Consulting with your institution’s ethics committee or research advisor can help ensure that your research project meets the required ethical standards.
• Evaluate Feasibility and Novelty : Evaluate the feasibility and novelty of your chosen research topic. Consider whether the research question is answerable within the available resources and time constraints. Additionally, assess whether your topic brings something new to the field, whether it fills a knowledge gap, or offers a fresh perspective on an existing topic. A balance between feasibility and novelty is essential for a successful research paper.
• Consult Literature Reviews : Conduct thorough literature reviews on your chosen topic to gain a comprehensive understanding of the existing research. Literature reviews help you identify gaps in the current knowledge and provide a foundation for your research question. They also enable you to build on previous findings, develop a robust research methodology, and position your research within the context of the broader field of pharmacology.
• Remain Flexible : Lastly, remain flexible throughout the process of choosing a research topic. As you delve deeper into the literature and research process, you may discover new avenues of interest or encounter unexpected challenges. It is essential to remain open to refining or adjusting your research topic based on new insights, emerging data, or feedback from your research advisors. Flexibility allows you to adapt and ensure that your research remains relevant and impactful.

Choosing a pharmacology research paper topic is an exciting and important step in your academic journey. By following expert advice, identifying your interests, staying updated with current research, seeking guidance, considering practicality and resources, addressing current challenges or gaps, collaborating with peers, adhering to ethical considerations, evaluating feasibility and novelty, consulting literature reviews, and remaining flexible, you can select a research topic that is engaging, relevant, and has the potential to contribute to the field of pharmacology. Remember, this is your opportunity to explore, innovate, and make a lasting impact in the dynamic field of pharmacology research.

How to Write a Pharmacology Research Paper

Writing a pharmacology research paper requires careful planning, organization, and attention to detail. It is an opportunity for you to showcase your understanding of the subject matter, critical thinking skills, and ability to communicate scientific information effectively. In this section, we will provide you with expert guidance on how to write a pharmacology research paper that is well-structured, informative, and compelling.

• Choose a Well-Defined Research Question : Start by formulating a clear and well-defined research question. Your research question should be focused, specific, and address a gap in the existing knowledge. Consider the significance of your research question in the context of pharmacology and how it contributes to the overall understanding of the field. A well-defined research question sets the foundation for your entire research paper.
• Conduct a Thorough Literature Review : Before diving into your research, conduct a thorough literature review on the chosen topic. Familiarize yourself with the existing research, theories, and findings related to your research question. This will provide you with a solid understanding of the current state of knowledge and help you identify gaps or areas for further investigation. Additionally, the literature review will inform your research methodology and discussion of results.
• Develop a Clear Structure : A well-structured research paper is essential for effectively conveying your ideas and findings. Begin with an engaging introduction that provides background information, context, and clearly states your research question. Follow with a comprehensive literature review that supports your research question and highlights the gaps in knowledge. Next, present your research methodology, including details on sample selection, data collection, and analysis methods. In the results section, present your findings in a clear and organized manner using tables, graphs, or figures as necessary. Finally, discuss your results, interpret their significance, and relate them back to your research question in the discussion section. Conclude with a concise summary of your findings and their implications.
• Use Reliable and Credible Sources : Ensure that the sources you use for your research paper are reliable, credible, and peer-reviewed. Consult reputable scientific journals, textbooks, and conference proceedings. Avoid relying solely on internet sources or non-scholarly publications. Citations are critical to acknowledge the work of other researchers and to support your claims and arguments. Use a consistent citation style, such as APA, MLA, or Chicago, and follow the guidelines carefully.
• Analyze and Interpret Your Data : If your research involves collecting and analyzing data, ensure that your data analysis is thorough and accurate. Use appropriate statistical methods to analyze your data and present the results in a clear and meaningful way. Interpret the findings in the context of your research question and discuss any limitations or potential sources of bias. Remember to relate your findings back to the existing literature and explain how they contribute to the broader understanding of pharmacology.
• Write Clearly and Concisely : Effective scientific writing is clear, concise, and free of unnecessary jargon. Use language that is precise and straightforward, avoiding ambiguous or vague statements. Clearly articulate your ideas and ensure that your arguments are logical and well-supported by evidence. Use appropriate scientific terminology, but also consider your target audience and strive to communicate your findings in a way that is accessible to readers who may not have expertise in pharmacology.
• Pay Attention to Formatting and Style : Follow the formatting and style guidelines specified by your instructor or the target journal. Pay attention to details such as font size, line spacing, margins, and headings. Use subheadings to organize your content and make it easier for readers to navigate. Adhere to the specific citation style required for your paper and ensure that your references are complete and accurate.
• Revise and Edit : Revision and editing are essential steps in the writing process. Take the time to review your research paper for clarity, coherence, and accuracy. Check for grammatical errors, spelling mistakes, and punctuation errors. Ensure that your ideas flow logically and that your paper is well-structured. Consider seeking feedback from peers, instructors, or mentors to gain different perspectives and improve the overall quality of your paper.
• Proofread : Before submitting your research paper, thoroughly proofread it to ensure that it is error-free. Check for any typos, inconsistencies, or formatting issues. Read your paper aloud to catch any awkward phrasing or unclear sentences. It can also be helpful to have someone else read your paper to identify any errors or areas that need improvement.
• Ethical Considerations : Ensure that your research paper adheres to ethical considerations. If your research involved human subjects, ensure that you have obtained the necessary approvals and informed consent. Respect patient confidentiality and anonymity when presenting your research findings. Adhere to the ethical guidelines set by your institution or the relevant regulatory bodies.

Writing a pharmacology research paper requires careful planning, thorough research, effective communication, and attention to detail. By following the expert advice provided in this section, you can develop a well-structured and informative research paper that contributes to the field of pharmacology. Remember to choose a well-defined research question, conduct a thorough literature review, use reliable sources, analyze and interpret your data, write clearly and concisely, pay attention to formatting and style, revise and edit your paper, proofread for errors, and ensure ethical considerations are met. With diligence and commitment, your pharmacology research paper has the potential to make a meaningful impact in the field of pharmacology.

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• Expert Degree-Holding Writers : At iResearchNet, we have a team of expert writers who hold advanced degrees in pharmacology and related fields. They have in-depth knowledge of the subject matter and are well-versed in the latest research trends and methodologies. Our writers are experienced in crafting research papers that adhere to the highest academic standards and follow the guidelines provided by your institution.
• Custom Written Works : We understand that each research paper is unique, and that’s why we offer custom-written works tailored to your specific requirements. Our writers will collaborate with you to understand your research question, objectives, and any specific instructions provided by your instructor. This ensures that the final paper is original, well-researched, and meets your expectations.
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91 Drug Trafficking Essay Topic Ideas & Examples

🏆 best drug trafficking topic ideas & essay examples, 🎓 good research topics about drug trafficking, 📌 simple & easy drug trafficking essay titles, ❓ research questions about drug trafficking.

• Drug Trafficking and Drug Abuse Drug trafficking contributes to drug abuse in the society. Drug trafficking also contributes to increased criminal activities that affect the security of citizens.
• International Drug Trafficking: Critical Thinking Moreover, it is of concern that the power of drug traffickers is constantly growing and that they are influencing the economic and political affairs of cities. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
• International Drug Trafficking: Analysis and Solution If an attempt is made to unify the process for all significant areas of drug trafficking, such a system will fail.
• Drug Trafficking and Pablo Escobar Pablo Escobar created the largest drug cartel in the world, and the criminal activities affecting the population at the time still negatively impact the community.
• Drug Cartels Problem Overview Drugs have been the major cause of the rise in the levels of corruption, disobedience to the law, and human rights abuses The selection highlights the key challenge of drug cartels in Latin America.
• Drug Trafficking in the United States This shortage of cocaine has been brought due to low production of cocaine In Mexico, and this was as a result of pressure from the United States government to DTOs, large seizure of cocaine consignment […]
• Policy Project: The Drug Trafficking The committee was also in making reports to the convention. Reforms in judicial systems should be advocated to the countries that are signatories of UN convention.
• Drug Trafficking in the UK This is the extent of the information available at the start of the research. The first element that has to be developed is the list of organizations that could potentially be involved with the smuggling […]
• Economics of Organized Crime and Drug Trafficking Three major conditions associated with the development and origins of mafias include the abdication of legitimate government power, excessive bureaucratic power, and the financial potential of illegal markets.
• Human and Drug Trafficking as Transnational Organised Crimes While a transnational crime implies illegal actions and the breaking of law across borders or between two or more countries, the UN Convention has not made an effort of listing the type of crimes for […]
• International Drug Trafficking and Its Legal Status The large-scale of the global drug trade has grown primarily due to the levels of financing and expansion that organized crime has invested in the industry.
• The Crown Court Case: Drug and Weapons Trafficking To continue the process of the trial, it is necessary to translate the found text and identify what the defendant was about to do before he was arrested, as it will help to proceed with […]
• Drug Trafficking, National Security and Intelligence In most of the cases, these cartels used carrot-and-stick approach when it came to dealing with security agencies both in their home country and in the United States. The drug cartels in this country use […]
• What Can Law Enforcement Do About Drug Trafficking Therefore, there is a need for the creation and implementation of new federal and local laws that would ensure the appropriateness of police operations in the field of drug trafficking prevention.
• Drug Trafficking in Central Asia and US Interests The interests of the United States in the Central Asia Region increased significantly after the 9/11bomb attacks in the United States.
• Drug Traffickers Arrest: Intelligence Cycle The case study about the arrest of 7 drug traffickers by Drug Enforcement Agency, Immigration and Customs Enforcement, and Homeland Security Investigations agents is a perfect case that required collection of information, processing it to […]
• Illegal Drug Trafficking Rates This is one of the most thriving trades in the world markets owing to the fact that, although majority of nations have criminalized drug trafficking, due to effects of the economic crisis that affected most […]
• Mexican Drug Cartels and Human Trafficking Reports from Mexico says that due to the pressure exerted on the drug cartels by the government, they have resolved in other means of getting revenue and the major one has been human trafficking alongside […]
• The Mexican Drugs Cartels Apparently, Mexican drug cartels have dominated the illegal drug trading in the United States, as there is increased co-operation with the prisoners and street peddlers in the United States; moreover, drug trafficking has spread rapidly […]
• Colombian Drug Cartels: Government Response For instance, the Cali cartel participated a great deal in the downfall of the Medellin cartel as it was involved in the manhunt of the leaders of the Medellin cartel which saw the killing of […]
• Mexican Drug Cartels and the War on Drugs The examination of the current research on Mexican drug cartels and the War on Drugs helps to understand the causes of the outburst of violence, define the major tendencies of the Mexican War on Drugs […]
• Drug Cartels in Mexico According to sociologist Luis Astorga, the history of drug cartels in Mexico has a correlation with the political eras in the region. As such, they are the eyes and ears of the drug cartels.
• Drug Trafficking in the US Kleiman argues that drug trafficking in the US has brought about harmful effects to families, children and the greater population of the young people.
• Pre-Colombia Era of Drug Trafficking in the Americas: Andean Cocaine, 1947-1973 This led to the period where cocaine was considered as an illicit drug in most parts of the world. The United States utilized its popularity to spread the word over the continents on the dangers […]
• Reducing Drug Trafficking in the United States For this to be effective, the US government has instituted a task force that specializes in the capturing of drug dealers and traffickers.
• US Proposed Plan for Reducing Security Threat by Mexican Drug Cartels Terrorism in the modern world has become a big threat to the security of the world and especially the US citizens which is the largest economy in the world.
• Achieving Wealth and Power: Drug Trafficking
• Border Patrol Enforcement Have Impact on Illegal Drug Trafficking
• The Battle Between Border Security and Drug Trafficking
• Can National Governments Prevent Illicit Drug Trafficking?
• Death Penalty for Drug Trafficking: Is It Required?
• Drug Smoking and Drug Trafficking in the World
• The Link Between Drug Trafficking and Gang Violence
• Drug Trafficking and Distribution of Drugs: Overview
• Linking Drug Trafficking and Illegal Immigration
• The Relationships Between Drug Trafficking and Insurgent Terrorists
• Drug Trafficking and Its Effects on America
• Link Between Drug Trafficking and the Financing of Terrorism
• Drug Trafficking and Its Effects on the American Civil War
• Relations Between Drug Trafficking, Organized Crime, and Terrorism Interactions
• Drug Trafficking and Its Effects on the Human Body
• Illicit Trade and Drug Trafficking Proving to Be a Major Problem
• Drug Trafficking and Its Effects on US Policy and Economy
• Joint Interagency Engagement and Drug Trafficking
• Drug Trafficking and Narco-Terrorism as Security Threats
• Mexican Drug War: Drug Trafficking and Its Effects on Mexico
• Drug Trafficking and the Criminal Justice System of America
• Reducing Drug Trafficking In the United States
• Drug Trafficking Between Mexico and The United States
• Terrorism and Drug Trafficking at the South American Borders
• Drug Trafficking: Consequences, and Accountability
• Overview of the Biggest Drug Trafficking Organization
• Drug Trafficking Has Caused the Coffee Industry
• The Economics Behind Drug Trafficking and Cartels in Mexico
• Drug Trafficking Organizations and Counter-Drug Strategies in the US-Mexican Context
• The Fight Against Drugs and Drug Trafficking in America
• The History, Effect, and Cost of Drug Trafficking on Society
• The Long Existed Business of Drug Trafficking in Latin Countries
• Punishments and Laws Associated With Drug Trafficking in the United States
• UN’s Efforts to Control Drug Trafficking in Thailand, Laos, Myanmar, and Korea
• The United States’ Strategy for Combating Drug Trafficking
• War Against Drug Trafficking and the Drug Crisis in the USA
• Overview of Transnational Criminality and Illicit Drug Trafficking
• United States Drug Trafficking Problem Analysis
• Why Drug Trafficking Causes Gun Violence?
• Would Legalizing Drugs Discourage Drug Trafficking?
• How Can Drug Trafficking Be Controlled?
• Why Does Drug Trafficking Continue to Rise Despite the Risks Involved?
• How Does Drug Trafficking Affect the United States?
• What Is the Connection Between Drug Abuse and Drug Trafficking?
• How Does Drug Trafficking Impact the Economy and the World at Large?
• Why Is It Important to Stop Drug Trafficking?
• When Did Drug Trafficking Become a Problem?
• Is Human Trafficking Bigger Than Drug Trafficking?
• What Is the Difference Between Drug Trafficking and Drug Smuggling?
• How Can We Solve the Problem of Drug Trafficking?
• What Is the Golden Triangle in Drug Trafficking?
• Is Drug Trafficking and Smuggling the Same Thing?
• What Are the Effects of Drug Trafficking in the Country?
• Why Is Drug Trafficking a Threat to Any Nation?
• What Are the Root Causes of Drug Trafficking in Central America?
• How Do Drug Trafficking Organizations Work?
• What Is the Penalty for Drug Trafficking in the USA?
• Is Human Trafficking More Profitable Than Drug Trafficking?
• What Is the Biggest Drug Trafficking Organization in the World?
• Does the FBI Handle Drug Trafficking?
• What Is the Political Effect of Drug Trafficking?
• Did Latin America’s Drug Trafficking Thrive During COVID-19?
• Who Started Drug Trafficking in Colombia?
• How Is Drug Trafficking to Blame for Violence in Latin America?
• What Has the UN Done for Drug Trafficking?
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Essays About Drugs

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The Important Lessons of Self Importance and Self Reliance Taught by My Mother

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Writing about drugs has always been one of those topics that both colleges and universities explore in the most varied curriculum courses. As a rule, it deals with more than addiction but also encompasses medication, history, anthropology, and the other sciences through the lens of substance analysis and the cultural aspect of things. As for the history of the subjects, you can go as far as exploring the culture of Aztecs and Ancient Rome to writing about drug trafficking and the prevention measures. Since this subject poses major social importance, feel free to explore it as part of your course.

Taking a look at the history, the use of drugs has always been around since it has started out not as the entertainment of a doubtful nature but mostly as medication and a way to combat the pain. Think about painkillers as an example. Alternatively, you can use various modern methods of exploration and talk about how drugs are perceived in modern society if your university course deals with culture. Most importantly, try to focus on several aspects of writing about drugs by including at least one social point.

Not many of you may remember about the D.A.R.E. campaign that has been one of the first national movements against the youth of drugs among young people. One of the most famous anti-drug activists is Jackie Chan who has been named as the world's first global anti-drug ambassador. The other people include an American actress called Melissa Gilbert who serves as the national spokesperson for the Partnership for Drug-Free Kids. The involvement of celebrities has been much lower than what it could have been, yet focusing on the children seems to be an important initiative to think about it since it is the only way to protect our future.

• Drugs can be used for medical purposes.
• The control of drugs for medical purposes should not be sold over the counter.
• The use of soft drugs leads to the use of “something more significant”.
• While drugs have always been around, the lack of education is a greater issue.
• Providing anti-drug initiatives is the way of control that would explain the dangers.

The topic of drugs has always been interesting for educators, researchers, and students. Some want to experiment with the cultural aspects and study the past, while others will focus on the exploration of the criminal side of things. Either way, your college task may deal with the educational initiatives that you would like to provide as a way to protect the youth. You can even tell about your experience and share the ways how a person can recover.

Regardless if you are writing an essay for your Social Sciences course, study to become a journalist in the future, or explore drugs through the lens of Chemistry and Pharmacology, dealing with this topic becomes inevitable. You can see some examples in our database to see how broad it can be if you expand your research towards Latin America, Mexico, or the Middle East. Make sure to support each argument with a good source and provide your opinion as well. Remember that writing about drugs is a very sensitive topic in some cases, therefore, show respect and care.

In truth, there are many ways to address this problem, yet it requires a systematic approach and the involvement of schools, parents, educators, and social services. The culture of the community and the gangs should change because once the drugs are perceived as something popular, it is always taken as something good that provides a person with a status. Nevertheless, one should start with the young people and teach them to avoid this kind of trouble in the first place. While it is hardly possible to control the drugs around the world, it is possible to say “no”.

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A closed-loop drug-delivery system could improve chemotherapy

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When cancer patients undergo chemotherapy, the dose of most drugs is calculated based on the patient’s body surface area. This is estimated by plugging the patient’s height and weight into an equation, dating to 1916, that was formulated from data on just nine patients.

This simplistic dosing doesn’t take into account other factors and can lead to patients receiving either too much or too little of a drug. As a result, some patients likely experience avoidable toxicity or insufficient benefit from the chemotherapy they receive.

To make chemotherapy dosing more accurate, MIT engineers have come up with an alternative approach that can enable the dose to be personalized to the patient. Their system measures how much drug is in the patient’s system, and these measurements are fed into a controller that can adjust the infusion rate accordingly.

This approach could help to compensate for differences in drug pharmacokinetics caused by body composition, genetic makeup, chemotherapy-induced toxicity of the organs that metabolize the drugs, interactions with other medications being taken and foods consumed, and circadian fluctuations in the enzymes responsible for breaking down chemotherapy drugs, the researchers say.

“Recognizing the advances in our understanding of how drugs are metabolized, and applying engineering tools to facilitate personalized dosing, we believe, can help transform the safety and efficacy of many drugs,” says Giovanni Traverso, an associate professor of mechanical engineering at MIT, a gastroenterologist at Brigham and Women’s Hospital, and the senior author of the study.

Louis DeRidder, an MIT graduate student, is the lead author of the paper , which appears today in the journal Med .

Continuous monitoring

In this study, the researchers focused on a drug called 5-fluorouracil, which is used to treat colorectal cancers, among others. The drug is typically infused over a 46-hour period, and the dosage is determined using a formula based on the patient’s height and weight, which gives the estimated body surface area.

However, that approach doesn’t account for differences in body composition that can affect how the drug spreads through the body, or genetic variations that influence how it is metabolized. Those differences can lead to harmful side effects, if too much drug is present. If not enough drug is circulating, it may not kill the tumor as expected.

“People with the same body surface area could have very different heights and weights, could have very different muscle masses or genetics, but as long as the height and the weight plugged into this equation give the same body surface area, their dose is identical,” says DeRidder, a PhD candidate in the Medical Engineering and Medical Physics program within the Harvard-MIT Program in Health Sciences and Technology.

Another factor that can alter the amount of drug in the bloodstream at any given time is circadian fluctuations of an enzyme called dihydropyrimidine dehydrogenase (DPD), which breaks down 5-fluorouracil. DPD’s expression, like many other enzymes in the body, is regulated on a circadian rhythm. Thus, the degradation of 5-FU by DPD is not constant but changes according to the time of the day. These circadian rhythms can lead to tenfold fluctuations in the amount of 5-fluorouracil in a patient’s bloodstream over the course of an infusion.

“Using body surface area to calculate a chemotherapy dose, we know that two people can have profoundly different toxicity from 5-fluorouracil chemotherapy. Looking at one patient, they can have cycles of treatment with minimal toxicity and then have a cycle with miserable toxicity. Something changed in how that patient metabolized chemo from one cycle to the next. Our antiquated dosing fails to capture that change, and patients suffer as a result,” says Douglas Rubinson, a clinical oncologist at Dana-Farber Cancer Institute and an author of the paper.

One way to try to counteract the variability in chemotherapy pharmacokinetics is a strategy called therapeutic drug monitoring, in which the patient gives a blood sample at the end of one treatment cycle. After this sample is analyzed for the drug concentration, the dosage can be adjusted, if needed, at the beginning of the next cycle (usually two weeks later for 5-fluorouracil). This approach has been shown to result in better outcomes for patients, but it is not widely used for chemotherapies such as 5-fluorouracil.

The MIT researchers wanted to develop a similar type of monitoring, but in a manner that is automated and enables real-time drug personalization, which could result in better outcomes for patients. In their “closed-loop” system, drug concentrations can be continually monitored, and that information is used to automatically adjust the infusion rate of the chemotherapy drug and keep the dose within the target range. Such a closed-loop system enables personalization of the drug dose in a manner that considers circadian rhythm changes in the levels of drug-metabolizing enzymes, as well as any changes in the patient’s pharmacokinetics since their last treatment, such as chemotherapy-induced toxicity of the organs that metabolize the drugs.

The new system they designed, known as CLAUDIA (Closed-Loop AUtomated Drug Infusion regulAtor), makes use of commercially available equipment for each step. Blood samples are taken every five minutes and rapidly prepared for analysis. The concentration of 5-fluorouracil in the blood is measured and compared to the target range. The difference between the target and measured concentration is input to a control algorithm, which then adjusts the infusion rate if necessary, to keep the dose within the range of concentrations between which the drug is effective and nontoxic.

“What we’ve developed is a system where you can constantly measure the concentration of drug and adjust the infusion rate accordingly, to keep the drug concentration within the therapeutic window,” DeRidder says.

Rapid adjustment

In tests in animals, the researchers found that using CLAUDIA, they could keep the amount of drug circulating in the body within the target range around 45 percent of the time. Drug levels in animals that received chemotherapy without CLAUDIA remained in the target range only 13 percent of the time, on average. In this study, the researchers did not do any tests of the effectiveness of the drug levels, but keeping the concentration within the target window is believed to lead to better outcomes and less toxicity.

CLAUDIA was also able to keep the dose of 5-fluorouracil within the target range even when the researchers administered a drug that inhibits the DPD enzyme. In animals that received this inhibitor without continuous monitoring and adjustment, levels of 5-fluorouracil increased by up to eightfold.

For this demonstration, the researchers manually performed each step of the process, using off-the-shelf equipment, but they now plan to work on automating each step so that the monitoring and dose adjustment can be done without any human intervention.

To measure drug concentrations, the researchers used high-performance liquid chromatography mass spectroscopy (HPLC-MS), a technique that could be adapted to detect nearly any type of drug.

“We foresee a future where we’re able to use CLAUDIA for any drug that has the right pharmacokinetic properties and is detectable with HPLC-MS, thereby enabling the personalization of dosing for many different drugs,” DeRidder says.

The research was funded by the National Science Foundation Graduate Research Fellowship Program, a MathWorks Fellowship, MIT’s Karl van Tassel Career Development Professorship, the MIT Department of Mechanical Engineering, and the Bridge Project, a partnership between the Koch Institute for Integrative Cancer Research at MIT and the Dana-Farber/Harvard Cancer Center.

Other authors of the paper include Kyle A. Hare, Aaron Lopes, Josh Jenkins, Nina Fitzgerald, Emmeline MacPherson, Niora Fabian, Josh Morimoto, Jacqueline N. Chu, Ameya R. Kirtane, Wiam Madani, Keiko Ishida, Johannes L. P. Kuosmanen, Naomi Zecharias, Christopher M. Colangelo, Hen-Wei Huang, Makaya Chilekwa, Nikhil B. Lal, Shriya S. Srinivasan, Alison M Hayward, Brian M. Wolpin, David Trumper, Troy Quast, and Robert Langer.

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Study uncovers drug target in a protein complex required for activation of NF-κB

by Dana-Farber Cancer Institute

A new paper by Dana-Farber Cancer Institute scientists lays the foundation for targeted therapies to inhibit the activation of nuclear factor kappa B (NF-κB), a transcription factor that plays a role in various autoimmune and inflammatory diseases and cancers.

The study tracks the mechanism of NF-κB activation to identify a key point of vulnerability. NF-κB is activated by circulating lipopolysaccharides (LPS) that bind to the cell surface receptor TLR4. Using CRISPR/Cas9, researchers showed that this LPS receptor TLR4 depends on OST-A—an oligosaccharyltransferase complex—to function properly. OST complexes can be inhibited with a compound called NGI-1, but the molecular mechanism of its action has been unclear.

By performing a CRISPR screen and cryo-electron microscopy studies, researchers found that NGI-1 binds to OST-A at the complex's catalytic subunit, STT3A. There, NGI-1 traps the complex in an inactive state, preventing TLR4 from getting to the cell surface. This, in turn, prevents the activation of NF-κB.

The development of agents capable of inhibiting STT3A represents a promising strategy for blocking the activation of NF-κB in response to LPS. The involvement of NF-κB in a range of autoimmune conditions, inflammatory diseases , and cancers suggests that this approach could have broad utility.

The findings are published in the journal Cell .

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Nih research matters.

April 23, 2024

Research in Context: Treating depression

Finding better approaches.

While effective treatments for major depression are available, there is still room for improvement. This special Research in Context feature explores the development of more effective ways to treat depression, including personalized treatment approaches and both old and new drugs.

Everyone has a bad day sometimes. People experience various types of stress in the course of everyday life. These stressors can cause sadness, anxiety, hopelessness, frustration, or guilt. You may not enjoy the activities you usually do. These feelings tend to be only temporary. Once circumstances change, and the source of stress goes away, your mood usually improves. But sometimes, these feelings don’t go away. When these feelings stick around for at least two weeks and interfere with your daily activities, it’s called major depression, or clinical depression.

In 2021, 8.3% of U.S. adults experienced major depression. That’s about 21 million people. Among adolescents, the prevalence was much greater—more than 20%. Major depression can bring decreased energy, difficulty thinking straight, sleep problems, loss of appetite, and even physical pain. People with major depression may become unable to meet their responsibilities at work or home. Depression can also lead people to use alcohol or drugs or engage in high-risk activities. In the most extreme cases, depression can drive people to self-harm or even suicide.

The good news is that effective treatments are available. But current treatments have limitations. That’s why NIH-funded researchers have been working to develop more effective ways to treat depression. These include finding ways to predict whether certain treatments will help a given patient. They're also trying to develop more effective drugs or, in some cases, find new uses for existing drugs.

Finding the right treatments

The most common treatments for depression include psychotherapy, medications, or a combination. Mild depression may be treated with psychotherapy. Moderate to severe depression often requires the addition of medication.

Several types of psychotherapy have been shown to help relieve depression symptoms. For example, cognitive behavioral therapy helps people to recognize harmful ways of thinking and teaches them how to change these. Some researchers are working to develop new therapies to enhance people’s positive emotions. But good psychotherapy can be hard to access due to the cost, scheduling difficulties, or lack of available providers. The recent growth of telehealth services for mental health has improved access in some cases.

There are many antidepressant drugs on the market. Different drugs will work best on different patients. But it can be challenging to predict which drugs will work for a given patient. And it can take anywhere from 6 to 12 weeks to know whether a drug is working. Finding an effective drug can involve a long period of trial and error, with no guarantee of results.

If depression doesn’t improve with psychotherapy or medications, brain stimulation therapies could be used. Electroconvulsive therapy, or ECT, uses electrodes to send electric current into the brain. A newer technique, transcranial magnetic stimulation (TMS), stimulates the brain using magnetic fields. These treatments must be administered by specially trained health professionals.

“A lot of patients, they kind of muddle along, treatment after treatment, with little idea whether something’s going to work,” says psychiatric researcher Dr. Amit Etkin.

One reason it’s difficult to know which antidepressant medications will work is that there are likely different biological mechanisms that can cause depression. Two people with similar symptoms may both be diagnosed with depression, but the causes of their symptoms could be different. As NIH depression researcher Dr. Carlos Zarate explains, “we believe that there’s not one depression, but hundreds of depressions.”

Depression may be due to many factors. Genetics can put certain people at risk for depression. Stressful situations, physical health conditions, and medications may contribute. And depression can also be part of a more complicated mental disorder, such as bipolar disorder. All of these can affect which treatment would be best to use.

Etkin has been developing methods to distinguish patients with different types of depression based on measurable biological features, or biomarkers. The idea is that different types of patients would respond differently to various treatments. Etkin calls this approach “precision psychiatry.”

One such type of biomarker is electrical activity in the brain. A technique called electroencephalography, or EEG, measures electrical activity using electrodes placed on the scalp. When Etkin was at Stanford University, he led a research team that developed a machine-learning algorithm to predict treatment response based on EEG signals. The team applied the algorithm to data from a clinical trial of the antidepressant sertraline (Zoloft) involving more than 300 people.

EEG data for the participants were collected at the outset. Participants were then randomly assigned to take either sertraline or an inactive placebo for eight weeks. The team found a specific set of signals that predicted the participants’ responses to sertraline. The same neural “signature” also predicted which patients with depression responded to medication in a separate group.

Etkin’s team also examined this neural signature in a set of patients who were treated with TMS and psychotherapy. People who were predicted to respond less to sertraline had a greater response to the TMS/psychotherapy combination.

Etkin continues to develop methods for personalized depression treatment through his company, Alto Neuroscience. He notes that EEG has the advantage of being low-cost and accessible; data can even be collected in a patient’s home. That’s important for being able to get personalized treatments to the large number of people they could help. He’s also working on developing antidepressant drugs targeted to specific EEG profiles. Candidate drugs are in clinical trials now.

“It’s not like a pie-in-the-sky future thing, 20-30 years from now,” Etkin explains. “This is something that could be in people's hands within the next five years.”

New tricks for old drugs

While some researchers focus on matching patients with their optimal treatments, others aim to find treatments that can work for many different patients. It turns out that some drugs we’ve known about for decades might be very effective antidepressants, but we didn’t recognize their antidepressant properties until recently.

One such drug is ketamine. Ketamine has been used as an anesthetic for more than 50 years. Around the turn of this century, researchers started to discover its potential as an antidepressant. Zarate and others have found that, unlike traditional antidepressants that can take weeks to take effect, ketamine can improve depression in as little as one day. And a single dose can have an effect for a week or more. In 2019, the FDA approved a form of ketamine for treating depression that is resistant to other treatments.

But ketamine has drawbacks of its own. It’s a dissociative drug, meaning that it can make people feel disconnected from their body and environment. It also has the potential for addiction and misuse. For these reasons, it’s a controlled substance and can only be administered in a doctor’s office or clinic.

Another class of drugs being studied as possible antidepressants are psychedelics. These include lysergic acid diethylamide (LSD) and psilocybin, the active ingredient in magic mushrooms. These drugs can temporarily alter a person’s mood, thoughts, and perceptions of reality. Some have historically been used for religious rituals, but they are also used recreationally.

In clinical studies, psychedelics are typically administered in combination with psychotherapy. This includes several preparatory sessions with a therapist in the weeks before getting the drug, and several sessions in the weeks following to help people process their experiences. The drugs are administered in a controlled setting.

Dr. Stephen Ross, co-director of the New York University Langone Health Center for Psychedelic Medicine, describes a typical session: “It takes place in a living room-like setting. The person is prepared, and they state their intention. They take the drug, they lie supine, they put on eye shades and preselected music, and two therapists monitor them.” Sessions last for as long as the acute effects of the drug last, which is typically several hours. This is a healthcare-intensive intervention given the time and personnel needed.

In 2016, Ross led a clinical trial examining whether psilocybin-assisted therapy could reduce depression and anxiety in people with cancer. According to Ross, as many as 40% of people with cancer have clinically significant anxiety and depression. The study showed that a single psilocybin session led to substantial reductions in anxiety and depression compared with a placebo. These reductions were evident as soon as one day after psilocybin administration. Six months later, 60-80% of participants still had reduced depression and anxiety.

Psychedelic drugs frequently trigger mystical experiences in the people who take them. “People can feel a sense…that their consciousness is part of a greater consciousness or that all energy is one,” Ross explains. “People can have an experience that for them feels more ‘real’ than regular reality. They can feel transported to a different dimension of reality.”

About three out of four participants in Ross’s study said it was among the most meaningful experiences of their lives. And the degree of mystical experience correlated with the drug’s therapeutic effect. A long-term follow-up study found that the effects of the treatment continued more than four years later.

If these results seem too good to be true, Ross is quick to point out that it was a small study, with only 29 participants, although similar studies from other groups have yielded similar results. Psychedelics haven’t yet been shown to be effective in a large, controlled clinical trial. Ross is now conducting a trial with 200 people to see if the results of his earlier study pan out in this larger group. For now, though, psychedelics remain experimental drugs—approved for testing, but not for routine medical use.

Unlike ketamine, psychedelics aren’t considered addictive. But they, too, carry risks, which certain conditions may increase. Psychedelics can cause cardiovascular complications. They can cause psychosis in people who are predisposed to it. In uncontrolled settings, they have the risk of causing anxiety, confusion, and paranoia—a so-called “bad trip”—that can lead the person taking the drug to harm themself or others. This is why psychedelic-assisted therapy takes place in such tightly controlled settings. That increases the cost and complexity of the therapy, which may prevent many people from having access to it.

Better, safer drugs

Despite the promise of ketamine or psychedelics, their drawbacks have led some researchers to look for drugs that work like them but with fewer side effects.

Depression is thought to be caused by the loss of connections between nerve cells, or neurons, in certain regions of the brain. Ketamine and psychedelics both promote the brain’s ability to repair these connections, a quality called plasticity. If we could understand how these drugs encourage plasticity, we might be able to design drugs that can do so without the side effects.

Dr. David Olson at the University of California, Davis studies how psychedelics work at the cellular and molecular levels. The drugs appear to promote plasticity by binding to a receptor in cells called the 5-hydroxytryptamine 2A receptor (5-HT2AR). But many other compounds also bind 5-HT2AR without promoting plasticity. In a recent NIH-funded study, Olson showed that 5-HT2AR can be found both inside and on the surface of the cell. Only compounds that bound to the receptor inside the cells promoted plasticity. This suggests that a drug has to be able to get into the cell to promote plasticity.

Moreover, not all drugs that bind 5-HT2AR have psychedelic effects. Olson’s team has developed a molecular sensor, called psychLight, that can identify which compounds that bind 5-HT2AR have psychedelic effects. Using psychLight, they identified compounds that are not psychedelic but still have rapid and long-lasting antidepressant effects in animal models. He’s founded a company, Delix Therapeutics, to further develop drugs that promote plasticity.

Meanwhile, Zarate and his colleagues have been investigating a compound related to ketamine called hydroxynorketamine (HNK). Ketamine is converted to HNK in the body, and this process appears to be required for ketamine’s antidepressant effects. Administering HNK directly produced antidepressant-like effects in mice. At the same time, it did not cause the dissociative side effects and addiction caused by ketamine. Zarate’s team has already completed phase I trials of HNK in people showing that it’s safe. Phase II trials to find out whether it’s effective are scheduled to begin soon.  

“What [ketamine and psychedelics] are doing for the field is they’re helping us realize that it is possible to move toward a repair model versus a symptom mitigation model,” Olson says. Unlike existing antidepressants, which just relieve the symptoms of depression, these drugs appear to fix the underlying causes. That’s likely why they work faster and produce longer-lasting effects. This research is bringing us closer to having safer antidepressants that only need to be taken once in a while, instead of every day.

—by Brian Doctrow, Ph.D.

Related Links

• How Psychedelic Drugs May Help with Depression
• Biosensor Advances Drug Discovery
• Neural Signature Predicts Antidepressant Response
• How Ketamine Relieves Symptoms of Depression
• Protein Structure Reveals How LSD Affects the Brain
• Predicting The Usefulness of Antidepressants
• Depression Screening and Treatment in Adults
• Serotonin Transporter Structure Revealed
• Placebo Effect in Depression Treatment
• When Sadness Lingers: Understanding and Treating Depression
• Psychedelic and Dissociative Drugs

References:  An electroencephalographic signature predicts antidepressant response in major depression.  Wu W, Zhang Y, Jiang J, Lucas MV, Fonzo GA, Rolle CE, Cooper C, Chin-Fatt C, Krepel N, Cornelssen CA, Wright R, Toll RT, Trivedi HM, Monuszko K, Caudle TL, Sarhadi K, Jha MK, Trombello JM, Deckersbach T, Adams P, McGrath PJ, Weissman MM, Fava M, Pizzagalli DA, Arns M, Trivedi MH, Etkin A.  Nat Biotechnol.  2020 Feb 10. doi: 10.1038/s41587-019-0397-3. Epub 2020 Feb 10. PMID: 32042166. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, Mennenga SE, Belser A, Kalliontzi K, Babb J, Su Z, Corby P, Schmidt BL. J Psychopharmacol . 2016 Dec;30(12):1165-1180. doi: 10.1177/0269881116675512. PMID: 27909164. Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer. Agin-Liebes GI, Malone T, Yalch MM, Mennenga SE, Ponté KL, Guss J, Bossis AP, Grigsby J, Fischer S, Ross S. J Psychopharmacol . 2020 Feb;34(2):155-166. doi: 10.1177/0269881119897615. Epub 2020 Jan 9. PMID: 31916890. Psychedelics promote neuroplasticity through the activation of intracellular 5-HT2A receptors.  Vargas MV, Dunlap LE, Dong C, Carter SJ, Tombari RJ, Jami SA, Cameron LP, Patel SD, Hennessey JJ, Saeger HN, McCorvy JD, Gray JA, Tian L, Olson DE.  Science . 2023 Feb 17;379(6633):700-706. doi: 10.1126/science.adf0435. Epub 2023 Feb 16. PMID: 36795823. Psychedelic-inspired drug discovery using an engineered biosensor.  Dong C, Ly C, Dunlap LE, Vargas MV, Sun J, Hwang IW, Azinfar A, Oh WC, Wetsel WC, Olson DE, Tian L.  Cell . 2021 Apr 8: S0092-8674(21)00374-3. doi: 10.1016/j.cell.2021.03.043. Epub 2021 Apr 28. PMID: 33915107. NMDAR inhibition-independent antidepressant actions of ketamine metabolites. Zanos P, Moaddel R, Morris PJ, Georgiou P, Fischell J, Elmer GI, Alkondon M, Yuan P, Pribut HJ, Singh NS, Dossou KS, Fang Y, Huang XP, Mayo CL, Wainer IW, Albuquerque EX, Thompson SM, Thomas CJ, Zarate CA Jr, Gould TD. Nature . 2016 May 26;533(7604):481-6. doi: 10.1038/nature17998. Epub 2016 May 4. PMID: 27144355.

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Taking Multiple Medications? You May Need to Scale Back.

Many people in the United States are taking five or more prescription drugs. That can lead to serious complications.

By Knvul Sheikh

Around one in five adults between the ages of 40 to 79 is taking five or more prescription drugs, according to data from the Centers for Disease Control and Prevention. And the older patients are, the more likely it is they’re taking even more medications.

But taking many medicines simultaneously, known among medical experts as polypharmacy, increases people’s risk of experiencing severe side effects and drug interactions, said Dr. Nina Blachman, an associate professor of medicine and geriatrics at the N.Y.U. Grossman School of Medicine.

Studies show that taking multiple medications is associated with a faster decline in memory in some patients with mild cognitive impairment, and with a greater risk of falls among people with balance problems or weakened muscles. And certain combinations of drugs can lead to excessive bleeding, dangerously low blood sugar or other serious complications that lead to hundreds of older adults being hospitalized every day. While medicines can be critical for improving our quality of life, it is important to understand how people end up taking too many drugs unnecessarily and when to ask for help trimming your prescription list.

How prescriptions can pile up

As people age, they develop more health issues such as diabetes, heart disease, arthritis and high blood pressure, and “end up on more and more medications,” Dr. Blachman said. Many are never taken off the drugs they’ve been prescribed for years, even if they no longer need them or if there are newer formulations available that can treat different symptoms simultaneously.

Patients sometimes also see a variety of medical providers, each of whom may prescribe medication without necessarily communicating with one another.

Sometimes medical professionals may prescribe drugs to treat the side effects of another medication, in what doctors refer to as a “prescription cascade.” For example, people who take certain over-the-counter pain medicines called nonsteroidal anti-inflammatory drugs may experience an increase in blood pressure, which doctors may misdiagnose as a new ailment and prescribe calcium channel blockers as a treatment. But in some people, these blood pressure drugs can lead to ankle swelling, which may then lead to a prescription for a diuretic to reduce fluid buildup in the body.

“So you just end up chasing side effects of one medication after the next,” Dr. Blachman said.

Older patients may also be more likely to develop new or worse side effects to drugs because kidney and liver function can decline with age, making the body less able to filter out some medications, said Barbara Farrell, a scientist with the Bruyere Research Institute in Ottawa. This can lead to patients being prescribed even more medications to treat those side effects.

While polypharmacy is most common in older people, younger adults and even children, particularly those with complicated chronic conditions like epilepsy, learning disorders or mental health issues, can also end up on many medications.

To further complicate matters, pharmacists and doctors don’t always know how or when to safely help patients come off drugs, Dr. Farrell said. But in recent years, she and other experts have pushed for more guidelines on tapering or stopping prescription drugs.

How to review your medications and cut back where you can

Ideally, doctors and pharmacists should do what’s called medication reconciliation each time you see them, said Kuldip Patel, the senior associate chief pharmacy officer at Duke University Hospital in North Carolina. To do this, his team reviews the list of medications people are taking whenever they are admitted to or discharged from the hospital. But that doesn’t always happen in every medical setting, he said.

Experts suggest asking a primary care doctor or pharmacist to do a full medication review at least once a year. Many pharmacies offer such evaluations under free medication therapy management programs. Make a list of your medicines — including supplements and over-the-counter drugs — or grab all of your pill bottles and take them with you to the appointment, Dr. Patel said.

But perhaps the best time to speak up about prescription use is before you start a new drug. Ask your doctor questions such as “Am I experiencing a symptom that could be a side effect of a drug I’m taking?” or “Can I try to manage this symptom with lifestyle changes first?”

When you do need a medication, check if you can start with a lower dose, Dr. Farrell said. Remind the doctor of medications you are taking and ask how the new drug will interact with them.

Lastly, ask how long you’ll need to take a medication and work on a plan with your doctor to stop taking it if needed. You should understand how your provider plans to help you taper off the drug, what withdrawal symptoms to watch for and how to make sure the issue you were being treated for doesn’t return. “These are questions people should be asking even in their teens and 20s when they’re being started on some of these medications,” Dr. Farrell said. “Then hopefully someday we’ll be able to prevent people from getting to the point where they’re taking 25 medications all together.”

An earlier version of this story misstated the title of Dr. Nina Blachman. She is an associate professor of medicine and geriatrics, not an assistant professor.

How we handle corrections

Knvul Sheikh is a Times reporter covering chronic and infectious diseases and other aspects of personal health. More about Knvul Sheikh

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