[Pharmacological and psychosocial aspects of drug dependence]

Use and abuse of psychotropic drugs start with history, but toxicomania starts much later, with the discovery of morphine, in early XIXth. Century; and increases sharply after the 2nd. World War. The author reviews the general classifications of drug abuse, stressing the many differences among them, as well as the differences in clinical approaches to each one of them, and in criteria for treatment. Abuse of drugs takes many different forms roughly reduced to three: a) "traditional" addicts, with permanent and heavy intake of barbiturates, amphetamines, alcohol and narcotics; b) regular mass consumers of medicines, legally prescripted by doctors on grounds of unwise criteria or sheer complicity; c) members of the "Drug Culture" making of drug abuse a symbol of doctrinary social claims. Addictive drugs are classified, according to Lehmann, into three groups: 1. Expansive drugs: producing intense feeling and elation, according to three classes: a) Thrill drugs, causing an immediate deep pleasure, a jolt in the stomach and warm waves towards the abdomen and genitalia, with orgasmic effects; b) Easiness drugs, increasing energy and self-reliance and decreasing fatigue or ill-feelings; c) self-realization drugs, leading to deep and rich self-awareness, and heighted aesthetic and intellectual potential. 2. Reductive drugs: lowering the intensity of sensations and emotions, in three kinds: a) Releaser drugs, causing removal of inhibitions and production of phantasies; b) Sedation drugs, easing tensions and anxieties; c) Stupefying drugs, blurring all contact with the outer world. The author analyzes the patterns of intake, which include generally two or more different types of drugs, and vary in the same individual according to circumstances. Finally, several factors leading to addiction are considered, among them: biological and genetical endowment or predisposition; psychological conflicts or flaws; and social factors.