History of Drug Use

Man has sought substances to make himself feel good for thousands of years. It’s likely that man’s relationship with (feel good substances) is close to as old as mankind itself. There are records of the ancient Egyptians consuming alcohol over 5000 years ago. The Bible it’s self is full of references to alcohol consumption. The mythical Noah from Noah’s Ark is written aboutgetting drunk. Opium use can be traced by to the Ancient Sumerians whom recorded it as the joy plant in their ancient language also over 5,000 years ago. Wine was such a great part of the culture and lives of the Ancient Greeks that their mythology included Dionysus, a god of wine. Both ancient Greeks and Romans used opium for pain relief.Tobacco was brought back from the Americas by Christopher Columbus in 1493.When John Rolfe came to the New World (USA) he successfully grew and exported tobacco in the new colony of Virginia in the 1610’s. Cannabis plants have been grown for thousands of years. It was grown for industrial purposes such as using hemp to make rope, ship’s sails and paper. The Mayflower which brought over the pilgrims also brought hemp seeds over from Europe and the Declaration of Independence in 1776 was written on hemp paper. Napoleon’s army is said to have brought Hashish back to France from Egypt in 1801, though Napoleon himself saw the ill effects of it and was an early prohibitionist outlawing it’s use. In 1803 morphine was developed from opium which was used as a powerful pain reliever. China developed an opium addiction problem in the 18 th century resulting in the 1729 prohibition of the sale of it by by the Qing Yongzheng Emperor.Britain had a trade deficit for Chinese goods and to combat this they smuggled opium into China ignoring trade laws. This all lead to a larger opium addiction epidemic in China and the Opium Wars between Britain and China from 1839 to 1842 and then again in 1856 to 1860.The US had an epidemic of morphine addicted citizens in the 1800’s after the Civil War since many injured soldiers became introduced to it initially as a treatment for their painful amputations. Morphine is still used in modern medicine for pain relief.

US Drug Laws

Historian Cliff Schaffer stated in an interview that the US drug laws were initially birthed from the racist belief there was a class of people who could control themselves and a class that could not (Gardner 2016). One literal example was in 1901 US Senator Henry Cabot Lodge introduced a resolution which was passed banning the sale of opium and alcohol to “uncivilized races” called the Native Races Act.In 1906 the Food and Drug Act was passed required that the ingredients of medicine by listed on the table so if there were harmful things inside the public were made aware. In 1914 the Harrison Narcotics Act was passed making the first federal drug prohibition law. In 1919 the 18 th Amendment passed prohibiting alcohol. There was also a less known cigarette prohibition; in 1921 cigarettes were outlawed in 14 states.The Marijuana Tax Act was passed in 1937. It didn’t outlaw the use of the drug but rather required anyone dispensing it to register with the Internal Revenue Service.In 1950 theAlberty Food Products Co. V. U.Srequiring the intended use of the medicine to be clearly stated on the label. In 1951 Durham-Humphrey Amendment requiring differentiation between over the counter medication and prescription medication. This helped to prevent some drug abuse by requiring habit forming medicine to be restricted to purchase only be prescription so a doctor could supervise and limit usage. An example would be a dentist prescribing 10 Vicodin pills after dental surgery. The patient is limited to only 10 pills because it’s the dentist’s professional medical opinion that 10 pills is all that person needs and in order to abuse the use of this drug they would need to speak with the dentist again who would make the professional medical call of if more pills are necessary, thereby preventing overuse or abuse.In 1971 President Nixon declared “War on Drugs”. Unfortunately, the US has been fighting this war ever since since drug use is still rampant throughout the country including children and young adults. In 1986 President Ronald Reagan’s wife Nancy Reagan launched an anti-drug program labeled “Just Say No”. In addition to visiting schools across America to discuss the dangers of drug use, she appeared on television with her anti-drug message, speaking directly to the American people as a parent, informing families all over the country about the problems of drugs in the nation.

Cocaine

The genesis of cocaine use was having the cocoa leaf chewed by indigenous people of South America. It gave a delightful energy boost similar to the modern cup of coffee. In 1860 a German chemist, Albert Niemann, isolated the active ingredient in the cocoa plant and published his findings, calling his discovery cocaine . Cocaine began to be used in the US in the 1860’s as an ingredient in health tonics and pain medicine. Cocaine was widely used after that discovery, infamously used by Sigmund Freud and mentioned throughout the fictional popular Sherlock Holmes books.

Opium

Opium comes from the sap of the poppy plant. Morphine, Laudanum andHeroin and all come from this poppy plant. It was used in Alexander the Great’s military as a pain killer similar to how morphine was used in modern warfare. In 1805 Friedrich Wilhelm Adam Serturner created morphine by extracting it from opium. Laudanum was also a popular form a medicine, which is a tincture of opium and often cheaper than alcohol. In 1898 heroin was created out of opium in Germany and sold by the German pharmaceutical company Bayer. It was originally used a cough medicine but quickly caused a problem as the most addictive form of opium. 

C. Modern Prescription Medications

Society doesn’t merely have a problem with illegal drugs but also the abuse of prescription medication. Like many of the drugs which are now illegal cited in my history of drug use many people today legally consume medication which they become addicted to. Medication is still prescribed today which contains opium which are called opiates. Examples of opiates used today are Morphine, Hydrocodone, and Codeine. A person can harm themselves on legally prescribed drugs just like illegal drugs if they abuse them. Legally prescribed pills are sold just as illegal drugs are to people wishing to only take them recreationally as well as consumed by people who abuse the prescriptions given to them for recreation. This is why laws exist causing a doctor to need to refill prescriptions rather than an unlimited prescription. Some doctors are more liberal with their prescription pads, writing a prescription for a narcotic when Tylenol or Aspirin would suffice. Another way legal prescription drugs are abused are by patient altering the prescription pad to attempt to get more pills than prescribed. Sleeping pills such as Ambien and stimulants such as Ritalin are also abused for recreational purposes. 

Treatment and Alternatives to Drug Use

To find an alternative to drug use one needs to first define drug use. In writing this paper I have used the word “drug” to include tobacco and alcohol as they are a vice as well used to enhance a positive feeling in the body. The definition could even be expanded to include caffeine. Regardless of how you define drug it’s widely accepted that a good alternative is find the reason why the person is seeking help from this substance. Drugs are often a means of self medication for a problem so finding the causation of that problem and trying to solve it or at least handle it better is an alternative to drug use.

The best thing to happen in regards to the health and welfare of the US in regards to drugs is the knowledge of their harmful effects. Knowledge such as the links between tobacco and cancer or the high rates of addiction for cocaine and heroin so the individual could make informed decisions is the best tool. The US was founded by people being told what to do rebelling so we are not exactly a nature of rule followers. That is why it’s opinion based on logic and reasoning that informing people of the dangers of something so they can make the choice to stop using something is more effective than the outright outlawing of it. Secondly realizing that drug addiction is a disease and treating as such instead of a purely a criminal act was another important change. There is no disease which has the side effect of going to gun store, filing for the license, loading the weapon, and then firing it as someone you do not like but the physical dependence on a drug is an actual biological change with physical symptoms so should be treated like the disease it is rather than just a criminal act. Courts have ruled that an individual attend a drug rehabilitation program instead of just sentencing them to jail as punishment. In the situation of habitual drunk driving a judge may demand they put a Breathalyzer in their vehicle which further demonstrates the court’s understanding of alcohol addiction as a sickness and driving under the influence isn’t a malicious act always. 

Alcoholism and prescription drug abuse was something families didn’t talk about out of shame. One event that helped break the stigma of alcoholism and drug abuse and making American public realize it was a problem of everyone, including good families was Betty Ford admitting to addiction to both. Betty Ford was President Gerald Ford’s wife and she admitted openly to the American public that she had a problem, sought treatment and then founded the Betty Ford Center in 1982 to help others. Understanding this was a problem that could even effect the president’s wife helped break the stigma of addiction and getting help for it. One of biggest signs that drug addiction is being less stigmatized by society but rather socially understood and treated like illness are the commercials for treatment centers on television. By advertising openly on television it conveys a message that this doesn’t have to be a secret or treated like just a crime but something you can get help for in a supportive setting. This is especially true for the resort style treatment centers that display commercials more akin to a vacation advertisement, displaying pools, yoga classes and professional chefs. This approach is a vast contrast to stigmatizing drug addiction as just a crime or something only the poor uncivilized members of society do. Patients get counseling on how to be a healthier more adjusted person rather than just stop their addiction cold turkey. This is a much more logical approach because as mentioned above, in order to recover from addiction someone should learn why they turn to drugs and how to cope with their problems in a healthier way. 

Formal addiction recovery programs exist such as Alcoholics Anonymous (AA), Betty Ford Center and many more treatment centers that address treatment of the whole person by medical professional which includes diet consultation, fitness, and talk therapy by licensed therapists to find the root of why people are abusing a substance. Treating drug addiction is not an easy thing to do since the addicts cannot simply stop using the drugs for a few days and get cured (Drugabuse,gov, n.d.). In most cases, long-term care should be provided to the patients to enhance the recovery. Another thing which makes the rehabilitative approach complex is the fact that there is no single treatment which is right for everyone. While treating the patients, all the needs of the patients ought to be addressed for the treatment or rehabilitation to be effective. This needs change often. With that, the plans of treatment have to be reviewed regularly and then modified to meet the changing needs of the patients. There are options for treating drug addiction which have successfully been used before. They include: medication, one-on-one therapy, group therapy, long-term follow-ups to prevent relapse and medical devices and applications used to treat withdrawal symptoms and evaluation or treatment for mental health issues such as depression.

The upsurge in treatment centers and advertisements for treatment centers is really a positive thing because as referenced in my long report about the historical use of drugs, this has been a problem that has needed to be addressed for a long time. The use of “feel good substances” and the abuse them is no new phenomena but effective formal treatment methods are.

Devices and medications are used in drug addiction treatment in the following ways. The medication and devices help in the suppression of withdrawal symptoms at the time when detoxification is being undertaken. The medications can be used to assist in the establishment of normal brain functioning and reduce cravings. In case of the patients who are addicted to multiple substances, the treatment for the different addictive substances is done. Below is a list of some addictive substances and their treatment.

Addictive drug	Treatment
Opioids	Methadone, naltrexone and buprenorphine.
Tobacco	Bupropion and varenicline (Nicotine replacement therapies such as spray, patch, gum and lozenges are also used).
Alcohol	Acamprosate, Naltrexone and Disulfiram

Modern Day Social Attitudes on Addictive Substances 

As referenced above drugs have typically been accepted by society, then as more people get addicted and adverse effects manifest legislation and public opinion has generally shifted towards it negatively. Examples of this are cocaine, tobacco and opium which were all used at one time with general ignorance, amnesty and acceptance until more knowledge was gained about their ill effects. 

Tobacco unlike the other examples has not been outlawed but is severely regulated. Smoking tobacco is generally viewed negatively today for the health risks associated so a user is deemed rude if they start smoking among other people without asking permission or stepping outside away from others. Smoking tobacco products was once glamorous and widely accepted with America’s favorite family; Lucille Ball and Desi Arnaz openly smoking casually throughout the 1950’s television show; I Love Lucy. After their characters casually lit up throughout the episode they would further promote smoking by personally advertising for Phillip Morris cigarettes in television commercials. Today cigarette advertisements are highly regulated and cannot be advertised on family television and it’s rare to see fictional characters smoking unless it’s either a period film or they are the bad guy. This is all evidence of the public’s changing view towards the smoking of tobacco products. Furthermore, it is often illegal to smoke inside most establishments or even in front of a business, school or hospital unless you are many feet off the property. 

Alcohol has faced similar restrictions to a lesser extent. Though it is legal there are added restrictions to it such as age requirements for consumption and to sell it a business must have an added liquor license which is expensive. Though drinking is perfectly legal for consenting adults on a federal level their still exists local laws restricting the sale of alcoholin“dry counties”. In dry counties the sale of alcohol is prohibited. This prohibition has been received more positively by citizens since it’s only a restriction at the local level which allows people to “vote with their feet” and move elsewhere if they don’t like it. It allows more freedom to choose for themselves. To combat drunk driving some police departments have set up random drunk driving checkpoints. There also public service commercials about the fact “cops are cracking down on drunk driving” to further put the warning out not to drink and drive. Public opinion is mixed on the reaction to this. Some parents embrace this as a good measure since it keeps their families safer but many people believe it’s a violation of their rights. YouTube is full of driver recorded videos who protest being stopped in a checkpoint, refuse to answer questions and cite the rights as US citizens who should not be stopped unless they are under suspicion of committing a crime. 

Marijuana is arguably the drug of most controversy in modern day. It’s generally agreed that heroine and cocaine shouldn’t be legal and consumed freely by the public. Opium products such as morphine are by prescription only which is not causing much debate. However, marijuana legalization is divided in current public opinion. As a result, laws on it’s legal use are not consistent throughout the country in contrast to other formerly illegal drugs. Some states have legalized its recreational use, some have only legalized its medical use and some have no legalization of this drug. Colorado for example is popular out legalizing the use of marijuana, while my state of New Jersey only allows it for medical purposes. As knowledge of medical benefits emerge on the use of Marijuana the argument for legalization has strengthened. 

The issue of drug use in American society has been the source of debate for a long time. There have been different views held with regard to the regulation of drug use in the America society with drug policies reigning. Studies indicate that penalties have been established for different drug categories with certain drugs attracting lighter punishments while others are bound to have harder punitive actions. A poll released by Pew Research Center has indicated that out of three Americans two hold the view that people should not be taken to courts for prosecutions when found in possession of certain drugs. Different states, as well as the federal government, have set regulations governing how people caught in possession of illicit drugs ought to be treated. In this light, of the people interviewed, fifty-four percent supports that marijuana should be legalized while sixty-three percent are of the opinion that there should be a movement away from enforcing mandatory minimums ( Pew Research Center, 2015) . Furthermore, since marijuana stands out as the most abused drug in America, forty-four percent of the interviewed population opine that it the drug should be rendered legal for use only in medicine while thirty-nine percent hold the view that people should be allowed to use Marijuana for personal reasons.

According to the Pew Research Center that conducted the polls, a majority of the American citizens are in agreement that it is no longer feasible to have mandatory minimums for drug offenders but rather adopting a treatment approach ( Pew Research Center, 2015) . Of the interviewed population, sixty-seven percent opine that the government needs to put more emphasis on the treatment of cocaine and heroin drug users with only twenty-six percent holding contrary opinion inclining towards prosecution ( Pew Research Center, 2015) . Furthermore, thirty-two percent of the interviewees view drug use as a cause for concern in the country terming it as a national crisis while fifty-five percent think it is a serious problem rather than a crisis.

Pharmacological Bases 

Pharmacology can be viewed as the branch of biology that is responsible for evaluating how drugs act most notably with the interaction of the chemical components of the drugs and the biochemical functioning of the body system. Drugs have a significant effect on brain cells. Other than marijuana, heroin has been shown to bind to the opioid receptors in the brain making the brain to release dopamine. It can be argued that drugs overtake the functioning of the limbic system ( Watkins, n.d.) .

When taken, the addictive drugs can alter the way the users think, feel and behave. This occurs as a result of the drug taken disrupting neurotransmission and hence the normal brain’s response to experiences and the environment. The neurotransmitters convey information about the environment from the neuron to another through the circuit of the brain and determines human’ responses. Different drugs affect the neurotransmission differently to cause the addictions and impaired judgment or the responses associated with the intake of the drugs (Drugabuse,gov, n.d.).

There are drugs which mimic the neurotransmitters. Heroine is a good example of such a drug. Such drugs chemically resemble the brains encephalin and endorphin to an extent that the drug engages and stimulates their specialized receptors. Marijuana mimics anandamide and other cannabinoid neurotransmitters. Nicotine attaches to the neurotransmitter for the cholinergic system named acetylcholine.

Some drugs do alter the neurotransmission through their interaction with molecular components of the sending and receiving process other than the receptors (drugabuse.com, n.d.). An example of such an addictive drug is cocaine. It attaches to dopamine transporter and the dopamine failed to re-enter the neuron. It thus builds in the synapse stimulating receiving-neuron receptors and produces much dopamine impact on the receiving neurons than it naturally occurs. Other drugs alter the neurotransmission in different ways than altering the quantity of receptors which are stimulated. An example is Benzodiazepines such as lorazepam and diazepam. These produce a feeling of relaxation since it enhances the reception of neurons’ responses when inhibitory neurotransmitter GABA (an inhibitory neurotransmitter) attaches to the receiving neurons’ receptors (Drugabuse,gov, n.d.).

To be more specific when someone smokes Marijuana the following happens;

The smoke is inhaled causing the chemicals in marijuana to be absorbed through the lungs and into the blood. Then it’s carried through the blood into the heart which pumps the blood. As this chemical spreads through the blood the vessels dilate including in the eyes which is where the quintessential blood shot pot smoker eyes look come from. Blood pressure drops which is why some people feel light headed when smoking the drug. The THC chemical from the drug travels through the blood to the brain. The THC chemical takes control of the receptors within the brain. When the drug is eaten the THC is absorbed through the small intestine then into the blood where it then travels into the hypothalamus of the brain. Again it takes control of the receptors of the brain (L. 2011).

Long-term effects on the brain from long term use can result in reduced blood flow to the frontal Lobe which is responsible for decision making, thinking, learning and memory (Hospital 2018).

The limbic system is the brain part that has complex structures including the hypothalamus, amygdala, and the hippocampus that are charged with regulating the emotions in human beings. Through overtaking the functioning of the limbic system, heroin and other prescribed opioids are able to influence the body systems ( Watkins, n.d.) . Studies have established that the affected limbic system for example in the hypothalamus may result in sending messages to the pituitary gland triggering the release of hormones into the bloodstream.

Cocaine has a similar mode of functioning flooding the brain with dopamine gaining control of the central nervous system creating surges in energy levels, attention, focus, and wakefulness. Additionally, there is shown an impact on the heart that is achieved through inhibiting norepinephrine reuptake. Norepinephrine as a neurotransmitter and hormone has been shown to increase in functioning during instances of danger and stress ( Watkins, n.d.) . As such, with the inhibiting of norepinephrine reuptake, the sympathetic nervous system is affected resulting in prolonged and exaggerated sympathetic nervous activity. It is worth mentioning that the sympathetic nervous system is responsible for preparing the body for flight or fight as a defensive mechanism. When this mechanism is triggered, the heart muscles are forced to contract increasing the rate of the heart beating and consequently increased blood pressure. Additionally, cocaine leads to constriction of capillaries downplaying the rate of blood flow to the heart muscle.

Personal Thoughts

I’d like to end this paper with concluding that drugs have had an overall negative effect on society. Humans have an addictive personality and desire to seek things that feel good so historically unfettered access to these “feel good” substances have led to trouble. Weather we are referencing the opium addiction epidemic of China centuries ago or the current opioid addictions of today we see a degradation of society through the use of drugs. Even the widespread use of legal “feel good” substances such as tobacco have had an extremely negative effect on society with it’s links to cancers and heart disease which happens to be the number one cause for death in the United States. Some drugs aren’t inherently bad but due to their addictive nature must be carefully controlled. This is why the modern laws requiring prescriptions by doctors to first initiate access to drugs and then re-fill that prescription if you want more is very positive. I am thankful that pain killers exist even if they contain substances from the opium plant because when used correctly make painful surgery more easy to recover from. Due to their addictive nature it’s highly necessary that our government and medical providers whom we trust do their job to regulate and oversee drug use to essentially save the people from themselves. Even legal substances such as alcohol and tobacco are highly regulated in regards to whom can buy and sell them to prevent the misuse especially with children whose body and brains are still developing so are at added risk to ill effects of the substances. When looking back on the prohibition of the 1920’s I conclude that rather than just the outright banning of substances to protect people, putting controls on them in addition to education and treatment facilities for the abuse of them seems more effective. If the public is educated on the negative effects of drugs and also how they have negatively effected the lives of others such as destroying marriages, causing unemployment, car accidents or lead to a life of crime to feed the addiction they might make more informed decisions.

Due to their habitual indulgence in drugs, parents who abuse drugs like marijuana often neglect their children. They miss access to parental love, counsel as well as basic needs. Research has shown that parents who abuse drugs prioritize drugs to social welfare of their siblings. According to 2002 to 2003 National Survey on Drugs Use and Health (NSDUH ) data, 4.3 percent of pregnant women aged between 15 and 44 years admit having had used drugs in a duration of a month. The same report alludes to new mothers to the tune of 8.5 percent having used illicit drugs within a duration of one month (National Drug Intelligence Center, 2006). 

Children whose parents, guardians or relatives use marijuana suffers not only physically but also undergoes emotion torture. This impairs their growth as they are deprived of health care due to physical illnesses inflicted by their relatives. They also lack basic needs like food clothes education and shelter. There also exist notorious parents who manufacture illicit drugs at the comfort of their homes. More often than not, the children who occupy those premises inhale, for example, hydriodic acid that is emitted from methamphetamine production. This interferes with their developing brains and eventually brings about brain disorders amongst the children. National Committee of Laboratory study and safety(NCLSS) data has it that 9895 illicit methamphetamines was seized by US law enforcers in 2004 and 2474 children who lived in those laboratories as they were displaced from their homes were adversely affected. (If you need any other help you can reach me by juniormucheke at g mail dot com). 

Disruption of the societal fabric, that is family, is another effect of cocaine use to those caught in its downward spiral. Studies show that if a family member is in drugs like cocaine, and a problem emanating from its side effects of ensues, then there is a ripple effect on the entire family members. If one spouse is an addict, there is a problem of strain on the other partner as they have to work on their own to cover up what was initially a shared responsibility this weakens the institution of a family. It causes the other spouse unnecessary fatigue, stress and eventual disillusionment. Additionally, it raises parental upbringing concerns due to morale derailment on the part of the other partner. Children of parents who excessively consume alcohol often have a tendency to follow suit to the steps of their parents hence contributing less to the society in future. As a coping mechanism, children of alcoholics turn into drugs creating a poverty vicious cycle. Youths who abuse opium for example leads to other roles of the family being overlooked as their parents have to channel the available resources to either treatment or rehabilitation. 

A strong correlation exists between drugs and substance abuse and crime rates. The reason is the addicts are trying to gather money to obtain substances of their choice. It is estimated that there are 30 million drug addicts world-wide, with heavy concentration among the youths, and that drug addiction has spread through the populations, especially the youth ( Possi, 2018 ). Usually violence characterizes their orthodox ways of financing their drug life. According to report by the US; over half of federal prison occupancy consists of individuals addicted to hard drugs like cocaine, bhang and opium. Drug related crimes cost the nation 45 billion dollars in states prisons and a whopping 144 million dollars in federal prison annually. This causes the society time, money and unnecessary strain to local resources. 

Dismal performance in the place of work. ‘Narcotic consumers are incompetent, foolhardy, impulsive and/or have ‘sensational –seeking’ personalities and therefore lack inner control…’’ ( Goldberg, 2016 ). Drug abusers are mostly worn out, wasted, arrives to the place of work late and at times never report to work at all. They are unproductive in work due to feeble intrinsic drive and this causes role multiplicity and role strain from the other colleagues to cover up for the un resourceful addict. This breeds irritation on the part of the other employees, poor relationship and exhaustion. This hinders the other employees’ maximum productivity at work. 

References

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Drugabuse.com, (n.d.)“History of Substance Abuse: History of Substance Abuse Rehabilitation”. Retrieved from https://drugabuse.com/addiction/history-drug abuse/ 

Gardner, F. (2016, October 01). The History of Illegal Drugs (Earth documentary). Retrieved from https://www.youtube.com/watch?v=j-zNiK3c7vo 

Goldberg, T. (2016).  Demystifying drugs: A psychosocial perspective . Springer. 

HISTORY, I. (2015, August 22). The Opium War - Lost in Compensation l HISTORY OF CHINA. Retrieved from https://www.youtube.com/watch?v=kd2CYPdYwcY&t=175s 

Hospital, B. A. (2018, March 19). Cocaine and the Brain, The Holman Archives Video, Radiology Department. Retrieved from https://www.youtube.com/watch?v=ZKkyQZE5m5I 

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Pew Research Center. (2015, January 12). America's New Drug Policy Landscape. Retrieved from http://www.people-press.org/2014/04/02/americas-new-drug policy-landscape/ 

Possi, M. K. (2018). Effects of drug abuse on cognitive and social behaviours: a potential problem among youth in Tanzania.  Utafiti Journal ,  3 (1). 

Timeline of Events in the History of Drugs. (2014, December 15). Retrieved from https://inpud.wordpress.com/timeline-of-events-in-the-history-of-drugs/ 

US Legal, Inc. (n.d.). Marijuana Tax Act Law and Legal Definition. Retrieved February 22, 2019, from https://definitions.uslegal.com/m/marijuana-tax-act /

Watkins, M. (n.d.). How Drugs Affect the Brain and Central Nervous System. Retrieved from https://americanaddictioncenters.org/health-complications addiction/central-nervous-system