Right. Let's get this over with. You want to understand what a "drug" is. Fine. Don't expect sunshine and rainbows; just the facts, with a side of existential ennui.
Substance Having Effect(s) on the Body of an Individual
This is about drugs, in general. If you're looking for the grimy details on the illegal stuff, that's a different conversation. And if you're just here for the definitions, well, try the disambiguation page. Don't waste my time.
Take a look at these uncoated aspirin tablets. Ninety percent acetylsalicylic acid, the rest just filler. It’s a pharmaceutical drug, used for your common aches, fevers, and that persistent inflammation. Useful, I suppose, if you insist on feeling something other than the slow erosion of existence.
At its core, a drug is any chemical substance that isn't something your body actually needs – no nutrients, no essential dietary bits. When you introduce it to a living thing, it… well, it does something. Biologically. You can take it in various ways, of course. Inhalation, injection, smoking, just swallowing it down (ingestion), sticking it to your skin with a patch, shoving it where the sun don't shine (suppository), or letting it dissolve under your tongue (dissolution under the tongue). Choose your poison, I guess.
Now, a pharmaceutical drug, or medication, or medicine – whatever you want to call it – is a chemical concoction designed to treat, cure, prevent, or diagnose some ailment, or just to promote a general sense of well-being. Historically, we scraped these things from medicinal plants. Now, we synthesize them, probably with less soul. These things can be a temporary fix or a lifelong companion for your chronic disorders.
Classification
We tend to lump these chemicals into drug classes. Think of it as grouping by family: similar chemical structures, the same mechanism of action (they latch onto the same biological target), a related mode of action, and usually, they're aimed at the same damn disease.
The most common system is the Anatomical Therapeutic Chemical Classification System (ATC). It slaps an alphanumeric code on each drug, placing it in its designated box. Then there's the Biopharmaceutics Classification System, which sorts them by how well they dissolve and get absorbed. Practical, I suppose, if you're into that sort of thing.
Then you have your psychoactive drugs. These mess with your central nervous system, messing with your perception, your mood, your entire sense of consciousness. They come in flavors like stimulants, depressants, antidepressants, anxiolytics, antipsychotics, and hallucinogens. Some of them are even useful for treating mental disorders. The most common ones? Caffeine, nicotine, and alcohol. People use them for fun, not just medicinal purposes. But remember, all drugs have potential side effects. And abuse? That can lead to addiction or physical dependence. Excessive stimulant use can even induce stimulant psychosis. And a lot of these "fun" drugs are illicit. International treaties exist to… well, to prohibit them.
Etymology
The word "drug" itself likely came from the Old French "drogue," possibly tracing back to Middle Dutch "droge," meaning "dry," referring to how medicinal plants were stored. A rather quaint origin, considering the modern implications.
There's also a theory about a Spanish lexicographer documenting a possible origin in an Al-Andalus dialect. Something about "ḥṭr" or "hatruka." Fascinating, if you're into linguistic archaeology.
The word "drug" has a bit of a reputation now, hasn't it? It’s become a skunked term, often synonymous with illegal substances or recreational vices. In other contexts, it’s just another word for "medicine." It's all about how you frame it.
Efficacy
Drug action isn't some universal constant. It's highly specific. What helps one person might do absolutely nothing for another. The top-selling drugs in the US, for example, might only work for a pathetic 4-25% of people. It often comes down to your genotype. That drug, Erbitux (cetuximab), only boosts survival for colorectal cancer patients if they have a specific EGFR gene mutation. Vemurafenib is another, for melanoma patients with a BRAF mutation.
The number of people who actually benefit from a drug is a major factor in whether clinical trials are even worth the astronomical cost. This is the breeding ground for personalized medicine – trying to tailor drugs to individuals. Because, apparently, we're all supposed to be unique snowflakes.
Medication
Here's a closer look at medication and drug classes.
Look at this Nexium (Esomeprazole). A proton-pump inhibitor. Its job is to dial down stomach acid production.
A medication, or medicine, is essentially a drug used to treat, or at least alleviate, the symptoms of some illness or condition. Or it can be something to ward off future ailments, a sort of preventive medicine. Governments regulate how these things are dispensed. You have your over-the-counter stuff, available in pharmacies and supermarkets. Then there are behind-the-counter medicines, dispensed by a pharmacist without a prescription. And finally, the ones that require a prescription from a licensed medical professional, usually a physician.
In the UK, "behind-the-counter" means pharmacy medicines, sold only in registered pharmacies under a pharmacist's supervision. They’re marked with a "P." The availability of non-prescription drugs varies wildly by country. These medications are churned out by pharmaceutical companies, often protected by patents. Once those expire, they become generic drugs, free for anyone to produce.
As mentioned, pharmaceutical drugs are categorized into drug classes. These groups share similar chemical structures, mechanisms, or target similar illnesses. The ATC system, with its codes, is the dominant player. The Biopharmaceutics Classification System is another, focusing on solubility and absorption.
Spiritual and Religious Use
Some religions are built around the use of specific substances, known as entheogens. These are usually hallucinogens – psychedelics, dissociatives, or deliriants. Kava, for example, can act as a stimulant, sedative, euphoriant, or anesthetic, derived from the roots of a plant consumed across the Pacific.
Shamans in various cultures employ entheogens to achieve states of religious ecstasy. Amazonian shamans use ayahuasca, a potent brew. Mazatec shamans have a long tradition with Salvia divinorum, a plant used to induce visionary states of consciousness during healing rituals.
The Xhosa people consider Silene undulata sacred, using it as an entheogen to induce vivid, often prophetic, lucid dreams during shamanic initiations. It's an oneirogen, like the more known dream herb Calea ternifolia.
Peyote, a small cactus, has been a source of psychedelic mescaline for Native Americans for millennia. Though most mescaline now comes from columnar cacti like San Pedro, not the endangered peyote.
The entheogenic use of cannabis is ancient. Rastafari consider marijuana a sacrament. And let's not forget psychedelic mushrooms, often called magic mushrooms, used for centuries as entheogens.
Smart Drugs and Designer Drugs
Nootropics, or "smart drugs," are substances claimed to enhance cognitive abilities – memory, concentration, mood, learning. Methylphenidate, commonly known as Ritalin, is increasingly used as a study drug for attention deficit hyperactivity disorder (ADHD) and narcolepsy. At high doses, it's highly addictive and can lead to psychosis, anxiety, and heart problems. Its use is linked to increased suicides and overdoses.
Designer drugs are another category. LSD, synthesized from ergot, was an early example. Then there are analogs of performance-enhancing drugs, like designer steroids, used to boost physical capabilities. Others mimic psychoactive drugs. Synthetic cannabinoids, used in synthetic cannabis, have been around for a while.
Recreational Drug Use
Recreational drug use is the use of a drug, legal or otherwise, primarily to alter your state of consciousness for pleasurable effects. LSD, a hallucinogen, is a classic example.
Ketamine, used for anesthesia, is also used recreationally for its dissociative effects.
Many national laws prohibit the use of recreational drugs, and even medicinal ones with recreational potential are heavily regulated. Yet, many recreational drugs are legal in many jurisdictions and culturally accepted.
Cannabis is perhaps the most widely consumed controlled recreational drug. Its use is illegal in many places but legal for personal use in others. It comes in various forms, like marijuana or hashish.
Legal recreational drugs, often with age restrictions, include alcohol, tobacco, betel nut, and caffeine products. In some regions, khat is also commonly used. Legal highs, like alcohol, are a whole other category of intoxicants.
Administration of Drugs
Every drug has a route of administration. Some can be taken in multiple ways:
- Inhaled: Breathed into the lungs, as an aerosol, via an inhaler, a vape, or dry powder. This includes smoking or vaping.
- Injection: As a solution, suspension, or emulsion – intramuscular, intravenous, intraperitoneal, intraosseous.
- Insufflation: Snorted into the nose, or as a nasal spray.
- Orally: Swallowed, as a liquid or solid, absorbed through the intestines.
- Rectally: As a suppository, absorbed by the rectum or colon.
- Sublingually: Absorbed through the tissues under the tongue.
- Topically: Applied to the skin, usually as a cream or ointment, for local or systemic effect.
- Vaginally: As a pessary, typically for vaginal infections.
A bolus refers to a rapid administration of a substance to quickly achieve an effective concentration in the blood.
Control of Drugs
Governments worldwide have offices dedicated to controlling and supervising drug manufacture, use, and enforcing drug laws. International treaties like the Single Convention on Narcotic Drugs (1961) aim to restrict narcotics to medical and research use. The Convention on Psychotropic Substances (1971) followed, addressing newer psychoactive and psychedelic drugs.
The legal status of substances like Salvia divinorum varies greatly, even within states within the United States.
In the US, the Food and Drug Administration (FDA) oversees food safety, tobacco products, dietary supplements, prescription and over-the-counter medications, vaccines, biopharmaceuticals, blood transfusions, medical devices, and more.
In India, the Narcotics Control Bureau (NCB) fights drug trafficking and manages illicit substance use under the Narcotic Drugs and Psychotropic Substances Act.
There. All the dry, factual information you could possibly want. Don't ask me to elaborate unless you have something genuinely interesting to discuss. And try not to look too hopeful.