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Origins of Addictive Behavior: A Nature Heritage or a Neuropsychiatric Nurtured

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ARTICULO DE REVISION
Origins of Addictive Behavior: A Nature Heritage or a Neuropsychiatric Nurtured
Reality?
Luis Maia, PhD
Abstract
In this paper we present a revision on the origins of Addictive Behavior and related neural basis. Although there are abundant
specific bibliography and professions focusing on addictions treatment, the reasons why people started with addictive behaviors and
consequently maintain are still not well understood. This article explores the construction, meaning, and impact of addiction in histori-
cal and psychological perspective. The challenge to the usual concept of addictions causes has significant implications for medical
practice and for treatment programs. Furthermore, with this article we present the phenomena of Multifactorial Polygenic Heritage as
a possible theory for the explanation of addictive behavior, being consequently important for its prevention and treatment. The roles
of social, cultural, and population differences, as they may relate to addictive behaviors, are explored. Keywords. Electroneurography.
Electromyography. Nerve injury. Accessory spinal nerve.
Keywords: Addiction; Vulnerability; History of Drugs, Neuropsychiatry of Drugs
Resumen
En este documento presentamos una revision sobre los origenes del comportamiento adictivo y sus bases neurales. Aunque hay
abundante bibliografia especifica y profesiones centrandose en el tratamiento de adicciones, todavia no se entienden bien las razones
por lo que las personas comenzaron con comportamientos adictivos y los mantienen. Este articulo explora la construccion, significado
e impacto de la adiccion en una perspectiva historica y psicologica. El desafio para el concepto habitual de causas de adicciones tiene
importantes repercusiones para la practica medica y para los programas de tratamiento. Por otra parte, con este articulo presentamos
los fenomenos del patrimonio poligenico multifactorial como una teoria posible para la explicacion del comportamiento adictivo, con
consecuencias importantes para su prevencion y tratamiento. Las funciones sociales, culturales y las diferencias de poblacion, en lo
que se puede referir a comportamientos adictivos son explorados.
Palabras clave: Adiccion; Vulnerabilidad; Historia de las Drogas; Neuropsiquiatria de las Drogas.
Resumo
Neste artigo apresentamos uma revisao sobre as origens do comportamento aditivo e as suas bases neurais. Embora haja abundante
bibliografia especifica, bem como profissoes no campo, enfocando o tratamento de dependencias e os motivos que levam as pessoas a ini-
ciarem os seus comportamentos de adicao e, consequentemente, mante-los, estes ainda nao sao bem compreendidos. Este artigo explora
a construcao, significado e impacto da dependencia numa perspectiva historica e psicologica. O desafio ao conceito usual de causas de
dependencias tem implicacoes significativas para a pratica medica e para programas de tratamento. Alem disso, neste artigo apresenta-
mos os fenomenos da Heranca Poligenica Multifatorial como uma possivel teoria para a explicacao do comportamento de dependencia,
sendo consequentemente importante para a sua prevencao e tratamento. Sao ainda explorados os papeis sociais, culturais e as diferencas
de populacao, bem como eles podem incidir sobre os comportamentos de dependencia.
Palavras chave: Adicao, Vulnerabilidade; Historia das drogas; Neuropsiquiatria das Drogas
Rev. Ecuat. Neurol. Vol. 19, No 1-2, 2010
Auxiliar Professor - Beira Interior University - Portugal.
Correspondencia:
Clinical Neuropsychologist, PhD (USAL - Spain)
Clinical Psychologist (Minho University - Portugal)
Neuroscientist, MsC (Medicine School of Lisbon - Portugal)
Beira Interior University, e-mail: lmaia@ubi.pt
Medico Legal Perit (Medicine Institute Abel Salazar - Oporto,
Portugal)
Graduation in Clinical Neuropsychology (USAL - Spain)
Graduation in Investigative Proficiency on Psychobiology (USAL -
Spain)
Clinical Psychologist (Minho University - Portugal)
Beira Interior University, e-mail: lmaia@ubi.pt
64 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010

Introduction
depressing effect had just been discovered". In its review,
The term "addiction" was initially used by medical
the authors suggest that Ethanol was the first substance
and moral authorities as a medical condition to charac-
intentionally used in order to make surgery possible. As
terize what was till that time denominated of "habitual
example of that, they state that ethanol was the only anes-
drunkenness", used in the late 18th century.1-2 The term
thetic drug (in form of wine) used by barber-surgeons
addiction did not exist before that date and rapidly evol-
from the Napoleonic army, that invaded Russian in 19th
ved for the field of actual illegal drugs, which at that time
Century. This therapeutic utilization was interrupted be-
were the only drugs used in the majority of the fields of
cause the non-significant therapeutic index and problems
medicine, like the opiate morphine, in the case of Vete-
in intentionally awaking patients, and culminated with
rans of America Civil War (1861-1865). The terminology
the interruption of these procedures in the early 20th
"Addiction" is currently used as a general term to cover
Century.
up a subject with a number of other expressions particu-
In terms of curiosity, these inebriating and amne-
larly "alcoholism"; and well before, "inebriety," in the ex-
sic effects served as the basis for the first written known
tended records of talking with reference to alcohol; and
description of an incest relation between Lot (Abraham's
"dependence," in contemporary nosologies.3
nephew) and his two daughters (altogether they have
The most widespread psychoactive drug used by
left from Sodome).8 From these relationships Moabite
mankind, since ancient and biblical times is alcohol, and
and Amanite tribes originated. According to the authors
a simple glance in the Old Testament demonstrate the
this lascivious effect of alcohol to facilitate rape was
importance in psychological effects, and even in terms
replaced by the benzodiazepine flunitrazepam (Rohip-
of genetic influence, as well as moral, environmental and
nol), legally banned in several countries (although they
so forth.4,5 Alcohol and opiate substances were the first
have been first developed as benzodiazepine drug used
psychoactive substances used with this purpose around
as a hypnotic and in anesthesia), because its capacity to
5,000 year B.C.6 The deleterious consequences of alcohol
cause semiconciousness and memory blackouts (several
abuse or misuse were well recognized in the prehistoric
unwanted sexual encounters were reported by victims of
age, and it took mankind a long time to make any real
sexual assault under the influence of this drug).8 As ano-
progress in providing help to those individuals who were
ther example of anesthetic effect of alcohol they quote the
affected.4 The production of alcohol is the oldest of all
Book of Marc 15, "And they gave him wine mixed with
intentional psychoactive drugs production. In the same
myrrh; but he did not take it", the refuse from Jesus was
way, the historical searches indicate that fermentation
considered as a refuse of the anesthetic effect of alcohol,
of some fruit or honey is the first remote origin of the
preferring to suffer the pain of crucifixion from 9:00 a.m.
first psychoactive agent. Archaeological discoveries re-
to 3:00 p.m. in the Golgotha hill.
veal that pieces to production and consumption already
Pulque is, probably, the oldest fermented drink in pre-
existed 8.000 b.C and that, at least, in 5.000 B.C. they
Hispanic Mexico.9 The culture of the Maguey (a variation
were used to store honey; it is deduced that honey were
of Pulque) is almost as old as the origins of agriculture
fermented and diluted in water (mead or hydromel) and
in America. There are testimonies that inform on the cul-
has been the first wine for human consumption.7
ture of the maguey in the zone of Tehuacan towards year
Alcohol utilization has been well described in seve-
6 500 B.C. Its utilization was strictly reserved to ritual
ral passages of the bible and has been used as inhalational
purposes and only by tribal leaders or sorcerers, being
anesthesia, hypnosis and amnesia, chronobiology, among
its utilization by ordinary people severely repressed. In
other.8 From the Bible Book of Proverbs (p. 123) they quo-
equal way the earliest confirmed evidence for wine dates
te the Proverb 20: "Wine makes men foolish and strong
back to 5.000 B.C. This evidence is in the form of tartrate
drink makes men come to blows", as well as the Book of
deposits on a pot from the Zagros Mountains of Iran. It is
Genesis, 19, "And that night they made their father take
questionable whether wine could precede this discovery
much wine. . and the older daughter went into his bed;
by more than a thousand years as it, perhaps, required the
and he had no knowledge of when she went in or when
advances in pottery which took place at this time. Before
she went away and so the two daughters of Lot were with
this discovery, the oldest confirmed evidence for grapes
child by their father".
within human settlements was in pips from wild vines da-
Parting from these passages, some authors made se-
ting from c 4500 B.C.10 Some claim that there is evidence
veral extrapolations. They state that probably some gra-
for cultivated grapes dating back to 8000 B.C, in the so
pes were left in some place, like a hole in a rock, about
called Noah Hypothesis, although there is no evidence to
6,000 years ago.8 Progressively, "they deteriorated and
relate findings of this period to cultivated varieties and
became a viscous mass, under the action of the sun and
also, the evidences found are so few as to make this date
invisible creatures (yeasts), which quenched the thirst
doubtful.10 Like the historian Edward Gibbon, affirm that
of some primitive hungry man... alcohol's stimulating-
wine search was one of the reasons that had taken the
Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 65

Barbarians to invade the Europe.11 Also, Grapevine is the
I B.C. introduces in his "triaca magna" and many great
most cited plant in the Bible and the first miracle of Jesus
contemporary men used it with therapeutic aims like em-
was to convert water into wine in the weddings of Cana-
peror Marco Aurelio who used it to calm his migraines.
an; also The Mediterranean armies, since the antiquity,
After a period of relative silence on its use, in the age it
had always drunk wine; The Justinian Code prescribed
mediates the Arabs (who never let use it) spread the use
posca, sour wine and water, as part of the ration of the
of opium by all its occupied territories, being known that
soldiers; The drunkenness of Alexander, the Great, and
Avicenna dies intoxicated by himself in 1037.14 In Middle
of its father, Filipe, became famous and proverbial; Pas-
East, where he was very employed by medicine, it was
sed two millennia, and the Napoleonic armies continued
extended towards India and, later, in century IX, until
to receive wine; one hundred million liters had been more
China, while in western Europe the opium acquired the-
than bought for the French soldiers; In World War II the
rapeutic importance in century XVI, after the trips of the
military ration of the Frenchmen arrived up to one liter
doctor and Swiss alchemist Paracelsus, whom its spread
daily; But in the year of 1917, the French army bought
for diverse aims in laudanum form or in tinctures.12 Ini-
120 million liters.11
tially, in China, Opium was used orally as medicine, and
Other remarkable categories of agents that modify
in the later century XVII, the consumption of smoked
states of minds are vegetables, or herbal varieties, like
opium became popular in that country.7 The consumption
plants. For instance, people from the Waley of Rivers
was increased in an alarming form and the internal pro-
Tigres and Eufrates (3.000 B.C) consumed Amapola (a
duction was not sufficient, so that in century XIX, 16.2
plant) to produce euphoria and "well-being" (the same
million Chinese citizens was addicted to smoked opium
plant was reported in India, 1500 B.C, as a "wonderful
(6% of the adult population).2 In China opium was well-
plant").9 Hallucinogenic Solanaceae use, like Belladon-
known from century VIII although it began to be used
na, Datura and the Mandragora, goes back to old testimo-
to obtain medicine as a result of its introduction by the
nies of Middle and Far East; in Europe, they were bound
Arabs in Asia towards centuries IX and X.14 However, it
traditionally with witchcraft, being used in ceremonial
was not but towards the century XVI that next to the in-
and therapeutic contexts. Levitation phenomena are attri-
troduction of the use of tobacco by the Dutch and Portu-
buted to them, as well as telepathy and fantastic physical
guese sailors that gradually opened the doors to its con-
feats. In Eurasia the muscaria amanita, a psychoactive
sumption like means of enjoyment and pleasure, which
fungus used by shamans of Siberia in its rituals was very
locates in century XVIII with an intense commerce of
abundant.12 The opium, juice of a type of poppy, is one
opium with India.14 The business was served and thus the
of the most known versatile drugs; due its active ingre-
British Empire begins to monopolize the transaction of
dient, morphine, the opium induces lower pain, produces
opium in Asia being happened to sell 300 Tons in 1821
joy, induces dream and reduces afflictions; the plant of
to more than 3000 Tons in 1848. According to several
the poppy, well-known like narcotic, always was used
authors the attempt to restrain the opium commerce ge-
like food, forage and oil, but there are historical regis-
nerated two successive wars (1839-1842 and 1856-1858),
tries which their psychotropic functions already were
between England and China, culminating with the Chi-
known in 3.000 B.C.13 The first written signs of Opium
nese defeat and the obtaining of a series of privileges on
existence as a plant and its use overcome to the Sume-
the part of England, as the complete legalization of the
rian times 3000 years B.C, although it is not but in the
commerce of Indian opium and the loss of the adminis-
Ebers Papyrus in century XVI B.C where is found for the
tration of Hong Kong.2,7
first time the reference to opium name in a product list
In equal way, in Europe, in the heat of century XIX,
of medical effects, with the following indication: "For
Opium spreads slow but inexorably wrapped by an im-
children who shout too much hard."14 Also, the Greek
portant tolerance and animated by intellectuals and es-
culture knows the plant entirely and therefore Hesiod in
sayists: Quincey, Musset, Coleridge, Dickens, Scott, Poe,
century VIII previously mentions it in his works, and cite
Baudelaire, Gautier, Balzac, and thus one releases list
Morpheus (that in century XIX would give name to Mor-
of illustrious guarantee it; so that in the XX the spirit
phine), and until in the very same Odyssey appears the
follows: Apollinaire, Modigliani, Toulouse-Lautrec, Pi-
"Nepenthes" like the "drug of the forgetfulness."14 Howe-
casso and thus until the stubborn defense that in 1929
ver, the principles of their systematic use are tie logically
makes Cocteau in its work "Opium".14 The purification
to Hippocrates, Herodotus and Theophrastus in century
of opium alkaloids, that already the doctors of Napoleon,
III B. C., time in which already begins the controversy
Derosne and Seguin, plus the invention of the syringe by
(that would never leave to us) on the medicinal double
Pravaz, causes that morphine extends like the analgesic
slide and of dangerous substance.14 Additionally, the Ro-
powder like in all the Wars (Crimen, American Succes-
mans, heirs of the Greek culture, know, indicate and use
sion, etc.), and also by the richer social layers of Europe,
the Opium with naturalness, and thus Galen in century
where the equipment of injection for morphine becomes
66 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010

sophisticated models of last fashion and the books on the
islands, Mexico, Central America and Brazil smoking
wonders of the injection are multiplied.14 From this to its
tobacco rolls. In a wake of Uaxactun, Guatemala, that
generalized prohibition in almost the entire occidental
dates from century X is the figure of a Mayan priest smo-
world was jus a little step.
king, who demonstrates that the use of tobacco was well
Other famous hallucinogens have also millenarian
established long before the discovery of America, which
foundation. In America, the old indigenous civilizations
also was confirmed by Sahagun.20 The Indians of North
also had the custom to use hallucinogenic plants in their
America also smoked, in the region of Ontario in a zone
ceremonies. After century X, B.C. there is stone-fungus
called Tionontati (Tobacco Nation).20 In Europe tobacco
between monuments of Izapa culture (actual Guatemala),
was first described in Chronicles of Colombian discove-
as well as in Peru (pipes of ceramics of century IV B.C.
ries as well as India's adventures. Gonzalo Fernandez de
with a figure of peyote, an hallucinogenic cactus that
Oviedo y Valdez (Historia General de las Indias, Sevi-
contains mescaline).12 Thus Peyote fungus whose active
lla, 1535), states "Among other reprobables customs the
principle is mescaline, goes back to the pre-Columbian
Indians have one is specially injurious and that consists
American civilizations, and later its use is even very
of the absorption of a certain class of smoke to which
wide-ranging among North American Indians (Mescale-
some call "tobacco" to produce a stupor state (. .) absorb
ros Apaches, Comanches Kiowas and Cheyenes); Aldous
the smoke by means of a hollow cane, that is what the
Huxley, being one of the last intellectuals in proving it
Indians call "tobacco" and not to the grass".18 Also, Co-
and spreading it to the own, in his book "In the doors
lumbus was surprised by the use of tobacco in religious
of the perception" describes the effects of the hallucino-
and social ceremonies, like those of peace and purifi-
gen in itself.15-16 Peyote, for the Indians was something
cation of the spirit, because for the Indians the tobacco
religious, mythical, that the same provided invulnerabi-
had magical powers and pleased the Gods. Tobacco was
lity sensation that served to discover distant and hidden
considered a panacea, since it was used to fight the as-
things; its main alkaloid is the mescaline, that produces
thma, the fevers and convulsions, the intestinal and ner-
an own dissociative syndrome like in schizophrenics, ori-
vous upheavals and bites of animals.18 There are reports
ginating chromatic visions and hallucinations.17
that supports that early in 1560 A.C. tobacco was known
The relation between witches with ointments (drugs)
in Spain and Portugal. The author stresses the origin of
is a constant since an interrelation its supposed and was
the name Nicotine. According to him, the ambassador of
appraised and the spoor that suffered; one of the first that
France in Portugal, Jean Nicot, was interested in the use
occurred account of this was doctor Andres Laguna and
of the plant and when he returned to its country he took
more recently it has been shown by M.J. Harner, that has
tobacco leaves with himself to offer to queen Catherine
studied thorough the ointments that used, reaching the
de Medicis. For that reason, tobacco was called "grass
conclusion that if not all, the majority contain atropine,
of the queen", "nicotiana" or "grass of the ambassador".
powerful alkaloid at least; the cane or broom on which
Catherine de Medicis suffered from strong migraine and
many witches said to fly served to apply the plants that
the ambassador recommended taking the plant inhaling
contained it to the sensible vaginal membranes and that
it by the nose. The pains disappeared and the tobacco
that alkaloid produced a deep lethargy to those who of
began to be used like medicine in France and the rest of
them were worth, to the way of our present drugs - "trips"
Europe. When Linnaeus published its Species Plantorum,
also denominate the artificial paradises in which the drug
he chose the scientific name of Nicotiana tabacum in tri-
addicts submerge day today is something in which they
bute to Nicot.18 In 1584, Walter Raleigh founded on North
agree who approach the subject with rigor and serious-
America the colony of Virginia, copied from natives the
ness.17
custom to smoke in pipe and the culture of the famous
The popular nicotine also has some remarkable evi-
tobacco in Virginia, that was introduced in England in
dences. The acclimatization of the plant Nicotiana ta-
Isabel the Ist Era.18 The possible therapeutic virtues of
bacum in Cuba was developed by the aravacas Indians
tobacco, took the conquerors of Hispanic America to
2,000 years old before Christ.18 Although some authors
transfer the seeds for their culture to the old continent at
have affirmed that it was already present in the old or-
the beginning of century XVI; the Spaniards also took
ganizations of the east, their most known origin is the
their culture towards Prusia and Philippines (from where
American, being accepted that the first culture in using
he moved towards China) and the Portuguese scattered it
tobacco leaves to smoke them was the Mayan, from
by Africa, Italy, Iran, Java, India and Japan.2 Rapidly to-
2,000 B.C.19
bacco become the main economic resource of the English
Tobacco is a solanachea plant that grows mainly in
colonies and for that, the great marine trips of centuries
the Eastern hemisphere, also cultivated in Turkey, Russia
XVI, XVII and XVIII around the world contributed to
and other countries of Europe.20 Columbus and the con-
take tobacco and the habit to smoke until the coasts of
querors that followed saw it the Indians of the Antillean
Asia, Africa and the Australian Continent.18 In several
Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 67

oriental countries like Japan, Russia, China and Turkey
lized by Bayer as substitute of the opium and morphine in
tobacco's use was strongly fought initially with drastic
the detox programs; its effects as a potent pain killer and
measures; for instance, Sultan Murad IV ordered the exe-
stimulating effect lead to widespread commercialization
cution of numerous smokers and, in 1638, the Chinese au-
and only many years later the commercialization for this
thorities threatened beheading the tobacco dealers; Turks
aim was interrupted.12 The heroin began to become po-
got up themselves to the world-wide market of tobacco
pular like recreational drug in the United States and En-
and became heavy smokers, like the Chinese.18.
gland first and, later, in almost the entire world, being
The earliest reference of the medicinal properties of
sought as the symbol of pernicious effects of drugs.24
the cannabis dates from 2700 B.C., when in China was
Ecstasy was one of the most popular illegal psycho-
used for the treatment of flue, rheumatic malaria, pains
tropic drugs back to the past 1980 era.25 One of the most
and menstrual upheavals. After that, was widespread
used drugs amongst youngsters that although most of
throughout history in India, Middle East, South Africa
medical references about de origins is methylenedioxy-
and South America.21 Hemp (sativa cannabis, Marihua-
methamphetamine (MDMA, ecstasy) that makes referen-
na) has been cultivated in China for 4,000 years.6 The
ces of its development as an appetite suppressor, by the
Ancient Greeks, and particularly Galen make references
German pharmaceutical company Merck in 1912, it is no-
about cannabis. Also, Galen in his De alimentorum facul-
thing but a common error.26 Although MDMA had been
tatibus (6, 549-550), write about cannabis' seed, compa-
developed in 1912 the first known study in humans was
red to the seed of agnocastus; jointly with the reference
published in 1978, by Shulgin et al. about chemistry, ki-
in De simplicium medicamentorum temperamentis ac
netics, dosage, and psychotropic effects.27-28 Only in 1984
facultatibus and in De victu attenuante.22 Some of its
it was baptized as "Ecstasy" in California, USA.26
very know effects by nowadays where already descript
What about cocaine? In America, the Inca empire
although being unknown the plethora of effects that are
(Andean) produced three annual harvests from cocaine
available today (in Galen passages some effects where
leaf (erythroxilum cocaine lam) which were used as anal-
cited like difficult to digest, cause pain in the stomach,
gesic and energizing of daily use, specially due to fatigue
migraine, spoils humors and also produced an altered
produced by height; in the Aztec society, was also used
state of mind in some people, particularly when it was
the ingestion of the so called teonanacati fungus and the
smoked and not eaten. In equal way, Greek people knew
consumption of peyote with religious aims.6 The leaf of
about its vapors, and obviously, about its special effects,
Cocaine (Erythroxylon Cocaine, of Linnaeus), overco-
and the fact that roughly nobody described abuse of this
mes its beginnings in the historical knowledge by year
stupefacient in a straight line was maybe due to its rarity
2000 B.C., being found artifacts and instruments for its
(cannabis was not believed to be originally from Greek)
mastication in Chilean and Peruvian coasts; the word
or its abnormal consumption.22
Cocaine comes from Khoca that means literally "tree" or
Cannabis is part of THC drugs (Tetrahydrocanna-
"plants",14 and when it emerges in all his splendor in the
binols). Its effects are well described: when the drug is
pre-Columbian times, locating itself like the center of the
smoked the effects appear quicker than when ingested,
religious and social system of the Incas, for whom the
being the primary effects euphoria, relaxation and chan-
plant was a divine gift.29 Other authors states that the use
ges in the perception.23 In heavy consumers more promi-
of the stimulating cocaine in America is as old as the use
nent delusions can occur, time notion are modified, the
of the alcohol, opium and the cannabis in the old conti-
short term memory is affected, mental processes become
nent and Asia, so that cocaine leaves already were chewed
confused, the person can forget the contents of conver-
in the Andean region from approximately 5,000 B.C.30
sations and be not able to communicate accurately; ul-
Erythroxilum cocaine grew at the beginning of wild way
timately, other negative effect are paranoia, respiratory
but it began to be cultivated in the century X A.C., by the
problems, dryness in mouth, cardiac acceleration, psy-
Chibcha Indians of Colombia, that later spread it to south,
chological dependence and, if the consumer have tenden-
being used in sacred rituals and medicine procedures.31.
cy to develop neuroses and psychoses, the use of canna-
In Inca culture where mastication of Cocaine leaf was
bis can unchain the problem.23
mainly reserved for aristocracy and the sacerdotal body,
Morphine (name in honor to Morfeo, God of the
except for sometimes specific rituals or in some initia-
dreams), was isolated of the opium at the beginning of
te processes, and the own Americus Vespucci in 1499
century XIX by the German Fiedrich William Sertuner
is noticed of the behavior of some Indians of Venezuela
and happened to replace (along with codeine) the opium
coast, apparently raised and without fatigue in spite of
in the medical treatments, specially after the introduction
the work.14 Before the era of great navigations in century
of hypodermic injection like therapeutic, in 1855.2,7 In
XVI cocaine was not well-known in other places of the
1874, was created the first semi synthetic opiate, diacetyl-
world. When the Spaniards arrived, they were surprised
morphine, also well-known as heroin. It was commercia-
with the effects of the leaves chewed by the workers. At a
68 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010

first moment, by religious reasons, they tried to prohibit
substance abuse could have evolved in order to exploit
it but later they used it like stimulating in the operation of
antiparasitic property of plant toxins, amongst other pos-
the silver mines.2 The consumption by American Natives
sibilities. Independently of the best hypothesis found,
was attacked and condemned in the first celebrated Ec-
they suggest more and deeper neurochemichal research
clesiastical Assembly in Lima in the year of 1551, once it
to explain the apparent tendency for humankind drug
was considered to be related to idolatry and witchcraft.32.
abuse.34
It is praised and recommended by their active principle -
Considering the distribution of drugs in natural
the cocaine - and their pharmacological effects at the end
environments in ancestral ages, if we consider that re-
of century XIX, when Sigmund Freud and Halsted and
sources were limited and so probably the overactivity
Hall, used it in their experiments of psychopharmacology
of salient (wanting) behavior. So, there is no reason to
and local anaesthesia, respectively.32-33
postulate the development of dopaminergic reward corti-
Amphetamine is a chemical derivative of ephedri-
co-mesolimbic system in terms of a "built-in regulatory
ne, synthesized for the first time in 1887 by Rumanian
system of salience".35 By that reason, the author postulate
chemistry L. Edeleano, which baptized the substance as
that factors like genetic and environmental ones could
phenilisopropilamine. The experimental medical use of
have no consequences in ancient environments, because
amphetamines began in 1920. The role of World War II
of their limitations. This could be a factor that could have
that lead to its administration to the soldiers in a mas-
leaved us more vulnerable to addictive behavior, mostly,
sive form, with the objective to fight the fatigue and to
according to the author, the development of ancient psy-
maintain them alert.2 Almost all the armies used them.
chotropic plant chemicals.35
For instance, the American army distributed more than
We present a table I with some landmarks of evolu-
180 million tablets to its combatants; amphetamines also
tionary addictive behavior and drug discover.
have been used like an agent to improve physical and
In the same line, psychotropic drugs could have evol-
cognitive performance (doping effects).2
ved to present allelochemical reactivity in order to deal
LSD was accidentally discovered by Swiss chemis-
with threats from herbivores and pathogenic invasions, as
try Albert Hoffman in 1938 when it tried to find an ana-
if they were an imitation of mammalian neurotransmitter
logous substance to stimulate circulatory system, being
system, that act like competitive binders, obstructing nor-
commercialized by Sandoz factory under the name of
mal functioning of central nervous system.34-35 This ideas
Delycid, with the alleged objective of facilitate psycho-
reinforce that where the evolution of mammalian brains
therapy and to fight some upheaval like chronic alcoho-
and psychotropic drugs where co-dependent, that is to say
lism, sexual anomalies, etc.; when it was verified that
that existed an ecological interaction and influenced one
the drug produced unforeseeable effects, it was finally
another in terms of evolution.34 One set of examples to re-
forbidden.6
inforce this hypothesis, but maybe the most striking one is
At this point, let us remind the title of this paper:
that in the mammalian CNS we found opioid receptors, but
Origins of Addictive Behavior: nature or nurture? And
the truth is that the body do not provide any natural opioid
let us think a little about it.
substance by himself (so that could be pretty more logical
Some authors present a recent review about the de-
that some environmental effect forced the mammalian or-
nominated "paradox of drug reward in human evolution"
ganism to develop receptors to exogenous opioids).35
and the evaluation of the paradox between evolutionary
Most of the times, the way to describe the beginnings
biology's punishment model and neurobiology's reward
of ancient drug utilization is based on the artifacts that re-
model.34 The current existing models of drug reward have
mains from older eras and is target of the study of the so
effectively bypassed the paradox by ignoring the evolved
called archeobotany or archaeoethnobotany.36
function of plant drugs and the probable co-evolution of
For example, considering hallucinogenic drugs, ha-
plant defensive compounds and herbivore nervous sys-
llucinogenic plants are most of the times considered as
tems. The principal conclusions was that there are some
the principal source of psychoactive drugs.37 The authors
major assumptions underlying the current evolutionary
state that these drugs must be used to reach deep altered
reward models that should take into that: a) "drugs are
states of consciousness. It's also stated that several inves-
an evolutionary novelty; b) humans (and mammals) are
tigators believe that this was particularly accurate during
inherently vulnerable; c) and hedonic reward best cha-
the Tiwanaku empire expansion, surrounding the era of
racterizes the psychological and physiological responses
500-1000 A.D., along the Atacama Desert of Chile. In
to drug exposure".34 They consider the contradictory evi-
equal way, emphasize the roll that artifacts played in those
dence that shows that most of abuse drugs are derived
conclusions, such as decorated snuffing tablets and tubes,
from toxic elements, developed to be toxic and avoid and
as well as grave goods during this period ("until now the
repeal enemies (e.g Butolin Toxine).34 Also, the authors
type of drugs consumed in this paraphernalia has been
suggest that, as an hypothesis that the nature of human
unclear")37
Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 69

About the archeological discovers in Shumla Cave
netic factor in facilitation of drug use initiation like in
number 5, Rio Grande, Texas, USA, and states that the
nicotine,40 alcohol41 and a plethora of drugs. For instance,
identification of mescaline, in that sample, strengthens
in a study of two groups with more than one thousand fe-
the evidence that native North Americans considered
male twins, monozygotic and dizygotic, were evaluated
and used the psychotropic properties of peyote for at
possible association of genetic influence on drug use.42
least 5700 years ago.38 Prior studies have shown that the
They found some evidences that genetic influences have
utilization of psychotropic drugs in that region of Nor-
a say to vulnerability to drug use, and each category of
th Mexican and South American border could be dated
drugs, apart from hallucinogens, presents distinctive ge-
from 8500 BC.39
netic influences. The genetic influence of vulnerability
There are several studies that stress a possible ge-
was superior for heroin than for other drugs.42 In other
Tabla 1. Landmarks on addictive behavior (35)
a
Archaeological records indicate the presence of psychotropic plants and drug use in
ancient civilizaons as far back as early hominid species about 200 million years ago.
b Roughly 13,000 years ago, the inhabitants of Timor commonly used betel nut (Areca
catechu), as did those in Thailand around 10,700 years ago.
c
At the beginning of European colonialism, and perhaps for 40,000 years before that,
Australian aborigines used nicone from two different indigenous sources: pituri plant
(Duboisia hopwoodii) and Nicoana gossel. North and South Americans also used nicone
from their indigenous plants N. tabacum and N. rusca.
d Ethiopians and northern Africans were documented as having used an ephedrine-
analog, khat (Catha edulis), before European colonizaon.
e Cocaine (Erythroxylum coca) was taken by Ecuadorians about 5,000 years ago and
by the indigenous people of the western Andes almost 7,000 years ago. The substances
were popularly administered through the buccal cavity within the cheek. Nicone,
cocaine, and ephedrine sources were first mixed with an alkali substance, most oen
wood or lime ash, creang a free base to facilitate diffusion of the drug into the
blood stream. Alkali paraphernalia have been found throughout these regions and
documented within the archaeological record. Although the buccal method is believed
to be most standard method of drug administraon, inhabitants of the Americas may
have also administered substances nasally, rectally, and by smoking. Many indige-
nous civilizaons displayed a view of psychotropic plants as food sources, not as
external chemicals altering internal homeostasis.
f
The perceived effects by these groups were tolerance to thermal fluctuaons, increased
energy, and decreased fague, all advantageous to fitness by allowing longer foraging
session as well as greater ability to sustain in mes of limited resources.
g
The plants were used as nutrional sources providing vitamins, minerals, and proteins
rather than recreaonal psychotropic substances inducing inebriaon. Due to limited
resources within ancient environments, mammalian species most probably sought
out CNS neurotransmier (NT) substutes in the form of psychotropic allelochemicals,
because nutrient NT-precursors were not largely available in the forms of food. Therefore,
drugs became food sources to prevent decreased fitness from starvaon and death. It is
believed that early hominid species evolved in conjuncon with the psychotropic flora
due to constant exposure with one another. This may be what eventually allowed
the above civilizaons to use the flora as nutrional substances, therefore increasing
both their fitness and viability.
70 Revista Ecuatoriana de Neurologia / Vol. 19, N o1-2, 2010

separated studies including samples of twins of both
the idea is that in drug abuse (whether in initiation or
sexes, suggest a superior genetic weight in men for vul-
in chronic abuse) at least three major factors should be
nerability to drug abuse/dependency reaching 60-80%
taken into consideration: the psycho emotional subject,
of the genetic weight in the development of drug use
the environment and the "genetic subject". This could
and abuse.43-44
be considered as a Multifactorial Polygenic Heritage.
Some authors presented a literature review on family
Several studies strongly suggests this for alcohol depen-
and in two well known phases of drug addiction treatment
dence starting in animal,54 human first-degree relatives
and processes: engagement and treatment.45 According
of alcoholics,55 adopted Childs from alcoholic and non-
to the cited sources, the article highlights the necessity
alcoholic biologic parents,56 monozygotic and dizygotic
for addict patients to be treated along with their families
twins,57 siblings of alcoholics compared with nonalco-
(some authors suggest Familiar Therapy) so that adequa-
holics in terms of risk factor.58 The same hypothesis has
te results could be expected. The importance of socio-
been putted for other drugs although at a lower rate of
cultural issues can influence institutional treatment and
published data. For the importance and clearness of ideas
call attention for the necessity that treatment of addict's
we transcribe here a part where this point is strongly
patients and their families, as well as effective preventive
approached:59
action programs.45 These point gains considerable rele-
If genetic factors are involved in drug abuse, what
vance since it is well known the dependence developed
does this mean? First, we must realize that genes do not
by intra-uterine via in pregnant mothers that continues
directly cause behavior.
the use and abuse of drug during pregnancy, with pro-
No gene or set of genes, for example, will directly
ved deleterious effects for her siblings.46 Some examples
cause a person to become a drug abuser or to engage in
are the fetal alcohol syndrome,47 neonatal withdrawal
drug-taking behavior.
syndrome,48 neonatal abstinence,49 effects of pre-natal
Instead, genes are segments on chromosomes that
exposure by cocaine, amphetamines and heroin,50-51 etc.
code for the production of specific proteins (or serve to
For example, in a recent study with 1836 subjects
regulate the activities of other genes) that are important in
tried to "examine substance use and dependence among
the control of behavior. If a gene is absent, a protein that
cocaine dependent subjects and their siblings compared
controls the development or function of a physiological
to individuals recruited from the same neighbourhood
system may not be produced. In certain cases, the impact
and their siblings in order to better understand family
may be obvious, as in the case of phenylketonuria, when
and neighbourhood contributions to the development of
failure of a gene to code for the enzyme responsible for
dependence" (p. 14).52 Cocaine dependent subjects came
metabolism of phenylalanine results in development of a
from treatment centres and community-based subjects
severe form of mental retardation. In other cases, however,
were sample-matched to cocaine dependent cases, with
the impact of genes on behavior may be less obvious but
one full sibling for each case and community-based sub-
just as real, as when genetic factors produce a tendency
ject. The results show a higher risk rate of cocaine and
or predisposition to respond in a certain manner. Such
other substances use in siblings of cocaine users. Never-
is believed to be the influence of genes on a number of
theless, the authors conclude that Cocaine dependence
behavioral traits and disorders, including alcoholism and
is characterized by poly-substance use and dependence.
drug dependence. Thus, genes are not the sole determi-
Stressing that the prevalence of substance dependence in
nant of alcoholism or drug dependence, but their presence
the community subjects was higher than reported for the
(or absence) may increase the likelihood that a person will
general population, they state that cocaine dependent ca-
become alcoholic or drug dependent. Second, as the above
ses probably live in higher-risk communities, characteri-
statement indicates, genes do not act alone in determining
zed by an elevated prevalence of substance dependence.52
whether a person will become alcoholic or drug dependent.
Although all data presented, many researchers and
Our experience in behavioral genetics suggests that both
also a great part of social general opinion, support ideas
genetic and environmental factors will ultimately be im-
from the Institute for Health and Social Policy, from USA,
plicated in the etiology of drug abuse. As with alcoholism,
that suggest that the most important factors for the initia-
simple cause-and effect models will not be sufficient for
tion and continuation of drug utilization are societal fac-
explaining vulnerability. Rather, various combinations of
tors, that could include the tolerance for drug utilization
biological and environmental factors are likely to be identi-
- perceptions of negative social and health consequences
fied that function to attenuate or exacerbate an individual's
of the use of these drugs - as well as the availability and
likelihood for becoming drug dependent. Just because an
the ways the drugs are set in the market.53 In our opinion,
individual has a genetic tendency for developing drug de-
this type of hypothesis appears not to consider the possi-
pendence does not mean he or she will necessarily develop
ble inner predisposition for drug consumption, based on
the disorder. Whether the disorder develops will ultimately
the well known vulnerability model. Generally speaking,
depend on environmental influences. Certain types of en-
Vol. 19, No1-2, 2010 / Revista Ecuatoriana de Neurologia 71

vironmental influences are believed to be necessary for a
forced treatment during incarceration?),61-62 the social con-
genetically vulnerable person to develop drug dependence.
trol strategies,63 direct effects in ruining careers,64 and
For example, one environmental influence that is essen-
in homelessness,65 disruptive behaviours,66 other health
tial to the development of the disorder is that an individual
consequences, as altered sates of cortical activation and
must initially engage in drug-taking behavior. Thus, while
neuronal malfunction,67-69 neuropsychological deficits,70-72
a person may be genetically loaded for drug dependence,
and so on.
if drugs are never used, that person will never run the risk
Furthermore, the complete disaster of scare stra-
of becoming drug dependent. The presence of other envi-
tegies in drug use prevention is very important.73 Also,
ronmental factors in the development of drug dependence
the role of media messages about addictive behaviour
(e.g., drug availability, the manner in which a person uses
and deleterious substances or habits should strongly be
drugs) is also suspected. These may include environmen-
revised.74 The future, as well as the real present, will pro-
tal influences that operate within the immediate milieu
bably force us to accept and implement more educative
(e.g., family and peer influences) or more broadly (e.g.,
strategies than scaring or punishing strategies to avoid
cultural factors). Third, genes may influence a person's
individual drug use initiation.
tendency to develop drug dependence in many ways. Most
The answer to our work question: Addiction - nature
people believe that genetic influences operate by produ-
or nurture? is, naturally, not available by now. However
cing an aberrant or idiosyncratic biological response to
one thing seems to make sense to us. At the beginning
drugs. For example, genes may make some people more
of mankind drug use, most of then appear to be started
(or less) sensitive to a drug's effect, or they may produce a
as a recreational use, as part of rituals or cultural panto-
qualitatively different drug effect in some people than in
minas. Furthermore, generations after generations, drugs
others. While this may indeed be the case, it is important
utilization, or if we prefer, addictive behaviour, became
to recognize that there are mechanisms other than pharma-
probably coded in our inheritance. Understanding the
cological mechanisms that may account for genetic effects.
phenomena of Multifactorial Polygenic Heritage (the in-
One nonpharmacological mechanism is that genes may de-
teractions of the psycho emotional subject, the environ-
termine personality characteristics that increase the pro-
ment and the "genetic subject") could probably be very
bability of drug abuse. For example, a person may inherit
helpful in preventing and treating addictive behavior.
a sociopathic personality that increases the likelihood of
contact and experimentation with drugs.
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