Long-term use of phenazepam in small doses. Phenazepam. Composition, release forms, analogues. Instructions for use, indications, contraindications. Prices and reviews

Before you understand the actions of the drug, you need to understand what the drug is in itself and what it is used for.

70s 20th century - only then did humanity know what Phenazepam is. In the SRSR, the drug became the first tranquilizer, which at that time was considered a fairly big breakthrough.. Now the drug is used in most cases for the treatment of diseases and disorders associated with the psyche.

Indications

• depression
• emotional instability
• psychosis, unreasonable aggression
• post-traumatic shock
• insomnia, sleep disturbance
• intrusive thoughts
• unreasonable feeling of fear, anxiety and restlessness
• alcohol addiction
• nervous tics, convulsions

Phenazepam is a highly effective tranquilizer, and not everyone can use it.

Contraindications

• kidney and/or liver problems
• myasthenia gravis
• angle-closure glaucoma
• pregnancy
• lactation
• children under 18
• poisoning with alcohol/drugs/other tranquilizers/antidepressants
• suicidal tendencies
• hypersensitivity to the individual components of the drug

It is not recommended to drive a car or engage in other work that requires heightened attention if you have taken the drug, because Phenazepam acts like a sleeping pill, and you can just fall asleep during the process. And this can harm you and even the people around you.

Side effects

• increased drowsiness
• fatigue
• addiction
• dizziness, loss of consciousness
• dry mouth
• headache
• nausea
• memory problems

The drug should not be taken for more than two months, as a very serious dependence occurs. For some, it may even come much earlier.

The action of the drug

Phenazepam affects the human body in a complex and has many actions.:

• Sedative. The action of the drug occurs on the nucleus of the thalamus and the brain stem. This action is intended to reduce neurotic symptoms. The action of Phenazepam is proven by the fact that after taking the medicine, patients become less aggressive and irritable. Instead, peace comes.
• Hypnotic. The tablet acts on the body in such a way that if a person cannot fall asleep, then after taking the drug, sleep will not take long. This is due to the fact that active substance Phenazepam bromdinhibits brain cells and removes human consciousness from stimuli that prevent sleep. It can be both external stimuli (noise, voices) and internal (obsessive thoughts, fear, anxiety). After treatment, sleep and its regimen are regulated.
• Anxiolytic. This action of Phenazepam is displayed on emotional state person. Obsessive thoughts, feelings of fear, restlessness and anxiety disappear. A person becomes calm, because emotional stress is removed. In this case, the drug directly affects the human central nervous system.
• Anticonvulsant. The active substance of the drug Phenazepam affects the central nervous system and enhances nerve inhibition. The impulses that caused the seizures are reduced. Soon, nervous tics and convulsions generally disappear.

How the drug behaves in the body

The drug reaches its highest concentration in the blood 1-2 hours after taking the drug. This means that it is then that the medicine begins to act most effectively.

Half of the drug is excreted in about 12 hours. How long Phenazepam is excreted depends entirely on what dose you have taken. But you need to take into account the fact that every 12 hours the drug in your body becomes 2 times less.

For example: if you took a tablet of the drug with 2 mg of the active substance, then after 12 hours the drug will remain in the blood 1 mg, after another 12 - 0.5 mg, and so on. Following such a scheme, you can find out how long Phenazepam will completely stop its action and leave your body.

Dangerous combination

Phenazepam is a drug that must be taken with extreme caution. There are substances that in no case should be taken together with the drug, otherwise the consequences of such a combination can be fatal.

Let's see what kind of body reactions to Phenazepam, when taking it with incompatible substances, we should expect.

• Alcoholic drinks. Vodka, tequila, wine, champagne, beer - everything that has an alcoholic degree in it should in no case be taken together with Phenazepam. Even if we are talking about non-alcoholic beer, we never know what effects we can expect from a given drug, so even this combination is prohibited. Alcohol and Phenazepam enhance each other's actions, while negatively affecting the central nervous system. A person under such influence becomes uncontrollable, aggressive, capable of harming himself and his loved ones. There is a risk that in a dream a person may choke on vomit or his heart may stop. Do not take Phenazepam with alcohol!
• drugs. Everything is clear here. The use of drugs is generally illegal, and if it is also combined with tranquilizers, like Phenazepam, then such a combination is the right way to the grave. Drugs and Phenazepam, which also has a narcotic side effect - addiction, mutually reinforce each other's actions and thereby simply destroy the central nervous system. It threatens to aggravate side effects and lethal outcome.
• Sleeping pills. The same thing happens here - a negative effect on the central nervous system.
• tranquilizers. The drug itself is a highly active tranquilizer and if you use too much or another tranquilizer along with Phenazepam, the consequences can be very terrible.
• Anticonvulsants.
• Antipsychotic drugs.

With such a dangerous combination, an overdose is the best you can get away with.

Overdose

Lethal dose of Phenazepam for human body- 10 mg.

How to understand that you have an overdose from the drug:

• drowsiness - literally fall off your feet
• trembling in the body
• you find it difficult to breathe, not enough air
• slow heart rate
• very hard jump blood pressure down
• misunderstanding what is going on

Death from an overdose can occur if medical attention is not provided on time. But not always even an ambulance can save from a fatal outcome. It all depends on how strong the overdose is.

Let's summarize

Phenazepam is a very unpredictable drug and its effects may not be as positive as we expect. But if you follow the prescription of a qualified doctor, the effect of the treatment will be positive. Always remember about the dangerous effect of the drug Phenazepam with alcohol, drugs, other tranquilizers, hypnotics and anticonvulsants. Never take these substances together. And don't use drugs at all. Do not self-medicate!

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An overdose of phenazepam is a consequence of the use of a large amount of the drug or its use for a long time. That is why you should not self-medicate.

Phenazepam has a sedative effect on the nervous system

Phenazepam - benefits and harms

This drug is able to act on the central nervous system and other human organs. Treatment is carried out under the supervision of a doctor. Due to the fact that the drug belongs to the narcotic group, it can cause hallucinations, tremors and muscle spasms.

What is the harm of the drug?

1. Incorrect intake can cause poisoning.
2. The following symptoms may appear: weakness, hallucinations, drowsiness, dizziness, absent-mindedness, impaired coordination, motor and mental passivity, depression.
3. While taking the drug, it is forbidden to engage in activities that require increased attention and, if negligent, can harm others.
4. Digestion is disturbed.
5. Causes an allergic reaction.
6. It is strictly forbidden to drink alcohol during treatment.

The benefits of the drug

A remedy is used to treat such conditions:

Phenazepam is prescribed for insomnia

1. Increased irritability.
2. Psychoses of different complexity.
3. Insomnia.
4. Emotional stress.
5. Epilepsy.
6. Rigidity of the muscles.
7. Vegetative dysfunctions.
8. Hyperkinesis.

Widely used in the field of neurology.

Why is phenazepam dangerous?

The danger of the drug is justified by the fact that it has narcotic properties. Taking it without the knowledge of the doctor, you can irreversibly harm the body. Regular use of the drug destroys the psyche, causing mental disorders. Also, the work is broken:

• gastrointestinal tract;
• circulatory system;
• genitourinary system;
• of cardio-vascular system.

Each violation leads to the development multiple pathologies. Special attention should be given to patients who:

• pregnant women;
• elderly.

It is important to remember that phenazepam is not compatible with alcohol.

Phenazepam for pregnant women

Appointment is contraindicated for women in position and nursing mothers. This is due to the fact that it provides pernicious influence for fruit:

• suppresses the nervous system;
• destroys the respiratory system;
• the child is born with a violation of the sucking reflex.

But there are exceptions in which the drug is possible for pregnant women:

• epilepsy;
• convulsions of a different nature;
• psychiatric illnesses;
• neurological diseases.

In all cases, the appointment is made only if the patient cannot cope with the disease on his own. But the born child will be forced to endure the consequences of drug withdrawal, since even in utero it is addictive.

Can phenazepam be used in the elderly?

Due to the fact that the elderly have a reduced activity of the organs, they are prohibited from prescribing the drug. Phenazepam is one of the medicines that can cause organ dysfunction or aggravate existing diseases.

Phenazepam in narcology

In narcology, this drug is used to treat drug addicts. It is prescribed to relieve physical condition drug addict. Phenazepam should be taken with caution as strong action on the nervous system can cause anger and attacks of aggression.

There have been cases of strong suppression nervous system that lead to suicide.

Appointment is also possible as replacement therapy. In this case, it is important not to take the medication at the same time as the drugs.

Phenazepam poisoning - symptoms

Poisoning with phenazepam is very simple. It is enough not to follow the recommendations of the doctor or prescribe treatment yourself. Initially, a feeling of side effects may appear, but symptoms of poisoning will soon appear:

• disorientation;
• weak pulse;
• rare breathing;
• lack of motor reflex;
• constant sleepiness;
• tremor;
• involuntary vertical or horizontal movement of the pupils;
• low pressure;
• confusion.

Phenazepam poisoning in children

This remedy is not intended for the treatment of persons under 18 years of age. Phenazepam poisoning in children is the result of adult inattention. The drug used by children is very quickly absorbed into the blood due to active metabolism. Therefore, it must be kept out of the reach of children.

If, nevertheless, it happened that the child swallowed the medicine, then the following symptoms begin to appear:

Keep phenazepam out of the hands of children

• nausea;
• vomit;
• hallucinations;
• lack of coordination;
• failure in breathing;
• coma.

Having noticed such phenomena, it is urgent to deliver the child to the hospital, where he will be provided with qualified assistance.

The main thing, in all these actions, is to provide assistance in time.

How to avoid drug overdose

An overdose is possible when taking a large amount of the drug. It is hazardous to health. Symptoms depend on the dose taken, up to the state of coma and death. It is very difficult to determine the exact dose for treatment, since everyone's body functions and reacts differently to the drug.

To avoid overdose, it is prescribed to take the minimum dose. If the desired effect is not achieved, then the doctor gradually increases the amount of the drug.

The lethal dose of phenazepam is from 7 mg per day, as well as fatal a one-time intake of a large amount of funds will end.

Phenazepam poisoning

If you drink a large number of medicines, then you need to see a doctor immediately, otherwise death guaranteed. The action of phenazepam begins with depression of the nervous system, and gradually passes to all organs. The liver, heart and kidneys are especially affected.

Phenazepam poisoning: treatment

Only a doctor can neutralize the effect of phenazepam to the full extent and with minimal health losses. Due to the incompatibility of phenazepam with alcohol, even a small dose taken by an intoxicated person can lead to severe poisoning. It is very difficult to cleanse the body of phenazepam.

The poisoned person will have to undergo a series of procedures that drag on for a decent time:

• gastric lavage;
• the introduction of a drug that blocks the action of a tranquilizer;
• maintenance of organs;
• restoration of body functions;
• medical cleansing of the lymphatic system.

But before the doctor arrives, you should always be with the patient and, if he remains conscious, carry out the following procedures:

• artificially induce vomiting;
• accept Activated carbon or stronger adsorbents.

These manipulations will greatly help in further recovery by neutralizing effective effect drug.

Phenazepam should be taken strictly according to the doctor's prescription.

The consequences of poisoning for humans

The effect of phenazepam on the body is very strong. That is why the self-administration of this medication is prohibited. It should be taken only with the prescription of a doctor and in strictly indicated doses.

After poisoning, the victim's body has serious violations. Some of them bring great harm body, and some have to put up with for the rest of their lives.

With long-term use of the drug, an addictive effect occurs. You should not take it as a sleeping pill given the multiple contraindications and the danger of consequences.

Addiction to phenazepam qualifies in medicine as drug addiction. In this case, treatment is carried out in a narcological dispensary.

Removal of phenazepam from the body is carried out for a long time. Timing is affected by:

• age;
• patient status;
• the reason for the appointment;
• duration of treatment;
• dose used.

After the end of treatment, the drug is excreted from the body by gradually reducing the dosage. The result of excretion is checked by taking a urine and blood test.

Video

Phenazepam: effectiveness, duration of administration, side effects, overdose

In this medical article, you can read drug Phenazepam. Instructions for use will explain in which cases you can take pills, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the form of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Phenazepam, from which you can find out if the medicine helped in the treatment of neurosis, psychosis, epilepsy and other mental and psychosomatic disorders and diseases in adults and children, for which it is also prescribed. The instructions list the analogues of Phenazepam, the prices of the drug in pharmacies, as well as its use during pregnancy.

Phenazepam is a highly active tranquilizer that has a pronounced anxiolytic, anticonvulsant, hypnotic and central muscle relaxant effect on the body. Instructions for use prescribes taking pills for the treatment of psychosis, sleep disorders, neurotic and psychopathic conditions.

Release form and composition

The drug Phenazepam is available in the form of tablets for oral administration with a dosage of 500 mcg, 1 mg and 2.5 mg.

Tablets are white, flat-cylindrical, scored on one side. The medicine is packed in blister packs of 10 pieces and 25 pieces in cardboard box, the tablets are accompanied by an annotation with detailed description characteristics.

Each tablet contains the active ingredient Phenazepam at a dosage of 500 mcg, 1 mg, 2.5 mg, respectively.

pharmachologic effect

Phenazepam instruction refers to tranquilizers that have anxiolytic, anticonvulsant, central muscle relaxant and sedative effects. The tranquilizing and anti-anxiety effect is superior in strength to Phenazepam's analogues.

Also, the drug has an anticonvulsant and hypnotic effect. The anxiolytic effect of the drug is expressed in a decrease in emotional stress, weakening fear, anxiety and anxiety. According to the reviews received, the medication has practically no effect on affective, hallucinatory and acute delusional disorders.

What helps Phenazepam?

Indications for the use of the drug include:

• neuroses, pseudo-neurotic (neurosis-like) states, psychopathy, psychopathic disorders and other conditions that are characterized by the appearance of a feeling of fear, increased anxiety, irritability, mood variability (its lability), increased tension;
• alcohol withdrawal syndrome;
• a sharp increase in tone and stable resistance of the muscles to the effects of deforming forces (muscle rigidity);
• instability (lability) of the autonomic nervous system;
• dyskinesia, tics;
• autonomic dysfunction syndrome;
• hypochondriacal syndrome, accompanied by various kinds of unpleasant or painful sensations (hypochondriac-senestopathic syndrome, including in cases where treatment with other tranquilizers did not give the expected result);
• temporal and myoclonic epilepsy;
• reactive psychosis;
• prevention of phobic conditions and conditions accompanied by a feeling of tension;
• sleep disorders;
• panic reactions.

The annotation to the drug also indicates that Phenazepam can be used for preliminary medical preparation sick to general anesthesia and surgical intervention.

Instructions for use

Phenazepam is prescribed orally. A single dose is usually 0.5-1 mg, and for sleep disorders - 0.25-0.5 mg 20-30 minutes before bedtime.

• For the treatment of neurotic, psychopathic, neurosis-like and psychopathic conditions, the initial dose is 0.5-1 mg 2-3 times a day. After 2-4 days, taking into account the effectiveness and tolerability of the drug, the dose can be increased to 4-6 mg per day, morning and daily dose is 0.5-1 mg, at night - 2.5 mg.
• With severe agitation, fear, anxiety, treatment begins with a dose of 3 mg per day, rapidly increasing the dose until a therapeutic effect is obtained.
• In the treatment of epilepsy, the dose is 2-10 mg per day.
• For the treatment of alcohol withdrawal prescribed at a dose of 2.5-5 mg per day.

IN neurological practice in diseases with increased muscle tone, the drug is prescribed 2-3 mg 1 or 2 times a day. The average daily dose of Phenazepam is 1.5-5 mg, it is divided into 3 or 2 doses, usually 0.5-1 mg in the morning and afternoon and up to 2.5 mg at night. The maximum daily dose is 10 mg.

In order to avoid the development of drug dependence, during the course of treatment, the duration of the use of phenazepam, like other benzodiazepines, is 2 weeks. But in some cases, the duration of treatment can be increased up to 2 months. When the drug is discontinued, the dose is reduced gradually.

Contraindications

Before you start taking Phenazepam tablets, you must definitely consult a neurologist or psychiatrist. Be sure to carefully read the instructions before you start taking the drug, the tablets should not be taken orally if the patient has one or more conditions:

• shock conditions;
• coma;
• pregnancy and breastfeeding period;
• age up to 18 years;
• individual hypersensitivity or intolerance to the drug;
• myasthenia gravis;
• acute respiratory failure;
• severe chronic obstructive pulmonary disease;
• closed-angle glaucoma.

Relative contraindications for use are:

• age of patients over 65 years;
• liver failure;
• depression;
• organic brain diseases;
• taking other psychotropic drugs;
• kidney failure.

Side effects

• dizziness, headache;
• nausea;
• impaired memory, concentration, coordination of movements (especially at high doses);
• dry mouth;
• ataxia;
• possibly paradoxical arousal;
• skin rash, itching;
• diarrhea;
• decreased libido;
• violation of the menstrual cycle;
• dysuria;
• muscle weakness;
• drowsiness.

At long-term use, especially in high doses - addiction, drug dependence.

Children, during pregnancy and lactation

Phenazepam should not be used in the 1st trimester of pregnancy and lactation period. Pregnant women can take the medicine in case of emergency: the drug has a toxic effect on the fetus. The drug is contraindicated in children under 18 years of age.

special instructions

Caution is required when using Phenazepam in patients with hepatic or kidney failure, persons prone to substance abuse, with organic brain damage, elderly patients.

Like analogues, Phenazepam may cause drug dependence during long-term therapy. large doses. During treatment, the use of ethanol is strictly prohibited.

It affects the concentration of attention, so it is required special care when driving vehicles.

drug interaction

The drug Phenazepam is not recommended to be administered simultaneously with anticonvulsants, hypnotics, sedatives, tranquilizers. This is due to the fact that under the influence of these drugs therapeutic effect the drug is enhanced, which increases the risk of side effects and overdose.

The drug enhances the antihypertensive effect of drugs for the treatment arterial hypertension that should be taken into account and adjust the dose of drugs in order to avoid a rapid drop in blood pressure.

Phenazepam's analogs

According to the structure, analogues are determined:

1. Fezipam.
2. Phenorelaxan.
3. Elzepam.
4. Thezaneph.
5. Tranquezipam.

Analogues of Phenazepam have a similar effect:

1. Lorazepam.
2. Medazepam.
3. Relium.
4. diazepam.
5. Alprazolam.
6. Valium.
7. Sidenar.
8. Lorenin.
9. Relanium.
10. Apaurin.
11. Lorafen.
12. Tofisopam.
13. Sibazon.
14. Nozepam.
15. Tavor.
16. Ativan.
17. Seduxen.

Holiday conditions and price

The average price of Phenazepam (tablets) in Moscow is 100 rubles. It is released from pharmacies only by prescription.

Keep the tablets out of the reach of children, at room temperature. The shelf life of the drug is indicated on the package and is 4 years from the date of production.

Phenazepamum is a tranquilizer prescribed for the treatment of insomnia, depression, epilepsy. It has been used in medicine for almost 40 years, but in last years doctors prescribe the drug extremely rarely, preferring, albeit less effective, but more safe medicines new generation. The reason is that Phenazepam is addictive and because of the resulting euphoric feeling, people use it like a drug. The article details the features of the remedy, gives instructions on what to do if a person has developed a dependence on pills.

History and medicinal uses

The creation of Phenazepam in the 70s of the last century is one of the most important achievements of domestic medicine. Before him, tranquilizers were not made in the USSR, but from abroad similar drugs were not supplied. People with severe psychopathic and neurotic conditions turned out to be doomed - it was not possible to quickly remove seizures and normalize the condition, so patients, in fact, were simply closed from society in psychiatric institutions.

Phenazepam made it possible to quickly stabilize even the most severe psychopathological and neurotic states. The main indications, according to the instructions, are:

• Depression.
• Chronic insomnia.
• An uncontrollable feeling of fear and anxiety.
• post-traumatic syndrome.
• Increased irritability, psychosis.

Sometimes doctors prescribe Phenazepam to treat alcoholism.

Phenazepam is able to have a muscle relaxant effect (that is, relax smooth muscles). Due to this property, the drug is taken to relieve seizures in epileptics. A tranquilizer is also prescribed in the treatment of alcoholism. Able to quickly eliminate withdrawal symptoms (convulsions, tremors, vegetative dysfunctions and other conditions that appear against the background of a sharp withdrawal from alcohol).

Narcotic properties of the drug

Phenazepam contains chemical compound with the complex name "bromodihydrochlorophenylbenzodiazepine" (it is not considered a drug, but belongs to the group of benzodiazepines). When ingested, the substance inhibits polysynaptic spinal reflexes, reduces the excitability of the subcortical parts of the brain.

Phenazepam is dangerous because it is addictive, like a drug. People take it to get a "high", which manifests itself as follows:

• Inhibition of the reaction occurs, the perception of visual and auditory images decreases.
• The mood improves, all problems begin to seem insignificant.
• There is a relaxation of the muscles of the body, there is a feeling of flight.

Any specialist in narcology will confirm: it will not be possible to hide the drug intake, since Phenazepam is easily detected during analyzes. One tablet will be excreted from the tissues for at least 3 days. The use of the drug with 100% accuracy shows a urine test for benzodiazepines. No other drug test is required.

How and why drug addicts use Phenazepam

For drug addicts, it is not typical to drink this drug alone, it is taken with alcohol, sleeping pills or various drugs. Phenazepam begins to act after about 40 minutes, the effect lasts about 2-3 hours. But you can make a "cocktail" with cocaine, heroin, opiates or LSD, then the feeling of drug intoxication is prolonged several times.

Addiction develops in just 10-14 days of daily use of the drug. Phenazepam causes three types of addiction:

• Chemical addiction (the body adapts to the dose of benzodiazepine and for its “shake-up” it is necessary to increase the number of pills).
• Physiological dependence (when Phenazepam is excreted from the tissues, pain, nausea, convulsions, insomnia, etc. occur).
• Psychological breakdown (phenazepam addicts begin to perceive the tranquilizer as the only way get away from problems, improve mood).

For more long-acting often Phenazepam is taken with alcohol or combined with other drugs.

To get increased euphoria, drug addicts drink 4-5 tablets of Phenazepam at a time. Naturally, such a set is not compatible with health, the risk increases deadly overdose.

Effect and consequences of use

It is possible to identify that a person has taken Phenazepam by the following signs:

• The skin becomes pale, sometimes cyanotic.
• Phenazepam causes confusion - drowsiness appears, a person does not control his actions, answers questions inappropriately.
• There is always a lack of coordination, the gait becomes uncertain.
• An increase in mood is observed - the patient under a tranquilizer smiles or laughs for no reason.
• Dry eyes appear - the addict constantly combs them, the whites turn red.
• The pupils of the eyes dilate, there is practically no reaction to light.
• Characteristic appears on the tongue white coating, constantly thirsty.

Reviews of drug addicts confirm that Phenazepam gives a "high" for about 4-5 hours. Then comes the so-called “recession” stage: drowsiness appears, the feeling of anxiety and aggression increases, the signs of depression intensify. To relieve negative feelings and again feel euphoria, repeat taking the pills. This is the physical and psychological dependence.

4 tablets of the drug are lethal dose.

The danger of a tranquilizer is that already 4 tablets are a lethal dose. But drug addicts are characterized by an immoderate desire to prolong the “high”, due to addiction, they can take Phenazepam in handfuls.

An overdose of a tranquilizer manifests itself in different ways:

• Disorders of the cardiovascular system may occur, accompanied by a critical drop in blood pressure, respiratory depression.
• Failures of the hematopoietic system (neutropenia, leukopenia, anemia, thrombocytopenia) are characteristic.
• The function of the kidneys and the genitourinary system is sharply impaired (dysfunction appears in the form of incontinence or urinary retention, symptoms of acute renal failure).
• The onset of vomiting, coupled with loss of consciousness, can lead to blockage of the larynx with vomit and asphyxia.

These overdose symptoms require immediate medical attention. But it is better not to take things to extremes - if a person shows signs of using Phenazepam as a drug, he should immediately contact a drug dispensary.

How to treat addiction

Since drug addicts always take Phenazepam in increased dosage, That health care begins with gastric lavage. The doctor gives the patient 1.5 liters hypertonic saline and takes measures that provoke the patient to vomit. After that, the narcologist gives any sorbent (the most common option is activated carbon).

If a person took Phenazepam without indications regularly, then he is automatically registered with a narcological register. If necessary, the patient is given safer tranquilizers for the first time (so that there is no withdrawal syndrome, from which the cardiovascular system), gradually reducing their dosage and reducing the intake of drugs to nothing. For removal psychological dependence sessions with a psychotherapist.

Summarize. Phenazepam is primarily a medical remedy. But if it is not accepted medical indications and in combination with alcohol and various psychotropic substances, then the drug begins to act like a drug. Its excessive consumption is dangerous, as it causes strong dependence and threatens to overdose.