[The abuse and dependence of chemical agents in an evolutionary approach/From adaptation to the phenomenon of "run-away" and beyond].

A recent paradigm shift in medicine resulted in the emergence of so-called evolutionary medicine, which studies the interactions between the environment and biological phenomena in a timeline to understand diseases and develop new treatments. In the course of evolutionary discussion of chemical substance abuse, the issue was approached through five steps. The biological level helps to understand the interference and coevolution of chemical agents and biochemical mechanisms, thus demonstrating the vulnerability toward chemical agents. The psychological level approaches behavior and its change, taking into account the consequences of the substance-induced false feelings. The social, cultural and civilization levels take into account the effects of the non-physical environment by discussing the interactions among individuals, the benefits of communication and group formation, and the subsequently emerging conflicts. The integration at individual level is implemented by the Zinberg three-pillar model, while for the integration at the level of population the phenomenon of run-away is recommended in the literature. The paper disputes the latter and suggests the concept of civilization disease to describe the phenomenon. To explain the epidemic of chemical substance abuse in our age, two additional, interrelated reasons are listed: the change in the relation to time and spirituality. And also, the question whether the appearance of epigenetics in medical thinking means the renaissance of degenerationism is raised in the article. The author has finally arrived at the conclusion that the reasons for the increase of chemical substance use in the postmodern era are basically the consequences of the strengthened psycho-social mismatch such as the rate of environmental change, changes in social control, social insecurity and anxiety, and the secularization of drug use. Therefore, the clue to solve the problem is the rethinking of the opportunities provided by the development of technology and the role of human being therein. With other words a further paradigm changing is needed.