Head Games: Introduction to the Drugs of Abuse

In this post, we are going to look at the “head games” or the effect of psychoactive drugs in the life of the person who abuses or is dependent on alcohol and other drugs.  It must be noted that these “games” are neither fun nor entertaining but are very dangerous, as overdose and death are very real possibilities when people misuse or abuse prescriptive or illicit drugs.

We will look at the effect these drugs have on the head or brain of the person, as most drugs of abuse not only do damage to the brain, but also to other parts of the body, as the three major nerve systems in the body—the central, autonomic and the peripheral nervous systems are affected. Before we go on, lets look at some definitions of the words that are important in understanding these head games.

1. Substance Abuse: The use of any chemical to change or modify your mood or behavior and involves any or all of the following behavior: (a) Continuing to use the chemical even when it causes an inability to fulfill major role responsibilities at work, school, home, etc.;   (b) Experiencing legal problems due to the use of the chemical; (c) Continuing to use the chemical in dangerous situations or conditions; and (d) Continuing to use the chemical in spite of experiencing relationship and other social problems.  The more neutral term substance use disorder is used to describe the wide range of the disorder, from a mild form to a severe state of chronically relapsing, compulsive drug taking (DSM-IV-TR, 2000; DSM – 5, 2013).

2. Substance Dependence: The use of any chemical to change or modify your behavior and involves at least three of the following: (a) Tolerance, or the need to use greater amounts of the drug to achieve the same high, or, not achieving the same intense high when you use the same amount of the drug; (b) Withdrawal, or when a person demonstrates a need to have the drug to in order to stop the unpleasant effects associated with stopping the use of the chemical; (c) More of the chemical is taken over a longer period of time than intended; (d) The person continually and unsuccessfully tries to quit using the chemical; (e) The person spends a lot of time trying to “score” the drug; and (f) The person gives up on important relationships, jobs, and recreational activities due to using the chemical.  Some clinicians will choose to use the word addiction to describe more extreme presentations, but the word is omitted from DSM- 5 substance use disorder diagnostic terminology because of its uncertain definition and its potentially negative connotation (DSM-IV-TR, 2000; DSM – 5, 2013).

3. Pharmacology: The study of the effects of the drugs on the body.

4. Central Nervous System: Comprised of the brain and spinal cord, it sends and receives messages from throughout the body and has a major part in regulating bodily processes, as well as organizes and directs our behavior.

5. Autonomic Nervous System: Receives messages from the Central Nervous System to the major organs (heart, stomach, intestines) as well as to the glands, blood vessels, and other tissues and organs. The main function of the “ANS” is two-fold: (a) To keep the body “balanced” or at a state of homeostasis by regulating processes involving internal organs, such as blood pressure and body temperature, and (b) To prepare the body for emergencies by making the proper physiological adjustments.

The ANS involves 2 divisions, the Sympathetic and the Parasympathetic systems. The Sympathetic system is involved in all of the “fight or flight” mechanisms in the body, while the parasympathetic system is involved in the relaxation, digestion, and excreting of material from the body. Psychotropic (mind altering) drugs have a heavy effect on these areas in our body, and almost all side effects from taking drugs are parasympathetic effects.

6. Peripheral Nervous System: Composed of nerves from the spinal cord to the body to deliver and receive messages from the brain for the analysis and interpretation of information.

7. Neuron: A single cell that is the elementary building block of the nervous system. The parts of a neuron are:

(a) The Dendrites, or the branching portion of the neuron that carries impulses to the Cell Body;

(b) The Cell Body, which contains the nucleus of the cell;

(c) The Axon, or the part of the neuron that carries impulses away from the Cell Body; and

(d) The Terminal Bouton, the “pre-synaptic” part of the cell that sends information to the next neuron, or brain cell.

8. Neurotransmitters: Chemicals in the brain that are produced and released by neurons or nerve cells that stimulate activity in other target cells (that is, in other nerve cells, or organ cells). Neurotransmitters are available for release from the nerve cell as needed and have a very short life after their release. When used, they are either metabolized by enzymes in the body or taken back (“re-uptake”) into the nerve cell to be used at a later time.

There are more than 60 different neurotransmitters in the body; however, we will look at six of them, as these neurotransmitters are greatly affected by the use of psychotropic drugs. The neurotransmitters are:

a) Dopamine (“I gotta have it”): Brings a kick to the brain and plays an active role in the control of appetite and pleasure, which includes food and sex. Dopamine is also produced in the Ventral Tegmental Area and has fibers that go to the limbic system and the nucleus accumbens (see below). When dopamine is low, the person feels depressed; when it is flowing, the person is going on a mission.

b) Serotonin (“I got it”): Plays an active role in the regulation of sleep, emotion, arousal, pain perception, aggressive and impulsive behavior, anxiety, depression, sexual behavior, and food intake. It is also involved in “softening” or modulating human behavior; and its root is “serum,” or the “fluid portion of the blood that heals.”

c) Norepinephrine (“Fight or flight”): Governs the sympathetic nervous system and plays an active role in the involuntary response to fear or anger. Too much could cause mania, while too little could cause depression.

d) GABA (“S l o w s us down!): Is involved in 50% of all neurons and is a universal sedative. It functions as a “blocker” of messages from one neuron to the next, making it harder for an effect to be produced. Also involved in relieving anxiety, creating a sleepy effect, disruption of memory functioning.

e) Glutamate (Speed it up!): Glutamate is involved with 40% of all nerve signals sent throughout the brain and is involved in learning and memory formation. In excess, it is an intense excitant of nerve cells, creating schizophrenic effects.

f) Endorphins (“No more pain”): Neurotransmitters that are the body’s natural pain killers and have the same properties as opiates or morphine. They create the effect of pain relief, euphoria, sedation, and respiratory depression.

9. Limbic System: Refers to all the structures involved in the feeding, defense, reproduction, emotional responses and the consolidation of memory. It is not a spot but a system of interaction between the amygdala, hypothalamus, the thalamus, the cerebral cortex, olfactory cortex, the reticular formation, and the striatum. Most importantly, it is that region of the brain that creates emotions (love, hate, sadness, depression, etc.), and has a weak connection to the frontal lobe, which moderates our ability to think, reason, make executive decisions, and integrate data.

10. The Mesolimbic Dopamine Pathway (or highway) has been shown to be very important to understanding addiction. This pathway has dopamine-rich neurons that go from the Ventral Tegmental Area to the Nucleus Accumbens (keep in mind that all of these components/areas of the brain affect our emotions in a powerful way).

Drugs like Amphetamine, Cocaine, and Morphine stimulate these areas; and this stimulation is believed to be the source of the powerful rushes and intense feelings of pleasure that a person experiences when they use drugs.

In addition to the powerful stimulation that is occurring in the brain, the experience from using the drug becomes hard-wired into the brain, so much so that a that a person connects the act of getting high with the euphoric and positive feeling (recall) of being high and without even saying it, they feel they want to, have to do this again. Thus, an addiction or the body’s psychosocial/spiritual relation to the chemical of abuse is born.

Next in HEAD GAMES: The Drugs of Abuse (Alcohol, Amphetamines, Cocaine, Hallucinogens (Marijuana and LSD), Opiates and Sedative/Hypnotics

Feel free to leave a comment or pass this post to others who you think would like to read it and by all means visit my other page at dr ken mcgill’s blog for more helpful “counseling” information.

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