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How Do Prescription Drugs Affect the Brain

Prescription drugs are controlled substances and can only be obtained with a prescription from a doctor. Before handing out prescriptions, doctors weigh the benefits and dangers of their use by a patient. The growing popularity of prescription drug abuse comes from the fact that these drugs are taken to elicit feelings of well-being and euphoria.

Prescription addiction purely to ‘feel good’ is growing. In the United States, about 54 million people reported using prescriptions drugs for recreational purposes. Over the mid and long term, prescription drug abuse can affect how the brain functions.

Since the brain manages all functioning and thoughts, it makes sense that a drug would have to travel to the brain to have any effect. Think of it this way: an over-the-counter cough suppressant relaxes the cough reflex so that the individual can get some sleep. That reflex is regulated by the brain, so the active ingredient in the cough medicine has to change the messages in the brain to be effective.

Once there, the chemicals in the cough suppressant interfere with normal brain chemistry to produce the desired effect. Prescription drug abuse affects the brain in a similar way. In this article, we look at the different types of prescription drugs that are frequently abused, the categories they fall into and the effects each group has on the brain.

Types of Prescription Drugs

Prescription drugs are commonly available in pill or tablet form intended to be taken orally. In some cases, those who misuse or abuse them may try to make such drugs work more quickly by crushing and snorting them. Another way is to dissolve them in water and to inject them so that the effect is immediate.

  • Opioids: These are used to relieve pain via their interaction with opioid receptors throughout the brain. Common examples include Vicodin, Percocet, OxyContin, and fentanyl.
  • Sedative, Hypnotics, and Anti-anxiety drugs: This is a broad category of drugs designed to manage anxiety, panic, seizures, or to help in sleep. This is done by increasing inhibitory brain signaling throughout the central nervous system (CNS). They can be further subcategorized into the benzodiazepines—such as Valium, Xanax, and Klonopin; the barbiturates—such as phenobarbital; and non-benzodiazepine sleep aids—such as Ambien and Lunesta.
  • Stimulants: These are used to treat attention deficit hyperactivity disorder (ADHD) and some sleep-related disorders and include the amphetamines—such as Adderall and Dexedrine, and methylphenidate—such as Ritalin and Concerta. These act to increase the activity of certain brain neurotransmitters, primarily dopamine and norepinephrine, to achieve the effects of stimulating their central nervous system (CNS).

How Opioids Affect the Brain

Prescription opioids activate receptors in the brain and decrease its pain signals. This receptor interaction is also associated with a release of dopamine into the brain. This can result in feelings of euphoria, elation, or pleasure. When dopamine is released, other areas of the brain react, creates a memory and associates it with pleasure. This is one of the key reasons why many people—even those who begin taking these drugs according to a prescription—may start to use them in increasing doses. Over the medium and long term, users may need to take higher and higher doses in order to elicit the same ‘high’. Eventually, this can help lead to users being addicted to prescription drugs.

Some potential short-term, neurological effects of opioids include:

  • Mood changes.
  • Depression.
  • Drowsiness.
  • Impaired memory, judgement, and attention.

Over the long term, prescription drug abuse will affect the brain in the following ways:

  • Tolerance: Higher and more doses will need to be taken to achieve the same effects.
  • Drug dependence: Withdrawal symptoms such as depression, insomnia, anxiety, restlessness, and irritability can be unpleasant. The individual may decide to continue taking the drugs to avoid these withdrawal symptoms in an attempt to appear to function ‘normally.’

This may result in a prolonged use of opioids. For the user who has developed a significant physiological dependence on opioids, it can seem that there is ‘never’ a good time to stop. This is because of the negative prescription drug withdrawal symptoms associated with stopping or reducing drug use.

However, there are two ways to stop opioid use comfortably and safely -- formal detox and substance abuse treatment.

Opioids mimic the body’s natural chemicals -such as endorphins and dopamine - that help to deal with pain and stress situations. An opioid will bond to the users’ receptors in their brain and act like a sedative, reducing physical pain and helping the user to relax.

An opioid creates a greater euphoric feeling if it is taken in higher than prescribed doses. The user’s brain experiences an excess of pleasure neurochemicals, like serotonin and dopamine, activating the brain’s pleasure and reward neurotransmitters. With prolonged use, the brain develops more receptors that will bind with the drug and the user finds himself or herself needing more and more of the drug in order to achieve the same desired effects. As the brain starts to depend on the drug to create these feelings instead of on its own, the user will experience withdrawal symptoms which can often be painful and distressing.

Over a long period of time, the brain stops functioning normally and is not able to naturally create the right chemicals within the body to deal with pain and stress, that is, significantly reduced pain tolerance. The user is no longer able to deal with pain without the medication (or illegal drug). In fact, it is highly likely that any pain experience will be far more intense than the time before the opioid was introduced to help alleviate pain. Sustained opioid use will affect the user’s moods and can cause severe mood swings as the opiate will impact the mood and emotion regulating neurotransmitters in the brain.

After prolonged use, a variety of psychiatric side effects of prescription drugs have been reported, including depression, agitation and hallucinations. An individual will begin to depend on the prescription drugs on choice to ‘make it through the day.’ Further, renal and urinary disorders such as retention, polyuria and dysuria have been observed.

Let’s take a look at how Oxycontin affects abusers. For example, females taking Oxycontin have reported reproductive problems and breast disorder, while men cite impotence as a side effect. Other patients have complained that coughs have worsened and in extreme cases their voices have altered.

One clinical trial has evaluated the safety of Oxycontin in minors between the ages of 11 and 16. The average treatment length spanned roughly three weeks. The most frequently reported side effects included vomiting, nausea, headaches, pyrexia and constipation.

Continually measuring and adjusting the dose of Oxycontin so that it provides the desired level of pain relief is vital – while keeping an eye on and managing any adverse side effects.

In recent years, more and more research has been conducted to gain a better understanding of opioid addiction. Continued use creates an addiction that is considered a chronic, progressive brain disease characterized by an altered structure. This affects the way the brain functions and causes the user to become obsessive about the opioid, to the point of self-destructiveness and an often big change in behavior.

How Sedatives, Hypnotics, and Anti-anxiety Drugs Affect the Brain

The next category of drugs are barbiturates, benzodiazepines, and sleep medication. These are sedatives, hypnotics or anti-anxiety drugs known as anxiolytics, also known as central nervous system (CNS) depressants. They reduce the neural excitation by potentiating the effects of an inhibitory neurotransmitter known as gamma-aminobutyric acid (GABA). These GABA-mediated effects help to increase relaxation, relieve anxiety, and manage certain sleep conditions like insomnia.

The effects of prescription depressants on the brain include:

  • Mood swings.
  • Inappropriate aggressive or sexual behavior.
  • Memory and attention problems.
  • Disorientation.
  • Impaired coordination.
  • Feeling drowsy or ‘stoned.’
  • Coma.

Much like chronic opioid abuse, long-term abuse of prescription depressants can lead to the development of severe physical dependence.

Individuals have become physically dependent in as little as 4 weeks. This means that they likely will experience some degree of acute withdrawal should they try to stop taking the drug on their own. Many people who try to stop taking these drugs relapse because the brain creates intense cravings for them.

How Stimulants Affect the Brain

Common prescription stimulants, such as amphetamines and methylphenidate, have molecular structures that are similar to certain brain chemical messengers, such as dopamine and norepinephrine. Prescription stimulants increase the activity of the brain chemical dopamine and norepinephrine.

Dopamine is a neurotransmitter which regulates how a person perceives and experiences pleasure. In short, Dopamine affects feelings of pleasure. During pleasurable moments or situations, this neurotransmitter is released, which causes a person to seek out a desirable activity over and over again. For example, eating (sugary foods) are stimulants of dopamine being released in the brain. This is the reason why sugary foods like chocolate and cakes are usually enjoyable and why people continuously engage in them.

The brain and nervous system utilize neurotransmitters to send messages in the form of electrochemical impulses throughout the body and, thus, regulate all of the body's functions.

Similarly, Norepinephrine affects blood vessels, blood pressure and heart rate, blood sugar, and breathing.

In the short term, individuals using stimulants feel euphoric or a rush. They also experience the following:

  • elevated blood pressure and heart rate
  • increased breathing
  • decreased blood flow
  • increased blood sugar
  • opened-up breathing passages

At high doses, prescription stimulants can lead to a dangerously high body temperature, an irregular heartbeat, heart failure, and seizures.

Stimulants affect the brain in the following ways:

  • Paranoia.
  • Anger.
  • Agitation.
  • Seizures.
  • Reduced sleep.
  • Reduced interest in eating.

An individual trying to stop taking these drugs may experience discomfort and cravings.

In fact, stimulants can cause a person to become very sensitive to some of their effects instead of building a tolerance. What this means is that after repeated stimulant abuse, a previously harmless dose can more easily result in severe consequences, such as a seizure.

Addiction can cause a loss of emotional control, because most people under the influence of drugs do not feel their emotions. Once the drugs wear off, the emotional pain can be too much to process. An abuser will often act out those emotions until he can calm them with more drugs.

While the short- and long-term effects of prescription drug abuse may vary from person to person, many people currently suffer from the effects of abusing prescription drugs every day. Factors affecting the exact symptoms that are experienced may depend on a person’s age, gender, individual physiology, genetic makeup, and mental health condition.

And while some side effects are relatively mild, many abused substances lend themselves to severe and life-threatening outcomes, particularly as a person’s pattern of use progresses. Addiction is a particularly debilitating result of drug abuse that can lead to significant impairment in many areas of a person’s life—from work to school and interpersonal functioning.

Prescription Drug Treatment Options

Formal addiction treatment, like Peaks Recovery, can help address the underlying issues driving substance abuse and addiction. Many prescription drug abuse treatment options are available, including inpatient, outpatient and after-care rehab.

Self-help withdrawal from certain types of drugs can sometimes prove to be deadly. Professional detox can ensure comfort and safety throughout the withdrawal process. Then once an individual is stabilized, they can transition into a prescription drug addiction treatment program.

Once that is completed, various aftercare or ongoing support measures can help people to stay clean and sober in the long run. These measures may include 12-step groups, non-12-step support groups, individual therapy, and group counselling.