The Brain Injury Association of America estimates, “for every fatal overdose, there may be five nonfatal overdoses, many of which go unreported.” Those nonfatal overdoses have several long-term impacts, one of which is brain injury or impairment.
Almost any drug overdose can cause some sort of brain injury or impairment. The type and severity of the brain injury or impairment depend mostly on the type of substance, the amount used, and the frequency of the drug abuse.
Effects of Opioid Overdoses on the Brain
Opioids, like heroin, prescription opioid painkillers, and Fentanyl, all work by attaching to proteins called opioid receptors, which are found all over the body, including in the brain and spinal cord. With these receptors blocked the brain no longer perceives pain and produces feelings of euphoria instead.
A side effect of opioid use is the slowdown of other body functions like heartbeat and breathing. During an opioid overdose, the body goes through a central nervous system depression. The breathing and heartbeat can be dangerously slowed or even stopped.
At this point, the person can lose consciousness due to lack of oxygen – often followed by coma or death. If the person does not die, they will likely experience a toxic brain injury.
In addition to toxic brain injuries, several studies have shown that opioid use can deteriorate the white brain matter – largely in control of temperature regulation, blood pressure, heart rate, digestion, and hormones – and the gray brain matter – largely in control of speech, hearing, feeling, seeing, memory, and muscles.
Toxic Brain Injury
Typically a brain injury from an opioid overdose is caused by a lack of oxygen, called hypoxic or anoxic brain injury. Hypoxic brain injuries occur when the brain is not receiving enough oxygen and anoxic brain injuries occur when the brain is not getting any oxygen. The severity of the brain damage depends on how long the brain is without oxygen. The longer the brain is without oxygen, the more damaged the brain will be.
Some common symptoms of a brain injury due to overdose include:
- Impaired balance and movement
- Trouble seeing, hearing, or speaking.
- Inability to write
- Lack of concentration and memory
With extreme brain damage, the person can be in a vegetative state, where they have no ability to interact and their brain is mostly shut down.
“It only takes three to five minutes of oxygen deprivation to cause a permanent brain injury.” It’s vital to start rescue breathing when you find someone who has overdosed on opiates. Rescue breathing will help circulate oxygen to the brain – saving their life and minimizing damage to the brain.
Chemical Changes to the Brain
When something triggers feelings of pleasure, your brain attempts to remember and crave whatever caused the pleasure. Normally, those things are innocent and often beneficial, like food, exercise, and sex. Opioids disrupt this process and change how your brain works. These changes to your brain can make it harder to stop an addiction and can cause depression and anxiety.
With opioid drug use, your brain is flooded with dopamine, the hormone that makes you feel pleasure. Over time your brain becomes less responsive to dopamine. This makes the brain require more of the opioid to achieve the same feelings of pleasure and it makes other experiences less enjoyable. It has a numbing effect on your feelings.
With long term use, your brain will develop a dependence. With a dependence on a drug, your brain doesn’t know how to function without the drug. Without the drug, the opioid receptors start to malfunction, which is often the cause of withdrawal symptoms. At a point, opioid use becomes less about the pleasure felt and more about avoiding the symptoms of withdrawal.
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Cocaine and other Stimulants
Any stimulant use increases your risk of heart attack, stroke, or seizure – all can cause a lack of oxygen flowing to the brain, leading to toxic brain damage.
Cocaine especially is known to cause damage to your brain in other ways.
The dopamine that floods into your brain cells with cocaine use is often left stuck in your brain cells, blocking your brain cells’ ability to communicate with other brain cells. This blockage can make your brain less sensitive to dopamine. This means you need more cocaine it the future to reach the same high.
Your body also will start to produce less dopamine thanks to the build-up of dopamine in the brain. This will make it difficult to feel pleasure at all, leading to mood disorders like depression and anxiety.
The dopamine being flooded into the brain with regular cocaine use eventually damages the structure of the brain – this can lead to seizures and other neurological issues.
Cocaine use constricts your blood vessels. The increased effort to move your blood around can damage your heart. This damage decreases your heart’s ability to get blood to parts of your body – most importantly the brain. When your brain is starved of the oxygen in the blood, the brain cells quickly start to die off. Glucose metabolism slowdown from cocaine use also causes brain cell die-off or can impact their ability to function.
Someone regularly using cocaine will lose double the amount of gray matter in the brain that a non-cocaine user will lose in a year.
Alcohol-Related Brain Damage
The overconsumption of alcohol can lead to alcohol-related brain damage (ARBD). ARBD conditions mainly include those that mimic dementia, like Wernicke-Korsakoff syndrome and alcoholic dementia. These conditions are mainly caused by a deficiency of vitamin B1. Alcohol interferes with your body’s ability to absorb and use vitamin B1.
Regular heavy drinking damages brain cells and shrinks brain tissue. It also damages blood cells, often leading to heart attacks or strokes. Both can lead to damage to the brain from lack of oxygen.
An overdose of alcohol, or acute alcohol poisoning, can make you stop breathing or stop your heart. This has the potential to decrease or eliminate the amount of oxygen reaching your brain.
Marijuana and the Brain
The research on marijuana’s impact on the brain is often confusing and incomplete. Studies on rats showed structural and functional changes to the hippocampus – leading to cognitive impairments. This seems to be especially true for youth. Marijuana use at a young age seems to be associated with learning and memory problems later in life.
The memory impairment stems from marijuana altering how the hippocampus processes information. Aging naturally causes neuron loss in the hippocampus and it’s thought that THC may speed up that process.
A long-term study done in New Zealand on marijuana use found an average loss of 6 to 8 IQ points for people who used marijuana in adolescence when compared to those who didn’t use marijuana in adolescence. Those IQ points were never recovered. Marijuana use in adulthood has no impact on IQ points.
The Adolescent Brain Cognitive Development study, funded by the National Institutes of Health, is currently underway. This decade long study will follow American children from childhood to adulthood and provide more concrete evidence on how marijuana impacts developing brains.
Recovering and Repairing the Brain
It is possible to recover from and repair brain damage – to a point. If the damage was severe, the effects will likely be lifelong. Even with reversible damage, it can take a long time to recover. It has been shown that even 100 days after quitting a drug, the brain is still showing the impacts of drug use.
Parallel treatment is essential for recovery, meaning the brain injury and the drug addiction need to be treated at the same time. According to the Brain Injury Association of America, “Approximately one quarter of those entering brain injury rehabilitation are there as a result of drugs or alcohol, while nearly 50 percent of people receiving treatment for substance misuse have a history of at least one brain injury.”
Despite these statistics, many find themselves being treated for a brain injury, while the drug addiction is all but ignored. Finding a facility that can treat both is vital for long-term recovery.
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