Psychoactive drugs such as tobacco, alcohol, cannabis, amphetamines, ecstasy, cocaine, and heroin can change consciousness, mood, and thoughts. Psychoactive drugs are substances that can alter the consciousness, mood, and thoughts of those who use them. Examples include: tobacco alcohol cannabis amphetamines ecstasy cocaine heroin Tobacco smoking is spreading rapidly in developing countries and among women. The average consumption of cigarettes is particularly high in Asia and the Far East, with the Americas and Eastern Europe following closely behind. Prevalence of smoking among adults and youths in selected countries (2008) Annual per Prevalence of smoking (%) capita Adults Youths Country consumption Males Females Males Females of cigarettes Argentina 1495 46.8 34.4 25.7 30 Bolivia 274 42.7 18.1 31 22 Chile 1202 26 18.3 34 43.4 China Ghana Indonesia Jordan Kenya Malawi Mexico Nepal Peru Poland Singapore Sri Lanka 1791 161 1742 1832 200 123 754 619 1849 2061 1230 374 66.9 28.4 59 48 66.8 20 51.2 48 41.5 44 26.9 25.7 4.2 3.5 3.7 10 31.9 9 18.4 29 15.7 25 3.1 1.7 14 16.2 38 27 16 18 27.9 12 22 29 10.5 13.7 7 17.3 5.3 13.4 10 15 16 6 15 20 7.5 5.8 ALCOHOL: Whereas the consumption of alcohol is decreasing in developed countries, it is increasing in countries of the former Soviet Union and in developing countries, especially in the Western Pacific Region. Adult (15+) Per Capita Alcohol Consumption by Development Status UNDERAGE ALCOHOL USE IN THE UNITED STATES • 11 percent of 8th graders reported drinking during the past 30 days, with 3.6 percent of them drinking to intoxication. • 28 percent of 10 graders reporting past 30-day use and 14.5 percent drinking to intoxication • 42 percent of 12th graders reporting past 30-day use and 28.1 percent drinking to intoxication. Source: Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on drug use: 2012 overview—Key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. From http://www. monitoringthefuture.org//pubs/monographs/mtf-overview2012.pdf (accessed February 22, 2013). How psychoactive drugs affect the functioning of the brain Psychoactive drugs alter communication between brain cells. Some psychoactive substances are able to mimic the effects of neurotransmitters. Others interfere with normal brain function by blocking it, or by altering the way neurotransmitters are stored, released, and removed. The human brain is organized into a number of different regions with highly specialized functions. The hindbrain is vital to staying alive because it controls breathing and wakefulness. The midbrain is involved in learning, emotion (limbic system), and reinforcing behaviors, such as eating and drinking, that lead to pleasure and to life preservation. This area thus plays an important role in drug dependence. The forebrain is very complex and its outer layer (the cerebral cortex) controls the ability for abstract thought and planning. When drug-dependent people are exposed to stimuli that provoke cravings, specific regions of their forebrain become activated. Different psychoactive drugs have different ways of acting in the brain to produce their effects. They bind to different receptor types, and can increase or decrease the activity of neurons through a range of mechanisms. Consequently, they have different effects on behavior, different rates of development of tolerance, different withdrawal symptoms, and different short-term and longterm effects. The most common psychoactive drugs can roughly be divided into four groups: Depressants (e.g., alcohol and sedatives) Stimulants (e.g., nicotine and ecstasy) Opioids (e.g., morphine and heroin) Hallucinogens (e.g., PCP and LSD) Depressants, such as alcohol, sedatives/hypnotics and volatile solvents, diminish the activity of the central nervous system. Substance Ethanol (alcohol) Hypnotics and sedatives Inhalants (volatile solvents) How it works Tolerance Withdrawal Effects of prolonged use Alters the effects of Develops due to Withdrawal from Changed brain the neurotransmitters increased processing long-term use can function and structure, glutamate and GABA. in the liver and include shaking, reduced mental Probably increases changes to receptors sweating, weakness, capacity, decreased activity in the in the brain. agitation, headache, brain volume. dopamine system nausea, vomiting, involved in seizures, and delirium motivation and tremens. learning. Enhances the effects Develops quickly due Anxiety, alertness, Memory problems. of some to changes in brain restlessness, neurotransmitters (e.g. receptors. insomnia, excitability, GABA). seizures. Like other sedatives Some tolerance Increased Changes in how and hypnotics, develops, but is susceptibility to dopamine works in probably affect difficult to estimate. seizures during the body, problems in specific transmitters. withdrawal the nervous system, Increases activity in reduced mental the dopamine system capacity; psychiatric involved in problems. motivation and learning. Stimulants, such as nicotine, cocaine, amphetamines and ecstasy, increase the activity of the central nervous system. Substance How it works Toleranc Withdrawal Nicotine Activates specific Develops receptors. Increases through the production and metabolic release of dopamine. factors, as well as receptor changes. Cocaine Prolongs the effects Perhaps short- There is not much of transmitters such term tolerance. evidence of as dopamine. withdrawal. Depression is common among dependent people who stop using the drug Effects of prolonged use Irritability, hostility, It is difficult to separate anxiety, unease, the health effects due to discomfort, nicotine from the effects depressed mood, due to other components decreased heart rate, of tobacco. increased appetite. Abnormalities in specific regions of the brain, loss of some mental capacity, problems with movement, decreased reaction times. Amphetamines Increase the release Develops and prolong the quickly effects of dopamine and related transmitters. Fatigue, depression, Sleep disturbances, anxiety and intense anxiety, decreased craving for the drug. appetite; changes in dopamine brain receptors, changes in metabolism in some parts of the body, reduction of mental capacity and deterioration of movement. Ecstasy Increases the release May develop in Depression and and prolongs the some insomnia effects of the neuro- individuals. transmitter serotonin. Damages some brain systems, leads to physical changes and to changes in behavior. Long-term psychiatric and physical problems such as loss of memory, problems with decision-making and self-control, paranoia, depression and panic attacks. RATS ON DRUGS Opioids, such as morphine and heroin, relieve pain, dull the senses, and induce sleep. Substance Opioids How it works Tolerance Activate specific Due to short-term receptors that are and long-term abundant in an area receptor changes, of the brain that is and to changes in involved in the way some cells motivation and communicate. learning. Withdrawal Effects of prolonged use Can be severe. Watering eyes, runny nose, yawning, sweating, restlessness, chills, cramps, muscle aches. Long-term changes in certain receptors. Changes in learning and in the response to stress. Hallucinogens such as PCP and LSD, can distort perceptions to induce delusions or hallucinations. Substance Cannabis How it works Tolerance Activates specific Develops quickly. receptors. Affects the dopamine system involved in motivation and learning. Hallucinogens (such Different substances Develops quickly. as LSD and PCP) in this class act on different brain receptors. Withdrawal Effects of prolonged use Withdrawal is rare Long-term exposure perhaps because may produce longcannabis remains in lasting reduction of the body for a long mental capacity. time. May make mental illness worse. There is no evidence Short or long term of withdrawal. disturbed mental state in which a person experiences hallucinations, delusions, personality changes and loss of contact with reality. Flashbacks or reexperiencing of drug effects, long after drug use. Inside the Tripper’s Brain