IF SYMPTOMS PERSIST
By DR. JOSE PUJALTE JR.
“I thought he was immortal.”– Michael Jackson fan on Michael Jackson (1958-2009), RIA Novosti (Russian News)
The simplest way to understand this is: More is not necessarily better. Prescription drugs – the kinds legally prescribed and procured – the kinds that come from doctors can be abused. Of course, drugs can also be illegally purchased and some use them for non-medical reasons.
Drug Addiction. According to the US National Institute on Drug Abuse (NIDA), drug addiction is defined as “a chronic, relapsing disease characterized by compulsive drug seeking and use, despite harmful consequences, and by neuro-chemical and molecular changes in the brain.” Simply put, the user over time loses all control because of the need to get high. At some point, brain tissue is damaged. No wonder crime and drugs are so closely related.
Most Abused Drugs. There are three — opioids, depressants, and stimulants.
Opioids are most often prescribed to treat pain while depressants, specifically central nervous system (CNS) depressants, treat anxiety and sleep disorders. As for stimulants, these are indicated for narcolepsy (a sleep disorder) and ADHD or attention deficit hyperactivity disorder. It is when these are abused or used inappropriately that they become dangerous and a source of personal and social problems.
How Drugs Affect the Brain. In general, drugs – because they are chemicals – have a way of affecting the communication system of the brain. Drugs can disrupt nerve cells – the basic unit of the nervous system – as they send, receive, and process information. Drugs are able to do these either by imitating or mimicking the natural brain chemical messengers (or neurotransmitters) or by overstimulation of the brain’s “reward circuit.” Drugs flood the brain with the neurotransmitter dopamine – ultimately giving euphoric effects. This is the “high” or euphoria that drug addicts look for. Sadly, over time, drugs destroy organic neural tissue (the brain!) – the very areas critical in decision making, judgment, learning, and memory, and behavior control.
Opioids. These prescription narcotics do one great service – they block the perception of pain. Opioids do this by attaching to specific proteins found in the brain, spinal cord and gut called opioid receptors. However, they can also give the feeling of euphoria and again, these are what addicts crave for. Examples of opioids are:morphine, codeine, and oxycodone. Overdosing on these drugs can cause respiratory depression and even death. As a rule, they are taken under medical supervision and used only for a short time.
Depressants. CNS depressants (sedatives, tranquilizers) are given to severely stressed, anxious, or erratically sleeping patients. Diazepam, chlordiazepoxide, and alprazolam are benzodiapenes effective for short-term treatment of sleep problems. Barbiturates such as mephobarbital and pentobarbital treat anxiety, tension, and also sleep disorders. The problems come when these are abused – that means used when no longer needed or taken in large doses. Generally, depressants slow down brain activity. Over time, dependence can occur and unmonitored changes in dose (or stopping altogether) and result in seizures and other life-threatening effects.
Stimulants. Examples of stimulants are dextroamphetamine, methylphenidate that mimic natural brain chemicals called dopamine and norepinephrine. Stimulants increase alertness, attention, and energy, but also elevate blood pressure, heart rate, and breathing or respiratory rate. Repeated use of stimulants, even for short periods, can cause hostility and paranoia in the user. Overdose can cause irregular heartbeats and seizures.
Treatment. Sooner or later, drug addiction in a person may be recognizable to friends or relatives. Fortunately, treatment is available beginning with detoxification. Primarily, “detox” is needed to care for the expected withdrawal symptoms as the patient is weaned from drugs and rendered “drug-free.” Ironically, drugs are prescribed to treat drug addiction! Naltrexone blocks the effects of opioids as do methadone and buprenorphine. Behavioral therapy and support groups are mainstays of treatment too.
Used appropriately, drugs free us from pain, anxiety, tension, and depression. Abused, drugs lead us to pain, anxiety, tension, depression, and death.
Dr Pujalte is an orthopedic surgeon. E-mail [email protected]