Prevention/Treatment, Part 3

Question 1: Give an overview of brain damage in teens after substance abuse.

Answer 1: Early drug use is linked to later depression in teen girls, but in boys the study found no evidence that drug use leads to depression, or that depression leads to drug use. Young drug abusers are up to three times more likely to suffer brain damage than those who do not use drugs. Scientists at the University of Edinburgh studied the brains of 34 deceased intravenous drug abusers of heroin and methadone and compared them to the brains of 16 young people who were not drug users. Their examination revealed brain damage in the drug abusers normally seen in much older people. The damaged nerve cells were in the areas of the brain involved in learning, memory and emotional well being, and were similar to damage found in the early stages of Alzheimer's disease. The study showed evidence of an increased risk of brain damage associated with heroin and methadone use, which may be highest in the young, when individuals are most likely to acquire the habit.It was found that the brains of these young drug abusers showed significantly higher levels of two key proteins associated with brain damage. In a previous study it was found that drug abuse causes low grade inflammation in the brain. Taken together, the two studies suggest that intravenous opiate abuse may be linked to premature aging of the brain.The drug abusers who were examined in the study sadly died at a young age, but there are many others who do not realize the long-term effects that these drugs may be causing.

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Question 2: Discuss the gateway drug theory.

Answer 2: The gateway drug theory is the belief that use of a lower classed drug can lead to the subsequent use of harder, more dangerous drugs. The term is also used to describe introductory experiences to addictive substances. Some believe tobacco, alcohol, and marijuana are gateway drugs.Some research suggests that serious drug abusers adopt an atypical drug use sequence with use of other drugs initiated before marijuana or alcohol. There are many pharmacological similarities between various drugs of abuse. Individual social histories show that hard drug users do progress from one drug to another, but the reasons are not clear enough to generalize a gateway.

Question 3: Describe how some drug placement is paradoxical.

Answer 3: The placement of some drugs is paradoxical: both morphine and fentanyl are on Schedule II, and heroin is on Schedule I. Fentanyl is approximately 80 times the potency of morphine, and heroin is somewhere between morphine and fentanyl. Clearly, morphine has been used by physicians for over 150 years. It is very addictive, but it is very effective for severe pain, so it is licensed for careful medical use. Heroin was introduced in the late 19th century and licensed the same way until it was completely banned in 1924. Fentanyl has been used for less than 50 years and has always been carefully restricted.Dextromethorphan (DXM), a drug found in many OTC cough medications, is also explicitly exempt from scheduling under the original 1970 version of the CSA. However, the DEA has noted DXM to be abused recreationally as a dissociative anesthetic similar to PCP or ketamine. DXM is therefore listed as a 'chemical of concern' and is being considered for possible evaluation for scheduling.

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