NIDA for Teens: The Science Behind Drug Abuse
Find NIDA for Teens on: NIDAnews on Twitter NIDANIH on YouTube Facebook NIDA-NIH on Flickr Sara Bellum Blog RSS
  • How Does Someone Become Addicted to Opioids?

    Long-term opioid use changes the way nerve cells work in the brain. This happens even to people who take opioids for a long time to treat pain, as prescribed by their doctor. The nerve cells grow used to having opioids around, so that when they are taken away suddenly, the person can have lots of unpleasant feelings and reactions. These are known as withdrawal symptoms.

    Have you ever had the flu? You probably had aching, fever, sweating, shaking, or chills. These are similar to withdrawal symptoms, but withdrawal symptoms are much worse.

    That is why use of opioids should be carefully watched by a doctor—so that a person knows how much to take and when, as well as how to stop taking them to lessen the chances of withdrawal symptoms. Eventually, the cells will work normally again, but that takes time.

    Someone who is addicted to opioids has other problems as well. For example, they keep taking the drug even though it may be having harmful effects on their life and their health. They have strong urges to take the drug—called cravings—and they no longer feel satisfied by natural rewards (like chocolate, TV, or a walk on the beach).

    woman with flashlight in brain
    Associated Drug of Abuse: 
  • The Search Continues

    There is still a lot that scientists don’t know about the effects of opioids on the brain. Maybe someday you will make the next big discovery!

    Until then, join me—Sara Bellum—in the magazines in my series, as we explore how drugs affect the brain and nervous system.

    Mind Over Matter is produced by the National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services. These materials are in the public domain and may be reproduced without permission. Citation of the source is appreciated. NIH Publication No. 14-3856. Printed 1997. Reprinted 1998, 2000, 2003, 2005, 2006, 2007. Revised 2009, 2014.

    Associated Drug of Abuse: 
  • Surprising Facts

    Opioids can make you throw up—this can even happen to someone given opioids by a doctor—which is why many people don’t like taking them.

    Your brain makes its own versions of opioids, called endogenous opioids. These chemicals act just like opioid drugs, attaching to opioid receptors in your brain. Endogenous opioids help your body control pain. If you’ve ever felt pleasantly relaxed after exercising a lot, that feeling was probably caused by the release of these natural chemicals (sometimes called “endorphins”) in your brain.

    Opiates stop pain from getting to the brain.
    Associated Drug of Abuse: 
  • Opiates

    Opiates are powerful drugs derived from the poppy plant that have been used for centuries to relieve pain. They include opium, heroin, morphine, and codeine. Even centuries after their discovery, opiates are still the most effective pain relievers available to physicians for treating pain. Although heroin has no medicinal use, other opiates, such as morphine and codeine, are used in the treatment of pain related to illnesses (for example, cancer) and medical and dental procedures. When used as directed by a physician, opiates are safe and generally do not produce addiction. But opiates also possess very strong reinforcing properties and can quickly trigger addiction when used improperly.

    Associated Drug of Abuse: 
  • Research Reports: Heroin

    All materials appearing in the Research Report Series are in the public domain and may be reproduced without permission from NIDA. Citation of the source is appreciated.

    Research Report Heroin
    Associated Drug of Abuse: 
    Publication from NIDA: 
    Yes
  • Mechanism of Action

    Mechanism of Action

    opiates stop brain from receiving pain signals

    Opiates elicit their powerful effects by activating opiate receptors that are widely distributed throughout the brain and body. Once an opiate reaches the brain, it quickly activates the opiate receptors that are found in many brain regions and produces an effect that correlates with the area of the brain involved. Two important effects produced by opiates, such as morphine, are pleasure (or reward) and pain relief. The brain itself also produces substances known as endorphins that activate the opiate receptors. Research indicates that endorphins are involved in many things, including respiration, nausea, vomiting, pain modulation, and hormonal regulation.

    When opiates are prescribed by a physician for the treatment of pain and are taken in the prescribed dosage, they are safe and there is little chance of addiction. However, when opiates are abused and/or taken in excessive doses, addiction can result. Findings from animal research indicate that, like cocaine and other abused drugs, opiates can also activate the brain's reward system. When a person injects, sniffs, or orally ingests heroin (or morphine), the drug travels quickly to the brain through the bloodstream. Once in the brain, the heroin is rapidly converted to morphine, which then activates opiate receptors located throughout the brain, including within the reward system. (Note: Because of its chemical structure, heroin penetrates the brain more quickly than other opiates, which is probably why many addicts prefer heroin.) Within the reward system, the morphine activates opiate receptors in the VTA, nucleus accumbens, and cerebral cortex (refer to the Introduction for information on the reward system). Research suggests that stimulation of opiate receptors by morphine results in feelings of reward and activates the pleasure circuit by causing greater amounts of dopamine to be released within the nucleus accumbens. This causes an intense euphoria, or rush, that lasts only briefly and is followed by a few hours of a relaxed, contented state. This excessive release of dopamine and stimulation of the reward system can lead to addiction.

    Opiates also act directly on the respiratory center in the brainstem, where they cause a slowdown in activity. This results in a decrease in breathing rate. Excessive amounts of an opiate, like heroin, can cause the respiratory centers to shut down breathing altogether. When someone overdoses on heroin, it is the action of heroin in the brainstem respiratory centers that can cause the person to stop breathing and die.

    As mentioned earlier, the brain itself produces endorphins that have an important role in the relief or modulation of pain. Sometimes, though, particularly when pain is severe, the brain does not produce enough endorphins to provide pain relief. Fortunately, opiates, such as morphine are very powerful pain relieving medications. When used properly under the care of a physician, opiates can relieve severe pain without causing addiction.

    Feelings of pain are produced when specialized nerves are activated by trauma to some part of the body, either through injury or illness. These specialized nerves, which are located throughout the body, carry the pain message to the spinal cord. After reaching the spinal cord, the message is relayed to other neurons, some of which carry it to the brain. Opiates help to relieve pain by acting in both the spinal cord and brain. At the level of the spinal cord, opiates interfere with the transmission of the pain messages between neurons and therefore prevent them from reaching the brain. This blockade of pain messages protects a person from experiencing too much pain. This is known as analgesia.

    Opiates also act in the brain to help relieve pain, but the way in which they accomplish this is different than in the spinal cord.

    There are several areas in the brain that are involved in interpreting pain messages and in subjective responses to pain. These brain regions are what allow a person to know he or she is experiencing pain and that it is unpleasant. Opiates also act in these brain regions, but they don't block the pain messages themselves. Rather, they change the subjective experience of the pain. This is why a person receiving morphine for pain may say that they still feel the pain but that it doesn't bother them anymore.

    Although endorphins are not always adequate to relieve pain, they are very important for survival. If an animal or person is injured and needs to escape a harmful situation, it would be difficult to do so while experiencing severe pain. However, endorphins that are released immediately following an injury can provide enough pain relief to allow escape from a harmful situation. Later, when it is safe, the endorphin levels decrease and intense pain may be felt. This also is important for survival. If the endorphins continued to blunt the pain, it would be easy to ignore an injury and then not seek medical care.

    There are several types of opiate receptors, including the delta, mu, and kappa receptors. Each of these three receptors is involved in controlling different brain functions. For example, opiates and endorphins are able to block pain signals by binding to the mu receptor site.

    The powerful technology of cloning has enabled scientists to copy the genes that make each of these receptors. This in turn is allowing researchers to conduct laboratory studies to better understand how opiates act in the brain and, more specifically, how opiates interact with each opiate receptor to produce their effects. This information may eventually lead to more effective treatments for pain and opiate addiction.

    The following activities, when used along with the magazine on opiates, will help explain to students how these substances change the brain and the body.

    Associated Drug of Abuse: 
  • Activity One

    Activity One

    Objective

    The student will learn the way in which opiates alter the function of nerve cells.

    Activity

    Remind students that long-term abuse of opiates, such as heroin, changes the way nerve cells in the brain work. These cells become so used to having the heroin present that they need it to work normally. This, in turn, leads to addiction. If opiates are taken away from dependent nerve cells, these cells become overactive. Eventually, they will work normally again, but in the meantime, they create a range of symptoms known as withdrawal. Have students create visual representations of normal nerve cells, dependent nerve cells, overactive nerve cells, and an opiate. Then have the students use these representations to develop, in comic art format, the process by which opiates change the normal functioning of neurons.

    Associated Drug of Abuse: 
  • Activity Two

    Activity Two

    Objective

    The student will learn how opiates produce an analgesic effect.

    Activity

    Note that opiates are powerful painkillers and are used medically for treatment of pain. When used properly for medical purposes, opiates do not produce an intense feeling of pleasure, and patients have little chance of becoming addicted. Have students search the Internet and other sources for information about pain, pain control, and the way opiates produce their analgesic effect and then prepare a brief summary report.

    Associated Drug of Abuse: 
  • DrugFacts: Cough and Cold Medicine Abuse

    Spoon full of cough and cold medicine

    Some over-the-counter (OTC) and prescription cough and cold medicines contain active ingredients that are psychoactive (mind-altering) at higher-than-recommended dosages and are frequently abused for this purpose. These products may also contain other drugs, such as expectorants and antihistamines, which are dangerous at high doses and compound the dangers of abuse.

    Two commonly abused cough and cold medicines are:

    • Dextromethorphan (DXM), a cough suppressant and expectorant found in many OTC cold medicines. It may produce euphoria and dissociative effects or even hallucinations when taken in quantities greater than the recommended therapeutic dose.
    • Promethazine-codeine cough syrup, a medication that contains codeine, an opioid that acts as a cough suppressant and can also produce relaxation and euphoria when consumed at a higher-than-prescribed dose. It also contains promethazine HCl, an antihistamine that additionally acts as a sedative. Although only available by prescription, promethazine-codeine cough syrup is sometimes diverted for abuse.

    How Are Cough and Cold Medicines Abused?

    Cough and cold medicines are usually consumed orally in tablet, capsule, or syrup form. They may be mixed with soda for flavor and are often abused in combination with other drugs, such as alcohol or marijuana.

    Because they are easily purchased in drugstores without a prescription, cough syrups, pills, and gel capsules containing DXM—particularly “extra strength” forms—are frequently abused by young people (who refer to the practice as “robo-tripping” or “skittling”). To avoid nausea produced by high doses of the expectorant guaifenesin commonly found in DXM-containing syrups, young people may instead abuse Coricidin® HBP Cough & Cold capsules (street name C-C-C or triple-C), which contain DXM but lack guaifenesin.

    Drinking promethazine-codeine cough syrup mixed with soda (a combination called syrup, sizzurp, purple drank, barre, or lean) was referenced frequently in some popular music beginning in the late 1990s and has become increasingly popular among youth in several areas of the country. A variation of “purple drank” is promethazine-codeine cough syrup mixed with alcohol. Users may also flavor the mixture with the addition of hard candies.

    How Does Abusing Cough and Cold Medicines Affect the Brain?

    When taken as intended, cough and cold medicines safely treat symptoms of lower and upper respiratory congestion and discomfort caused by colds and flu. But when taken in higher quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illegal drugs.

    When taken in high doses, DXM acts on the same cell receptors as dissociative hallucinogenic drugs like PCP or ketamine. Users describe effects ranging from mild stimulation to alcohol- or marijuana-like intoxication, and at high doses, sensations of physical distortion and hallucinations.

    Codeine attaches to the same cell receptors targeted by illegal opioids like heroin. Consuming more than the daily recommended therapeutic dose of promethazine-codeine cough syrup can produce euphoria similar to that produced by other opioid drugs; people addicted to codeine may consume several times the recommended, safe amount. Also, both codeine and promethazine HCl act as depressants of the central nervous system, producing sedating or calming effects.

    When abused, both codeine and DXM directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction—a chronic relapsing brain disease characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.

    What Are the Other Health Effects of Abusing Cough and Cold Medicines?

    Abusing DXM can cause impaired motor function, numbness, nausea or vomiting, increased heart rate and blood pressure, and at high doses, extreme agitation, increased body temperature, and a buildup of excess acid in body fluids. High doses of acetaminophen, a pain reliever commonly found with DXM, can cause liver damage. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred as a result of the combination of DXM with decongestants often found in the medication.

    When abused, promethazine-codeine cough syrup presents a high risk of fatal overdose due to its effect of depressing the central nervous system, which can slow or stop the heart and lungs. Mixing with alcohol greatly increases this risk. Promethazine-codeine cough syrup has been linked to the overdose deaths of a few prominent musicians.

    Learn More

    For more information on abuse of DXM, see
    http://www.deadiversion.usdoj.gov/drug_chem_info/dextro_m.pdf (PDF, 37KB)

    For more information on abuse of promethazine-codeine cough syrup, see
    http://www.drugabuse.gov/drugs-abuse/emerging-trends

    Drug Facts
    Publication from NIDA: 
    Yes
  • Opiáceos

    Clara Mente

    Tal vez hayas oído de ciertas drogas como la heroína, la morfina o la codeína. Éstas son ejemplos de opiáceos. Si alguien usa opiáceos una y otra vez, es probable que su cerebro comience a depender de estas drogas.

    Opiates
    Associated Drug of Abuse: 
    Spanish DrugPub ID: 
    mi100s
    English DrugPub ID: 
    mi108
  • DrugFacts: Prescription and Over-the-Counter Medications

    Some medications have psychoactive (mind-altering) properties and, because of that, are sometimes abused—that is, taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed. In fact, prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.

    Past year illicit use among 12th graders, Marijuana 36.4%, Amphetamines 8.7%, Synthetic Marijuana 7.9%, Adderall 7.4%, Vicodin 5.3%, Cough med 5.0%, Tranquilizers 4.6%, Hallucinogens 4.5%, Sedatives 4.8%, Salvia 3.4%, Oxycontin 3.6%, MDMA 4.0%, Inhalants 2.5%, Cocaine 2.6%, Ritalin 2.3%

    The classes of prescription drugs most commonly abused are: opioid pain relievers, such as Vicodin or Oxycontin; stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall, Concerta, or Ritalin; and central nervous system (CNS) depressants for relieving anxiety, such as Valium or Xanax.1 The most commonly abused OTC drugs are cough and cold remedies containing dextromethorphan.

    People often think that prescription and OTC drugs are safer than illicit drugs, but that’s only true when they are taken exactly as prescribed and for the purpose intended. When abused, prescription and OTC drugs can be addictive and put abusers at risk for other adverse health effects, including overdose—especially when taken along with other drugs or alcohol.

    How Are Prescription Drugs Abused?

    Prescription and OTC drugs may be abused in one or more of the following ways:

    Taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing their unused pain relievers with their family members. 

    Most teenagers who abuse prescription drugs are given them for free by a friend or relative.

    Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects.

    Graphic showing the spectrum of Prescription Drug Abuse from improper use to abuse: 1 Taking someone else's prescription to self-medicate. 2 Taking a prescription medication in a way other than prescribed. 3 Taking a medication to get high.

    Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.

    ADHD drugs like Adderall are also often abused by students seeking to improve their academic performance. However, although they may boost alertness, there is little evidence they improve cognitive functioning for those without a medical condition.

    How Do Prescription and OTC Drugs Affect the Brain?

    Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs.

    For example, stimulants such as Ritalin achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and rohypnol. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences.

    When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.

    What Are the Other Health Effects of Prescription and OTC Drugs?

    Opioids can produce drowsiness, cause constipation, and—depending upon the amount taken—depress breathing. The latter effect makes opioids particularly dangerous, especially when they are snorted or injected or combined with other drugs or alcohol.

    Opioids and Brain Damage

    While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.

    Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

    More people die from overdoses of prescription opioids than from all other drugs combined, including heroin and cocaine (see "The Prescription Opioid Abuse Epidemic" below).

    The Prescription Opioid Abuse Epidemic

    Over 2 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers. The terrible consequences of this epidemic include overdose deaths, which have more than quadrupled in the past decade and a half. The causes are complex, but they include overprescription of pain medications. In 2013, 207 million prescriptions were written for prescription opioid pain medications.

    Opiod deaths (per 100,000 population) by age group,  15-24 years old, Opioids 3.7, illegal drugs 2.2, 25-34 year olds, Opiods 7.1, Illegal 4.4, 35-44 year olds, Opiods 8.3, illiegal 5.3, 45-54 year olds, Opioids 10.4, Illegal 6, 55-64 year olds, Opioids 5, Illegal 2.5, over 65, Opiods 1, Illiegal .3

    Stimulants can have strong effects on the cardiovascular system. Taking high doses of a stimulant can dangerously raise body temperature and cause irregular heartbeat or even heart failure or seizures. Also, taking some stimulants in high doses or repeatedly can lead to hostility or feelings of paranoia.

    CNS depressants slow down brain activity and can cause sleepiness and loss of coordination. Continued use can lead to physical dependence and withdrawal symptoms if discontinuing use.

    Prescription Opioid Abuse: A First Step to Heroin Use?

    Prescription opioid pain medications such as Oxycontin and Vicodin can have effects similar to heroin when taken in doses or in ways other than prescribed, and research now suggests that abuse of these drugs may actually open the door to heroin abuse.

    Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.

    Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.

    Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.

    All of these drugs have the potential for addiction, and this risk is amplified when they are abused. Also, as with other drugs, abuse of prescription and OTC drugs can alter a person’s judgment and decision making, leading to dangerous behaviors such as unsafe sex and drugged driving.

    Learn More

    For more information on prescription and OTC drugs, please refer to the following sources on NIDA’s Web site:

    References

    1. These are proprietary names of particular drug products. Generic versions may also exist.
    Publication from NIDA: 
    Yes
  • La respuesta del cerebro a los opiáceos

    Clara Mente estudiando las amapolas

    ¡Hola! Me llamo Clara Mente y quiero darles la bienvenida a mi serie de boletines informativos que exploran la respuesta del cerebro a las drogas. En este ejemplar, investigaremos varios datos fascinantes sobre los opiáceos. Alguna de esta información fue descubierta recientemente por los científicos que lideran la investigación en este campo.

    Si alguna vez viste la película "El Mago de Oz", entonces has visto la planta de la amapola. Esta planta es la fuente de un tipo de drogas llamadas opiáceos. Cuando Dorothy se acuesta en el campo de amapolas, cae en un sueño profundo.

    Con razón que el nombre en latín de esta planta –Papaver somniferum– quiere decir "amapola somnífera" o "amapola que te da sueño".

    Los opiáceos se fabrican del opio, que se deriva de la amapola. También se los conoce como narcóticos. Tal vez hayas oído de ciertas drogas como la heroína, la morfina o la codeína. Éstas son ejemplos de opiáceos.

    Los opiáceos pueden producir una sensación rápida e intensa de placer, seguida por una sensación de bienestar y calma adormecedora. Pero también se pueden convertir en una adicción. Si alguien usa opiáceos una y otra vez, es probable que su cerebro comience a depender de estas drogas.

    Associated Drug of Abuse: 
  • DrugFacts: Prescription and Over-the-Counter Medications

    Some medications have psychoactive (mind-altering) properties and, because of that, are sometimes abused—that is, taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed. In fact, prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.

    Past year illicit use among 12th graders, Marijuana 36.4%, Amphetamines 8.7%, Synthetic Marijuana 7.9%, Adderall 7.4%, Vicodin 5.3%, Cough med 5.0%, Tranquilizers 4.6%, Hallucinogens 4.5%, Sedatives 4.8%, Salvia 3.4%, Oxycontin 3.6%, MDMA 4.0%, Inhalants 2.5%, Cocaine 2.6%, Ritalin 2.3%

    The classes of prescription drugs most commonly abused are: opioid pain relievers, such as Vicodin or Oxycontin; stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall, Concerta, or Ritalin; and central nervous system (CNS) depressants for relieving anxiety, such as Valium or Xanax.1 The most commonly abused OTC drugs are cough and cold remedies containing dextromethorphan.

    People often think that prescription and OTC drugs are safer than illicit drugs, but that’s only true when they are taken exactly as prescribed and for the purpose intended. When abused, prescription and OTC drugs can be addictive and put abusers at risk for other adverse health effects, including overdose—especially when taken along with other drugs or alcohol.

    How Are Prescription Drugs Abused?

    Prescription and OTC drugs may be abused in one or more of the following ways:

    Taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing their unused pain relievers with their family members. 

    Most teenagers who abuse prescription drugs are given them for free by a friend or relative.

    Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects.

    Graphic showing the spectrum of Prescription Drug Abuse from improper use to abuse: 1 Taking someone else's prescription to self-medicate. 2 Taking a prescription medication in a way other than prescribed. 3 Taking a medication to get high.

    Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.

    ADHD drugs like Adderall are also often abused by students seeking to improve their academic performance. However, although they may boost alertness, there is little evidence they improve cognitive functioning for those without a medical condition.

    How Do Prescription and OTC Drugs Affect the Brain?

    Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs.

    For example, stimulants such as Ritalin achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and rohypnol. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences.

    When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.

    What Are the Other Health Effects of Prescription and OTC Drugs?

    Opioids can produce drowsiness, cause constipation, and—depending upon the amount taken—depress breathing. The latter effect makes opioids particularly dangerous, especially when they are snorted or injected or combined with other drugs or alcohol.

    Opioids and Brain Damage

    While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.

    Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

    More people die from overdoses of prescription opioids than from all other drugs combined, including heroin and cocaine (see "The Prescription Opioid Abuse Epidemic" below).

    The Prescription Opioid Abuse Epidemic

    Over 2 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers. The terrible consequences of this epidemic include overdose deaths, which have more than quadrupled in the past decade and a half. The causes are complex, but they include overprescription of pain medications. In 2013, 207 million prescriptions were written for prescription opioid pain medications.

    Opiod deaths (per 100,000 population) by age group,  15-24 years old, Opioids 3.7, illegal drugs 2.2, 25-34 year olds, Opiods 7.1, Illegal 4.4, 35-44 year olds, Opiods 8.3, illiegal 5.3, 45-54 year olds, Opioids 10.4, Illegal 6, 55-64 year olds, Opioids 5, Illegal 2.5, over 65, Opiods 1, Illiegal .3

    Stimulants can have strong effects on the cardiovascular system. Taking high doses of a stimulant can dangerously raise body temperature and cause irregular heartbeat or even heart failure or seizures. Also, taking some stimulants in high doses or repeatedly can lead to hostility or feelings of paranoia.

    CNS depressants slow down brain activity and can cause sleepiness and loss of coordination. Continued use can lead to physical dependence and withdrawal symptoms if discontinuing use.

    Prescription Opioid Abuse: A First Step to Heroin Use?

    Prescription opioid pain medications such as Oxycontin and Vicodin can have effects similar to heroin when taken in doses or in ways other than prescribed, and research now suggests that abuse of these drugs may actually open the door to heroin abuse.

    Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.

    Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.

    Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.

    All of these drugs have the potential for addiction, and this risk is amplified when they are abused. Also, as with other drugs, abuse of prescription and OTC drugs can alter a person’s judgment and decision making, leading to dangerous behaviors such as unsafe sex and drugged driving.

    Learn More

    For more information on prescription and OTC drugs, please refer to the following sources on NIDA’s Web site:

    References

    1. These are proprietary names of particular drug products. Generic versions may also exist.
    Publication from NIDA: 
    Yes
  • Opioids

    Maybe you've heard of drugs called heroin, morphine, or codeine. These are examples of opioids. If someone uses opioids again and again, his or her brain is likely to become dependent on them.

    Mind Over Matter: The Brain's Response to Opioids cover
    Associated Drug of Abuse: 
    Spanish DrugPub ID: 
    mi100s
    English DrugPub ID: 
    mi108
  • Clonación de los receptores

    Las células nerviosas padecen de la adicción y de los síntomas del síndrome de abstinencia

    Después de años de experimentos, los científicos han descubierto cómo copiar (“clonar”) los genes que controlan la producción de los receptores de opiáceos. Ahora les será más fácil a los científicos hacer receptores de opiáceos y estudiar cómo los opiáceos afectan las células nerviosas.

    Este descubrimiento puede llevar a otros hallazgos emocionantes tales como mejores tratamientos para la adicción a los opiáceos.

    Los opiáceos actúan sobre diferentes partes del cerebro y del sistema nervioso

    El cerebro y el sistema nervios

    El tallo cerebral controla las cosas que tu cuerpo hace automáticamente, como respirar y toser. Los opiáceos actúan sobre el tallo cerebral para detener la tos y disminuir la respiración. (azul)

    La espina dorsal transmite las señales de dolor del cuerpo. Al actuar en la espina dorsal, los opiáceos bloquean los mensajes de dolor y permiten que las personas soporten el dolor aún de lesiones graves. (amarillo)

    El sistema límbico controla las emociones. Los opiáceos cambian al sistema límbico para producir sensaciones más intensas de placer, rebajamiento y felicidad. (rojo)

    Associated Drug of Abuse: 
  • The Brain's Response to Opioids

    Hi, my name’s Sara Bellum. Welcome to my magazine series exploring the brain’s response to drugs. In this issue, we’ll investigate the fascinating facts about opioids.

    If you’ve ever seen The Wizard of Oz, then you’ve seen the poppy plant—the source of a type of drug called an opioid. When Dorothy lies down in a field of poppies, she falls into a deep sleep. No wonder the Latin name of this plant—Papaver somniferum—means “the poppy that makes you sleepy.” Opioids can be made from opium, which comes from the poppy plant, or they can be made in a lab. Either way, they can be helpful medicines—they are used as powerful painkillers, they are sometimes prescribed to control severe diarrhea, and they can also be found in cough medicine. Maybe you’ve heard of drugs called Vicodin, morphine, or codeine. These are examples of opioids. When used properly as medicine, they can be very helpful. But opioids used without a prescription, or taken in other ways or for different reasons than the doctor prescribed, can be dangerous and addictive.

    Heroin is another example of an opioid, but it isn’t used as a medicine—it’s used to get high.

    woman with magnifying lens
    Associated Drug of Abuse: 
  • Las células nerviosas padecen de la adicción al igual que de los síntomas del síndrome de abstinencia

    woman with flashlight in brain

    ¿Qué les pasa a las personas y a sus cerebros cuando se vuelven adictos a los opiáceos? El uso de opiáceos por largo tiempo cambia cómo funcionan las células nerviosas del cerebro. Estas células se acostumbran tanto a los opiáceos que llegan a necesitar de ellos para poder funcionar normalmente.

    Si se les quita el opiáceo a estas células nerviosas dependientes, muchas de ellas se vuelven hiperactivas. Eventualmente, estas células volverán a funcionar normalmente, pero mientras tanto, pueden causar una gran variedad de síntomas en el cerebro y en el resto del cuerpo. Éstos se conocen como síntomas del síndrome de abstinencia.

    ¿Alguna vez te ha dado gripe? Probablemente, tuviste síntomas como malestar, fiebre, sudoración, temblores o escalofríos. Éstos son parecidos a los síntomas del síndrome de abstinencia, excepto que estos últimos son mucho peores. ¡Uuuyyy! cuerpo.

    Dibujar

    Ésta es una manera de ilustrar lo difícil que es para las células funcionar sin la droga de la que dependen. Toma un papel e intenta dibujar una ilustración de una revista sin usar la mano que normalmente usas.

    Las células nerviosas se pueden volver dependientes de los opiáceos.

    Las células nerviosas dependientes de los opiáceos pueden perder su capacidad para transmitir mensajes normalmente.

    Cómo responden las células nerviosas a los opiáceos

    Hay lugares en ciertas células nerviosas del sistema límbico, el tallo cerebral y la espina dorsal, que reconocen a los opiáceos. Cuando estos sitios, llamados receptores de opiáceos, son estimulados por dicha droga, provocan una respuesta tanto en el cerebro como en el resto del cuerpo.

    Los científicos han identificado tres tipos de receptores de opiáceos: delta, kappa y mu (denominados así por las letras griegas del mismo nombre). Cada uno de estos tipos de receptores está involucrado en diferentes funciones cerebrales. Por ejemplo, los receptores mu son los responsables por los efectos analgésicos (que alivian el dolor) de la droga opiácea llamada morfina.

    Associated Drug of Abuse: 
  • How Do Opioids Work?

    Opioids look like chemicals in your brain and body that attach to tiny parts on nerve cells called opioid receptors. Scientists have found three types of opioid receptors: mu, delta, and kappa (named after letters in the Greek alphabet). Each of these receptors plays a different role. For example, mu receptors are responsible for opioids’ pleasurable effects and their ability to relieve pain.

    Opioids act on many places in the brain and nervous system, including:

    • the limbic system, which controls emotions. Here, opioids can create feelings of pleasure, relaxation, and contentment.
    • the brainstem, which controls things your body does automatically, like breathing. Here, opioids can slow breathing, stop coughing, and reduce feelings of pain.the parts of the brain that are affected
    • the spinal cord, which receives sensations from the body before sending them to the brain. Here too, opioids decrease feelings of pain, even after serious injuries.

    Whether it is a medication like Vicodin or a street drug like heroin, the effects of opioids (and many other drugs) depend on how much you take and how you take them. If they are injected, they act faster and more intensely. If opioids are swallowed as pills, they take longer to reach the brain and are much safer.

    receptors
    the parts of the brain that are affected
    Associated Drug of Abuse: 
  • Los opiáceos paran el dolor

    Clara Mente observa los opiáceos parar el dolor

    ¿Sabías que algunos opiáceos tienen usos médicos importantes? Son poderosos analgésicos y a veces los médicos los recetan para controlar la diarrea severa. Si miras la etiqueta del remedio para la tos, puedes encontrar que uno de los ingredientes es un opiáceo llamado codeína.

    Cuando se usan adecuadamente para propósitos médicos, los opiáceos no producen una sensación de placer intenso, por lo que la probabilidad de que causen adicción en los pacientes es muy poca.

    Datos sorprendentes

    Tu cerebro produce su propia versión de los opiáceos, llamados endorfinas u opioides endógenos. Estas sustancias químicas actúan como los opiáceos, adhiriéndose a los receptores de opiáceos.

    Tu cuerpo controla el dolor a través de los opioides endógenos. Si alguna vez te has sentido completamente relajado después de haber hecho mucho ejercicio, es probable que esa sensación haya sido el resultado de la liberación de esta sustancia química natural dentro de tu cerebro.

    Associated Drug of Abuse: