Neurobiological Impact of Stimulants Depressants and Hallucinogens

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Neurobiological Impact of Stimulants Depressants and Hallucinogens
Dr. Dawn-Elise Snipes PhD, LPC-MHSP

Objectives
- Define stimulants, depressants and hallucinogens
- Discuss
- Mechanism of action
- Symptoms of intoxication
- Symptoms of withdrawal
- Short and long term effects

- See also https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts

Tolerance and Withdrawal
- All psychoactive drugs cause alterations in the neurotransmitter balance.
- Through exposure to either persistent or abnormally high levels of a substance
- Bodily tissues develop resistance to prevent system overload. (ice cubes in the bath)
- The body responds by increasing “balancing” neurotransmitters. (turn up the water heater)
- Once the body has come to depend on the higher level of the substance, when it is withdrawn, then the “balancing neurotransmitters” exert their effect.
Intro
- Method of administration greatly effects the intensity and duration of onset for various drugs
- Oral (slowest)
- Inhalation/Snorting
- Inhalation/Smoking
- Injection
- Rectal suppository
- Skin patches (pain relief, smoking cessation)
Intro
- Drugs affect everyone differently, based on:
- Size, weight and health (cardiac, thyroid, biological neurotransmitter levels)
- Whether the person is used to taking it
- Whether other drugs are taken concurrently
- The amount taken
- The strength of the drug (varies from batch to batch with illegally produced drugs)
What are Stimulants
- Stimulants are substances that act to excite the central nervous system (HPA-Axis)
- Caffeine
- Amphetamines
- Cocaine
- Used to treat asthma and other respiratory problems, obesity, ADHD, narcolepsy, and occasionally depression

What are Depressants
- Depressants exert the opposite effect of stimulants.
- They s-l-o-w everything down
- Mechanism of Action
- Depressants exert their effects through a number of different pharmacological mechanisms, the most prominent of which include facilitation of GABA, and inhibition of glutamatergic or monoaminergic (dopamine, noradrenaline and serotonin) activity

What are Hallucinogens
- Hallucinogens cause profound distortions in a person’s perceptions of reality.
- Some plants and mushrooms (or their extracts) are hallucinogenic, but hallucinogens can also be man-made
- Commonly divided into two broad categories
- Classic hallucinogens (such as LSD)
- Dissociative drugs (such as PCP).
Dissociatives
- Ketamine—also known as K, Special K, or cat Valium—is odorless and tasteless and has amnesia-inducing and dissociative properties. (Can facilitate sexual assault.)
- DXM (Dextromethorphan)—also known as robo—is a cough suppressant and expectorant
- Salvia divinorum—also known as diviner’s sage—is a psychoactive plant typically ingested by chewing fresh leaves or by drinking their extracted juices.
What are Hallucinogens
- Hallucinogens interfere with the action serotonin and/or glutamate, which regulate:
- Mood
- Sensory perception and response
- Sleep
- Hunger
- Body temperature
- Sexual behavior
- Muscle control
- Pain perception
- Learning and memory

Summary
- Stimulants range from caffeine to methamphetamine and “amp up” the system
- Opioids, benzodiazepines, barbiturates, alcohol, inhalants are all CNS depressants
- Combinations of depressants have an exponential additive effect
- Evaluate patients for exposure to all CNS depressants intentional and incidental
- Hallucinogens include LSD, PCP, Peyote, Ketamine and Dextromethorphan
- Recent research has indicated that HPPD is not due to “traces of the drug being freed up”

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