Monday, 25 July 2016

The Psychology of Drugs

Ecstasy


Background Information


Definition: Methylenedioxymethamphetamine (MDMA), which is more commonly known as ecstasy, is chemical made drug.  It acts as both a stimulant and a hallucinogen due to its molecular structure, which is similar to that of amphetamines and LSD. Stimulant drugs typically speed up the messages travelling between the brain and the body. It can contain both amphetamines and some hallucinogens. Amphetamines are stimulant drugs, meaning they speed up the brain and the central nervous system. Hallucinogens are drugs that can cause people to see, hear, feel or smell things that do not exist (To have hallucinations). Other names for ecstasy include E, XTC, eccy, eckies, pills, pingers, bikkies, flippers and molly. 

Ecstasy is a synthetic drug, containing the drug MDMA. However, many pills sold as ecstasy only have a small amount of MDMA or none at all, instead, other drugs and 'fillers' such as household cleaning products are often used. Thus making it hard to know exactly what reactions to expect after taking ecstasy or how bad the side effects will be.

Ecstasy comes in a tablet form and is usually swallowed. The pills come in different colours and sizes and are often imprinted with a picture or symbol. It can also come as capsules, powder (usually snorted) or crystal/rock. Ecstasy is currently illegal in Australia. Currently in Victoria, penalties range from $2,000 fines and/or one year imprisonment for cultivation, to fines of up to $250,000 and/or 25 years imprisonment for commercial trafficking.


Effects of Ecstasy

Ecstasy is both a hallucinogenic and a stimulant drug due to its molecular structure. Users will experience a ‘high’, meaning a rush of good feeling as well as intensified feelings, both good and bad feelings. Like most drugs, there is no safe level of drug use, and use of any types of drugs carries some risks.

The neocortex (which is in yellow), is important in cognition, memory and altered perceptions. 

The limbic system is another part of the brain that is affected by the use of ecstasy. 
The amygdala (which is in red) is linked to both fear and pleasure.
Hippocampus (which is in blue) is thought to be the centre of emotion, memory.
Basal ganglia (which is in purple) is responsible for voluntary motor control, procedural learning, eye movement, and cognitive, emotional functions.
Hypothalamus (which is in green) is involved in changes in mood, emotions, and the production of anxiety it is also involved in memory. 

Ecstasy affects everyone differently, based on:
  • Size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time
  • The amount taken
  • The strength of the drug (varies from batch to batch)


The effects of ecstasy are usually taken into effect about 20 minutes to an hour after it's taken and lasts for around 6 hours.  

There are many effects that can be experienced, as well as various sections of the brain that are linked to these specific occurrences. For example:
  • feelings of confidence, happiness and empathy
  • accelerated heart rate and breathing
  • rise in blood pressure
  • sweating and dehydration
  • nausea
  • jaw clenching and teeth grinding
  • loss of appetite
  • hallucinations 
  • an increased urge for sex
  • loss of inhibitions
These short term effects are generally linked to the neocortex or the limbic system.

The long term effects that have been observed due to a lack of proper functioning of the neurotransmitters, show that conditions such as depression, anxiety, insomnia, and memory loss are more likely to occur.

Ecstasy can make some users feel anxious, confused, and paranoid, as though someone is trying to hurt them or is plotting against them. Ecstasy affects cognition (thinking), mood, and memory.

One of the most desirable effects of ecstasy is its ability to provide feelings of warmth and empathy. As of right now, scientists are unsure which area of the brain is involved in the ability of ecstasy to generate feelings of empathy. However, researchers believe that it is the release of extravagant amounts of serotonin that produces the “high” effects that are typically experienced by ecstasy users.


Parts of the Brain Effected by Ecstasy
The use of ecstasy predominantly affects the serotonin pathway. It causes the release of serotonin, a neurotransmitter that is synthesised, stored, and released by specific neurons. It is crucial in the regulation of processes within the brain, including mood, emotions, aggression, sleep, appetite, anxiety, memory, and perceptions. Serotonin pathways connect to various regions of the brain. Similar to most psychoactive drugs that produces a sensation of pleasure, ecstasy also increases the release of dopamine into the reward circuit as well as norepinephrine. Thus, resulting in an increase in neurotransmitter activity in the brain.

Serotonin helps maintain a stable mood and other emotional functions and also is involved in the regulation of sleep cycles, pain control, digestion, etc.

Dopamine is a transmitter involved with regulating mood and focus as well as other central nervous system functions.

Norepinephrine is a neurotransmitter that is involved in the "fight and flight" response and in the regulation of mood, anxiety, sleep, energy and focus.

Naturally, the release of neurotransmitters such as serotonin and dopamine occurs in cycles, although, upon the influence of ecstasy, it blocks the absorption of serotonin and dopamine by the synaptic terminal (where they are usually taken back in) and is instead absorbed in unnatural amounts by the biochemical cascade. Thus, the use of ecstasy will block the natural reabsorption of serotonin. The excessive release of serotonin, dopamine and norepinephrine can cause the brain to become naturally depleted of these chemical messengers. As a result, when there is a stoppage of intake of the drug, what is considered to be too much turns into a shortage.

It has been challenging for scientists to study the actual effects of the use of ecstasy in the human brain due to the unavailability of the imaging technology that is needed to carry out these specific experiments. Thus, most of the research based on the effects of ecstasy has been completed with laboratory animals. However, the research that has been done has shown that ecstasy produces a greater release of serotonin and less dopamine release than other stimulants, such as methamphetamine. It has also shown that continual high doses of ecstasy will lead to direct damage to brain cells that are involved in thinking and memory.




Addiction

Definition: Addiction is the state of being physically and mentally dependent on a particular substance.


Behaviours Observed by Addicts

1. They lie.
In order to mislead people about where they were when buying or using drugs, addicts usually have to tell lies. Purchasing drugs can be costly, thus someone who is addicted to drugs will have to lie about where the hundreds or thousands of dollars that has been put into purchasing these narcotics have gone to.

2. They manipulate.
Generally, family and close friends of an addicted person will seek happiness, success and safety for that individual. Usually this will take the form of promises such as, promising “to do better”, “to go to meetings”, “to start going to church”, “to get another job”, “to stop seeing drug dealers or other drug users”, especially after the individual has been caught.

3. They are very likely to be engaged in criminal acts.
This isn’t particularly true for every addict, but it is a typical pattern for a person who has been addicted for a considerable time. This is because eventually the money runs out, they have pawned or sold everything of value, they owe friends and family money. Thus, turning to crime seems to be the only resort to obtain the substances they are addicted to.

4. An addict will shift the blame.
This is also not true for every addict, however, it is usually observed in individuals who are addicts. Those who are addicts typically shift the blame for any misconduct to anyone, as they as though they are never responsible for any wrong.

5. An addict is very likely to become abusive.
It is very unfortunate and devastating that an addict’s blame can even take a violent and abusive form. With the delusional thinking common to most addicts, they can perceive those around them as being threatening, dangerous or malicious. As they shifts the blame, they may physically, mentally or emotionally attack those they blames.


Treating Addiction


No one treatment is suitable and applicable to every addict. However, there are a few successful treatments, such as:
  • Allow for detoxification, which is the process in which the body rids itself of the drug
  • Attend behavioural counselling or psychotherapy. Psychologists and specialists will assist in coping with cravings, avoiding the substance, and dealing with possible relapses, which are all key to effective addiction programs. Counselling can take the form of one-to-one (one-on-one) or family sessions with a psychologist or specialist. It has been seen that if the patient’s family can become involved, there is a better probability of positive outcomes.
  • Attend self-help groups. Self-help groups may help the patient meet other people with the same problem, which often boosts motivation. Self-help groups can also be a useful source of education and information.
  • Change habits, whether this is meeting with the same people who may influence the addiction, or even ceasing a particular process that may be undertaken involving the drug. For example, stopping a habit in which an individual needs to have a Panadol tablet in the morning before completing any work.
  • Take medication (for opioid, tobacco, or alcohol addiction)
  • Undergo evaluation and treatment for mental health issues such as depression and anxiety
  • Consistently attend long-term follow-up to prevent relapse



Role Psychiatrists play in Treating Addiction

Psychiatrists will assist in engaging people in drug abuse treatment, providing then with incentives to remain abstinent, as well as modify their attitudes and behaviours related to drug abuse, and increase their life skills to handle stressful circumstances and environmental prompts that may trigger cravings for drugs and thus induce another cycle of compulsive abuse.



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