Fact File 1 Teacher 39;s Guide

[Marthe Bernskoetter]

Hithere! Mind Matters (formerly referred to as Mind Over Matter) is a series that explores the ways that different drugs affect your brain, body, and life. In this issue, we are going to talk about how drugs affect the brain.

When used in combination with the printed materials, the background information and lesson plans contained in this guide will help students understand the physical reality of drug use and inspire curiosity about neuroscience. Some activities to reinforce the topics are suggested at the end of the guide. You can also develop some of your own.

Different brain circuits are responsible for coordinating and performing specific functions, such as sensing our environment, thinking and reasoning, language abilities, and movement. Networks of neurons send signals back and forth to each other and among different parts of the brain, the spinal cord, and nerves in the rest of the body (the peripheral nervous system).

To transmit a message, a neuron releases a chemical neurotransmitter via transporter molecules into the gap (or synapse) between it and the next cell (Figure 3). The neurotransmitter crosses the synapse and attaches to receptors on the receiving neuron, like a key into a lock. This causes changes in the receiving cell. Other molecules called transporters recycle neurotransmitters (that is, bring them back into the neuron that released them), which limits or shuts off the signal between neurons.

Other drugs, such as amphetamines or cocaine, can cause neurons to release abnormally large amounts of natural neurotransmitters which prevent the normal recycling of these brain chemicals by interfering with transporters (Figure 4). This also amplifies or disrupts the normal communication between neurons.

Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks progression to a substance use disorder (SUD) and addiction. Brain areas affected by drug use include:

The prefrontal cortex powers the ability to think, plan, solve problems, make decisions, and exert self-control over This is also the last part of the brain to mature, making teens most vulnerable to the effects of drugs. Shifting balance between this circuit and the reward and stress circuits of the basal ganglia and amygdala reduce impulse control and make a person with an SUD seek the drug compulsively.

Marijuana is derived from the dried leaves and flowers of the cannabis plant. Delta-9-tetrahydrocannabinol (THC) is the main ingredient in marijuana that makes people high. Marijuana changes brain messages that alter sensory perception and coordination. This can affect how users see, hear, and feel stimuli and can delay reflexes.

1National Academies of Sciences, Engineering, and The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for research. Washington, DC: The National Academies Press; 2017

When nicotine was isolated from tobacco leaves in 1828, scientists began studying its effects in the brain and body. This research eventually showed that, although tobacco contains thousands of chemicals, the main ingredient that produces addiction is nicotine. More recent research has shown that the addiction produced by nicotine is extremely powerful and is at least as strong as addictions to other drugs such as heroin and cocaine.

People can smoke, chew, or sniff tobacco. Smoked tobacco products include cigarettes, cigars, bidis, and kreteks. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip, and snus. Snuff can also be sniffed. In recent years, nicotine has been extracted from certain types of tobacco plants to use as a liquid in electronic cigarettes.

The nicotine in tobacco is highly addictive, which causes the person to continue to smoke. But most of the severe health effects of smoking tobacco comes from other chemicals released when lit with flame, burned and smoked. The smoke from combustible tobacco products contains more than 7,000 chemicals and releases toxins that can lead to lung cancer, chronic bronchitis, and emphysema. It increases the risk of heart disease, which can lead to stroke or heart attack. Smoking has also been linked to leukemia and other cancers, cataracts, and pneumonia. All these risks apply to the use of any smoked product, including hookah tobacco. Smokeless tobacco increases the risk of cancer, especially mouth cancers.

Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Smoking while pregnant may also be associated with learning and behavioral problems in exposed children.

People who live or work with others who smoke are exposed to secondhand smoke, either coming from the burning end of the tobacco product or exhaled by the person who is smoking. This can cause health problems in both adults and children, such as coughing, phlegm, reduced lung function, pneumonia, and bronchitis. Children exposed to secondhand smoke are at an increased risk of ear infections, severe asthma, lung infections, and death from sudden infant death syndrome. Secondhand smoke exposure can also lead to lung cancer and heart disease.

The U.S. Department of Health and Human Services has established a national toll-free quitline, 1-800-QUIT- NOW, to serve as an access point for anyone seeking information and help in quitting smoking. Or go to teen.smokefree.gov which also has information about how to stop vaping.

A survey collected in 2019 shows alarmingly high rates of e-cigarette use among teens, with rates doubling in the previous two years. In 2019, more than 1 in 4 students in 12th grade reported they had vaped in the past month, about 1 in 5 in the 10th grade, and 1 in 11 in eighth grade. These self-reported estimates come from the 2019 Monitoring the Future (MTF) survey, a nationally representative sample of eighth, 10th and 12th graders in schools nationwide, funded by a NIDA grant to the University of Michigan, Ann Arbor. For more information, visit Teen e-cigarette use doubles since 2017.

Some students put marijuana into vaping devices. Reports of marijuana vaping doubled in eighth, 10th and 12th graders between 2017 and 2019, with nearly 4% of eighth graders reporting they had vaped THC in the past month in 2019, compared to nearly 14% of 12th graders.

Scientists are still learning about the health effects of vaping, but we know that nicotine in any form is a highly addictive drug, and that e-liquids expose the lungs to a variety of chemical mixtures. While people are not inhaling toxic particles produced by burning tobacco, studies show that e-cigarette vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal nanoparticles from the device itself. In addition, the vapor is produced by heating an oil mixture, and human lungs were not designed to filter an ongoing intake of oil droplets.

The most popular e-cigarette products look like USB memory sticks or thumb drives, often under the brand name JUUL. There are many reports of teens bringing these devices into classrooms with teachers not recognizing what they are. In addition, vaping devices do not leave the after-stench of tobacco cigarettes or secondhand smoke, so they can easily be used in school bathrooms with no telltale effects. It is critical that schools develop plans to monitor use of these devices. A recent study shows that many students who had used e-cigarettes by the time they started ninth grade were more likely than others to start smoking cigarettes and other smokable tobacco products within the next year.8

For many who use these tobacco products, long-term brain changes brought on by continued nicotine exposure can result in addiction. People trying to quit may have withdrawal symptoms, including:

The U.S. Department of Health and Human Services has established a national toll-free quitline, 1-800-QUIT- NOW, to serve as an access point for anyone seeking information and help in quitting smoking. Or go to teen.smokefree.gov which also has information about how to stop vaping.

The chemical structures of various inhalants are diverse, making it difficult to generalize about their effects. It is known, however, that the fumes can change brain chemistry and may permanently damage the brain and central nervous system.

Inhalants enter the bloodstream quickly and circulate throughout the brain and body. They have direct effects on both the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves throughout the body).

Using brain imaging techniques, such as magnetic resonance imaging (MRI), researchers have discovered marked structural changes in the brains of chronic inhalant users. These changes include a reduced size in certain brain areas, such as the cerebral cortex, cerebellum, and brain stem. These changes may account for some of the neurological and behavioral symptoms that long-term inhalant users exhibit, including impaired cognitive and motor skills.

Overdose symptoms can cause seizures and coma. They can even be deadly. Many solvents and aerosol sprays are highly concentrated, meaning they contain a large amount of chemicals with a lot of active ingredients. Sniffing these products can cause the heart to stop within minutes. This condition, known as sudden sniffing death, can happen to otherwise healthy young people the first time they use an inhalant. Using inhalants with a paper or plastic bag or in a closed area may cause death from asphyxiation (being unable to breathe).

There are currently no approved medications to treat inhalant addiction, although research is active related to multiple types of addictive drugs. For now, health providers focus on behavioral approaches. These include:

Opioids are powerful drugs derived from the poppy plant that have been used for centuries to relieve pain. There are legal opioids (like prescription pain relievers) and illegal opioids (like heroin and illicit fentanyl). They are chemically related, produce similar effects, and can all lead to addiction and overdose. Prescription opioids are powerful, pain-reducing medications. Some prescription opioids are made directly from the opium poppy plant. Others are made by scientists in a laboratory although they have similar chemical structures.

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