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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– Once the body has come to depend on the higher level of the substance, when it is withdrawn, then the “balancing neurotransmitters” exert their effect.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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