According to the United Nations Office on Drugs and Crime (UNODC) 2021 World Drugs Report, about 275 million people worldwide have used drugs, with over 36 million suffering from substance abuse disorders.¹ In Indonesia, the increase experienced by 0.15 percent, or 3.66 million people based on a survey from the National Narcotics Agency (BNN).²

The central nervous system, as well as major body functions such as blood pressure, breathing, heart rate, and body temperature, could be accelerated or decelerated by the effects of drugs. Drugs work with the brain and body to influence moods, emotions, and behaviours by altering brain chemistry and perception, as well as how people interact with the environment around them.³

Drug misuse also affects the levels of certain of the brain’s chemical messengers, or neurotransmitters, such as: ³

> Dopamine – This neurotransmitter is involved in movement, reward and reinforcing behaviours, motivation, and attention, as well as regulating emotions and enhancing enjoyment.

Dopamine-suppressing medications: Marijuana, heroin and other opioids, stimulants, ecstasy, and PCP.

> Serotonin – This neurotransmitter oversees regulating emotions and stabilizing moods.

Medications that affect serotonin levels: Ecstasy and hallucinogens.

> Gamma-Aminobutyric Acid (GABA) - GABA works as a natural sedative, reducing anxiety and decreasing the stress reaction while also slowing down central nervous system processes.

Drugs that affect GABA levels include benzodiazepines

> Norepinephrine – Because it speeds up the central nervous system in reaction to the "fight-or-flight" response, norepinephrine is also known as the "stress hormone." It also boosts energy levels while improving focus and attention.

Opioids and ecstasy are two drugs that might affect norepinephrine levels.

Drug usage disrupts certain areas of the brain, such as: ³

> The brain stem oversees vital activities like sleeping, breathing and heart rate.

> The limbic system houses the reward circuitry of the brain and aids in the regulation of emotions and the ability to feel joy.

> The cerebral cortex is the brain's "thinking center," controlling problem-solving, planning, and decision-making abilities, as well as assisting people in processing sensory information.

Some types of drugs misuse and their effects include: ³

> Marijuana

The psychoactive component in marijuana, delta-9-tetrahydrocannabinol (TCH), may impact the hippocampus, which controls short-term memory, as well as the cerebellum and basal ganglia, which control coordination and involuntary muscle movements. Marijuana use may have a calming and soothing impact. Impaired motor abilities, mood swings, altered time and sensory perception, diminished memory, and difficulty thinking effectively and solving issues are all prevalent short-term negative effects of marijuana consumption. Long-term marijuana usage and its influence on the brain can include memory problems, decreased coordination, learning difficulty, and sleep disorders.

Chronic marijuana smoking can also cause breathing and respiratory issues, as well as chronic cough and bronchitis. Marijuana use can also cause heart rhythm and other normal cardiac processes to be disrupted. There are differences in effects for each person, which is influenced by the size of the dose used and the high content of cannabis concentrate consumed.

> Heroin and Prescription Opioids

Heroin and prescription opioid medicines such as oxycodone, acetaminophen/hydrocodone, fentanyl, methadone, and hydromorphone hijack the limbic system in the brain, generating a tremendous high that people want to replicate, leading to self-reinforcing behaviours.

Opioids also function as central nervous system depressants by disrupting the natural synthesis of norepinephrine. Opioids reduce body warmth, slow heart rate, blood pressure, and breathing processes, and inhibit pain perceptions.

Heroin is the quickest-acting opioid, taking effect almost instantly and being exceedingly addictive.  Long-term, chronic heroin use can also cause the white matter of the brain to deteriorate, which can affect how a person responds to stress, regulates emotions, and makes decisions. Long-term problems about continued opioid drug usage include lung issues and infections of the heart's lining.

> Kokain, Metamfetamin and Other Stimulants

Stimulant drugs like cocaine, methamphetamine (meth), and prescription amphetamines like amphetamine/dextroamphetamine and methylphenidate, which are used to treat attention deficit hyperactivity disorder (ADHD), work by speeding up the central nervous system, increasing heart rate, body temperature, and blood pressure, while also increasing energy levels, focus, attention, alertness, and wakefulness, and suppressing appetite.

Cocaine and methamphetamine provide a powerful high by rapidly flooding the brain with dopamine. Cocaine is frequently overused in a binge-like fashion in order to prolong the high. After a stimulant high, the "crash" can be severe, leaving a person feeling exhausted, hungry, irritated, intellectually confused, and melancholy. Regular cocaine use can cause paranoia and have a deleterious impact on central nervous system activities, resulting in cardiac arrhythmias, sudden cardiac arrest, ischemic heart disease, a respiratory syndrome specific to cocaine snorting, hypertension, convulsions, stroke, and death.

Meth has similar effects on the brain and central nervous system, causing considerable damage to the brain's dopamine system, which can lead to memory and learning challenges, as well as movement and emotional regulation concerns. Meth has a comparable effect on the brain and central nervous system, and users may experience hallucinations, anxiety, and disorientation.

> Ecstasy

Ecstasy, commonly known as Molly or MDMA, is a popular club drug and psychoactive substance. It has both stimulant and hallucinogenic characteristics because it binds to serotonin transporters in the brain. Serotonin, norepinephrine, and dopamine activity are all stimulated within an hour of ecstasy entering the bloodstream. Ecstasy increases feelings of emotional connection and warmth while also intensifying and distorting the senses, increasing energy levels, lowering anxiety, and increasing pleasure. Ecstasy usage causes an increase in heart rate, body temperature, and blood pressure.

The adverse effects of ecstasy abuse and/or overdose include hyperthermia, high blood pressure, panic attacks, faintness, involuntary teeth clenching, impaired vision, nausea, sweating, chills, arrhythmia, heart failure, renal failure, dehydration, loss of consciousness, and seizures. Additional dosages of MDMA taken while the drug is still in the system, it might disrupt metabolism, worsening cardiovascular and toxic adverse effects. While the bulk of the adverse effects of MDMA go off in a few hours, confusion and anxiety can remain up to a week after ingesting ecstasy.

MDMA disrupts how the brain processes information and maintains memories, and long-term use can exacerbate these cognitive difficulties. Regular ecstasy usage can cause anxiety, irritability, sleep problems, depression, anger, impulsivity, lack of appetite, and a diminished interest in sex. Ecstasy can also be psychologically addicted, causing withdrawal symptoms if it is not used.

> LSD, PCP, Ketamine and Hallucinogens

Hallucinogens are a type of substance that causes reality and perceptions to be distorted. There are two types of hallucinogens:

> Classic Hallucinogens (LSD, Peyote, Psilocybin, DMT, Ayahuasca)

> Dissociative drugs (PCP, Salvia, DXM, Ketamin)

The central nervous system can be affected by hallucinogenic and dissociative substances, causing changes in body temperature, heart rate, breathing, and blood pressure. Sedation, amnesia, muscle spasms and convulsions, hostility and violence, psychotic symptoms like schizophrenia, and immobility are all possible side effects.

Glutamate, a brain molecule involved in memories, cognition, emotions, and how people feel pain, is thought to be disrupted by dissociative medications. People who use dissociative substances may experience a sense of separation from themselves, their surroundings, and reality. Impaired motor functions, auditory and visual abnormalities, memory loss, anxiety, numbness, and bodily tremors are all possible outcomes.

Serotonin and the prefrontal cortex of the brain are regarded to be the main targets of classic hallucinogens. Drug-induced psychosis causes mood swings, reality distortions, and sensory perception distortions, as well as seeing, hearing, or experiencing things that are not there. Even one use of a hallucinogenic substance can have long-term and detrimental effects on the brain and body. 

The more often the drug is used, the chemicals contained in the drug will increasingly have a negative impact on the body, especially on the brain and can cause dependence. 

Reference article:

United Nations-Office on Drugs and Crime. UNODC World Drug Report 2021: Pandemic effects ramp up drug risks, as youth underestimate cannabis dangers. United Nations Press release 24 Juni 2021. Available at : https://www.unodc.org/unodc/press/releases/2021/June/unodc-world-drug-report-2021_-pandemic-effects-ramp-up-drug-risks--as-youth-underestimate-cannabis-dangers.html

Antara Kantor Berita. BNN: Prevalensi pengguna narkoba di 2021 meningkat jadi 3,66 juta jiwa. Release on Thursday, 10 Februari 2022. Available at: https://www.antaranews.com/berita/2696421/bnn-prevalensi-pengguna-narkoba-di-2021-meningkat-jadi-366-juta-jiwa

Meredith Watkins. How Drugs Affect the brain and Central Nervous System. Americana Addiction Center. Last Update: 7 Januari 2022. Available at: https://americanaddictioncenters.org/health-complications-addiction/central-nervous-system 

Reference of Picture:

https://www.nyas.org/events/2016/arrested-development-the-teenage-brain-and-substance-abuse/