Drug Abuse and Brain Damage (Encephalopathy)

Encephalopathy is a term that doctors and researchers use to describe various types of brain damage, malfunction, or disease that trigger some form of mental impairment. Some people develop relatively mild forms of encephalopathy, such as slight deficits in memory or thought processing, while others develop severe or catastrophic problems that can lead to such outcomes as dementia or death. A number of different legal and illegal drugs can trigger the onset of mild or severe brain impairments when abused. In some cases, the effects of drug abuse-related encephalopathy can be at least partially reversed; in other cases they produce permanent brain deficits.

Encephalopathy Basics

Encephalopathy is a general rather than a specific term. Underneath its heading are a varied group of over 150 different processes or conditions that can lead to serious brain injury or malfunction. Examples of these processes and conditions include hepatic encephalopathy (brain damage caused by liver disease), hypoxic ischemic encephalopathy (brain damage caused by inadequate levels of oxygen in brain tissue), and anoxic ischemic encephalopathy (brain damage caused by a complete lack of oxygen in brain tissue). In addition to drug abuse, potential underlying causes of the various encephalopathies include alcohol abuse, kidney failure, severe malnutrition, exposure to a variety of toxic chemicals, brain tumors, any condition that triggers an increase in internal brain pressure, parasite infection, bacterial infection, viral infection, infection with abnormal proteins called prions, and any disease that seriously alters the body’s normal metabolic (energy-producing) functions.

Drug-Related Encephalopathy

Many of the substances that can produce some form of encephalopathy are commonly identified as potential drugs of abuse, including cocaine, amphetamines, methamphetamines, hallucinogens, inhalants, heroin and all other legal or illegal opioid narcotics. However, a broad range of other substances can also trigger brain damage when used improperly or excessively, including antidepressants, antipsychotics, anabolic steroids, and anesthetics. Some people develop encephalopathy when they abuse just one of these drugs, while others develop problems when they combine multiple drugs or combine drug abuse with alcohol use.

All of the drugs capable of harming brain function produce their fundamental damaging effects by disrupting normal activity in the central nervous system, which includes both the brain and spinal cord. They can also contribute to brain-related problems by damaging additional organs such as the kidneys, heart, liver or lungs. In some cases, central nervous system damage stems from the one-time use of unusually large doses of a given drug. However, according to a study published in 2010 in the Annals of the New York Academy of Science, most people develop drug-related encephalopathy when they abuse drugs for extended periods of time.

Potential Outcomes

As indicated previously, some people recover from drug abuse-related encephalopathy. This usually occurs when the drug in question produces harmful effects only while it’s present in the body; when it leaves the body, its effects fade and normal brain function returns. Also as indicated previously, some people with drug abuse-related encephalopathy suffer permanent brain damage. In addition, some people die from the brain-related effects of drug abuse.

In the majority of cases, fatal outcomes associated with drug-related brain damage appear in people who develop anoxic ischemic encephalopathy, a condition that can occur when not enough oxygen passes through the lungs into the bloodstream, when the blood already in circulation in the body contains insufficient amounts of oxygen to sustain normal brain function, or when oxygen-rich blood is not circulated efficiently inside the brain’s tissues. Areas of the brain commonly affected by drug abuse-related damage include the hippocampus, which helps coordinate sensory information, emotions and memory; the putamen, which helps regulate learning processes and body movement; and the cerebellum, which controls such basic functions as body balance, equilibrium, and coordination. Encephalopathy in these areas may produce a form of swelling called edema, or outright cell and tissue death (necrosis).

Considerations

In addition to the specific type of drug that triggers the onset of brain damage, the odds of recovering from drug abuse-related encephalopathy vary according to factors that include the affected individual’s sensitivity to the effects of the drug in questions, doctors’ ability to medically counteract that drug, and the amount of time it takes to administer any counteracting treatments. Some people have other medical problems that can worsen their chances for recovery or survival, including such things as bacterial infections, viral infections, and exposure to environmental toxins. The only known way to prevent drug-related encephalopathy is strict adherence to prescription guidelines for legal drugs and strict avoidance of illegal drugs of abuse.