33. Drug effects and withdrawal hazardous to health

By Tom O'Connell

One of the finest explanations I've ever been exposed to about drug effects was during a presentation by Dr. Michael Carvalho, a specialist in psychopharmacology at the Veterans Administration Medical Center in Manchester, NH, where he coordinated a mental health unit with 700 outpatients. He knew what he was talking about.

Carvalho, who also taught at Massachusetts College of Pharmacy, was providing in-service education for the staff members of Beech Hill Hospital in New Hampshire, one of the nation's leading drug rehabilitation centers. And I was invited to sit in.

This expert cautioned that "in all medications, including aspirin, there's a two-edged sword." He explained, "You have to have an appreciation for drugs having effects on multiple systems rather than the targeted effect." In other words, a drug may help a headache but at the same time it may cause a lesion in the stomach or intestines.

When a person takes an illicit or prescription drug to feel better it may have negative effects on the brain, central nervous system, endocrine system, digestive system, or virtually any and every system in the body that we need to maintain health.

The words I have never forgotten from this lecture were: "There's no such thing as an ideal medication." What do drugs do? They act on receptor sites in the brain and central nervous system. "Drugs have two primary effects," Carvalho said. "They either stimulate or block activity."

When drugs are used chronically, receptor sites adapt. Then when drugs are taken away, receptor sites overreact. In withdrawal a person usually gets the opposite effect of the drug's therapeutic effects. Let's say you take a drug to relieve insomnia and then stop it. The brain and central nervous system will "rebound" and you'll have extreme insomnia.  

Drugs either stimulate or depress us. If you take a stimulant drug and then stop it, you'll get very depressed. If you stop a depressant drug you'll get over stimulated. If you stop an anti-depressant or anti-anxiety drug, expect the opposite effect.      

Is there a perfect drug? Carvalho said, "Pharmacologically, all drugs are capable of producing withdrawal effects if stopped abruptly." And withdrawal can be life-threatening.

A key reason for returning to addictive behaviors is the pain that follows quitting. Withdrawal symptoms are so intolerable that we are seduced into seeking relief once again with alcohol, other drugs, destructive relationships, gambling, food...or whatever.

In summary, we take a drug for one purpose but each drug causes various unwanted effects. The body adapts to the chemical effects. Then when we stop the drug, the body rebounds and causes us great distress.

After many years on alcohol, designer drugs, and antipsychotic drugs, the effects on brain and central nervous system may be irreversible and the person won't be able to  stop without extreme danger. But with most drugs the effects are reversible. Yet medical supervision is critical. Too many addicts have died trying to manage their own withdrawal.

Since each person's metabolism differs, and tolerance varies, drug effects vary  from person to person. And the hazards of withdrawal do too. So if you plan to quit, remember that withdrawal from drugs needs to be medically supervised.

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