Substances of Abuse and the Brain

Abstract

Asmentioned in the first chapter ofthis textbook, substances ofabuse pose a profound public health challenge, especially to the developing brain. “Give the brain a fighting chance” is an appropriate slogan for this chapter. Chapters 1–3 outlined the effects of toxic stress, poor nutrition, limited access to folic acid and Vitamin D, poverty, racism, and discrimination on the developing brain. These types ofinsults on the body and brain are a form of trauma. Substances of abuse pose a threat to the developing and developed brain and the impact on the brain is similar to trauma. Substances of abuse can limit an individual’s access to the top (cortical thinking, compromising cognition, impulse control, exercising good judgement, and emotion regulation) part of the brain, leaving them mostly in the bottom survival part of the brain (poor impulse control, emotional dysregulation, increased proclivity for aggression, and fight/flight or freeze). In the case of working to impact change in youth, understanding the depth and width of substances ofabuse on the brain is key. This chapter is dedicated to outlining the impact of the various substances of abuse on and at critical stages of brain development and making the connection between compromised cognition in the context of substance use. The capacity to change (behavior namely) relies heavily on the cortex (top part of the brain) being functional. Most of the behavior change work in youth is heavily geared toward cognitive behavioral processes. To this end, assessment of cognitive capacity should happen early in the work with youth in order to appropriately manage expectations and support the change process.