Original URL: http://fun.familyeducation.com/stress/mental-health/40220.html

Stress Busters: Chemical Coping – Drink, Downers, and Dope

So much for the body's pharmacopia of beneficial and not-so-beneficial solutions to stress. What about all the chemicals in the cupboard that we take to cope? When we're stressed, irritable, or worried, many of us relax with a drink, a joint, or even a prescribed tranquilizer such as Valium (diazepam) or Xanax (alprazolam). They help take the edge off.

You know how it feels. You've just finished a hard day at the office, and you can't wait to get home. You get on the road only to sit in bumper-to-bumper traffic for the next 40 minutes. You arrive home to an equally harried spouse and two noisy kids, vying for your attention. All you want to do is have a drink and forget about everything....Or you're a student with a paper due, and your computer just wiped out an entire afternoon's work. A joint looks really good to you right now....Or you just found out you owe back taxes, and, while you don't know whose fault it is, you're the one who has to come up with the money. Where is that bottle of Valium?

These scenarios may be realistic – but can we say the same about the solutions? The substances that people so often take to chill out have their share of downsides. Let's see how they work and what those downsides are. They include:

• Alcohol.
• Tranquilizers.
• Cannabis.

As you will see, each of these exerts its relaxing effects by boosting these brain chemicals:

• GABA, the relaxing neurotransmitter.
• Dopamine, the "feel-good" neurotransmitter.
• Endorphins, our natural euphoriant.

All Liquored Up: Alcohol Examined
Humans have enjoyed alcohol for at least 6,000 years of recorded history. Today, alcohol plays a pivotal role in society and in economics, with 2.3 billion alcoholic drinks consumed each week in the United States alone.

What happens when you take a drink? Within minutes, that first glass of the evening begins to loosen you up, to lower your inhibitions, and to put you in a cheery and gregarious mood. This effect is due to the release of dopamine, which stimulates you, quickly followed by endorphins, which make you feel high, and then GABA, which helps you relax. The alcohol also gives your blood sugar a boost. Sounds good, doesn't it? That's why we do it. This pleasant effect usually lasts for an hour or so.

Several drinks later, though, you might notice you're feeling irritable, depressed, or even hostile (or others will). Your thinking and memory may become fuzzy. You could end up unsure of where you are, whom you're with, and why you're there. You might then get sleepy or, on a bad night, pass out.

A "hangover" – nausea, headache, and/or stomach upset – may greet you the following morning. You also may have forgotten much of what happened the night before, a phenomenon known as a "blackout." This can be a serious problem especially if you really abandoned your inhibitions. You may now wonder whether the good time was worth it.

Here are some sobering statistics on alcohol consumption:

• A recent study revealed that hangover-induced absenteeism and poor job performance cost the U.S. economy about $148 billion a year.
• Researchers found that people with hangovers posed a danger to themselves and others long after their blood alcohol levels had returned to normal, suggesting that hangovers could be more insidious than the actual inebriation.
• According to the National Highway Traffic Safety Administration, in the year 2000, 40 percent of all fatal car accidents were alcohol-related (Los Angeles Times, Oct. 1, 2001).

Why Alcohol Is Bad News
Short Term

• Impaired memory: You're not sure where you left your keys, or your car, or who you flirted with (or more) the night before.
• Blackouts: You can recall nothing due to the toxic by-products of alcohol – the information was not stored.
• Impaired sexual function.
• Inappropriate behavior, dehydration, and accidents – including fatal ones.
• Morning-after hangover.

Long Term

• Addiction: Though the stimulation caused by alcohol may feel good initially, the brain seeks internal balance, or homeostasis. When you keep pushing the brain to release a neurotransmitter, it responds by "downregulating" – that is, reducing production of that specific chemical. The result is that over time, you will need to drink more to keep getting the same effect.
• Long-term alcohol use can lead to a host of health problems such as gastritis, ulcers, liver problems (including cirrhosis, where scar tissue replaces liver cells), pancreatic disease, and permanent brain and nerve damage.
• Pregnant women who abuse alcohol can seriously damage their unborn infants.
• Causes depletion of neurotransmitters and nutrients.
• During acute alcohol withdrawal, chronic alcoholic patients may suffer convulsions from a life-threatening condition called "the DTs" (delirium tremens). DTs can cause hallucinations, convulsive shaking, and other serious physiological changes.

Sedatives And Tranquilizers: "Mother's Little Helpers"
From the early 1900s until the mid-1950s, barbiturates such as phenobarbital and Seconal were the drugs of choice for treating anxiety and insomnia. Unfortunately, they also were associated with thousands of suicides and accidental deaths among both children who took them accidentally and adults who overdosed on them. Other side effects included widespread abuse and dependency, and chemical incompatibility with other drugs and alcohol. By 1954, these drugs were being replaced by the new, "nonaddictive" meprobamate (Miltown) as the calming agent of choice. It turned out to be as addictive as the old drugs.

The 1960s saw the introduction of the currently popular benzodiazepines: diazepam (Valium), chlordiazepoxide (Librium), clonazepam (Klonopin), and the shorter-acting alprazolam (Xanax) and temazepam (Restoril). In the United States alone, 25 million prescriptions are written annually for these so-called "minor tranquilizers" to treat anxiety and insomnia. Their calming effect is due to their action on the receptors for the inhibitory neurotransmitter GABA (gamma-aminobutyric acid). By increasing GABA activity, the benzodiazepines tend to dull awareness and overall brain activity. In effect, they calm your anxiety but also dull your senses.

Marcy is a case in point. At age thirty-five, Marcy found herself stuck in an unhappy marriage and with a young child. Seeing no escape, she began to take large doses of Valium to shut out the pain. One day, while filling yet another prescription for Marcy, the pharmacist said, "In case you don't know it, you're addicted. Speak to me when you're ready to stop." This was her wake-up call.

In shocked response, she simply stopped the drug cold. She was too ashamed to face the pharmacist, who would have advised a slow withdrawal program under medical supervision. Then, not knowing she was suffering from withdrawal symptoms, she simply, in her words, "went crazy" for the next two months or so while she became accustomed to living without the drug.

Valium had caused Marcy's brain (GABA receptors, to be precise) to downregulate in response to Valium's relaxing action. This led to extreme agitation (withdrawal) when she stopped taking it, which lasted until her brain readjusted itself. "When I finally got my mind back, I decided to leave my husband. I never looked back. Nor did I ever dare take another tranquilizer," declares Marcy, now, at forty-eight, a successful writer and a proud grandmother.

Fortunately for Marcy, her pharmacist said the right thing. However, many people addicted to prescription drugs often go for years, having their prescription refilled in large, impersonal pharmacies, or rotating between several different stores. Harried physicians with little time to really listen to patients find it easier to renew a prescription than to deal with someone's symptoms. And the prospect of detoxification is a tough one for either of them to deal with.

Be very aware that if you are addicted to tranquilizers, withdrawal must be taken seriously. In fact, withdrawal can prove fatal if not done correctly and under medical supervision.

Downsides of Benzodiazepines
Regular usage will cause:

• Tolerance – after taking benzodiazepines for some time, more is required to get the same effect.
• Forgetfulness, drowsiness, accident-proneness, and social isolation.
• Insomnia.
• Hangover – morning-after fogginess or accidents from an undetected hangover (a leading, hidden contributor to automobile accidents).
• Addiction – must continue to take it just to stay "even."
• Serious withdrawal effects upon quitting, including anxiety, insomnia, irritability, tremors, mental impairment, headaches, and possibly even seizures and death.

Cannabis: From the Stone Age to the "Stoned" Age
People in Asian and Middle Eastern countries have used marijuana (Cannabis sativa) as an intoxicant for thousands of years. With the birth of Islam, cannabis was embraced as the preferred psychoactive substance, replacing the Judeo-Christian favorite, alcohol. Cannabis was later used in Western medicine for at least two millennia, until the early 1900s, when the use of pharmaceuticals largely replaced herbal medicines. It was finally declared illegal for medical use in the 1930s but continued to be used in subcultures, particularly those of artists and musicians.

Then, during the 1960s and 1970s, cannabis use became integrated with the growing counter-culture movement, turning up in communes, colleges, and wherever young people gathered. Today, cannabis is consumed by 11.2 million Americans over age eleven – including baby-boomers who never stopped using it – making it the most widely used of all illegal drugs.

How does it work? The immediate effects of smoking cannabis are mild euphoria and, often, drowsiness. Research shows that brain receptors respond to cannabis by releasing the feel-good neurotransmitter, dopamine. Cannabis's effects on judgment, coordination, and short-term memory make it inadvisable to drive, to operate heavy machinery, or to try to learn anything new while under its influence. This is due to the high concentration of cannabis receptors in both the hippocampus, the part of the brain that controls memory, and the cerebellum, the part of the brain that governs motor coordination. Moreover, these effects may actually last longer than those of alcohol.

Up in Smoke: Side Effects
Research on the effects of driving under the influence of cannabis concludes that cannabis-induced impairment persists from four to eight hours – long after the subjective effects have worn off. Ninety-four percent of subjects fail roadside sobriety tests 90 minutes after smoking, while 60 percent fail after 150 minutes. Just as with those from alcohol and tranquilizers, the effects from cannabis use last longer than is easily recognized, resulting in needless accidents.

Researchers have found that daily cannabis users, after several days of abstinence, continue to show subtle but measurable impairment in their mental processing. But it's not clear whether this after-the-fact impairment results from changes in the brain or from the slow, continuous release of marijuana constituents that have been stored in the brain and fatty tissues.

A recent study by Dr. Harrison Pope and colleagues, published in the American Medical Association's Archives of General Psychiatry, provided some interesting findings regarding the long-term cognitive effects of cannabis use. The researchers evaluated three groups: past heavy users, who had smoked no more than twelve times in the prior three months; heavy users, who had not stopped; and light users, who had smoked no more than fifty times in their lifetime). After a 28-day abstinence period, the participants were given a neuropsychological test for memory, attention, and verbal ability on Days 0, 1, 7, and 28. Despite impairment detected in the earlier testing sessions, by Day 28, all three groups scored similarly on the test. The conclusion was that the cognitive impairment caused by cannabis was acute only and was reversible once the intake was stopped.

Here's the experience of Gene, a forty-five-year-old, married physical therapist:

I'd only smoke a hit or two every other day, but I had been doing this for years. I finally stopped smoking marijuana completely eight months ago, and I feel a lot better. My workouts have improved, and my overall energy level is up. When I smoked, I would feel relaxed at first, but after an hour or so, my mood would dip. I'd get cranky and want another hit. The next one wouldn't do it, though, so I gave up trying. The moodiness was probably due to a low blood-sugar reaction – you know, "the munchies." Then, I'd eat, so I put on too much weight.

I finally decided I'd had enough of it all, and just quit. I became really irritable. Not only was I craving a smoke, but I had to handle all kinds of emotional issues that were coming up, things I hadn't ever dealt with. Fortunately, I had some aromatherapy and herbal products that really helped cut the cravings and lift my mood. Eventually, after about six to eight weeks, my moods evened out. Now, if I find myself wanting a joint to relax, I take a whiff of my aromatherapy oil or a dose of kava. Overall, I'm glad to be over the whole thing. Life feels more real to me now. My wife likes me better now, too. She says I'm more emotionally available, more stable, and nicer to be with!

In our own observations, young people who smoke their way through high school (or even earlier) and continue through young adulthood are more likely to have problems. They seem less able to cope with the challenges of everyday life or to be able to plan appropriately for their futures. Their emotional development seems blunted: the marijuana fog may have prevented them from fully experiencing a complete range of emotions and relationships. Stoned on the hero's journey, they miss the passages necessary for growing up and accepting their place in the adult world.

Pitfalls of Pot
Regular usage will cause:

• Impaired coordination, judgment, and short-term memory, which persists for four to eight hours. May result in accidents.
• Mood swings and irritability due to low blood-sugar reaction.
• Blunted emotional development in young people who are chronic users, leading to problems in coping with everyday challenges and planning for the future.
• Throat and lung irritation, as with tobacco.