Synopsis

Substance abuse is a global health threat, particularly among the young generation. Use of Illegal substance can lead to structural damage of the brain and long-term effects on neurological function. In this serial “your brain on drugs” sunrise courses, legal recreational substance abuse such as nicotine, alcohol, and cannabis, will be covered in earlier sessions, this talk focuses on illegal substances, including amphetamine and its derivatives (MDMA, a.k.a. Ecstasy), cocaine, heroin, and solvents (toluene and N2O). Most of the illegal substances are lipid-soluble and easily entering the central nervous system, producing quick effects on neurons and eliciting addiction. The mechanisms of brain injury encompass excitotoxicity, vascular injuries, and cell damages that further causes acute or subacute leukoencephalopathy. Their direct and secondary effects on the brain will be discussed along with the structural and functional MR imaging manifestations. Although the imaging findings of brain on drugs are often non-specific, some classic findings do raise high index of suspicion to the specific drug being used. It is important to understand the underlying pathomechanisms of illegal drugs to the brain, so the treatment can be improved.