I am going to start a series around drug and alcohol use and abuse, which will revolve around what I call the two “As”.    These are how it Affects your body and your body functions and whether it can be Addicting.  We all can cite, both for and against, many “cases” and “anecdotes” that are primarily designed to reaffirm one’s already held belief.   While I have certain conservative views based upon my experience in this industry and those close to me, I will endeavor to keep this based upon documented, scientific fact.  Contrary to what you are thinking, my purpose is not to convince someone to avoid using or abusing drugs or alcohol.  The only way behavior changes is if there is enough incentive or pain to do so.  Going forward, assume drugs include alcohol.

Rather, my goal is to educate you to ensure you are not performing a function that risks your life and safety, or that safety of others while under the influence; and to explain how use affects you in the long term.  I also wish to caution you about how addicting certain substances can be to a certain percent of the population.  This may sound odd coming from an owner of a drug and alcohol testing business, but I hope to never see you in our clinic due to substance use, abuse, or chemical dependence.  Of course, we all think we are bullet-proof and all I can do is educate and leave the decision up to you.

So to begin, I want to provide a physiology lesson on the various systems that drugs (including alcohol) influence.

In my recent National Geographic magazine, there was an interesting article titled. “Unlocking the Healing Power of You.”


The main focus of the article explores “where does the body leave off and the mind take over to control the body’s feelings and health.”  For our purposes, it will help us define some terms.

PAIN – A painful sensation travels from the site of injury in the body through the peripheral nervous system and along the spinal cord to reach the brain.

RELIEF – Pharmaceutical treatments trigger the brain to release hormones and neurotransmitters into the central nervous system, modulating the pain signal.

PLACEBO EFFECT – a strong belief that a treatment can heal an ailment will prompt the brain to tap into its own pharmacy, flooding the nervous system with medicating neurotransmitters and hormones

NOCEBO EFFECT – the inverse of a placebo effect.  It can be activated if a patient anticipates a negative experience; this expectation can cause pain to increase

THE MEMORY OF PAIN – The past informs how the brain and body respond to future pain and treatment. These physiological memories of pain guide placebo and nocebo effects.

RECOGNITION – An expectation of pain relief from treatment is processed by the prefrontal cortex and other cortical regions.  Pain flows to the brain.

RESPONSE – The expectation of relief sends signals from the cortices to the brain stem to release neurochemicals, such as opioids, to counter the pain signals traveling to the brain.  Relief flows from the brain to intercept the pain coming to the brain.

REGULATION – Released neurochemicals meet the pain signal at the dorsal horn in the spinal cord, reducing its intensity. The thalamus relays this response to other parts of the brain

The brain regulates many body functions through neurotransmitters and hormones.  They play roles in placebo and nocebo responses by blocking, amplifying, or diminishing signals that instruct our minds how to react to outside stimuli.  Some of these are listed below.

Opioids – Endorphins, the body’s natural opioids, attach to the same receptors as synthetic painkillers, modulating sensations like pain, hunger, and thirst.

Endocannabinoids – The endocannabinoid system connects the body with the part of the brain that controls mood, appetite, and pain. Some internal cannabinoids are similar to THC in marijuana.

Dopamine – Placebos can cause the release of dopamine in the brain; it regulates desire, pleasure, and reward. When a nocebo effect kicks in, dopamine is deactivated.

Prostaglandins – In high-altitude headaches, prostaglandins dilate blood vessels in the brain to induce pain. This response falls during a placebo effect and rises with nocebo.

CCK – Released by anxiety, cholecystokinin can work against the ameliorating effect of opioids—a nocebo effect that increases pain.

The end result of all substances ingested, from Heroin to Coffee to Cough Medicine to Viagra is designed to either calm you or a part of your body down or lift you or a part of your body up.

It is also true that over time, we all build up a tolerance to those substances; and in many cases we require more of that substance to maintain that state.  It is also true that anything that depresses or elevates the body functions has the potential to be a safety issue, depending on the level of skill needed for the function and the environment.

So next week we will throw out some more terms around progression from use to chemical dependence and start to tackle the first and most controversial substance, Marijuana.