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Long-Term Effects of Drug Use on the Brain

by Landmark Recovery

February 26, 2019
A plastic mold of the human brain. Many substances have harmful affects on the brain.

Drug and alcohol addiction can lead to a number of dangerous long-term health consequences. Many people know that these types of substances can lead to short-term physical health issues like respiratory depression and liver problems, and can lead to overdoses and death. However, there are many mental effects of using drugs and alcohol that are not discussed as often. Some of these substances can lead to problematic mental health problems. And there is evidence that even after reaching sobriety, these problems may persist.

Drug and alcohol use may prove to to have debilitating effects on mental functioning, but there is even more evidence of this when the drug use is started in the adolescent stage of life, or even before birth. Prenatal and adolescent drug use are linked to problems with brain structure and functioning, and, because the brain does not fully finish developing until the age of about 25 the effects may prove to be permanent.

Abuse of substances like heroin, cocaine, alcohol, and more lead to a number of short-term health risks but many don’t fully understand the seriousness of the long-term effects of this type of substance abuse. The cognitive impairment associated with some of these drugs can last for months, years, or even life.


Effects of Drugs on the Brain

A plastic mold of the human brain. Many substances have harmful affects on the brain.

Drug use can eventually lead to drug addiction due to dopamine’s impact on the reward system in the brain. When using drugs, dopamine in the brain increases which causes the feeling of euphoria, or high, that many drug users seek. This leads to the brain adjusting to the overwhelming surges in dopamine by producing less dopamine or reducing the number of receptors that can receive the chemical. As a result, the dopamine’s impact on the reward circuit in the brain can become low, limiting a person’s ability to experience any pleasure.

People who abuse drugs can eventually feel lifeless and flat and are unable to enjoy many things. Now this person needs to keep taking drugs again and again just to bring dopamine function back to equilibrium, this only makes the problem worse. It becomes a cycle that causes and pushes the addiction to more dangerous territory.

It should be noted that some drugs are more dangerous and addictive than others. Moreover, the motivation to use drugs like prescription opioids, cocaine, heroin, and other drugs changes between the initial stages of drug dependence and the later stages, causing users to use more drugs depending on the build up of tolerance.

Most know that extended and increased use of some drugs can lead to a number of physical problems, but drug addiction is also known to cause many mental problems and erode a person’s cognitive abilities, even after sobriety is achieved.



Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. A person addicted to methamphetamine can experience a number of psychotic symptoms including paranoia, visual and auditory hallucinations, and delusions. These psychotic symptoms can last for months and even years after a person has quit abusing the drug.

Methamphetamine abuse is also linked to negative effects on non-neural brain cells called microglia. Microglia is important for defending the brain against infectious agents and removing damaged neurons. However, increased activity of these cells can end up assaulting healthy neurons.

“A study using brain imaging found more than double the levels of microglial cells in former methamphetamine abusers compared to people with no history of methamphetamine abuse,” said one report by the National Institute on Drug Abuse.



There is evidence that shows that repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in the neurological and hormonal system in the brain. Many of these issues are not easily reversed.

There have also been studies that have found that chronic heroin-dependent subjects had widespread disruption of white matter in the brain, specifically in the anterior and superior regions.

The deterioration of white matter in the brain can affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

There is also evidence that heroin leads to a reduced gray matter in some portions of the brain such as the frontal lobe. Gray matter in the frontal lobe is associated with things like motor function, problem solving, and memory.



Cocaine is one of the many drugs in which users will feel a depressive state when not on the drug after being a chronic user, this is due to the the dopamine imbalance in the body during this time. However, the drug can also lead to problems with cognitive brain functioning.

Some research on cocaine indicates that the drug diminishes functioning in the orbitofrontal cortex which can underlie the poor decision-making and lack of self-insight shown by people addicted to cocaine.

Regular cocaine use can also cause extensive white matter damage in the brain. This damage seems to be associated with high levels of impulsivity and poor cognitive control. However there is conflicting evidence regarding cognitive deficiency in the long-term, with some studies citing that there is not enough evidence to support that broad cocaine use is associated with a decline in cognitive functioning.



Opioid dependence has become a major health problem in the United States, with prescription opioids now contributing to the death of tens of thousands of Americans each year. Most research on how opioids affect the brain relate to illicit opioids like heroin rather than prescription pills.

However, one study found that prescription opioid-dependent individuals had “white matter tract abnormalities and alterations to functional connectivity” compared to a control group. Prescription opioid dependency also correlated with decreases in amygdala volume. Amygdala is a brain region that affects emotions, judgement, and decision-making abilities.

Given how popular prescription opioids have become in the United States since the 1990s, it is important to understand just how much opioids are affecting the population. More studies need to be done on the effects that opioids have not only on short-term health but long-term health as well.



People who have been drinking large amounts of alcohol for long periods of time run the risk serious brain effects. Drinking can result in the damage on the brain and can even result indirectly from poor health and severe liver disease, two effects of heavy alcohol use. Exactly how alcohol affects the brain and the likelihood of reversing the impact of these effects are still researched today.

It should be noted that a person’s susceptibility to alcohol-related brain damage may be associated with age, gender, drinking history, and nutrition. About half of the nearly 20 million alcoholics in the United States seem to not deal with cognitive impairments while the other half have neuropsychological difficulties. Up to 2 million alcoholic develop permanent conditions that require lifetime care.

One common brain disorder among alcoholics is Wernicke-Korsakoff syndrome. Symptoms associated with this disorder include mental confusion, paralysis of the nerves in the eyes, and difficulty with muscle coordination. This problem can eventually develop to impact learning and memory problems.

There is evidence that most alcoholics with cognitive impairment show at least some improvement in brain functioning within a year of abstinence, although for some people it takes much longer.



Marijuana is the most widely used illicit drug in the United States. Because it is the so popular in the country, it is important to understand how the drug can affect brain activity and cognitive functioning. According to the National Institutes of Health, there is conflicting evidence that marijuana exposure, even during the development, can lead to long-term or even permanent changes in the brain.

Some studies suggest that marijuana use in adolescence can lead to altered connectivity and reduced volume in brain regions that deal with functions such as memory, learning, and impulse control. However, other studies have not found differences between brains of people who do and do not use marijuana.


Drug Use and the Developing Brain

A pregnant women holding her belly

Babies that are exposed to drugs or alcohol while still in the womb and adolescents that experiment with these substances can end up facing harsh consequences that may be with them for life.

While in the womb, the brain is still being formed and molded, but even after birth the brain is not fully developed. The general consensus is that the at brain is not fully finished forming until later in life, around the age of 25. Because of this, exposure to substances can lead to damage that influences the structure and functioning of the brain, which may end up being permanent.


Prenatal Exposure

There are a number of serious consequences as a result of prenatal exposure to drugs. For example, prenatal exposure to alcohol is one of the leading causes of mental retardation in the United States.

However, the issue isn’t just alcohol, prenatal exposure to other substances like cocaine or opiates have been linked to problems with language skills, impulse control, and visual attention. For children exposed to to alcohol or marijuana prenatally, there is also a risk of memory deficiency.

Research has shown that prenatal exposure to methamphetamine has been linked to both cognitive deficits and altered brain structure. One study found that exposure to the drug correlated with a shorter attention span and delayed memory among children aged 3 to 16 compared to a control group.

Prenatal exposure to tobacco is one problem that is concerning because of how often it happens, with some estimates saying that over 10 percent of expecting mothers using tobacco. Some studies suggest that exposure to tobacco smoke can lower intelligence as it was linked to a 12-point gap in IQ between exposed and unexposed adolescents.

It should also be noted that since the rise of opioids and the emergence of the opioid crisis in the United States, there has been an influx of cases of neonatal abstinence syndrome (NAS), in which babies are born experiencing withdrawal symptoms due to prenatal exposure to opioids.

In addition to all this, fetal alcohol and drug exposure increases an individual’s susceptibility to later substance abuse issues.


Adolescent Exposure

Adolescence is not only a high-risk period for substance abuse, it can also have disastrous effects on the brain development, because much of the development takes place during this time.

While there needs to be more research surrounding adolescent exposure to drugs and alcohol, chronic use of these substances will have an effect on the brain regardless.

There is a much evidence that shows that abuse of substances, like alcohol, cannabis, and more, can lead to disruptions in cognition. One study found that marijuana and alcohol users had smaller prefrontal cortex volumes than non-drinkers. The prefrontal cortex is part of the frontal lobe, an area of the brain that deals with planning, inhibition, emotion and regulation.

According to one study, adolescents who had recently recovered from an alcohol dependence disorder revealed a poorer memory ability than a control group. There is also evidence that it can impact attention, information processing, and functioning. Overall, heavy drinking during adolescence correlated with a reduced ability to keep up with age expectations.


In Conclusion

People who abuse drugs or alcohol are putting not only their short-term health at risk due to problems like respiratory depression, organ failure, and even death, they also need to be aware of the long-term effects that these substances may have on their mind. There are many drugs that can influence and impede brain functioning, and if these drugs are taken chronically for a period of time, these problems may last for months, years, or may even be permanent. However, getting sober from drugs and alcohol can help you minimize these adverse effects of drug use.

At Landmark Recovery, we have the staff and tools that can help you or a loved one get the help they need. Our staff will give you the individualized care you deserve while utilizing therapy and support groups to help educate you and build up the sober support network that can help you maintain sobriety. Please reach out to our admissions staff to learn more about your path to recovery with the help of alcohol or drug rehab.

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.