Substance misuse doesn’t just take a toll on physical health—it hits hard on mental health too. Whether it’s alcohol fueling feelings of depression or stimulants kicking up anxiety, understanding how these substances affect mental health can be the key to seeking effective help. In short, there’s no “biological free lunch” and any substances you use/abuse have impacts on your brain health. Let’s dig into the most commonly abused substances, their impact on mental health, and how new drugs of abuse are reshaping the landscape.
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How Substance Abuse Affects Mental Health: The Science Behind It
Substance use doesn’t just affect your body—it rewires your brain, often for the worse. Substances interact with neurotransmitters, the brain’s chemical messengers, disrupting normal functions. Here’s how some of the most commonly abused substances affect mental health, backed by science.
Alcohol’s Effect on the Brain
Alcohol primarily affects the brain by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces neural activity, leading to feelings of relaxation. However, over time, this suppression of neural activity can alter the brain’s reward system, making it harder to experience pleasure without alcohol. Chronic drinking is associated with a reduction in serotonin levels, which contributes to anxiety and depression. Ahem, ever heard of hangxiety at 2:00 AM after a night of drinking?
Opioids (Heroin, Fentanyl, Prescription Painkillers)
Opioids bind to receptors in the brain responsible for pain and reward, flooding the system with dopamine—a neurotransmitter associated with pleasure. While this might sound like a good thing, it creates a dangerous imbalance. Over time, the brain reduces its natural dopamine production, making it nearly impossible to feel pleasure without the drug. This is why opioid use often leads to depression, mood swings, and emotional numbness. Also, ever heard of opiate withdrawals? They can feel brutal.
Stimulants (Cocaine, Methamphetamine)
Stimulants are known for their ability to trigger a massive dopamine release, leading to feelings of euphoria and increased energy. However, these drugs also cause the brain to deplete its dopamine reserves rapidly, leaving users feeling irritable, anxious, or depressed after the high wears off. Chronic use damages dopamine receptors, making it difficult for the brain to regulate emotions and pleasure naturally. Stimulant abuse is also linked to structural brain changes, including reduced gray matter volume, which contributes to long-term issues like paranoia, hallucinations, and aggression.
Cannabis
Cannabis interacts with the endocannabinoid system, which plays a role in mood regulation, memory, and appetite. While occasional use might not cause harm, frequent and heavy use—especially in adolescents—can alter the brain’s structure. Studies suggest that long-term cannabis use reduces connectivity in areas like the prefrontal cortex, responsible for decision-making and emotional regulation. This can lead to heightened anxiety, paranoia, and an increased risk of developing psychotic disorders, particularly in those with a genetic predisposition. Also, this isn’t the same stuff your parents smoked…unless you’re the aforementioned parent reading this…it’s gotten much stronger over the years. This can really exacerbate the above issues.
To add some confusion to the matter, North Carolina does not have “legal weed”, but that doesn’t mean there aren’t technically legal THC options that can create some mental health issues.
The New Wave of THC Products in North Carolina: What You Need to Know
If you’ve been to a smoke shop or gas station lately, you’ve probably seen the flashy packaging of Delta-8, THC-O, or HHC products claiming to be “legal THC.” North Carolina’s legal loopholes have brought these new forms of THC into the spotlight, but just because they’re legal doesn’t mean they’re harmless. Here’s the lowdown on what these products are, how they’re affecting people, and why you might want to think twice before diving in.
Delta-8 THC: THC’s Mellow Cousin?
Delta-8 THC is often billed as the “lite beer” of cannabis—milder than Delta-9 THC (the stuff in traditional marijuana), but still psychoactive. It’s derived from hemp and is technically legal under federal law, which is how it’s showing up everywhere in NC. Sounds great, right? Well, not so fast. Delta-8 still hits the brain’s endocannabinoid system and can cause side effects like anxiety, paranoia, and difficulty concentrating, especially if you overdo it. Plus, since it’s largely unregulated, you never really know what you’re getting in those gummies or vapes.
THC-O Acetate: The Wild Card
THC-O is like the overachieving sibling of Delta-9 THC—it’s reportedly up to three times stronger. That might sound fun on paper, but it’s a synthetic cannabinoid, meaning it’s made in a lab, and there’s very little research on what it actually does to your body or mind long-term. Users have reported hallucinations and extreme mental fog, and because it’s synthetic, the risks of contamination or improper dosing are sky-high. Let’s just say this isn’t the kind of experiment you want to run on your brain.
HHC: The New Kid on the Block
HHC, short for Hexahydrocannabinol, is another newcomer in the THC world. It’s less potent than Delta-9 THC but still packs a punch. It’s being marketed as the “chill” alternative to weed, but don’t be fooled. Early reports suggest it can mess with your focus and memory, and like the others, its unregulated nature means you might be inhaling or ingesting more than you bargained for.
The Unseen Risks of “Legal THC”
Here’s the kicker: These products are legal because of loopholes, not because they’re safe. They’re often poorly regulated, so you can’t be sure of the potency or even what’s in them. One vape hit might feel fine, and the next might send you spiraling into anxiety or paranoia. If you already deal with mental health challenges like anxiety or depression, these products can make things worse—fast. Believe us, we’ve seen it many times.
The Takeaway
Every substance interacts with the brain in unique ways, but the common thread is their ability to disrupt normal brain chemistry. These changes don’t just fade overnight—they require time, treatment, and often professional intervention to heal. By understanding the science behind these effects, individuals can make more informed decisions about their substance use and seek the right support when needed.
Substance Abuse and Mental Health Treatment in Raleigh
AIM is pretty familiar with how substances impact mental health. We provide lots of mental health services to both Raleigh and Chapel Hill. We are able to offer outpatient addiction treatment in Raleigh in the form of PHP and IOP. If you are interested in getting some help with your substance use, mental health, or both then you can complete a form below and we will get you scheduled for an immediate appointment.
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