Drug overdose deaths remain the leading cause of preventable death in the United States. With 68,630 drug overdose deaths in 2020, some 28.3 of every 100,000 Americans dies of drug overdose. Yet, most people who suffer from a drug overdose survive. In fact, in 2016, 297 per 100,000 Americans was hospitalized for an opioid-related overdose. But, what happens when you overdose and make it to the hospital in time to get treatment?
Opioid-overdose reversal drugs like Naloxone are crucial in improving opioid overdose survival rates, but they don’t make overdose safe. In fact, for many people, a drug overdose means long-term or even permanent damage. In fact, current estimates show that for every drug overdose death, there’s likely to be 5 more that survive, but with significant impacts to brain health.
Oxygen Deprivation During Brain Overdose
During an overdose, the body enters a state of central nervous system depression. This normally results in shallow breathing, decreased heart rate, and loss of consciousness. In severe cases, it results in the individual not breathing at all. Many of the common signs of drug overdose, like blue lips and fingertips are signs of oxygen deprivation.
Oxygen deprivation is also the most significant risk to the brain during an overdose. Permanent damage to the brain starts after just 4 minutes without oxygen. And, if you have reduced oxygen supply, parts of your brain are not getting oxygen. This means that any severe case of overdose will result in the brain not getting oxygen, resulting in hypoxic brain injury (where the brain doesn’t receive enough oxygen) and anoxic brain injury (where the brain receives no oxygen).
In both cases, the longer the reduction in oxygen, the more severe and permanent that damage will be. In one study, it was shown that damage can result in amnesia, stroke, encephalopathy, and brain abnormalities – but these cannot be predicted without knowing which parts of the brain are deprived of oxygen during the overdose.
Toxic Brain Injury
Persons suffering from a drug overdose are also at risk of a syndrome known as toxic brain injury. This happens when chemical input (opioids, for example) disrupt the nutrients needed for the brain’s normal function. This may be changes in neurotransmitters and brain tissue, oxygen, and nutrients. Whatever the case, it can mean significant tissue damage, injury, or even brain cell death. Significant chemical alterations can also result in permanent changes to neurotransmitters and chemical makeup of the brain. Essentially, drug abuse can cause permanent brain damage and overdose makes that more likely.
This also impacts your emotional state and well-being, with shifts typically including increases in depression, anxiety, and even psychosis. Many medical professionals consider this to be one of the reasons that individuals who abuse drugs and alcohol are more than twice as likely to have a mental health disorder as individuals without substance use disorders.
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Substance Misuse and Brain Injuries
Individuals with substance use disorders are significantly more likely to have brain damage than the general population. In fact, the Brain Injury Association of America shows that 25% of persons seeking out treatment for brain injury are there following drug and alcohol abuse. On the other hand, nearly 50% of persons in rehab and substance use disorder treatment have brain injuries or past brain injuries.
That can be complicated, as the symptoms of extreme intoxication and brain injury are very similar. For this reason, persons suffering from an overdose may be showing signs of a brain injury which may not be noticed because they are intoxicated. In reverse, individuals with severe substance misuse problems are often not treated because they have symptoms of brain damage.
Substance use disorders also significantly prolong recovery from brain injury – as oxygen deprivation, chemical imbalance, and even increased likelihood of physical injury decrease your ability to heal. This means that even drug and alcohol misuse are likely to cause brain damage and long-term problems with the brain – without factoring an overdose into it.
Symptoms of Brain Damage Following an Overdose
Individuals with a brain injury, whether from reduced oxygen or from toxic brain injury, are significantly likely to behave as if intoxicated or drunk, even when not drinking. They may actually reduce drug and alcohol intake, especially over the short term. Here, symptoms often look like:
- Reduced balance
- Impaired motor controls
- Speaking impairments
- Difficulty hearing
- Reduced concentration
- Reduced short-term or long-term memory
- Inability to make decisions or solve problems
- Difficulty communicating
The longer the overdose and the longer oxygen deprivation, the worse these symptoms are likely to be. In severe cases, someone suffering from an overdose may enter a vegetative state or coma, may experience severe reductions in mental faculties, and may die.
Unfortunately, there’s little to predict when, how, or if the brain will recover from these types of injuries. Most people recover within 3 months of a brain injury. Others can take years to recover. In addition, some injuries simply do not recover. In fact, full recovery from oxygen deprivation-related brain injuries is extremely rare. Most people make partial recoveries – although timelines can vary significantly from patient to patient and depending on the extent of the damage. In fact, in one study following 367 persons with brain damage following an overdose, only 13 had made a full recovery after one year. Another 36 had died, mostly of repeated overdose.
If you or a loved one is struggling with substance use disorder, rehab, counseling, and mental health treatment will help. Substance abuse, especially opioid use disorder, is incredibly dangerous for your mental and physical health. And, while drugs like Naloxone exist to remove some of the immediate danger of overdose related death, risks are ongoing and include long-term brain damage and mental health problems. Therapy and treatment can help you to get your substance use under control, medication-assisted treatment can help you to stop using, and both can ensure you have the tools to build a healthy life for yourself and your family – without relying on getting high. Millions of Americans are struggling with drug addiction, if you’re one of them, getting help will allow you to get your life back.