Abstract
Cannabis is the most frequently abused recreational drug worldwide. Its major psychoactive component, ∆9-tetrahydrocannabinol (∆9-THC), interacts with specific cannabinoid (CB) receptors in the brain. Until today distinct neuropathological alterations have not been described.
Opioids are the most frequently consumed drugs of abuse causing death by central respiratory depression. CNS findings include hypoxic-ischemic leukoencephalopathy, spongiform leukoencephalopathy, and a broad spectrum of CNS infections.
Fatalities after the consumption of psychostimulants (cocaine, amphetamines, methamphetamine, and related synthetic drugs) have been reported in several autopsy series with cardiovascular and cerebrovascular events as the most frequent causes of death. The latter include intracerebral and subarachnoid hemorrhages as well as hemorrhagic or ischemic stroke.
Alterations of neurotransmitters, receptors, second messengers signal transduction systems, and oxidative status have been reported for all of the abovementioned drugs but the findings are fragmentary and inconclusive.
Designer drugs and new psychoactive substances (NPS) are a heterogeneous class of noncontrolled substances. The major classes include synthetic opioids, synthetic cannabinoid receptor agonists (“spice”), psychostimulant NPS (“bath salts”), hallucinogenic NPS, dissociative substances, and designer benzodiazepines. Most of these substances mimic the effects of well-established drugs of abuse. However, their consumption is associated with a high incidence of intoxications or fatalities, especially in the context of polydrug abuse. Detailed neuropathological investigations are lacking so far.
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Büttner, A. (2021). Basic Substance Characteristics and Neuropathological Findings in Drug Abusers. In: Neuropathology of Drug Abuse. Springer, Cham. https://doi.org/10.1007/978-3-030-60531-5_4
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