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Will My Brain Heal If I Stop Doing Drugs?

It’s no secret that most drugs put a hurtin’ on the old noggin, but the damage they do is less permanent than you’d think

Everyone who’s taken drugs wonders, “Is my brain irreparably fucked?” 

Well, I’m here to tell you that the answer is… maybe?

There are an assortment of ways in which drugs can wound your noodle. For starters, almost every enjoyable substance you can think of has the potential to kill your brain cells. That includes alcohol, heroin, amphetamines, weed (possibly), opioids, inhalants and cocaine (research on MDMA and psychedelics like shrooms and acid is more complicated, so I’ll touch on those in a moment). Psychostimulants, like meth, and liquor bulldoze your blood-brain barrier, allowing toxins from your blood supply to slaughter your brain cells. Meanwhile, booze and inhalants like Sharpies harm your myelin, a system of protective sheathing around the neurons in your brain and spinal cord. This can result in neurological dysfunction, as well as impaired reasoning, movement, vision and hearing.

How this brain-cell bloodbath manifests itself depends on the individual, the drugs they’ve taken and how much they’ve indulged. In general, the more drugs you do — and the longer you do them — the higher your chances are of developing some sort of cerebral damage.

One example is anhedonia, an inability to experience pleasure. This is a common symptom of chronic stimulant use, because substances like meth and coke can alter your dopaminergic reward system. That means, without them, you’ll have a harder time enjoying simple pleasures like eating a good meal or gossiping with a close friend.

These sorts of problems are especially likely in children and teenagers who use drugs, because their brains are still in development. For example, some studies suggest that weed has virtually no long-term effects on developed brains (again, there’s conflicting research), but others show that people who engage in “persistent cannabis use” during their adolescence suffer from lasting impairment like a loss of up to eight IQ points. Animal studies imply that this is because of changes to the hippocampus, a brain structure that plays a major role in learning and memory.

As I hinted at earlier, psychedelics are something of a wildcard (I’ll get to MDMA later). There’s not a whole lot of long-term research on how they affect the brain, and while they may cause persistent psychosis (studies debate this) and hallucinogen persisting perception disorder (lasting hallucinations) in rare cases, it’s not clear whether those are the result of mental or physical changes. For what it’s worth, a 2005 study found no evidence of psychological or cognitive shortcomings among Native Americans who used peyote regularly.

Similarly, although you’ve probably heard stories of people who took LSD and ended up “permafried,” there’s currently no substantial evidence to suggest that acid has any long-term effects on the brain. Again, it’s possible that psychedelics can increase the risk of psychosis in people who are already prone to it, but that’s all we really know for now.

Moving on: Besides possibly decreasing your IQ, drugs also have the potential to induce more severe complications like cerebral atrophy, strokes and Wernicke-Korsakoff Syndrome, a grievous degenerative brain disorder that can manifest as permanent mental confusion. Issues like these may develop after an opioid overdose, for example, which can prompt cerebral hypoxia, a lack of oxygen to the brain. They can also come about because of poor health, a side effect of long-term drug use drives people to neglect their basic needs (Wernicke-Korsakoff Syndrome, for instance, can be caused by dietary deficiencies).  

That said, if you manage to quit drugs before they take too much of a toll (when that occurs depends on the person), the changes to your brain shouldn’t be quite so drastic. Instead, you’re more likely to experience alterations to that dopamine reward system I mentioned earlier. 

In short, most drugs inspire a neurochemical reaction that increases the amount of dopamine released by your brain. As you take more of these substances, your brain compensates for all that synthetic dopamine by establishing a new homeostasis that relies on less natural dopamine. Thus, your brain becomes less responsive to everyday rewards like a big bowl of ravioli and instead craves more drugs. This lack of natural dopamine is also the culprit behind “comedowns” and certain withdrawal symptoms.

Fortunately, Evan Haines, co-founder of Oro House Recovery Centers, tells me that your brain will eventually return (at least mostly) to its natural state. “It’s such an amazing organ,” he says. 

It should be no surprise by now that how long that process takes depends on a number of factors, ranging from physiological differences to the intensity of drug use. It also varies from drug to drug. For example, a study of meth users found that nerve damage caused by the drug heals completely after a year or more of abstinence. Another report came to a similar conclusion, but they also found that other brain regions didn’t recover after even 14 months of sobriety.

A brain scan of meth users over time

Likewise, Haines says the effects of benzos (Valium, Xanax, Klonopin) on your nervous system can be felt well after a year of sobriety. “The level of anxiety you’ll feel will eclipse whatever you were feeling when you first went to see a psychiatrist,” he warns. “If you go to an online benzo-withdrawal support group, you’ll read people saying that it took 18 months for them to feel normal again.” This is something people should be aware of, especially because benzo prescriptions skyrocketed during the pandemic.

While palpable, ultra-long-lasting withdrawal symptoms aren’t as common with MDMA, one study shows that subtle changes to the brain, including cell damage, can be detected for at least 18 months. The users had taken a total of six pills on average over some time (the doses aren’t noted, but a standard dose is between 70 and 125 milligrams), which would suggest that it really doesn’t take much to alter your brain. Still, there are a number of contradictory studies, and many reports claim that although MDMA has the potential to be neurotoxic when abused, it also has the potential to be used safely. (The same could be said for many drugs — i.e., if you use them rarely enough and in small enough amounts, they’re less likely to harm you.)

Just to give you one more example, monkeys that were given coke for 100 consecutive days during an experiment sustained considerable changes to their brains after a month of sobriety, suggesting that it takes much longer to come back to normal (especially if you’re doing blow every goddamn day).

There are many studies out there, and we could parse them endlessly. But the takeaway seems to be that though your brain may never be quite the same after a bout with drugs, it should improve a good amount given enough time. To encourage that improvement, Haines suggests indulging in natural forms of dopamine, serotonin and endorphins; that means eating well, working out and just generally taking care of yourself.

Now please excuse me while I read a book to get those eight IQ points back.