Andreas Büttner - Neuropathology of Drug Abuse

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Drug abuse represents a significant health and social issue worldwide and is associated with substantial morbidity and mortality (Degenhardt et al. ).

The drugs of abuse consumed as single substance or in combination include predominantly cannabis, opiates, cocaine, amphetamines, methamphetamine, and designer drugs with novel psychoactive substances as a recent concerning development (Bttner ).

For epidemiological studies and for the impact of a possible drug abuse in an individuals health affection or death the sampling of appropriate biological material for detailed toxicological studies is of utmost importance (Dinis-Oliveira et al. ).

Since the majority of drug abusers perform polydrug abuse (see Sect. ). Finally, secondary compromising effects on the central nervous system (CNS) by the lifestyle of the drug abuser may be a confounding factor.

Considering most clinical, radiological, and autopsy studies in humans it should be noted that most are retrospective and predominantly based on polydrug abusers. In addition, the frequency and amount of drug used by each user differ greatly and the study samples consisted of heterogeneous groups. Nevertheless, despite all the difficulties regarding human studies, the vast majority of reports provided data to support the conclusion that drugs of abuse can promote deleterious effects on the human brain. Especially vulnerable are adolescents since drug exposure revealed a variety of long-lasting behavioral and neurobiological consequences in that age group (Salmanzadeh et al. ).

Besides cardiovascular complications, psychiatric and neurological affections are the most commonly observed adverse effects of drug toxicity (Asser and Taba ). Further details for each class of drugs of abuse will be described separately in the particular chapter.

Although neurological complications are frequently observed in drug abusers and numerous neuroimaging studies have shown conspicuous findings (see Chap. ), little is known about the fundamental neuropathological alterations of the cellular elements of the human brain. In the past, detailed postmortem studies of human drug abusers were scarce and the reports predominantly focused on the consequences of hypoxia-ischemia or cerebrovascular events. In addition, the majority of these studies did not perform systematic and detailed microscopic and/or morphometric studies. Therefore, despite a large body of literature on sophisticated animal models, this book will focus on the neuropathological findings associated with drugs of abuse in humans.

The pharmacology and CNS effects of alcohol, nicotine, and solvent abuse are reviewed elsewhere (Beckley and Woodward ).