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What your brain looks like on prescription pills

Most of us think prescription drugs are safer than illicit drugs, but that's only true when they are taken exactly as prescribed, and for the right purpose. NBC's Dr. Nancy Snyderman explains the effect prescription meds like sleeping pills and painkillers have on the brain.

The famous TV commercial that showed an egg frying and warned Americans “this is your brain on drugs” was meant to focus on illicit substances, but its message is equally applicable to many popular prescription medications.

That’s because these medications, just like drugs of abuse, hijack the brain circuits designed to make us feel pleasure when we’re doing the things that keep us alive or keep the species going. So, when we eat something tasty or have sex, the reward centers of the brain are stimulated and we feel good, which makes us want to go back and do it all over again.

Similarly, pain relievers tap into the reward center – one of the oldest regions of the brain, often called the primitive brain – to make us feel better. And that may help explain how it is that pain killers take more lives than heroin and cocaine combined.

Much of the time these drugs do their job well. If we have back problems, they quiet the pain. But things can go wrong when the reward center is hit too hard or too often, NBC’s chief medical editor Dr. Nancy Snyderman explained.

You take it for back pain “and then the medication goes right to these two reward centers,” Snyderman told TODAY’S Natalie Morales.  “But those are the same reward centers that light up when you’re on cocaine or cigarettes, or your having sex or gambling.”

And if these reward centers are stimulated too much, Snyderman said, they become “fatigued.”

“And if you fatigue your brain, it’s going to take more and more and more to take care of that [back pain]. And that’s when you become an addict.”

A look at how sleep aids work in the brain can also help explain why people get in trouble with these medications.

Some of the most popular sleeping pills, benzodiazepines, work by quieting almost every region of the brain. Untouched is the primitive area, which controls organs that must run even when you’re asleep, such as the heart and the lungs.

One of the problems people get into with sleeping pills is that there can be a sort of hangover in the morning, because the drugs haven’t worn off even though a person has come to consciousness.

“You wake up in the morning and expect to be [alert] and the fact may be that your brain is still asleep,” Snyderman said.

What people have to remember is that the sleeping pills affect brain regions that control your body. You can get into trouble because these drugs can lead to “dizziness and instability,” Snyderman said.  “You get in a car and you can’t drive straight and you have an accident.” 


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