Infographic 4.3: The Dangers of Drugs in Combination

The introduction reads as follows: Taking multiple drugs simultaneously can lead to unintended and potentially fatal consequences because of how they work in the brain. Drugs can modify neurotransmission by increasing or decreasing the chemical activity. When two drugs work on the same system, their effects can be additive, greatly increasing the risk of overdose. For example, alcohol and barbiturates both bind to GABA receptors. GABA’s inhibitory action has a sedating effect, which is a good thing when you need to relax. But too much GABA will relax physiological processes to the point where unconscious, life-sustaining activities shut down, causing you to stop breathing and die. Hundreds of deaths are caused annually in the U.S. when drugs like alcohol and barbiturates are taken in combination (Kochanek et al., 2012). In 2009 alone, 519,650 emergency room visits were attributed to use of alcohol in combination with other drugs (SAMHSA, 2010). The infographic shows three pairs of sending and receiving neuron ends. A lightning bolt pointing downward in each of the sending neurons is labeled “Action potential.” Particles are shown in the space between the neurons, coded as GABA for dots, Alcohol for squares, and Barbiturates for triangles. The receiving neuron in each graphic shows receptors labeled “GABA receptor” that penetrate the wall of the neuron. In the first pair of neurons, labeled “Normal GABA Activity” several GABA particles are shown exiting the sending neuron, floating in the space between neurons, and bound to the GABA receptors on the receiving neuron. The caption reads, “GABA activation, which calms nervous system activity, is essential for proper functioning of the central nervous system. Without GABA, nerve cells fire too frequently.” In the second pair of neurons, labeled “Alcohol” both GABA and alcohol particles are shown floating between the neurons and binding to the receptors on the receiving neuron. The caption reads, “Alcohol activates the same receptors, increasing GABA’s activity.” In the third pair of neurons, labeled “Alcohol & Barbiturate,” GABA, alcohol, and barbiturate particles are shown floating in the space between the neurons and binding to the receptors on the receiving neuron. The caption reads, “Barbiturates bind to and activate GABA receptors too, creating even more GABA-related inhibition.” At the lower part of the infographic are three graphics, showing illustrations of a brain with dotted arrows extending to drawings of the lungs and the heart. In the first graphic showing “Normal GABA Activity,” an arrow labeled “Excitatory +” and another arrow labeled “- Inhibitory” are the same size, and point to the brain. The caption reads, “When systems are functioning normally, GABA’s inhibitory signals perfectly balance excitatory signals in the central nervous system (CNS). This results in regular breathing and heart rate. In the second graphic showing “Alcohol Activity,” the arrow labeled “Excitatory +” is much smaller than the arrow labeled “- Inhibitory.” The sizes of the lungs and heart graphics are smaller than in the first graphic. The caption reads, “When alcohol increases GABA’s inhibitory signals, excitatory and inhibitory signals in the CNS are out of balance. Along with increased relaxation, heart and breathing rates decrease. Increasing levels of alcohol could eventually lead to stupor and coma.” In the third graphic showing “Alcohol & Barbiturate Activity,” the arrow labeled “Excitatory +” is about 25% of the size of the arrow labeled “- Inhibitory.” The sizes of the lungs and heart graphics are smaller than in the second graphic. The caption reads, “Together, alcohol and barbiturates further unbalance excitatory and inhibitory signals, suppressing heart rate and the impulse to breathe.”