Street drugs and dopamine theory overdoses

Furious Seasons has alerted me to an interesting article in the Boston Globe about street dealing of the antipsychotic drug quetiapine – interesting because it reveals some of our prejudices about the neuroscience of recreational drug use.

One of the mantras of neuroscience is that drugs of abuse boost the dopamine system. This led to the somewhat bizarre headlines earlier this year that modafinil may be ‘addictive’ because it was found to increase dopamine function in the nucleus accumbens, a key part of the reward system.

The reason this was bizarre is because while there are many reports of people illicitly using the drug to avoid sleep and maintain focus, there are none about ‘modafinil addicts’. In fact, I couldn’t find a single case in the literature.

However, the ‘all drugs of abuse boost dopamine’ mantra trumped the fact that there aren’t any actual addicts to make people warn about its potential for addiction. And by people I don’t just mean the press, I mean the neuroscientists who carried out the research, including Nora Volkow, head of the US’s National Institute on Drug Abuse.

And this is why the reports of the abuse of quetiapine (trade name Seroquel), both in the popular press and in the medical literature, are so interesting, because quetiapine is a dopamine blocker.

In fact, it reduces function at the same D2 dopamine receptors in exactly the same ‘reward circuits’ that are supposedly always stimulated by drugs of abuse.

In other words, it does exactly the opposite of what the received wisdom tell us, and yet, it is being widely abused to the point where people are getting gunned down over shady quetiapine deals.

As scientists one of our greatest vices is fitting the world into our theories, rather than fitting our theories to the world. For neuroscientists, this is especially tempting because society has come to the popular but false conclusion that brain-based explanations trump behavioural or psychological observations.

There is more to drug abuse and addiction than dopamine and our clich√©s about the ‘reward system’ are hampering our efforts to make sense of it all.

Link to Boston Globe article ‘Psychiatric drug sought on streets’.
Link to Furious Seasons who have been on the case for ages.

7 Comments

  1. Posted July 15, 2009 at 12:40 pm | Permalink

    This blows my mind. I hated being on Seroquel. I can’t imagine how any of it’s effects could be enjoyable.

  2. Bryan
    Posted July 15, 2009 at 3:45 pm | Permalink

    Some people will be addicted to anything that induces sleep. Seroquel definitely delivers on that front (probably just the histamine receptor activity (although dopamine blocking might add something too a la Parkinson’s hypersomnia)). Just the fact that people get high on stimulants, depressants, or both should suggest that addiction isn’t confined to any one biological reaction. Variety is the spice of life.
    That said, it is very weird that anyone outside of prison would choose to use Seroquel when there are so many other, non-horrible options for knocking yourself out.

  3. Posted July 17, 2009 at 3:09 pm | Permalink

    I think people can also become addicted to the ritualized social aspect of finding, meeting, receiving and consuming a substance.
    Ritual is highly addictive. Consuming tea during the Japanese tea ceremony is very different from, say, knocking it back carelessly from a vending machine.

  4. J
    Posted July 3, 2011 at 2:22 am | Permalink

    I have illegally bought Seroquel before, and I know many of my friends who have done the same.

    It’s not a mystery why, it is not a pleasant drug but a useful one. I’d wager that most people who buy the drug are using it after taking another recreational drug, to get some sleep.

    Methamphetamine will prevent the user from getting any rest, long after the pleasurable effects of the drug have worn off. It’s also very useful as escape from a “bad trip” on a hallucinogen like lsd.

    I’d also like to assure you that Modafinil definitely can be addictive. My friend started using to help get her university assignments done, but became totally dependent and suffered severe side effects including fainting and eventually psychosis.

  5. taylormurphy M
    Posted July 3, 2011 at 2:36 pm | Permalink

    For what it’s worth, there are also no reports of Modafinil having any recreational value outside of the medical literature too. So if you check out the erowid website’s user’s reports on taking it, you’ll see people say it was interesting or helpful for staying up but has no recreational value

  6. TM
    Posted July 3, 2011 at 2:55 pm | Permalink

    When I bought Bromo-Dragonfly (a notoriously long-acting hallucinogenic), my friend gave me a few 25mg quetiapine pills for free in case I needed help falling asleep. I can’t imagine using it for recreational purposes, at least not at such low doses, but it did help my mind calm down after a long trip.

    It could also be very helpful if you’re experiencing overly disturbing thoughts on a psychedelic, as J mentioned, although I’ve personally never felt a need for such an escape.

  7. Posted July 5, 2011 at 7:07 am | Permalink

    All seroquel does is put you to sleep, although there can be some trippy effects if you’re coming off a psychotic episode. I’m pretty sure those trippy effects are from the psychosis, however…


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