How do you know unless you look?

SPECT looks at blood flow and activity patterns. It looks at how your brain works. We typically obtain two scans on patients - one at rest and the other during concentration. The images below are examples of the various SPECT patterns associated with different disorders and brain types.

alcohol and drug abuse


There is quite a bit of scientific literature about the harmful physiological effects of alcohol and drug abuse on the brain. SPECT scans of substance abusers have demonstrated a number of abnormalities in brain areas known to be involved in behavior, such as the frontal and temporal lobes.

On brain SPECT images, there are some similarities as well as differences in the damage we see caused by various substances of abuse. The most common similarity is that the brain has an overall toxic look to it; the SPECT studies look less active, more shriveled, less healthy overall and have a “scalloping effect”- a wavy, rough sea-like appearance on the brain’s surface. This pattern is also seen in patients who have been exposed to toxic fumes or have had oxygen deprivation. Normal brain patterns, on the other hand, show smooth activity across the cortical surface.

On the 3D surface brain images, several substances of abuse can show consistent patterns:

  • Cocaine and methamphetamine abuse appear as multiple small “holes” across the cortical surface
  • Heroin abuse appears as marked decreased activity across the whole cortical surface
  • Heavy marijuana abuse shows decreased activity in the bilateral temporal lobes and prefrontal cortex
  • Heavy alcohol abuse shows marked decreased activity throughout the brain

These findings can improve with abstinence, although long-term use has been associated with continued deficits seen on SPECT, even after years of abstinence.

SPECT images can be helpful for prevention and treatment of drug and alcohol abuse:

  • SPECT images can help break though the denial that often accompanies substance abuse by showing the actual damage caused by the drug or alcohol abuse.
  • SPECT can reveal any underlying neuropsychiatric condition that also needs treatment.

Marijuana’s Effect on the Brain

The damage from using marijuana can be mild or severe, depending on how long a person used, how much use occurred, what other substances were used and how vulnerable a particular brain is. As mentioned above, marijuana use commonly causes low blood flow in the prefrontal cortex (PFC) and temporal lobes.

Case Study: The Effects of Being On Marijuana vs. Off Marijuana

A 57-year-old physician had abused marijuana for 30 years. We performed this SPECT series because he had been unable to stop using without feeling very angry, irritable, agitated and anxious.

The first study was performed after he came to the clinic intoxicated from 3 straight days of heavy usage (see images 1 and 3). The second study was performed after he abstained from marijuana for 1 month (see images 2, 4 & 5).

Notice, the study without marijuana shows decreased PFC and temporal lobe activity (likely from the chronic marijuana use), but also patchy increased activity, especially in the deep left temporal lobe – an area often associated with anger, irritability and anxiety.

The study with heavy marijuana usage shows marked overall decreased activity, especially in the prefrontal cortex (PFC) and temporal lobes – areas associated with attention, memory and motivational problems, but there’s also a decrease in the overactive areas noted in the “off marijuana” study.

This scan series argues for the possibility of “self-medication,” but unfortunately this “medication” as the potential for long term damage to his brain.

Long Term Effects of Heroin & Methadone

Long Term Effects of Cocaine & Methamphetamine

Effects of Long Term Alcohol Use

Alcohol Abuse & Brain Trauma

Brain Images On and Off Drugs and Alcohol

Here we see the effects of drug and alcohol abuse vs. one year substance free. Notice the overall “holes” and shriveled appearance of the brain during abuse and the marked improvement with abstinence.

Effects of Heavy Nicotine & Caffeine Abuse


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