Nicotine can act as both a stimulant and a sedative. Immediately after exposure to nicotine, there is a "kick" caused in part by the drug’s stimulation of the adrenal glands and resulting discharge of epinephrine (adrenaline). The rush of adrenaline stimulates the body and causes a sudden release of glucose as well as an increase in blood pressure, respiration, and heart rate. Nicotine also suppresses insulin output from the pancreas, which means that smokers are always slightly hyperglycemic. In addition, nicotine indirectly causes a release of dopamine in the brain regions that control pleasure and motivation. This reaction is similar to that seen with other drugs of abuse-such as cocaine and heroin- and it is thought to underlie the pleasurable sensations experienced by many smokers. In contrast, nicotine can also exert a sedative effect, depending on the level of the smoker’s nervous system arousal and the dose of nicotine taken.