Opioid Dependency
Opioids are a class of drugs utilized for pain relief. These include heroin, fentanyl, and oxycodone among others. Legal opiates can be prescribed to patients to reduce pain; however, the danger lies in the addiction of these drugs when used for pleasure. Approximately 70% of drug-related overdoses involved the use of opioids in 2018 alone. Opioid addiction is “characterized by a powerful, compulsive urge to use opioid drugs, even when they are no longer required medically” (MedlinePlus). They can change one’s brain chemistry and lead to growing tolerance of the drug, which in itself is gravely dangerous for the user.
Opiate travels via the bloodstream to the brain and attaches to protein receptors of certain neurons. Research has shown that these receptors trigger “the same biochemical brain processes that reward people with feelings of pleasure when they engage in activities that promote basic life functions, such as eating” (Kosten and George). This stimulation of ‘reward feelings’ is the main cause for addiction in users, and the compulsion grows and grows over time into dependence. Thomas Kosten, M.D. and Tony George, M.D., states that “during periods when the drug is not available to addicts, their brains can remember the drug, and desire or craving for the drug can be a major factor leading to drug use relapse.” According to the CDC, there were 3 distinct waves of opioid overdose deaths: (1) a wave linked to the prescription of opioids during the 1990s, (2) a wave linked to the surge in heroin use in 2010, and (3) a wave in 2013 that included use of synthetic opioids like heroin. Heroin has increased by “5 times since 2010” (CDC), and there has been rising numbers in overdose deaths related to illegally manufactured fentanyl.
The neurological component of opioid addiction is complex, and added to that are both genetic and non-genetic factors. For example, the risk of opioid addiction is increased with a family history of substance abuse and other psychiatric disorders. Also included are living standards related to poverty, and the community that you surround yourself with. It is not one single reason that leads to a risk increase in opioid addiction, but all these social, lifestyle, economic and health factors combined.
There have been effective medicines that are prescribed to treat opioid addiction disorder including methadone and buprenorphine. Counselling and behavioural therapies are also available, as well as hospital-based treatments. Numerous organizations have been established to fight the growing epidemic of opioid addiction, such as demandZero which was created in New Haven by a group of community organizers. Clinician awareness of opioid users is key to solving this epidemic, as Kosten, M.D., and George M.D., describe that it “can provide insight into patient behaviors and problems and clarify the rationale for treatment methods and goals.”
References:
CDC. “Opioid Basics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 Mar. 2020, www.cdc.gov/drugoverdose/opioids/.
Kosten, Thomas R, and Tony P George. “The neurobiology of opioid dependence: implications for treatment.” Science & practice perspectives vol. 1,1 (2002): 13-20. doi:10.1151/spp021113
“Opioid Addiction: MedlinePlus Genetics.” MedlinePlus, U.S. National Library of Medicine, 18 Aug. 2020, medlineplus.gov/genetics/condition/opioid-addiction/.
