The Science Behind Opioid Intoxication and AddictionPR Newswire PR Newswire • November 26, 2019
Opioid substances have been used for centuries, with some scholars believing that the oldest written reference to the use of the opium poppy can be found in a Sumerian clay tablet dating back to 2100 B.C. As long as opioids have been around, there have been people who have been addicted to them. All opioids, even opium, which is a naturally occurring substance extracted from the poppy plant, work in such a way that they can lead to addiction through the cascading effects of tolerance and withdrawal. This potential for addiction increased significantly when morphine was first extracted in the early 1800s, and grew even further in 1874 when heroin, the first synthetic opioid, was invented.
The Mechanism of “Painkillers”
One aspect of opioids that cannot be ignored is their real effectiveness at alleviating pain of many varieties. The opioid receptors in the brain work with endogenous, naturally produced compounds such as endorphins. Endorphins are your body’s answer to naturally alleviate pain and stress; when you get a cut, and it stops hurting after a while on its own, that is the effect of your body releasing endorphins.
Opioid drugs introduce chemicals into the brain that artificially bind to these same receptors, but do so in a manner that far exceeds what would be physically normal for any human being. This can be unhealthy for the body, with side effects ranging from drowsiness and fatigue to confusion, nausea and vomiting.
Just as opioids can provide an enhanced effect of alleviation of pain, they can also provide intense feelings of euphoria, making the medication highly addictive.
The Buildup of Tolerance
When repeatedly using just about any drug, more of it is needed when re-dosing in order to achieve the same effect. This occurs because the brain and body adjust to the presence of the drug, so taking the same amount will literally cause less of an effect than it did before.
One cause of this is the number of receptors in the brain decreasing, meaning there are fewer sites for the drug to bond to. The body is also very good at adapting, and one way that it adapts to constant exposure to a drug is by producing more liver enzymes to metabolize it. This double-whammy of tolerance makes it so that not only does the drug break down faster in the body, but the bonds between the brain’s receptors and the drug are less prevalent while it is present. As tolerance to a drug increases, so do the effects of withdrawal.
The Ordeal of Withdrawal
When a user withdraws from or stops using a drug, the brain is unable to achieve its normal levels of neurochemicals without the drug’s enhancement. This is indicative of physical dependence. When a person becomes highly dependent on a drug, he or she may rely on it to feel normal and will experience withdrawal symptoms in the drug’s absence. In this way, dependence and withdrawal go hand in hand.
In the instance of opioids, receptors that are associated with pain mitigation, relaxation, sleep and a feeling of well-being are most impacted. As a result, the characteristic symptoms of opioid withdrawal include muscle aches, irritability, anxiety and insomnia. Opioid withdrawal can also involve intense nausea and vomiting, abdominal cramping and a runny nose. Persistent vomiting and diarrhea can lead to dehydration, which can ultimately cause cardiac arrest and death if not treated.
The Layers of Addiction and Tolerance
Addiction is a multifaceted phenomenon. A person addicted to opioids will seek the pleasurable effects of the drugs while also seeking to avoid the symptoms of withdrawal. The higher a user’s tolerance, the more intense the withdrawal symptoms will be, and thus the more intense the addiction will be.
Addiction also hinges on psychological dependence. This is when a user has a belief that he or she needs the drug to function. In the same way that we have learned to seek and consume food when we feel the pangs of hunger, an addict has learned to seek and consume the drug of choice in order to satiate a craving. Managing cravings is an important part of overcoming addiction; however, in the case of opioid addiction, the cravings typically accompany dangerous withdrawal symptoms.
The Path To Escape from Addiction
It is important that we cultivate an awareness of the struggle that people addicted to opioids face. Many people are introduced to opioids after receiving legal prescriptions for chronic pain. Sometimes people who are not educated about dosage and the way addiction works will take higher doses when they can’t get the same level of pain relief by taking the prescribed amount. Having an educated public can help prevent this from happening.
It is equally important, however, for us to be understanding of the struggle of people who have become addicted. Overcoming withdrawal may require support and is never quick or easy. Education about how opioid addiction works and awareness of resources available to help addicts are necessary first steps on the path to helping people living with addiction get back to living normal lives.
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