What Are Opioids and Why Are They Dangerous?
What are opioids, as a search query, is searched approximately 40,000 times a month in the United States alone. It’s clear that the population is interested in what opioids are and with that, public education on the lethal drug is imperative to help to end the opioid epidemic.
Opioids are a class of drugs naturally found in the opium poppy plant. They are often prescribed as part of a pain management solution because they contain chemicals that relax the body and can relieve pain. Prescription opioids are used mostly to treat moderate to severe pain, though some opioids have been used to treat coughing and diarrhea. Opioids reportedly make people feel very relaxed and “high” – which is what leads users of the drug to develop an addiction. Overdoses and death are common and there is a link between chronic pain and opioid addiction, with nearly 80% of heroin users reported transitioning to heroin from prescription opioid abuse.
On an average day, 116 people in the United States die from opioid-related overdoses.
With that many people affected, it’s imperative that the public is educated on what opioids are and why they are dangerous. According to the National Institute on Drug Abuse (NIDA), “The misuse of, and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare.”
Opioid and drug overdose deaths have been rising in recent years. NIDA reports that in 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. In 2016, more than 42,000 Americans died of an opioid overdose, an increase of more than 27 percent in a single year. 2017 is expected to show another increase.
Craving and Reward
Opioids engage a natural reward cycle in the brain. “When we get hooked on the latest video game on our phone or our favorite flavor of Ben & Jerry’s ice cream, we are tapping into one of the most evolutionarily conserved learning processes currently known to science,” writes neuroscientist Judson Brewer in The Craving Mind. “This reward-based learning process basically goes like this: We see some food that looks good. Our brain says, Calories, survival! … See food. Eat food. Feel good. Repeat. Trigger, behavior, reward.”
When opioids act on the brain, they trigger the same processes that give people feelings of pleasure from activities like eating or sex, but they do it far more intensely. Opioids make specific brain cells pump out a chemical messenger called dopamine, which encourages repeating the pleasurable experience (positive reinforcement).
“Many factors, both individual and environmental, influence whether a particular person who experiments with opioid drugs will continue taking them long enough to become dependent or addicted,” write Thomas Kosten and Tony P. George in The Neurobiology of Opioid Dependence. “For individuals who do continue, the opioids’ ability to provide intense feelings of pleasure is a critical reason. … Opioids are prescribed therapeutically to relieve pain, but when opioids activate these reward processes in the absence of significant pain, they can motivate the repeated use of the drug simply for pleasure.”
People who take opioids as prescribed by their doctors do not usually become addicted to them. Many who do become addicted to these dangerous drugs are misusing them to self-medicate emotional pain by taking opioids in higher doses than prescribed or without a prescription at all.
The Addiction Cycle
If addiction has developed and the opioids are not ingested when triggered, withdrawal symptoms ensue. This can cause intense stress and physical pain, reinforcing the craving for release (negative reinforcement). Due to the phenomenon of tolerance, an addicted person has to take substances in ever higher doses. Since opioids—like other drugs—overstimulate the relevant receptors in the brain, it compensates by making more opioid receptors available, resulting in the increased need to achieve the euphoria of the first high. Meanwhile, the habit loop of trigger, behavior, reward, repeat continues.
This dangerous cycle is really a downward spiral of increasing craving and escalating substance use. Eventually, enormous and ever more dangerous doses are necessary just to feel normal. This is the reason some drug users eventually seek ever more potent opioids like fentanyl or even the elephant tranquilizer carfentanil.
Why some people develop an active addiction after using opioids while others do not have complex reasons. Often, co-occurring conditions such as anxiety disorders and depression play a decisive role in developing a substance use disorder.
Learn more about the craving and the reward system in our article The Power of Craving: Why Do I Crave?
How Did We Get Here?
One aspect of the current addiction crisis in the United States is the over-prescription of opioid pain relievers starting in the 1990s. The powerful opioid painkiller OxyContin, a time-release version of oxycodone, was hailed as a breakthrough treatment for chronic pain when it was approved by the FDA in 1995. It worked over 12 hours to maintain a steady level of oxycodone in patients suffering from a wide range of pain ailments.
Unfortunately, it could be easily abused to achieve a heroin-like high by crushing the pills and snorting or injecting the entire dose at once. The drug’s maker, Purdue Pharma, reformulated OxyContin in 2010 to make it harder to crush and stopped selling the original form of the drug.
In response to rising rates of opioid abuse and overdose, many states have enacted laws to restrict the prescribing and dispensing of opioids. So far, these laws have been unable to have a significant impact on the addiction epidemic. Some users switched to heroin or other illicit drugs after being deprived of access to opioid painkillers.
Purdue Pharma recently announced it will stop marketing opioid drugs to doctors, bowing to a key demand of lawsuits that blame the company for helping trigger the current drug abuse epidemic.
Restricting the availability of addictive drugs is not enough, however. To achieve lasting recovery from the disease of addiction, patients should learn how to abstain from all forms of addictive behavior and examine carefully the true reason for their substance abuse. While addiction to opioids is particularly pernicious because of the severe overdose risk, transferring cravings to compulsive gambling or overeating cannot be regarded as complete recovery.
The holistic-integrative health treatment model at Lakeview Health addresses the body, mind, and spirit of the patient. Wellness therapy is a health and fitness program focused on the needs of the body. Psychotherapy helps heal the mind, while the inclusion of spirituality and mindfulness allows patients to develop a new sense of purpose and to connect with a more positive sense of self.
In Lakeview Health’s residential treatment, we provide patients with a full body–mind–spirit experience because healing the whole-self acts as a comprehensive re-calibration. The whole sense of self, the way they define themselves and function in society, is reset.