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Why Is Opioid Addiction So Difficult to Overcome and How to Do It

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It is indisputable that the opioid epidemic has been and continues to be one of the most deadly and devastating things to have happened in the United States. It has caused hundreds of thousands of overdose deaths in just a few short years, and show no signs of slowing down. 

In the U.S., overdosing has become the leading cause of death in people under age 55, outpacing both car crashes and gun violence, with more than 100 people dying of an opioid overdose every single day. 

According to the National Institute on Drug Abuse (NIDA), in 2017 alone, of the 72,000 drug overdose deaths in the U.S., just under 50,000 of them, about 68 percent, were opioid-related. Among these opioid overdose deaths, about 33 percent involved heroin, 35 percent involved prescription painkillers like morphine and OxyContin, and an overwhelming 60 percent, not quite 29,500 overdose deaths, involved the synthetic opioid fentanyl. 

At this point, the dangers of opioid addiction are widely known, the terrible costs evident. But despite all of this, people continue to use and become addicted to opioids in numbers that only seem to be increasing. What is it that makes an opioid addiction so difficult to overcome? Read on to learn more about how opioid addiction works to keep people dependent and in its grip and how it can still be overcome. 

How Do Opioids Work?

Opioids are analgesic drugs, which means they help to relieve pain and make it more manageable. Many opioids are in some way naturally derived from morphine, including heroin, while others, such as fentanyl, are entirely synthetic and made in a lab. 

Opioids are central nervous system (CNS) depressants, which means they slow down activity in the nervous system to keep nerve impulses carrying feelings of stress and pain from reaching the brain. Your body actually produces its own opioids, which are chemicals in the brain. Also known as neurotransmitters, they are responsible for regulating stress and pain in the body, but they cannot do it nearly as efficiently as opioid drugs. 

The way all opioids essentially work is by mimicking naturally produced opioids that enter the brain and bind themselves to what is known as opioid receptors. They bind with them and then activate them again and again with the directive to create more opioids until the receptors become overstimulated and release a massive flood of excess opioids throughout the brain and central nervous system.

Opioids mask pain signals with much greater strength and efficiency than the brain and body could ever do naturally. They also produce intense feelings of sedation and euphoria as they affect the following areas:

  • The spinal cord. The spinal cord is mainly responsible for receiving the body’s pain signals and passing them on to the brain. Opioids create what are basically blocks around the spinal cord that keep those signals contained, which helps dull moderate-to-severe pain.
  • The brainstem. Opioids create these same blocks around the brainstem, providing another layer of inhibition to keep pain signals out. It also slows down breathing, which is what gives opioids their cough-suppressant effects and why opioids like codeine were used in cough medicine.
  • The limbic system. The limbic system is a crucial part of the brain when it comes to not just opioid use but addiction in general. Here, opioids produce their secondary effect, which is creating a significant spike in the levels of a different transmitter called dopamine. Dopamine regulates, among other things, emotion, cognition, and pleasure. When produced in excess, dopamine creates a strong sensation of euphoria, the “high” that people associate with opioid abuse. 

How Do People Become Addicted to Opioids?

Opioid abuse literally changes the brain’s chemistry over time and the way it rewires the limbic system, fundamentally altering and interfering with dopamine production is possibly the most important part of it. 

No one ever intends to become addicted to opioids, and many people who abuse them initially do so because of their incredible ability to mask pain. However, it’s the impact on dopamine that kick-starts the cycle of addictive behavior. 

In a way, dopamine is how your brain trains you to survive. When you perform actions like eating, sleeping or laughing with a friend, the brain releases a feel-good burst of dopamine to reinforcing the motivation for you to continually take part in activities that help you survive, such as nourishment, rest, and social connection, controlling how we process motivation and reward.

When excess opioids raise the levels of dopamine in the brain to the point of creating a major rush of euphoria, it’s teaching the brain that this spike in dopamine is a reward for the performed activity, which, in this case, is using opioids.

As someone continues using, the association becomes cemented: take opioids, get dopamine. What’s more, the body cannot naturally compete with the overwhelmingly stronger dopamine response provided by opioid use. 

This is part of what leads to the compulsive, drug-seeking behavior associated with addiction. The other activities someone has been trained to do through dopamine’s motivation and reward process can’t compare, and so they are pushed aside in favor of opioid use until it has become someone’s highest priority.

However, as this continues and the body and brain become more reliant on opioids for dopamine, they simultaneously become more tolerant to the effects of opioids like heroin or morphine and start needing larger and larger amounts to mask the symptoms of chronic pain as well as trigger the necessary amount of dopamine. 

And this is how opioid addiction takes hold, causing intense cravings and crippling withdrawal symptoms when someone tries to stop using, which leads them to continue taking more and more of them in an attempt to stave off cravings and chase the original dopamine high, even as they suffer permanent, often lethal physical and mental damage. 

How Can Opioid Addiction Treatment Help?

Seeking out the aid of a professional addiction treatment center can help you to overcome opioid addiction, starting with medical detoxification to flush out any trace of opioids from your system to achieve sobriety and get you mentally and physically stabilized. 

After detox, the next step is an addiction recovery treatment program. According to NIDA, someone needs to remain in treatment for at least 90 days to reach a minimum level of effectiveness to maintain sobriety . Stopping after detox essentially makes overcoming opioid addiction impossible and all but guarantees a relapse. In a 2010 research study on heroin addiction, more than 90 percent of the participants who did not follow their detox up with treatment relapsed; 60 percent of them went back to using heroin in just one week.

In addiction recovery treatment, clients can overcome their opioid addictions by working to gain an understanding of their addiction and the underlying causes of it, addressing all aspects of it. From there, they will work with doctors, clinicians, and staff to learn how to replace unhealthy, addictive behaviors with much more positive and effective methods of coping that will help them maintain long-term sobriety.Throughout their recovery, a client will usually work with a clinician to create a treatment plan composed of different therapies and treatments that have been evaluated to be most effective for them. Their plan may include:

Start Your Recovery Journey Today

Overdose deaths caused by the opioid epidemic continue to rise, but with the help of the dedicated and compassionate doctors and staff at Ocean Breeze Recovery, you can avoid becoming another tragic statistic and get on the path to lasting sobriety.If you or a loved one is struggling with opioid abuse or addiction, don’t wait to take action, because addiction won’t. Call 844-554-9279 to speak to an admissions specialist about getting the help you deserve. They are available 24 hours a day, seven days a week to provide you with a free and confidential consultation that can help you find the treatment program the best fits your needs or those of your loved one. You can also contact us online for more information.

Sources

National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

WebMD.com. ( 2018, September 20) Opioid (Narcotic) Pain Medications. How Opioids Work. WebMD Medical Reference. Bhargava, H. MD from https://www.webmd.com/pain-management/guide/narcotic-pain-medications#1-2

American Society of Anesthesiologists. (n.d.) Opioid Abuse. Why do people become addicted to opioids? from https://www.asahq.org/whensecondscount/pain-management/opioid-treatment/opioid-abuse/

NIDA. (2018, January 17). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition

Sinha, S., Lieberman, Z., & Davis, L. (2018, December 19). Heroin Addiction Explained: How Opioids Hijack the Brain. Retrieved from https://www.nytimes.com/interactive/2018/us/addiction-heroin-opioids.html

Smyth, B. P., Barry, J., Keenan, E., & Ducray, K. (2010, June). Lapse and Relapse Following Inpatient Treatment of Opiate Dependence. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20669601

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