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Why Are Opioids So Addictive?

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The reason why opioids are so addictive is their powerful effects on the mind and body. Opioids are made to bind opioid receptors and trigger the release of dopamine. Dopamine is a chemical messenger in the brain, a neurotransmitter that controls the reward and pleasure center. In this case, the reward is a feeling of relaxed euphoria. 

The unfortunate situation with opioids is that, with time, small dosages no longer produce the same level of reward. Tolerance builds as dosages increase until a high-dosage opioid addiction develops. 

Opioid Addiction: An Ongoing Problem

Opioids are highly addictive drugs, typically for short-term treatment of chronic or acute pain. However, taken within the limitations of small doses for a short term, they can be highly effective. It is difficult to predict who will develop a psychological dependence before physical tolerance is in place.

Typically, those with a genetic propensity, certain environments, and high levels of stress develop an addiction to opioids. Opioid receptors are the body’s natural ability to control pain, identify rewards, and develop habitual behaviors. They are located within the central nervous system and encapsulated in the outer part of nerve cells.

When opioids attach to them, chemical changes relieve pain and initiate the reward system when high levels of dopamine are released. The high levels of dopamine are why opioids are so addictive. This process is the foundation for drug cravings when the brain remembers how pleasurable the effect was. 

How Opioids Hijack The Brain’s Reward System

To understand how opioids hijack the brain’s reward system, we must first understand how it works. The brain’s reward system helps us remember people, places, and factors that keep us alive. Dopamine, a neurotransmitter, is responsible for encouraging people to repeat certain behaviors that make them feel good, like when they eat a good meal. There are no significant problematic behaviors when dopamine levels are normal and constant.

Opioid medications trigger the brain to release an unusually high level of dopamine. This abnormal amount of dopamine causes some serious problems, like making brain cells less responsive to naturally produced dopamine. This means the user needs the opioids to receive the reward and is also the source of drug cravings. These cravings can initiate thought processes that make the user believe they need the drug, even when they don’t want to use it. 

Opioid and Brain Receptors

Opioid receptors facilitate the body’s natural ability to regulate pain, identify rewarding behaviors, and develop habitual or addictive behaviors. They are embedded in the outer part of nerve cells within the nervous system.

When the opioid molecules find and attach to the receptors, chemical changes occur, which trigger the reward system to feel pleasure and relieve pain, which is why opioids are so addictive. This reward system is the mesolimbic (midbrain) reward system. 

Opioids and Euphoria

Euphoria, an extreme feeling of pleasure, is triggered when the opioids attach to the receptors, and a flood of dopamine occurs. Dopamine release happens in both the ventral tegmental area (VTA) and the nucleus accumbens (NAc) sections of the brain.

Just like taking a photo with a cell phone, the brain takes a photo of the moment, including the good feelings that connect to the opioids. The total picture is set into the memory, including the situation occurring and the environment surrounding the experience. Each factor in the memory can initiate drug cravings. 

Rising Opioid Tolerance

Increasing tolerance levels are the red flag in the addiction equation. The longer the brain is exposed to opioids, the more opioids it takes to produce the desirable euphoric effect. The brain adapts, becomes less responsive to the opioids, and the brain structure begins to change. The VTA-NAc sectors of the brain will not respond unless larger amounts of opioids are in use. 

The function of the locus coeruleus in the brain is also dysfunctional. Instead of initiating feelings of sedation, the opioids produce jitters, anxiety, muscle cramping, or in other words, withdrawal symptoms. Tolerance continues to build, and this is why opioids are so addictive. More drugs lead to dependence, which ends in opioid addiction, which requires a medically managed detox program.  

Opioids and Mental Health

The American Psychiatric Association speaks to opioids and mental health in their article about the opioid crisis. Psychologically, people with opioid use disorder can develop depression, anxiety, and other cognitive impairments.

Once the mental health conditions develop, some individuals take more drugs to alleviate the symptoms of depression and anxiety. This can also occur when alcohol enters into the equation. 

Why Are Opioids So Addictive? Reducing Chronic Pain

Chronic pain is challenging to live with, so when opioids are in use for the treatment of chronic pain, misuse can easily occur unintentionally. Opioids are for short-term use, but when use continues over a long period, the body builds tolerance, and to control pain, the requirement is a higher dose of opioids.

The user may become caught up in the vicious cycle of abuse when they try to stop using or lessen the dosage. Withdrawal symptoms develop and produce more discomfort, so the user succumbs to the cravings and takes more opioids. 

Who is Most at Risk For Opioid Abuse?

Chronic or acute pain sufferers are at a high level of risk for developing an opioid use disorder. After dealing with long-term pain management, those with an opioid prescription for pain control quickly learn to rely on the absence of pain, which is why opioids are so addictive.

Opioids are highly addictive, so if the use continues into the long term, tolerance, dependence, and addiction quickly escalate. Healthcare providers must be more aware of the length of use for their patients.

Opioid Withdrawal and Detox

Opioid withdrawal can occur when the body adjusts its functions to rely on the presence of opioids in the system. The brain’s chemistry changes with chronic opioid usage and creates a need for the drug to maintain a balance.

When the opioid dosage decreases or ends, the body and the brain go into panic mode without the drug. Signs and symptoms of withdrawal can quickly occur. Opioid withdrawal includes psychological and physical symptoms. 

Initial opioid withdrawal symptoms include any of the following:

  • Anxiety
  • Restlessness and irritability
  • Muscle aches, including joint pain and headaches
  • Nausea, vomiting, or diarrhea
  • Intense drug cravings
  • Hot and cold flashes
  • Tremors

What to Expect During Opioid Detox

Opioid detox is challenging to manage. Medical management in a professional detox program and facility is the safest method of detox. Heroin detox is painful and may need additional options for treatment. Medication-assisted treatment (MAT) offers relief for difficult withdrawal symptoms and helps prevent relapse during detox. 

Medical professionals closely monitor vitals such as blood pressure and heart rate during detox. Detox is an individual process that depends upon the drugs that are in use, the physical and mental health of the client, and the length and dosage of the addiction. It is never a good idea to try to detox alone at home, it could be a significant event that could result in adverse conditions. 

Levels of Care After Detox

Once detox is complete, it is imperative to continue treatment to begin learning how to live a sober lifestyle and prevent relapse. Residential inpatient programs are very effective and successful. However, everyone has unique and personal needs, so other programs may be a better option.

Outpatient programs have their benefits and can be equally effective. It is just important to know that treatment can be successful and that it is possible to leave opioids in the past. 

Rely on a Safe and Professional Environment for Opioid Treatment in California

Safety, security, comfort, and professionalism are basic standards for opioid treatment. However, Sierra Health + Wellness provides premium environments and programs for individuals who may have an opioid use disorder. Select an elite location to jump-start your recovery process by contacting them today for more information.

Contact Sierra Health + Wellness today and immediately feel a sense of relief.