How Does the Body Get Addicted to Opioids?

Opioid overdose-related deaths have been a national concern for the past few years. In our own state of Connecticut, fatalities have tripled since 2012. Whether Fentanyl, prescription painkillers or heroin is to blame, cities that have shouldered costs related to Narcan administering and rehabilitation are now fighting back, filing lawsuits against major drug manufacturers.

According to the Centers for Disease Control and Prevention, opiates and opioids continue to lead all drug overdose-related deaths. While heroin is responsible for roughly one-third, the rest stem from prescription drugs, frequently given to patients recovering from surgery or serious injury. How does a doctor’s prescription turn into a full-blown addiction that may involve seeking illegal drugs? Although much of the blame falls on drug companies, who initially played down prescription painkillers’ side effects, the body’s response plays a significant role.

How Addiction Gradually Occurs

Depending on the drug, prescription painkillers are typically recommended for moderate to severe pain. When the user takes a pill or uses a patch, the drug enters the brain via the bloodstream. In the process, it creates a higher-than-average amount of endorphins and dopamine. The body typically associates these neurotransmitters with a sense of reward, pleasure or satisfaction, so the patient then experiences a temporary feeling of euphoria.

Short term, patients may be able to stop use. On the other hand, long-term repeated use stunts the brain’s ability to produce these two chemicals. In fact, patients may only get that euphoric sensation from taking an opioid or worse, may stop feeling any pleasure unless they take the drug.

Based on this chemical reaction, addiction manifests through three stages:

• Tolerance: A patient still gets natural pleasure sensations but must use larger and larger doses to experience the same initial high.
• Physical Dependence: At this point, stopping or tapering opioid usage causes the body to develop withdrawal symptoms. These may range from depression to tremors and vomiting.
• Psychological Dependence: The patient finds that he or she can’t function without regularly using opioids. By this stage, the drug has changed how the brain’s nerve cells work, causing the neurons and other nerves to produce three to four times more cyclic AMP, a substance responsible for the body’s electric pulses. When the drug gets taken away, the nerve cells have become dependent on the opioids’ effects. They may have a strong and violent reaction, over-firing these pulses.

Physically, the overload of electric impulses essentially causes the body to operate on overdrive. Rather than be sluggish or have slow respiration, the body may experience:

• Elevated blood pressure
• Diarrhea
• Feelings of dysphoria
• Extreme anxiety

Overdose may happen when a patient takes such a high quantity of opioids that the brain stem stops the body’s breathing.

Who’s More Susceptible to Opioid Addiction?

Over the past 16 years, prescriptions for opioids quadrupled. In 2012 alone, doctors wrote close to 260 million prescriptions for patients. More doesn’t always mean better and recent studies have found that, of those taking prescription painkillers long term, 25 percent get addicted. According to a 2014 survey, of a group receiving treatment for opioid addicted, a large percentage eventually turn to heroin. Because of restrictions, it’s cheaper and easier to find.

Not everyone has the same reaction to opioids. While some experience a euphoric feeling, others get sleepy or nauseous. Beyond the side effects, certain characteristics make patients more prone to developing an opioid addiction, including:

• Previous or current addiction to alcohol, tobacco or another prescription drug.
• Family history of addiction, which may be linked to various genetic aspects.
• Age. While young adults are generally more likely to experiment, figures from the Center for Behavioral Health Statistics and Quality show that 12 percent of 18- to 25-year-olds have taken a prescription painkiller for non-medical reasons.
• Mental illness – particularly anxiety, depression or PTSD. Patients living with these conditions may start using these drugs to relieve emotional distress.
• Mood disorder. A 2017 study of chronic pain patients found a large percentage become hooked on prescription painkillers if living with a mood disorder. A 2012 study further found that individuals living with depression and other mood disorders are twice as likely to misuse prescribed opioids.
• You intentionally take a higher dose than the doctor prescribed.
• You take someone else’s pain medication, whether to treat your own pain or to get high.

 
Falsely advertising opioids like Oxycodone and down playing the side effects of these drugs for years have caused millions of patients to get addicted. We believe it’s time to hold the drug companies accountable for their negligent practices.