Fairytales are full of stories of princesses and princes who were given a magical substance that changed how they looked, how they felt and what they were able to do. As the fairytale story progresses, however, the cost of this transformation becomes more and more clear and stark. Sometimes, the princess is even asked to choose between her life and her access to the substance.
People addicted to opiates may understand these stories all too well. At the beginning of their addictions, the opiates provided the promise of a pain-free, happy sensation that could last for hours. At the end of their addictions, they endured chemical changes that made them incapable of making good decisions, resisting temptation and stopping their abuse. It’s a high price to pay.
Heroin is the most well known of all opiates. It’s often sold as a sticky brown substance that is typically heated up and injected directly into the bloodstream. According to an article published by the National Institute on Drug Abuse (NIDA), heroin is considered “highly addictive,” as it rapidly enters the system and goes to work. Drugs that work quickly and bring big results tend to be more addictive than drugs that come on slowly and produce mild or moderate results.
- A rush of euphoria
- A sweeping sense of relaxation
- Flushing of the skin
- Heaviness in the hands and feet
This euphoric feeling often drives the heroin addiction, as it’s quite difficult to experience a burst of happiness with this intensity outside the drug-using arena. This is the lure used to set the addiction. The relaxed feeling may also be beneficial, especially for people who consistently feel wound-up or on edge when they’re not using drugs.
People who take in prescription painkiller medications like Vicodin also feel a rush of euphoria followed by a feeling of relaxation, and that feeling can be intensified if the user crushes and snorts the pills, instead of taking them orally. By crushing the pills, the user allows all of the drug to hit the system at the same time. Some medications contain time-release elements that allow them to dissolve slowly in the user’s system, so drugs trickle in at a low dose over a long period of time. Users who crush pills get around this time-release element altogether. Prescription painkillers like this are technically not considered “opiates,” as they’re not derived from poppy plants. Instead, these are drugs created in a laboratory that can mimic the action of the natural opiates. To most addiction experts, the distinction is a bit of a technicality. Since opiates and opioids work on the body in much the same way, it matters not whether they’re created in a poppy field or on a laboratory workbench. The results are the same.
According to an article published by the National Institutes of Health, 2.2 million Americans 12 and older used prescription painkillers like Vicodin for nonmedical purposes in 2005. This means that more people are abusing prescription painkillers than are abusing heroin. It could be that people don’t consider prescription medications dangerous, as they’re not buying the drugs from dealers or injecting them into their veins. A pill just seems harmless. It could also be that the popularity of prescription medications with addicts is due to the fact that the drugs are incredibly easy to find, and inexpensive to obtain. In fact, according to an article published by The Partnership at Drugfree.org, 85.2 percent of people surveyed who admitted to opioid abuse got the drugs for free from a friend or family member. The drugs were also given willingly, meaning that no theft occurred. The drugs were just handed out like gifts. Drugs that are available, inexpensive and seem safe have all of the elements required for an addiction.
Some people are able to take in heroin or prescription medications just once, and they may never develop addictions as a result. Other people aren’t so lucky. Scientists have long wondered what separates the two groups, and research on this is ongoing. One study in the Journal of Addiction Medicine found that people who were addicted to opiates tended to perform worse on tests of anxiety than people who did not take drugs. It could be that nervousness lies behind an addiction. It’s also commonly believed that addictive tendencies tend to run in families. In other words, it could be that there is an addictive gene coded somewhere in the DNA, and if someone turns that gene on by taking in a drug, addiction soon follows. More research is being done in this arena. One thing is clear, however: Opiates do have the capacity to cause an addiction in almost anyone, and as the addiction takes hold, changes in the brain make that addiction stronger and stronger.
The Science of Opiate Addiction
The brain uses chemicals to pass information from cell to cell. These chemicals are called neurotransmitters, and they’re passed from a transporter in one cell to a receiver in another cell. All drugs work by disrupting this system in some way. According to the NIDA, opiates work by augmenting the release of one particular neurotransmitter called dopamine. A small signal that would normally use just a tiny amount of dopamine is now using a huge amount of dopamine. It’s a bit like turning up the volume on the radio. A whisper is suddenly converted into an overwhelming scream. A boost of dopamine like this floods the receiving cell with too much information. Dopamine is used by cells that are associated with pleasure and reward. This accounts for the sense of euphoria that opiate addicts feel when they use drugs. As the dopamine floods the body, the user is flooded with happy feelings from the pleasure and reward portions of the brain.
As the user continues to use, the body makes adjustments. In fact, an article from the NIDA suggests that the body actually begins to bury some dopamine receptors inside the cells, so they cannot receive the signals and become flooded. Soon, the person’s chemical makeup is changed. The body is accustomed to a flood of dopamine, and the only real way to get a flood of dopamine is through drug use. If the user stopped taking drugs, the body might not be able to pick up any dopamine that naturally occurs in the system. A fundamental shift has occurred. Using the radio analogy once more, a whisper signal would no longer be heard. The body needs the scream.
In addition, according to an article published in the Journal of Neuroscience, people who abuse opiates develop secondary changes in the way their bodies respond to stress. When long-time addicts are exposed to a minor stress, such as a tiny shock on the foot, their brains respond by asking for drugs. They experience a surge of cravings when they’re exposed to any sort of stress.
These biological fundamentals could help to explain why opiate addicts continue to use the drugs even though they know that the drugs aren’t really beneficial. Their bodies simply believe, on a cellular level, that the drugs are helpful and necessary, and they send out signals that override the conscious mind.
Risks of Abuse
People who abuse heroin or prescription drugs face serious consequences as a result of their addictions. For example, heroin is illegal in the United States, and using a prescription medication without a prescription is also illegal. Addicts could face serious law enforcement action as they continue to use drugs and break the law. A conviction for possession could keep these people out of the employment market for years.
- Collapsed veins
- Infections underneath the skin
- Pockets of infection in the heart and lungs
- Infection with HIV/AIDS or hepatitis B
Heroin abusers are also at high risk for overdose. Since the drug is only provided on the black market, it’s not tested for strength or purity, so it can be difficult for the buyer to know just how strong the drug is before it’s used. Sometimes the user might buy a batch of heroin that is much more pure or much stronger than the heroin user is accustomed to, and respiratory failure could quickly follow. In addition, some dealers add other drugs to their heroin, and those additional drugs could combine with the heroin and also cause respiratory failure.
People who abuse prescription medications aren’t immune from this overdose risk. According to the Mayo Clinic, prescription painkillers can cause a slow heartbeat and slowed respiration. It’s possible that an addict could take too many medications and seem to be asleep, when in fact, the addict is slowly dying. People who crush prescription medications and snort them are at higher risk of overdose, as they’re taking in all of the medication in one burst. People who are accustomed to crushing standard painkillers could overdose if they suddenly switch to crushing extended-release tablets. They’ll take in a much higher dose of the drug, even though the pill might not seem any larger.
Addiction is also isolating, and it can be incredibly difficult for addicted individuals to maintain their relationships with their loved ones. Their lives may revolve around getting the drug, and this could cause them to lie, steal or hurt others in order to feed their addictions. They may choose to spend time alone, using their drugs, instead of spending time at work or with family members. In short, their lives become defined by and consumed by their drug use. It’s not a pleasant way to live.
Help Is Available
All of this may sound terrifying or depressing, but there is reason to be hopeful. As the science underlying opiate addiction becomes clearer, doctors are developing new and innovative ways to treat the addiction. For example, medications can be used to help mimic the effects of the opiates, keeping the neurotransmitter levels in balance and therefore allowing the addict to feel “normal” even without the presence of drugs. Therapy programs can help addicts retrain their brains to develop good habits that don’t include addiction. Healing is certainly possible.
At Axis, we’ve helped many people recover from addictions to opiates that they once thought were impossible to beat. Please call us today to find out more about our residential programs for opiate addiction and how we can help you or a loved one recover.a