A Closer Look into the Effects of Opioids

By: Francesca Cocchiarale

Edited by: Brendan Walsh

The opioid epidemic has been a huge topic in both healthcare fields and American politics over the past two to three decades. Not only have opioids caused a shocking number of deaths in the United States, but they have also imposed deeper problems within the ethics of prescription drugs and the economic reasoning behind the administration of medicine. The exponential increase in the use of opioids started in the mid 1990s, when the American Pain Society announced that pain was to be considered a 5th vital sign when evaluating patient information and symptoms (the four original vital signs were pulse rate, temperature, respiration rate, and blood pressure, and still are established as this today). The medical community responded to this established rule by attempting to eliminate pain through increased use of prescription drugs. This eventually led to the over-prescription of drugs that were meant to relieve chronic pain symptoms related to injuries, chronic illnesses, and post-surgeries. Not enough research or accountability was applied to the use of opioids when they first started being prescribed at such high rates in the 1990s when the medical community was not aware of the future of addiction and the harm that opioids would cause. Now, parts of America are left in an opioid crisis. About 115 Americans die each day because of opioid overdose, and prescriptions have become more attainable due to the over-prescription of painkillers by medical professionals. Specifically, women are more likely to report feelings of chronic or acute pain, leading to a higher rate of prescription towards women than men, making them more at risk for addiction and eventual overdose.

Personally, I have seen the effects of the opioid epidemic in places like Southeastern Ohio, where people are struggling to keep themselves afloat after getting involved in the use of opioids, illegally or through a prescription. Even if your life is not affected by opioid addiction, it is important to know the scientific basis of why opioids are used to help pain and how they lead to addiction so quickly in some circumstances. Here, I will discuss the basics of opioids. 

The Definition of Opioids and How Addiction Occurs 

Opioids are drugs that attach to receptors within brain cells after flowing through the bloodstream; binding to these receptors causes a lowered perception of pain and a heightened reaction involving reward systems. All medications and drugs that are categorized under opioids interact with opioid receptors within our bodies. Essentially, the activation of opioid receptors decreases the amount of pain initially being felt, and the ability of pain transmission throughout the body to be recognized. Opioids also result in a huge increase in the release of dopamine, which can boost feelings of pleasure. Lower doses, and infrequent use, of a prescription drug identified as an opioid causes a person to feel an altered state of consciousness and experience analgesia, which is the alleviation of some pain. High and frequent doses of opioids cause severe constipation and respiratory depression, where breathing becomes almost impossible to accomplish. Most people that overdose from opioids experience respiratory failure as well as other symptoms that negatively affect basic processes within the body.

Addiction, in general, is characterized by an inability to stop taking a drug because of its psychological, biological, and emotional effects on the brain and the body. For opioids specifically, the body becomes accustomed to large dopamine increases and the other effects of these drugs, leading to tolerance. Tolerance is when a person becomes so accustomed to a drug their body no longer reacts to the same amount they have been taking. This leads to higher doses and more frequent use to give the same numbing and calming effect that the person originally felt. This can then lead to addiction, since the biological structure of the brain and the body has changed for the use of this drug, and the person requires the drug to feel normal again.

Treatments Currently Available

The United States healthcare system has been largely impacted by the number of deaths stemming from opioid use and abuse, and this has led to research and facilities geared towards finding treatments for those who are exposed to opioids. Here are some treatments, both prescription-based and facility-based, that are currently approved for those who are struggling with opioid addiction.

  • Opioid Agonists: Methadone and Buprenorphine. Opioid agonists are drugs that bind to the opioid receptor (just like regular opioids do) and activate the receptor without giving the adverse effects that the opioid drug itself can give, such as respiratory failure. Usually, when a person is addicted to a drug, taking that drug away completely as a treatment method causes horrible withdrawal symptoms, but these drugs allow the patient to be weaned off slowly and safely. Both of these prescriptions are approved by physicians, and they allow patients to experience a safe and “controlled” opioid dosage, eventually leading to better health.
  • Opioid Antagonists: Naloxone and Naltrexone. Opioid antagonists are drugs that bind to the opioid receptor and essentially act as a blocker and a non-activator, where the opioid receptor does not have the ability to bind. Though these bind to the receptor, they do not produce the same drug effects that opioid agonists do, giving a different response.
  • Treatment Centers for Addiction. Treatment centers, which are located all across the country, provide a safe haven for those who need to “start anew” and approach behaviors within their life differently. Centers geared towards treatment of alcohol and drug dependence/addiction allow patients to stay in facilities with others that have a history of addiction, where medical treatments and behavioral therapies are applied over an extended period of time. This choice is known to be expensive and some might not accept various insurance options. This is something to keep in mind when seeking treatment whether it be for you or a loved one. Because there are a multitude of facilities across different parts of the country, there are a variety of options to choose from when searching for facilities, and this can allow individualized preferences to be met.

Drug addiction, especially opioid and opiate addiction, is something that should be taken seriously since it has destroyed thousands of lives over the past couple of decades. The most important way to combat this epidemic is being educated and aware of how drugs work in a scientific and emotional sense, making it more possible to spot addiction in a loved one or a friend.

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