Opioid dependence is a disease that affects nearly 2.5 million people in the United States aged 12 years or older according to a national survey conducted in 2006. Often times, these people begin using opioid drugs to combat pain, be it physical or psychological. As a result of numerous interviews conducted through scientific studies and due to my own personal experiences, it can be assumed that these individuals believe that they function better in the world while under the influence of opioid drugs than they do in their sober state. Most opioid addicts self-medicate to eradicate feelings of depression, anxiety, or hopelessness. However, they often end up creating a dilemma larger than the one they used drugs to mask in the first place.
Addiction most often begins with a psychological abnormality in the brain, also commonly referred to as a chemical imbalance. Individuals who suffer from such brain dysfunctions seek to self-medicate in an attempt to correct this improper balance of chemicals and neurotransmitters. Unfortunately, the substances these people turn to because of the relief they provide are only a temporary fix and often lead to an eventual physical or psychological dependence in the brain.
Dependence, a condition whereby an individual must continuously ingest an external substance in order to avoid painful withdrawal symptoms, is quite distinguishable from addiction. While both conditions include the compulsive intake of a drug to avoid an abstinence syndrome (withdrawal), addiction has the added characteristic of continued behavior despite negative consequences. It can therefore be assumed that people who become habituated to prescribed opioid pain-relievers, are not necessarily addicted to them until the quality of their lives begins to deteriorate as a result of drug abuse. For instance, suffering relationships with loved ones, job loss, extreme financial distress, or criminal activity such as theft or even burglary are all indicators of addiction.
In recent years, scientists have become more and more convinced that people who exhibit opiate dependence and addiction may have an underdeveloped endorphin system in their brain, a condition now commonly referred to as “Endorphin Deficiency Syndrome” (EDS). Whether these individuals were genetically predisposed to this syndrome or whether it was developed through environmental factors is irrelevant. It remains clear that scientific data and evidence now points to the fact that opiate addicts often acquire their addiction as a result of this sort of brain dysfunction.
This is how it works. When a person begins taking opioid drugs of any kind, be it street heroin or prescription painkillers, he or she may find its effects pleasant and euphoric. People who are endorphin deficient are much more likely to enjoy the effects of opioid drugs than people who are not endorphin deficient. This is because the opioid is already acting like a replacement medication in the person with “EDS” by substituting the normal production of endorphins with opioids, which act in much of the same way and bind to the same receptor sites. The person may say he or she finally feels at peace, is able to fully express him or herself, and has a level of motivation never experienced before. This is due to the fact that endorphins, as well as their external relatives, opioids, activate areas of the brain that mediate feelings of pleasure, pain and motivation levels, in addition to many other brain functions.
The individual now knows how to achieve these pleasant effects and continues to ingest opioids in order to feel this euphoria (which to many others may simply feel like being “normal”). The brain now recognizes that an exogenous chemical which binds to its opioid receptor sites is consistently on-board. Thus, it begins to slow its production of natural endorphins, in whatever amount the individual’s brain produced before. This is because it now realizes that the person no longer requires production of the endogenous chemical, in the amount synthesized prior to repeated intake of the opioid drug, in order to perform the mechanisms endorphins normally regulate. The more opioids the person ingests, whether it be via intravenous injection, insufflation, or simple oral ingestion, the more inhibited endorphin production will be until it ceases altogether. It could now be said that the person is dependent on the drug as he or she now needs it to function normally.
The abstinence syndrome, or withdrawal, comes about when the dependent person, for any reason, discontinues his or her opioid intake for a period of time. Since the individual’s brain no longer synthesizes endorphins in sufficient quantity, he or she suffers from improperly regulated mechanisms normally controlled by endorphin production, but which have now been controlled by exogenous opioids, which are also no longer present. It takes the brain some time to heal its endogenous endorphin system enough so that sufficient endorphin chemicals are synthesized. During this transitional period, the dependent person undergoes painful withdrawal symptoms including, but not limited to, yawning, watery eyes, sneezing, dilated pupils, exhaustion, restlessness, alternating chills and hot flashes, sweating, diarrhea, nausea, intensified gag reflex and vomiting, all of which are properly regulated in non-opioid dependent people.