OPIOIDS: THE SCIENCE BEHIND THEM
The opioid crisis is a key topic in our nation. The number dying from opioid overdoses equates to about a plane crash each day. Substance abuse in Tennessee alone is estimated to inflict a $2 billion injury in the form of lost wages, productivity and job loss in addition to the cost of health care and treatment.
In January, USA Today noted that 175 people die daily in the U.S. from drug overdoses, the patient load of a Boeing 737. The columnist observed that if America experienced a plane crash daily, air travel would cease until corrective actions were in place.
A class of drugs, the opiates, has become the newest favorite of those with addiction tendencies. We’ve had the cocaine crisis, the crystal methamphetamine crisis and there, sadly, will be another crisis, yet to be named, with another drug.
The opioid crisis, however, exploded with a rise in the prescriptions patients receive following an emergency room visit for a painful injury, after a surgery or, in a vast number of cases, a family member or friend sharing their leftover Oxycontin, Percocet, Lortab or Vicodin, just to name a few pain relievers commonly used.
To appreciate why opioids are so addictive, and deadly when misused, a little science is helpful.
An opioid is a synthetic or manmade derivative of an opiate. The original opiate is opium from the poppy seed. Morphine is a potent pain reliever from which heroin is processed and related. Methadone, Dilaudid and codeine are also synthetic variations that are used as agonists that bind to specific receptors to either excite or inhibit. Other agonists are nicotine, marijuana and hallucinogens like LSD.
These substances are psychoactive and work at receptors in the brain to change perception and behavior. Our bodies naturally produce many of these substances, called neurotransmitters, but not in an adequate amount to address acute or nonstop pain.
To provide effective pain relief, research labs at pharmaceutical companies are attempting to produce a powerful drug that works without the side effects. In the case of opiates, addiction is among the most dangerous side effects as is potential death due to respiratory failure in an overdose. Yes, your breathing is controlled by your brain.
But the opioid class is so very addictive because of the opioids’ impact on increasing dopamine release in the brain. Dopamine is the neurotransmitter involved in the part of the brain that is our reward center that provides pleasure and euphoria in some cases. Not only do these pain relievers address the treatment of pain, but they also alter perception and motivation.
So, the medicines we consume which are psychoactive — that work in the brain — must be studied, researched and monitored, even with a prescription. When misused or abused, our brains actually change and, according to the National Center for Biotechnology, develop abnormalities. Simply, drug abuse produces the presentation of mental illness.
In the state of Tennessee, overdoses due to prescription opioids have significantly dropped while those involving heroin and illegally produced fentanyl smuggled in from other countries have dramatically risen.
Don’t self-medicate or play doctor. All medicines should be used as directed and under a health care provider’s care.