Learn About Addiction
Getting a fix. Chasing the dragon. These are just some of the street terms for using heroin, but they illustrate a thought process that perfectly describes what it means to struggle with addiction. The drugs become your singular focus. Research also shows that 1 in 4 people who try heroin become addicted.
So why is it that opioid addiction — or as it’s more appropriately referred to, opioid use disorder — becomes so all-consuming? We reached out to Dr. Caleb Banta-Green, principal research scientist with the University of Washington’s Alcohol and Drug Abuse Institute, to help us unpack a little more about the science of addiction.
Opioids & Your Brain
It took several decades before researchers leaned that opioids caused permanent changes to the brain’s opioid receptors. Your brain becomes hard-wired to seek opioids to maintain its new normal. For some people, this happens in a matter of days.
“Opioid use disorder causes measurable changes in the brain. It’s a real thing that you can see,” says Banta-Green. “It’s a biological condition that’s driving behavior. While it looks like a person making bad choices over and over, it’s really about the brain being hijacked by the drug.”
Prescription opioids release much higher levels of the chemicals than what our bodies naturally produce, so they can overwhelm our system and bind to places they shouldn’t. Binding to some of these other receptors can completely eliminate the sensation of pain, creating drowsiness, mental confusion, and nausea, as well as euphoria.
Naloxone, also known as Narcan, is the life-saving drug that can reverse an overdose. It is not addictive, nor can it cause harm if administered. Some skeptics believe that naloxone is a crutch that just enables users to keep using. Not so, says Banta-Green.
“Naloxone puts them in sudden, acute withdrawal. This is the last thing they want, and precisely why they use opioids…to avoid withdrawal.” Banta-Green also points to a recent study done at Harborview that showed “no evidence that providing naloxone increases overdose or opioid use risk behaviors.”
Dependence vs. Addiction
A person who uses opioids on a regular basis can develop a tolerance, feeling like they need to take more in order to feel “normal.” Dependence is when a person’s body has begun to develop a tolerance to a drug, and more of that drug is needed to get the same effect. If the drug were to be stopped, the body would begin to go through withdrawal. This can happen even if the drug is taken as directed by a doctor.
Addiction, however, is when an individual becomes physically unable to stop taking a drug even though that drug use is causing negative consequences. It is important to note that opioid addiction is not a moral failing, but a chronic disease. Just as you would do for a heart condition or cancer, finding the right mix of treatment options and services is crucial.
Another similarity to heart conditions or cancer is the random nature of how addiction can happen. For some, there were adverse experiences in child- or adulthood that caused emotional or physical trauma. These events lead to an increased risk of any substance use disorder.
For others, they were born and genetically geared to either like opioids and feel “normal” on them, or they simply don’t. The tricky part is that you won’t know which camp you fit into until you try an opioid for the first time.
Opioid use disorder is 100 percent preventable, but it’s also 100 percent treatable. The first and most effective is medication assisted treatment (MAT) with buprenorphine and methadone. People can be on those medications and in recovery, with an added bonus of reducing death by 50 percent.
“With illicit opioids, you don’t know what you’re getting and they’re short-acting. Your brain and body have been hijacked, and you are in a life that is a physical, mental and emotional roller coaster,” says Banta-Green. “MAT gets you to a steady ground to help get you through the day, rather than looking for a fix every few hours. Medications don’t fix everything, but they’re a big start.”