After I published “Could Your Brain Be Wired for Alcoholism?” last month, a number of my followers requested some similar information on how pain meds (opiates) affect the brain. As I was putting that together I realized that with pain meds there are some safety concerns for all. So while this blog post does talk about the science of opiates in the brain, it also raises the question of whether or not these medications are safe for long term pain management.
How Opiate Pain Meds Work
You may be surprised to know that there are already naturally occurring opioids in the body. They are meant to calm the body down, and they manage the reward and pleasure systems of the brain. When you take synthetic opioids (pain meds), they attach to the existing opioid receptors in the body and your reward system feels an extreme rush of something called dopamine. Dopamine stimulates the neurons of your body in a way that creates a very high level of pleasure or excitement. To be specific, it’s the mesolimbic reward system in the brain that produces dopamine and the related feelings of pleasure. This process is what causes your pain to be relieved.
How Does the Brain Become Addicted?
Brains are naturally inclined to learn to repeat actions that stimulate the reward system or provoke feelings of pleasure. Without the interference of synthetic opiates, the actions your brain wants to repeat are common things like eating, sex and other activities you enjoy. However, once you’ve taken opiates for even a short period of time, your brain wants to repeat that activity too.
In short, your brain basically trains itself to be addicted to opiate pain medication and that’s how addiction develops. Repeated use of opiates also makes the receptors in the brain less sensitive to their presence. That means more (a higher dosage) is needed to achieve the same effect, which is how the initial physical dependence begins.
Other factors have been shown to be involved in opioid addiction as well. These include environmental factors, family dynamics and overall mental health. Individual personality factors play a role as well and there is growing evidence indicating that a genetic predisposition exists in opioid abuse like it does in alcoholism. One recent study concluded that about 30% of the causal factors in opioid addiction is related to genetics.
There are things you can do to help prevent opioid abuse in yourself or a loved one. First, take some time to research in more depth the science of opioid addiction and the dangers of these type of medications before deciding to use them. Second, get educated about some alternative methods of managing chronic pain available (see the Where to Get Help section below for some great resources).
Warning Signs of Addiction
The warning signs of opioid addiction include:
Taking medication in a way other than exactly as prescribed (i.e. more frequently than indicated or more than 1 dose at a time)
Frequent periods of extreme euphoria followed by excessive tiredness
Neglecting responsibilities and not functioning well managing life tasks
Unable to control opiate use despite negative consequences
Nausea and vomiting
Lack of motivation
Biologically we may all be ill-equipped to use this medication without risking addiction. The pleasure centers of the brain that are stimulated by the opioids are very strong. Continued use for more than a short period of time seems to trigger a physical craving that is uncontrollable and continued use creates a tolerance requiring more and more of the drug to achieve the desired effects. This may likely be true for everybody.
The magnitude of overdoses and deaths related to pain medication addiction today is staggering. Many communities are declaring it a public health crisis and actively taking steps to stem the tide of this epidemic. I feel there also needs to be more dissemination of accurate information regarding the many aspects of this epidemic, including the safety concerns for opioid use in and of itself.
Medical professionals are becoming savvy about restricting the use of this class of prescription medications for pain management. Some states are passing laws that prohibit physicians prescribing more than several days of opiates for pain management. Armed with the latest information about the dangers of addiction from opiates, we’re seeing a shift away from long-term use of these opiates and finding other ways to manage pain that are not addictive.
Where to Get Help
An excellent resource for opiate free chronic pain relief is local expert Anastasia Bean, LPC, NCC. Ms. Bean specializes in Complex Pain Recovery and offers therapeutic services as well as chronic pain groups and is a wealth of information on other alternatives, too. More information can be found on her practice website Connections Behavioral Health. In addition, you may find assistance through the Chronic Pain Anonymous website.
If you think that you or a loved one may already be experiencing a problem with addiction to pain meds or other substances, please don’t hesitate to contact me at (678) 316-3991 for a free 20-minute consultation. You may also visit my website for more information.