Heroin and other opioid substance addictions seem to be making a serious bid at creating the downfall of western civilization.
The rate of heroin use has skyrocketed in the United States in recent years, even making inroads in demographics that normally stay away from that kind of stuff – women, the privately insured, and those with higher income.
Why the sudden uptick in popularity of a drug that kills thousands every year by overdose? We’d say “it’s addicting,” but you already know that. The truth is that the use of opioids changes your brain chemistry almost immediately, making it hard to ever get back to normal.
The Pleasure Principle
It’s human nature to seek pleasure and avoid pain. Heroin addiction plays right into that from the first time you take it. When an opiate travels by bloodstream to the brain, it attaches to receptors that trigger the same kind of pleasurable feelings associated with basic life functions like eating and sex.
Do we ever get tired of either of these two activities? For most of us the answer is probably not. You start to see why an opiate like heroin or oxycodone can quickly become a problem.
The Brain Reward System
Let’s talk about the Mesolimbic Reward System (midbrain). This system is the one that, when bathed by an opioid, releases the chemical dopamine that causes the feelings of intense pleasure described in the previous paragraph.
Other areas of the brain record a “snapshot” of the environment that gave rise to the wondrous feeling and remembers it for future reference. This conditioned association knows what persons, places, or things were present when the pleasurable feeling occurred.
In the early stages of heroin addiction, it’s a simple drive to recreate a pleasant experience that compels a person to do almost anything to acquire the drug again.
At some point, though, the compulsion changes to include the concepts of tolerance and dependence.
After Pleasure Comes Tolerance
A heroin addict will soon notice that it takes increasingly higher doses of the drug to achieve the same feeling of pleasure. This is called tolerance.
Since it’s an illegal drug, it becomes obvious the hurdles that have to be cleared on a daily basis just to try and remain functional become formidable. Withdrawal symptoms occur only after a person has developed a tolerance for the drug.
How does tolerance work? Brain cells with opioid receptors become less responsive over time, almost as if they become worn down and need more of the substance than the last time to become stimulated again.
And Then Dependence
As if the pleasure-seeking behavior and tolerance weren’t bad enough, the next stop on the conga line to heroin addiction is called dependence. This occurs when you take enough of the drug over a long enough period of time that permanent changes occur in the brain.
In the case of heroin addiction, dependence occurs in the locus ceruleus. Neurons in this area stimulate breathing, blood pressure, alertness, and other basic life functions. When opioid molecules bind to receptors here, the result is drowsiness, low blood pressure, and slow respiration.
Over time, the receptors learn to adapt to this opioid intoxication by producing more of the chemical needed to maintain stasis. When opioids are withdrawn, excessive amounts of the chemical flood the body, producing jitters, anxiety, muscle cramps, and diarrhea.
This is how a body becomes physically dependent on heroin and other similar opioids.
Transitioning to Heroin Addiction
Moving from dependence to addiction involves more impactful and longer-lasting changes in the structure and function of the brain. There are various scientific models that explain the changes in the brain during addiction and one model suggests that changes take place in the pre-frontal cortex.
These changes correspond with various regions of the brain to compromise the reward and executive systems of the brain. When addiction occurs, the user’s ability to control judgment and impulses is diminished to the point where they cannot restrain their impulses or drug usage behaviors.
Certainly the fear of withdrawal plays a role, but using the drug becomes more important than everything else.
The end of the line in the pleasure-seeking, tolerance, dependence cycle is addiction. By the time a user has progressed to the final stage, they have altered the function of their brain.
To stop using heroin incurs a long line of hideous withdrawal symptoms. To avoid these, the brain prompts a user to do whatever is necessary to keep the drug in the system. WHATEVER is necessary, up to and including theft, assault, lying.
This is the end result of an opioid addiction – a complete rejection of the rules of society in pursuit of that next hit. Life is reduced to where the next hit is coming from and what has to be done to get it.
Originally heroin was created around the turn of the 20th century as a safer, less-addictive opiate alternative that would help addicts kick a morphine or cocaine habit.
A few decades later they realized it was 2 or 3 times more potent than the original problem. By then it was the most widely abused drug in America.
In today’s world, the path to heroin problems is often arrived at via legal prescriptions of opioid painkillers. According to the Centers for Disease Control, 45 percent of heroin addicts also abuse painkillers.
What should create the most concern is that opiate dependency can eventually create permanent brain damage, the kind that greatly diminishes future quality of life.
For those seeking help, it’s important to begin with detox followed by addiction treatment for the safest and most successful recovery path.
Alo House is LegitScript Certified and a Joint Commission Accredited Addiction Treatment Center.
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