Why the human brain loves opioids

For centuries, societies have coveted opioids for the euphoria and the pain relief they provide. In the 1800s, when chemists extracted
morphine from opium poppies, it became the go-to treatment
for the American Civil War. After morphine caused widespread addiction,
drug companies invented what they thought was a “non-addictive” substitute: a cough syrup called heroin. That turned out poorly for the 20th century. Today, prescription opioids, like fentanyl and oxycodone, crowd America’s medicine cabinets and its streets. Opioid overdoses now kill more Americans
every year than car accidents But to understand how we arrived here, you’ll need to venture deep into the mind. Here’s why our brains love opioids. When opioids enter the brain, they land on
tiny docking stations at the ends of your nerves called receptors. Typically, the receptors catch chemical messengers, called neurotransmitters, to activate your nerve cells. Opioid receptors do just the opposite. They stop electric pulses from traveling
through your nerve cells, also known as neurons. This dampening is handy with pain relief. Say you have chronic back pain. Your inflamed muscles are constantly sending pain signals to your brain via neurons in your spine. Opioids quiet those nerves, relieving your pain. Opioids have three major receptors: Mu, Kappa and Delta. But the Mu receptor is the one to remember. The Mu receptor is responsible for
the consequences of almost all opiates. It slows breathing, eliminates pain
and fills the mind with warm euphoria. But too much of this opioid
off-switch becomes addictive. Opioid addiction starts in the midbrain, where Mu-opioid receptors turn off a batch
of nerve cells called GABAergic neurons. GABAergic neurons are themselves
an off-switch for pleasure. They prevent other midbrain neurons from
flooding the brain’s pleasure circuits with another transmitter, dopamine. It was definitely a party at first and
it felt…it was fun, you know. No consequences right away. At one stop along these pleasure circuits,
the nucleus accumbens, the dopamine triggers a surge of happiness that reinforces the idea
that opioid drugs are rewarding. And in our brain’s fear center, the amygdala,
the dopamine relieves anxiety and stress. It’s just an overall sense of well-being. No problems, just warm. Decision-making brain areas become overwhelmed
and cravings set in. All drugs come with a dark side
as they clear the body. This is known as withdrawal. Too much beer causes a hangover the next day. ALL: Cheers Ugh… …what the hell? A cocaine high is followed by a crash. But opioids, especially long-lasting ones
like methadone, don’t change a person’s outward behaviors. You can still drive and go to work. I was a functioning addict. I worked at a real estate company. I was a broker with over 900 agents. However, opioids cause brain circuits to slowly
adopt a new state of normal. Soon, without opioids in the body, addicts feel constantly anxious
and their stress hormones stay elevated. I just remember waking up and everything
was blurry and I felt really bad. Opioids typically trigger constipation and
tweak body temperature. Remove them, and a person with opioid dependence has persistent diarrhea, hot and cold sweats and goosebumps. Some describe opioid withdrawal as
the sickest feeling they’ve ever had, and the desperate hunger for relief drives addiction. I had an Oxycontin in my jeans pocket
and I couldn’t find it and I remember just crawling all around on the ground and I didn’t know what was happening to me. Here’s the dangerous kicker. The potency of opioids diminishes
over time if you abuse them. Eventually, rather than remedy
your chronic back problem, your pain becomes linked with the emotional and physical
toil of opioid withdrawal. It becomes a vicious cycle. Popping more painkillers or injecting heroin more frequently becomes the way to keep
all those bad feelings at bay. Or if you started recreationally, the struggle against withdrawal
becomes all consuming. You keep chasing that high and
you never get that original feeling again. You kind of get immune to it. You’re just maintaining… and then without it, you’re sick.

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