Opioids: Addictive Drugs
It all starts with knee pain, or perhaps a back ache that’s started to affect your daily life. Or it could be reoccurring migraines or the physical effects of anxiety, like a tense jaw. We go to the doctor who prescribes us one of the many opioids typically used for pain control… and everything changes. Opioids are some of the most powerful pain-relieving medications we have, but at the same time they’re also the most addictive.
When we talk about opioids, maybe some names come to mind. Michael Jackson, Prince, and Philip Seymour Hoffman all died from their addictions to tranquilizers and opioids or other substances. One such product is fentanyl, a synthetic opioid analgesic that can only be obtained with a prescription.
“Divinum opus est sedare Dolores (Relieving pain is divine work).”
Celebrity deaths are attention-grabbing, but there’s one objective fact we can’t ignore: these drugs are causing more deaths than drug cartels. We don’t talk about it a lot, but psychiatrist Allen Frances, one of the authors of the DSM-IV, does. Recently, he has been a major critic of the pharmaceutical industry.
Opioids are the most commonly prescribed drugs for pain relief, but the problem is that the price we pay for relief is too high. Moreover, we often do it blindly, not fully understanding their long-term consequences.
Opioids, extremely addictive medication
Opioids are, at first, positive for our brains. Why? Because they mimic the activity of endorphins, producing feelings of pleasure and dulling pain. Therefore, these medications are very useful during surgery, for acute and persistent pain, or for improving the quality of life for cancer patients.
“The priority of any addict is to anaesthetize the pain of living to ease the passage of day with some purchased relief.”
In addition, it’s important to differentiate between opiates and opioids. On the one hand, “opiates” refers to substances extracted directly from the opium plant, such as morphine. On the other hand, “opioids” refers to all synthetic or semi-synthetic products with the same effects as natural opiates.
How do they act?
While some opioids act immediately, others must be taken repeatedly to work. It doesn’t matter whether we feel pain at the moment we take the drug; it prevents and regulates the appearance of pain. All of this happens via a sophisticated mechanism in our brain. It works like this:
- First of all, these drugs reach our body and bind with specific opioid receptors (μ, κ, and δ) of the nervous system and other tissues.
- These receptors are related to the Gi/o protein. Then, the protein acts by inhibiting the action of adenylate cyclase, opening potassium channels and closing the presynaptic calcium receptors. This reduces neuronal excitability and, consequently, any type of pain.
The action of opioids usually lasts, on average, between 3 and 4 hours. However, synthetics can last much longer. These drugs create a sense of peaceful relaxation, a drastic reduction in anxiety, and often a pleasant feeling of happiness.
Despite these positive aspects, the effects are short, limited, and costly. The price: our physical and mental health. Basically, when the flood of chemicals produced by the drug disappears, our brain enters “panic” mode.” Then, if a person has taken them for a longer period of time, they will have developed a tolerance and therefore will soon experience withdrawal.
Effects of opioids in our body
The effects of opiates and opioids vary depending on how long the person has been taking them. However, we can break it down into the following stages:
Firstly, the initial phase
- Overheating of the skin
- Dry mouth
- Heaviness in the extremities
- Nausea, itching
Then after 3-5 hours
- Miosis: contraction of the pupil
- Small visual hallucinations
- Difficulty concentrating
Finally, the long-term effects
- Digestive disorders: lack of appetite, chronic constipation
- Cardiovascular alterations
- Arthritis and other rheumatic problems
- Serious disorders of memory, attention and loss of motivation
- Hallucinations, sudden changes of mood, depression, anxiety, insomnia
- Venous inflammation
- Infections of the skin and white tissues
- Liver diseases
- Respiratory diseases
The need to regulate the administration of opioids
Hippocrates defined opiates under the slogan “Divinum opus est sedare Dolores” (relieving pain is divine work). But in this case we have to disagree with the wise doctor, remembering once again that relieving pain is the work of doctors and not gods. Our responsibility is to use these substances well.
In fact, one third of those who use opioids for a month become tolerant and then become addicted to it. It is also known that, since 1999 sales of opiates have quadrupled worldwide.
The pharmaceutical industry deals in physical and mental pain. Therefore, more than just individual awareness is needed. We also need adequate regulatory strategies from governments, state agencies, and medical centers.
Jesús Florez (2008) “Farmacología humana” Barcelona: Masson