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Opioids are a class of drug that is either derived from the opium poppy plant or is made in a lab to mimic the poppy plant. They directly affect the brain and spinal cord and provide pain relief and feelings of euphoria.
Opioids are used to reduce pain, especially in chronic medical conditions or right after an injury or surgery. They reduce pain by binding to opioid receptors on nerve cells in the brain and blocking pain signals that are sent to the brain from the rest of the body. Though reducing pain is good, there are many side effects of this drug class that make it dangerous and very addictive.
Dopamine
Dopamine is a chemical messenger that is responsible for the body’s reward system. It is responsible for letting your body know what actions are beneficial to you like eating, sleeping, and relationships that positively impact you and your life.
When your brain knows or thinks that something or someone is good for you thanks to dopamine, it will make you want to participate in that behavior again.
Opioids trigger the brain to release about twice as much dopamine into the body as a regular activity, such as eating, does. This is a major aspect of why opioids are so addictive. The excess dopamine released by opioids makes the brain feel that taking the drug is more important and rewarding than other behaviors necessary to our survival and wellbeing.
These increased levels of dopamine also make the user feel excessively happy, an effect also known as euphoria (3), leaving the user craving that feeling once the drug’s effect wears off. Euphoria combined with the major impact opioids have on the brain’s reward system makes the user feel overwhelmingly positive about the act of continuing to take the drug. This mindset and feeling does not at all fade easily and can quickly lead people into addiction, or in other words, to develop an opioid use disorder (OUD).
Tolerance and dependence
As the body experiences the increased amounts of dopamine released by the drug, it stops releasing natural dopamine to compensate. This is called tolerance, as the brain and body are no longer as responsive to the drug’s effects. As a result, users or those with OUD may not feel as happy as they normally would in everyday life without opioids.
This is dependency, as the user’s brain begins to depend on the drug to supply the dopamine it has stopped creating itself. As a user’s tolerance increases, so does their dependence. Their body will feel the need to take more of the drug in order to achieve the effects it gave them when they first started taking it, or even to feel normal throughout the day. This is a very dangerous thing, as any awareness one might have that they are taking more of the drug is overshadowed by the need they feel to extract the feel-good or pain-relieving effects of the drug. This makes it much easier to overdose.
Death by opioids
Opioids interact with neurons in the brain that produce a chemical called noradrenaline (NA). Noradrenaline is responsible for stimulating wakefulness, breathing, blood pressure, and more. Opioids suppress the release of NA, which makes users feel drowsy, breathe slower, and lowers their blood pressure.
Taking too much of an opioid strengthens these effects to a point where they are deadly. For example, slowing breathing to the point that it stops and decreasing blood pressure to fatal levels.
Each aspect of what makes opioids so addictive is doubly what makes them so deadly. While dopamine creates an extremely hard to resist need for the drug, tolerance and dependence only drive that need for the drug up even more. All the while these three aspects of addiction numb the user to the idea of danger typically presented by opioid overdose.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
