Why the Hell are So Many People Addicted to Opioids?

Over 10,000,000 people in the US are addicted to opioids

If you’re looking for an article explaining how the big pharmaceutical companies created and marketed billions of opioid medications to increase their bottom line, this is not the article to read.

Patrick Radden Keefe at The New Yorker has done a fabulous job of documenting how the Sackler Family (owners of Perdue Pharma, creators of OxyContin™) set in motion a masterplan to manufacture and distribute literally billions of dollars worth of opioid medications by allegedly stating, “OxyContin is virtually non-addictive“. Read – The Family That Built an Empire of Pain

This Article Looks at the Following:

  • Why do some people get addicted, while others seem to have full immunity?
  • Why do some people appear to be more addicted than others?

If you haven’t already read it, take a peek at our article covering the origins of opioids and narcotic addiction titled, Narcotic Addiction – Where it all Started. As it turns out the poppy plant has been a very popular part of both Eastern and Western cultures for thousands of years.

Be it friends or family, we all know people who are addicted to opioids, and many more who aren’t addicted. According to hhs.gov, an estimated 10,000,000 American’s abuse prescription pain killers, and nearly 800,000 people use heroin. However, those numbers may be low, since tracking the use of illicit (street drugs) is difficult to monitor.

That also means that over 321,000,000 people in the United States are not abusing opioids. Considering those stats, it would seem a very small segment of the population gets addicted, but most people do not. Why is this?

Why is that one person can become addicted after just one “hit” of a drug, while others can take it or leave it?

According to public health adviser at the National Institute on Drug Abuse, Maureen Boyle, “Addiction is a combination of your genetics, neurobiology, and how that interacts with psychosocial and social factors.”

This means that addiction acts a lot like heart disease or type 2 diabetes. It can be treated, but if it’s not treated, it can become a chronic disease that lasts year after year.

Dopamine Plays a Huge Role in Addiction
Regardless of who is using a drug, the one thing that they have in common is the way the drug will cause the brain neurotransmitter dopamine to surge. Dopamine is considered the “feel good” chemical in the brain. It’s found in the reward center of the brain, or the survival center that prompts us to drink water, eat, and have sex in order to survive.

The problem is that drugs cause a better dopamine surge than things like food, water, sex, etc. The drugs cause such a “happy frenzy” in the brain, that the brain begins craving that particular drug more than it craves the regular boosting rewards like food. (source: hopetherapyandwellness.com)

Obviously, dopamine is a powerful motivator. One definition of the word euphoria is, “a false sense of well-being”. After all, who doesn’t want to feel well?

Avoiding Pain or Seeking Euphoria?
Years ago I asked my parents why they often had a drink after coming home from work. I remember clearly my father telling me, “It helps me to relax after a long day”. I guess he had a lot of long days since he drank almost every day.

My addiction experience was not at all me seeking to feel euphoria or to “get high”. Rather, I was trying to escape intense emotional pain that came to me after both my mother and brother died suddenly, losing my career almost overnight and the extreme financial pressure that created. I suffered deep emotional pain for almost six years. Opioids provided some relief from that pain and allowed me to work long hours in an attempt to fix my financial issues.

“Opioids were an escape hatch for me. I was having a lot of trouble dealing with life on life’s terms.”

Opioids were an escape hatch for me. I was having a lot of trouble dealing with life on life’s terms. Rarely did I feel any euphoria. I would have welcomed it. Often, I simply felt relief from an overactive brain that was focused solely on all the bad things that had happened in a fairly short period of time, and fear that more bad things were about to happen.

Why Do Some People Appear to Be More Addicted Than Others?

What’s most interesting is “how addicted” some people tend to become. Meaning that some people who become addicted seem hopelessly lost in their addiction, unable to cope with life or function normally without opioids in their system. They are truly “chemically dependent” and their lives tend to fall apart quickly with or without drugs since opioid usage becomes paramount to daily living.

In my case, I was using opioids to cope with life. I eventually got sick of life addicted, not being happy, and needing a solution to living life on life’s terms without taking drugs. It’s been a long, slow road of recovery that began with intensive inpatient treatment, followed by weekly therapy, daily AA meetings, and doing the 12-steps to address my problems and make changes in the way I approach life.

M<y road to recovery began in January 2014, and I can honestly say I’m very much a work in progress. I feel I am very much one of the lucky ones in that my addiction appears to have been more “situational”. I suffered from extreme anxiety and depression which opioids seemed to alleviate – for a while anyway.

I’ve also noticed that people who struggle with alcohol abuse have a very different set of challenges, in that they pass liquor stores constantly, making their drug of choice very readily available.

Other people I’ve met in recovery seem to have very different motivations for abusing drugs and alcohol. Some are situational, but many seem to be more genetic in nature.

Extremely Addicted to Opioids
A good example of extreme addiction is one that I experienced personally with my oldest brother Jeff. Jeff passed away from drug overdose in 2005, leaving behind a wife, two teenage sons and what was at one time a thriving business.

At one point Jeff was taking the equivalent of 25-30 Percocet pills every day. Not only that, but he crushed and snorted all of his pills to make sure he got the full effect, instantly.

Obviously, Jeff had built-up a tolerance to opioids over time, but it’s still interesting to think that that dose would probably kill someone who was not used to taking opioids in large numbers.

How was my brother Jeff able to consume so many opioids and still function? How was it that opioid use and abuse became his primary focus for living life? In Jeff’s last six months of life he made a conscious choice to be a full-time addict, completely letting go of his family and business. He stayed in his apartment, alone watching TV and snorting pills all day every day.

Nothing else mattered to Jeff in the end. Getting enough opioids every day was his only mission in life. He told me so just two weeks before he overdosed and died.

I watched Jeff’s life deteriorate from “normal” to eventually dying from overdose in just two short years.

“Nothing else mattered to Jeff in the end. Getting enough opioids was his only mission in life”

Some People Seem Immune to Opioid Addiction
Then, there’s the other side of the coin. There are people that take a 5mg hydrocodone pill and pass out. They never desire or crave opioids. Many people are given opioids after surgery to help with pain. They take the pills as prescribed (or even less) and never think about them again. Some people even seem to “hate” the feeling opioids give them, so they avoid them like the plague.

The Energy Crisis – I Can, and Will Get Anything Done While Using Opioids

When I was addicted opioids and was taking my daily cocktail of 150mg of oxycodone and 100mg of OxyContin, I had a very interesting side effect that only a fellow opioid addict can understand: Not even once did I ever get tired, sleepy or unable to function. Quite the opposite. I always gained a ton of energy and clarity when taking opioids.

“I always gained a ton of energy and clarity when taking opioids”

I actually got very used to using opioids as a tool for when needing to get long, difficult or even boring tasks completed, knowing they would provide the extra energy and motivation I needed to get them done. I used to be a software engineer and my opioid usage provided the fuel and extreme focus I needed to write and analyze millions of lines of code, as well as making the 10-12 hour days at my computer not only tolerable, but actually enjoyable.

“It was like I was having a party in my head and no longer needed the outside world”

Opioids made everything more enjoyable. Even long, boring visits with family and/or friends were made more enjoyable with opioid usage. It was like I was having a party in my head and no longer needed the outside world.

Heroin Abuse in Vietnam (That Didn’t Continue at Home)

During the Vietnam war it is estimated that 34% of American soldiers used heroin while deployed and that roughly 20% became addicted. Soldiers who were interviewed after returning home claimed that heroin usage in Vietnam lowered the daily stresses of combat and constant threat of death. Heroin was not only readily available in Vietnam, it was also very cheap.

Most interesting is the fact that only 1% of American soldiers who used heroin in Vietnam continued their use after returning home to the United States. (Source: wileyonlinelibrary.com)

How was it that so many people deployed to Vietnam were able to stop using heroin and never pick it up again? (source: jamanetwork)

What’s your experience with opioid addiction? Please share your comments and experience below.

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