The Substance Abuse and Mental Health Services Administration (SAMHSA) collects this data yearly to look at the number of Americans over the age of 12 misusing prescription medication or illicit drugs. The results are staggering. Prescription and illicit opioid misuse continues to increase despite the growing attention to this public health crisis.
130 Americans die every day from an opioid overdose.
The opioid epidemic costs an estimated $500
11.8 million Americans misused an opioid
Only 1 in 5 Americans received treatment for opioid addiction.
Merriam – Webster defines addiction as:
compulsive need for and use of a habit-forming substance (such as heroin, nicotine or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal;
broadly : persistent compulsive use of a substance known by the user to be harmful.
While the description is correct, it isn’t complete. By that definition addiction seems to be a choice made by the individual. Even with the acknowledgement that the substances are habit-forming and that there are physiological symptoms of withdrawal, the definition lacks an understanding of the true nature of addiction.
Individuals can be addicted to not only substances, but people, activities and things that bring them a feeling of joy or satisfaction. Unfortunately those feelings are often short-lived and more and more of their “drug of choice” is needed to bring about the satisfaction they are seeking. This is the chronic, relapsing nature of the disease of addiction. It is neither a moral failing nor a lack of willpower.
While the physical and psychological aspects of addiction may seem insurmountable, there is hope. Our improving understanding of the complex nature of this disease allows doctors, clinicians, policy makers, insurance companies and others the ability to improve access to evidence-based treatment. Along with improvements to policy and treatment comes much needed social change. As we begin to understand that addiction is not a moral failing or lack of willpower, the disease becomes destigmatized and those struggling can receive the help and support they need.
The physical cycle of addiction and withdrawal is in large part responsible for the chronic, relapsing nature of this disease, but psychological factors must be considered to understand the whole picture. Most individuals who struggle with addiction begin to, at some point, use their drug of choice as the solution to things in life that are difficult to deal with or cause negative emotions. Many individuals struggling with addiction may have begun using drugs in the first place for this very reason.
The feeling of euphoria caused by opioids can lessen or completely remove fear, anxiety, depression, sadness or any other emotions an individual may not be able to handle. This contributes to the psychological cycle of addiction happening alongside the changes in an individual’s brain chemistry. This pattern of events often describes the lives and experiences of those addicted to drugs or alcohol.
While the physical addiction to an opiate is what causes the withdrawal symptoms that make it so difficult to stop, it is not the only reason an individual continues to use a substance they know is harmful. Whether a person was prescribed medication for a health reason, or began using opioids recreationally, there is a psychological component to ongoing use. An individual begins to use in response to negative thoughts, feelings and issues, making the opiate the “solution” rather than the “problem”.
Opioids, and other mind-altering substances, have an immediate impact on an individual’s brain. They cause the release of “feel-good” hormones that give the person a rush of euphoria, and in the case of prescription medications, relief from the pain or anxiety they may be experiencing. As time passes, more of the medication or drug must be taken to attain that feeling. This fact is the beginning of the chemical cycle in the brain which causes physical addiction.
Opioids attach to receptors in the brain that are normally activated by hormones released in response to pain or stress.
These receptors control the body’s response to the opioid including a reduction in pain and feeling of euphoria, as well as constipation, sleepiness and other negative side effects.
The brain begins to adjust to the surges in dopamine caused by the presence of opioids and produces less dopamine naturally.
If opiates are not present, individuals start experiencing withdrawal symptoms. This can happen in just days or weeks of daily opioid use.
Individuals start to need the opioid in order to feel "normal" instead of only to feel "high”.