Researchers have to understand why opioid dependence is so deadly to help in solving the epidemic they cause. According to the latest Diagnostic and Statistical Manual of Mental Disorders, there are two recognized addiction types. These are substance use and gambling disorders. When addictive substances are lumped together into a single category, it means they affect similar brain pathways. However, this could be wrong.
This manual highlights 11 different diagnostic substance use disorder criteria. This list includes a strong substance craving or the inability to cut down or stop using it. Proper diagnosis should involve meeting two or even more of these criteria. People are addicted in hundreds of ways, according to Aldo Badiani, a University of Sussex in Brighton, UK researcher. Therefore, reasoning that all combinations of addiction have the same mechanisms might not be true.
People call addiction hotline numbers at AddictionResource.com with different problems relating to drug use. Unified drug addiction theories assume that all substance use disorders involve similar brain circuits. But, researchers have conducted studies over the last decades and countered this narrative. For instance, these studies have suggested that nicotine and alcohol addictions should not be lumped together. Nicotine and cocaine or cannabis should also not be lumped together.
Additionally, addiction to any of these substances shouldn’t be lumped together with opioid drug addiction. Scientists should understand why opioids grasp the body and brain so uniquely to explain how the hold can be released.
The Biology of Opioid
Just like other substances with addictive properties, opioids hijack the Mesolimbic pathway or the reward pathway of the brain while impairing decision making. However, unlike the other addictive substances, opioids like morphine target a certain category of a cell-surface receptor that has higher specificity. The spinal cord and brain have the µ-opioid receptors targeted by opioids. However, these receptors are also found in the gut. That’s why some opioids induce constipation.
What’s differentiates opioids from other drugs is their ability to make their users develop a physical dependency. Their withdrawal is terrible and intense to a level of promoting their continued use, says Ellen Unterwald, a pharmacologist. Ellen is a substance abuse researcher at Lewis Katz School of Medicine at Temple University in Philadelphia, Pennsylvania.
After using opioids for a few weeks, withdrawal symptoms start to hit the users eight hours after getting the last dose. This is something unique to this category of drugs. A person dependent on opioids, therefore, must take the substances several times every day to feel normal. Otherwise, they experience withdrawal symptoms. These symptoms can include nausea, intense diarrhea, muscle pain, and vomiting.
The other addictive substances don’t take hold of their users with this ferocity. Even with the subsiding physical symptoms, the user has to deal with long-term changes in the brain. Similar changes are also caused by other addictive substances and are responsible for anxiety, depression, and anhedonia. These symptoms are the major reason why people rehab numbers seeking emergency assistance.
The fact that opioids are more addictive is not what makes them dangerous. According to researchers, opioids are more deadly. That’s because the body has different concentrations and classes of the µ-opioid receptor. And, every part of the body with µ-opioid develops tolerance at its pace.
According to Hamid Akbrali, a pharmacologist at the Commonwealth University in Richmond, Virginia, tolerance is not bad. What’s problematic is developing tolerance to various opioids effects at varying rates. The user develops tolerance to the euphoric and pain-relieving effects faster than they do to respiratory depression.
In most cases, cocaine-related death occurs in individuals that have not used it for some time and start taking it at their usual dose. Since they have lost tolerance for cocaine, the dose they were previously comfortable with can have fatal results. Opioids, on the other hand, can cause death if the reward pathway of the user becomes more tolerant and demand more of the addictive substance than the respiratory pathway is capable of coping up with. This slows down the heart and breathing leading to their eventual stopping.
But, the mismatch of tolerance is poorly understood. Akbarali has some work that implicates bacteria in the gut, called the gut microbiota. He says that these bacteria are changed by chronic opioids. The epithelial barrier is broken down by the drugs. The cells of this layer line the human digestive tract. When this layer degrades, the bacteria relocate to the gut wall. This increases inflammation leading to increased opioids tolerance. When this happens, a person should call rehab to seek assistance.
Research has shown that opioid tolerance can be negated by the removal of gut bacteria. This, in turn, decreases the reward-seeking behavior. According to research, this happens because of the communication between gut microbes and the brain that affects behavior. And because there are crowds of opioid receptors in the gut, both withdrawal and drug use have severe symptoms.
Behavior and the Human Brain
Opioids addiction involves dozens of neural networks in different brain locations. Connectivity or interactions of these regions can be used in predicting how a person will respond to drugs and treatment. Researchers have established that interaction patterns can be used to accurately predict individuals that will take opioids or cocaine during treatment. Additionally, opioids patterns and specific regions of the brain differ from those involved in cocaine treatment. Therefore, identifying these connections can potentially help with the identification of treatment targets. The connections can be used to determine the right treatment for people that call drug addiction hotline numbers and describe their substance use problems. These are the findings that researchers are now capitalizing on in their search for potential interventions.
Since the environment affects behavior and response to drugs, researchers are developing an application to encourage users with cravings to change it. The app enables them to change the environment in a way that reduces the desire to use addictive substances.
In conclusion, researchers note that 80% of the people with opioid addiction relapse within a year. That means the current opioid addiction treatment methods are not doing good. As such, improvement is required. More targeted, better approaches based on the comprehension of opioid addiction neurobiology are required. Embracing such approaches is the only way to reduce the number of people that call addiction help hotline numbers seeking immediate assistance.