Opioids: Addictive Drugs

It all starts with knee pain, or maybe back pain that starts to affect your daily life. Or it could be recurring migraines or the physical effects of anxiety, such as a tense jaw. We go to the doctor who prescribes us one of the many opioids typically used for pain relief…and everything changes. Opioids are some of the most powerful pain-relieving drugs we have, but at the same time they are also the most addictive.

When we talk about opioids, a few names may come to mind. Michael Jackson, Prince and Philip Seymour Hoffman all died from addictions to sedatives and opioids or other substances. One such product is, for example, fentanyl, a synthetic opioid that can only be obtained with a doctor’s prescription.

Celebrity deaths get a lot of attention, but there’s one objective fact that we can’t ignore: these drugs cause more deaths than drug cartels. We don’t talk about it often, but psychiatrist Allen Frances, one of the authors of the DSM-IV, does. Lately, he has become 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 so blindly and do not fully understand what the long-term consequences will be.

Opioids, highly addictive drugs

Opioids are initially positive for our brains. Why? Because they mimic the activity of endorphins, arousing feelings of pleasure and numbing pain. Therefore, these drugs are very useful during surgery, for acute and persistent pain, or for improving the quality of life of cancer patients.

In addition, it is important to distinguish between opiates and opioids. On the one hand, “opiates” are substances extracted directly from the opium plant, such as morphine. On the other hand, “opioids” are any synthetic or semi-synthetic products with the same effect as natural opiates.

How do they work?

While some opioids work immediately, others must be taken repeatedly to work. It doesn’t matter if we feel pain when we take the drug; it prevents and regulates the appearance of pain. All this happens via a sophisticated mechanism in our brains. It goes like this:

• First, these drugs reach our bodies and make contact with the specific opioid receptors (μ, κ, and ) of the nervous system and other tissues.
• These receptors are related to the Gi/o protein. The protein then works by inhibiting the action of cyclic adenosine monophosphate, opening potassium channels and closing presynaptic calcium receptors. This reduces neuronal excitability and thus any kind of pain.

The effect of opioids lasts on average between three and four hours. However, synthetics can last much longer. These drugs create a sense of peaceful relaxation, a drastic reduction in anxiety, and often a pleasant sense of happiness.

Despite these positive aspects, the effects are short, limited and expensive. The prize: our physical and mental health. When the flow of chemicals provided by the drug disappears, our brains basically panic.  If a person takes these drugs for an extended period of time, he or she also develops a tolerance and therefore will quickly experience withdrawal symptoms.

Effects of opioids on our bodies

The effects of opiates and opioids vary depending on how long the person has taken them. However, we can break it down into the following stages:

First of all, the initial phase:

• Skin overheating
• Dry mouth
• Heaviness in the limbs
• Nausea
• Itch

Then after three to five hours:

• dullness
• Niose: contraction of the pupils
• Constipation
• Confusion
• Minor visual hallucinations
• Dizziness
• Difficulty concentrating
• Apathy

Finally, the long-term effects:

• Digestive Disorders: Loss of Appetite, Chronic Constipation
• Changes related to the heart
• Arthritis and other rheumatic problems
• Severe memory, attention and motivation disorders
• Hallucinations
• Sudden mood swings
• Depression
• Fear
• 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, realizing again that relieving pain is the work of doctors and not gods. It is our responsibility to use these substances properly.

In fact, one third of people who take opioids for a month become tolerant to them and then become addicted to them. It is also known that worldwide opiate sales have quadrupled since 1999.

The pharmaceutical industry deals with physical and mental pain. Therefore, more is needed than just individual awareness. We also need adequate regulatory strategies from governments, state agencies and medical centers.

Bibliography

Jesús Florez (2008) “Farmacologia humana” Barcelona: Masson