Anatomy Of Addiction: How Heroin And Opioids Hijack The Brain

[Z]

http://www.npr.org/sections/health-shots/2016/01/11/462390288/anatomy-of-addiction-how-heroin-and-opioids-hijack-the-brain


When Jack O'Connor was 19, he was so desperate to beat his addictions to alcohol and opioids that he took a really rash step. He joined the Marines.
"This will fix me," O'Connor thought as he went to boot camp. "It better fix me or I'm screwed." After 13 weeks of sobriety and exercise and discipline, O'Connor completed basic training, but he started using again immediately."Same thing," he says. "Percocet, like, off the street. Pills." Percocet is the brand name for acetaminophen and oxycodone. Oxycodone is a powerful opioid. It's one of the most commonly prescribed painkillers, and is a key factor in one of the country's most pressing public health problems — an opioid addiction epidemic. It is a crisis that started, in part, from the overprescription of painkillers like Percocet, and then shifted to heroin as people addicted to prescription drugs looked for a cheaper high. O'Connor is one of an estimated 2.5 million Americans addicted to opioids and heroin, according to the National Institute on Drug Abuse. Over three years, he detoxed from prescription painkillers — and heroin — more than 20 times. Each time, he started using again. So why is it so hard for opioid addicts to quit? You can boil it down to two crucial bits of science: the powerful nature of opioids and the neuroscience behind how addiction hijacks the brain "The first recording of opioid use was 5,000 years ago," says Dr. Seddon Savage, an addiction and pain specialist at Dartmouth College. It was "a picture of the opium poppy and the words 'the joy plant.' "
[/size]'It Ruined Me That Time. But I Loved It Jack O'Connor says he ended his freshman year of college as an alcoholic. He went home that summer desperate to replace alcohol with something else. And it was not hard to do. In 2012, opioid pain medication prescriptions were written — that's enough painkillers for every American to have a bottle of the pills. O'Connor got his hands on some 30-milligram Percocet.
"I ended up sniffing a whole one, and I blacked out, puking everywhere," says O'Connor. "I don't remember anything. It ruined me that time. But I loved it."Opioids got him higher faster than any drug he had tried. And even though different drugs produce different highs, they all involve the same pathway in the brain. How Opioid Addiction Works Opioids increase the amount of dopamine in a part of the brain called the limbic reward system. Dopamine causes intense feelings of pleasure, which drives users to seek out the drug again and again.

[/size]They trigger the release of dopamine, which is a neurotransmitter that causes intense pleasure in parts of the brain that include the limbic system, according to Savage. It links brain areas that control and regulate emotions such as the pleasures of eating, drinking and sex. "This is a very ancient part of the human brain that's necessary for survival," says Savage. "All drugs that people use to get high tickle this part of the brain."People can become psychologically and physically dependent on opioids very quickly. Breaking the physical dependence involves a several-day nightmare called detox, when the body gets used to being without the drug."It is an amazing thing to see someone basically vibrating in their chair, feeling nauseated, looking like hell," says Jeffrey Ferguson, a detox specialist at Serenity Place in Manchester, N.H.  Jack O'Connor put himself through detox 20 times, but that didn't stop his addiction. O'Connor's limbic reward system had hijacked other systems in his brain — systems that drive judgment, planning and organization — driving them all to seek that pleasure of getting high. This process can go on during years of sobriety, according to Savage.[/size][size=1.7rem]"Addiction recruits memory systems, motivational systems, impairs inhibitory systems and continues to stimulate the drive to use," she says.  O'Connor says all his decisions began to serve his addiction. When he was using, everything was about getting the next drink or drug. Over his years of addiction, O'Connor lied to his family and stole from his job — all while also trying to get sober. A little over a year ago, he put himself through a five-day detox clinic and managed to get through five more days in the real world sober. Then he couldn't take it. One day he started obsessively searching his credit cards for drug residue. He found a bag of heroin in his wallet."Somebody's telling me I need to get high," he thought at the time.And that's what he did.'I Don't Need It Anymore' Feelings like joy and shame also play a role in drug dependence, and make it hard to quit. Practical issues are a challenge, too. "Finding the job, saving money, finding a place to live," says Ferguson. "Maybe they have some felony convictions. It's a lot." And the country is facing a shortage of addiction treatment facilities and specialists; the shortage ranges wildly from one state to another. Treatment for opioid addiction includes a variety of services: medication, talk therapy, job support, all stretched out over years. Detox isn't enough."For people who don't get intensive treatment, people who are just detoxified [from opioids]," says Savage, "relapse rates can be above 90 percent."

O'Connor is now 23 and he's finally sober — Jan. 11 is his one-year sobriety date. In that time he's been in a nonmedical residential treatment program in Dover, N.H., where he lives and works. He has support — a girlfriend, his family, the Marines. And in the same way that he once replaced his coping skills with drugs, he has rebuilt his coping skills around quitting drugs."I don't need it anymore," he says. "I literally, physically and emotionally don't need it." And as much as O'Connor loved the feeling of getting high on heroin, now there is something he loves more: "I love the way I feel sober," he says.[/size]

[Lolleedee]

Percocet 30's?  When I read stuff like that the whole article, even though the rest of it might be good, looses it's credibility. Doesn't anyone fact check anymore??

[Illadelph215]

Great article Z, had a couple interesting links including the one with the Silk Road and history of the plant and trade. I too have thought of joining the service numerous times to escape addiction and thankfully I was denied because of my tattoos. Didn't seem to work for the former user in the article. Very interesting. And as for the Percocet 30s issue, to this day almost everyone I know or have known from Pa to Maryland to Virginia calls them Perc. 30s including me. Weird for sure. But it sticks.

[Guts]

Great article Z, had a couple interesting links including the one with the Silk Road and history of the plant and trade. I too have thought of joining the service numerous times to escape addiction and thankfully I was denied because of my tattoos. Didn't seem to work for the former user in the article. Very interesting. And as for the Percocet 30s issue, to this day almost everyone I know or have known from Pa to Maryland to Virginia calls them Perc. 30s including me. Weird for sure. But it sticks.

You can get denied for too many tattoos? How do they decide what is considered too many? I could maybe understand them denying you if you had like a swastika or something like that but to deny someone for too many is kinda stupid...

[Illadelph215]

Yup it was pretty retarded. It was the Marines specifically though, the Army didn't have a problem with it. The issue was that my one half sleeve came down to far and was noticeable. It isn't porn or racist shit but it is a horror themed sleeve so it isn't fairie's or butterfly's either. I'm not sure if that's still the rule as this was a 4 or 5 years ago and they weren't in a rush for recruits. It was a blessing in disguise though as nothing against the brave who serve as I have many marines on my family but I just don't think it was for me. At least nothing were fighting for now or then anyway.

[Z]

I thought it was interesting and sort of been there done that as well.  The suggestion to join the marines is one I had never heard before.  I think they always wrap the articles in these recovery stories to give it a positive and human feel instead of faceless addicts, but it comes across as a bit repetitive and somehow condescending towards addicts.


I heard the sleeve thing before.  In Canada it is visible tattoos, and it goes with size of tattoo as well I think.  I tried to join when I was 21, but I was turned away for my stretched ears.  At the time I had small geometric tattoos on my lower arms, but it wasn't an issue strangely.  I remember telling the recruiter that if they paid for the surgery I would get it undone, but he seemed pretty disinterested in the whole thing.  pretty strange for the immediately post 9/11 world of 2002, but it is what it is I guess.  It's probably for the best.  My wife had just gotten pregnant and I was recently clean from drugs for a short period of time.  I would have hated myself for leaving my kid(eventually kids), and I couldn't imagine how sleeping in the poppy fields of Afghanistan would have turned out for me.


Sorry about the weird formatting.  My computer crapped all over the copy/paste function today.  Amazingly the comment section in the article is worth a read.  I guess the NPR attracts a better class of commenter than almost anywhere else.

[Illadelph215]

When my buddy came back from afghanistan we had a little welcome home party for him. He had lots of film that he took him his deployment and wanted us to watch it with him. He amount of poppy fields blew my fricken mind. I sware those things went on and on for days. Football fields and football fields filled with it.

[DirtyJerzy]

"The joy plant"..... I like that, simple, to the point, and spot on.

As a side note I think NPR in general attracts a more intelligent bunch with a much broader and rounder world view. I fux with npr, and most everybody else I've met that is an NPR listener, I've gotten along with really well. Less judgmental group as a whole, that's for sure.

That'd be a nice fb page: "junkies for NPR". And not like people who are "npr junkies", but junkies that like to get loaded and listen to npr.

[SPARKSFLY666]

Unrelated, couldn't resist. WAIT WAIT DONT TELL ME. On NPR..  Furtherly unrelated. When I catch myself
Listening to nothing but npr in the truck for days on end, I hear the NOFX lyric "when did punk rock get so safe?" And I laugh at myself. But for real though. NPR for junkies is a nice thought.

[Zoops]

I like having my brain hijacked.

Yeah, they had me interested until the mention of "30mg Percocet" too.

The notion that anyone who uses opiates non-medically needs to be "detoxed" or go to treatment needs to be changed. I use opiates because if I don't I have the urge to drink alcoholically. It's much more beneficial to me to be under the influence of opiates, all that wonderful morphine and codeine in the poppy seeds. A bit of heroin every once in a while will cut it but mention heroin and you're into "bad guy" territory.

This is a funny SNL skit about NPR:

A classic.

[sk8phaze]

Ha! Nailed it Zoops with the SNL clip. Plus I like having my brain hijacked, is it the other way around?