A break down of Opiate abuse
(Read Part I of Tolerance, Tissue Dependence, and Withdrawal from Opiates)
The desire for relief from pain and the experiencing of pleasure combined with tolerance, tissue dependence, and withdrawal are the main reasons for the the addictive nature of opioids. Tolerance occurs when the body tries to neutralize the opiate, or any other psychoactive drug, by a variety of methods. It may speed up the metabolism, particularly in the liver. It may desensitize the nerve cells to the psychoactive drug’s effect. It may excrete the drug more rapidly out of the body through urine, feces, or sweat. Or, it may alter the brain and body chemistry to compensate for the effects of the drug.
The body’s adjustment requires the user to increase dosage if to achieve the same desired effect. Since tolerance occurs rapidly with opioids, users might require ten times as much of the drug in as little as ten days to achieve the same effect. There is almost no limit to the development of opioid tolerance. After a year of opioid use one terminal cancer patient was using 5 fentanyl patches, 20 Demerol tablets, and continuous morphine suppositories. The limitless tolerance compares to a drug such as nicotine where three packs a day are usually the limit.
Tolerance develops at different rates for different individual body systems. High tolerance will develop for the opioid effects on pain relief, respiratory depression, sedation, vomiting, and euphoria. However, there is little tolerance for constriction of pupils or for constipation.
Tissue Dependence
The adaptation of the body to the effects of a strong opioid will temporarily and sometimes permanently alter brain chemistry. An animal study by Dr. Eric Nestler from Yale University showed that chronic administration of morphine to rats actually reduced the size of dopamine-producing cells by 25%. This means that when chronic opiate use is stopped, the body has less ability to produce its own dopamine and therefore less ability to feel elated or even feel normal pleasure. This dopamine depletion intensifies the desire to use the drug again, or relapse.
This and many other changes in body chemistry result in tissue or physical dependence since the body relies on the drug to feel normal. Researchers also found that animals that became physically dependent, then were withdrawn from the drug, and then were readministered the drug would redevelop tissue dependence more rapidly.
-Charlie Graham
Charlie Graham is the Director of the Celebrate Recovery Program at Sober Living by the Sea and The Landing Treatment Center for Men.
[...] READ PART II of Tolerance, Tissue Dependence, and Withdrawal from Opiates [...]