Humanity’s Relationship with Opiates
For more than 3000 years, humans have had a relationship with opiates. Most of that time we were limited to crude preparations from the opium poppy. That all began to change in 1806 when the active chemical in opium was first isolated. It was named morphine, after Morpheus, the ancient Greeks god of sleep and dreams. That marked the beginning of humanity’s complex pharmacological relationship with opioid compounds. Morphine users soon discovered just how addictive opiates could be. Opioid addiction would finally reach national awareness following The Civil War when thousands of war wounded returned home dependent on morphine and opium derivatives. It would take almost 100 years after The Civil War before the disease concept of addiction was proposed. Dr. William Silkworth of New York’s Towns Hospital first spoke of addiction as a psychological illness in the 1930s. Finally, in 1954, the wider medical community accepted the idea. Ruth Fox, one of the early pioneers of addiction medicine, would go on to form the American Society of Addiction medicine (ASAM).
Understanding Opiate Addiction
Opiates all operate in much the same way. They activate receptors in the brain causing the brain’s “reward system” to flood with dopamine. A healthy brain uses dopamine releases to reinforce positive behaviors, among other things. Sex, a delicious meal or strenuous exercise all produce dopamine, for example. Dopamine brings a sense of well-being and calm, which naturally drives humans to seek activities which release it. Opiate use has a way of ‘short circuiting our normally healthy relationship with this reward system. The drug becomes the priority source of the release of dopamine. This can thoroughly throw the usual set of priorities we have into chaos. Opiate seeking and using behavior is repeatedly reinforced and a pattern quickly develops.
Opiate dependence directly involves the brain’s reward pathways in a way unlike any other category of drug. It causes people to quickly develop deep-seated behavior patterns that can be maddeningly difficult to undo. Believe it or not, semi-synthetic opiates like heroin, were first developed to try and make a less addictive opioid. Modern opiate addiction research has moved us beyond simply trying to treat symptoms into a deeper understanding of addiction and a focus on long-term outcomes. Per the Substance Abuse and Mental Health Services Administration (SAMHSA) more than 2 million Americans are currently grappling with opiate use disorders.
There is good news in the world of treatment for opioid addiction, however. More research has been done in the past decade than in the 50 years before it. These studies are producing positive results. As we better understand the mechanism of opiate addiction, the treatments we develop become more effective. Since the early 2000’s the opioid epidemic has exploded in the U.S. This has driven the demand for effective long-term solutions. Medication Assisted Treatment or MAT has earned widespread acceptance for consistently delivering better outcomes. In fact, the CDC is conducting a long-term study of over 1,000 patients to learn even more about the long-term sobriety for MAT patients.
The aim of MAT along with other aftercare programs is lifetime abstinence. Research shows that longer connections with treatment providers improves outcomes for opioid dependent patients. Aftercare planning and outpatient treatment with or without MAT avoids relapses more effectively than the traditional treatment model where a patient discharges after a few weeks and is told to simply attend meetings on their own. MAT is only one of several answers and it is not intended to continue for a lifetime for most patients. The complex and powerful addictive nature of opiates means that patients must be committed to change to maintain their recovery. There is no single cure for addiction in the form of a pill, no easy answer. The good news is that the treatment field is continually improving. Very promising developments in the treatment of opioid addiction have emerged in recent years. As science learns more about the inner workings of the brain and how genes play a role in addiction, we can expect to see even more effective treatment.
If you or a loved one is living with opiate dependence and you want to make a change, give Blue Hills Health & Wellness a call. We can help 24-hours a day, 7-days a week.