Opioid Euphoria

What do you feel when you take a narcotic/opioid pain pill?

There are usually three reactions people have after having being given them for the first time for pain relief: we are disoriented and uncomfortable, even while our sensation of pain is temporarily deadened; we feel ambivalence combined with gratitude for the pain relief and the willingness to have that relief for the next pain-inducing event; or we feel that we have finally found nirvana.The truth about opioids, pain relief, and addiction has long been unclear and confusing. Sadly, this has been purposefully done by the makers of these drugs with one goal: profits. But these statistics are now becoming well known and will hopefully help reverse the trend of opioid addiction and deaths:

Approximately 25% of people who use an opioid will become addicted after a short period of use, which could be once, 3 days or a week.

The longer you use an opioid, the chances will increase that you will be addicted. This is because almost everyone will build up tolerance to them, which leads to addiction.

Genetics play a very important, but as yet not fully understood, role in what type of reaction each of us have to opioids. What is clear is that those families who have tendencies toward addictions – alcohol, drugs, food, gambling, sex, etc – will be those most likely to be drawn to opioids due to sensing them as pleasurable. There is something in their brain that is wired differently than others.

Our addiction doctor and recovery counselors have explained it to us and this is the essence: There are four areas of the brain that handle the substances and experiences we send it. Very simply put, they are:

Pain center: The PAG, known as the central gray, has cells that produce enkephalin that suppress pain

Emotional center: The amygdala regulates how we process emotions, memories, and rewards

Addiction center: The nuclean accumens, due to neuroplasticity, changes over time and builds up tolerance

Control center: The brain stem, the control center between the brain and the rest of the body, controls basic body functions like breathing, swallowing, heart rate, consciousness, etc.

The first three areas have the ability to build up tolerance, which is what keeps addicts coming back for more – and each time needing more. That is the nature of tolerance. The fourth area, the brain stem, has the least ability to build up tolerance. This is why an overdose – using an amount that is significantly more than what your body has built up a tolerance for – shuts down the respiratory center and you stop breathing.

In our family, and in the families of our son’s friends who are addicts or alcoholics, there are definite genetic predispositions to alcoholism that is traceable back many generations. Other addictions are no so easily identified, but they are there. It is not something anyone initiated or wanted or can change. But what can change is knowing the genetic trait is present and taking preventative steps as early in life as possible.

Talking openly and honestly about our predecessors – and our own – addictions is the first step. Seeking wise informed counsel for what things to avoid, especially while young, may help prevent some of the pitfalls. But for most teens, and especially for those from high risk families, experimentation will be unavoidable. Knowing as soon as possible if your child is moving away from their normal behavior and intervening with proven methods may save them – and you – from the pain that hundreds of thousands parents like my husband and I have now had to live with.

Our Children’s First Opioid Exposure: The Dentist

Dentists are the leading prescribers of opioids for U.S. teens and the largest increase in dental prescriptions from 2010 to 2015 occurred in 11- to 18-year-olds, according to a study published in the Journal of the American Dental Association…For many young patients, this is going to be their first experience with opioids. “The fact that we’re still prescribing opioids when we’ve demonstrated that non steroidal’s are as affective most of the time is a little disturbing,” said Dr. Paul Moore, co-author of the study. (03-27-18, Az Daily Star)

If these statistics are delivering a disturbing jolt to you, as they did to me, read on. The American Dental Association recently published an analysis of five studies in their Journal evidencing that non steroidal anti-inflammatory (NSAID) drugs work just as well – or better – for most dental pain (such as tooth extractions, root canals, implants) as opioids. The ADA announced a new policy that essentially tells dentists to eliminate opioids from their arsenal, if at all possible, while it is also pushing for mandatory education for dentists that encourages using other painkillers. Finally.

Many of us remember having teeth extracted before braces as young teens and also our wisdom teeth when we were young adults. We were sent home with a few pain pills that contained codeine. When I had a root canal a few years ago, the dentist sent me home with a prescription for a huge supply of Vicodin. What on earth was he doing? This same oral surgeon gave our son a 10-day supply of Percocet until his appointment to get his wisdom teeth extracted – and then another 10-day supply (with a refill) after the surgery. Over twenty days of Percocet? Our son then returned to heroin and within two weeks died of an overdose. JL had been clean and sober for 6 months until that first Percocet….

What role did we, as parents, play in this tragedy? JL didn’t want to tell the dentist that he was a recovering opioid addict and we, reluctantly, agreed. He knew, and we should have known, that this was drug-seeking behavior. He was 25 so we had no authority to deny him medication. But we did have leverage – we were paying for the surgery – we could have very easily stood our ground and insisted that he not have opiates before or after. But we would have had to be willing to let our son experience pain, which we had been trying to help our children avoid since birth. (see my blog Pain, Feb 19, 2018)

Parents of children and young adults do play an important role in the prevention of exposure to opioids – and all addictive substances. We are not powerless and regardless of angering our kids, our love for them and our commitment as their parents and guardians needs to be embraced and encouraged. I hope these insights into one of the earliest and easiest avenues of a negative life-altering experience will help others avoid the mistakes so many of us made over a decade ago.

Note shared by a friend:

Thanks to Opiate Nation for not only bringing to our attention the issue of addiction in this country but also for providing an understanding approach to those of us who suffer from addiction or from its disastrous spin-off. I have to live, as they say, a day at a time dealing with the history of addiction in my family of and of the irretrievable loss of my beloved son as a result of it.

While my son abjured the use of pain killers following oral surgery when he was in his teens, a subsequent year-long hospitalization as the result of an accident in a mine of necessity introduced him to the world of opiates. He left the hospital addicted to prescription medications. an addiction from which he never recovered. He ultimately took his own life. Parents are often accused of being the culprit in this vicious cycle. If indeed we were, it was from our own ignorance that we did not intercede. We simply didn’t see the danger. Bless the writers of this incredibly informative blog for understanding the pain that each of us with addiction in our family suffers daily. We still enjoy life, but not as much, and we still laugh, but not as robustly.  Our lives have been irrevocably  diminished. Having a sympathetic ear through this blog brings surcease from our ongoing anguish.

 

 

 

Spring: New Life?

Spring is the season of regeneration, new life, hope. The time of year when the whole earth seems excited to be alive after being dormant all winter. For those who celebrate Easter, the season begins with introspection through prayer and repentance. As we reflect on our life and behaviors that are destructive to ourselves and our relationships, we hope to shed them like the husk of a seed when it is buried in the ground. We expectantly wait for the transformation that happens deep inside that will spring up as new life, like the sprout from a seed. Yet, as it pushes up through the crusty ground, the process of transformation is not without struggle.
This is what those who are living with addiction hope for when they go to AA meetings and enter recovery programs: as they surrender control, they’re hoping for a total change from agony and depression into a new life.

People, Places, Things is a play about addiction and wearing masks by British playwright Duncan MacMillan and director Jeremy Harren. It opened to rave reviews. In an interview with NPR the creators share that at the center of the play is the 12-step process. It shows that for those who have trouble with AA and surrendering to God perhaps it is easier to understand it as acknowledging that you can’t have control over life. We are all powerless over People, Places, Things. It is literally one day at a time. They visited a recovery center in London to get insights for the play. And as one of the actors said after witnessing the daily life-and-death struggle that addicts fight:

“One day at a time. And Life has to win every single day.
Death has to only win once.”

In Tracey Mitchell’s blog (http://traceyh415.blogspot.com/2018/03/) she shares about a young person she has been corresponding with since 2013 and the cycles of opioid addiction and attempted recovery he went through repeatedly. He voiced his utter frustration: “It’s so insane how this drug has taken hold over me.” Tracey heard from him a few more times and then nothing: “I don’t know all the details. I just know I could have written this story. This was my story. Except I did not die at 25. I didn’t need to worry about fentanyl (in the late 1990’s). I got off everything at 27. I consider myself lucky…No one should ever have to die alone like this.”

Yes, no one, especially a young person, should have to die having failed to experience a new beginning – after so much effort at turning over control and hoping for a normal life. But, with the purity of heroin in America having risen sharply in the last 15 years, and fentanyl now mixed in unbeknownst to users, the physical addiction is beyond comprehension. For those who are overdosing and dying in record numbers, they had no intention that their next use would be their last. This was what happened to our 25-yr-old son. Whatever he bought and used was more potent than what he was expecting and accustomed to. He died alone, with the needle still in his vein. Death only had to win once.

Prevention is the best way to stop these needless deaths. But once addiction to opioids has taken control, harm reduction with a solid 12-Step program is the best way to help addicts emerge from the darkness and be able to have a truly new life.