Opioid Addiction Writing Sample

The prevalence of opioid addiction is on the rise. Opioid related overdoses were responsible for over 42,000 deaths in 2016, which is more than ever before (“Public Affairs”, 2018). Opioid addiction is continuously being studied to develop more effective treatment programs and to examine the impacts of long-term use on the nervous system. Drug addiction is when the individual has awareness of the harmful effects that the substance has on his or her daily life but continues to use the drug anyways (Gould, 2016). Opioids affect executive function, the limbic system, decision-making, biological aging, cognitive decline, and neurotransmitter release (Cheng et al., 2013; Müller et al., 2018). Some effects are seen after short-term use while others are seen after long-term use (“What are opioids”, 2018)

Opioids are drugs that bind to the opioid receptors of cells in the central nervous system to block the feeling of pain (“How Drugs Affect the Brain”, 2018). Common examples of opioids include fentanyl, oxycodone, morphine, methadone, and heroin (“Opioid (Narcotic) Pain Medication”, n.d.). Opioids increase the amount of dopamine released in the brain, which is the neurotransmitter responsible for creating the feeling of pleasure (“Dopamine”, n.d.). Dopamine is also responsible for executive functions such as attention, which can be impacted by abuse use of opioids (“Dopamine”, n.d.). Detrimental effects occur as the brain develops a tolerance to the opioids interacting in the central nervous system (“How Drugs Affect the Brain”, 2018). Quitting the use of opioids is difficult due to the undesirable effects of withdrawal as dopamine levels decrease when the opioids wear off (“How Drugs Affect the Brain”, 2018).

Routine use of opioids results in long-term effects to the brain (“How Drugs Affect the Brain”, 2018). Significant effects may occur because of the decrease in overall cognitive function, due to the damage of the dorsolateral prefrontal cortex (Cheng et al., 2013). Other impacts of opioid use involve a decrease in size of the hypothalamus, which is a part of the limbic system that is responsible for how the body responds to stress (Müller et al., 2018). Drug addiction is often viewed as only affecting an individual or a community. However, the following research demonstrates the importance of reviewing how routine use of opioids can effect structural and cellular changes in the brain. Regular use can lead to decrease in cognitive function, increase in cellular aging, and decrease in hypothalamic volume (Cheng et al., 2013; Müller et al., 2018).

A study reviewed how opioid use, specifically heroin, influences biological aging at the level of the cell (Cheng et al., 2013). The enzyme telomerase was examined through the extraction of a blood sample. The researchers reported that telomerase is a common marker of stress and serves as a link between aging-related diseases. Telomeres protect the endings of chromosomes and if the chromosomes are uncovered, damage to DNA may occur as well as the aging process may begin earlier. The effects of heroin use at the cellular level and the level of the structures of the brain were being examined. The structures examined include the prefrontal cortex and the medial temporal lobe, which have both been studied previously in relation to the aging process. Damage to the prefrontal cortex has shown an impact on cognition. In other various studies the link between damage to the prefrontal cortex and the medial temporal area due to heroin use has resulted in impairments to both the structure and role that the areas carry out (Cheng et al., 2013).

There were 63 total participants, including 33 heroin users and 30 healthy controls (Cheng et al., 2013). The 33 participants that were self-reported heroin users were volunteers from two different treatment centers. Participants were reportedly not receiving any medical treatment at the time of the study and specifically reported heroin was used for majority of drug use (over 50% of the time). To compare intelligence between the heroin users and healthy controls the researchers administered the Raven’s Progressive Matrices assessment and the Hospital Anxiety and Depression Scale. To evaluate telomerase activity in the participants a blood sample was taken and measured based on previous approved protocol seen in other research studies. The participants also had an MRI completed to analyze the structures of the brain hypothesized to be impacted. Participants also underwent an fMRI scan while awake. Results from both the MRI and fMRI were combined with years of education of the participant and results from the Hospital Anxiety and Depression Scale in order to increase the accuracy of the findings. The cognitive areas assessed in the study were executive functioning, attention, working memory, learning and memory, and visuospatial skills. All areas of cognition were assessed based on standardized measures of assessment (Cheng et al., 2013).

The results demonstrated that telomerase activity was lower in heroin users compared to healthy controls (Cheng et al., 2013). The researchers found that heroin users have smaller amounts of dorsolateral prefrontal cortex grey matter, which correlated with smaller amounts of telomerase activity. The results determined that the structure and function of the right dorsolateral prefrontal cortex, and telomerase activity were impacted due to heroin use in comparison to the control group. The researchers primarily focused on the link between the dorsolateral prefrontal cortex and three other areas of the brain. Other structures examined consisted of the left orbitofrontal cortex, right entorhinal cortex, right superior occipitoparietal cortex, and bilateral anterior cingulate cortex. All the connections between the previously mentioned areas and the dorsolateral prefrontal cortex were negatively impacted due to heroin use. The results confirmed the hypotheses that heroin abuse correlates with low telomerase activity, which results in biological aging. Heroin abuse also decreases the ability for the dorsolateral prefrontal cortex to interact with other areas of the brain that are also related to aging. Lower telomerase levels and damage to the dorsolateral prefrontal cortex are what speed the aging process and explain why higher level of cognition is affected for individuals who abuse heroin, similarly to aging adults (Cheng et al., 2013).

The following study was conducted to examine the effects of routine heroin abuse affects the hypothalamus (Müller et al., 2018). The hypothalamus is primarily responsible for how the brain processes stress. Specifically, the researchers focused on how the size of the hypothalamus structure changed due to heroin use. The researchers examined the postmortem brains of 14 heroin abusers that died due to overdose and 12 non-heroin users that died due to other various causes unrelated to substance abuse. The mean age of the 14 brains affected by heroin was 30.8 and the mean age for the 12 controls was 44.4. The results demonstrated that heroin users had increased total brain volume compared to the control group due to young age. A neuropathologist and a forensic pathologist examined all of the brains. Additionally, a toxicology test was run to determine other substance abuse. The researchers then examined each brain by making cuts anterior to genu of the corpus callosum and posterior to splenium of the corpus callosum. The brain cuts were put into wax and secured. The overall volume decrease before and after mounting the brain tissue was examined. The tissue of the hypothalamus was then stained and measured based on the distance between the sections and multiplied by the transverse cuts made to each brain. The researchers considered the size of the tissue prior to making adjustments to the brain as well as the size of the hypothalamus in comparison to the entire brain in order to make the results an accurate representation (Müller et al., 2018).

The volume of hypothalamus compared to the total brain volume was smaller in the brains of heroin addicts than control group members (Müller et al., 2018). The left hemisphere hypothalamus volume was 20% smaller in the brains of heroin addicts in comparison to the control group. The results assist in guiding further research when examining what long-term effects occur to the brain of someone who abuses heroin, or opioids. The results not only demonstrate that an impact was made on the size of the hypothalamus but that function of the hypothalamus is impacted as well. The results indicate that the hypothalamus is affected in individuals who are addicted to opioids, which leads the researchers to believe that further research is necessary (Müller et al., 2018).

Opioid addiction is dangerous for many reasons, specifically to physical and biological health. Opioid abuse, specifically heroin, affects both the areas and functions of the different structures in the brain from being able to carry out designated responsibilities (Cheng et al., 2013). The research previously reviewed only begins to examine how opioid addiction affects structures of the brain and how the nervous system is affected at the cellular level (Cheng et al., 2013). Research with opioid addicted individuals can be difficult due to the limited amount of participants that are willing to volunteer for research; therefore the sample size for opioid addiction research is typically small (Müller et al., 2018). The results from Cheng et al. (2013) and Muller et al. (2018) are both statistically significant and clinically significant. The implications from both studies indicate that routine use of heroin will result in unfavorable effects to the nervous system (Cheng et al., 2013; Müller et al., 2018).

In the previous research discussed, Cheng et al. (2013) examined four areas that are related to the dorsolateral prefrontal cortex and how the impact of heroin affected the different areas. The four areas included the orbitofrontal cortex, the entorhinal cortex, the occipitoparietal cortex and the anterior cingulate cortex. All of the previously stated areas in combination are responsible for emotion, cognition, memory, perception of time, decision-making, and visuospatial tasks. All of the results demonstrated that each area was negatively impacted by heroin abuse (Cheng et al., 2013). For an individual to have deficits with decision-making, memory, perception of time, visuospatial abilities, and emotion portrays how harmful heroin abuse can be in everyday life (Cheng et al., 2013). Müller et al. (2018) determined the link between heroin abuse and telomerase activity, which is responsible for aging. The results go to further justify how heroin negatively impacts the lives of people addicted to opioids. The previous articles help further the research of the specific areas that are impacted by heroin abuse and make progress for how specific areas can be further examined. Research is important in order to develop better treatment regiments and to further understand the significant impact of opioid addiction.

Due to the prevalence of opioid addiction I originally assumed that there would be a plethora of research on the topic of opioid addiction. However, I realized websites discussing opioid addiction were more accessible compared to research articles with a purpose, methods, and results. I realized that the websites I found provided information about general structures that were impacted and that the websites said that research has found significant impacts, but the research was not provided to back up the facts. While I think lay references may aid the general public in understanding difficult topics such as opioid addiction, the lay references often give vague statements that allow for misinterpretation. For someone to understand what is happening in the nervous system, further research is needed to look beyond the vague statements to understand what is happening. I found that reading lay references was less dense, but that the websites left me with many questions. Research articles are difficult to read at times due to the complexity of terms, but more information is offered with methods to explain where and how the information was retrieved and how the information is reliable. Lay references may provide people with inaccurate information, which can then distort the perception of opioid addiction.

Drugs, Brains And Behavior

Why other people are addicted to drugs? That’s the question that crosses to our mind when we saw an addict person. Sometimes, assumed that drug users are commonly lack of self-control and that’s why they couldn’t stop using drugs and resulting to change their behaviors. Facing the reality today, addiction in drugs is a very complicated disease, and quitting it can take more time to be successful of quieting it. In fact, because of drugs it changes how the brain works faster compulsive because of drug abuse, quitting is somehow difficult, even for those people who trying to do so. Through the scientific advances, we gathered more knowledge about how the drugs work in the brain, and we discover that addiction in drug can be successfully treated to help people who want to end using drugs and choose to live a lead productive life. Drug misuse and addiction had big disadvantages for individuals and in our society. For instance, a research of Dr.Claude estimates a total overall costs of substance abuse in the United States, including productivity and health- and crime-related costs, exceed 600 billion dollars annually. This includes approximately 181 billion dollars for illicit drugs, 193 billion dollars for tobacco, and 235 billion dollars for alcohol. As surprising as these numbers are, they do not fully describe the breadth of vicious public health and safety implications of drug misuse and addiction, such as Broken Family, loss of occupation, child abuse, domestic violence, and failure in school.

Addiction is a long-lasting; this is a returning of brain disease that might be the reason of obsession of drug and seeking to use it, despite of the dangerous effects towards addicted to it and to those people who are close to him or her. Even though the major decision to take the drugs is voluntary for most users, the brain also vary the happening every time a person’s try to self-control and ability to resist strong desire urging them to take some drugs again. Luckily, some treatments are available to help people counter addiction’s powerful disruptive effects. Research shows that merging addiction treatment medications with behavioral therapy is the best method to ensure success for most patients. Treatment methods that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to continuous recovery and a life without drug abuse. Similar to other chronic, relapsing diseases, such asthma, diabetes, or heart disease, drug addiction can be managed successfully. Furthermore, as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again.

While taking drugs at any age can lead to addiction, research illustrates that the earlier a person begins to use drugs, the more likely he or she is to develop severe problems. This may reflect the harmful effect that drugs can have on the developing brain; it also may effect from a mix of initial social and biological vulnerability factors, as well as unstable family relationships, exposure to physical or sexual abuse, genetic susceptibility, or mental illness. Still, the fact will remains that early use is a strong indicator of problems ahead, including addiction. Scientists approximation that genetic factors account for between 40 and 60 percent of a person’s defenselessness to addiction; this includes the effects of environmental causes on the function and expression of a person’s genes. A person’s phase of development and additional medical conditions they may have are also factors. Adolescents and people with mental disorders are at bigger risk of drug abuse and addiction than the general population.

Drugs contain chemicals that tap into the brain’s communication system and disruption the way nerve cells usually send, receive, and process information. There are at least two ways that drugs effect this disruption: (1) by imitating the brain’s natural chemical messengers and (2) by overstimulating the “reward circuit” of the brain. There are some drugs (e.g., marijuana and heroin) have a alike structure to chemical messengers called neurotransmitters, which are certainly produced by the brain.[footnoteRef:7] This resemblance allows the drugs to “fool” the brain’s receptors and trigger nerve cells to send abnormal messages. Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release unusually large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is required to shut off the signaling between neurons. The result is a brain lacking in dopamine, a neurotransmitter presents in brain regions that control the movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally answers to natural behaviors linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to psychoactive drugs. This response sets in motion a reinforcing pattern that “teaches” people to recurrence the rewarding behavior of abusing drugs. If a person continues to abuse drugs, the brain familiarizes to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a decreasing of dopamine’s impact on the reward circuit, which lessens the abuser’s ability to enjoy the drugs, as well as the events in life that formerly brought pleasure. This decrease compels the addicted person to keep abusing drugs in an attempt to convey the dopamine function back to normal, except now larger amounts of the drug are required to reach the same dopamine high—an effect known as tolerance. Long-term abuse causes of changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that impacts the reward circuit and the ability to learn. When the optimal concentration of glutamate is changed by drug abuse, the brain tries to compensate, which can impair cognitive function. Brain imaging studies of drug-addicted individuals show variations in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs spontaneously despite adverse, even devastating consequences—that is the nature of addiction.[footnoteRef:8] [7: Ibid, 17.] [8: John Brick and Carlton Erickson, Drugs, the Brain, and Behavior: The Pharmacology of Abuse and Dependence (Haworth Therapy for the Addictive Disorders) 1st Edition (United Kingdom: 1998) 115.]

Drug addiction is one of a preventable disease. Results from NIDA (National Institute on Drug Abuse) -funded research have shown that prevention programs involving of families, schools, communities, and the media are effective in reducing drug abuse. Even though many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. Thus, education and outreach are key in assisting youth and the general public understand the risks of drug abuse. Teachers, parents, medical and public health professionals must keep sending the message that drug addiction can be prevented if one never abuses the so called drugs.[footnoteRef:9] [9: Patrick W. Nee, The Key Facts on Drug Abuse: Everything You Need to Know About Drug Abuse. (New York: 2013) 55.]

Relapsing Disease

It’s no secret the abuse of drugs has become a widespread epidemic. Although it seems to be stereotypical for teens, this problem is rising more in the adult population. There really is no set population or genre to label as the specific drug abuser. Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to. Fortunately, researchers know more now than ever about how drugs affect the brain and have found treatments that can help people recover from drug addiction and lead productive lives. A question most people ask is “what is drug addiction?” Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a ‘relapsing’ disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug. It’s common for a person to relapse, but relapse doesn’t mean that treatment doesn’t work. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs. Another question that is asked a lot by people is “What happens to a person when a person takes drugs?” Most drugs affect the brain’s ‘reward circuit,’ causing euphoria as well as flooding it with the chemical messenger dopamine. A properly functioning reward system motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, leading people to repeat the behavior again and again.

As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug to try and achieve the same high. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, or social activities. Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include: Learning, Judgment, decision-making,stress, memory, and behavior. Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction. As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isn’t a cure. However, addiction is treatable and can be successfully managed. People who are recovering from an addiction will be at risk for relapse for years and possibly for their whole lives. Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patient’s drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery. More good news is that drug use and addiction are preventable. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking. Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction. They have these key roles because of the trust people have in them and by doing so they try to keep teens and adults away from drug abuse to help guide them to live lives where they don’t need to depend on these things on a daily basis to go on with their day. Having to depend on drugs for a daily use gets very costly and tends to have the users do anything to obtain the drug such as stealing money from family members, steal valuable items from the household to sell for money, and lie to get the drug. Neighbors, friends, and coworkers also experience the effects of substance abuse because a person who abuses substances often is unreliable. Friends may be asked to help financially or in other ways. Coworkers may be forced to compensate for decreased productivity or carry a disproportionate share of the workload. As a consequence, they may resent the person abusing substances. People who abuse substances are likely to find themselves increasingly isolated from their families.

A main psychoactive drug that many people have an addiction to is alcohol. Alcohol is a major depressant even though some people don’t feel that it isn’t. Alcohol acts as a disinhibitor, which slows brain activity that controls judgement and inhibitions. Prolonged excessive drinking characterizes alcohol use disorder and can shrink the brain. Adult women have less of a stomach enzyme that digests alcohol and can become addicted to alcohol more quickly than men, they are at risk for lung, brain, and liver damage at lower consumption levels. Along with alcoholism lower doses of alcohol relax the the drinker by slowing sympathetic nervous system activity. While larger doses cause reactions to slow, speech to slur, and skilled performance to deteriorate. If paired with sleep deprivation, alcohol is a potent sedative. When you add these physical effects to lowered inhibitions, the result can be deadly. Alcohol can also be life threatening when heavy drinking follows an earlier period of moderate drinking, which depresses the moderate response. Memory disruption is also affiliated with alcohol. It can disrupt memory formation and heavy drinking can have long term effects on the brain and cognition. Also if a person drinks too much it may lead to that person blacking out, in which drinkers are unable to recall the people they met that night, what they said, or even did while intoxicated. These result partly from the way alcohol suppresses REM sleep, which helps fix the day’s experience into permanent experiences.

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