​#4 Addiction, dependence and tolerance part 2

Because of how opioids affect our brains, it is very easy to become addicted. For many, opioid use begins with an injury or surgery and take opioid pain killers prescribed by their medical provider to deal with acute pain related to their medical condition.  Initially, prescribed opioids can be very effective in dealing with acute pain and increase the feeling of pleasure in the brain. For some, even the legitimate prescribed course of opioids can begin the process of becoming dependent and addicted.
After taking the opioids for a brief time, tolerance begins to develop.  The initial effects of the original dose don’t attain the same results.  As a result, the patient needs increasing amounts to achieve the same effect. When a patient develops tolerance, he may ask his doctor to increase the dose to get the same effect.
After a person develops tolerance and the amount of opioids taken increases, the next phase is dependence.  At this stage, the individual feels a physical and psychological need to take the drug. Not taking opioids may result in physical symptoms of withdrawal.  (Severe flu like symptoms, body aches, runny nose and watery eyes, hot and cold sweats, abdominal cramping, nausea, vomiting and diarrhea. )
Addiction is the last phase.  In addiction, the actual wiring and structure of the brain has changed so the individual no longer gets the pleasurable effect of the opioid but has to take the drug to avoid withdrawal and dope sickness.  The person compulsively seeks out the drug without regard to negative consequences for themselves or those around them.  The individual loses interest in things that used to be pleasurable:  family, friends, jobs, hobbies and food, becoming obsessed with finding the next dose.
In a recent conversation with someone who has been in recovery for ten years, I learned that while most young people understand that abusing drugs is wrong and can hurt you, they don’t understand that even just experimenting with drugs one-time can lead down the path of addiction and years of wasted life.  My friend said “If I could make kids understand anything it would be: Don’t try drugs even once.  For many, just experimenting with drugs one time is what leads to years of being lost in addiction or completely losing your life.  If you never start drugs, you won’t need treatment or recovery. You won’t destroy your life and family.”
As my friend indicated our youth are especially vulnerable.   One dose of opioids for those under fifteen years of age makes them five times more likely to become addicted later in life.  A person’s brain does not stop developing until they are in their early twenties; until then their brains are especially sensitive to the effects of drugs.
The elderly are also vulnerable.  As we age, we have more pain causing health issues and more prescriptions.  Often the elderly live alone and mismanage their prescriptions, not taking them as directed.
Again, it is very easy to unwittingly become addicted to opioids even when prescribed by your medical provider for a legitimate pain need, but with knowledge and vigilance, we can be prepared and fight opioid abuse. 
Sources:  teens.drugabuse.gov, drugfree.gov, drugabuse.gov, https://medmark.com/does-long-term-opiate-use-change-the-brain. 
Next time:  A story of addiction
Lynn Saylor is an AmeriCorps member serving in the United Against Opioid Abuse Initiative through the White County United Way.  She can be contacted at [email protected].  Previous articles may be found on whitecountyunitedway.org/opioids.html.
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