Treating opioid addiction
by Dr. Russell Surasky
Sep 21, 2016 | 11924 views | 0 0 comments | 461 461 recommendations | email to a friend | print
The term "opioid" is generally used to refer to both drugs derived from the opium poppy, such as morphine, codeine, and heroin, and synthetic drugs that produce similar narcotic effects such as Oxycodone and Hydrocodone, more popularly known as Percocet and Vicodin.

Opiate receptors are found in the brain and spinal cord. They significantly reduce the sensation of pain but also play an enormous role in the way we feel mentally and emotionally.

They cause an overall feeling of "well-being" and significantly reduce symptoms such as depression and anxiety. Opiates also cause negative symptoms including drowsiness, nausea and constipation.

The human body naturally produces its own substances ("endogenous opioids") that act in similar ways to modulate pain and also regulate life-sustaining functions such as the need for food, water, and sex.

Endogenous opioids trigger the brain's reward center to produce feelings of pleasure when these vital needs are satisfied. Opioid drugs stimulate the reward system just as endogenous opioids do.

They produce a euphoric effect and over time rewire the brain to pursue that effect as it does a basic life need, making the individual as powerless to resist the impulse to take more drugs as he or she is to resist the need for food and water.

Opioids attach to proteins called "opioid receptors" located on nerve cells in the brain and stimulate them to flood the reward system with dopamine and other substances that reduce pain and produce pleasurable feelings.

Opioid drugs act on the same receptors as our own endogenous opioids, but their chemical composition may produce a more intense effect.

Opioids prescribed for pain are powerful aids in relieving suffering, but they have great potential for misuse and become dangerous and addictive when taken to excess or for non-medical purposes.

Drugs overstimulate the reward system, producing not just a calming, pleasurable feeling, but the euphoria that characterizes opioid abuse. When the drug wears off, it detaches from the receptors and the brain signals the need for another dose.

After as little as a few weeks of use, opiates “hijack” the brain to the point that it needs the drug for survival and the compulsion to continue taking the drug becomes overwhelming.

Withdrawal and counseling aren't enough. Unless the neurological changes to the brain can be reversed, those cravings may persist for a lifetime.

One of the newer and most effective treatments is Vivitrol, an extended-release medication that is injected once a month and immediately stops cravings. Vivitrol is a safe medication that helps the brain heal from the changes that have occurred during the drug use.

Vivitrol itself is not an opioid, is not addictive and does not cause dependence. A patient who has been treated with Vivitrol and then takes opiates anyway will not feel high.

People who are treated with Vivitrol but then take opiate drugs do not get sick or high, absolutely nothing will occur. Patients quickly learn that they might as well throw their money in the garbage before spending it on these drugs.

Treatment is individualized for each patient to ensure that the psychological and behavioral aspects of the disease have been adequately addressed and the individual has developed the life skills needed to remain drug free.

Dr. Russell Surasky of Surasky Neurological Center for Addiction in Great Neck is board certified in both neurology and addiction medicine.
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