Opioids have been around a long time. The first recorded reference to opioid use is from 5,000 years ago. It’s a picture of the opium poppy and the words “the joy plant”. In 2012, 259 million opioid pain medication prescriptions were written — that’s enough for every American to have a bottle of the pills.
Percocet is the brand name for acetaminophen and oxycodone. Oxycodone is a powerful opioid. It’s one of the most commonly prescribed painkillers, and is a key factor in one of the country’s most pressing public health problems — an opioid addiction epidemic. It is a crisis that started, in part, from the overprescription of painkillers like Percocet, and then shifted to heroin as people addicted to prescription drugs looked for a cheaper high.
There’s an estimated 2.5 million Americans addicted to opioids and heroin.
How Opioid Addiction Works
Why are opioids so hard to quit? You can boil it down to two crucial bits of science: the powerful nature of opioids and the neuroscience behind how addiction hijacks the brain. And even though different drugs produce different highs, they all involve the same pathway in the brain.
Opioids increase the amount of dopamine in a part of the brain called the limbic reward system. Dopamine causes intense feelings of pleasure, which drives users to seek out the drug again and again.
They trigger the release of dopamine, which is a neurotransmitter that causes intense pleasure in parts of the brain that include the limbic system. It links brain areas that control and regulate emotions such as the pleasures of eating, drinking and sex.
People can become psychologically and physically dependent on opioids very quickly. The limbic reward system then recruits other systems in his brain — memory systems, motivational systems, inhibitory systems, systems that drive judgment, planning and organization — driving them all to seek that pleasure of getting high.
Feelings like joy and shame also play a role in drug dependence, and make it harder to quit. Practical issues like finding a job, saving money, and keeping a place to live become huge challenges. Sometimes felony convictions make it even worse.
And the country is facing a shortage of addiction treatment facilities and specialists; the shortage ranges wildly from one state to another. Treatment for opioid addiction includes a variety of services: medication, talk therapy, job support, all stretched out over years. For people who don’t get intensive treatment, detox isn’t enough. For people who are just detoxified from opioids, relapse rates can be above 90 percent.
Below, you can listen NPR’s discussion on opioid recovery. It features a longtime user who is finally sober. “I don’t need it anymore,” he says. “I literally, physically and emotionally don’t need it. I love the way I feel sober.”