LIVING IN WEST VIRGINIA, THE PHRASE “OPIOID EPIDEMIC” IS VERY FAMILIAR. At some point, the aging white population in West Virginia was dealing with a lot of health issues. Pharmaceutical companies took advantage of this and began to pump a lot of opioid-based pain pills into the state.
West Virginia has been a poorer state, and there has been less regulation placed on prescription practices. Because of the dense rural populations in the state, there is also a lack of access to treatments for addiction.
Another significant factor contributing to the epidemic generally has been misleading marketing by pharmaceutical companies to doctors.
Opioids are used to alleviate pain. They typically come from or mimic natural substances foundin the opium poppy plant. Morphine is a non-synthetic narcotic. Only a small fraction of it crosses the blood-brain barrier —the semi-permeable membrane that decides what goes into the brain and comes out of it. Opioids can also cross into the placenta, potentially causing withdrawal symptoms within a newborn baby.
The effects of opioids depend on how much of it is taken. Low to moderate doses result in pain relief, lack of concentration and dreaming quite a bit during sleep.
As doses increase, feelings of elation or euphoria may increase, which could lead to addiction.
There can also be a sense of restlessness and anxiety. The higher doses can result in unconsciousness, decreasing body temperature and blood pressure and respiratory failure. Opioids interact with the brainstem, the region of the brain that helps with the most basic functions, which is why respiratory failure can occur.
Our bodies have endogenous neuropeptides. The molecular structure of exogenous opioids mimics endogenous ones. Thus, consuming exogenous opioids leads to competition for our opioid receptors.
Our four opioid receptors are mu-receptors, delta-receptors, kappa-receptors and NOP-R. Mu-receptors are closely associated with morphine. Delta-receptors have to do with our sense of smell, motor integration and cognitive function.
Kappa-receptors are involved in our perception of pain and feelings of dysphoria.
NOP-R are associated with learning and motor function.
Endogenous opioids behave in an inhibitory manner. Similarly, so do exogenous ones. Inhibitory spinal neurons release endorphins (hormones released by the brain to reduce pain), inhibiting the activation of spinal projection neurons (involved in transmitting signals from the spinal cord to the brain). This is one way that the transmission of pain signals is reduced.
Another way is through the descending modulatory pathways. These also can inhibit excitatory neurons.
The most important pathway comes from the periaqueductal gray region in the midbrain.
Opioid activity has been shown to occur in our brain’s limbic structures and hypothalamus, both of
which are regions involved in our emotions, which further explains the pain component of our emotions.
Opioids are also shown to result in reinforcing behavior; essentially, if an animal continues to choose to self-administer while under the influence of a drug, it leads to the conclusion that that drug is involved in reward and can thus become addictive.
There are different drugs such as buprenorphine that can be used to treat addiction. Additionally,there are psychological treatments as well.
VAAGEESHA DAS is a second year college student and columnist for The Dominion Post. Information comes from: Cleveland Clinic medical. (n.d.). Endorphins: What they are and how to boost them. Cleveland Clinic. health/body/23040-endorphins; Nygard, S. (2024). Opioids [PowerPoint slides].
