Opioids are highly potent prescription painkillers. However, they’re also highly addictive—so much so that they’ve created a worldwide epidemic.
Besides their addictive nature, the overprescription, misuse, and abuse of opioids have contributed to the issue. It’s a chain of events that often starts with prescription opioids with the purpose of treating pain from an injury and takes a turn for the worse after the discontinuation of the prescription. Many users then switch to variants of this substance available on the street—usually heroin and its synthetic variations, such as fentanyl.
What is Opioid Use Disorder?
The series of events beginning with the misuse of prescription painkillers leads to opioid use disorder, a chronic illness characterized by a compulsive need for the drug and continuous use. Although it has a multitude of physical symptoms, this illness is essentially a brain disorder, as it impairs the balance of the brain.
Without proper treatment, the impairments can persist even after physical detox. Yet, most rehabilitation methods are based on detox treatment except for Accelerated Neuro-Regulation (ANR). Unlike these treatments, ANR doesn’t merely treat withdrawal symptoms; it targets the root of the addiction by reversing the changes in the brain made by opioids and restoring its balance.
Those changes are neurobiological, and they happen because brain cells with opioid receptors gradually become less responsive to opioid stimulation.
As a result, larger doses of opioids are needed to stimulate the VTA brain cells to release the same amount of dopamine in the nucleus accumbens (NAc), a subcortical brain structure with roles in both pleasure and mediation of pain. It’s worth noting that the NAc is also an effective source of analgesia.
To put it simply, long-time opioid users need this substance not to get high but to feel “normal.” As for the high, it’s generally described as a rush of euphoria that comes with the relief of pain, depression, and anxiety.
The symptoms of opioid use disorder are both physical (small pupils, drowsiness, decreased respiratory rate) and behavioral (irritability, moodiness, nervousness, change in personality or attitude). The more advanced the addiction, the more severe the symptoms become.
How Does Opioid Use Disorder Affect Mental Health?
The long-term consequences of opioid use are as grave as they are numerous. These include endocrine abnormalities, immunomodulation, hyperalgesia, and mental health implications, which further branch into several groups we’ll discuss below:
1. Increased Risk of Depression and Anxiety
While the opioid high involves the relief of depression and anxiety, long-term opioid use ironically increases the risk of those mental issues.
Addicts usually develop depression and anxiety as withdrawal symptoms after a prolonged use of opioids (four to eight weeks). Those begin several hours following the last dose of opioids and peak within 72 hours.
During that time, the brain releases large quantities of norepinephrine, previously suppressed by the drug, to bring energy level and blood pressure into balance. This sequence leads to acute withdrawal symptoms, including feelings of depression and anxiety.
2. Cognitive Impairment
Prolonged opioid use can cause cognitive impairment, which can increase the chances of relapse, creating a vicious cycle of addiction.
The cognitive deficits created by the drug don’t resolve after physical detox or with medication-based treatment, which is where the differences between the ANR approach and withdrawal treatments come into focus. Instead of focusing on detox, ANR tackles the root of the problem by restoring the chemical balance of the brain, reducing the risks of long-term mental issues.
3. Higher Chances of Developing Psychosis
Opioid abuse implies a low risk of developing psychosis. The substance has even been hypothesized to have an antipsychotic effect. However, according to research, opioid withdrawal can trigger acute psychotic episodes in cases of bipolar disorder.
Namely, it’s been noted that opioid addicts with bipolar disorder undergoing medication treatment can develop psychotic symptoms, such as delusions, hallucinations, and agitation, due to abrupt discontinuation of their maintenance medication.
4. Insomnia
Due to the rapid changes in the brain that take place when one stops using opioids, cases of insomnia have been documented in recovering addicts, often as a side effect of depression and anxiety.
This inability to sleep can persist long after the withdrawal period is over and can cause a user to relapse. This is why addressing the physical aspects of opioid abuse and treating dependency isn’t enough.
Rather, treatment needs to focus on the psychological aspects of the disorder and treat addiction itself, which is exactly what the ANR method is designed to do.
5. Memory Impairment
Prolonged opioid abuse can interfere with both long-term and short-term memory. In fact, swelling in the cerebellum and hippocampus (a section of the brain involved in the formation of memories) has been documented among several opioid overdose patients suffering from amnesia.
Although it doesn’t have to be fatal, this swelling can cause physical issues like seizures and abnormal movement patterns in addition to permanent memory impairment.
OUD and Barriers to Treatment
Opioid use disorder often goes hand in hand with denial. Namely, users generally refuse to admit they have an addiction problem. As a general rule, they believe they can control their habit when they first start using opioids.
However, they soon develop dependence and addiction and enter a stage where they don’t use the drug to get high but to feel “normal.”
This is why acknowledging that the problem exists is a crucial first step toward recovery. In other words, an addict can recover only when they decide to seek help.
Conclusion
Opioid use disorder severely affects users’ physical and mental health alike. Some of the mental health implications of opioid abuse and addiction include depression, anxiety, cognitive impairment, psychotic episodes, and memory impairment.
They usually stem from each other and go hand in hand with physical health issues, such as endocrine abnormalities, immunomodulation, and hyperalgesia. Therefore, it’s paramount that the treatment addresses both physical dependency and addiction.
