Opioid use and its effect on the brain.
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п»ї<title>Opioid use and its effect on the brain.</title>
The serious health crisis in the United States today due to the opioid addiction epidemic is putting the country and its institutions in serious trouble. The issue is that there is no feasible short-term solution to these problems.
Eighty percent of the world's opioid production, either through medical prescription or originating in the illegal market, is consumed in the United States. Health services are unable to cope with the numerous deaths caused by opioid use.
It is estimated that around 200 people die every day in the country as a result of opioid addiction. What is more, the total number of deaths from this cause is already comparable to the deaths of American soldiers in the Vietnam War.
The data we are now receiving on the high incidence of addiction generated by the consumption of opioids such as OxyContin or morphine derivatives such as Fentanyl have set off all the alarms. Statistics speak of addiction in more than 10% of patients in just the first five days of consumption.
This crisis has already been declared a "national public health emergency" in the United States. So, below we will take a look at what opioids are, how they act in the human brain and what studies are currently being conducted on the subject.
"As soon as an addict accesses a deeper form of satisfaction than is possible through self-destructive behavior, the way out will naturally open up before him."
-Deepak Chopra
What are opioidsOpioids are pain-relieving drugs whose active ingredients are extracted from the capsule of the opium plant. They are natural substances that have been known for a long time and are found in the juice of poppy seeds. In 1803 an alkaloid was isolated from opium, morphine; later derivatives such as codeine and heroin were developed.
Opioids or narcotics are a strong analgesic prescribed for acute or chronic pain, especially cancer-related pain. The problem is that there are many risks associated with their consumption, mainly the high addiction rates they are generating in patients. We say patients because many of those people who show addiction are people who were prescribed opioids after a surgical operation, an accident or a broken arm.
Opium was legal in the United States until 1914 but was banned due to the high tolerance it generates and the severe withdrawal syndrome it causes. It is one of the most addictive drugs, as it reaches the brain very quickly. It produces a powerful effect of analgesia, drowsiness and gratifying sensations of pleasure.
There are three classes of opiate substances:
Opium alkaloids, such as morphine (the prototypical opioid) and codeine.
Semi-synthetic opioids, such as heroin and oxycodone.
Fully synthetic opioids, such as pethidine and methadone.
How do they act in the brain? All drugs of abuse activate the pathways of the brain's reward system. This system comprises the ventral tegmental area, the nucleus accumbens and the prefrontal cortex. The perception of pain involves the participation of several neural structures.
Through afferent pathways, this substance reaches regions of the brainstem and diencephalon, including the thalamus and the periaqueductal gray matter. In addition, synapses are produced in the thalamus, projecting to other areas such as the frontal lobe, the limbic system or the hypothalamus, mainly.
Opioids act in the afferent system (pathways through which the stimulus travels to the brain) but they also act in the efferent system (reverse pathway). They also activate the excitatory connections between the periaqueductal gray matter and the raphe nuclei. The painful stimulus is reduced by inhibiting GABA-containing interneurons.
What is being done to address the crisis generated by opioid use? There are numerous fronts that this opioid use crisis has opened up. There is a very significant demand for assistance to people who have developed addiction to these drugs. In the absence of new prescriptions, these people are turning to the illegal market and replacing them with heroin, which is cheaper and easier to obtain.
Most notable is the work being carried out by the Mount Sinai research team in Florida. This research has focused on an intracellular network that controls the actions of opioids in the periaqueductal gray matter, as this network plays a very important role in the analgesic response.
These researchers succeeded in blocking the RGSz1 gene, responsible for encoding the negative modulator of opioid tolerance. The result was a significant reduction in pain with much lower doses of medication. In addition, a less rewarding effect was achieved, an important factor in the development of addiction.
For the time being, the team is evaluating the opioids currently prescribed. They want to classify them by their abuse potential based on the RGS protein they activate. Their findings may be decisive in the fight against this serious epidemic of opioid abuse.
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