Peer Response – Opioid Addiction and Substance Use Disorders

Responding to Peer 1

Hello,

Thank you for your post. Your information gives insight into the profound influence of neurology on substance use histories, particularly in the setting of opioid addiction. Philip Seymour Hoffman’s sad story exemplifies how addiction can corrupt the brain’s reward system, leading people down a dangerous path despite their best intentions. The significance of dopamine in pleasure regulation and the quick onset of psychological addiction following opioid use illustrate the neurological mechanisms at work (Psarianos et al., 2023). When tackling opioid addiction, it is critical to acknowledge that it is a significant neurological and psychological difficulty rather than a matter of willpower or character. Evidence-based methods, like combining medication and behavioural therapy, have shown promise in helping people take back control of their lives (Zamboni et al., 2021). These drugs operate by stabilizing brain chemistry, reducing cravings, and relieving withdrawal symptoms, which can be excruciating. Understanding the neurological basis of addiction is critical for creating successful interventions and highlighting that addiction is a brain disease, not a moral failing.

References

Psarianos, A., Chryssanthopoulos, C., Paparrigopoulos, T., & Philippou, A. (2023). The Role of Physical Exercise in Opioid Substitution Therapy: Mechanisms of Sequential Effects. International Journal of Molecular Sciences, 24(5), 4763. https://doi.org/10.3390/ijms24054763

Zamboni, L., Centoni, F., Fusina, F., Mantovani, E., Rubino, F., Lugoboni, F., & Federico, A. (2021). The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders: A Narrative Review of Evidence. The Journal of Nervous and Mental Disease, 209(11), 835–845. https://doi.org/10.1097/NMD.0000000000001381

Responding to peer 2

Hello,

Thank you for sharing these moving stories of those who have struggled with substance use disorders (SUDs) and emphasizing the complexities of addiction. In each case, we see how SUDs may affect people from all walks of life, whether they are world-famous singers like Whitney Houston, prominent actors like Charlie Sheen, or promising legal professionals.

The temptation of narcotics can provide a short-term respite from significant emotional suffering and fears (Mulder, 2023). The neurobiological features of addiction, such as the impact of narcotics on the brain’s reward system, can make it extremely difficult for individuals, even those with outstanding talent and accomplishment, to break away from the cycle of addiction. Similarly, Charlie Sheen’s tale demonstrates that addiction does not discriminate on the basis of fame or riches. The relentless scrutiny and stigmatization highlight the need for a more sympathetic and knowledgeable approach to dealing with SUDs in society (Kobe, 2023). Recognizing the interdependence of these elements is critical in designing effective prevention, treatment, and support programs for those dealing with addiction and its terrible consequences.

References

Kobe, R. (2023). Mental Health and Wellbeing. Richmond Kobe.

Mulder, T. (2023). Suffering in Silence: Ministering to Those with Mental Illness. WestBow Press.

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Question

Peer Response – Opioid Addiction and Substance Use Disorders

In 2014, 46-year-old Actor and Producer, Philip Seymour Hoffman was found dead, alone in his apartment, due to an apparent heroin overdose. His body was found amidst syringes, cocaine, prescription pill bottles and 50 small bags of heroin. Hoffman had gone public about his past drug addiction. In 2006, he told 60 Minutes that when he was 22, he “got panicked for my life” and gave up drugs and alcohol. He was clean for 23 years. Twenty-three-years. And then he relapsed.

In 2004, there were 1,879 heroin deaths, while in 2010 this spiked to 3,038. Across the US, there are approximately 600,000 heroin addicts, each spending from $100 to $200 daily to support their addiction. In 2012 Hoffman began taking prescription pain pills. And he relapsed. He wasn’t being selfish. He wasn’t being stupid. He didn’t think he was invincible. He was an addict, and he relapsed and died alone in his apartment. Despite all the advances in treatment, increased understanding of brain chemistry, a realization that addiction causes changes in neural pathways and various new meds that suppress cravings, this simple fact remains true: “Once an addict, always an addict”. And if you’re an addict you can never have just one”. Regardless of your sex, race, and creed, if you’re an addict, you’re an addict for life. Addiction is a brain disease. If you go through rehab, you’re not cured. You’re clean. (Dale Archer, M.D.)

Opiates are especially hard to withdraw from because opioids target the brain’s reward system and flood the circuit with dopamine, a neurotransmitter that regulates movement, emotion, and feelings of pleasure. Since opioids target the brain’s pleasure receptors, some people experience euphoria. Studies also show that psychological addiction can take place in just 3 days. Repeated opioid use overloads circuits in multiple brain regions, including those involved with learning and memory, emotion, judgement, and self-control. At the same time, the brain gradually releases less dopamine in response to other things the person once found pleasurable. Substance Abuse and Mental Health Services Administration (SAMSHA)

The principal site in the brain that triggers the onset of opioid withdrawal syndrome is the locus coeruleus at the base of the brain. Neurons present in locus coeruleus are noradrenergic and have increased opioid receptors. The locus coeruleus region is the main source of noradrenergic innervation of the limbic system and cerebral cerebellar cortices. The noradrenergic activity in locus coeruleus neurons, an opioid receptor-linked mechanism, is a prime causative site of opioid withdrawal symptoms. Research has also shown that gray matter and nucleus raphe magnus is also involved in the presentation of opioid withdrawal syndrome. (Nora Volkow, Director of the National Institute on Drug Abuse)

The opioid withdrawal syndrome is often characterized as a flu-like illness. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, signs and symptoms of opioid withdrawal include lacrimation or rhinorrhea, piloerection ‘goose flesh,’ myalgia, diarrhoea, nausea/vomiting, pupillary dilation, photophobia, insomnia, autonomic hyperactivity (tachypnea, hyperreflexia, tachycardia, sweating, hypertension, hyperthermia), and yawning.

Opioid addiction treatment can vary depending on the patient’s individual needs, occur in a variety of settings, take many different forms, and last for varying lengths of time. Evidence-based approaches to treating opioid addiction include medications and combining medications with behavioural therapy. A recovery plan that includes medication for opioid addiction increases the chance of success. Medications used in the treatment of opioid addiction include supporting a person’s recovery by helping to normalize brain chemistry, relieving cravings, and, in some cases, preventing withdrawal symptoms. The choice to include medication as part of recovery is a personal medical decision, but the evidence for medications to support successful recovery is strong. (Centers for Disease Control and Prevention).

References

Dale Archer M.D. Psychology Today

Substance Abuse and Mental Health Services Administration (SAMHSA)

Nora Volkow, Director of the National Institute of Drug Abuse

Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)

Centres for Disease Control and Prevention (CDC)

Peer 2.)

a.The individual I choose from the Famous people we’ve lost because of their substance use history is Whitney Houston, a singer and an actress. According to a record executive who worked with the singer for years, Whitney “did drugs to escape her pain,” (People.com/celebrity). The PEOPLE interviewed the family and friends at the time of her death, and that there were two Whitney Houston: which is the dazzling pop princess and the girl from Newark, New Jersey, who turned to drugs in her 20s.

In this case, there were a lot of expectations in terms of her personality, that she looks so sturdy and strong, but deep inside, you have someone who had suffered and struggled with insecurities, emotionally with personal issues with her family. Her life of rebellion from her marriage and using drugs as her outlet. Whitney entered rehab multiple times throughout her adult life, but she continued to struggle with addiction until it ultimately took her life. (People.com/Whitney-Houston’s-long-battle-with-drug-addiction).

b.Fictional characters are portrayed in movies or TV shows with the SUD. A good example is Charlie Harper (Two and a Half Men) portrayed by Charlie Sheen who also have a history of substance addiction. Unfortunately, living in the spotlight meant that Sheen also faced constant attention, and ridicule and, early on, was subjected to rumours and generalization, hinting and stigma that often surrounds the disease of addiction. Substance abuse impacts everyone differently, and the Charlie Sheen addiction story confirms that addiction does not discriminate. Famous or unknown substance abuse and mental health issues can cost lives and cause lasting damage to individuals and families. (aspenridgerecoverycenters.com/Charlie-sheen-addiction).
c. I worked with this individual when she was still alive, and started when she was a legal intern in our department. When I interviewed her, I saw her potential as a lawyer, who is so smart, full of energy, and knows how to sing and rap. When she passed the bar, she got hired in our department, and there is no question of determination in defending her clients all the way. She’s a fighter and a good public defender, however, behind the scenes, there is something wrong until we discovered that she’s struggling of addiction both drugs and alcohol that leads to depression that took her life. It was unexpected, but it happened, and that is one of the incidents that all of us didn’t know what to say, and everyone was asking, what happened?
In this case, we found out that there are so many grounds that we need to look at seriously with people who are struggling with mental disorders and substance abuse with trauma. I believe we also need to consider the surroundings and environment, family background or history, insecurities, feeling alone, pain, grief, and so many factors that everything leads to death.