Why Can’t I Stop Using Opioids On My Own? And Why Suboxone Is One of the Best Solutions Available.
The answer is: You can stop, but it isn’t easy, and it isn’t advisable.
The reason for this is that substances that cause addictive reactions in brain chemistry work in a powerful craving center in the brain called the nucleus accumbens. This area is rich in a neurotransmitter called Dopamine which is highly reinforcing. This part of the central nervous system is technically called the limbic system, but in general, speech is often referred to as the “reptile brain.” Opioids are particularly powerful stimulators of this part of the brain – and so they cause a very powerful craving, accompanied by a very powerful drive to get to the opioid at all costs, and despite the wiser, higher cortical thinking that sees all the reasons that you shouldn’t use them. The brain is wired so that the limbic system easily overrides cortical thinking, wisdom, and one’s promises to oneself and others that you’re just going to stop.
But what also makes this harder, is that with repetitive opioid abuse, the withdrawal is extremely uncomfortable. Its symptoms include sweating, nausea, vomiting, diarrhea, severe muscle cramping and pain, and depression. So the effect isn’t linear – it’s exponential. The combination of the limbic system craving the drug and the intense withdrawal discomfort is not the equivalent of 3 + 3 = 6 buy is more like 3 cubed equals 9 – and this makes this cycle very hard to break.
Adding to the risk is that because this combination of accelerated intense craving and severe discomfort impairs judgment, people who relapse are not thinking straight and are much more likely to take significantly more opioids than they had previously been using. This tragically often results in a potentially fatal overdose during the relapse phase. This is why some states, like Maine, have made the use of Narcan (opioid blocking injectables) available without a prescription to reduce the potential fatalities.
This is why suboxone treatment can be lifesaving. Suboxone successfully binds with opioid receptors and when used appropriately blocks withdrawal symptoms, but also binds with the opioid receptors to prevent even the most potent and dangerous opioids of abuse like fentanyl or street heroin, ineffective. They simply cannot bind with the opioid receptor once suboxone is in place. It’s like a priceless insurance policy that substantially reduces the risk of a fatal overdose. It’s easily available and can be monitored by a psychiatrist trained in how to use it.
If you or someone you know is having a problem with opioid abuse or dependence, suboxone is a serious consideration. You could be saving a life.
By DAVID SALVAGE MD