Salem Press | 2011 | Salem Health: Addictions & Substance Abuse
Essay title:: Narcotics: Short- and Long-term Effects on the Body Category: Health Issues and Physiology
Definition: Though using substances is a choice, over time use of substances can grow into dependency. The overuse, or abuse, of substances brings about lasting physiological changes to the brain that lead to psychological and behavioral changes in the abuser. With the abuse of narcotics, the damage to the brain is profound.
Addiction to Narcotics Addiction is a brain disorder. Narcotics disrupt the biochemical processes of the brain and become addictive. To understand the damage to the body narcotic abuse inflicts requires an understanding of why narcotics are used and how the alter the brain.
The term "narcotic" is another word for opioid drugs, or opiates, which have been used to relieve pain throughout history. Though historically, narcotics were naturally derived from the poppy plant, those prescribed today may be natural or synthetic, all of which are still technically classified as opioids. They include morphine, heroin, codeine, opium, hydrocodone, oxycodone, meperidine, methadone, and others.
Because narcotics (opioids) produce a euphoric state of relaxation, even sleep, they serve a medical purpose for controlling pain in medical patients. Narcotics impact the opioid-U receptors in the brain, also known as the painkilling parts of the brain, or the reward pathway. The effect is a slower transmission of chemicals between neurons. Ironically, when abused, narcotics block endorphins, the brain's organic pain-control chemical. With addiction, the addict senses an urge to replace missing endorphins with the high experienced from the ingestion of narcotics. Increasingly, the addict needs higher narcotic doses to feel well.
In his book Helping the Addict You Love, Laurence W. Westreich warns friends and relatives of the addicted about the damage to the brain substance-abuse generates and how it leads to the impairment of judgment and common sense. Love and logic are not enough to convince an addict to stop using the addicted substance. There is much more going on in the body physiologically with addiction that hampers the addict's mechanism for making good decisions. According to Westreich, there are six models for explaining why individuals become addicted to substances. Based in neuroscience, the Learning Theory Model suggests that addiction evolves from the reward mechanism in the brain. The high is the reward, and the brain adjusts to receive more of the reward. The Self-Medication Hypothesis suggests that individuals abuse substances as a way of coping with traumatic events and stresses in life. The Biopsychosocial Model assumes that addiction is driven by a combination of psychological and social factors and therefore must be treated in tandem with treatment for the underlying factors, which may be genetic. The Disease Model labels addiction a disease, or a medical condition that must be treated medically and not as a defect in the addict's moral character. Conversely, the Moral Model assumes fault in the addict's moral character as the fundamental cause for the development of the addiction.
In their book Freedom from Addiction, David Simon and Deepak Chopra summarize the impact of narcotic drugs on the body this way: "Opiate-derived chemicals directly activate the pleasure receptors of the brain, bypassing all usual methods to achieve comfort. ... When the opiates are metabolized, the body is left without intrinsic or extrinsic pain relievers." Therefore, the short-term impact on the body is intense pleasure, while the long-term impact is the degradation of the brain to regulate pleasure and pain in the body.
Narcotics Abuse vs. Dependency In Addiction: Why Can't They Just Stop?, authors John Hoffman and Susan Froemke define substance "abuse" and "dependence." Accordingly, "abuse" is "a pattern of substance use that causes someone to experience harmful consequences," including failure to meet key responsibilities, engaging in reckless activity, and refusing to resist the substance despite warning from friends or relatives. "Dependence" is a physical addiction to a substance resulting physiological and behavioral changes to the dependent user. Physiologically the person needs increasingly higher volume of the substance to achieve a high and experiences intense withdrawal symptoms when deprived of a dose of the substance. Behaviorally the person is obsessed with acquiring the next dose of the addicted substance, prioritizing the substance over all other relationships and obligations, including care for his or her own health.
Some people can become addicted to narcotics without necessarily abusing narcotics. Rather, they may become dependent on narcotics from using them to manage chronic physical pain over time. Even when narcotics are prescribed by a doctor, patients must be aware of their potential for dependency and addiction. The abuse begins with the result of euphoria that the user senses immediately. The opioid receptors in the brain and nervous system are stimulated offering a reward of elation and relaxation.
According to WebMD, "there is somewhat of a continuum between opioid abuse, opioid dependence, and addiction." Signs of abuse include the user's inability to fulfill normal responsibilities and the prevalence of interpersonal problems. Dependence is characterized by the consumption of larger doses of the narcotic more frequently and over a large span of time, an increased tolerance of the effects (the high) of the narcotic, and a clear demonstration that the user is obsessed with acquiring the narcotic's effects regardless of cost to his or her own health and important personal relationships. Addiction is the state of the craving for the narcotic becoming so compulsive and overpowering that the addicted individual's behavior is grossly self-destructive.
Short-Term Effects The short-term effects of narcotic stimulants like cocaine and crack cocaine are increased heart rate, elevated blood pressure, decreased appetite, dilated pupils, hyperactivity, talkativeness, and nervousness. Ingesting stimulants like meth, and speed will bring about a feeling of euphoria, decreased appetite, fever, paranoia, aggression, confusion, and irritability. Opiate narcotics like heroin, morphine, and prescription painkiller like oxycodone, vicodin, and others will produce a surge of euphoria and drowsiness. Opiates can also slow down systems in the body, such as the nervous, respiratory, and digestive. the physical dependence can become severe and gravely impact the body's normal nervous, respiratory, and digestive functions. Heroin tricks the brain's neurotransmittors by activating abnormal messaging. Cocaine and meth trigger the release of large amounts of dopamine, the neurotransmittor that controls pleasure. In effect, the reward circuit of the brain is over-stimulated.
Long-Term Effects Long-term abuse causes the brain to adapt to the drug-induced surges of dopamine, thereby producing less of its own naturally. The brain then cannot stimulate the reward circuit on its own. The neurotransmittor glutamate is permanently altered, and the brain develops a drive to gain messaging to the reward center via narcotics. This desire trumps all other decisions and judgment. The long-term effects of narcotic stimulants like cocaine and crack cocaine include the reduction of dopamine receptors in the brain, the loss of the sense of smell if snorted, bowel gangrene if eaten, and permanent damage to the lungs if inhaled. Chronic use of meth and speed will cause psychotic behavior, hallucinations, respiratory complications, irregular heart beat, and could trigger a stroke or death. Injecting heroin or morphine can damage the body permanently in brining about bacterial infections in the blood, heart valves, liver or kidneys. It can also cause serious damage to the lungs in inhaled or snorted. With prescription painkillers like oxycodone or vicodin,
Addiction is the underlying long-term effect on the body. The body craves the substance biologically just like food. "The addict's need for his or her substance of choice is like a starving person's primal need for food." Westreich explains. "Drugs and alcohol literally 'hijack' the brain, physically and emotionally driving the addict to find, use, and keep using whatever drug he or she has chosen." Once addicted, withdrawal is a necessary challenge to overcome when first embarking on the journey of recovery from the addicted narcotic. If a person is addicted to cocaine or crack cocaine, he or she will suffer withdrawal symptoms of fatigue, depressed mood, anxiety, and irritability. Discontinuing the consumption of meth or speed, will spiral an addict into a state of intense cravings, depression, paranoia, and aggression. In withdrawal from opiates, whether street heroin or prescription pain pills, the addict will experience extreme restlessness, severe pain surging through the muscles and bones, diarrhea, vomiting, and cold sweats.
Further Reading Hoffman, John and Susan Froemke, editors, Addiction: Why Can't They Just Stop?, New York: HBO, 2007. The companion book to the HBO documentary of the same name, offering information and testimonies about addiction in the United States.
Lawford, Christopher Kennedy. Moments of Clarity. NewYork: William Morrow, 2009. First-person accounts of addiction and the journey of recovery.
McMain, Shelley and Michael Ellery. "Screening and Assessment of Personality Disorders in Addiction Treatment Settings." International Journal of Mental Health and Addiction (Jan. 2008).
Simon, David and Deepak Chopra. Freedom from Addiction, Deerfield Beach, FL: Health Communications, 2007.
Westreich, Laurence M. Helping the Addict You Love. New York: Simon & Schuster, 2007. A guide for family member and friends of addicts in leading the addicted into and through treatment and recovery.
Zwanger, Mark. "Narcotic Abuse." E-medicine Health, WebMD, 2011.
Web Sites of Interest American Council for Drug Education http://www.acde.org
Center for Substance Abuse Treatment (CSAT) http://csat.samhsa.gov
Narcotics Anonymous http://www.na.org.
WebMD's E-medicine Health http://www.emedicinehealth.com/narcotic_abuse