Science of Addiction

Opioids are some of the most addictive drugs in the world. They are a family of painkillers that include: morphine, fentanyl, oxycodone, hydromorphone and heroin. Symptoms of addiction can appear in under three days. Addiction and dependence are defined separately: opioid addiction is a compulsive action when a person can’t stop using; opioid dependence is when a person builds up a tolerance and their brain releases less endorphins each time. A higher dose is now needed to get the same effect, and users begin to need the drug to feel ‘normal.’

The physical signs of addiction can include minor symptoms like mood swings, nausea, sweating and more extreme symptoms such as seizures and a lower breathing rate that can lead to an overdose, and in extreme cases, death. The long-term use of opioids can create different health issues including increased risk of heart failure and breathing problems that can cause ataxic breathing–which can cause damage to the part of the brain that controls heart and lung functions. Rehabilitation and recovery from an opioid addiction is possible but difficult. Treatment success is said to be dependent on many factors including: patient-provider rapport, social support and treatment. Around 40 to 60 per cent of people relapse in their first year of recovery.

Dr. Sarah Liskowich is a family physician and works at the Family Medicine Unit and the Four Directions Community Health Centre with recovering users. Dr. Peter Butt is a physician and addictions consultant for the Saskatoon Health Region.

In the short term, opioids release endorphins– neurotransmitters that make a person feel pleasure. The release of these neurotransmitters can help with pain relief and improve quality-of-life but the positive sensation can become addictive, leading to dependency. Opioids also affect the prefrontal cortex. This part of the brain is responsible for thinking of consequences, problem solving and short term memory tasks. The prefrontal cortex is essentially hijacked by the opioids and a person has difficulty thinking of anything else.