Considering how the physical effects of opiate abuse play a central role in driving continued drug use, many may assume the drug’s physical effects drive addiction in the same way. Opiates no doubt interact with the brain’s physical makeup in profound ways; however, drug cravings develop out of the brain’s psychological makeup.
While rates of opiate addiction today are higher than they’ve ever been, rates of relapse run considerably high as well. According to American Family Physician, rates of relapse for opiate addiction run as high as 90 percent within six months’ time for long-term users who forego ongoing treatment after detox. For these reasons, it’s imperative to continue on in treatment after the detox stage to prevent opiate abuse behaviors from reemerging.
The Opiate Addiction Progression
As of the first time taking an opiate drug, the brain’s chemical processes make adjustments to accommodate opiate effects. Since opiates bear strong similarities to the brain’s own endorphin chemicals, the brain will continue to reconfigure its chemical pathways in response to opiate effects for as long as a person keeps taking the drug.
By the time addiction develops, the brain’s structural makeup has changed to the point where it actually works differently in terms of a person’s psychological, emotional and behavioral makeup. In effect, opiate abuse practices continue to transform the brain in fundamental ways.
Physical Dependence vs. Psychological Dependence
After so many weeks or months of opiate abuse, users start to feel the effects of physical dependence in the form of withdrawal effects. In a nutshell, physical dependence most reflects the state of chemical imbalance in the brain brought on by opiate abuse. Ultimately, the brain can no longer function normally in the absence of opiate effects.
With frequent, ongoing opiate abuse, worsening chemical imbalances start to warp how specific areas of the brain work, such as the cognitive centers, limbic system (regulates emotions) and brain reward system. According to Stanford Medicine, these developments underlie psychological dependence.
Once psychological dependence takes hold, a person’s overall mindset or psychological makeup has come to rely on opiate effects to cope with everyday life pressures. Herein lies the source of drug cravings.
Opiate Abuse Behaviors
More than anything else, the effects of opiate abuse on the brain reward system drive the thinking and behaviors that characterize addiction. This system identifies positive behaviors and experiences based on dopamine level outputs. Not surprisingly, dopamine is one of the endorphins most affected by opiate effects.
During the course of a developing opiate addiction, elevated dopamine levels tell the brain reward system to assign a high importance to anything having to do with getting and using the drug. This “importance” is felt as a “need,” or craving by the addict.
As long as a psychological dependence on opiates persists, a person will continue to experience drug cravings. This means, a person can successfully complete detox and maintain abstinence for months thereafter while still experiencing drug cravings.
As difficult as opiate detox can be, opiate addiction treatment doesn’t actually begin until a person starts to work through the psychological effects of addiction. Behavioral treatments, such as psychotherapy, support group work and drug education pick up where drug detox leaves off in terms of helping those in recovery develop a drug-free mindset.
If you or someone you know continues to struggle with opiate abuse urges and drug cravings in recovery and have questions about available behavioral treatment options in your area, please feel free to call our toll-free helpline at 800-584-3274 Who Answers? to speak with one of our addictions specialists.