2017-07-16 / Insight

Addiction specialists explain how some people become hooked

BY PHIL FOLEY
810-452-2616 •


Dr. Michael Chaney Dr. Michael Chaney LAPEER COUNTY — We were built for opioids.

Every human being on the planet has receptors in their brains for dopamine. Dopamine is what makes people feel good, said Dr. Michael Chaney, an associate professor at Oakland University and OU’s Coordinator of the Addictions Specialization in the Department of Counseling.

Dopamine is a neurotransmitter that helps control the brain’s reward and pleasure centers. The feelings of pleasure from everything “from sex to chocolate cake” said Chaney is the result of dopamine washing through our brains. The problem with heroin, OxyContin and other synthetic opioids, said Chaney, is that they do a much better job of latching on to the endorphin receptors in the brain than hormones the body creates on its own.

Heroin and other opioids are synthetic version of what our bodies produce on their own. Opioids just do a better job of mimicking what dopamine does, while turning off the hormone that limits dopamine’s effect.

He said that while serotonin, another hormone produced by the body, normally regulates dopamine by limiting its production, heroin and its chemical cousins turn off the serotonin regulating switch.

This said Chaney creates the condition heroin addicts call “chasing the dragon.” With the serotonin switch turned off, once a person’s body has metabolized the opioid, they feel bad — really bad.

The longer a person uses heroin, he said, the more they are merely trying not to feel bad and recreate that first feeling, which they can’t.

The discomfort levels become so high, Chaney said, the user will do anything to stop them. However, Ryan Ashley, the program coordinator for substance abuse treatment at the University of Michigan-Flint, noted, no one dies from heroin withdrawal.

He said alcohol actually changes the body’s physiology, making it possible to die of a heart attack or stroke during detox, without proper medical care. “Heroin withdrawal will make you feel like heck, but you’re not going to die from it,” Ashley said. “It’s like the world’s worst stomach flu.”

Chaney and Ashley agree the two most significant things in treating opioid addiction are time and counseling.

“The brain is remarkable resilient,” noted Chaney. Given enough time, “The brain can repair itself.” However, that can take three to six months, which means 30-day residential detox programs have only limited effectiveness.

Even with a long-term program, Ashley said, relapse is part of the equation.

However, Ashley noted, “Somebody who’s a heroin addict at a younger age, if you get them to survive to their mid-40s they will likely reduce their use and quit.”

But Ashley and Chaney agreed, time is not on the addict’s side.

Unlike prescription drugs, heroin and other street drugs are something of a deadly jack in the box. Fentanyl and carfentanil are cheaper and easier for drug dealers to obtain than heroin.

Chaney said fentanyl is 15 times more powerful than morphine and Carfentanil, which has been used as a large animal tranquilizer, can be absorbed through the skin, making it a danger for first responders.

Both synthetic opioids have contributed to the current national death rate of 90 to 100 people nationwide each and every day, according to Center for Disease Control (CDC) figures. CDC experts expect that daily fatality rate to climb to 250.

Part of the difficulty of addiction treatment, Ashley said, is “There is still a stigma around substance abuse.” He said many people see it as moral weakness. “It’s somebody else’s problem.”

The fact is anyone — from a high school athlete to a construction worker — can get injured, be overprescribed an opioid and find themselves addicted.

Ashley said opioid addiction also has a strong mental health component. He said people facing addiction need a solid support system and in some cases a complete change of lifestyle.

“If you’re on a diet and you eat while watching TV, you’re likely eating poorly,” Ashley said. That’s why groups like Narcotics Anonymous and FAN are important.

However, Ashley noted, “Sadly, some people may have to make hard decisions.” If their environment pushes them back to drug use, they have to get out of it.

Both professionals suggested it would be helpful if more doctors limited opioid prescriptions. The both noted many doctors will give a patient a 30-day script for pain killers when all they really need is enough pills for a few days.

The theory, they said, is if the patient needs more than a few days of pain medications, the 30-day script will keep them from having to pay a second co-pay.

That leaves a lot of extra opioids lying around. “We need to educate physicians,” Ashley said.

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