Opioid Addiction: The Impact on an Individual and Society Haber 1

Opioid Addiction: The Impact on an Individual and Society

Ashley Haber

University of Arizona

HPS 405

Dr. Duke Duncan

Opioid Addiction: The Impact on an Individual and Society Haber 2

Biology

There are many disorders that lead multiple age groups to severe health risks. One of the

most extreme conditions that is overly common in our society is Opioid Addiction. Addiction is

defined in many ways, but is essentially a relapsing and chronic disorder in which the individual

consistently seeks out dangerous substances while failing to recognize their harmful results and

long-lasting impacts on the body (National Institute on Drug Abuse, 2018). Opioids belong to an

extremely dangerous group of illegal drugs including the “illegal drug heroin, synthetic opioids

such as fentanyl, and pain relievers available legally by prescription, such as oxycodone

(OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others (National Institute

on Drug Abuse, 2019a)”.

Opioids are designed to take away pain and bring feelings of pleasure. They produce

these effects because once they enter the bloodstream, they attach to opioid receptors on nerves

within the brain and block signals and messages sent from the body through the brain (American

Society of Anesthesiologists, 2019). These particular receptors fall under the classification of G-

protein coupled receptors (GPCRs), which can be activated both naturally within the body or

through drugs (National Institute of Health, 2019). Once these chemicals bind to the receptors,

the body produces the same sensations a person experiences when encountering extreme

pleasure. The part of the brain that opioids activate is called the mesolimbic reward system,

which is known as the reward system (Kosten & George, 20012). A neurotransmitter released in

this part of the brain is called dopamine, and when released it can cause extreme feelings of

euphoria (Kosten & George, 2002). The human body isn’t equipped to produce enough natural

opioids to block pain or cause an overdose; it is the drugs that can do this because their chemical

structure is so similar to natural neurotransmitters that they trick the nervous system into
Opioid Addiction: The Impact on an Individual and Society Haber 3

allowing then to bind to the opioid receptors (The National Alliance of Advocates for

Buprenorphine Treatment, 2008).

It is important to not only understand the biology of opioids themselves, but the biology

of addiction and how the condition affects an individual. When the brain experiences the

repeated release of dopamine and other neurotransmitters causing desirable emotions, the brain

has “memory”, and remembers the feelings associated with the entrance of the chemicals. “These

memories, called conditioned associations, often lead to the craving for drugs when the abuser

reen-counters those persons, places, or things, and they drive abusers to seek out more drugs in

spite of many obstacles” (Kosten & George, 2002). This memory and association are a huge part

of opioid addiction, but equally important is tolerance and dependence.

Tolerance, or the want to increase the dosage of drugs to heighten the effect, happens to

drug users because after the repeated use of opioids the receptors in the brain become less

stimulated (Kosten & George, 2002). Due to this, more of the drugs are needed in order to

produce and release the same amount of dopamine as the first time the user ingested the drugs.

Drug dependence, or the likelihood of the onset of withdrawal symptoms without the body

encountering opioids, is only able to happen to a person if they have already developed a

tolerance for opioids (Kosten & George, 2002). This poses dangers to the user because their

body will continue to rely on the drugs to ensure their body doesn’t go into withdrawal mode. It

is important to note that those addicted to drugs have a higher chance of encountering major

stress in their everyday life, more than the average individual (Kosten & George, 2022). This can

be credited to the fact that the stressors in life can cause individuals to want and return to the

feelings of euphoria experienced when using opioids.

Opioid Addiction: The Impact on an Individual and Society Haber 4

Epidemiology of Condition

The rise in medical professionals prescribing opioids as well as the increase of non-

prescriptions use of opioids has led to an increase in the misuse of opioids among society. There

are many risk factors to opioid addiction; prior history of substance abuse, age, geographic

location, mental disorders, and the degree of pain are all aspects that can increase the likelihood

of an individual to become addicted to opioids (Strain, 2018). The root causes of the problem can

be different for each addict. An important one to take note of is the prior and unresolved history

of substance abuse. This is important because the chance of a recovered drug addict to relapse is

extremely high if one the main reasons of addiction stems from previous interaction with the

drugs.

Since the 1990’s, the abuse of opioids has become out of control, and the incidence of

opioid use has reached epidemic status (Strain, 2018). It is estimated that 11.4 million Americans

misused prescription opioids in 2017, amounting to 47,600 overdoses (HHS, 2019). After the

increase in opioid use, and the start of the epidemic, the use of heroin drastically increased

around 2010. Users turned to heroin because it was it was cheap and widely available, unlike

other prescription drugs. The use of heroin increased among all ages, genders, and

socioeconomic groups; the death rate due to heroin overdose increased by 268% within the years

2002 to 2013 (National Capital Poison Control, 2019). The NIH states that around 21-29% of

patients that receive a prescription for opioids misuse them, and 8-12% of them develop an

addiction (National Institute on Drug Abuse, 2019b).

Although death rates due to opioid overdoses are high among every age group and

gender, men have a slightly higher death rate. In Massachusetts, it was recorded that “76 percent

of opioid overdose deaths occurred among people under the age of 50, and men aged 18 to 34
Opioid Addiction: The Impact on an Individual and Society Haber 5

had opioid-related death rates nearly three times higher than those of women of the same age”

(National Institute on Drug Abuse, 2019b). “The age group with the greatest past-year

nonmedical use of opioids is young adults aged 18 to 25, yet the greatest use (i.e., exposure) of

prescription opioids is among adults aged 26 and older” (National Institute on Drug Abuse,

2019b). The geographic location comes into play when considering heroin. Since heroin is cheap

and available, in lower socioeconomic areas the use of heroin is typically higher than those with

higher income; those who began building their dependence on opioids though prescriptions that

do not have the prescriptions anymore are likely to turn to heroin (National Institute on Drug

Abuse, 2019b).

Implications on The Socioecological Model

Opioid addiction is impactful among several levels. In relation to the socioecological

model, one level where drugs can impact most is the individual level. Being reliant and

dependent on drugs in everyday life can cause stress and use of lots of money; these factors on

top of the health impacts opioids cause an individual to develop can be detrimental. Another

level is the interpersonal level. Families that have a member who is impacted by substance abuse

are heavily impacted. If there are children in the family, they are being exposed to erotic

behavior and even the chance of mistreatment. They also can be confused that this behavior is

regular.

On a community level, the entire community as a whole is affected. The safety and well-

being of communities are at risk when there are high rates of drug abuse among them. Programs

within communities are relevant under this level also because some of the responsibility to

regulate and treat opioid addiction is reliant on the community. There must be proper treatments

and programs offered to those who have trouble with drug use, as well as regulation of
Opioid Addiction: The Impact on an Individual and Society Haber 6

prescription drugs when given to patients, whether that be a follow-up appointment for those

prescribed with opioids, or patients being assigned a monitor when the drugs are taken. This

level ties into the public policy level as well because the need for interventions and programs in

low socioeconomic populations is crucial in order to treat the individuals affected in these

populations.

Interventions

One of the reasons opioid addiction is currently an epidemic is the ineffective treatments

and programs available to struggling individuals. A successful program is the BAART Program.

This program is in multiple states across the United States and delivers treatment to people

addicted to opioids. The program delivers counseling and medication assisted-treatment to limit

the feelings of addiction. “The BAART continuum of care includes opioid treatment programs,

behavioral health services and integrated primary care in select locations (BAART Programs,

2019). BAART offers medication options and sometimes provide their patients with

Buprenorphine and or Methadone. Buprenorphine is a drug that is FDA approved, and is

successful because “Buprenorphine is a partial opioid agonist, which can be used on a limited

basis to treat chronic pain, but whose primary purpose is the treatment of opioid addiction”

(BAART Programs, 2019). They also offer methadone, which is “a full agonist opioid meaning

that it acts similarly to other opioids by fully activating the receptors in the brain” (BAART

Programs, 2019). The program also offers counseling, wither group or individual, in which the

patient is assisted in rebuilding their life after they overcome opioid addiction (BAART Program,

2019).

Another program that is successful is Narcotics Anonymous (NA). Similar to Alcoholic

Anonymous, NA is a support group of those affected by drug abuse that meets to help each other
Opioid Addiction: The Impact on an Individual and Society Haber 7

combat the urge to use drugs. This program supports the full abstinence of substances, and

provides its members with incentives to attend meetings (friendships, support, alternative

activities, etc.) (Narcotics Anonymous, 2019). This intervention is community based, and each

community has designated locations where NA meetings take place. This intervention is

successful because it does not discriminate against anyone. Any person affected by drug abuse

no matter the magnitude of exposure of socioeconomic class is able to attend. Both NA and

BAART Program are successful, and have shown great results. The only limitation is that both of

them are non-profit, so funding can become an issue. In addition, they both do not account for at

home care, meaning there is not too much follow up in the home. Despite this, interventions like

BAART Program and NA are crucial to the recovery of individuals battling opioid addiction.
Opioid Addiction: The Impact on an Individual and Society Haber 8

References

American Society of Anesthesiologists. (2019). What Are Opioids? - When Seconds Count.

Retrieved from https://www.asahq.org/whensecondscount/pain-management/opioid-

treatment/what-are-opioids/

BAART Programs. (2019). Recovery From Opioid Addiction Using MAT. Retrieved from

https://baartprograms.com/

HHS. (2019). What is the U.S. Opioid Epidemic? U.S. Department of Health and Human

Services. Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html

Kosten, T. R., & George, T. P. (2002, July). The neurobiology of opioid dependence:

Implications for treatment. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/

Narcotics Anonyomous. (2019). Narcotics Anonymous - About Us. Retrieved from

https://www.na.org/?ID=aboutus

National Capital Poison Control. (2019). History of the Opioid Epidemic. Retrieved from

https://www.poison.org/articles/opioid-epidemic-history-and-prescribing-patterns-182

National Institute of Health. (2018, June 05). How opioid drugs activate receptors. Retrieved

from https://www.nih.gov/news-events/nih-research-matters/how-opioid-drugs-activate-

receptors

National Institute on Drug Abuse. (2018, July). The Science of Drug Use and Addiction: The

Basics. Retrieved from https://www.drugabuse.gov/publications/media-guide/science-

drug-use-addiction-basics

National Institute on Drug Abuse. (2019a). Opioids. Retrieved from

https://www.drugabuse.gov/drugs-abuse/opioids
Opioid Addiction: The Impact on an Individual and Society Haber 9

National Institute on Drug Abuse. (2019b, January 22). Opioid Overdose Crisis. Retrieved from

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

Strain, E. (2018, September). Opioid use disorder: Epidemiology, pharmacology, clinical

manifestations, course, screening, assessment, and diagnosis. Retrieved from

https://www.uptodate.com/contents/opioid-use-disorder-epidemiology-pharmacology-

clinical-manifestations-course-screening-assessment-and-diagnosis

The National Alliance of Advocates for Buprenorphine Treatment. (2008). The National

Alliance of Advocates for Buprenorphine Treatment. Retrieved from

http://www.naabt.org/faq_answers.cfm?ID=6

U.S National Library of Medicine. (2019). Opioid addiction - Genetics Home Reference - NIH.

Retrieved from https://ghr.nlm.nih.gov/condition/opioid-addiction