Feature image: Michael P Ramirez
Over the last 10 years in the United States, there has been a growing epidemic of abuse and overdose involving opioid painkillers and their illicit street-bound cousin, heroin. Now that President Donald Trump has officially recognized this epidemic as a national crisis, more attention and effort will be dedicated to resolving the chaotic force behind it.
What is addiction?
Addiction is an insidious chemical process that slowly rewires the brain of the victim. Essentially, the different neurotransmitters produce different effects, and dopamine is the reward chemical. Whenever we eat, sleep, or have sex, dopamine is released in larger amounts than almost any other time; drugs are the only other stimuli that can mimic these effects. All addicting drugs, from alcohol to heroin, increase the levels of synaptic dopamine in the brain. This provides a feeling of reward that makes the user seek out the drug again, thus facilitating addiction. In severe cases, the drug becomes as important to the brain as food, sleep, and sex; this is addiction.
Painkillers like oxycodone and morphine mimic chemicals that the brain naturally produces, called endorphins. When you physically work out, or get a cut, the brain releases endorphins to reduce the feeling of pain that the injury produces. Endorphins bind with opioid receptors and one of their effects is the release of dopamine in the reward pathway. This helps to reduce the pain and the anxiety that comes along with it.
Prescription painkillers bind with the same receptor and produce the same response, but they can be hundreds of times more powerful than the endogenous opioids that your brain produces. This causes a massive release of dopamine and therefore produces the conditions of addiction, sometimes after the first use. First, the drug produces a euphoric feeling that is tied to its pain-relieving ability. However, the brain builds a tolerance to the drug during use that leads to symptoms of withdrawal when the drug is removed. When feelings of physical pain and anxiety occur when the drug isn’t present, an addiction has formed.
What is the opioid crisis?
Over the last two decades, the amount of painkiller prescriptions has tripled. Opioids are the most-prescribed class of medicines in the United States, and in 2016 there were nearly 290,000,000 individual prescriptions written for them; that’s almost one per man, woman, and child in this country. Many of those addicted to heroin and other illegal drugs first started down that path by going through an injury or surgery. When they take the medicine their doctor prescribed to them, they experience the euphoric and rewarding effects of the drug, and its use is reinforced. When the prescription runs out, some still crave it.
When an individual goes back to his/her doctor and asks for another prescription to help with the pain, doctors overwhelmingly give them a refill on the prescription, which allows them to get more of the drug. Some individuals who have been caught in this viscous cycle will even go to more than one doctor in order to get more than one prescription. Often times, they realize that it’s cheaper and more effective to just buy heroin off the street than to continue procuring expensive and elusive prescription painkillers.
How can CBD help?
Many individuals who have gone through addiction in the past, or who understand the deadly risks involved with it second-hand, will ask their doctor not to write them a prescription for opioids after a surgery. Some will choose to take NSAIDS, or non-steroidal anti-inflammatory drugs, like Aleve or Voltaren. But a growing number of people are choosing the natural alternative to prescription painkillers: CBD.
CBD has a plethora of different analgesic (pain-relieving) and anti-inflammatory properties, as do other cannabinoids found in hemp and cannabis strains. First and foremost, CBD increases the strength of a signal that a sensory nerve requires to send a “pain” signal to the brain. In addition, CBD and most other cannabinoids are potent anti-inflammatory agents, in the sense that they chemically block the hormones that initiate an inflammatory response on the cellular level.
Most importantly, CBD regulates the output and degradation of neurotransmitters, which is what ultimately gets disrupted in cases of addiction. By diminishing both the negative and the positive reactions neurochemically, CBD maintains a tighter balance among the enzymes that synthesize neurotransmitters like dopamine, and the enzymes that break them down. All of these different balancing acts performed by CBD and the other cannabinoids results in a statistically significant reduction in painkiller usage among those who take CBD vs. those who do not. Though support is still in its early stages, CBD may become a major player in the fight against opioid addiction.