Finally, someone is willing to state the truth, one that goes against all the rabidly anti-opioid media hype:
Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think.
But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it.
Yet, this is exactly the kind of research that is not getting funded these days.
All funding seems to be going to studies that continue correlating opioid pain medication with negative outcomes. Most of the negative outcomes found are actually due to a person living with constant pain, not the medication they take to relieve it. (see Opioids Blamed for Consequences of Chronic Pain).
In fact, people who are not addicted to opioids may feel subjectively worse after taking the drug, according to cognitive neuroscientist Siri Leknes.
“I think that the notion that opioids [always] cause pleasure is a myth,” said Leknes, who is a principal investigator at the University of Oslo in Norway.
An individual’s reaction to opioids depends on many interwoven factors, such as where the person is, their mood, previous drug exposure, genetics and metabolism, she explained.
If scientists assume that opioids spark euphoria in most people, they run the risk of overlooking important differences in how individuals react to the drugs, whether on the operating table or in the addiction clinic.
her new work investigates the effects of the drug remifentanil, an opioid commonly given before minor surgical operations to relieve pain, ease anxiety and boost the effects of anesthetics, according to the Mayo Clinic.
Once administered, remifentanil flips switches in the body and brain known as mu-receptors …within networks of cells that regulate pain in the body. Opioid drugs can relieve pain by tampering with the signals that race through this circuitry.
Not everyone experiences the same level of euphoria from opioids, and not everyone that uses opioids will develop an addiction or opioid use disorder,” Kiluk told Live Science in an email.
Scientists are still unpacking exactly why individuals react differently to the drugs, he said.
most opioid research has been conducted with current or former addicts as participants, Leknes said, with some studies going so far as to only include participants who say they enjoy taking the drugs.
This bias in the literature may make opioid-induced euphoria seem commonplace, Leknes said, but she wondered whether the average healthy person finds bliss while hooked to an opioid drip.
Actually, PROP has gone so far as to equate opioid prescriptions with addiction by calling them “heroin pills”.
Leknes and her colleagues studied how 160 patients reacted to remifentanil before undergoing minor surgery.
Across the board, the patients reported feeling high after receiving remifentanil, but on average, they actually felt 0.5 points worse on a 10-point scale after taking the drug. In other words, the high they felt was unpleasant rather than euphoric.
A small subset of people did report feeling slightly better after the drug was administered, but even these participants still gave the experience a 5 out of 10 on the “liking” scale.
In other words, clearly no one reached euphoria on the operating table in the course of the study.
Notice that it’s not “only a few”, but unequivocally “no one” that reached euphoria.
“Pleasure-seeking individuals might be interested in taking another dose of an opioid if available, which in the long run might then lower the threshold to continuous opioid use,” Tarja Heiskanen, a specialist in anesthesiology at the Hospital District of Helsinki and Uusimaa in Finland and co-author of the BJA paper, told Live Science in an email.
However, limitations of the BJA paper make it impossible to say that remifentanil was truly behind the reported pleasurable experiences, according to Leknes
“I think it’s especially important to point out that opioids do not reliably cause pleasure or relief of subjective stress and anxiety in the lab or in stressful clinical settings,” Leknes added
I’m sure that anyone exposed to the media for the last 10 years would be completely surprised by this truth, the truth that pain patients have always known.
models of opioid addiction should acknowledge that not everyone begins abusing the drug in search of euphoria, she said.
“The notion that people become addicted to drugs because they initially chose to take these drugs for pleasure is a belief that stems from a different time, in which we believed addiction to be a moral issue rather than a medical one.”
This is just like the pathetically ineffective “drug-war” which is also from a different time. Managing drug abuse with law enforcement is a travesty that has only increased our societal problems, which is exactly what is leading to the crisis of overdoses in the first place.
Our attitude towards and methods of dealing with addiction are long overdue for a complete overhaul to align them at least a little bit with the reality experienced by real people in their real lives.