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Opioids - How They Work

Paul Auchterlonie

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As interim and turnaround CEO of University Park Behavioral Health, Paul Auchterlonie draws on experience in strengthening the organizations in behavioral health care. Paul Auchterlonie has focused largely on nurturing the development of programs that treat opioid dependence.

Opioids are a class of drug that function by interfering with the brain's reward centers. Opioid structures are very similar to those of natural neurotransmitters dopamine and endorphins, which attach to certain receptors in a person's brain cells. Once attached, the neurotransmitter causes cellular activity that reduces pain and increases feelings of pleasure.

Opioids also reduce pain and boost pleasure, but they do so at a rate and intensity far greater than the brain's natural compounds. This accounts for much of the drug's history as a pain reliever, as well as its appeal as a drug of abuse. Opioids cause a flood of “feel-good” chemicals that lead to a sense of calm and an emotional high.
When a person experiences such intensely positive feelings, they are naturally predisposed to want to feel them again. The person begins to increase his or her intake of opioids and the body begins to acclimate, which means that the individual needs higher concentrations of the drug to feel the same high.
As the person needs to take more of the drug to avoid the intense physical, emotional, and mental symptoms that arise as each dose wears off, he or she becomes more susceptible to an overdose, which occurs when the opioids attach to receptors responsible for controlling breathing. As the opioids bind to those receptors, breathing can slow to dangerously low levels.
To reduce the likelihood of a fatal episode, opioid users need to seek out the help that will allow them to stop using. This may include the use of medication, although each program will differ in its strategy.