Is Hopelessness Addicting? The Opioid Epidemic in Pittsburgh

Last year, Pennsylvania witnessed an increase of about 20 percent in overdose deaths compared to 2016.  Synthetic opioids are a major contributing factor for this increase, claiming over 30,000 deaths in 2017, according to the Centers for Disease Control.  However, synthetic opioids are not the only problematic drugs.  In 2017, there were 72,000 overdose deaths by fatal drugs such as heroin, synthetic opioids, fentanyl and methadone.  Pittsburgh is no stranger to the current opioid problem.  Our city reported 737 deaths in 2017, with fentanyl (547), heroin (288) and cocaine (277) being the top three commonly used drugs.  This is a 267 percent increase in overdoses since 2013: truly shocking. 

Death is not the sole problem associated with opioids: addiction serves as a catalyst.  Addiction is considered a long-term disease, which affects the wiring of neural circuits primarily in your basal ganglia, extended amygdala and prefrontal cortex.  These structures are responsible for your reward system, motivation, irritability, anxiety, self-control, problem-solving and decision-making.  Our reward systems are extremely influential in creating repetitive behaviors.  When our body does something pleasing—this can be a thought or behavior—various molecules are released by neurons in our basal ganglia, which then strengthens our reward pathway for the desired action.  This is also considered reinforcement if the action is performed more than once.  Experiments on rats at the University of Valencia showed dominant activity in the basal ganglia in rats who habitually ingested drugs, proving how the basal ganglia in drug addicts also strengthens each time they use a certain drug.  Once your brain is physically “wired” to a specific orientation, establishing new habits can be challenging.  In an article published in Behaviour, scientists AJ Machin and RIM Dunbar found that a user is capable of regulating, abandoning or destroying unimportant relationships when made to choose between these or the substance.  This is why many addicts suffer from relapse

The basal ganglia and reward system play an important role in understanding in addiction.  However, addiction can not only result from drugs, thoughts or behaviors; research has been conducted on determining how brain systems are susceptible to helplessness and depression.  Simply put: you can become addicted to feeling a certain emotion.  An emotion pivotal to understanding drug addiction is helplessness.  If you look at pictures online of drug addicts living on the streets, there is sadness, hopelessness and an underlying look of desperation to them.  These feelings are powerful, and when their brain is physically wired to only think about drugs, hopelessness is understandable.  In some cases, learned helplessness prevails as a cause to why addicts do not seek help or try to quit.  Learned helplessness is the mental state where an organism is forced to bear aversive or unpleasant stimuli.  They become unable or unwilling to avoid encounters with these stimuli, even if they are escapable, because they have learned that they cannot control the situation.  A more relatable example for college students of learned helplessness is not studying for Russian Fairy Tales because no matter how hard you study, the exam will be impossible to pass.  To relate exams to drugs, addicts may not seek help because they believe that despite their best efforts, they will never quit or that they will relapse. 

To become addicted to an emotion is very similar to becoming addicted to drugs, especially heroin.  The following information is cited from a National Institutes of Health research publication.  Addiction is broken down into three phases.  Phase one is the intoxication state.  Here dopamine and opioid peptides release in your brain and designate actions—including heroin use—as rewarding. This reinforces the drug-using behavior. The second phase is withdrawal.  The extended amygdala is responsible emotions such as irritability and anxiety during this phase. There are also several physical symptoms, such as nausea, headaches, fevers, chills and even seizures in some cases.  As neurotransmitters like dopamine decrease in the reward system, there is powerful motivation for the organism to engage in previous behaviors, including feeling the emotion or using heroin.  The final phase is anticipation.  The prefrontal cortex circuits responsible for decision-making, problem-solving and self-control influence prior behaviors and reinforce cravings.  This explains why people that want to feel a certain emotion act in a way that will allow them to express that emotion, and why heroin addicts seek out heroin, and often relapse. 

The data and science are shocking and terrifying.  Emotions can be addicting, including hopelessness, which can lead to learned helplessness.  Feeling helpless when addicted to drugs leads to failure to seek help, which may result in overdose.  Opioid use is steadily increasing, along with overdoses, causing growing attention through documentaries such as Heroin(e) or Warning: This Drug May Kill You.  Addiction is a very serious and fatal disease that unfortunately gets cast as weakness of character instead of the mental illness it is. Groups in Pittsburgh are working to provide resources and start programs that will reduce the levels of  fatal drug use and overdose with initiatives such as Code4PA, Prevention Point Pittsburgh and the Coalition to Stop Opioid Overdose. 

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