The country is in a public health crisis, yet the media is largely ignoring it. Between 1979 and 2010, the number of overdose deaths in New York State rose a dramatic 169 percent. This means that more people are now dying from fatal overdoses than motor vehicle accidents. We can attribute the majority of those fatal overdoses to prescription opioid abuse.

Why are the Numbers Up?

The truth is that one of the primary reasons that prescription drug abuse has skyrocketed is because they are more readily available than ever before. This was a response to complaints from pain advocacy groups and patients themselves – they wanted doctors to become less restrictive when it comes to giving out prescriptions for opioid pain pills. As the availability of these substances increased, more and more people started to use them. The most-prescribed drug of any kind for much of this decade is hydrocodone (Vicodin).

While no one would argue that improved pain control for people who need it is a good thing, people are exposed to substances that were previously unheard of. Add in the fact that these substances can be extremely addictive and you will start to understand why this problem is not going to go away. In order to understand why, we need to delve deep into the brain.

More about the Opioid-Addicted Brain

Like many other illicit substances, opiates stimulate specific areas of the brain. These areas of the brain perceive pleasure, which is why it feels good for people to use. However, these parts of the brain do more than just ‘make us feel good’. These parts of the brain also tell us what is important, what matters to us and what we need to care about.

Having sex, seeing someone we care about, spending a great night with friends, going for a run, all those are activities that are inherently important for human survival. As a result, the brain ‘rewards’ us for performing that type of behavior by releasing a tiny bit of dopamine. This is our body rewarding us for doing things that help us continue our survival.

However, when people abuse these substances, they flood their brain with dopamine. This explains the euphoric rush that they feel. Because it feels so good, our brain deems it worthy of repeating again and again. Because people continue to abuse these substances, chasing after that good feeling that they are unable to replicate themselves, it begins to teach the brain that this is something essential. Our brain is eventually going to perceive opioid use on the same level of importance as food or water.

This is why people struggling with addiction demonstrate the behavior they do. Their brains are suggesting that all the other important things such as having sex, performing at work, or paying attention to family and friends are just not as important as getting high one more time. What started as voluntary use is quickly becoming someone with a hijacked brain.

The Difference between Dependence and Addiction

It is important to note that there is a difference between someone struggling with opioid addiction and opioid dependence. People who receive a prescription for a medication such as OxyContin are going to develop a level of physical dependence and a tolerance to the substance. However, those people are on recommended, generally lower doses of the medication. If this person were to stop using altogether, they might undergo relatively mild withdrawal symptoms. While it may be uncomfortable at first, it certainly would not be on the same level that someone with a full-blown addiction would experience. The person’s body would ‘detoxify’ and the person would be able to move on with his or her life. The chance of that person seeking out more drugs in the immediate future is slim to none.

However, someone struggling with opioid addiction is actively abusing large amounts of the medication in order to lessen their struggles with anxiety or to get high. The prolonged period of abuse and the higher doses make the withdrawal symptoms far worse. The reward pathway of the brain is changed, leading to continued use despite negative consequences, serious cravings and compulsive drug seeking behaviors. The type of medication is ultimately not important – whether it be OxyContin, Percocet, Vicodin, heroin or morphine. The result is the same. All of these are in the opioid family and have similar effects on our body. It is important that people receive an education on just how similar these substances are, just because a pharmaceutical company manufactures something does not mean that it is safe to abuse as people see fit.

Change Does Not Come Automatically

While it is true that many regulating agencies are finally waking up to the notion of this massive problem (or are at least unable to turn a blind eye anymore), the issue is that the genie is out of the bottle. Anyone who does the slightest bit of research on how dependence works understands that it is not possible to say, “We are making it harder to get these medications now, which should solve the problem.” Instead, the majority of users are going to find an alternative method to satiate their cravings.

This is already happening with people struggling with prescription opioid addiction. Too many people are making the switch to heroin. Heroin is affordable, it is readily available and provides a comparable (if not more intense) high than the previously abused substance. For most people, this is not a rational decision, it is simply about fighting off those withdrawal symptoms for one more day. It is about feeling ‘baseline’ for a few more hours.

If we look at the staggering number of people that have addiction problems because of medication abuse, it is evident that drug treatment is more important than it has ever been before. Because without proper treatment, we could see a shift of people who turn away from legally-manufactured, yet illegally-abused drugs and turn to black market substances instead.