Opioids, trauma and addiction

Endogenous opioids naturally occur in the body and play a vital role in our emotional health. It is a system of neurons that produces three opioids – endorphins, enkephalins and dynorphins. These opioids act as neurotransmitters and neuromodulators and they regulate our pain response. For example, a runner may feel pain towards the end of a long run, but the exercise also produces endorphins that reduce the pain and make the person feel uplifted. However, in people with trauma disorders such as PTSD (post traumatic stress disorder), opioids function differently.

PTSD puts people at risk of developing addictions due to the biological behaviour of opioids in a body and mind that has suffered trauma. In Judith Herman’s book ‘Trauma and Recovery: The Aftermath of Violence’.she says endogenous opioid regulation is altered significantly by trauma and that “traumatized people who cannot spontaneously dissociate may attempt to produce similar numbing effects by using alcohol or narcotics.”

The effects of dissociation

What does she mean by dissociation? It’s a tool the mind uses to protect us from the effects of distressing events. Children are at high risk of developing dissociative disorders after trauma, but adults may also suffer from dissociation. When the traumatic event is occurring, then dissociation is a good and helpful human response, but the problem comes when the traumatised person can’t disconnect from the dissociative state and continues to live in a kind of suspended reality.

Some sufferers describe it as a feeling of being disconnected from themselves and from the world. Someone who is dissociating may be unable to move or speak. Other symptoms include amnesia, confusion about their personality and taking on different identities.

Opioids create a dissociative state where emotional responses are altered and pain is numbed. For example, when scientists tested stress responses in already-stressed animals, they discovered that the animals became desensitised to the stressors, because endogenous opioid production automatically kicked into high gear.

It is important that we recognize the relationship between addictive disorders and trauma so that we can adjust treatment programmes to include regulation of the body’s endogenous opioid production. This will help the person to heal faster.

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