America is in the midst of an opioid epidemic that has affected communities throughout the nation without regard to racial or socio-economic status. Opioid overdose deaths have skyrocketed in the last several years and our state and federal governments have begun to treat the opioid epidemic as a public health concern, focusing on treatment rather than criminalization and incarceration.

1. www.blvdcenters.org

2. America is in the midst of an opioid epidemic that has affected communities
throughout the nation without regard to racial or socio-economic status. Opioid
overdose deaths have skyrocketed in the last several years and our state and
federal governments have begun to treat the
opioid epidemic as a public health concern,
focusing on treatment rather than
criminalization and incarceration.
However, opiate addiction is
extremely difficult to treat because
opiates hijack the brain’s pleasure
center, changing the structure of the
brain, and creating a life-or-death
need for the drug. Without the use of
Medication-Assisted Treatment
(MAT), an overwhelming majority of
opiate addicts will relapse and a
significant number of those folks will
overdose and some will die.

3. Opiates activate opioid receptors in the brain’s
pleasure center that regulate pain, reward, and
pleasure. When activated these receptor cells
release the neurotransmitter dopamine creating
an intense sense of pleasure (“Effects of Specific
Drugs on the Brain – Heroin,” National Institute
on Drug Abuse (NIH),
www.drugabuse.gov/publications/research-
reports/heroin).

4. According to Dr. Seddon Savage, an addiction and pain specialist at Dartmouth
College, the brain’s pleasure center, the limbic system, connects areas of the brain
that control emotions “such as pleasure of eating, drinking, and sex” (“Anatomy of
Addiction: How Heroin and Opioids Hijack the Brain, Rodolico, Jack,
http://www.npr.org/sections/health-
shots/2016/01/11/462390288/anatomy-of-addiction-
how-heroin-and-opioids-hijack-the-brain, January 11,
2016). The limbic system “is a very ancient part of the
human brain that’s necessary for survival,” says Dr.
Savage, and opiate addiction hijacks it into believing
the drug is needed for survival (Id.). Furthermore, long-
term opiate use can actually cause physical changes in
the “structure and physiology of the brain” creating
neurological imbalances that are difficult to reverse
(Id.). Opiate addicts will go to any length to secure the
drug because the limbic system becomes hardwired to
seek opiates for survival.

5. Stripped of his or her will to say no to
opiates because taking the drug is a
matter of life or death, the addict
requires medication and counseling as
the most effective form of opiate
addiction treatment according to the
medical establishment (“Dying to be
Free,” Cherkis, Jason,
http://projects.huffingtonpost.com/dyi
ng-to-be-free-heroin-treatment?
utm_source=scoopinion). However,
most addiction treatment in the U.S.
stubbornly adheres to the outdated 12-
step model and eschews fact-based,
scientific treatment practices.

6. Given the powerful
nature of opiate
addiction, with its
record levels of
overdose deaths
across the country,
government at all
levels has begun to
pay attention to the
problem. And, some
inpatient treatment
centers have
recognized the efficacy
of MATs and changed
long-standing policy.

7. However, it may be years before
adequate opiate treatment is available
for most addicts because current
abstinence-based 12-step treatment
programs are deeply entrenched and
stand to lose billions of dollars in
treatment revenue.
Moreover, if the Affordable Care Act is
repealed, there is no indication whether
addiction treatment will be covered by
insurance companies. The next few
years will determine the direction the
U.S. takes in dealing with the opiate
epidemic. Opiate addicts could be facing
a catch-22: get ineffective treatment
now or no treatment in a year or two.