Struggling with my addiction: Recovery, addiction, and the everyday stuff

I’ve written about my own struggles with my addiction on here numerous times. I’ve used crystal meth, ecstasy, cocaine, marijuana, alcohol, LSD, mushrooms, and more, though the first few were the ones that really got me.

After an extended career as a dealer and addict, I turned a new leaf and made a new life for myself. It took a couple of rehabs and a hefty jail sentence. Still the link between my addiction and my recovery is not always strong.

My notions regarding the strong relationship between addiction and personality factors like attention-problems, impulsivity, sensation-seeking, and others comes from both my research and my personal experience. I’ve seen the genetic, behavioral, and clinical manifestations; I’ve also lived it firsthand.

I’ve always been known for doing things I wasn’t supposed to and then feeling sorry for them (or not). It was true when I was 5, long before my first sip of alcohol. Sadly, I’m realizing it is still true now and will most likely be true forever.

I can’t keep anything organized in my head. I never could. I was the kid who lost his house keys 5 times a year, forgot about midterms and finals, let alone school assignments, and who could never remember birthdays, anniversaries, or other important dates and times. These days, I’ve learned to rely on my pda/phone to help me with at least some of those things and it’s made my life much easier. But the underlying problem remains.

The problem is that I’m still impulsive and I still do things I shouldn’t. It’s a constant struggle to pull myself back, a very conscious struggle most of the time. When I say that addiction can be treated, it doesn’t mean that it actually disappears, though for me, it has certainly taken a backseat. If anything, it was after getting sober that I realized my drug use was so tied up with sex that I most likely had developed a sex addiction as well.

I’m not sober now (I drink socially), but I’m very aware of my intoxication level when I drink and rarely let it get out of hand. I can count on one hand the number of times I’ve gotten actually drunk in the five years or so since I began the forbidden “AA experiment.” It works for me, though it might not be for everyone.

The point is that nowadays, I have too much going on in my life that I love to throw it all away over getting high. My fiance, my education, and my work are important to me. The thoughts are still there, but I don’t act on them. It took a lot of work to get here and I seriously hope that I never have to put that work in again, but recovery, addiction, and my everyday stuff can still be a struggle.

You have to build the life you want and do your best to make maintaining that life a priority. It’s not easy, but it can be done. Look here for an exercise that can help you figure out what that life should even look like.

Addiction brain effects : Opiate addiction – Heroin, oxycontin and more

Okay, we’ve talked about crystal meth and cocaine and how they affect the brain during drug use. As I mentioned, both cocaine and meth interfere with the way the brain stores and cleans up important neurotransmitters, including, most importantly, Dopamine and Norepinephrine.

opiates-morphine & heroinThe class of drugs known as opiates, which includes morphine, heroin, codeine, and all their derivatives (including oxycontin), acts on the brain in a completely different manner. Since our goal at All About Addiction is to explain drug use and abuse as comprehensively as possible, let’s turn our attention to this opiate addiction next.

Heroin, morphine, oxycontin, vicodin and other opiates

While cocaine and crystal meth work by disrupting the normal functioning of molecules responsible for cleaning up released neurotransmitters, opiates work by activating actual receptors that naturally occuring neurotransmitters activate. Substance like this are known as agonists; they perform the same action (identically as, to a lesser, or greater extent) as a substance the body already manufactures.

In the case of morphine, heroin, and most other opiates, the most important receptors activated are knownOpiate Receptors as µ-opioid receptors. Activation of the µ-opioid receptors is associated with analgesia (suppression of pain), sedation, and euphoria, which makes sense given the relaxing, pleasure inducing effects of opiates.

Natural opioids (also called endogenous opioids), which include endorphins, are used by the body to relieve pain and increase relaxation, especially during periods of extreme stress. These are the chemicals that make sure we can function during accidents, like after breaking our leg…

Opioids and dopamine

Opioids also increase the amount of dopamine in the brain indirectly. As I mentioned in the earlier posts, dopamine is thought to be the reward indicator in the brain. Unlike crystal meth and cocaine, heroin and its relatives increase the activity of dopamine neurons by releasing the hold that other neurons (that use GABA) have on them. Think of this as the release of pressure on a hose spraying water on a lawn. When the pipe is pinched, only so much water can get through, but once the clasp is released, water can flow in greater quantity; this is essentially what opiates do.

Heroin addiction and long term opiate use

Like I said before, this doesn’t sound so bad, does it? All we’re talking about here is the increasing of the functioning of system that already exists in the brain. The problem isn’t so much in the process, the problem starts when this system gets activated for long periods of time.

HeroinHeroin addicts, and other frequent users of opiates complain about the extreme discomfort they feel when they stop using the drugs. This discomfort has been described as the worse case of the flu you could imagine. Doesn’t sound too appealing, does it? In fact, withdrawal symptoms associated with stopping opiate use are at least one of the main reasons many users return to the drug after trying to clean up. This in addition to all the other effects of the drug on the brain to make wanting to stop so much harder.

The reason for the pains and aches? Given the overactivation of its pain suppression system, the body not only reduces its own supply of opioids, but it also turns up the sensitivity on its pain receptors. Heroin users notice this as an increase in tolerance, but they compensate for it by simply using more. However, when they stop, they’re left with a body unable to suppress its own, hyper sensitive pain system. The results are more than uncomfortable, they’re simply excruciating…

Another common complaint of addicts is diarrhea. This, again, is simply the reversal of the constipation caused earlier by heroin’s actions on opioid receptors that are present in the peripheral system (outside the central nervous system).

I’ve heard addicts speak online about the slow recovery from opiate addiction and I want to dispell a myth here:

Opiates DO NOT stay in your system for weeks or months – The drug itself is gone from the body within days. The reason for the continued suffering is the slow adjustment of your brain and body back to the way things were before the drugs. Think of how long the tolerance took to develop… Now play the tape back in reverse. That’s what happening to you. You can help relieve the pain, but know that if you use anything in the opiate family, you’re making the process last much longer…

So, in summary: As usual, the actions of opiates on the body and brain are not all the severe, extreme, or inappropriate. Opiates are still used in medicine for pain suppression, not only because they work, but because the potential for abuse when used in this way are minimal to non-existent. However, as with all drugs, continued, chronic, abusive use of opiates will change the way your body functions in ways that will produce the exact opposite effects of those users like so much. This leaves people not only with possible addiction problems, but also with a terrifyingly uncomfortable return back to normal functioning.

Addiction help

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The brain addiction connection : Crystal meth, and our friend dopamine

We’ve talked about the general way in which neurons in the brain communicate with one another and then reviewed the ways in which cocaine messes some of the basic processes that the brain depends on.

It’s time to move on to another drug, and since the brain-addiction connection is similar for meth and cocaine, it seems the natural next step…

Methamphetamine (speed, ice, glass, crystal, meth)

Remember how we said that cocaine affects the way that dopamine is cleaned up after being released? Well, crystal meth also affects dopamine, but in a different way:

Instead of not allowing a molecule (DAT) to pull released dopamine back into the cell that released it, methamphetamine doesn’t allow the dopamine in a cell to be stored in the little packets that it’s supposed to be put away in. Like the DAT molecule, there’s another molecule that packages dopamine (and other neurotransmitters actually).

This molecule is called vesicular monoamine transporter (VMAT) because it puts a specific kind of neurotransmitter (called monoamines) into packets called vesicles.

You may be asking this right about now:

“If cocaine and crystal meth act in such similar way, why are their effects so different?”

That’s a very good question.

Even though these two ways of affecting dopamine seem very similar, they cause different changes in the levels of dopamine in the brain:

This flood is similar to the effect of crystal meth on the brain. By interrupting the way the brain packages dopamine, speed causes an unstoppable flood of this neurotransmitter.While cocaine doesn’t allow the neurons to take dopamine back up (reuptake), the brain has these small monitoring devices called autoreceptors. These receptors detect the levels of dopamine in the brain and adjust the output. When cocaine increases dopamine levels, these autoreceptors decrease the amount of dopamine being released.

The problem with crystal meth is that the dopamine can’t be packaged at all, which means that whether the autoreceptors tell the brain to turn down dopamine output, the fact that the dopamine won’t go into it’s packages means it just keep leaking out.

Imagine having a burst pipe and trying to stop the flood by turning down the faucet… not too helpful, right?!

So what you end up with is a long lasting flood of dopamine that the brain can’t do much about… You may have already figured it out, but this is one of the many reasons why crysal meth has become the new drug epidemic; it just does its job really really well!

Dopamine function in a non-drug-using, meth addict after quitting, and a meth addict after 1 year of staying cleanThe long lasting effects on the brain are similar to those of cocaine, but can be even more devestating. Meth is very neurotoxic meaning that at high levels, it can actually kill neurons by over exciting them. In fact, for both cocaine and methamphetamine, but especially for meth, it can take a very long time (a year or more) for dopamine function to look like anything close to a non-user’s brain (look for the decrease in red in the middle figure showing less overall activity in this area).

Check out this video about meth’s effects: