Drugs for Physical and Emotional Pain Change Your Brain

Drugs for Physical and Emotional Pain Change Your Brain

January 28, 2016 | 22,101 views

By Dr. Mercola

Prescriptions for opioid painkillers have risen by a staggering 300 percent over the past 10 years.1 This drastic increase in the number of opioid prescriptions written and dispensed is thought to play a major role in the global problem of addiction to opioids such as heroin, morphine, and prescription pain relievers.

In the U.S. alone, 2.1 million people suffer from substance use disorders related to prescription opioid pain relievers, while an estimated 467,000 are addicted to heroin.2 Prescription pain relievers are considered a “gateway drug” to heroin. Over the past five years, heroin deaths have increased by 45 percent.

This increase is blamed on the rise of addictive prescription drugs such as Vicodin, OxyContin, Percocet, codeine, and Fentora, all of which are opioids. (The reason for the resurgence of heroin is in large part due to it being less expensive and, sometimes, easier to obtain, than its prescription counterparts).

Despite the prevalence of the problem, why some people become addicted and others do not remains a mystery. It’s known, however, that such drugs lead to neuroplastic changes in animals when taken long term, and now new research shows they also occur in humans, even after short-term use.

One Month of Morphine May Change Your Brain

In a study by researchers at the University of Alabama at Birmingham, people with chronic low back pain received either morphine or a placebo daily for one month. Both groups experienced similar reductions in pain, but there was a major difference among those taking morphine — changes in the brain.

Magnetic resonance imaging (MRI) scans showed the patients taking morphine had a 3 percent reduction in gray matter volume over the course of the study. The reductions occurred in regions of the brain that regulate emotions, cravings and pain response.3

Further, the morphine group had increases in gray matter volume in areas related to learning, memory and executive function. Lead study author Joanne Lin told Reuters:4

“Because we are seeing that opioids rapidly change the brain, our take-home message is that opioids should be reserved for cases when most other treatment options have failed.”

A similar study published in 2011 also found daily morphine can cause neuroplastic changes in the human brain after only one month of use. According to that study:5

“Several brain regions underwent volumetric change over the morphine use period … Following the month of morphine administration, reduced gray matter was observed in the right amygdala.

The amygdala, together with the hippocampus, drive reward-related learning processes via modulatory influences on the nucleus accumbens.

The amygdala is involved in drug-induced associative learning, drug craving, reinforcement, the development of dependence, and the experience of acute withdrawal.

Atrophy in the amygdala was found in a previous study to be an important area of morphologic difference distinguishing opioid-dependent individuals from healthy controls.

… Learning involving the amygdala may lead to long-term behavior patterns that continue even as pleasurable effects subside; perhaps forming the basis for opioid misuse in some individuals.”

Your Brain Has Specialized Opioid Receptors

In 1972, Johns Hopkins University researchers discovered that your brain’s neurons have specific receptor sites for opiate drugs, including heroin, morphine, hydrocodone and oxycodone.6 Such drugs exert their effects by attaching to the opioid receptors found in your brain and spinal cord.7

Why would your brain have a specific site for binding to opiate drugs? The sites are actually there for another purpose, including to bind to endorphins, your body’s “natural opiates.”

As it turns out, opiate drugs have a chemical structure that’s very similar to your body’s natural feel-good chemicals, endorphins. This allows them to partake of the endorphin receptors and ultimately overtake their place in your body. PBS Frontline reported:8

“Like an evil twin, the morphine molecule locks onto the endorphin-receptor sites on nerve endings in the brain and begins the succession of events that leads to euphoria or analgesia.

This imposter is more powerful than the body's own endorphins because the organism can actually control how much of the feel-good chemical hits the brain.

Since we are all pleasure-seeking organisms, the motivation to self-administer such a drug is easy to understand. The drawback, of course, is addiction.”

Americans Risk Becoming Drug Addicts to Become Pain-Free

Pain is one of the most common health complaints in the U.S., but record numbers of Americans are, sadly, becoming drug addicts in an attempt to live pain-free.

According to 2010 data, there were enough narcotic painkillers being prescribed in the U.S. to medicate every single adult, around the clock, for a month.9

By 2012, a whopping 259 million prescriptions for opioids and other narcotic painkillers were written in the U.S., which equates to 82.5 prescriptions for every 100 Americans.10 And those narcotics are responsible for 46 deaths each and every day.

Americans use the most opioids of any nation — twice the amount used by Canadians, who come in second place in terms of prescriptions.11

The problem has become noticeable enough that even U.S. officials now warn that narcotic painkillers are a driving force in the rise of substance abuse and lethal overdoses. The rise in heroin addiction in the U.S. is linked to dependence on prescription opioids.12

Indeed, what many fail to realize is that opioid prescription painkillers are very similar to heroin. This is part of why so many painkiller addicts end up using heroin when their tolerance level surpasses their allotted prescription dosage, or when they can no longer refill their prescription.

Heroin use can quickly turn deadly, but please don’t be mislead that it takes heroin use to cause a fatal overdose. All opioids depress your heart rate and breathing. Large doses can cause sedation and slowed breathing to the point that breathing stops altogether, resulting in death.

Stopping the drugs on your own, meanwhile, is difficult and causes significant withdrawal symptoms, including flu-like symptoms (nausea, vomiting, diarrhea, weakness and muscle cramps) that may last for up to 10 days. According to PBS Frontline:13

“The phrase 'cold turkey' probably comes from the appearance of goose bumps all over the body, which resembles a plucked turkey. Muscle spasms in the legs produce kicking movements, and this may be the derivation of the expression 'kick the habit.'”

Painkillers and Sedatives Linked to Increased Risk of Committing Homicide

The use of mind-altering drugs has risen along with the number of mass shootings and other homicides in the U.S. Antidepressants in particular have a well-established history of causing violent side effects, including suicide and homicide. A 2015 study published in the journal World Psychiatry found, however, that painkillers and sedatives are linked to homicide. 

Researchers analyzed data involving nearly 1,000 people who had been convicted of homicide, including studying police reports to determine if narcotics were being used at the time of the murders.14 Surprisingly, commonly used pain relievers, including acetaminophen (Tylenol) and ibuprofen, were associated with a more than 200 percent increased likelihood of committing homicide. Other drugs also increased the risk, including:15

• Opiate pain relievers (raised the risk by 92 percent)
• Benzodiazepine sedatives (Valium, Xanax, etc. raised the risk by 45 percent)
• Antidepressants (31 percent)

The researchers concluded that the increased risk of committing a homicide associated with opioid and non-opioid pain relievers deserves further attention, including whether such drugs should be used for the treatment of pain among people with a criminal history.16

If Drugs Alter Your Brain, They Could Potentially Alter Your Behavior Too

It’s not altogether surprising that opiates could alter behavior.17 Painkillers work by interacting with receptors in your brain resulting in a decrease in the perception of pain. They are inherently addictive, as they also create a temporary feeling of euphoria, followed by dysphoria that can easily lead to physical dependence and addiction.

Perhaps this state of unease may drive violent behaviors as well. We also know they lead to physical changes in your brain, the consequences of which are unknown. Withdrawal from antidepressants has also been linked to severe psychiatric problems.

Further, please note that these are not the only type of drugs associated with violent, homicidal behavior. A 2010 study by the Institute of Safe Medication Practices identified no less than 31 commonly prescribed drugs that are disproportionately associated with cases of violent acts.18

Topping that list were the quit-smoking drug Chantix, followed by Prozac and Paxil, and drugs used to treat attention deficit hyperactivity disorder (ADHD). Given the significant neurological effects that may occur when you take medications like antidepressants, sedatives and opioids, they should be used as a last resort, not a first line of treatment.

Are You in Severe Pain?

I strongly recommend exhausting your options before resorting to a narcotic pain reliever, and I'll list a number of alternatives at the end of this article. That being said, if you’re in severe pain I agree that these drugs do have a place, and can be a great benefit when used cautiously and correctly. It's quite clear that these drugs are being overprescribed, and can easily lead you into addiction and other, more illicit, drug use.

I strongly suspect that the overreliance on them as a first line of defense for pain is a major part of this problem. So if you are dealing with severe or chronic pain, my first suggestion would be to see a pain specialist who is familiar with alternative treatments and the underlying causes of pain.

You need a knowledgeable practitioner who can help you attack the pain from multiple angles, giving you both relief and healing. One option that is receiving increasing attention in the U.S. is cannabis. It’s the cannabidiol (CBD) in cannabis that has medicinal properties. CBD is an excellent painkiller and has been used successfully to treat a variety of pain disorders.

In states where medicinal marijuana is legal, such as California, you can join a collective, which is a legal entity consisting of a group of patients that can grow and share cannabis medicines with each other. By signing up as a member, you gain the right to grow and share your medicine.

I do, however, still recommend working with a health care practitioner who can guide you on the most effective dosage and form of use (cannabis may be inhaled, smoked, vaporized, taken orally or even applied topically (in oil form).

19 Non-Drug Solutions for Pain Relief

I strongly recommend exhausting other options before you resort to an opioid pain reliever. The health risks associated with these drugs are great, and addiction and overdose are very real concerns.

Below I list 19 non-drug alternatives for the treatment of pain. These options provide excellent pain relief without any of the health hazards that prescription (and even over-the-counter) painkillers carry. This list is in no way meant to represent the only approaches you can use.

They are, rather, some of the best strategies that I know of. I do understand there are times when pain is so severe that a prescription drug may be necessary. Even in those instances, the options that follow may be used in addition to such drugs, and may allow you to at least reduce your dosage. If you are in pain that is bearable, please try these first, before resorting to prescription painkillers of any kind.

1. Eliminate or radically reduce most grains and sugars from your diet. Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
2. Take a high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they manipulate prostaglandins.)
3. Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.
4. Emotional Freedom Techniques (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain.
5. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain. 
6. K-Laser Class 4 Laser Therapy. If you suffer pain from an injury, arthritis, or other inflammation-based pain, I’d strongly encourage you to try out K-Laser therapy. It can be an excellent choice for many painful conditions, including acute injuries.
7. By addressing the underlying cause of the pain, you will no longer need to rely on painkillers. K-Laser is a class 4 infrared laser therapy treatment that helps reduce pain, reduce inflammation, and enhance tissue healing — both in hard and soft tissues, including muscles, ligaments, or even bones.
   The infrared wavelengths used in the K-Laser allow for targeting specific areas of your body, and can penetrate deeply into the body to reach areas such as your spine and hip. For more information about this ground-breaking technology, and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
8. Chiropractic. Many studies have confirmed that chiropractic management is much safer and less expensive than allopathic medical treatments, especially when used for pain, such as low-back pain.
9. Qualified chiropractic, osteopathic, and naturopathic physicians are reliable, as they have received extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which lasts between four to six years. These health experts have comprehensive training in musculoskeletal management. 
10. Acupuncture can also effectively treat many kinds of pain. Research has discovered a "clear and robust" effect of acupuncture in the treatment of: back, neck, and shoulder pain, osteoarthritis, and headaches.
11. Physical and massage therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
12. Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses are typically required and you may need 8 mg or more per day to achieve this benefit.
13. Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
14. Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.19
15. Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
16. Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple, including some of the bromelain-rich stem, may also be helpful.
17. Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
18. Evening Primrose, Black Currant and Borage Oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
19. Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
20. Medical cannabis has a long history as a natural analgesic, as mentioned.20 At present, 20 U.S. states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10 to 20 percent) of cannabidiol (CBD), medicinal terpenes, and flavanoids.
21. As discussed in this previous post, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC) — the psychoactive component of marijuana that makes you feel "stoned" — and high in medicinal CBD. The Journal of Pain,21 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis. 
22. Methods such as yoga, Foundation Training, acupuncture, exercise, meditation, hot and cold packs, and mind-body techniques can also result in astonishing pain relief without any drugs.
23. Grounding, or walking barefoot on the earth, may also provide a certain measure of pain relief by combating inflammation.