Depression & Opiates

I've had depression since early childhood. Before I started taking meds for it, it could be very severe, and I thought about ending my life for years. The anti-depressants I take have helped me cope.

Keven's depression also began in early childhood, and I sought help for him when he was in 3rd grade. He was on and off anti-depressants throughout his life. It helped a lot in his younger years, so he stopped taking them at age 13. Two years later he discovered drugs and discovered the intense pleasure brought on by using opiates.

I often wonder what would have happened if he kept taking his medication - would he still have tried heroin? Would he have felt good enough about himself and his life to "say no to drugs?" I doubt it. We warn our children at home and in school about the dangers of drugs, some are too scared to try any and other, like Keven, are allured by the unknown. I think in Keven's case it also had a lot to do with wanting his new friends to accept him so, against warnings from Anthony (who was already addicted) he tried it. He injected it on his first use! That's very uncommon, but Keven was an all or nothing kind of person.

I'm going to be talking about depression on and off because it's so common and puts our vulnerable youth at an even greater risk for trying drugs. Today the focus is on WHY do opiates make you feel so damn good. I think if we understand this, it will help us empathize more and criticize less which would help end stigma and make it easier for people with depression OR substance use disorder to reach out for help.

When someone takes opioids, they get an intense rush of pleasure or euphoria and that feeling can be addictive to many people. Opiates attach to certain brain receptors that are responsible for reward and pleasure. Opioid drugs block pain and also create feelings of calm, and they may have antidepressant effects, although this is not why they are used.
When you take an opiate, it makes you feel good because its chemical structure replicates a natural neurotransmitter, activating certain nerve cells. Then your brain is flooded with dopamine, which is the neurotransmitter responsible for the regulation of pleasure. Your natural reward system is overstimulated in a way that it couldn’t be naturally, thus the euphoria.
When your brain experiences that type of high, it often wants to repeat the behavior that created it, thus the tendency to continue using opiates, even in the face of negative consequences.
Our brains are designed to keep repeating activities that are associated with reward or pleasure and your brain rewires itself, and that’s what pushes you to keep using opiates.
It’s important to realize not just why opiates make you feel good, but how intense the artificial feel-good impact can be. When you take opioids, the endorphins are released at a much higher level than they would be naturally from a pleasurable activity.
Over time, the brain’s pleasure centers stop eliciting such a strong response though. Your brain starts responding to the flood of dopamine in a way that diminishes the euphoria of using opiates, which is how physical tolerance, and eventually opioid addiction, develop. It also becomes much more difficult to achieve not only the same high, but your brain’s neural function starts to change to the point where it’s difficult to derive pleasure naturally. However, the brain can recover and go back to its normal level of functioning over time.
Understanding why opiates make you feel good is also helpful to see how people can overdose relatively easily. As tolerance builds, people tend to continue chasing their initial high and they may start taking larger amounts of the drug or move to other drugs that are more potent. For example, people may start taking prescription opiates and then move to heroin. Not only can it be more potent than some prescription opioids, but heroin may also be cheaper.

By The Recovery Village

Editor Camille Renzoni

Medically Reviewed By Jessica Pyhtila, PharmD 08/02/21