🚨 Introduction

You’ve heard the phrase—“Opioids hijack the brain.” But what does that really mean? Why do people continue to use opioids like tapentadol, tramadol, heroin, or oxycodone even when it destroys relationships, jobs, and health?

This article breaks down the neuroscience and psychology of opioid addiction—and why willpower alone is never enough.

🧠 What Happens in the Brain?

When someone uses an opioid, it binds to mu-opioid receptors in the brain. This triggers a powerful release of dopamine, the brain’s reward chemical.

🔄 Cycle of Dependence:

1. Relief from pain or distress

2. Euphoric rush

3. Craving for more

4. Tolerance (need higher doses)

5. Withdrawal if stopped

6. Return to use to avoid pain → the addiction loop

Over time, natural dopamine levels drop. The brain becomes dependent on the opioid to function “normally.”

💣 Why It’s Hard to Quit

1. Crippling Withdrawal Symptoms

• Physical: vomiting, diarrhea, chills, muscle pain

• Psychological: anxiety, depression, panic

• In PAWS: emotional numbness, insomnia, and hallucinations can persist for months

2. Brain Changes

• Long-term use rewires circuits that manage:

  • Motivation

  • Impulse control

  • Stress response

• This makes even minor stressors a trigger for relapse

3. Loss of Natural Rewards

• Food, relationships, hobbies no longer feel pleasurable

• Opioids become the only way the brain knows how to “feel okay”

4. Social Stigma & Isolation

• Many users feel judged

• They avoid treatment until it’s too late

👤 Case Example

Ravi, 32, began using tramadol for tooth pain. Within a year, he was injecting tapentadol. Despite several quit attempts, he relapsed each time—usually after stressful events or during insomnia. He told us:

“I don’t even feel high anymore. I just use it to feel human.”

With structured treatment, Ravi is now in remission, working, and rebuilding his life.

🧰 What Helps Recovery?

1. Medications (MAT):

   • Buprenorphine-naloxone (Suboxone): Reduces cravings and blocks euphoric effects

   • Methadone (in licensed centers): Longer-acting opioid replacement

   • Naltrexone: Blocks effects of opioids, used in motivated individuals

2. Counseling and Therapy:

   • CBT for relapse prevention

   • Group support for stigma reduction

   • Family therapy to rebuild trust

3. Relapse Prevention Plans:

   • Sleep hygiene, nutrition, and exercise

   • Identification of triggers

   • Coping skills for stress

🧭 Takeaway

Opioid addiction is a brain disease, not a failure of character. With the right support system—medical, psychological, and social—recovery is not only possible, it’s expected.

In the next part, we’ll explore how to treat opioid addiction step-by-step, including detox, medications, and community-based care.

👨‍⚕️ About the Author

Dr. Srinivas Rajkumar T, MBBS, MD (Psychiatry)
Consultant Psychiatrist | Apollo Clinics Velachery & Tambaram
Specialist in Addiction Medicine, Mood & Cognitive Disorders
🌐 Read more: www.srinivasaiims.com
📞 Call: 85951 55808
📩 LinkedIn: Dr. Srinivas Rajkumar T