Drug addiction is about chasing the high, feeling warm and fuzzy, and dissolving from reality in a wash of euphoria. At least, that’s what we’ve been told. But new research reveals that opioid euphoria is actually a myth for most people.
Opioids work by binding to the natural opioid receptors in a person’s brain. They manipulate specific chemical signals, causing a surge of dopamine, which results in that euphoric effect we’ve dubbed a “high.” In short, we characterize opioids as producing pleasure and relieving pain.
With these facts and characterizations in mind, the majority of research that has been done on drug addiction relies on the idea that addicts are chasing those feelings. On that same note, most studies regarding drug effects examine current or former drug addicts, who, in fact, generally feel pleasure when using. However, that disqualifies the concept that some people might not feel pleasurable effects when using those same drugs.
Opioid Euphoria… A Myth?
More and more recent researching is proving that the average person does not actually achieve opioid euphoria after a dose of painkillers. One cognitive neuroscientist, Siri Leknes, expands that research with the idea that those who do not struggle with opioid addiction might actually feel worse after using the drug, especially if it’s their first use.
Leknes reasons that a person’s “high” is subjective to multiple factors, such as setting, mood, genetics, and previous drug exposure.
Let’s say one person (Person A) — who has not only never used pain pills before, let alone struggled with opioid addiction — is given a dose of opiates on the operating table shortly before a surgery. Another person (Person B), who has misused opiates in the past, voluntarily takes the same type of pills with some friends in his own living room in expectation of that pleasurable feeling. Can we really expect that these two people will experience the same high? Leknes’s research suggests that not only would Person A likely not experience opioid euphoria, but he’s also likely to feel subjectively worse than he did before taking the drug.
Opioids Made These Patients Feel Worse
Leknes’s work specifically takes a look at the opioid remifentanil. The drug is typically given to patients before minor surgical operations to ease anxiety, relieve pain, and boost anesthetic effects.
Curious about the bias created by drug studies that focus on addicts who do experience opioid euphoria, Leknes’s team studied the effects of a remifentanil drip on 160 patients who are not addicted to opioids before their minor surgeries. Patients rated their moods before the drug was administered and then rated their moods once more after the drug took full effect. The patients also disclosed how much they liked the drug’s effects, the level of drug-related discomfort they experienced, and how “high” they felt.
All patients reported that they did indeed feel high. However, on average, the patients felt 0.5 points worse (on a 10 point scale) after the drug took effect. That is to say, their high was unpleasant, not euphoric.
In fact, even on the positive end of the scale, those who reported liking the drug’s effects hovered around 5 on the 10 point scale. In other words, no one reached an opioid euphoria.
(Similar results were found in studies that examined other opioids, like oxycodone for example.)
It’s Just The Beginning
Research supporting the idea that opioid euphoria is not guaranteed for each person or each use continues to mount. But we’re still in the early stages and, as is the nature of addiction, there are many nuanced factors that need to be examined.
That said, assuming that everyone experiences extreme pleasure or euphoria (or that one drug effects everyone the same way) is harmful to treating people both operatively and in addiction recovery facilities.