Well, the experts got together—expert psychiatrists—and they decided that the prime suspect in the case of ‘who caused us to be opiate addicts‘ is our genes. At the annual meeting of the Royal College of Psychiatrists, they discussed why it is that one person can take an opiate prescription or indulge in another addictive substance and walk away unscathed while others of us do the same thing and end up addicts. It turns out that the answer lies deep in the brain and is determined by our genes.

That Dang Dopamine

Wim van den Brink is a professor at the Academic Medical Centre at the University of Amsterdam in the Netherlands and an expert in the field of addiction. According to Medical News Today, “addicts have fewer dopamine or pleasure receptors in the brain and consequently seek out more and more stimulation.”

Says Professor van den Brink: “Addicts find it difficult to receive pleasure. They are not likely to enjoy most of the ordinary things most of us enjoy, experiences such as a day at the beach or night at a club. They are looking for more and more stimulus.”

But genes and brain chemistry don’t do it alone; environmental influences also play a part. And with continued use, addiction causes a decrease in dopamine receptors, which means an even more addictive personality. “In this way addicts become even more interested in drugs and drug-using friends,” says Professor van den Brink.

What is an Addictive Personality?

Of course, the term means that you’re more likely to become addicted to a pleasurable activity or substance than the average Joe. But according to Professor van den Brink, “The emotional memory of the ‘wonderful experience and the drive to repeat it leads to craving and relapse.” It also means that you’re less likely to fully appreciate the fact that the short-term pleasure provided by prescription painkillers and other opiates means long-term physical, emotional and spiritual damage, at least not enough to be able to use willpower alone to maintain a drug-free life.

Are you an addictive personality or did you come by drug addiction some other way?

Having gone through the experience of being addicted to opiates, counseling other opiate addicts, working at epidemiological studies focused on researching opiate addicts, and then formally studying the finer points of opiate addiction, I’ve pretty much hit every side of this addiction thing and what I’ve found are a ton of misconnections, misunderstandings and, sadly, people who are burnt out. So I want to write a book. Actually, I’ve had a few ideas:

• A Year in the Life of Dope Fiend – Have you noticed the spate of “A Year of Blankety Blank” books that are all over the book stores? One person goes without TV for a year or shopping, writes a book and it’s a big hit. Now my version, it could go a number of ways. It could be a personal chronically of addiction – the first year, the last year, the worst year – or it could be more a documentary style book following a group of people through a year of use.
• Getting Clean, Staying Clean – I’ve said it before and I’ll say it again: personal stories are essential to better understand how addiction works and how best to treat it. A few clicks online and you can find a number of resources detailing clinical methods to get clean. But how about the actual implementation of those methods? And I don’t mean the technical details that epidemiological studies track, like length of time without a relapse or length of relapse. I mean, what else are people doing to stay clean once the physical addiction has been dealt with and they’ve been handed a set of behavioral tools to use in place of getting loaded? Everyone’s story is unique. This could be one story or a collection of stories, and it wouldn’t matter if they stayed clean or not, because the stories of those who return to using are just as important as the stories of those who don’t.
• Guide for Substance Abuse Counselors by Addicts – That’s right. Finally, we get to tell the counselors, the medical professionals, the people who run the studies and do outreach exactly what it is we need, what we don’t need, what works and what doesn’t. Again, this is a very personal thing, so multiple voices would be necessary in order to make it well-rounded. There are a number of reasons so many people in the substance abuse industry end up turning to drugs themselves, and maybe if they could hear what they’re doing right and what they could be doing better, this would serve them as well as the people who come to them for help.

What do you think? Do you have a book you’re burning to write based on your experiences with opiate addiction? What about your experiences with getting clean? You know, buprenorphine has been available in this country for less than 10 years. Are there any books out there by people who have used it to get clean, whether or not it worked for them? Maybe that’s the book you need to write!

Imagine a world in which the distribution of clean needles is not only legal but convenient, not relegated to two-hour exchanges in a back alley or handed out surreptitiously in the park after midnight. Imagine, if you will, that there are actual vending machines which dispense clean needles, guaranteed to be brand new and disease free, any time of the day. Sounds like a strange plot detail in a futuristic script, doesn’t it? Well, if it does, then the future has found the Czech Republic, ladies and gentlemen.

What They’re Saying About Needles in Vending Machines

According to Medical News Today and the CTK/Prague Daily Monitor, the citizens of Prague may now access clean needles from two automatic syringe machines.  Says Medical News Today:

“The machines – the first to be installed in the country – provide a syringe and disinfection materials for 20 Czech koruna, or about $1.25. A second packet for 30 koruna, or about $1.90, also includes clean water, vitamin C and a special substance to dilute drugs. The project was launched by the group PROGRESSIVE to provide constant access to clean syringes, even if pharmacies are closed…. If the pilot project in Prague is successful, it could be expanded to other parts of the country.”

Why is the United States So Sadly Far Behind the Times?

Like Vojtech Janouskovec, the head of PROGRESSIVE’s No Biohazard program says, “The use of clean syringes prevents the spreading of infectious diseases, such as hepatitis.” It’s common knowledge. It’s not about legalizing drugs. It’s about saving lives and, honestly, it’s about saving money on the treatment for diseases like Hep C and HIV that are so commonly passed among intravenous drug users. But this is a country that flipped out about condom dispensers in high school bathrooms. Can you imagine the fall out over a needle vending machine?