About Methadone and Buprenorphine - Drug Policy Alliance

DependencyOpioids have been used for thousandsof years, and it has long been knownthat many people who have becomedependent on opioids have extremedifficulty permanently ending theiruse of them.Suffering through the withdrawalsickness is only part of the problem.The real difficulty has always beenstaying off the drugs once the periodof withdrawal is over.Just as in the case of those who areunable to stop smoking, it is difficultto explain why it is so hard not toreturn to the use of opioids. Reasonsinclude long-term depression, lack ofenergy, drug cravings, and suddenattacks of physical withdrawal sickness.Some people find that theseproblems diminish over time andeventually disappear altogether –but others continue to suffer thesesymptoms indefinitely, and manyof them eventually relapse to theirregular use of opioids.people with a long history of opioidproblems have experienced changesto the part of their brains that allows aperson to feel and function normally.This part of the brain makes and usesits own natural opioids.The best known of these naturalopioids are the chemicals knownas endorphins. The word endorphinliterally means “the morphine within.”Indeed, these chemicals are functionallyidentical to morphine or heroin.We don’t yet understand everythingthat these natural opioids do in thebody, but evidence suggests thatthey are involved with pain control,learning, regulating body temperature,and many other functions.It is possible that people who developa dependency on opioids wereborn with an endorphin system thatmakes them particularly vulnerable.For example, we know that addictionappears to run in some families.Relapse often has nothing to do withlack of will power or other personalityproblems. Instead, it appears that6About Methadone and Buprenorphine