The Complex Relationship Between Opioids, Addiction, and PTSD Dissociation
Like many mental illnesses, the presence of post-traumatic stress disorder (PTSD) increases a person’s risk of developing an addiction. Opioids especially can have a significant effect on the biology of PTSD – that is, endogenous opioids, which occur naturally in the body, are found to be altered in people who have PTSD.
Instead of their usual effects, opioids may produce effects similar to “spontaneous dissociation.” Moreover, people who cannot effectively dissociate from their traumatic experiences may turn to drugs or alcohol hoping to numb negative thoughts and feelings.
Let me clear, dissociative disorder (multiple personality) and PTSD dissociation are not the same thing – although they are oft considered to be closely related. In fact, diagnostically speaking there is a dissociative subtype of PTSD.
Instead, I am more generally referring to dissociation as “the disconnection or separation of something from something else or the state of being disconnected.”
That is, dissociation as a naturally-occurring, protective mechanism used by the brain to deal with highly unpleasant experiences.
Childhood trauma such as abuse or neglect is a common cause of PTSD dissociation, but the phenomenon can occur at any age. The purpose of dissociation is to numb the senses during the actual events as they occur, but when it happens at inappropriate times, it can be maladaptive and debilitating.
People with PTSD dissociation often report feeling disconnected from their body and others. They may also encounter amnesia, personality confusion, and take on various identities. A “flashback” can stop a sufferer dead in their tracks, rendering him or her unable to speak and trapped within the confines of their own mind. At the same time, the person may feel as if they are outside of their body looking in.
How The PTSD Brain Is Different
Brain scans and neuroscientific research has found that there are distinct regions of the PTSD brain that are activated when presented with triggers. For example, the locus coeruleus, found in the brain stem, is associated with the body’s stress responses.
Here, there is a high concentration of opioid receptors. When the brain perceives danger, endogenous opioids are released, and normal opioid receptor binding is impaired.
When a person develops PTSD dissociation, this effect continues long after the traumatic event is over, and there is a reduction in sensitivity to both emotional and physical pain. It’s a similar effect to what occurs in the brain during opioid-induced dissociation – opioids also produce an effect in which emotions are altered and pain is numbed.
Researchers have tested stress responses in distressed animals and found that the animals became desensitized to the stressors due to the increase in natural opioid production.
What’s more, researchers reversed this effect with naloxone, a medication used to treat the symptoms of an opioid overdose.
Also, persistently distressed animals exhibited a heroin-like high effect, and when the opioid blocker (naloxone) was administered, they began to show signs of addiction withdrawal.
Treating PTSD & Addiction
One of the most popular techniques for treating PTSD is Eye Movement Desensitization and Reprocessing (EDMR.) It is now used for a variety of mental conditions but is especially effective for treating people who have experienced trauma.
The technique involving eye movement is believed to function similar to REM sleep, rearranging and organizing memories to make them less intrusive.
EMDR is associated with endogenous opioid production, and persons who undergo EMDR therapy may be watched closely for natural opioid production. They may even be given opioid blockers to decrease the opioids numbing effect, and permit memories to be reprocessed.
During a typical EMDR session, a therapist will sit opposite the patient and move his or hand from side to side as the patient’s eyes follow it from left to right. Patients will participate in a series of these movements, as he or she focuses on a distressing memory.
As the patient’s eyes move, the distressing thoughts are allowed to pass, and discussion about feelings and experiences is facilitated afterward.
Persons who suffer from PTSD and addiction must have both disorders treated simultaneously – you can not successfully treat one with the other, as they are deeply entangled. Addiction is often the result of a person’s desire to numb or self-medicate negative thoughts and feelings. Subsequently, addiction itself alters the brain, making mental illness, including PTSD, depression, and anxiety worse over time.
Just Believe Recovery offers EMDR therapy, as well as a variety of other therapeutic methods to treat trauma, mental illness, and addiction, including individual and group therapy and counseling.
Traditional therapies are also supplemented with holistic approaches, such as art and music therapy and meditation techniques.
Finally, medication-assisted therapy may be used in many cases to help ease withdrawal effects and cravings associated with substance cessation.
~ G. Nathalee Serrels, M.A., Psychology