Opioids May Increase Feelings of Social Rejection



Opioids are highly effective analgesics with a wide range of applications from acute to chronic pain. However, some specialists are now suggesting that long-term medicinal use of these medicines can harm patients in more ways than previously understood. The connection between physical and emotional pain is currently being examined more closely in patients who take opioids for chronic pain to determine how significant this connection is and what it could mean for the future of pain management.


How the Brain Handles Pain

Humans experience both physical and emotional pain, and while they manifest differently, the mind processes both similarly with many overlapping circuits in the brain involved. When a person is physically injured, their primary motivation is to heal the damaged tissues and promote healing while avoiding further injury at all costs. When dealing with emotional pain, humans, a very social species, tend to avoid additional hurt from peers by replacing the rejected relationship with other companionship or using various coping mechanisms.


Looking at how similarly the brain handles both physical and emotional pain shows a two-way relationship where each type can further exacerbate the other. This is where the role of the body’s natural pain relievers, called endogenous opioids, comes into play in terms of social boding. However, long-term prescription opioid use disrupts these naturally occurring endogenous opioid systems in the body, potentially further perpetuating emotional and physical pain in patients, sometimes leading to depression, anxiety, and social distress.


An Argument against Long-Term Opioid Prescriptions

Two physicians from the University of Washington have opened the conversation about rethinking the medicinal opioid use for chronic pain in a recently written journal, but they’re certainly not the only ones. They suggest that physicians should look to opioid painkiller alternatives for long-term use to avoid creating an environment in the patient’s system where the body’s resilience for self-regulating pain and distress isn’t suppressed. Furthermore, those with opioid prescriptions for chronic pain who begin having trouble with emotional pain and mental illness are at a much higher risk of misuse. Those patients may start to use them in ways not directed by their doctors to deal with emotional and social effects, quickly leading to addiction.


Ideally, the two doctors believe opioids should only be prescribed for short-term use lasting no more than a month to prevent harmful risks associated with longer-term use. Ignoring the vital connection between emotional and physical pain can continue to fuel a vicious cycle where patients are dependent on opioids for longer due to their decreased natural resiliency. Reduced ability to cope with different forms of pain may explain why patients who stop taking their long-term opioid pain treatment are at greater risk for suicide and all-cause mortality. Treating patients as a whole across all medical fields may be an essential step towards getting a grip on the opioid crisis in America, especially with more conversations surrounding the way pain is handled both physically and emotionally.


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