Fanning the Flames of the Opioid Epidemic

 

    The Opioid epidemic has been a growing problem in America claiming nearly 500,000 lives and with increasing overdoses, each year Big Pharma and more specifically the Sackler family have come under fire. In an article written by Sean O’ Hagan, he discusses how the Sackler family built their fortune on the profits made from Purdue Pharma due to its aggressive marketing of OxyContin. This opioid had been prescribed by many doctors in extremely high doses creating an opioid dependency among many of those individuals who have prescribed it (Sean O’Hagan, 2022).  While doctors are pushing intense opioid prescriptions the addictive aspect of opioids is fanning the flames of the opioid epidemic. In the study, Opioid-induced rewards, locomotion, and dopamine activation: A proposed model for control by mesopontine and rostromedial tegmental neurons (Steidl et al,2017),  an investigation had been conducted to look at how opioid drugs recruit multiple brain pathways which contribute to the risk of dependence and addiction that results from continued use (Steidl et al. 2017). Understanding how opioids affect brain pathways and the reward system will contribute to more understanding of why the opioid epidemic and the Sackler family pushing the marketing of opioids is such a huge problem. the brain is a complex organ that uses multiple pathways that contribute to the increased reward one may get from using opioids or other types of drugs. Steidl and colleagues found that often the brain pathways recruited with opioid use are the rostromedial tegmental nucleus (RMTg), laterodorsal tegmental nucleus (LDTg), pedunculopontine tegmental nucleus (PPTg),  and the ventral tegmental area (VTA) (Steidl et al. 2017).  Knowing that the neurotransmitter Dopamine (DA) is important for the reward system in the brain Steidl, and colleagues identified that opioids inhibit the RMTg and VTA GABA (an inhibitory neurotransmitter) which then go on to inhibit the PPTg and the LDTg cholinergic neurons (Steidl et al, 2017). Once the cholinergic neurons now inhibited, they can now activate the VTA DA neurons increasing cholinergic signaling and further modulating the RMTg GABA neurons (Steidl et al, 2017). The study done demonstrates that opioid recruitment of multiple pathways allows for an increase in DA activation which contributes greatly to the addictive effects of opioids. With the addictive aspects of opioids and the knowledge that they often recruit multiple brain pathways creating an intense reward circuit due to the increased amount of DA found in the brain, and the prescription pushing done by companies like Sackler-Purdue Pharma and the high dosages prescribed to many patients the opioid epidemic is still raging. Exposing companies such as Purdue Pharma and others is the first step in creating a significant change in the opioid epidemic and ultimately saving lives. We need to ask ourselves what is the next step in this fight and how can I help?

 

 

 

Works Cited

O'Hagan, Sean. “Patrick Radden Keefe on Exposing the Sackler Family's Links to the Opioid Crisis.” The Guardian, Guardian News and Media, 27 Feb. 2022, https://www.theguardian.com/us-news/2022/feb/27/empire-of-pain-patrick-radden-keefe-sackler-opioid-crisis-oxycontin.

 Steidl, Stephan, et al. “Opioid-Induced Rewards, Locomotion, and Dopamine Activation: A Proposed Model for Control by Mesopontine and Rostromedial Tegmental Neurons.” Neuroscience & Biobehavioral Reviews, vol. 83, 2017, pp. 72–82., https://doi.org/10.1016/j.neubiorev.2017.09.022.