When compared to a plain stimulant (a dopamine releaser or reuptake inhibitor), opioids are pretty darn close to selectively activating the reward center.My answer to this is always the same: so what? Everyone is addicted to something. Some people are useless do-nothings who binge-watch netflix all day long, others are addicted to playing video games, sex, smartphones, gambling, drinking alcohol (oh now THAT is the right type of drug, right?), etc.
So why is it such a huge issue when euphoria causes me to be addicted to a substance that does absolutely no harm to my body or even my mind, much less to other people?
I don't believe that to be the case honestly. I think this whole aversion towards opioids and really drugs in general is a rather modern phenomenon that was kickstarted by the puritan movement in the early 20th century and finally got hold of society when the Anti-Opium law was passed in 1930, but prior to that Opium was part of so many medicines and has always been used recreationally since thousands of years, even though it never replaced alcohol in the west unfortunately. So I don't see this animosity towards opioids as something that has a deep, underlying root cause, but instead it is entirely driven by propagandistic indoctrination that is barely a century old. The fact that people don't even really know why they are against it, except repeating like programmed bots anti-drug talking points, proves that this has no deeper cause and is a superficial, albeit tenacious aversion.
This anti-opioid sentiment is more of a western thing anyway. The west is pathologically obsessed with being in control at all times and being productive and disciplined (with the exception of Japan where these qualities are taken to an extreme, which explains why drug use is frowned upon even more in Japan than in the west), which to a certain extent aren't bad qualities, but since an opioid high embodies the exact opposite of these qualities, it is only logical that a culture which is primed to embrace such attitudes comes to hate such a substance class. Society should allow periodical relaxations of such attitudes and learn to be more tolerant.
The middle east for example is very different in this regard. They have a history of Opium use. Just as much as alcohol is (unfortunately) part of western culture, Opium has always been part of middle eastern culture and that is simply because these people have a completely different mentality than we have. Even though Opium is illegal on paper in Iran, nobody really gives a shit when you start smoking Opium in public. It's an unenforceable law to prohibit Opium use.
The west should learn to be more like the east, even if it is only for the sake of our organ health. Seriously, what the fuck is it with the western mind and its degenerate thirst for an utterly toxic substance that harms nerves, cells and even the DNA? Alcohol wasn't even originally made to be drunk, but for conservation, and yet we somehow ended up integrating this crappy substance into our culture.
...and nobody seems to care about the societal harm caused by alcohol. And mind you, we aren't talking about the harm caused by alcohol addicts, but mere "social" drinking.
Yes, yes and yes. The problem is we don't know how to do that with the proteins/neurons/switches/pathways/receptors that are ultimately responsible for opioid-induced euphoria because we haven't been able to even agree on what the cause of that phenomenon is. If we can figure out the basics, then we can go deeper into the specifics and maybe find out how to develop a drug that prevents euphoria. I do NOT know how to do that. I just said it COULD be possible because we have been able to do similar things with other drug-induced side effects, that's all.
Neuroprotection alluded to GABAergic spiny msn neurons leading into the nucleus accumbens. These neurons act as an inhibitory "brake" on dopamine release from (Edit) the vta (and subsequent reward/euphoria). Opioids prevent these neurons from firing, relieving the inhibition of dopamine release.
The issue that Someguyontheinternet was getting at with opioids, is that the same opioid receptors in those regions also exert inhibitory control of other regions of the brain, causing side effects like respiratory depression. The receptors involved in these different circuits are the same, which makes finding a region-selective agonist akin to searching for the holy grail.
Rresearch animals are often bred with this bacterial protein called cre recombinase expressed in certain cell types. Cell type specificity is achieved by wiring the expression of cre to proteins expressed in specific cells (which allows for targeting of functionally similar populations). This protein recognizes recombination sites on DNA called LoxP sites, and can flip the DNA between two of these sites backwards. When scientists inject a virus containing backwards DNA flanked by loxP sites into a precise anatomical region, only cells expressing cre will orient the DNA correctly. This allows for targeting of both specific cell types and specific regions, which allows for probing of circuits.
Now the payload of these viruses activated by cre can be anything from proteins which indicate neuron firing, to customized receptors called DREADDs that bind to a drug (clozapine-N-oxide) that lacks affinity at any normal receptor.
Putting an inhibitory DREADD in GABAergic medium spiny neurons would turn clozapine-N-oxide into the closest thing to an opioid devoid of off target effects. Of course that would require breeding cre into people for many generations and be tremendously unethical, and will hopefully not occur (imagine the horrible social control that would be exerted if an entity did this at a population level).
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