Opioids and Brain Damage

By now, most everyone knows the havoc opioid addiction can wreak in a person’s life. Job loss, money problems, and broken relationships are common. What’s not so well known is the damaging effects of opioid abuse on the brain. The damage can take different forms, many of which are right out in the open. Opioids and brain damage is a real phenomenon that becomes increasingly worse when addiction goes untreated.

The Opioid Abuse Cycle and the Changes It Causes

Opioids produce psychoactive effects that alter the brain’s chemical and structural makeup over time. By nature, psychoactive substances alter brain functioning, causing changes in mood, consciousness, perception, and behavior. These effects all contribute to the opioid abuse cycle that develops with continued substance abuse.

Opioid effects set the cycle in motion by forcing certain brain cell receptors to release large amounts of dopamine, a neurotransmitter that regulates pain, pleasure, and other functions within the central nervous system. These interactions disrupt the brain’s natural chemical balance, creating a “high” effect. This is soon followed by withdrawal symptoms that result from the brain’s attempts to restore balance. Users who get caught up in this cycle will ingest more opioids in order to counteract withdrawal discomfort, and so the cycle repeats itself as the brain’s natural state skews further and further out of balance.

After weeks or months of opioid abuse, the brain’s chemical pathways start to change. This, in turn, causes structural changes to develop. Before long, changes to the brain’s physical structures start to change how the brain works, altering how you think, how you perceive the world around you, and how you behave.

Structural Changes Caused by Opioid Abuse

One key area where opioids and brain damage intersect is the progressive damage that occurs inside the synapses between brain neurons, particularly the dendritic spines. The brain houses as many as 100 trillion synapses, which are junctions where neurons send information to one another. Each synapse consists of the axon portion of one neuron, an open space, and the dendritic spines of another neuron.

The brain uses neurotransmitter chemicals, such as dopamine to send information from one neuron to another. Information travels from the axon of one neuron to the spines of another neuron. A neuron can form a synapse with multiple axons depending on how many dendritic spines it has.

When high doses of opioids interact with these structures on a repeated basis, dendritic spines start to decrease in number. This type of opioid brain damage diminishes the brain’s communication network. Over time, cognitive abilities, such as reasoning and problem-solving start to show noticeable declines.

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Opioids and Brain Damage – How Addiction Develops

The structural and chemical changes caused by opioid abuse inevitably interfere with specific brain systems, one of which is the reward system. The reward system works in tandem with the brain’s limbic system, which regulates emotions and the areas that regulate cognitive functions, such as thinking and decision-making.

Addiction develops out of the effects opioids have on the reward system. It’s through the reward system that your drives, motivations, belief systems, and priorities are formed. In effect, anything that promotes your survival, happiness, and contentment is recorded in these areas of the brain. This information acts as a template that drives your thinking, attention, and behaviors.

The reward system takes its cues from the levels of dopamine in the brain at any given moment. Whenever dopamine levels run high, the circumstances that caused levels to rise are seen as beneficial to your survival and well-being. Opioids trigger dopamine secretions. This is how frequent, ongoing opioid use damages reward system functions and causes addiction to develop.

Treatment Implications

The effects of opioids and brain damage have long-term implications that can affect a person’s progress in recovery. While detox helps flush out opioids and allows the body to recover, normal brain functioning can take years to return to normal. As recovering addicts move through the recovery process, damage done to the brain’s chemical pathways and reward system can make it difficult for them to retain new information and follow-through on treatment objectives.

Chronic, long-term opioid abuse also leaves the brain with fewer dopamine receptors than it had before. In effect, someone in recovery will have a difficult time experiencing feelings of pleasure or contentment, making him or her more prone to depression. Lastly, dopamine’s role in regulating reward system activities means recovering addicts are likely to experience severe drug cravings on an ongoing basis.

The Need for Opioid Addiction Rehab

While opioid brain damage can diminish brain function and overall quality of life, continued opioid abuse will only make a bad situation worse. For chronic, long-term users, the risk of an overdose fatality increases each time you use the drug. Ultimately, you end up playing Russian-Roulette with your life each time you engage in drug use.

There are several different types of opioid rehab programs, each designed to help you address the issues and challenges you’ll face at different stages of recovery. Long-term treatment programs are well-equipped to provide the level of medical care, behavioral treatment, and emotional support needed to help you regain normal brain functioning. These programs also offer medication treatments, such as methadone therapy which works well at restoring brain chemical balance and providing relief from withdrawal effects. When opioids and brain damage are at work, the need for opioid addiction rehab is critical.


  • ncbi.nlm.nih.gov – The Neurobiology of Opioid Dependence: Implications for Treatment
  • ncbi.nlm.nih.gov– Neurobiologic Processes in Drug Reward and Addiction
  • bha.health.maryland.gov – Maryland Department of Health, “The Intersection of Opioids and Brain Injury: Addressing Addiction Through a Brain Injury Informed Len”
  • sunshinebehavioralhealth.com – Sunshine Behavioral Health, “Opioid Rehab Centers”

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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