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One and Done

Updated: Jun 28, 2020

By Kamsi Iloeje

Graphic by Elaine Zhang, Graphics Editor

In 2016, the International Narcotics Control Board published multiple reports on narcotics, from its usage and supply to consumption in various countries. After scanning through multiple graphs, one in particular caught my eye. This graph showed the top five opioid countries from 2013 to 2015 and their respective consumption of opioids, in doses, per million people per day. Topping this prestigious list was none other than the United States of America.

Opioids have been and continue to be a major issue in American society. Kermit, a West Virginian town with only 400 residents, received nearly nine million opioid pills in the year 2015. More than 130 people experienced fatal opioid overdoses. On top of that, opioids aren’t the only problem. Drugs are ridiculously common in American society and are extremely normalized despite the countless lives they’ve ruined, from the richest executives to poor black and brown communities. The National Institute on Drug Abuse reported that the number of drug related deaths in the U.S. is at its highest from 1999. However, how do drugs actually affect the body? What makes opioids and other narcotics so addictive? And why is so hard to quit once you’ve started?

You may have heard of “one-and-done,” a phrase that describes that using drugs a single time can result in a lifelong addiction. Despite the constant characterization of this phrase as a myth by naive individuals, it is absolutely true. When drugs are snorted, injected, smoked, etc., its chemical properties affect the central nervous system in a process called pharmacodynamics. Once a drug makes its way into the bloodstream and to the brain, it has various effects on neurons and neurotransmitters. Certain drugs bind to the receptor of a neurotransmitter and cause the same effect as that neurotransmitter. An example of such a drug is heroin. Once it reaches the brain, enzymes convert heroin to morphine, which binds to the receptors for the neurotransmitter dopamine and releases excess amounts of it. This produces intense sensations of happiness and euphoria, called a “high.”

Another way drugs affect neurons is by binding to neurotransmitter receptors and impeding their natural effects. An example is the drug atropine. It binds to the receptors for the neurotransmitter acetylcholine (ACh). ACh releases excitatory signals that are used for movement. Atropine prevents this signal from being sent.

A final danger that drugs pose is effecting a reuptake. This is when a neurotransmitter, after traveling back across the neuronal synapse (structures where neurotransmitters travel from neuron to neuron), is reabsorbed by the presynaptic nerve ending from which it was secreted. An example of such a drug is cocaine. It blocks the reuptake of the neurotransmitter dopamine, which naturally produces sensations of euphoria and happiness. This blockage keeps dopamine at high levels in the synapse, where it keeps producing feelings of happiness. This is another example of a high.

Blocking reuptake of a neurotransmitter with drugs like cocaine is very dangerous. Your body’s supply of neurotransmitters is limited, and blocking their reuptake depletes your supply, which makes you feel horrible. Drugs that do this make your synapses remember the intense happiness produced by the extra neurotransmitters, causing you to lose receptors. As your brain adapts to the cocaine, higher dosages become necessary to produce the same “high” because natural dopamine stimulants like sex and delicable food lose their effect.

For drugs like heroin and opioids, a similar process occurs. Repeated drug use causes smaller amounts of dopamine to be released each time by the same dosage. As with opioid molecules, they bind to receptors in the locus coeruleus, whose neurons stimulate breathing, blood pressure, and other basic functions. Hence, opioid withdrawal causes excessive amounts of chemicals to flood the body, causing jitters, muscle cramping, and anxiety. At this stage, an individual becomes completely dependent on drugs to function, both mentally and physically.

Drug addiction is the final stage in the process. During this period, a drug user alters the function of their brain. These long-lasting changes induce drug-seeking behavior and other characteristics of drug addiction. The brain forces one to do whatever is necessary to maintain the presence of drugs in their system, so as to avoid withdrawal. At this point, a drug addict rejects basic aspects of their human life (family, religion, education), and replaces them with the obsession of finding more and more drugs. For many people, withdrawal becomes almost impossible at this stage. The brain, nervous system, and organ function have to adjust in order to return to a state when drugs weren’t necessary for daily function. The severity of withdrawal symptoms varies for each case, but individuals often experience some degree of extreme hunger, vomiting, seizures, anxiety, suicidal thoughts, cold sweats, and extreme mental fatigue.

Evidently, the cycle of drug use is a difficult one to break. Drugs have ruined the lives of millions and continue to do so today, playing a role in politics, global economic crises, and diplomatic relationships. In the eyes of many, they run the world. And until we find a way to properly deal with the drug epidemics ravaging the planet, they’ll continue to do so for years and years to come.


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