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Drugs were Katie Mack's connection to the world. Until she found real community in sobriety. Listen to the First Person diary here.
What empty well do opioids fill in someone suffering from addiction?
Maia Szalavitz explains in a New York Times piece that opioids can 'feel like love':
“So many people think that, Oh, people are addicted to the sensation of extreme pleasure. No, the reason you get addicted is because something is missing for you. And oftentimes, what's missing is the ability to feel love.”
Today, On Point: Why opioid addiction can feel like love — and what that means in a world of crumbling economic security and weakened social bonds.
Maia Szalavitz, neuroscience journalist. Author of "Undoing Drugs." Author of the New York Times article "Opioids Feel Like Love. That's Why They're Deadly in Tough Times." (@maiasz)
Dr. Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health.
On how opioids 'can feel like love'
Maia Szalavitz: “One of the most common descriptions of the opioid high is feeling warm, safe and loved. When I was addicted to heroin the first time I took it, I was just like, Oh, I'm OK, I can stop worrying. I am not the world's worst person that everybody hates, and self-hatred and shame are just an enormous part of addiction. Long before you ever actually become addicted. And so just getting relief from that horrible feeling was addictive to me."
What did it feel like when you first got high?
Maia Szalavitz: “Like being ultimately nurtured, and swaddled, and being safe, and Mommy loves you and you're all OK. It's a very primal feeling of OK-ness, and acceptance and just being all right. I should add here that it's only about a third of people who take opioids medically or for whatever reason they may take them. But only a third of people get this kind of warm, loving feeling. Probably because they're wired such that they have what they need in their endorphin system. And adding extra to that makes them uncomfortable, and in fact makes them feel numb and distant and nauseous."
On the roughly 30% of people who become addicted to the feeling of love opioids bring
Maia Szalavitz: “It’s 30% of the population. Because about 70% of the population has taken opioids medically. Only about a third of people who take opioids get this feeling, and only about half of those become addicted. Because sometimes people get this warm, overwhelming feeling of safety and they're like, Oh my gosh, I could get in trouble with this. I don't want to lose my wife, and my cat and my dog and my family. And so they're just like, I'll never take that again. But people who have that thing missing, and they find this sense of safety in a drug and they don't have anything else to live for. That is where the risk is.”
On how people often get addicted to opioids
Maia Szalavitz: “I should point out that the research shows that 80% of people who become addicted to prescription opioids actually don't have a prescription for them. They're more like the story of the woman we heard earlier in the show, where they get it at a party. They get it from friends, they get it from family. It's really important to note this. Because right now we're doing terrible things to pain patients who actually do need medication, in the idea that if we just keep cutting the medical supply, we will save people. And that is causing tremendous harm right now. So I want to make sure to emphasize this is the feeling that people with addiction get, and it is really seductive to people when the rest of their lives feel empty."
On Jaak Panksepp's research in opioids as love
Maia Szalavitz: "A man named Jaak Panksepp was one of the early researchers in this area. And he found that at doses that didn't even make the animals sleepy, you could relieve the separation anxiety and separation distress cries from young mammals by giving them these low doses of opioids. And conversely, if you block opioids, it will increase the separation distress cries. So he tries to get this published in Science, which is like the most prestigious journal in the early '70s.
"And they're like, Oh, no, no, no, that's too hot to handle. We can't do that. You can't compare maternal love to like heroin. Like, how could that even be? But in fact, that is how it works. And this is why heroin is so attractive to people who have been traumatized, people who don't have good relationships with other people for whatever reason, whether they're on the autism spectrum or they're just socially isolated. So it explains a lot about who is at risk for opioid addiction, and who will benefit from greater socializing and will need access to that in order to recover.”
On how to provide a sense of community for people who are suffering from addictions
Maia Szalavitz: "People are widely varied. And we need widely varied means of support for them. So for some people, it might be AA or NA. For some people, it might be going to the gym, going to the church, joining a choir, going to a local car club, whatever it is that makes you feel safe and connected. The other important piece is often medication. For me, I wasn't really fully able to feel socially connected until I got on antidepressants, and that made me a lot less needy, and clingy and a lot happier.
"And that really solved a lot of the social isolation that I had felt for most of my life. For some people, that medication might be actually an opioid like methadone or buprenorphine, and the data is really clear that taking methadone or buprenorphine long-term is the only treatment we have that cuts the death rate by 50% or more. So while it's definitely critical to get social support, a lot of people also are going to need medication in order to feel that social support.
"And this is kind of funny because ... why weren't you feeling it before may have to do with some chemistry in you, or some chemistry in you that got worsened by the addiction. But is often preexisting. I mean, if you listen to the stories of people with addiction, we feel different and not OK from a really young age, and that is telling us something. Our wiring is off for whatever reason. And you know, when you talk about genetics of opioid addiction one part of the genetics is whether you get this loving feeling from the drug or not."
Is there anything that we ought to be doing as a nation here to be more connected?
Maia Szalavitz: “We need to decriminalize, because we're wasting millions, hundreds of millions of dollars, locking the same people up over and over and over again for a disease that's defined by its resistance to negative consequences. So we need to show love to people with addiction, and care, if we are going to make this better. And really care about everybody more in the society.”
From The Reading List
New York Times: "Opioids Feel Like Love. That’s Why They’re Deadly in Tough Times." — "I had told myself that I’d never try heroin because it sounded too perfect. It’s like 'warm, buttery love,' a friend told me."
This program aired on December 16, 2021.