We've known for a long time that opiates are fantastic pain killers for physical pain. We use them in medicine all the time. Opiates relieve the pain of terminal cancer, general surgery and broken bones. But, it is more and more clear to me, that opiates are even more powerful in relieving emotional pain. I think this is the main reason why the relapse rate is so high for people with opiate addiction. I believe it is why so many people go back to using opiates even after they are fully detoxed. They have such strong memories of how good they felt on opiates and they want to get back those good feelings.

For a long time, I have been wondering why so many people get off opiates and then, somewhere down the road they relapse. Frequently, people will be in jail for years and then use opiates as soon as they get released. Patients often go into a 28-day treatment program but are back using opiates again within a week of discharge. The success rates for patients with opiate addiction to stay completely drug free are very low. This is why we recommend Naltrexone therapy to all of our patients, so that we can block cravings and prevent relapses, and give people a fighting chance to make the changes necessary for long-term recovery.

It has become more and more obvious to me that a huge part of the reason for this high relapse rate is the fact that opiates relieve emotional pain so well. The drugs come with a lot of side effects and, of course, are highly addictive, but the truth is they are very powerful painkillers for the emotional system.

All of us live with some emotional pain on a frequent basis. Mostly, however, our emotions operate on an unconscious basis, so we are not really aware of them. Our emotional system is very powerful. It is designed to keep us functioning in healthy and in safe ways. On a regular basis, our brains are vigilantly keeping track of threats and dangers. Usually, we are not really aware of it, but our brains have low levels of anxiety, fear, and worry all of the time. Sometimes, these emotions rise to the conscious level and we become aware of these feelings. Many of our emotions feel negative so we don’t like experiencing them. They are there to help us avoid making mistakes and to help us to make better decisions, but they are uncomfortable. All of us, from time to time are aware of feelings like anxiety, regret, loneliness, boredom, low self-esteem, fear, sadness, and anger.

The problem with opiates is that they are very powerful painkillers, and they numb out these negative emotions. When people use opiates, they feel “comfortably numb”. They no longer have to feel their anxiety, their stress, their anger, their loneliness, or their boredom. It is a very powerful effect. Opiate users like this feeling, and even years after they quit, they can still remember how good that felt. The memory circuits in the brain last a long time, especially the ones associated with these emotions. It is no wonder that patients will return to opiate use in times of stress, even after long years of abstinence.

The secret to recovery then, is to be willing to sit through whatever emotional discomfort comes along and learn other ways to deal with it. If we change our attitude about emotions, and see them for what they really are, then we are able to learn from them and really change. Our emotions are our teachers. Our emotions are there to provide feedback that something needs to change. If we feel bored, we need to find something fun to do. If we feel lonely we should call friends, or find new hobbies, or go to meetings. If we feel sad, we can share those feelings with a therapist or friends and grow from the experience. The last thing we should be doing is using drugs to numb or trying to trying to escape those feelings.

The Buddha said that life is suffering, but that we need to transcend the suffering. What that means to me is we need to stop perceiving our painful emotions as suffering, and instead, see any emotional pain we have as a useful guide. Our emotions are our best feedback loop to help us know when to change things and how to become happy on a regular basis. This is the path to achieving true bliss - not some drug-induced shadow of true bliss.