Dealing with chronic conditions to alleviate pain can be difficult. While people who smoke have declined, the amount of chronic pain is higher than ever. People who smoke are more likely to misuse opioids. Find out why smoking nicotine is an instigator for this and how to navigate the challenges of polysubstance use.
Nicotine Use
The quick absorption of nicotine into the blood stimulates adrenals to release epinephrine. This engages the central nervous system in a new way, increasing respiratory rate, blood pressure, and heart rate. Nicotine increases dopamine, which controls pleasure. Chronic exposure to nicotine may lead to nicotine addiction. This may act as a gateway to other drugs, leading to polysubstance abuse and other things. While nicotine impacts epinephrine and dopamine levels, there is data available that suggests ways it engages with opioid circuits.
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Feeling Calm
Nicotine use continues for many people because it causes a sense of calm for them. The analgesic effect on them helps block pain and acts as a way to buffer stimuli in the body. Drug addiction involves more than neurobiological ideas of how this works together. It is an impulsive and compulsive state where a person cannot stop thinking of the drug, taking the drug, or using it at any cost. The reward pathway is hijacked, so the states of becoming more addicted continue.
Smoking and Opioid Use
People who do not smoke cigarettes or use nicotine may find it difficult to use other substances without becoming addicted. Their brain is used to the pathways being hijacked by nicotine so crossover addiction is easier. Smokers who treat chronic pain with opioids may use higher doses because their brains are used to nicotine. This increased use can put them at greater risk. There is further suggestion cigarette smoke affects hydrocodone levels. Smokers with higher pain require more hydrocodone than nonsmokers, for instance, because of how their body responds.
Preventing Polysubstance Use
Substance abuse disorders often present higher for people with one existing addiction, like tobacco. These disorders help identify at-risk people for interventional programs when they are open to discussing challenges with their doctors and medical professionals. Routine screening for tobacco, substance, and alcohol use is crucial. Such screening programs face significant barriers. Research has shown a clear link between tobacco misuse and opioid misuse. Opioid misuse is over 3 times more common in smokers than nonsmokers. Opioid misuse is three times more common because:
- Smokers are more likely to abuse opioids than nonsmokers
- Screening people for opioid misuse is not foolproof, as many people with drug use have low rates of tobacco use
- Patterns of substance abuse tend to move towards using more than one substance
Patterns of tobacco and opioid use are just now being investigated more thoroughly. There is should be additional screening procedures for people who struggle with both. Screening for opioid use can identify people with past-year opioid misuse. People who use other drugs may find it lower while others find they struggle.
Healing from Drug Use
There is no cure for addiction and drug use. There are many ways to get help for people who struggle with addiction, whether it is treatment centers or addiction professionals who can offer support. When people deal with nicotine use and drug use concurrently, they often need treatment for both of the addictions with some care. It is difficult to provide care for people who abuse two or more substances because they may struggle with how to handle healing. Detox, rehab, and recovery are difficult. The key is to find ways of navigating recovery in a way that supports all the different areas of their lives that need help. Treatment for polysubstance use can tackle substance use, but also the underlying reasons they began using substances. This can include mental and spiritual issues, along with chronic pain or physical challenges they face. Helping someone heal from polysubstance use takes time but it is possible to support smoking cessation and quitting opioids. With the right treatment, a person can heal from substances and move forward in recovery.
