Learn Why There May Be a Correlation Between Smoking and Opioid Misuse

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. 

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Dear Renewal Lodge Visitors,

My name is John Bruna, co-founder of the Mindfulness in Recovery® Institute, and more importantly, a grateful member of the recovery community. I am incredibly fortunate to have found my recovery in 1984. Of course, I did not achieve continuous recovery through willpower or my own efforts, but through the guidance and caring support of countless others that selflessly taught me how to live through the 12 Steps.

My journey of recovery brought this once homeless, shame-based, traumatized, insecure young man to a life far beyond anything I could have ever imagined. I discovered self-worth, the joy of helping others, the gifts of parenting and grandparenting, and most importantly the ability to live a meaningful and purposeful life with integrity.

One of the greatest gifts of recovery is that I have the opportunity to give back and help others discover their self-worth, dignity, and the skills to fully live lives that they find truly meaningful. This is the inspiration for developing the skills of Mindfulness in Recovery® (MIR) to meet the needs of new generations struggling with alcohol and other substance use disorders. MIR is a set of evidence-based skills designed to help people fully integrate their tools of recovery in ways that are personalized, practical, and in alignment with their deepest values.

While we train counselors and therapists throughout the United States and abroad, I personally have chosen to work directly with the amazing team and clients at Renewal Lodge to develop the model MIR 12-step program for the nation. I choose Renewal Lodge because of the vision of its mission and the dedication of its team. Renewal Lodge is an extremely rare environment in which the staff embodies the very mindfulness and 12-step practices and skills they offer their clients. The results have been beyond my expectations. It is an honor to be here and I treasure my personal time with every client I meet.

With Gratitude,

John Bruna
John Bruna
Director of Mindfulness
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