Misuse of prescription drugs is now ranked only second in prevalence to that of marijuana in the United States. The young adolescents are identified as the age group with the highest rates of prescribed opiates abuse with 5.9 percent reporting nonmedical use. What makes matters even more concerning is that young adolescence is essentially characterized by rapid brain development and opiate abuse can exert significant influence on this important process.
Nevertheless, a dangerous misconception surrounds opioids: it is generally believed that just because a doctor prescribes most opioids, they are safe.
This, however, is entirely untrue. In fact, this misunderstanding may be a significant driving force behind the rampant opioid abuse among young individuals.
Development of the Adolescent Brain
Adolescence involves rapid and complex social, biological and psychological developments as the individual transitions from childhood into adulthood.
These alterations can potentially influence the efficiency and specialization of the adolescent brain through the elimination of unnecessary neural connections.
The teenager’s brain also experiences greater myelination, which allows for improved quality of white matter fiber tracts and efficiency of neural conductivity.
Research suggests that increased myelination facilitates a more efficient communication between frontal-subcortical brain regions, initiating improved top-down cognitive control in adolescence.
The neuro-maturation and neurochemical changes occurring during this period are related to an array of cognitive, emotional and behavioral changes, and are hypothesized to correspond to adolescents’ increased inclination for alcohol and drug use, alongside greater risk-taking and thrill-seeking behaviors. 
Opiates and Its Effect on the Brain
Opiates intake immediately affects the central nervous system (CNS). The very first ingestion or even the first few times opioids are ingested, an intense euphoric rush is experienced, especially with a strong opiate such as heroin.
Such an experience is entirely dependent upon how opiates influence the nervous system.
Synthetic opiates bind themselves to opioid receptors throughout the brain and spinal cord and manage sensations of pain, simultaneously stimulating the CNS natural reward system.
Then dopamine, a naturally occurring chemical that enforces feelings of happiness, floods the reward system and is 1000 times stronger than a naturally occurring release of dopamine.
These opiates then mimic the effects of endogenous opioids. Receptors in the reward circuits are activated causing a brief rush of intense euphoria, followed by a few hours of relaxation and contentment.
Despite the desirable medical effects of these drugs, there are other associated repercussions as well, indicative of how opiates affect the nervous system.
For example, the activation of some of the same pathways can lead to feelings of nausea and confusion as well as sedation.
Opiates are also central nervous system depressants. They influence regions of the CNS that control vital functions like breathing.
Excessive opiate intake can restrict the functioning of the respiratory center in the brain stem, resulting in decreased breathing or shutdown of breathing altogether.
It is this very action of opiates on the brain stem’s respiratory centers that can cause the user to stop breathing and die in case of an overdose.
The development of tolerance, addiction, and dependence are another significant effect opiates can exert upon the nervous system.
Even though not every user will become addicted, but the more frequent the use, the more the brain becomes wired to crave and to continue using the drug.
Since the reward pathways are still undergoing development amongst young adolescents, they are more susceptible to becoming addicted. The primary focus of the brain can just become fixated on finding more drugs. 
“When substance use disorders occur in adolescence, they affect critical developmental and social transitions, and they can interfere with normal brain maturation,” the National Institute on Drug Abuse reported in 2014. “These potentially lifelong consequences make addressing adolescent drug use an urgent matter.” 
A Youth-centered Approach
Dr. David E. Smith, an addiction medical specialist who founded the Haight Ashbury Free Clinics in San Francisco, believes that improving primary health care needs to be the first step.
Physicians need to be adequately trained in the diagnosis and treatment of addiction and to recognize early signs of adolescent substance use disorder.
“Engaging people earlier in their addiction improves their chances of recovery and overall better health,” Smith said. “Meanwhile, costs for the healthcare system are dramatically reduced.”
At the brighter side, communities are now seeking new strategies to combat addiction and speed access to care. This includes evidence-based treatment, addressing the unique needs of youth and involving therapies that have been scientifically validated.
As public policy and social attitudes have finally started to catch up with science, treatment still needs a lot more work put into it.
The 2012 National Survey on Drug Use and Health discovered that alarmingly 90 percent of drug-addicted youth, aged 12 to 17, got no treatment at all.
“Twenty years ago, we were just beginning to focus on evidence-based treatment for drug-involved youth,” says Dr. Holly Waldron, a senior scientist at the Oregon Research Institute who studies adolescent behavior.
“Historically, interventions for addictive behaviors have included confrontational approaches, but we’ve learned that confrontation does not produce an efficient change in substance-abuse behavior.”
Instead, Waldron and her colleagues understand that evidence-based interventions such as family therapy and cognitive behavioral treatments have proven to be far more effective for adolescent substance abuse.
“We’re actively involved in taking these treatments to community settings,” she said. “If we can connect kids to treatment, we know they’ll improve.”
About the Author:
A journalist and social media savvy content writer with wide research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute focusing on mental health and addiction recovery, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. The art of using words to educate, stir emotions, create change and provoke action is at the core of her career, as she strives to develop content and deliver news that matters.
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Published on October 15, 2017
Reviewed By: Jacquelyn Ekern, MS, LPC on October 15, 2017.
Published on AddictionHope.com