After becoming paralyzed from a fall right before my 18^th birthday, I was given opioids to cope with the substantial pain associated with that injury.  I can still remember one of the first times I was given a shot of a powerful opioid when I was lying in a hospital bed, unable to move my body below my chest.  I felt devastated by this injury and did not know how I was going to get through it.  After receiving that shot of an opioid medication, it changed my mental state instantaneously.  I was still paralyzed, I was still laying in that hospital bed not knowing what my life would look like going forward, but with the opioids flooding my brain with dopamine, increasing pleasure and inhibiting stress and anxiety, it suddenly did not feel as devastating.  It felt tolerable.  It did the job that it was supposed to do at the moment.  The problem developed when I kept taking opioid medications for years, and at increasingly higher amounts, to cope with physical and emotional pain caused by living with paralysis.  The alcohol, marijuana, nicotine and benzodiazepines added to the problem by flooding my brain with dopamine. 

After years of substance use, my brain developed tolerance to the drugs and no longer produced the same euphoric feelings.  Tolerance also triggers the brain to increase nerve activity which creates feelings of dysphoria and anxiety.  I lost the ability to feel pleasure, motivation or learn important life skills due to addiction to opioids.  It became difficult to go through my mail or get outside and get exercise.  This is an aspect of addiction it does not seem many people understand: people who struggle with addiction are not solely pursuing more pleasure, they are trying to stop highly unpleasant feelings and just feel normal.   

When I tried to stop taking opioids without any medication assistance, my brain and body told me I was going to die if I did not take them.  The escalation of my nerves overfiring became so strong that it made my body so rigid that I could not bend my legs at times and spent months in the hospital with chronic spasticity.  Not everyone will experience withdrawal symptoms this extreme but are likely to have a range of unpleasant physical and emotional symptoms associated with withdrawal. 

It took me years to get off high levels of prescription opioid medication and reprogram my brain to feel pleasurable emotions and sensations without these drugs.  Two main tools that worked for me were medication assisted treatment (MAT) and physical exercise.  I was given a drug called Buprenorphine to help wean off other opioids.  Buprenorphine is a partial opioid agonist that mimics some of the positive effects of stronger opioids, with a longer half-life.  This means I did not feel the same level of euphoria from Buprenorphine as I would from stronger opioids, like morphine or fentanyl, but it released enough dopamine to reduce the discomfort from my overactive nerves. 

Physical exercise produced a small effect at first by releasing natural endorphins and dopamine.  This showed me that I had some control over producing pleasurable feelings naturally, without opioids.  The more consistent I became with physical exercise, the stronger and more enduring the effect on my mood.  Physical exercise eventually led to other positive effects, like losing weight and making social connections, which triggered my brain to release more dopamine.  My dopamine system had healed enough that activities like playing basketball and making friends actually felt good again!  This was the beginning of my path back from a disordered, addicted brain, with a depleted dopaminergic system.