Pathophysiology and Multimodal Treatment Strategies for Opioid Use Disorder
Opioid Use Disorder (OUD) is a chronic, relapsing brain disease characterized by a powerful, compulsive urge to use opioid drugs, even when they cause harm. It involves complex changes in the brain’s reward system, specifically the mu-opioid receptors.
Neurobiology of Addiction
When opioids enter the bloodstream, they bind to receptors in the brain that regulate pain and emotion. Over time, the brain becomes desensitized to natural dopamine production, leading to physical dependence. Withdrawal symptoms—such as tachycardia, anxiety, and diaphoresis—often drive continued use.
Clinical Management
Effective treatment typically involves Medication-Assisted Treatment (MAT):
Methadone: A full opioid agonist that prevents withdrawal.
Buprenorphine: A partial agonist that reduces cravings.
Naltrexone: An antagonist that blocks opioid effects entirely.