James wrote:
“Could some of the physicians here clarify the issue? If opioids do reduce endorphin production or release, is that condition not temporary? I was under the impression that opioids, for the most part, do no physical damage other than possible death from respiratory repression upon overdose.”

Seigel’s just making it up, is the short answer. Of course opioid change receptor state - that’s how they work, Duh! But you are correct, and Siegels implication was false - opioids are non-toxic - literally they do not kill or ‘poison’ any organ systems of the body. There are no lasting physiological or anatomical effects of long-term opioid therapy on the brain or any other organ system. Unfortunately, we cannot say the same of chronic pain which has been shown to result in loss of brain mass, especially in the thalumus.

..alex…

I am concerned here with the way the opposition held their side through Marc Siegel. His face is now associated with Siobhan’s name, and he counteracts her message. Unfortunately, those little things matter with national exposure.

I will not pretend to debate physicians on the practice of medicine. In my activist efforts, I will stick with what I know. What I can say is that Siegel used a tried and true method to give his opinions a “scientific” hue with the public. People love explanations based on “brain chemistry”, and they attribute expertise to people who invoke those explanations for common events and behaviors.

I have a question for Dr. Deluca and other physicians who may be working on this. Siegel’s repeated message was that opioids cause brains to stop producing endorphins (another trendy “technical” term that is popular with the public because of freshman level textbooks — I think the public likes endorphin talk more than sex). He stops short of explaining exactly what he means by that. In particular, he leaves us with the impression that the condition is permanent (e.g. that opioids actually do “brain damage”). That is a very effective fear tactic, and I suspect it was done on purpose. When you tell this public animal that something causes “brain damage”, they will avoid it and be frightened of it. Unfortunately, I think Siegel probably scored a lot of points with his rather incomplete argument.

Could some of the physicians here clarify the issue? If opioids do reduce endorphin production or release, is that condition not temporary? I was under the impression that opioids, for the most part, do no physical damage other than possible death from respiratory repression upon overdose. That is, I thought all effects of opioids were temporary and reversible. Is that not true? Could I get some quick and dirty medical education on this issue?