Opioids and the brain

“She just wanted to learn how to skate.” Former DEA agent and United Methodist pastor, Dr. Barry Steiner Ball shared the personal encounter which changed his life’s mission. “We would go in houses at all hours,” he explained. “There would be adults passed out all over and in the middle would be a child. One that got me first. We went through a door and the first thing I remember that night was stepping and hearing crunching. It was dark and I got my flashlight and looked down and I was walking on dirty needles. They were everywhere.”

At first, he did not see the little girl in the dark house, but then his flashlight caught her standing in socked feet on a floor riddled with dirty needles. “She was holding a pair of skates while standing on the dirty needles,” he said. “It was a three-story house with passed out adults on every floor and she asked us, ‘Will you teach me how to skate?’” He said some of the agents spent the night teaching her how to roller-skate. “I learned that night, children are being impacted as the victims,” he said. “I don’t care how many defense attorneys stand up and say, ‘Your honor, this is a victimless crime.’”

Ball soon began traveling the country explaining the physiological reasons for opioid addiction to those who do not understand how so many are being impacted. On Tuesday, Nov. 5, he presented “Why it’s more than just saying no: How the brain responds to opioids” to a few dozen people at Hayesville First United Methodist Church.

He explained how he started working for the Drug Enforcement Agency. After retiring as a pastor, he was asked to work with a DEA task force for part of Maryland and West Virginia. “My eyes were opened instantaneously to what this epidemic is doing to that part of the country and everywhere,” he said. “It is devastating families and those lost in addiction. It is really tough for folks who are trying recovery, but what got me were the children. The children of those whose parents are lost in this addictive world.”

“Every agency, law enforcement, EMS, DSS and all of them are responding as best they can,” he continued. “But at every crossroads are churches with perfectly wonderful people inside who need a little bit of education and a little kick in the rear to help respond. If we don’t, the tsunami is going to overwhelm us.”

He defined an opioid as a depressant. “You actually feel very good,” he said. “It is a depressant because your heart and respiration slow down.” Your brain indicates relaxation; thus, an opioid overdose is not violent.

Opium has been derived from poppies for thousands of years to kill pain. Heroin was derived from opium as researchers were trying to regulate the formulas for pain control.

Then pain became the fifth vital sign at medical visits. “Opioids were designed for in hospital post-surgery or hospice care,” he said. “Because of people being worried about pain, physicians started prescribing more of this stuff for sprained ankles, sore necks, whatever. After ten days of taking them, it is not addiction, but there is a change in your brain wanting more.”

Harvesting opium from poppies is labor-intensive; therefore, it is costly. More potent drugs mean more money, so drug dealers began cutting heroin with the very potent fentanyl, or carfentanil, a large animal tranquilizer. “Users text each other about who has the best heroin,” he said. “The addicted mind wants the more potent drugs. If dealers can make more potent drugs without killing someone, the more money they make.” The synthetics are causing more deaths.

Yet, the limbic system in the brain of a person with substance use disorder craves the opioids and cannot detect when other substances may be there. “It is the brain’s chain of nerve cells which control pleasure, hunger, balance, temperature and more,” he pointed to a diagram on a chart. “In chains of nerves, there is a gap between each cell. They communicate with the brain through electrical and chemical processes. Every chain of nerves has a different chemical makeup of neurotransmitters which jump from cell to cell to convey the messages.”

Opioids affect the pain chain of nerves, but they also go to the pleasure center of the limbic system where the transmitters are dopamine, which offers pleasure. The molecules in opioids are like fake dopamine and they fill the gaps and stay.

“It does not take long for the brain to start saying that is what it wants,” he said. “Pretty soon, food is not important. Work is not important. Relationships are not important. Making sure I have a way to get that high is important. The length of time of the high is what makes opioids so appealing.”

He ended, “These children growing up in these homes have their flight or fight going all the time. Then we take them to school and say, ‘learn.’ They don’t know if they will survive the night or if mom and dad will survive the night. Their limbic system is on overdrive all the time.”

Ball’s goal is to involve people who don’t know or understand the epidemic. “By getting rid of the stigma and breaking down the issue into manageable parts,” he said. “We are not called to ‘fix’ all of these folks’ problems at once, but God calls us to a specific group, with our unique gifts and graces, to help them walk through their valley of shadow of death.  As we walk, God will provide new ministries with new persons and in connection with other, dare I say, churches and or community groups.” 

Ball hopes to have his presentation on-line early next year.