Putting the Narco in Narcolepsy: Connecting Heroin and Sleep Disorders
Most of the world is well aware of the numerous adverse effects of drugs like heroin. Considering the desolation of the ongoing opioid crisis in America, we have become increasingly informed as to the dangers of addiction and overdose death when dealing with these substances. Prescription painkillers and illicit synthetic opioids have all played a part in it.
But one connection we might not have drawn until recently is the relationship heroin appears to have with specific neurons in the brain that impact narcolepsy.
Some scientists seem to think that opioids may hold a hidden potential for a new kind of treatment. So could heroin actually be the next big breakthrough in treating narcolepsy?
What is Narcolepsy?
First things first- Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. This sleep-related condition is characterized by:
- Excessive sleepiness
- Sleep paralysis
In some cases, people with narcolepsy even experience episodes of cataplexy, which is a partial or total loss of muscle control. Symptoms typically appear in childhood or adolescence. Sadly, many people have symptoms of narcolepsy for years before getting a proper diagnosis. There are a few kinds of narcolepsy.
Type 1 narcolepsy
This was previously termed narcolepsy with cataplexy. An individual is diagnosed with type 1 narcolepsy when they either have low levels of the brain hormone hypocretin, or report cataplexy and having excessive daytime sleepiness on a special nap test.
Type 2 narcolepsy
This was previously termed narcolepsy without cataplexy. People with this condition experience excessive daytime sleepiness. However, they usually do not experience muscle weakness as an emotional reaction. They usually also have less severe symptoms and have normal levels of the brain hormone hypocretin.
This can be the result of an injury to the hypothalamus, a region deep in the brain that helps regulate sleep. Individuals suffering from secondary narcolepsy may also have severe neurological problems and sleep for long periods of over 10 hours each night.
Narcolepsy occurs equally in men and women. Experts believe it affects roughly 1 in 2,000 people. It can have several causes, including autoimmune disorders, family history or brain injuries.
But going back to the relationship with opioids, one chemical is of particular interest. Nearly all people with narcolepsy with cataplexy have extremely low levels of hypocretin.
Addiction and Chronic Sleep Disorder
A paper recently published recently in the journal Science Translational Medicine talks about the possibility of opioids being used for narcolepsy treatment. It details new work probing the connection between addiction and the chronic sleep disorder by studying the brain.
When narcoleptics nod off or experience a loss of muscle control, it’s because of a lack of hypocretin in the brain. Hypocretin is a chemical that promotes wakefulness and regulates REM sleep. In the recently published paper, researchers studied the brains of dead narcoleptics. In the process, they came across one supposedly healthy brain with an unexpectedly large number of hypocretin neurons.
After digging up the deceased individual’s medical records, the researchers discovered the donor had actually been a heroin addict.
The scientists decided to start examining the brains of people who had struggled with opioid use disorder. In the first four samples, researchers found the brains of opioid and heroin users had an average of 54% more hypocretin-producing cells than regular brains. Jerry Siegel, a neuroscientist at the University of California Los Angeles and co-author of the study, states:
“So it was natural to ask if opiates would reverse narcolepsy.”
Next, researchers administered morphine to narcoleptic mice over a two-week period. Morphine is essentially medical grade heroin. The researchers noticed an increase in the hypocretin-making cells of the mice. The effect also lasted for a few weeks after scientists cut off the dosage.
Thus, the team came to the conclusion that opioids like heroin can actually wake up dormant cells that make the necessary wakefulness chemical in the brain. Siegel adds,
“Understanding why opiates ‘awaken’ these cells is a task for the future.”
However, other scientists understandably have a lot of reservations about this kind of work. Even if data did suggest that opioids like heroin could be an effective treatment for narcolepsy in humans, there is a laundry list of practical limitations. Sleep expert Thomas Scammell of Harvard Medical School said in an interview,
“No mother of a 15-year-old with narcolepsy would sign onto us giving them several doses of morphine a day.”
And that seems like a pretty fair assumption to make. Even if opioids do have the ability to activate these neurons, it seems pretty counterintuitive to give someone what is essentially prescription heroin to stop them from nodding off.
But, some think there may be a way to reverse engineer these effects.
Could Hypocretin Treat Heroin Addiction?
The study’s findings may actually provide a whole new hope when it comes to innovative heroin addiction treatment.
If it can be determined that opioid users have more neurons that make hypocretin, researchers think maybe they need less. Thomas Scammell went on to say,
“If chronic use of opioids is increasing hypocretin production—and the authors show that nicely—then that could amplify the rewarding aspects of these drugs, making addiction all that much worse. I think that’s actually the most interesting part of their research.”
And Scammell may be right. If it is possible for researchers to further examine the relationship between higher levels of hypocretin and opioid addiction, it may be possible that heroin addiction treatment could benefit. Is it possible that finding an effective way of lowering hypocretin in the brain of heroin addicts could actually make the recovery process easier?
Anyone familiar with heroin addiction and recovery knows that in the early stages of trying to quit, people can use all the help they can get.
Getting off of heroin is not easy. There are a lot of factors that affect how an individual gets started on their path to recovery. Heroin withdrawal symptoms are estimated to begin somewhere between 6 and 12 hours of the last use. These symptoms typically peak within 2 to 3 days and usually last 5 to 10 days. Still, the level of dependency will impact the length of time of detoxing. During this period, people with opioid use disorder are at an elevated risk of relapse. Most people struggle through this period because of the uncomfortable and painful withdrawals.
Heroin detox is designed to provide safe medical assistance for those trying to stop using opioids. Not only is this about providing effective medical care, but detox programs are also meant to help the individual feel comfortable and relaxed during this crucial period of transition.
Also, a safe medical detox from heroin will be able to assess and address other mental health or physical health issues while the individual has a secure and supported environment to heal.