Ongoing efforts by state and local governments have helped abate the raging opioid epidemic, with deaths involving prescription opioids and heroin decreasing in recent years. The decrease is minimal, however. There were nearly 50,000 fatalities in 2019 alone — and opioid-related deaths continue to leave sorrow and devastation in their wake.
With the nation losing its bloody battle against the opioid epidemic, the hunt for sustainable prevention has never been more vital.
A new study published in Science Advances suggests vitamin D could be the missing piece when it comes to curtailing America’s opioid epidemic.
The notion came after a previous study found ultraviolet radiation triggers the skin to produce endorphins — feel-good chemicals in your body which diminish pain. It just so happens that opioids such as morphine, oxycodone, codeine and heroin mimic the chemical response of endorphins, which means sunlight has the ability to elicit opioid behavioral effects.
“How could it be that we have evolved a pathway to become addicted to the most abundant carcinogen in our environment,” Dr. David Fisher — lead researcher on the study — told The News Station. “There must be an evolutionary driver to make it worth the risk of getting skin cancer.”
“Vitamin D deficiency is painfully common.”Dr. David Fisher
This led Dr. Fisher and other researchers to hypothesize about the link between vitamin D and opioid responses. While the theory is yet to be tested through a clinical trial, genetic modelling on mice showed the researchers that vitamin D regulates the magnitude of opioid responses — low vitamin D sensitizes animals to opioid-seeking behaviors that are reversible upon vitamin D supplementation.
“A heroin addict, for example, if they were vitamin D deficient, may have a much stronger dependency, a much stronger adaptation response — essentially a stronger addiction — because the evolutionary pathway hoped it would be UV radiation that satisfies that opioid signal and that would’ve corrected the vitamin D level. But if you are only getting heroin that is not correcting the vitamin D level,” Fisher said. “It is a vicious cycle as the dependency is exaggerated and the vitamin D deficiency is never resolved.”
There is a distinct difference between an addiction and a dependency — addictions are marked by compulsive drug use whereas a dependence suggests it is needed to function ‘normally.’ Opioids often run a fine line between an addiction and a dependency, and a possible lack of vitamin D could explain this, as the endorphin-like response that opioids mimic fill the void of the missing vitamin D necessary for health.
After realizing how a vitamin D deficiency can lead mice to walk the dangerously fine line of addiction and dependency, the researchers turned to reversing the effects. According to the study, “oral supplementation rescued the vitamin D deficient mice by restoring the morphine preference pattern.” Put another way, their euphoric desire was satisfied by natural endorphins again.
“A proactive finding that we saw in the mice is that if we corrected the vitamin D levels just with oral supplementation, that exaggerated opioid response normalized itself. Which would suggest that in humans, the opioid response might be reversible if we correct the vitamin D deficiency.”Dr. David Fisher
This correction wouldn’t be hard. Most of our vitamin D comes from two sources: diet and sunlight. Foods such as fish, dairy, cereal, and orange juice contain vitamin D. However, diet tends not to be a very good source of natural vitamin D due to the tiny quantities that these foods give you. The other source is sunlight, but being a carcinogen, the amount of sunlight exposure needed to restore vitamin D levels is not possible to obtain without increasing the chances of skin cancer. Thankfully, we live in the modern age of medicine, and oral vitamin D supplements are easily obtainable from pharmaceuticals for not too large of a sum.
For the opioid epidemic — which has desolated families and communities across the nation — these findings could be a game changer. Vitamin D levels can easily be monitored and controlled, as Dr. Fisher pointed out, allowing opioids to be utilized medicinally without the fear of addiction.
“Surgery where patients are probably going to be prescribed opioids for a short period of time, maybe if vitamin D levels are checked and vitamin D deficiencies are corrected beforehand, it might lower the risk,” Dr. Fisher said. “We think this is potentially an important public health implication.”