Opioid Addiction: Is Vitamin D Deficiency A Driving Factor?

Abstract

Vitamin D deficiency is a common health problem worldwide among all age groups. Previous research studies have reported that ultraviolet (UV) exposure causes the skin to produce the hormone endorphin, which is chemically related to morphine, heroin, and other opioids.

A subsequent study reported that UV exposure raises endorphin levels in mice, displaying behavior consistent with opioid addiction. Recent research suggests that vitamin D supplementation may play a role in fighting opioid addiction.

What Is Vitamin D Deficiency?

Vitamin D, essential for a range of bodily functions, is predominantly obtained from exposure to sunlight. Once the body takes up vitamin D, it needs to be converted into its active form. Vitamin D is also naturally present in dietary sources like fish liver oils, fortified grains, dairy products, and egg yolks.

Vitamin D deficiency can occur when a person’s skin has an impaired ability to synthesize vitamin D from the sun. Individuals can also become deficient when their bodies cannot absorb the vitamin or convert it to its active form. People who avoid sun exposure, adhere to a vegan diet, or suffer from milk allergies may also be at a higher risk of vitamin D deficiency.

Vitamin D is vital for strong bones as it helps the body use calcium from the diet. Vitamin D deficiency has been associated with rickets, a condition leading to soft bones and skeletal deformities. However, increasing research suggests the importance of vitamin D in protecting against other health problems.

Know more: Genetic Factors That Could Increase Your Risk For Vitamin D Deficiency

Opioids Addiction: Tolerance

Opioids are a form of narcotic prescribed as an over-the-counter pain medication. If incorrectly used, they can have serious side effects and even result in opioid addiction.

Individuals may gain tolerance to opioid medication if taken regularly and might need an increased dose to achieve the same effect in easing pain. They may also develop a dependence on the medication due to extended period use. In this case, individuals who abruptly stop the drug use may experience withdrawal symptoms.

How Does Vitamin D Deficiency Influence Opioid Addiction?

A study led by Dr. David Fisher and his team of researchers at the Massachusetts General Hospital examined the potential link between UV radiation, vitamin D, and opioids.

Initially, the researchers began by studying two data sets.

The National Health and Nutrition Examination Survey with roughly 20,000 participants
Data of 3,000 Massachusetts General Hospital (MGH) patients between 2014 and 2016 with opioid use and more than 8,000 matched controls.

The researchers drew the following conclusions from the data sets:

Patients with insufficient vitamin D were 50 percent more likely to use opioid painkillers compared to patients with normal vitamin D levels.
Patients with vitamin D deficiency were 90 percent more likely to take opioids.
Patients diagnosed with an opioid use disorder were more likely to be classified as vitamin D deficient.

These results accounted for factors like age, gender, history of bone fractures, and chronic pain. However, further investigation was required to understand the association between low vitamin D and opioid use.

The Link Between Opioid Addiction And Vitamin D

The researchers used mouse models to understand the patterns seen in the clinical data.

They induced vitamin D deficiency in the mice using the following methods:

By feeding the mice a vitamin-deficient diet for eight weeks
By creating transgenic (modified) mice lacking the vitamin D receptor

50% of the diet-deficient mice were put on a regular diet for eight weeks before examining their response to morphine.

All the mice were then subject to a conditioned place preference (CCP) test in which the mice are placed in a multi-compartment chamber, trained to anticipate morphine in one chamber. Researchers then measured how long the mice spent inside the morphine chamber.

The following were observed:

In the mice with normal vitamin D levels, only after administering the highest dose of morphine, the mice started to prefer the morphine compartment.
But the vitamin D deficiency mice were 4 times more sensitive to morphine. So even with small doses of morphine, these mice started to prefer the morphine compartment.

The team found that the effect was reversed when they restored vitamin D levels using supplements. The researchers confirmed the results with a new batch of mice and additional sensory cues.

Furthermore, the researchers wanted to know whether vitamin D deficiency influenced how mice respond to opioids. For this, they placed control and deficient mice on a hot plate and measured their response to physical pain. Then, the test was rerun after administering the mice with morphine.

Test results reported that vitamin D–deficient mice stayed on the plate longer, implying the morphine worked more effectively as a pain reliever. There was an effect reversal upon vitamin D restoration. Additionally, the heightened pain threshold from a lack of vitamin D disappeared, demonstrating that the effect is opioid-mediated.

Are You Meeting Your Vitamin D Needs? Find out with our Gene Nutrition Report!

Vitamin D Deficiency and Ultraviolet (UV) Radiation exposure

The researchers exposed transgenic mice lacking vitamin D receptors to UV. Similar to earlier results, daily exposure to low-dose UV increased pain tolerance in the vitamin D–deficient mice. Findings also show that the mice spent more time in compartments associated with UV exposure, suggesting a lack of vitamin D sensitizes them to the rewarding effects of UV.

The team believes that mice and humans may have evolved molecular pathways to benefit from UV and vitamin D. These pathways induce the same feelings one might get when taking opioids but then control the cravings once vitamin D levels are sufficient.

Previous studies suggest that some people develop an urge to sunbathe and tan, mirroring the behaviors of opioid addicts. Fisher and his colleagues hypothesized that people seek out UV to benefit from an endorphin rush.

In conclusion, vitamin D deficient people would feel compelled to seek out the sun, receiving an endorphin rush. But once their bodies generate enough vitamin D, the endorphin production stops. In the case of opioids, there is no molecular switch to turn off the craving.

The association between vitamin D and opioid response can help with patient care. Checking vitamin D levels before a patient’s surgery could determine whether they are likely to have a heightened tolerance or develop an addiction.

Recommendations For Healthy Vitamin D Levels

Ensure you have healthy exposure to sunlight - at least 30 minutes to one hour in a week (varies depending on geographical location, skin tone, and other factors).
Include vitamin D-rich foods, including fatty fishes, eggs, beef, and all kinds of dairy products. Just one teaspoon of cod liver oil gives you 34 mcg vitamin D. You can include cod liver oil as a part of your everyday dietary supplement.

Also read: Will Fish Oil Supplements Help Your Heart Health? Depends On Your Genetic Makeup!

Try out a UV lamp! UV lamps mimic the action of the sun and can be especially helpful if your sun exposure is limited due to geography or time indoors.

Summary

Recent research has found a potential link between vitamin D deficiency and opioid addiction.
A study at the Massachusetts General Hospital examined the potential link between UV radiation, vitamin D, and opioids using human medical data and mouse models.
When the mice were administered with modest doses of morphine, those deficient in vitamin D continued seeking out the drug.
Further, in mice with vitamin D deficiency, the opioid responses reversed and returned to normal when vitamin D levels were restored.
In another set of experiments, the researchers found that mice lacking vitamin D receptors sought out UV exposure.
The results suggest that vitamin D supplementation can play a role in treating opioid addiction, and also help in patient care before surgery.
Regular sun exposure, vitamin D-rich foods, and UV lamps can help meet your vitamin D requirements.