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Any stimulus that excites free nerve endings, pain fibers, will cause endorphin release. Core temperature means rectal temperature. There is really no evidence that endorphin shock or overload is a real phenomena. The patient may also report feeling as though they are not completely occupying their body or that they are not in control of their speech or physical movements. Endorphins "endogenous morphines" are opioid like peptides that function as neurotransmitters and are produced by the pituitary gland and hypothalamus in the brains of all vertebrates. This natural analgesic is secreted from these areas of the brain in response to exercise, excitement, pain, eating spicy food, and sexual activity.

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This is the exact opposite of the effects that are required to induce shock.

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The classic signs of opium intoxication are decreased mental status, slowing of the respiratory rate, shallow breaths, decreased bowel sounds and constricted pupils. This stimulus can be strenuous exercise, the various inflammatory mediators released during infection or injury or an intense scene. Shock is caused by severe declines in blood pressure and the resultant lack of perfusion of organs.

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