Opioids mimic the body's natural pain relievers, binding to receptor proteins in the brain and sometimes inducing euphoria.
Onscreen: When you encounter something pleasurable or exciting, your brain’s reward pathway releases dopamine, a neurotransmitter that motivates you to seek out more of the thing you just experienced.
R. Corey Waller: Anytime someone hears the term “motivation,” they should really supplant that with dopamine. Because without dopamine, you don't have motivation.
Onscreen: Drugs, including opioids, can crank dopamine levels 10x higher than normal.
Robert Malenka: All drugs of abuse cause this unnatural rise of dopamine. And because of that, they’re among the most powerful experiences our brains can have.
Onscreen: Opioids like heroin and fentanyl are chemically similar to morphine, which is found naturally in the poppy plant. These drugs mimic the body’s natural pain relievers. They bind to receptor proteins in the brain and induce euphoria. Prolonged opioid use alters connections between brain cells, creating memories of euphoria that trigger fierce cravings and addiction.
Malenka: Individuals struggling with addiction are actually battling millions of years of evolution because our brains are exquisitely evolved to seek rewards.
Onscreen: But it’s not just about seeking pleasure. When someone stops taking opioids, the body releases stress hormones. This triggers symptoms of shaking, anxiety, pain, and intense dysphoria.
Waller: The body decreases the production of dopamine. Eventually you can’t even get enough dopamine produced to get out of bed, let alone produce good relationships and good decision making.
Onscreen: Opioids can affect the parts of the brain that regulate breathing. Taking too many can reduce the urge to breathe, leading to respiratory failure, and that means death.
Drugs are now available to help treat addiction. Methadone binds to opioid receptors, activating them more slowly than heroin and other drugs.
Cheryll Moore: Methadone is our gold standard. It’s the most studied, it’s been around forever. You attend a methadone clinic every day, you get a dose of medication, it fills your receptor sites so that the cravings don’t happen.
Onscreen: If taken as directed, methadone doesn’t cause euphoria. But it normalizes brain function altered by addiction, including dopamine levels. Suboxone is a brand name of the drug buprenorphine. It’s less potent than methadone. Suboxone only partially activates opioid receptors to reduce cravings. If taken as prescribed, both drugs cut mortality by about half, and 40 to 90% of patients are still in recovery after a year.
Written, Directed, and Produced by
Camera: Rob Lyall
Assistant Camera: Kevin Rigney
Field Producer: Robin Nielsen
Sound: Jordan Sy
Animation: Ekin Akalin
Digital Producer: Ari Daniel
Additional Camera: Arlo Perez
Additional Visuals: Shutterstock
Allison Eck & Nafisa Syed
© WGBH Educational Foundation 2018