this is Susan Susan loves to bike while
out for a ride she falls and breaks her
arms special cells called neurons send a
signal through the spinal cord to the
brain which interprets the signal as
pain Susan understands the pain means
she needs to go to the hospital and her
body is equipped for survival helping
her not to panic so she can seek help
many of her neurons are covered in
proteins called opioid receptors these
receptors act like a brake to slow down
the neurons ability to send pain signals
when injured her body releases natural
painkillers called endorphins like a key
in a lock endorphins activate opioid
receptors slowing down the pain signal
and preventing a panic Susan gets
treated for the broken bone but three
months later her arm still hurts and now
that pain is making her feel depressed
and anxious so her doctor prescribes an
opioid painkiller there are many
different opioids but they all share a
chemical similarity to our own
endorphins this allows them to bind to
the same opioid receptors and stop pain
signals but that's not all they do
deep inside Susan's brain is a region
called the ventral tegmental area or VTA
for short the VTA is full of neurons
that produce a chemical called dopamine
when something good happens dopamine is
released giving Susan a feeling of
pleasure
this helps teach her brain to keep
seeking out good things to keep dopamine
neurons in check inhibitory thoughts
keep the brakes on until something good
comes along just like the payment days
neurons are covered in opioid receptors
when Susan takes the painkiller
prescribed by her doctor the opioid
receptors turn off the rush of dopamine
temporarily eliminates Susan's
depression and anxiety and she feels
relief calmness and even euphoria as
Susan continues to take the painkillers
her brain responds by trying to regain
its balance her inhibitory neurons work
extra hard even when the receptors are
activated and it becomes harder and
harder for her dopamine neurons to
release dopamine Susan finds that she
needs to increase her dose of
painkillers in order to feel comfortable
this is called tolerance eventually
Susan's pills run out inhibitory neurons
over her let loose clamping down on the
dopamine neurons and shutting them out
almost completely now not only is Susan
in pain but the depression and anxiety
come back on top of that Susan feels
ravaged by an inescapable physical
sickness far worse than any flu Susan's
body is going through withdrawal most
people who take opioids for a long time
tend to experience some withdrawal but
they can still stop taking the pills and
return to normal but for people like
Susan it's not so easy for genetics in
the environment she grew up in put her
at a higher risk for addiction her
withdrawal symptoms aren't just
unpleasant
they're unbearable Susan thinks the only
way to feel normal is to find more
opioids and this is how the cycle of
opioid addiction emerges driven by a
brain trying to regain its balance but
there is hope for Susan though the road
to recovery can be challenging and there
may be setbacks treatments can retrain
Susan's brain with the help of
medication and therapy Susan finds
pleasure in her life once again
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you
you
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