PBS Explores The Science of Opioid Addiction

By Paul Fuhr 10/16/17

A recent PBS feature details how opioids hijack the brain and traces the history of the addiction itself.

 hands holding an open pill capsule releasing gears to a head of cogs

While much has been written about the nation’s opioid epidemic and the damage it’s caused, many Americans remain confused about what makes the drugs so powerfully addictive.

A PBS NewsHour feature not only details how opioids hijack the brain, but it traces the entire history of opioid addiction itself. “Pain and pleasure rank among nature’s strongest motivators,” the article began, “but when mixed, the two can become irresistible.” The feature suggests that opioids tap into a primal neurological urge to combine pain and pleasure—a desire that can be found as early as 3400 B.C. when Sumerians called opium poppies “the joy plant.” 

This storied timeline of opium (involving Assyrians, Babylonians, and Egyptians) winds its way to Chinese patients who “swallowed opium cocktails before major surgeries” in 1500, as well as a German chemist who developed a method of "purifying morphine from poppies."

Almost overnight, PBS revealed, morphine became “the go-to pain reliever for anxiety and respiratory conditions.” However, when the Civil War broke out, all bets were off. The countless wounded soldiers were given morphine to address their pain and many of them became addicted to the substance. (The addiction was darkly coined “Soldier’s Disease.”) In the late 1800s following the war, though, a cough syrup emerged to ease morphine addiction. 

Its name? Heroin.

Naturally, things went from bad to worse. “Doctors thought the [heroin] syrup would be ‘non-addictive,’” the PBS story said, before revealing that heroin quickly became “a low-cost habit that spread internationally.” A staggering 70% of the world’s opium supply (3,410 tons) is used in heroin production—a figure “that has more than doubled since 1985.”

By 2016, 17 million people worldwide used heroin, opium or morphine in some way, shape or form. The Centers for Disease Control and Prevention (CDC) announced that 53,000 people died from overdoses in 2016, too, which is “more than those killed in motor vehicle accidents.” Strangely enough, it’s not even the illicit market of opioids that worries policymakers and legal experts. No, it’s the troubling number of prescription opioids in everyone’s medicine cabinets.

The PBS feature doesn’t just claim that opioids are an accepted problem in our society—it goes so far as to estimate that prescription and synthetic opioids will “kill half a million people over the next decade.” 

Experts like Chris Evans, UCLA’s director of the Brain Research Institute, say “there’s [not] going to be a magic bullet" to resolve this complicated addiction.

How does opioid addiction happen? Put simply, opioid addiction occurs when “a person’s neurons adapt to the drugs,” which kicks into motion a constant tension between pain and pleasure in the body’s central nervous system. The brain becomes a gameboard of either dopamine-dosed euphoria or neuron-driven depression.

When drugs begin leaving the body’s system, “the pendulum swings back” and all the euphoria that person originally felt suddenly dissolves into depression and anxiety. “The surge of withdrawal from opioids [is what] makes the drug so inescapable,” the PBS story contended.

And like most addictions, opioid disorders are progressive: a person “needs a higher quantity of the drugs to keep withdrawal at bay.” Still, opioid replacement therapies like Suboxone “reduce a person’s chances for overdosing” as the drugs “stick to the [pain] receptors for a longer time, which curtails withdrawal symptoms.”

But treatments are imperfect at best. And while others seek to solve the epidemic, it reveals as much about addiction in America as it does about our collective resolve to finally face the fight deep inside ourselves.  

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.