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Understanding Opioids and How They Affect the Brain

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MEDICAL ANIMATION TRANSCRIPT: Opioids are drugs that are prescribed to treat moderately severe or severe pain. Examples of these drugs include hydrocodone, oxycodone, morphine, hydromorphone, methadone, and fentanyl. Heroin, an illegal drug, is also an opioid. In order to understand how opioids work, it's important to know how your body feels pain. The process begins when something harmful happens to your body. Information about this harm is converted to a nerve signal. The signal passes along nerves to your spinal cord and brain. In your brain, the signal is perceived as pain. Opioid drugs affect how you feel pain. They attach to structures called opioid receptors. These receptors are found on cells in your brain, spinal cord, and other areas of your body. Opioids act on these receptors to make you feel less pain. These drugs can also have other effects on your body. For example, they may give you an intense short-term high and feelings of extreme happiness. Opioids also activate the reward pathway in your brain. This causes certain parts of the reward pathway to release a chemical called dopamine. Scientists think dopamine helps you remember how good you felt while taking opioids and makes you want to keep taking them. This link between remembering things that make you feel good with a desire to do them again is an important part of developing addiction. Opioids may also slow your breathing and make you feel nauseated, and they may cause reduced motion of your intestines resulting in constipation. For most people, when opioids are taken as prescribed for a short time, they're fairly safe and effective, but these drugs can be taken in ways that weren't prescribed, such as taking too many, taking them to get high, or giving them to someone else. Misusing these drugs can raise your risk of developing drug tolerance, dependence, addiction, and overdose. Tolerance means the drug is less effective over time. This can happen when opioid receptors become less sensitive to the effects of the drug. As a result, more of the drug needs to be taken for you to get pain relief. Dependence happens if a person has symptoms when they stop using the drug. When the drug is removed or withdrawn, you feel sick. This sickness is called withdrawal. Opioid withdrawal has flu-like symptoms that include restlessness and anxiety, muscle aches, inability to sleep, watery eyes and runny nose, nausea and vomiting, stomach cramps and diarrhea, and dilated or widened pupils. Opioid addiction is a brain disease where you have an overwhelming craving for the drug. You can't stop taking the drug despite the harm it may cause you. Addiction is not the same as dependence. You can be tolerant of a drug or dependent on a drug without being addicted to it. Finally, opioid overdose is a condition where taking too much of the drug can cause life-threatening symptoms or even death. The amount that can cause an overdose varies from person to person and even within the same individual. The symptoms of opioid overdose can include confusion, feeling very sleepy or not alert, nausea and vomiting, constricted or small pupils, unconsciousness, slow or stopped breathing, and death. According to the Centers for Disease Control, over 100 Americans die each day from opioid overdoses. If you have questions about opioids or if you or someone close to you needs help for an opioid use disorder, talk to your healthcare practitioner.

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