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Drugs & Health Blog

Out of Control: Opioids and the Brain

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The NIDA Blog Team

Prescription opioids can be relatively safe and effective at reducing pain—when they’re used correctly (as prescribed by a doctor). Opioids become unsafe when they’re misused, and that can lead to addiction. An average of 128 Americans die every day from an opioid overdose.

But why, exactly, are opioids so addictive?

Scrambled systems

The answer is in the human brain. Opioids activate several brain systems, including one that motivates a person to take more of the drug. At the same time, opioids cause changes in another part of the brain that limits a person’s ability to stop taking them.

When these two brain processes work in combination, the effect is like hitting the accelerator in a car—without having any brakes. A person addicted to opioids feels an intense urge to take the drug again, and also has a hard time resisting that urge.

Opioids on repeat

The longer someone misuses opioids, the less self-control the person will have; it gets more and more difficult to resist taking the drug, or to follow through on a resolution to quit.

Opioids diminish the person’s ability to make a different choice. Their brain is like a car that, besides having no brakes, has a steering wheel that works poorlyor doesn't work at all. The video below shows how all this works.

Because prescription opioids can affect a person in such powerful ways, you should only use them exactly as prescribed. Otherwise, you risk letting a drug take control of your brain.

Comments posted to the Drugs & Health Blog are from the general public and may contain inaccurate information. They do not represent the views of NIDA or any other federal government entity.


My 33 yr old son just died from an accidental overdose of opioid. He had the problem since an arm injury requiring 3 surgeries, when he was cut from pain meds he still had a lot of pain, nothing else seemed to help. Well now a beautiful young man doesn't get to live the rest of his life. He was not a drug person, he was a very loving son, G-son, bro, friend. Please people help. I don't remember opioids being a problem in 70's-80, what happened? We have to stop the smuggling of Fentanyl before more son & daughters die, trust me it's the hardest thing I've ever tried to live thru

Thank you for reaching out to us. We are so sorry to hear about your son and commend you for wanting to help others in similar situations. NIDA is working hard to address the opioid crisis by funding research and working with other institutes in HHS to improve access to treatment, develop new medications, and better understand the crisis.

I’m doing a project for school on opioids, are there any resources you can direct me to?
I want to know the difference between how codeine effect a teenage and a adult. What are differences and the simulates.

Hi Emma, thanks for writing. Codeine is a prescription pain reliever, also known as an opioid. An opioid’s effects can be different from person to person. You can read up on prescription opioids on our drug facts page: To learn more about how drugs affect the brain, check out this page:

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