Out of Control: Opioids and the Brain

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Dr. Volkow screengrab and opioid animation
Image by NIDA.

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.

Find Help Near You

Use the SAMHSA Treatment Locator to find substance use or other mental health services in your area. If you are in an emergency situation, this toll-free, 24-hour hotline can help you get through this difficult time: call 1-800-273-TALK, or visit the Suicide Prevention Lifeline. We also have step by step guides on what to do to help yourself, a friend or a family member.

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