’To understand what goes through the minds and bodies of opioid users, The New York Times spent months interviewing users, family members and addiction experts. Using their insights, we created a visual representation of how the strong lure of these powerful drugs can hijack the brain.
Dr. Pedro Mateu-Gelabert, one of the nation’s top opioid researchers, said this work brings “an emotional understanding” to the epidemic but “without glamorizing or oversimplifying.”…’
The ‘visual representation’ is hokey and adds nothing but glitz to the narrative. Nevertheless, it is insightful. However, it is hard to understand why it took the Times months of interviewing, when the reporters could have interviewed Dr Nora Volkow, director of the National Institute of Drug Abuse, or read one of her review papers on the neurobiology of addiction, deriving the same sophisticated understanding in thirty minutes or less.
Regardless, it is important to understand that addiction is not just a weakness of will and that recovery is not just a matter of determination. Motivation and commitment are necessary but far from sufficient in the face of the powerful neurobiological changes precipitated by a period of consistent use of an addictive drug. And this is true not only with respect to opioids (so fashionable to think about given the nationwide ‘epidemic’) but but any class of addictive drug. (And, for that matter, we speculate that non-drug-related ‘addictive’ behaviors such as gambling may involve similar mechanisms.). Essentially, the machinery of pleasure, reward and satisfaction have been hijacked by the substance use. With abstinence, such changes do not reverse for months or even years.