[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:07.29,0:00:12.09,Default,,0000,0000,0000,,More than 3,000 years ago, \Na flower began to appear in remedies
Dialogue: 0,0:00:12.09,0:00:15.20,Default,,0000,0000,0000,,in Ancient Egyptian medical texts.
Dialogue: 0,0:00:15.20,0:00:17.78,Default,,0000,0000,0000,,Across the Mediterranean, \Nthe ancient Minoans
Dialogue: 0,0:00:17.78,0:00:21.93,Default,,0000,0000,0000,,likely found ways to use \Nthe same plant for its high.
Dialogue: 0,0:00:21.93,0:00:24.87,Default,,0000,0000,0000,,Both ancient civilizations \Nwere on to something—
Dialogue: 0,0:00:24.87,0:00:28.37,Default,,0000,0000,0000,,opium, \Nan extract of the poppy in question,
Dialogue: 0,0:00:28.37,0:00:32.24,Default,,0000,0000,0000,,can both induce pleasure \Nand reduce pain.
Dialogue: 0,0:00:32.24,0:00:35.08,Default,,0000,0000,0000,,Though opium has remained \Nin use ever since,
Dialogue: 0,0:00:35.08,0:00:39.29,Default,,0000,0000,0000,,it wasn’t until the 19th century \Nthat one of its chemical compounds,
Dialogue: 0,0:00:39.29,0:00:44.08,Default,,0000,0000,0000,,morphine, was identified \Nand isolated for medical use.
Dialogue: 0,0:00:44.08,0:00:48.30,Default,,0000,0000,0000,,Morphine, codeine, and other substances \Nmade directly from the poppy
Dialogue: 0,0:00:48.30,0:00:50.18,Default,,0000,0000,0000,,are called opiates.
Dialogue: 0,0:00:50.18,0:00:55.39,Default,,0000,0000,0000,,In the 20th century, drug companies \Ncreated a slew of synthetic substances
Dialogue: 0,0:00:55.39,0:00:57.13,Default,,0000,0000,0000,,similar to these opiates,
Dialogue: 0,0:00:57.13,0:01:02.06,Default,,0000,0000,0000,,including heroin, hydrocodone, \Noxycodone, and fentanyl.
Dialogue: 0,0:01:02.06,0:01:04.82,Default,,0000,0000,0000,,Whether synthetic or derived from opium,
Dialogue: 0,0:01:04.82,0:01:08.58,Default,,0000,0000,0000,,these compounds \Nare collectively known as opioids.
Dialogue: 0,0:01:08.58,0:01:12.91,Default,,0000,0000,0000,,Synthetic or natural, legal or illicit, \Nopioid drugs
Dialogue: 0,0:01:12.91,0:01:17.55,Default,,0000,0000,0000,,are very effective painkillers,\Nbut they are also highly addictive.
Dialogue: 0,0:01:17.55,0:01:19.55,Default,,0000,0000,0000,,In the 1980s and 90s,
Dialogue: 0,0:01:19.55,0:01:24.71,Default,,0000,0000,0000,,pharmaceutical companies began \Nto market opioid painkillers aggressively,
Dialogue: 0,0:01:24.71,0:01:27.41,Default,,0000,0000,0000,,actively downplaying \Ntheir addictive potential
Dialogue: 0,0:01:27.41,0:01:30.31,Default,,0000,0000,0000,,to both the medical community \Nand the public.
Dialogue: 0,0:01:30.31,0:01:34.10,Default,,0000,0000,0000,,The number of opioid painkillers \Nprescriptions skyrocketed,
Dialogue: 0,0:01:34.10,0:01:40.24,Default,,0000,0000,0000,,and so did cases of opioid addiction, \Nbeginning a crisis that continues today.
Dialogue: 0,0:01:40.24,0:01:43.22,Default,,0000,0000,0000,,To understand why opioids \Nare so addictive,
Dialogue: 0,0:01:43.22,0:01:48.05,Default,,0000,0000,0000,,it helps to trace how these drugs affect \Nthe human body from the first dose,
Dialogue: 0,0:01:48.05,0:01:53.11,Default,,0000,0000,0000,,through repeated use, \Nto what happens when long-term use stops.
Dialogue: 0,0:01:53.11,0:01:55.91,Default,,0000,0000,0000,,Each of these drugs \Nhas slightly different chemistry,
Dialogue: 0,0:01:55.91,0:02:02.82,Default,,0000,0000,0000,,but all act on the body’s opioid system by\Nbinding to opioid receptors in the brain.
Dialogue: 0,0:02:02.82,0:02:07.64,Default,,0000,0000,0000,,The body’s endorphins temper pain signals \Nby binding to these receptors,
Dialogue: 0,0:02:07.64,0:02:12.23,Default,,0000,0000,0000,,and opioid drugs bind \Nmuch more strongly, for longer.
Dialogue: 0,0:02:12.23,0:02:17.48,Default,,0000,0000,0000,,So opioid drugs can manage much more \Nsevere pain than endorphins can.
Dialogue: 0,0:02:17.48,0:02:22.94,Default,,0000,0000,0000,,Opioid receptors also influence everything\Nfrom mood to normal bodily functions.
Dialogue: 0,0:02:22.94,0:02:27.05,Default,,0000,0000,0000,,With these functions, too, \Nopioids’ binding strength and durability
Dialogue: 0,0:02:27.05,0:02:30.25,Default,,0000,0000,0000,,mean their effects \Nare more pronounced and widespread
Dialogue: 0,0:02:30.25,0:02:34.07,Default,,0000,0000,0000,,than those of the body’s \Nnatural signaling molecules.
Dialogue: 0,0:02:34.07,0:02:38.82,Default,,0000,0000,0000,,When a drug binds to opioid receptors, \Nit triggers the release of dopamine,
Dialogue: 0,0:02:38.82,0:02:42.26,Default,,0000,0000,0000,,which is linked to feelings of pleasure \Nand may be responsible
Dialogue: 0,0:02:42.26,0:02:46.63,Default,,0000,0000,0000,,for the sense of euphoria \Nthat characterizes an opioid high.
Dialogue: 0,0:02:46.63,0:02:50.74,Default,,0000,0000,0000,,At the same time, opioids suppress \Nthe release of noradrenaline,
Dialogue: 0,0:02:50.74,0:02:56.59,Default,,0000,0000,0000,,which influences wakefulness, breathing, \Ndigestion, and blood pressure.
Dialogue: 0,0:02:56.59,0:03:00.92,Default,,0000,0000,0000,,A therapeutic dose decreases noradrenaline\Nenough to cause side effects
Dialogue: 0,0:03:00.92,0:03:03.37,Default,,0000,0000,0000,,like constipation.
Dialogue: 0,0:03:03.37,0:03:09.18,Default,,0000,0000,0000,,At higher doses opioids can decrease heart\Nand breathing rates to dangerous levels,
Dialogue: 0,0:03:09.18,0:03:11.96,Default,,0000,0000,0000,,causing loss of consciousness \Nand even death.
Dialogue: 0,0:03:13.68,0:03:18.04,Default,,0000,0000,0000,,Over time, the body starts \Nto develop a tolerance for opioids.
Dialogue: 0,0:03:18.04,0:03:21.17,Default,,0000,0000,0000,,It may decrease its number \Nof opioid receptors,
Dialogue: 0,0:03:21.17,0:03:24.10,Default,,0000,0000,0000,,or the receptors may become \Nless responsive.
Dialogue: 0,0:03:24.10,0:03:29.03,Default,,0000,0000,0000,,To experience the same release of dopamine\Nand resulting mood effects as before,
Dialogue: 0,0:03:29.03,0:03:32.38,Default,,0000,0000,0000,,people have to take \Nlarger and larger doses—
Dialogue: 0,0:03:32.38,0:03:36.14,Default,,0000,0000,0000,,a cycle that leads to physical dependence \Nand addiction.
Dialogue: 0,0:03:36.14,0:03:39.66,Default,,0000,0000,0000,,As people take more opioids \Nto compensate for tolerance,
Dialogue: 0,0:03:39.66,0:03:42.76,Default,,0000,0000,0000,,noradrenaline levels \Nbecome lower and lower,
Dialogue: 0,0:03:42.76,0:03:46.30,Default,,0000,0000,0000,,to a point that could impact \Nbasic bodily functions.
Dialogue: 0,0:03:46.30,0:03:50.84,Default,,0000,0000,0000,,The body compensates by increasing \Nits number of noradrenaline receptors
Dialogue: 0,0:03:50.84,0:03:54.60,Default,,0000,0000,0000,,so it can detect much smaller amounts \Nof noradrenaline.
Dialogue: 0,0:03:54.60,0:03:57.21,Default,,0000,0000,0000,,This increased sensitivity \Nto noradrenaline
Dialogue: 0,0:03:57.21,0:04:00.28,Default,,0000,0000,0000,,allows the body \Nto continue functioning normally—
Dialogue: 0,0:04:00.28,0:04:05.29,Default,,0000,0000,0000,,in fact, it becomes dependent on opioids \Nto maintain the new balance.
Dialogue: 0,0:04:05.29,0:04:10.45,Default,,0000,0000,0000,,When someone who is physically dependent \Non opioids stops taking them abruptly,
Dialogue: 0,0:04:10.45,0:04:12.52,Default,,0000,0000,0000,,that balance is disrupted.
Dialogue: 0,0:04:12.52,0:04:17.26,Default,,0000,0000,0000,,Noradrenaline levels can increase \Nwithin a day of ceasing opioid use.
Dialogue: 0,0:04:17.26,0:04:19.53,Default,,0000,0000,0000,,But the body takes much longer \Nto get rid of
Dialogue: 0,0:04:19.53,0:04:22.93,Default,,0000,0000,0000,,all the extra noradrenaline receptors \Nit made.
Dialogue: 0,0:04:22.93,0:04:24.85,Default,,0000,0000,0000,,That means there’s a period of time
Dialogue: 0,0:04:24.85,0:04:28.08,Default,,0000,0000,0000,,when the body is too sensitive \Nto noradrenaline.
Dialogue: 0,0:04:28.08,0:04:31.34,Default,,0000,0000,0000,,This oversensitivity causes \Nwithdrawal symptoms,
Dialogue: 0,0:04:31.34,0:04:35.37,Default,,0000,0000,0000,,including muscle aches, stomach pains, \Nfever, and vomiting.
Dialogue: 0,0:04:35.37,0:04:39.100,Default,,0000,0000,0000,,Though temporary, opioid withdrawal \Ncan be incredibly debilitating.
Dialogue: 0,0:04:39.100,0:04:43.80,Default,,0000,0000,0000,,In serious cases, someone in withdrawal \Ncan be violently ill
Dialogue: 0,0:04:43.80,0:04:46.69,Default,,0000,0000,0000,,for days or even weeks.
Dialogue: 0,0:04:46.69,0:04:50.36,Default,,0000,0000,0000,,People who are addicted to opioids \Naren't necessarily using the drugs
Dialogue: 0,0:04:50.36,0:04:54.33,Default,,0000,0000,0000,,to get high anymore, \Nbut rather to avoid being sick.
Dialogue: 0,0:04:54.33,0:04:58.15,Default,,0000,0000,0000,,Many risk losing wages or even jobs \Nwhile in withdrawal,
Dialogue: 0,0:04:58.15,0:05:02.21,Default,,0000,0000,0000,,or may not have anyone to take care \Nof them during withdrawal.
Dialogue: 0,0:05:02.21,0:05:05.12,Default,,0000,0000,0000,,If someone goes back \Nto using opioids later,
Dialogue: 0,0:05:05.12,0:05:08.26,Default,,0000,0000,0000,,they can be at particularly high risk \Nfor overdose,
Dialogue: 0,0:05:08.26,0:05:12.26,Default,,0000,0000,0000,,because what would have been a standard \Ndose while their tolerance was high,
Dialogue: 0,0:05:12.26,0:05:14.45,Default,,0000,0000,0000,,can now be lethal.
Dialogue: 0,0:05:14.45,0:05:18.37,Default,,0000,0000,0000,,Since 1980, accidental deaths \Nfrom opioid overdose
Dialogue: 0,0:05:18.37,0:05:21.39,Default,,0000,0000,0000,,have grown exponentially \Nin the United States,
Dialogue: 0,0:05:21.39,0:05:25.37,Default,,0000,0000,0000,,and opioid addictions have \Nalso exploded around the world.
Dialogue: 0,0:05:25.37,0:05:29.53,Default,,0000,0000,0000,,While opioid painkiller prescriptions \Nare becoming more closely regulated,
Dialogue: 0,0:05:29.53,0:05:32.90,Default,,0000,0000,0000,,cases of overdose and addiction \Nare still increasing,
Dialogue: 0,0:05:32.90,0:05:35.64,Default,,0000,0000,0000,,especially among younger people.
Dialogue: 0,0:05:35.64,0:05:38.72,Default,,0000,0000,0000,,Many of the early cases of addiction \Nwere middle-aged people
Dialogue: 0,0:05:38.72,0:05:42.21,Default,,0000,0000,0000,,who became addicted to painkillers \Nthey had been prescribed,
Dialogue: 0,0:05:42.21,0:05:45.62,Default,,0000,0000,0000,,or received from friends \Nand family members with prescriptions.
Dialogue: 0,0:05:45.62,0:05:50.100,Default,,0000,0000,0000,,Today, young people are often introduced \Nto prescription opioid drugs in those ways
Dialogue: 0,0:05:50.100,0:05:55.88,Default,,0000,0000,0000,,but move on to heroin or illicit \Nsynthetic opioids that are cheaper
Dialogue: 0,0:05:55.88,0:05:58.09,Default,,0000,0000,0000,,and easier to come by.
Dialogue: 0,0:05:58.09,0:06:00.95,Default,,0000,0000,0000,,Beyond tighter regulation \Nof opioid painkillers,
Dialogue: 0,0:06:00.95,0:06:05.54,Default,,0000,0000,0000,,what can we do to reverse the growing \Nrates of addiction and overdose?
Dialogue: 0,0:06:05.54,0:06:10.42,Default,,0000,0000,0000,,A drug called naloxone is currently \Nour best defense against overdose.
Dialogue: 0,0:06:10.42,0:06:15.10,Default,,0000,0000,0000,,Naloxone binds to opioid receptors \Nbut doesn’t activate them.
Dialogue: 0,0:06:15.10,0:06:18.15,Default,,0000,0000,0000,,It blocks other opioids \Nfrom binding to the receptors,
Dialogue: 0,0:06:18.15,0:06:22.84,Default,,0000,0000,0000,,and even knocks them off the receptors \Nto reverse an overdose.
Dialogue: 0,0:06:22.84,0:06:26.11,Default,,0000,0000,0000,,Opioid addiction \Nis rarely a stand-alone illness;
Dialogue: 0,0:06:26.11,0:06:29.25,Default,,0000,0000,0000,,frequently, people with opioid dependence \Nare also struggling
Dialogue: 0,0:06:29.25,0:06:30.94,Default,,0000,0000,0000,,with a mental health condition.
Dialogue: 0,0:06:30.94,0:06:34.41,Default,,0000,0000,0000,,There are both inpatient \Nand outpatient programs that combine
Dialogue: 0,0:06:34.41,0:06:38.27,Default,,0000,0000,0000,,medication, health services, \Nand psychotherapy.
Dialogue: 0,0:06:38.27,0:06:41.03,Default,,0000,0000,0000,,But many of these programs \Nare very expensive,
Dialogue: 0,0:06:41.03,0:06:44.28,Default,,0000,0000,0000,,and the more affordable options \Ncan have long waiting lists.
Dialogue: 0,0:06:44.28,0:06:48.67,Default,,0000,0000,0000,,They also often require complete \Ndetoxification from opioids
Dialogue: 0,0:06:48.67,0:06:50.93,Default,,0000,0000,0000,,before beginning treatment.
Dialogue: 0,0:06:50.93,0:06:55.17,Default,,0000,0000,0000,,Both the withdrawal period and the common \Nmonths-long stay in a facility
Dialogue: 0,0:06:55.17,0:07:00.75,Default,,0000,0000,0000,,can be impossible for people who risk \Nlosing jobs and housing in that timeframe.
Dialogue: 0,0:07:00.75,0:07:04.73,Default,,0000,0000,0000,,Opioid maintenance programs aim \Nto address some of these obstacles
Dialogue: 0,0:07:04.73,0:07:08.02,Default,,0000,0000,0000,,and eliminate opioid abuse \Nusing a combination
Dialogue: 0,0:07:08.02,0:07:10.99,Default,,0000,0000,0000,,of medication and behavior therapy.
Dialogue: 0,0:07:10.99,0:07:14.26,Default,,0000,0000,0000,,These programs avoid withdrawal symptoms \Nwith drugs
Dialogue: 0,0:07:14.26,0:07:18.41,Default,,0000,0000,0000,,that bind to opioid receptors \Nbut don’t have the psychoactive effects
Dialogue: 0,0:07:18.41,0:07:23.55,Default,,0000,0000,0000,,of painkillers, heroin, \Nand other commonly abused opioids.
Dialogue: 0,0:07:23.55,0:07:25.53,Default,,0000,0000,0000,,Methadone and buprenorphine
Dialogue: 0,0:07:25.53,0:07:29.10,Default,,0000,0000,0000,,are the primary opioid maintenance \Ndrugs available today,
Dialogue: 0,0:07:29.10,0:07:32.16,Default,,0000,0000,0000,,but doctors need a special waiver \Nto prescribe them—
Dialogue: 0,0:07:32.16,0:07:34.91,Default,,0000,0000,0000,,even though no specific training \Nor certification
Dialogue: 0,0:07:34.91,0:07:38.00,Default,,0000,0000,0000,,is required to prescribe \Nopioid painkillers.
Dialogue: 0,0:07:38.00,0:07:40.20,Default,,0000,0000,0000,,Buprenorphine can be so scarce
Dialogue: 0,0:07:40.20,0:07:43.48,Default,,0000,0000,0000,,that there’s even \Na growing black market for it.
Dialogue: 0,0:07:43.48,0:07:46.62,Default,,0000,0000,0000,,There’s still a long way to go \Nwith combating opioid addiction,
Dialogue: 0,0:07:46.62,0:07:50.58,Default,,0000,0000,0000,,but there are great resources \Nfor making sense of the treatment options.
Dialogue: 0,0:07:50.58,0:07:55.04,Default,,0000,0000,0000,,If you or someone you know is struggling \Nwith opioid use in the United States,
Dialogue: 0,0:07:55.04,0:07:57.49,Default,,0000,0000,0000,,the Department of Health \Nand Human Services
Dialogue: 0,0:07:57.49,0:08:02.45,Default,,0000,0000,0000,,operates a helpline: 800-662-4357
Dialogue: 0,0:08:02.45,0:08:07.60,Default,,0000,0000,0000,,and a database of more than 14,000 \Nsubstance abuse facilities in the US:
Dialogue: 0,0:08:07.60,0:08:12.48,Default,,0000,0000,0000,,www.hhs.gov/opioids