Panelists discuss the opioid epidemic in the second installment of Brain Awareness Week


On Thursday, the Center for Research in Science (CRIS) hosted a panel entitled “Opioids and the Brain.” This panel was the second event in this year’s Brain Awareness Week. The two events aimed at shining a light on the opioid epidemic in the U.S., offering data and possible solutions.

“We want to get to the nitty gritty,” said Louise Huang, CRIS director and assistant dean for the College of Liberal Arts and Sciences. “We want to get to the science. We want to get to hearing these experts who have perspectives and experiences. What should we do? What can be done? … Hopefully we can have some breakthroughs.”

The panel was moderated by Phil Cox, assistant professor of psychology, and included keynote speaker, Gary Tsai, M.D. Among the other panelists were Katie Shubin, PA-C, physician assistant; Derrick Sueki, assistant professor for the department of physical therapy; and Curtis Lehmann, assistant professor of psychology.

After introducing the agenda for the night, Tsai played a short animated video called “Nuggets.” The film depicts a kiwi bird that walks down a straight path and discovers a golden nugget. Though initially hesitant to consume the golden nugget, the bird begins to enjoy the substance, soon growing dependant on it.

As the film nears its end, it becomes clear that the substance no longer has a lasting effect on the bird, and it needs more to go on. As the bird’s dependency grows stronger, the white background becomes dark gray, then black.

When the film was over, Tsai explained it was a good example of what opioid addiction and dependence looks like. The film is heavily symbolic of opioid usage, especially relating to heroin, which is often injected through a needle, like the bird’s beak. Heroin can also sometimes have a golden hue when in this state, though certain types can look darker.

“There’s a lot of emotion to something that’s a really simple animation,” Tsai said. “A lot of people who watch this, who may not have exposure to something like addiction, can kind of get in these four minutes a sense of what it’s like.”

Tsai shared data regarding opioid usage and its long-term effects on the brain. One aspect of this, he said, were the physical elements, such as dependency on the drugs, building tolerance and experiencing withdrawal. Tsai showed data that demonstrated the activity of a brain that was not exposed to opioids, one that actively was exposed to opioids and one that had been exposed to opioids a year prior.

The image showed how continued opioid usage has a negative impact on the brain, as a study from the U.S. National Library of Medicine confirms. Even after a year of sobriety, some parts of the brain continue to be less active than they were prior to opioid usage. Although more studies are being conducted to gain more insight into this issue, the general consensus is that continued opioid usage alters the brain’s chemistry.

Tsai and other panelists explained a person’s dependence on opioid usage has many causes, which can complicate the solution. Whether a person is prescribed opioids or takes them recreationally, there is never a simple cause or solution when a person becomes dependant.

Tsai described this problem as “a bio-psycho-social” issue. This, he said, means that opioid addiction has a biological cause pertaining to the body, a psychological cause pertaining to the mind, a social cause pertaining to one’s culture and society and a spiritual cause pertaining to one’s spiritual well-being. These issues can work against a person individually or collectively, leading to a substance use disorder (SUD).

The panelists agreed with Tsai, saying non-addicts need to connect with people who are addicted to opioids in order to help them move past the problem.

Lehmann explained there are three major FDA-approved medications used to help people with opioid addiction lean away from their urges: Methadone, Naltrexone and Suboxone.

“But in the end, it’s not going to be a medication that helps provide the full recovery to people,” Lehmann said. “Because the causes of their addictions are multifaceted, so you have to respond to those.”

Lehmann said because of this, people should also seek additional psychological and social help on the road to recovery. In this way, he said, addicts can learn how to navigate their lives and addictions towards a healthier outcome, learn how to deal with pain, trauma or mental illness.

The panelists also agreed that medical ideas of pain need to be reevaluated to help fix the opioid epidemic. Since many people are prescribed opioids for pain, the panelists explained, they oftentimes do not want to stop taking opioids out of fear of the pain returning.

“We need to reevaluate what the goal of pain management is,” Tsai said. “Previously, the goal of pain management was essentially zero pain. What we like to talk about now is the goal of pain management being functional pain.”

Tsai said getting some patients to “zero pain” may be impossible and, if that is the goal, can set those patients up for disaster.

“As we talk about addiction, it can be a kind of depressing topic. It can [seem] like there’s not much hope out there,” Sueki said. “But I want you to realize that … all of us are working together towards a multidisciplinary approach … to guide us out of this dark hole. There’s hope on the horizon.”