JOHN FRANKLIN, MD: We have naturally occurring pleasure centers in the brain that have what we call opioid receptors. Receptors are kind of like catcher mitts that receive the chemicals and turn on the pleasure system. That's why these drugs have such a powerful effect. The pleasure of the medication depends on what kind of medicine it is, how it's administered, how it's used. Medicines that get to the brain quicker, that have a steeper rise in the blood level, are more pleasurable or euphorigenic so that if you take one drug and you shoot it IV, you actually get a more powerful high than if you take it by mouth, because it gets to the brain quicker.
VAREN BLACK: What are some of the immediate effects of opioids? You mentioned the rush of a pleasurable feeling. What are some of the others?
JOHN FRANKLIN, MD: The pleasurable, sort of dreamy, oceanic feeling is the rush that the addicts are seeking. When people first are exposed to opioids, they actually may find it unpleasurable. They may be nauseous, may vomit. For some people it takes a while to get used to these medicines or to build up tolerance. You can tell, sometimes, by just looking at somebody if they're using opioids. They may have small pupils, the respirations may be decreased. They'll complain of constipation. These are all effects that opioids have on the body.
VAREN BLACK: What about suppression of pain, nausea and vomiting?
JOHN FRANKLIN, MD: All these opioid medicines can provide some pain relief. Probably the street drugs are less reliable as pain medications than some of the manufactured, synthetic types of medications.
VAREN BLACK: Those are the immediate effects. What are now some of the long-term effects of opioids, mostly heroin?