Addicted in West Virginia (04:17)

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Investigators say drug companies flooded McDowell County with more than 780 million addictive pain pills over a six-year period. Coal miner Jasen Edwards describes how he became addicted to OxyContin. Health Commissioner Rahul Gupta elaborates on addiction’s devastating effect on the state.

Opioid Refugees (04:16)

Psychiatrist Anna Lembke studies how Big Pharma drives the opioid epidemic. She describes “doctor shopping,” which allows patients to legally obtain pain pills. Her patient Casey got hooked on painkillers following a series of medical procedures only to be turned away to deal with addiction on her own.

Growing Epidemic (02:15)

Dr. Yasmin Hurd of the Friedman Brain Institute discusses the role genetics play in addiction. More than 90 percent of addiction cases start before age 21, when the brain is still forming. Many addicts turn to heroin when they can no longer obtain pain pills legally.

Addiction Neuroscience (08:03)

Researchers Robert Malenka, Corey Waller, and Nora Volkow explain the cycle of addiction. Addictive drugs create a rise in the brain’s dopamine levels and alter connections between brain cells; memories of euphoria trigger cravings and impair the user’s motivational drive. Addicts are driven to avoid withdrawal symptoms, which include shaking, anxiety, pain and intense dysphoria.

Fentanyl Threat (02:25)

Vancouver, British Columbia has become a gateway for a powerful, synthetic opiate manufactured in China; it is up to 50 times stronger than heroin. Gupta follows overdoses, using a digital map. Musicians Prince and Tom Petty are among celebrity deaths attributed to the drug.

Shortcomings of 12-Step Approach (04:54)

Mary and James Winnefeld describe their son’s struggles with addiction and their efforts to get him treated, which ended with his fatal overdose. Some 80 percent of treatment programs follow Alcoholics Anonymous model, which Laura Kehoe of Massachusetts General Hospital says sets opioid addicts up for failure.

Methadone and Suboxone Treatment (03:18)

Methadone binds to opioid receptors to normalize brain function, but it must be taken at clinics. The opioid buprenorphine partially activates opioid receptors to help with cravings. Both drugs have a high success rate when used as prescribed.

Addiction and Cognitive Function (02:35)

Psychologist Rita Goldstein explains changes that occur in the brain’s prefrontal cortex as a result of drug addiction, impairing a user’s ability to make good decisions. Hurd describes how drug use affects the brain’s key chemical messenger, glutamate, which makes thinking, memory, and learning possible. Grey matter and dopamine receptors can come back with recovery.

Addiction as Disease (02:29)

The drug naloxone, sold under the brand name Narcan, can reverse an overdose by pulling opioids off receptors in the brain; but it can put patients into acute withdrawal, leaving them vulnerable to future overdose. Kehoe characterizes the treatment of addicts as a human rights issue.

Addicted Infants (05:14)

A baby is born dependent on opioids in the U.S. every 25 minutes. Dr. Stefan Maxwell’s newborn patients experience symptoms that include vomiting, diarrhea, and frantic behavior. Trauma is a factor that contributes to their parents becoming addicts; experiencing five adverse events can increase the risk of addiction tenfold.

Supervised Drug Use (03:54)

Vancouver sanctioned the first legal site in North America where visitors could inject illegal drugs under medical supervision. The program, called Insite, also provides clean needles to prevent the spread of infectious diseases. The Overdose Prevention Society tests drugs for clients; the city’s overdose and H.I.V. rates have plummeted dramatically.

Harm Reduction in West Virginia (02:16)

Gupta travels with a volunteer medical team to bring free medical care to McDowell County, hoping to reduce preventable deaths. Overdose fatalities here are seven times the national average, and the team is trying to get naloxone to as many as people as possible. Patients are also offered free testing for hepatitis and H.I.V.

America's Addiction Crisis (04:05)

More than 80,000 people die from excessive drinking each year, and smoking is responsible for 400,000 deaths. Waller, Lembke, and others advocate treating addition as a preventable disease instead of applying superficial treatment once things go wrong. Viewers discover how addicts featured in the program have fared.

Credits: Addiction (00:46)

Credits: Addiction