Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse (NIDA), explains what judges need to know about the biology, neurobiology, and chemistry of opioid use disorder. He introduces drug therapies to include methadone, buprenorphine, naltrexone, and naloxone, and explains how opioid tolerance and dependence are manifested and affect the brain. Dr. Compton covers the influence of individual and environmental factors in addiction. He concludes with a brief discussion on the complementary roles of judges, who work within the public safety system, and those who work within the public health and treatment community, and the need to work together.

Dr. Compton addresses the following questions:

00:09 How does opioid abuse affect the brain and biochemical brain processes?

01:19 How do opioids affect perception of pain?

02:08 What is the current understanding regarding whether opioids are the best approach for treating chronic pain conditions?

04:10 How are opioid tolerance and dependence manifested, and how they affect the brain?

05:40 How do brain abnormalities differ between opioid dependence versus addiction?

07:17 How does stress and other environmental effects affect the brain and the use of opioids?

08:41 Recent thinking and NIDA-funded research says there is a heavy influence of social interaction on addiction. Has there been a change in the way research has been approached?

10:06 How do currently approved pharmacotherapies for opioid use disorder work?

14:09  How does Narcan work and how it is administered?

16:11 Are there known individual and environmental factors that influence whether people who use opioid drugs will eventually become dependent or addicted?

18:33 What do judges specifically need to know about the biology, neurobiology, and chemistry of opioid use disorder?

19:50 Is there anything else our viewers should know?