Video: Man in Opioid Withdrawal Explains Opioid Withdrawal

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I finally got to indulge my love of cringey YouTube thumbs!

This video explains the science behind precipitated withdrawal from opioids - an experience so awful that I liken it to suffering the Dementor's Kiss from Harry Potter while simultaneously experiencing a horrendous flu.

The talk is structured as follows (check timestamps if you want to skip ahead):

I. Brief Intro

II. What are receptors? [6:00]

a. What / where are opioid receptors?

b. What are mu opioid receptors and what biological functions do they have?

*Note on mu opioid receptor density in the human gut

III. What are ligands? [10:52]

a. Antagonists with examples: Red lights

b. Full agonists with examples: Green lights

c. Partial agonists with examples: Yellow lights

*Note on receptor affinity (binding affinity): At [18:05] I say "efficacy" when I mean "affinity"

IV. How does the neurophysiology of the mu opioid receptor system change with dependence / addiction, and how does this translate into "regular" and precipitated withdrawal? [22:00]

a. Receptor downregulation mechanisms

b. Why is precipitated withdrawal so much worse than "normal" withdrawal?

c. Commonly asked questions: [29:00]

(i) I'm not dependent on opioids, but I took a full-agonist opioid like fentanyl or oxycodone to get high or for pain relief and then took Suboxone (buprenorphine) shortly thereafter. Am I in danger of precipitated withdrawal?

(ii) I am dependent on a full agonist like methadone or fentanyl, and I'm considering starting Suboxone (buprenorphine). Is it possible that I will experience precipitated withdrawal?

(iii) Can I experience precipitated withdrawal when I'm dependent on one partial agonist and take another partial agonist?

(iv) Can I experience precipitated withdrawal when I'm dependent on a full agonist opioid and take another full agonist opioid?

Graph from NAABT.org that shows the level of mu opioid receptor stimulation / opioid effect provided by antagonists, partial agonists, and full agonists.