TECHNICAL SUPPLEMENT · CHAPTER 20

The Opioid Detour

Name: Pain, Not Pleasure | The Dopamine Brain, Chapter 20
Uploaded: 2026-09-18T07:56:12-07:00
Duration: 8 min 57 s
Description: We built two decades of policy on the idea that people keep taking opioids because the drug feels good. When somebody finally measured it, the middle score for feeling good was zero. What predicted who kept taking them was pain nobody had relieved. I will show you the wiring, the numbers, and what I have learned to say to a patient on a high dose.

We built two decades of policy on the idea that people keep taking opioids because the drug feels good. When somebody finally measured it, the middle score for feeling good was zero. What predicted who kept taking them was pain nobody had relieved. I will show you the wiring, the numbers, and what I have learned to say to a patient on a high dose.

12 pages · 17 references, every one verified · written by Dr. Gurpreet Singh Padda, MD, MBA, MHP

Watch Chapter 20

The chapter on video — the same argument, with the figures and the studies on screen as they come up.

The receipts behind Chapter 20

The book makes the argument. This supplement shows the evidence, claim by claim: the study, who was in it, the number and where it sits in the paper, what it does not show — and the questions to bring to your own physician. It is written to be shared with your doctor.

Enter your name, email and mobile number. The Chapter 20 PDF arrives by email within a few minutes, and the other thirty supplements arrive one a week, in order. We do not send marketing texts; your number is there so we can reply if you ask us something.

Educational material, not medical advice. If you are in the St. Louis area and want this looked at properly, that is what the Addictionology Center is for.