シャドーイング練習: Why Fentanyl Is So Incredibly Dangerous - YouTubeで英語スピーキングを学ぶ

Somewhere around 70,000 or so people die each and every year from an opioid-related overdose.

⏸ 一時停止中

再生速度:

240 文

文が短すぎたり長すぎる場合は、Editをタップして調整してください。

Somewhere around 70,000 or so people die each and every year from an opioid-related overdose.

Back in the early 2000s, the culprit was oxycodone, an opioid that most would probably recognize under the name of OxyContin.

But in 2013 or so, it was fentanyl that overtook both OxyContin and heroin on the center stage in the opioid epidemic.

As for who's to blame?

Well, it's a combination of things.

You have pharmaceutical greed and malpractice, you have healthcare providers that are over and misprescribing their patients.

And then you have a flood of illicitly produced fentanyl coming from China, Mexico, and India.

All of those factors were working together to create the current fentanyl crisis.

These days, fentanyl is being disguised as legitimate medications and then being smuggled into the United States and many other countries.

Some may think they're getting Xanax or Adderall, but instead are getting a high dose of fentanyl.

Considering fentanyl is around 50 times more powerful than heroin and 100 times more powerful than morphine,

and oftentimes only two milligrams of fentanyl is enough to deliver a fatal dose, dependence and accidental overdoses are skyrocketing.

In today's video, we're going to discuss the legitimate uses for fentanyl and what happens to the body when it's consumed.

We'll see why withdrawals are so brutally difficult to overcome and why overdosing is such an easy thing to do.

It's going to be an important one.

Let's do this.

Before we start today's video, if you or someone you know is struggling with opioid dependency or opioid use disorder and you're looking for help,

we've added some resources to the description of this video that we strongly encourage you to check out.

Let's first discuss the difference between an opiate and an opioid because there is an actual difference between the two.

Opiates are natural compounds that come from poppy sap and poppy plant fibers, so this would include morphine and codeine for example.

While opioids, that's more of an umbrella term and it's encompassing any compound

that is going to bind to and have an action on opioid receptors in the body.

So that would include the natural opiates like morphine and codeine

but also semi-synthetic opioids so that would include like heroin and then fully synthetic which would be fentanyl for example.

Now you may be wondering why the body has opioid receptors in the first place.

Well, it comes down to the fact that your body makes its own opioids to bind to those receptors.

They're called endogenous opioids and I guarantee you've heard of one of them, endorphins.

Endorphin stands for endogenous morphine but it's only one example of these opioids.

You also have what are called enkephalins, dinorphins, endomorphins, nociceptin or also called orphanin.

Now they'll bind to those receptors and they have a whole wide variety of effects

that we're going to discuss in a moment.

Just understand that exogenous opioids or coming from an external source, so this is going to be like heroin, morphine or fentanyl, will bind to those receptors, right?

So they're taking advantage of something that's already there and then what they do is they cause an exaggerated response.

Now to best understand how opioids work and why your body even bothers making endogenous opioids, we first need to understand how pain works and is processed.

Now we've already done an entire video on this so we'll go ahead and link that up above.

So if you want a more robust understanding, I strongly encourage you to check out that video.

But in a nutshell, let's say I jam my pinky finger, right?

So I hit it and that's going to send obviously a painful signal up a sensory neuron

and that neuron is going to travel from my pinky through my arm and up towards my spinal cord.

When it gets into the spinal cord, this is where it's going to synapse or communicate with a secondary neuron.

So this first neuron we call the presynaptic neuron.

Then the one that it synapses with or communicates with in the spinal cord is the postsynaptic neuron.

And what will happen is this postsynaptic neuron will now take the signal up the spinal cord.

Let me go ahead and grab this brain here and it's going to take it to the brain.

So you're looking at the right hemisphere of the brain as seen from the sagittal or midline view.

Now, grab my probe.

What's going to happen is the signal is going to travel up the brainstem

and it's going to go to this area here called the thalamus.

The thalamus is, you can think of it as like a hub.

It's going to direct signals to where they need to go.

So what will happen is the thalamus will send the signal into this region here

which is called the primary somatosensory cortex

and this is where you are going to be made aware of the fact that you have a problem.

Now, some data does suggest that the thalamus has some awareness but if it does, this is It's still going to be where the majority of your awareness is going to be.

But it's also going to send a signal to a structure that's deeper down in here

that we can't see called the amygdala.

The amygdala is responsible for processing negative emotions, so this is what makes you not very happy about the fact that you just jammed your finger.

So that's what we call the ascending pain pathway, but the brain or the body I should say also has a descending pain pathway.

Because think about it, after you've jammed your finger, you don't need to have that same pain level as long as the stimulus is gone.

The painful, that noxious stimulus is gone.

So what will happen is your body wants to start numbing the pain with those endogenous opioids.

So again, grab the brain here.

The thalamus will send a signal and it'll go down into this area here.

This is called the midbrain of the brainstem and in the midbrain is what is called gray matter.

Gray matter is just a location where cells are synapsing with each other but this gray matter is called the periaqueductal gray.

You're not really gonna be able to see that all

that much in this section here but from there a signal is going to be sent down the brainstem, down the spinal cord, and and go to

that location in the substantia gelatinosa where those two neurons were communicating with one another.

And it's at this site that the endogenous opioids will be secreted.

And it does this to modulate the pain.

And I say modulate on purpose, it's not like it's getting rid of the pain.

Right?

Just, you jam your finger and then wait two minutes, it's not as though the pain is just completely gone, there's still going to be pain there, and depending on how bad you jammed your finger,

the pain could be much worse.

So this is where the opioids will bind to receptors that we're about to discuss and changes your perception of the pain, which is absolutely fascinating.

Now without getting too far into the weeds when it comes to how this synapse and signal modulation works,

what's being communicated between the pre and the post synaptic neuron are neurotransmitters.

Now there's a lot of different types of neurotransmitters out there, but the ones that are going to be interesting or important to us are going to be glutamate and GABA.

GABA, more so GABA than glutamate.

Just think about it like this, a signal when it's being sent between neurons can either be excitatory or inhibitory.

If it's excitatory, it's just saying let's keep this signal going.

If it's inhibitory, it's saying let's stop this signal.

So if glutamate is released at the synapse, that's an excitatory signal.

But if GABA is released, that's an inhibitory signal.

So I want you to think about this for a second.

If you were able to prevent glutamate from being released,

that would also inhibit the signal or if you were to prevent GABA from being released,

that would also excite the signal and continue the signal on.

This is where opioids are going to do their thing.

Now the way the opioids are able to have an effect

or modulate the signal at the synapse is through those opioid receptors.

Now depending on where you look, you may see as many as five different types of opioid receptors

and each of those have their own subtypes

but for our purposes today we're going to focus on three of them and that's going to be the mu receptor, the delta receptor, and the kappa receptor.

Although we're primarily going to be focusing on the mu receptor

because that is the most well studied and it also happens to be the receptor that fentanyl prefers.

Although fentanyl will definitely choose all three of them but again it prefers that mu receptor.

Now you're going to find the mu receptor

and these other receptors throughout the entire body but they're going to be in different densities.

100

So with the mu receptor you're going to find a lot of them in the digestive system

101

which actually makes a ton of sense if you understand

102

that opioid usage comes with some pretty intense constipation and peristalsis type of issues.

103

But when it comes to the nervous system you're also going to find mu receptors in the substantia gelatinosa, right?

104

That spinal cord where those two neurons are communicating.

105

Again makes a ton of sense.

106

When it comes to the brain, I'm going to grab this hemisphere again.

107

You're going to find mu receptors in the brainstem

108

which is one reason that you're going to have issues with breathing

109

and we're going to see that when we get to overdosing here in a moment.

110

But you're also going to find mu receptors in the thalamus as well as the cerebral cortex.

111

But the mu receptors

112

that are in the cerebral cortex are primarily going to be associated with pain processing

113

which makes perfect sense because one of the reasons or actually the main reason you take an opioid is for analgesia.

114

But you're also going to find mu receptors in another pathway and that is going to be what's called the mesolimbic pathway.

115

The mesolimbic pathway is right here actually.

116

So there's an area here in the midbrain of the brainstem called the ventral tegmental area

117

and the ventral tegmental area is actually going to be communicating

118

with another area right about here again it's going to be deep called the nucleus accumbens.

119

And what will happen is it will actually be secreting GABA to the nucleus accumbens among other areas.

120

And if you recall me saying GABA is inhibitory, so when GABA is being secreted it's telling the other neuron to not secrete what it's going to secrete.

121

Well in this case, the nucleus accumbens secretes dopamine.

122

So right now, unless you're doing something very pleasureful and joyful, you're probably not secreting dopamine.

123

But let's say you enjoy some chocolate.

124

We all know chocolate is amazing.

125

So if you were to consume some chocolate, what's going to happen is the ventral tegmental area will say, we can enjoy this moment and it's going to stop secreting GABA

126

which will then allow the neurons here to start secreting dopamine.

127

Well opioids are going to do the same thing.

128

What's going to happen is they are going to bind to new receptors in the ventral tegmental area

129

which will then stop GABA secretion which will then cause dopamine release and flooding into the nervous system.

130

And this is the basis of addiction because it feels amazing

131

and this is what you'll see pretty much anyone who consumes opioids

132

and when they're beginning to consume opioids is that it feels fantastic.

133

The problem is that you're going to have to start taking more and more of the substance, whatever it is.

134

And again, it's not just opioids that do this, right?

135

There's a vast array of substances that will affect this mesolimbic or this reward pathway,

136

but when you start getting tons and tons of dopamine surges, you're going to have to start taking more and more to get the same dopamine surges.

137

And that is the basis of addiction, at least in terms of pleasure, joy, and eventually just outright need.

138

Now you may be wondering why fentanyl is even available given how extremely powerful it is.

139

If you recall me saying earlier it's around a hundred times more powerful than morphine, although I have seen some texts suggest that it could be as high as 400 times as powerful,

140

although they weren't perfectly clear if that was fentanyl or derivatives of fentanyl because as depressing as this is,

141

there are even more powerful synthetic opioids than fentanyl out there and they are on the street just as fentanyl is.

142

You have to understand that fentanyl is supposed to be administered under very specific circumstances

143

and so like think like extreme pain maybe someone has been taking morphine,

144

a lot of morphine for their pain eventually they become tolerant to it, they need something stronger.

145

Maybe they have cancer pain right because cancer can be extraordinarily painful.

146

Fentanyl has some great usage for that.

147

You'll also see fentanyl be administered by anesthesiologists.

148

Maybe someone's going under the knife or maybe they're having epidural for some for some reason.

149

So there are plenty of use cases for fentanyl

150

and they have been used in very good ways right in very controlled

151

and proper ways but it's just not meant to be where it is today

152

and you can see why that is such a problem because of that right.

153

It's so easy to overdose on fentanyl like extremely easy to overdose.

154

If you recall me saying opioids can actually have an effect on the respiration centers of the body

155

so in the brain stem but also into an area called the hypothalamus.

156

So you have to understand that right now as you're breathing, your body is monitoring everything.

157

You have respiratory rhythms going from to your diaphragm coming from the brainstem saying breathe in, breathe out, breathe in, breathe out.

158

Your brain is monitoring how much carbon dioxide is actually in your bloodstream

159

and so then that when carbon dioxide starts to increase, it'll actually reflexively cause you to inhale oxygen or exhale the carbon dioxide and inhale oxygen.

160

But if you have, if you're going, if you're overdosing on an opioid, that can get so saturated by the opioids themselves that you can't overcome that.

161

And so what will happen is you will actually die from respiratory depression.

162

You literally cannot breathe because the opioids have completely saturated those areas, the opioid receptors on those areas.

163

The only way out of that is with another opioid called Naloxone.

164

Also sometimes people will call it Narcan, that's a brand of it.

165

So what they'll do is by administering Narcan or Naloxone, what will happen is those will actually bind to those same receptors and prevent fentanyl,

166

morphine, or any of the other opioids from getting there and it will actually, so then what will happen is the person will come out of it.

167

They'll be able to breathe again and typically they'll go immediately into withdrawals and that will make them very uncomfortable.

168

You have to understand, withdrawals are, from what I hear, unbearable.

169

I mean, from any opioid.

170

This isn't just fentanyl exclusive because when you're withdrawing from it, you have to understand that the nerves,

171

that loss of pain, you get so used to it.

172

It's not just the dopamine.

173

It's not just the dopamine, the euphoria that you have to overcome, the addiction on that end.

174

It becomes excruciatingly painful because your neurons are used to not sending painful signals.

175

Now all of a sudden when there's no opioids to tell them not to send signals, any sensitization of those neurons, even if it's not painful.

176

Think about this.

177

If you're so used to not feeling pain, when that fully comes online,

178

your shirt itself can become painful because the neurons are just not used to processing that pain.

179

It makes withdrawal symptoms excruciating and so someone who actually will take Naloxone

180

or Narcan can actually kick right into one of those withdrawals.

181

It is absolutely awful.

182

In fact, everything about it is absolutely awful.

183

You know, opioids are one of those things that, you know, I am just deathly afraid of When I tell everyone

184

that I come into contact with who's going into the hospital, it's like, if you're going to be taking any kind of opioid, you need to be very careful with that, right?

185

I remember when I was in the hospital for some of my gut issues, and they were telling me, hey, we're going to be giving you this and that.

186

I was very resistant to taking any opioid in any capacity, and it's because I'm afraid of them.

187

It's not to say that they can't be beneficial.

188

I know they can.

189

It's just I literally live in fear

190

because I know what it can do to even the best and most well-intentioned of people.

191

And that's what's so unfortunate and heartbreaking for me, seeing so many people out there.

192

I'm a veteran and I have friends who have actually fallen victim to opioid abuse.

193

They have opioid use disorder, they have opioid dependence.

194

Living in North America, I don't know how you can drive on the freeway without seeing billboards just saying get help for your opioid addiction.

195

It's such a horrifying problem that is happening.

196

So, my hope is that we can find a way out of this.

197

And I'm not going to pretend as though I have a way out of it.

198

I don't want you to think that the anatomy guy who's teaching you on YouTube has the solution to the opioid epidemic.

199

I just am hoping that people can educate themselves on it to make better decisions about

200

if they have an opioid coming up, maybe they have some kind of procedure or something, or maybe they can just at least better understand someone who has already fallen into this opioid trap

201

because it is absolutely horrifying and depressing.

202

Now I want to take a moment and thank the sponsor of today's video, Brilliant.

203

Brilliant is a sponsor that we've been fortunate enough to work with almost since the beginning of this channel three years ago.

204

And honestly, this is 100% true.

205

John and I talk about how much we love Brilliant almost on a day-to-day basis

206

and that's because I use Brilliant on a day-to-day basis.

207

You see, Brilliant helps you learn math, science, logic, computer science and they do it in a really fun and interactive way.

208

So I just use the Brilliant app on my phone and I love to play Logic.

209

I don't even really want to call it games or puzzles.

210

That's not the right word for it because they're lessons

211

and they're really fun to the point where I can even get my four-year-old son to try and help me, especially when there's robots involved.

212

He gets really excited with the robots and you can just start moving everything around.

213

But I personally think Logic is one of the most important skill sets you can develop.

214

So I love chess.

215

I love Sudoku.

216

I love anything that really challenges my if this then that type of thinking in my brain

217

and that's something I use Brilliant every single day.

218

I can't tell you how many times I've recommended Brilliant to my students because Brilliant, what they do right is

219

that they show you the benefit of using not just logical type thinking but just scientific thinking in general,

220

mathematical thinking and they give you real world examples, right?

221

It's not just like boring word problems.

222

It's not this boring course that you're just sitting there hoping is going to get over at some point really soon.

223

Instead, they're fun and interactive but they're in ways

224

that you can actually understand and relate to in your real-world life and that bleeds into different aspects of your life.

225

This is something I've been telling my students for years, right?

226

You get better with chemistry, I guarantee you're going to start understanding other things better.

227

It's just.. that's just the way the world works

228

and brilliant is my absolute favorite way especially for those who may not be the most scientific

229

or mathematically minded to start breaking into this headspace

230

so utterly beneficial they have thousands of courses these aren't really games these are like full-blown courses

231

that are just

232

so interactive they're constantly updating them constantly creating new ones you

233

you really can't go wrong with just spending an hour or

234

so a playing around with Brilliant because I guarantee it's going to help you.

235

So, if you're interested, go ahead and visit brilliant.org slash IHA

236

and the first 200 people there will get 20% off their annual subscription.

237

I promise you, you're gonna love Brilliant, absolutely love them as a sponsor.

238

So, I hope you enjoyed today's video.

239

If you did, be sure to like, comment, subscribe, share this video with someone that maybe you think they could benefit from it as well.

240

But as As always, I appreciate you watching and hanging out with me for a little bit, and I will see you in the next video.

シャドーイングとは？英語上達に効果的な理由

シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。

☕ コーヒーをおごる

ShadowingEnglishは皆様の支援により完全無料を維持しています。サーバーやAIのコストは高額です。皆様のコーヒー一杯が私たちの支えになります！🙏

PayPalで寄付する

ShadowingEnglish.com – 英語シャドーイング練習

シャドーイング（Shadowing）でネイティブ英語を体に染み込ませよう。YouTube動画を一文ずつ聞いて声に出して繰り返し、本物の発音と流暢さを身につける。

シャドーイング練習: Why Fentanyl Is So Incredibly Dangerous - YouTubeで英語スピーキングを学ぶ

このレッスンについて

重要な語彙とフレーズ

練習のコツ

シャドーイングとは？英語上達に効果的な理由

シャドーイング練習: Why Fentanyl Is So Incredibly Dangerous - YouTubeで英語スピーキングを学ぶ

アプリをダウンロード

このレッスンについて

重要な語彙とフレーズ

練習のコツ

シャドーイングとは？英語上達に効果的な理由