>>Overdose deaths in America exceeded 100,000 for each of the past three years...
I prefer to see these as accidental fentanyl poisonings. It's not that addicts are pushing so close to an overdose 'cliff' as sometimes their supply is much stronger than they thought — sometimes strong enough to suppress autonomic breathing, and if there isn’t someone there to do that for you and/or administer Narcan (naloxone)…
That said, agreed 100% on pleasure being dependent on *which* neurons are being signaled, with the difference between the expected and the actual being quite important. It seems the point of most cortical stacks is to predict, their response being proportional to the diffference between prediction and actual experience. Not an area I've dug into much...