Identification of neuroadaptations in specific brain regions that generate withdrawal is crucial for understanding and perhaps treating opioid dependence. It has been widely proposed that the locus coeruleus (LC) is the nucleus that plays the primary causal role in the expression of the opioid withdrawal syndrome. MacDonald Christie, John Williams, Peregrine Osborne and Clare Bellchambers believe that this view and the interpretation of the literature on which it is based are at best controversial. Here, they suggest an alternative view in which regions close to the LC such as the periaqueductal grey, as well as other brain structures which are independent of the LC noradrenergic system, play a more important role in the expression of the opioid withdrawal syndrome.