-opioids-

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-as of [16 MARCH 2024]

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*MORPHINE*

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*CODEINE*

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*TRAMADOL*

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*HYDRO-CODONE*

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*OXY-CODONE*

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*HEROIN*

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*FENTANYL*

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*SUBOXONE*

*SUBUTEX*

*METHADONE*

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*LOPERAMIDE*

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*OPIOID RECEPTORS*

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“opium poppy” plant

(latin for “sleep-bringing poppy”)

(the ‘opium poppy’ was cultivated in lower mesopotamia as long ago as 3400 BCE)

“opium”
(dried latex of opium poppy plant)

(the chemical analysis of opium in the 19th century revealed that most of its activity could be ascribed to two ‘alkaloids’ (‘codeine’ and ‘morphine’))

(“opiates” are opium derivatives)

(“opioids” are substances that act on opioid receptors to produce morphine-like effects)

(medically they are primarily used for pain relief, including anesthesia)

Other medical uses include suppression of diarrhea, treating addiction, reversing opioid overdose, suppressing cough, and suppressing opioid induced constipation.

Extremely strong opioids are approved only for veterinary use such as immobilizing large mammals.

Opioids are also frequently used non-medically for their euphoric effects or to prevent withdrawal.

The side effects of opioids may include itchiness, sedation, nausea, respiratory depression, constipation, and euphoria.

Tolerance and dependence will develop with continuous use, requiring increasing doses and leading to a withdrawal syndrome upon abrupt discontinuation.

The euphoria attracts recreational use, and frequent, escalating recreational use of opioids typically results in addiction.

An overdose or concurrent use with other depressant drugs commonly results in death from respiratory depression.

Opioids act by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract.

These receptors mediate both the psychoactive and the somatic effects of opioids.

Opioid drugs include partial agonists, like the anti-diarrhea drug loperamide and antagonists like naloxegol for opioid-induced constipation, which do not cross the blood-brain barrier, but can displace other opioids from binding in those receptors.

Because of opioid drugs’ reputation for addiction and fatal overdose, most are controlled substances.

In 2013, between 28 and 38 million people used opioids illicitly (0.6% to 0.8% of the global population between the ages of 15 and 65).

In 2011, an estimated 4 million people in the United States used opioids recreationally or were dependent on them.

Current increased rates of recreational use and addiction are attributed to over-prescription of opioid medications and inexpensive illicit heroin.

(conversely, fears about over-prescribing, exaggerated side effects and addiction from opioids are similarly blamed for under-treatment of ‘pain’)

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