Medical Applications
*Opioids used to relieve pain, but can cause an exaggerated sense of well-being and if used in excess, dependence and addiction.
*Overdose can be fatal, usually due to respiratory failure.
*Urine tests can be done to check for opioid use.
*Treatment includes stopping the drug abruptly, substituting another drug and gradually reducing its dose to nothing, or substituting another drug that is taken indefinitely.
*Ongoing counseling and support are essential to controlling opioid addiction.
Opioids are important pain medications that are widely prescribed for both non-cancer and cancer-related pain. . These include codeine (which has a low potential for dependence), oxycodone, meperidine, morphine, pentazocine, and hydromorphone. Oral methadone and fentanyl taken by skin patch application are used for chronic severe pain. Heroin is illegal in the United States but is used in very limited applications in other countries 0 it is one of the strongest opioids.
Opioid drugs provide significant benefits for patients when used properly for their approved indications, but carry a risk of abuse, misuse, and death. More than 15,500 people died in the U.S. in 2009 after overdosing on narcotic pain relievers. That is a 300% increase over the last 20 years. And for each death, there are an additional ten treatment admissions, 32 emergency department visits and 825 nonmedical users of these drugs. The inappropriate use of opioids has become a major public health challenge for our nation.
Many people who use opioids to relieve pain for more than several days feel some symptoms of withdrawal when they stop, but serious dependence and addiction rarely occur when opioid use is medically supervised.
Tolerance can develop after two to three days of continued use, which means that people need larger quantities of a drug to feel the effects originally produced by smaller amounts. People who have developed a tolerance may show few signs of drug use and function normally in their usual activities as long as they have continued access to drugs.
Opioids are strong sedating drugs, causing people to become drowsy and quiet. They may cause euphoria, dull pain and can enhance sexual pleasure. Less desirable effects include constipation, nausea, vomiting, and itching. They can cause confusion, especially in the elderly. In large doses, they may cause lethargy or sleep and may slow the heart and breathing rate.
Taken in combination with other drugs can cause a serious disorder called serotonin syndrome which is characterized by confusion, tremors, involuntary muscle spasms or twitching, agitation, excessive sweating, and high body temperature
Opiod use itself does not cause many long-term effects other than dependence, but many complications can result from sharing needles with another person or unknowingly injecting other substances with the opiod.
*Overdose can be fatal, usually due to respiratory failure.
*Urine tests can be done to check for opioid use.
*Treatment includes stopping the drug abruptly, substituting another drug and gradually reducing its dose to nothing, or substituting another drug that is taken indefinitely.
*Ongoing counseling and support are essential to controlling opioid addiction.
Opioids are important pain medications that are widely prescribed for both non-cancer and cancer-related pain. . These include codeine (which has a low potential for dependence), oxycodone, meperidine, morphine, pentazocine, and hydromorphone. Oral methadone and fentanyl taken by skin patch application are used for chronic severe pain. Heroin is illegal in the United States but is used in very limited applications in other countries 0 it is one of the strongest opioids.
Opioid drugs provide significant benefits for patients when used properly for their approved indications, but carry a risk of abuse, misuse, and death. More than 15,500 people died in the U.S. in 2009 after overdosing on narcotic pain relievers. That is a 300% increase over the last 20 years. And for each death, there are an additional ten treatment admissions, 32 emergency department visits and 825 nonmedical users of these drugs. The inappropriate use of opioids has become a major public health challenge for our nation.
Many people who use opioids to relieve pain for more than several days feel some symptoms of withdrawal when they stop, but serious dependence and addiction rarely occur when opioid use is medically supervised.
Tolerance can develop after two to three days of continued use, which means that people need larger quantities of a drug to feel the effects originally produced by smaller amounts. People who have developed a tolerance may show few signs of drug use and function normally in their usual activities as long as they have continued access to drugs.
Opioids are strong sedating drugs, causing people to become drowsy and quiet. They may cause euphoria, dull pain and can enhance sexual pleasure. Less desirable effects include constipation, nausea, vomiting, and itching. They can cause confusion, especially in the elderly. In large doses, they may cause lethargy or sleep and may slow the heart and breathing rate.
Taken in combination with other drugs can cause a serious disorder called serotonin syndrome which is characterized by confusion, tremors, involuntary muscle spasms or twitching, agitation, excessive sweating, and high body temperature
Opiod use itself does not cause many long-term effects other than dependence, but many complications can result from sharing needles with another person or unknowingly injecting other substances with the opiod.
Withdrawal is uncomfortable but not life threatening. Symptoms can occur as early as four hours after opioid use stops and generally peaks within 48-72 hours. They usually subside after a week although the time frame varies with each opioid as they are each eliminated from the body at a different rate. Withdrawal symptoms are worse in people who have used large doses over a long period of time.
Opiod use during pregnancy is especially serious because heroin and methadone easily cross the placenta into the fetus. This causes withdrawal symptoms including tremors, high-pitched crying, jitters, seizures, and rapid breathing. If mothers take opioids immediately before labor and delivery, the baby’s breathing may be weak.
An opioid overdose is a medical emergency that must be treated quickly to prevent death. A drug called naloxone is given intravenously as an antidote to the opiod, rapidly reversing all adverse effects. It is used only when necessary (when breathing is weak) as it precipitates withdrawal symptoms in people who are dependent on opiods.
The two approaches to detoxification include stopping the opioid and allowing withdrawal to run its course, and substituting a similar but less potent drug, then gradually decreasing the dose and stopping the drug. Treatment is usually needed to lessen the symptoms of withdrawal. Clonidine can be used to provide withdrawal relieve but may have additional negative effects. Naltrexone may be used to block the effects of opioids and may help people remain drug-free when they are fully detoxified.
Drugs that can be substituted, then stopped include methadone and buprenorphine. Methadone is an opioid that is taken by mouth and blocks withdrawal symptoms and the craving for other opioids, especially heroin. Its effects last longer than those of other opioids so can be taken less frequently, usually once daily. The dose can then be decreased slowly. The use of methadone must be supervised in a licensed methadone treatment program. Buprenorphine is a partial opioid agonist, which means that is has ome effects of opioids but also blocks some of the effects. It doesn’t require supervision, so doctors may prescribe it in their office.
Maintaining addicts with regular doses of one of these drugs for a length of time – months or even years – enables them to be socially productive. For many addicts, lifelong “maintenance” is necessary.
Ongoing counseling and support is essential in addition to these other approaches. Support can include trained doctors, nurses, counselors, opioid maintenance programs, and family members, friends, and support groups.
The FDA has taken many steps to address the problem of opioid misuse over the last few decades and has established a task force to build upon existing initiatives to develop new ones. The task force’s approach currently targets drug development, opioid labeling, prescriber education, patient education, exploring innovative packaging/storage to prevent abuse, encouraging the development of products that treat abuse and overdose, as well of the role of other agencies.
Opiod use during pregnancy is especially serious because heroin and methadone easily cross the placenta into the fetus. This causes withdrawal symptoms including tremors, high-pitched crying, jitters, seizures, and rapid breathing. If mothers take opioids immediately before labor and delivery, the baby’s breathing may be weak.
An opioid overdose is a medical emergency that must be treated quickly to prevent death. A drug called naloxone is given intravenously as an antidote to the opiod, rapidly reversing all adverse effects. It is used only when necessary (when breathing is weak) as it precipitates withdrawal symptoms in people who are dependent on opiods.
The two approaches to detoxification include stopping the opioid and allowing withdrawal to run its course, and substituting a similar but less potent drug, then gradually decreasing the dose and stopping the drug. Treatment is usually needed to lessen the symptoms of withdrawal. Clonidine can be used to provide withdrawal relieve but may have additional negative effects. Naltrexone may be used to block the effects of opioids and may help people remain drug-free when they are fully detoxified.
Drugs that can be substituted, then stopped include methadone and buprenorphine. Methadone is an opioid that is taken by mouth and blocks withdrawal symptoms and the craving for other opioids, especially heroin. Its effects last longer than those of other opioids so can be taken less frequently, usually once daily. The dose can then be decreased slowly. The use of methadone must be supervised in a licensed methadone treatment program. Buprenorphine is a partial opioid agonist, which means that is has ome effects of opioids but also blocks some of the effects. It doesn’t require supervision, so doctors may prescribe it in their office.
Maintaining addicts with regular doses of one of these drugs for a length of time – months or even years – enables them to be socially productive. For many addicts, lifelong “maintenance” is necessary.
Ongoing counseling and support is essential in addition to these other approaches. Support can include trained doctors, nurses, counselors, opioid maintenance programs, and family members, friends, and support groups.
The FDA has taken many steps to address the problem of opioid misuse over the last few decades and has established a task force to build upon existing initiatives to develop new ones. The task force’s approach currently targets drug development, opioid labeling, prescriber education, patient education, exploring innovative packaging/storage to prevent abuse, encouraging the development of products that treat abuse and overdose, as well of the role of other agencies.