top view of syringe with pills

Opioids

Opioids are powerful pain killers that are highly addictive. They can be divided into 3 classes:

  1. Naturally occurring opioidsThese occur naturally & include morphine, narcotine, codeine, thebaine, papaverine and narceine. 
  2. Semi-synthetic opioidsThese include heroin, oxycodone, oxymorphone, and hydrocodone.
  3. Synthetic opioids: These include buprenorphine, methadone, fentanyl, alfentanil, levorphanol, meperidine, and propoxyphene.

Opioids can be taken orally, snorted intranasally & injected intravenously or subcutaneously. These are addictive because of their euphoric property. Other symptoms include a feeling of warmth, heaviness of the extremities, dry mouth, itchy face & facial flushing. It can also induce dysphoria, nausea & vomiting.

People affected with opioid use disorders frequently fluctuate between the physical states of intoxication & withdrawal.

Aetiology of Opioid Use Disorder:

  1. Genetic Factors (About 50-60%)
  2. Drug availability
  3. Social acceptability
  4. Family history of substance dependence
  5. Parental conflicts
  6. Peer pressure

Opioid Withdrawal:

Opioid withdrawal develops after the cessation of or reduction in opioid use that have been heavy & prolonged.

Symptoms:

  • Severe muscle cramps & Body-ache.
  • Abdominal cramps
  • Diarrhoea
  • Rhinorrhea
  • Lacrimation
  • Piloerection or goose flesh
  • Yawning
  • Fever
  • Pupillary dilation
  • Hypertension
  • Tachycardia
  • Temperature dysregulation
  • Tremors
  • Insomnia
  • Restlessness
  • Irritability
  • Nausea/ vomiting.

At anytime during the abstinence syndrome, a single injection of morphine or heroin eliminates all the symptoms of opioid withdrawal.

Comorbidity of Opioid Use Disorder:

(I) Psychiatric Illness:

About 70% of men & 75% of women with opioid use disorder have an additional psychiatric disorder. Most common comorbid psychiatric disorders are:

  • Mood Disorders
  • Antisocial Personality Disorders
  • Anxiety Disorders
  • Alcohol Use Disorders

(II) Physical Illness:

Major health consequences of opioid use disorders include an increased risk of blood borne infections such as HIV, HCV & HBV.

Reference:

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