BACKGROUND Incarceration is common among people who inject drugs. Prior research has shown that incarceration is a marker of elevated risk for opioid overdose, suggesting that the criminal justice system may be an important, under-utilized venue for implementing overdose prevention strategies. To better understand the feasibility and acceptability of such strategies, we evaluated the utilizatio...

Opioid drugs like morphine and fentanyl are the gold standard for treating moderate to severe acute and chronic pain. However, opioid drug use can be limited by serious side effects, including constipation, tolerance, respiratory suppression, and addiction. For more than 100 years, we have tried to develop opioids that decrease or eliminate these liabilities, with little success. Recent advance...

Regulation of the mu-opioid receptor gene by opioid analgesic drugs has not been observed in rats and mice following in vivo treatments that produce tolerance. Although in vivo heterologous regulation of mu-opioid receptor mRNA by non-opioid compounds has been reported, the failure to observe changes in mu-opioid receptor mRNA levels in vivo after treatment with opioid agonists raised the possi...

The discovery of numerous endogenous neuropeptides that participate in the formation, transmission, modulation, and perception of pain signals offers numerous strategies for the development of new analgesics. Nevertheless, the same research has not yet replaced opioids as the gold standard of pain treatment. Therefore, one possible avenue of drug development may shift interest from searching fo...

In the last 10 years, there has been an emergence of reports related to opioid-induced sudden sensorineural hearing loss (SSNHL). The underlying pathology is not completely understood, and the mechanism(s) of action of these drugs in the inner ear remains to be determined. Reports of SSNHL due to the abuse of opioid peptides and other drugs suggest that the opioid system in the inner ear is aff...

Chronic orofacial pain is common and complex, and it is frequently accompanied by comorbidities. These comorbidities include not only pain that may occur in other parts of the body (eg, neck pain, fibromyalgia, irritable bowel) but also psychosocial disorders such as depression, mood dysfunction, and sometimes substance use disorders involving drugs prescribed to manage the pain condition. For ...

n engl j med 367;14 nejm.org october 4, 2012 1373 1. Enteen L, Bauer J, McLean R, et al. Overdose prevention and naloxone prescription for opioid users in San Francisco. J Urban Health 2010;87:931-41. 2. Doe-Simkins M, Walley A, Epstein A, Moyer P. Saved by the nose: bystander-administered intranasal naloxone hydrochloride for opioid overdose. Am J Public Health 2009;99:788-91. 3. Role of nalox...

Working in a laboratory at the University of Michigan that was originally designed in the 1960s by Dr. Tomoji Yanagita, we have been evaluating opioid drugs for their ability to maintain behavior in rhesus monkeys. The animals are prepared with intravenous catheters that can be accessed from the outside of the cage. Inside the cage are two response levers and several stimulus lights. When one o...

Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1). In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids (2). In Massachusetts, unintentional opioid-related overdose deaths, including deaths involving heroin, increased 45% from 20...

PURPOSE Low-dose naltrexone (LDN) is used in a wide range of conditions, including chronic pain and fibromyalgia. Because of the opioid antagonism of naltrexone, LDN users are probably often warned against concomitant use with opioids. In this study, based on data from the Norwegian prescription database, we examine changes in opioid consumption after starting LDN therapy. METHODS We included...