The nucleus accumbens is a key component of the reward pathway that plays a role in addiction to many drugs of abuse, including psychostimulants and opioids. The effects of withdrawal from chronic morphine were examined in the nucleus accumbens using brain slices from morphine-treated animals. Recordings were made from interneurons in the shell of nucleus accumbens, and the presynaptic inhibiti...

Opioids are the mainstay of treatment for moderate to severe cancer pain. In recent years there have been many advances in the use of opioids for cancer pain. Availability and consumption of opioids have increased and opioids other than morphine (including methadone, fentanyl, oxycodone) have become more widely used. Inter-individual variation in response to opioids has been identified as a sig...

Pain is a hallmark of sickle cell disease (SCD) and its treatment remains challenging. Opioids are the major family of analgesics that are commonly used for treating severe pain. However, these are not always effective and are associated with the liabilities of their own. The pharmacology and multiorgan side effects of opioids are rapidly emerging areas of investigation, but there remains a sca...

In recent years there has been a shift from abuse of classical opioids such as heroin, morphine and methadone to abuse of prescription opioids such as hydrocodone, hydromorphone and oxycodone. This shift is in line with the significant increase in the prescription of opioids in the U.S. during the last ten years [1]. In 2011, there were 238 million prescriptions for opioids filled by U.S. pharm...

This paper details ethnographic observation of the development and performance a community-based theatre production in eastern Kentucky, titled The Homecoming. Participating provides community members an opportunity to collaboratively, creatively tell story their place. In Central Appalachia, where artform has over four decades history, plays regularly push back on damaging stereotypes actively...

The strategies used to manage children exposed to long-term opioids are extrapolated from adult literature. Opioid consumption during the perioperative period is more than three times that observed in patients not taking chronic opioids. A sparing use of opioids in the perioperative period results in both poor pain management and withdrawal phenomena. The child's pre-existing opioid requirement...

STUDY DESIGN A cross-sectional analysis of data obtained from patients with spinal and radicular pain and their spine center treating physicians was performed. OBJECTIVES To identify characteristics of patients treated with opioids that distinguish them from similar patients not treated with opioids in a large population of patients with spine and radicular pain, and to determine the prevalen...

INTRODUCTION Government agencies are increasingly emphasizing opioid safety in hospitals. In 2012, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) started a sentinel event program, the "Safe Use of Opioids in Hospitals." We sought to determine if opioid use patterns in our emergency department (ED) changed from 2011, before the program began, to 2013, after start of th...

OBJECTIVE There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS We performed a search in MEDL...

WHAT ARE OPIOIDS? When used as medications, opioids are important but powerful medications for severe pain. They are often used to reduce pain when patients are recovering from surgery or major injuries. Adverse effects of these medications can include feeling sleepy, dizzy, or confused. It is not safe to drive a vehicle after taking this type of medication. Another adverse effect is constipati...