Illicit opioid overdoses are a significant problem throughout the world, with most deaths being attributed to opioid-induced respiratory depression which may involve peripheral mechanisms. The current treatment for overdoses is naloxone hydrochloride, which is effective but induces significant withdrawal. We propose that selectively peripherally acting opioid receptor antagonists, such as nalox...

Severe adverse reactions to buprenorphine during induction are exceedingly rare the most commonly reported adverse reaction is the development of precipitated opioid withdrawal. You can minimize the risk of precipitated opioid withdrawal by documenting that the patient is in opioid withdrawal prior to induction (using an opiate withdrawal scale instrument), and then dosing carefully. Patients s...

Adaptations in neurons of the midbrain periaqueductal gray (PAG) induced by chronic morphine treatment mediate expression of many signs of opioid withdrawal. The abnormally elevated action potential rate of opioid-sensitive PAG neurons is a likely cellular mechanism for withdrawal expression. We report here that opioid withdrawal in vitro induced an opioid-sensitive cation current that was medi...

Chronic morphine administration induces adaptations in neurons resulting in opioid tolerance and dependence. Functional studies have implicated a role for the periaqueductal gray area (PAG) in the expression of many signs of opioid withdrawal, but the cellular mechanisms are not fully understood. This study describes an increased efficacy, rather than tolerance, of opioid agonists at mu-recepto...

The chronic use of opiates (i.e., narcotics such as the natural derivatives of opium including morphine or codeine) or opioids (i.e., semisynthetic derivatives of opium and other molecules that activate opioid receptors) induces dependence, which is associated with various specific behavioral and somatic signs after their withdrawal or after the administration of an opioid antagonist. Among the...

To the Editor: We thank Kim et al. for their recent work examining the effect of intraoperative remifentanil on postoperative analgesia in children.1 Certainly, the pharmacokinetic profile of this potent opioid is attractive in modern anesthetic practice, and a thorough understanding of the principles behind tolerance, hyperalgesia, and withdrawal of remifentanil are critical for its safe admin...

Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morp...

BACKGROUND Individuals with opioid dependence have cognitive deficits during abuse period in attention, working memory, episodic memory, and executive function. After protracted abstinence consistent cognitive deficit has been found only in executive function. However, few studies have explored cognitive function during first weeks of abstinence. The purpose of this study was to study cognitive...

Long-term use of opioids for pain management results in rapid development of tolerance and dependence leading to severe withdrawal symptoms. We have previously demonstrated that endothelin-A (ETA) receptor antagonists potentiate opioid analgesia and eliminate analgesic tolerance. This study was designed to investigate the involvement of central ET mechanisms in opioid withdrawal. The effect of ...

combined use of an opioid with a psychostimulant is popular among drug abusers. such “polydrug use” may increase drug effects or attenuate adverse effects of either drug alone. we proposed that a combination of methamphetamine (meth) and morphine may change physical opioid withdrawal symptoms. adult male rats were chronically injected with cumulative subcutaneous (s.c.) doses of morphine, meth ...