Exposure to opiates such as morphine can lead to psychological and physical dependence in both adult and infant humans. Infant rats experience opiate withdrawal behaviors that are qualitatively different from the withdrawal behaviors displayed by adult rats. In the adult, withdrawal is largely mediated by the mu-opioid receptor. We sought to understand more about what role each opioid receptor ...

Critically ill children are routinely treated with opioids to relieve pain, produce sedation, increase cooperation, and reduce metabolic demands. However, prolonged exposure to opioids followed by abrupt cessation frequently leads to opioid withdrawal syndrome. This syndrome is present in 35% to 57% of children who have received fentanyl by continuous infusion. It is characterized by a hyperadr...

BACKGROUND A difficult problem in treating opioid addicts is the maintenance of a drug-free state because of the negative emotional symptoms associated with withdrawal, which may trigger relapse. Several lines of evidence suggest a role for the metabotropic glutamate receptor 5 in opioid addiction; however, its involvement during opioid withdrawal is not clear. METHODS Mice were treated with ...

BACKGROUND Naltrexone is a competitive opioid antagonist and is often used to maintain abstinence in detoxified opioid dependent patients. However, it can precipitate an accelerated withdrawal when ingested by an individual with concurrent opioid use. METHODS We report the case of a 28 year old male with opioid dependence syndrome presenting with chaotic symptoms following ingestion of naltre...

Naltrexone is a long acting opioid receptor antagonist used in controlled opioid withdrawal drug programmes. When taken by an opioid dependent patient an acute withdrawal reaction will be precipitated. The case is presented where a known opioid drug misuser inadvertently ingested naltrexone in conjunction with heroin resulting in severe agitation, requiring heavy sedation followed by general an...

Instituting drug holidays for chronic opioid using patients is becoming commonplace for pain practitioners initiating procedures such as intrathecal pump or spinal cord stimulator trials. As such, pain practitioners need to be adept in their management of acute opioid withdrawal. Successfully weaning an opioid dependent patient off of chronic opioids requires a thorough knowledge of the availab...

Opioids are intensely addictive, and cessation of their chronic use is associated with a highly aversive withdrawal syndrome. A cellular hallmark of withdrawal is an opioid sensitive protein kinase A-dependent increase in GABA transporter-1 (GAT-1) currents in periaqueductal gray (PAG) neurons. Elevated GAT-1 activity directly increases GABAergic neuronal excitability and synaptic GABA release,...

Naltrexone is a long acting opioid receptor antagonist used in controlled opioid withdrawal drug programmes. When taken by an opioid dependent patient an acute withdrawal reaction will be precipitated. The case is presented where a known opioid drug misuser inadvertently ingested naltrexone in conjunction with heroin resulting in severe agitation, requiring heavy sedation followed by general an...

Opioid withdrawal causes a dysphoric state that can lead to complications in pain patients and can propagate use in drug abusers and addicts. Opioid withdrawal changes the activity of neurons in the nucleus accumbens, an area rich in both opioid-binding mu opioid receptors and glutamate-binding NMDA receptors. Because the accumbens is an area important for reward and aversion, plastic changes i...

It is widely believed that opioid withdrawal symptoms contribute to relapse to opioid use, but relapse is highly probable in experienced users even after prolonged abstinence and during opioid maintenance therapy. We have found using an animal model of relapse, the reinstatement procedure, that the two events that reliably reinstate heroin-seeking behavior are reexposure to heroin, and brief ex...