A Short Note On Opioid And Opioid Analgesics

"If we could sniff or swallow something that would, for five or six hours each day, abolish our solitude as individuals, atone us with our fellows in a glowing exaltation of affection and make life in all its aspects seem not only worth living, but divinely beautiful and significant, and if this heavenly, world-transfiguring drug were of such a kind that we could wake up next morning with a clear head and an undamaged constitution - then, it seems to me, all our problems (and not merely the one small problem of discovering a novel pleasure) would be wholly solved and earth would become paradise."

Narcotic analgesics, especially morphine are underused for pain control with in the medical field. This underuse is because medical professionals, including doctors, fear patient addiction, side effects and possible lose of their licenses. These fears deny adequate healing and a better quality of life to those who would benefit from a more effective use of these drugs, as done in hospice care.

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

Opioid addiction is a condition that is preventable as well as one which individuals display several noticeable risk factors before the actual addiction prognosis to the point of causing death. There is a strong correlation between the early misuse of prescription opioids, which are prescribed for non-cancer pain management, and the development of a dependence on such opioids. Early detection of risk factors such as the misuse of opioids that are prescribed will help indicate that a patient is developing an addiction.1 Physicians, nurses, pharmacists, and other healthcare providers must closely monitor patients and the rate at which opioids are consumed as well as refilled.

Some examples of opioid medications are: oxycodone, fentanyl, morphine, and meperidine (Hart 2013). Not all opioids are used for pain, but this paper will focus on those that are currently used for pain in the United States.

Individuals who use Opioids are Addicts. The history of this very debatable topic is very educational and interesting. Opioids are drugs that are prescribed for severe to chronic pain, some examples of opioids are: morphine,?methadone, Buprenorphine,?hydrocodone, and?oxycodone.?Heroin?is also an opioid and is illegal. Opioid drugs sold under brand names include: OxyContin?,?Percocet?, Palladone?(taken off the market 7/2005),Vicodin?, Percodan?, Tylox? and?Demerol? among others. These drugs are also classified as a schedule II drug. Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood

Modern day America is plagued by a surplus of tragedy, most may have seen viral videos of these “zombies” slumped in cars or streets and yet it continues. In fact, this terrifying epidemic was created by drugs that were intended for pain relief, Opioids. This includes prescription pain relievers like oxycodone, morphine, methadone, and hydrocodone. Ironically, the well-known street drug, Heroin, is one of the most serious offenders of the Opioid crisis (Anderson). With each day, more mothers, fathers, sisters, and brothers are witnessing and losing loved ones from overdoses, which is why the focus of society absolutely needs to be on a path of action towards the rising deaths, excessive prescriptions and governmental influences in opioid addiction.

The people of Maine are in trouble. We are losing our citizens to opioid abuse at an alarming rate. We have, thus far, been paralyzed to do anything about treating the disease that’s running rampant through our communities, families, and homes. The overprescribing of prescription opiates in the 1990s and 2000s, driven by the profit margins of the multinational companies getting rich on the backs of those in chronic pain, has led to an unprecedented amount of addiction, crime, and death amongst Maine’s people. The strict rules, laws, and changes put in place to curb the prescription and abuse of opioids in the state of Maine has exacerbated an already out of control problem. They have contributed not to the desired lowering of

Prescription drugs are given to patients daily all over the world. Opioid painkillers are known to provide pain relief, but there seems to be an excessive amount of death and injuries because, more than ever, they are highly marketed and incorrectly prescribed. More than 2 million of Americans are dependent or abuse prescription pain pills (Opioid Crisis…). Worldwide nearly 26.4 million people abuse opioids (Public Affairs). It’s not just an issue in the United States but is becoming a worldwide crisis. The issue is known as the opioid epidemic. This is the question that is being asked: What are the factors of prescription opioids in the United States?

There is a growing concern for the use of opiates in pain management and other medical treatments. Due to illegal use and abuse of the opiates, there has been an increase in overdose and dependency throughout the nation and even the world. The use of opiate substances can include pain management and even cough suppression in severe cases; however, the side affects make the drugs appealing to those with substance abuse problems. President Donald Trump has declared the opioid epidemic a national public health emergency, which has led to the discussions of how to control the abuse of these substances (Merica). Despite the growing concern about opioid use, there are some benefits in the use of opioid substances in pain management. Many argue,

Opioids attach themselves to specific proteins called opioid receptors. These opioid receptors are found throughout the body including the brain, spinal cord, and GI tract. When an opioid attaches to a receptor, it can reduce the perception of pain. Through this coupling with receptors, opioids can also produce drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can stop respiration leading to death (overdosing).

During the twentieth century, opioids were mainly used for the treatment of short-term pain or to comfort the suffering of terminally ill patients. Throughout the 2000s, Purdue actively marketed its controlled-release opioid Oxycontin as a safe and nonaddictive treatment for chronic pain. Other drug manufacturers soon followed suit, this move is what many public health experts believe is one of the root causes of the current opioid epidemic(McCoy,2014).

Opioids are drugs taken for relieving pain. This drug has its effect on the human body through the reduction of the intensity of neuro-pain signals which are relayed to the brain (Opioids, 2009). Classic examples are the painkillers that include morphine, methadone, and hydrocodone among others. Pain is a physical suffering caused by illness or injury and may vary from steady to constant and throbbing to pulsating. It is not reasonable for anyone of us to except no pain except for those who suffer from anhydrases. This is an unusual genetic disorder that makes one unable to feel pain. Opioids play a significant role in the health system but they can be hazardous if used for pleasure or in a case of addiction. It is therefore important that

Opioid drugs and their receptor is one of the most extensively studying areas in pharmacology. This field of research really began from isolation of morphine, an active ingredient of opium, by German pharmacist Friedrich Sertürner in 1989. The compound he managed to isolate was called morphine after Morpheus, the Greek god of dream. Later Pierre Robiquet in France isolated the second predominant alcholoid of opium, codeine. After the discovery that morphine can be used as anesthetic in some medical procedures, it became widely used during surgeries (Brownstein, 1993). In 1898, the Bayer Company in Germany synthesized another opioid compound, heroin. Heroin was a non-prescription drug, which was thought to be more potent than morphine in producing analgesia, and more powerful than codeine in cough suppression. The legal production of heroin was suspended in 1925 when high levels of heroin addiction were noticed (Hosztafi, 2001, Tsisanova, 2012). In 1939, Otto Eisleb synthesized meperidine, first opioid ligand structurally not related to morphine. This was followed by the discovery of methadone by Max Bochmühl and Gustav Ehrhart just before the Second World War in unfortunate attempt to synthesize addiction-free opioid (Sneader, 2005, Tsisanova, 2012). 1940s were marked with the discovery of opioid antagonists, nalorphine and naloxone. The later compound is still widely used in research as well as clinically

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,