Pediatric Half and Half MAT Waiver Training-Review of Opioid Pharmacology

Review of Opioid Pharmacology

Pdf Summary

This document provides a review of opioid pharmacology and the treatment of opioid use disorder. It covers historical perspectives, the epidemiology of opioid use by adolescents, opioid physiology, opioid use disorder, and treatment options for opioid use disorder.<br /><br />The historical background of opioids in the United States is discussed, including the invention of the hypodermic needle during the Civil War and the liberal prescribing of morphine by physicians in the late 19th and early 20th centuries. The Harrison Act of 1914 restricted the prescribing of narcotics to patients, which reduced overall morphine prescribing. Opioid addiction was largely seen as "bad behavior" before the 1970s, when methadone was first used as an opioid replacement therapy. In 2000, the Joint Commission defined pain as the fifth vital sign, leading to the widespread availability of strong opioid medications and a new epidemic of opioid addiction.<br /><br />The epidemiology of nonmedical use of opioids is discussed, showing a dramatic increase from 2002 to 2009 alongside the development of newer, stronger medications. The misuse of prescription pain relievers is driven by reasons such as relieving physical pain, getting high, relaxing or relieving tension, helping with emotions, helping with sleep, experimenting, or because of addiction.<br /><br />The pharmacology of opioids is explained, including the different categories of opioids (opioids, opiates, and nonmedical use of prescription medications) and their function at mu-opioid receptors in the central nervous system. The different treatment options for opioid use disorder are also discussed, including detoxification, opioid antagonist therapy (such as naltrexone), and opioid agonist therapy (such as methadone or buprenorphine).<br /><br />The document emphasizes the importance of a comprehensive approach to the treatment of opioid use disorder, including pharmacologic treatment, non-pharmacologic treatment (such as counseling and support groups), and addressing co-occurring disorders. It also highlights the public health issues related to the diversion and misuse of opioids, and the need for careful prescription monitoring and safeguards to prevent nonmedical use.

Keywords

opioid pharmacology

treatment of opioid use disorder

historical perspectives

epidemiology of opioid use by adolescents

opioid physiology

opioid use disorder

treatment options for opioid use disorder

epidemiology of nonmedical use of opioids

pharmacology of opioids

comprehensive approach to the treatment of opioid use disorder