Opioids

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An opioid refers to any substance from a group of analgesic agents derived from the ingredient opium. Opioids are a type of depressant, analgesic drug that slow down the messages being sent through the central nervous system between the body to the brain. Although used to treat pain, opioids can entice euphoric feelings and sedative effects which can be addictive which leads this drug group to be commonly abused.

Clinical Pharmacology

Four naturally occurring alkaloids can be isolated from the opium poppy seed (papaver somniferum). These plant-derived amines are morphine, codeine, papaverine and thebaine. These can be used to produce many varieties of semi-synthetic opioids useful in clinical medicine including diamorphine, dihydrocodeine, buprenorphine, nalbuphine, naloxone and oxycodone.

Benefits of Opioids

Adverse effects of opioids

There is no evidence to support the use of opioids in patients' with chronic pain (>16 weeks). Other adverse effects associated with opioid use include:

sleep apnoea

hypothalamic-pituatory axis supression (hormonal changes leading to symptoms such as decreased libido, infertility & fluid retention)

physical dependence and addiction

opioid-induced hyperalgesia

dental pathology

constipation

increased mortality (consumption of oral morphine (>200mg) daily increases unexplained death risk by three times compared with those not taking the opioid)[1]

Considerations in Physiotherapy

References

  1. Prescription Opioid Policy. A publication by The Royal Australian College of Physicians, Faculty of Pain Medicine ANZCA, The Royal Australian College of General Practitioners and The Royal Australian and New Zealand College of Psychiatrists.