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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Prescription, Nonprescription and Orphan Drugs01:02

Prescription, Nonprescription and Orphan Drugs

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Opioid Receptors: Overview01:22

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Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2, D-Pen5]-enkephalin or DPDPE for...
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Opioid use in young veterans.

Phipson C Wu1, Courtney Lang, Noelle K Hasson

  • 1VA Palo Alto Health Care System, Palo Alto, California, USA.

Journal of Opioid Management
|May 21, 2010
PubMed
Summary

Chronic opioid use is rising in young veterans, with many patients seeing multiple prescribers and receiving inadequate monitoring. Improvements in opioid management and specialist utilization are needed for this vulnerable population.

Area of Science:

  • Medical Research
  • Public Health
  • Veterans Affairs Healthcare

Background:

  • Prescription opioid abuse is a growing concern.
  • Young veterans are at high risk for opioid abuse due to various factors.
  • Understanding chronic opioid use patterns in this demographic is crucial.

Purpose of the Study:

  • To determine the prevalence of chronic opioid use in young veterans over time.
  • To describe prescribing patterns and monitoring of chronic opioid therapy.
  • To assess the effectiveness and safety of opioid management within the Veterans Affairs Palo Alto Health Care System (VAPAHCS).

Main Methods:

  • Retrospective, single-center study of young veterans (18-30 years) on chronic opioid therapy (2003-2008).
  • Data sourced from VISN 21 data warehouse, outpatient prescriptions, and electronic chart review.

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  • Effectiveness and safety analyses included patients on long-acting opioids for ≥6 months.

    • Main Results:

    • Chronic opioid use increased from 3% (2003) to 4.5% (2007) in young veterans.
    • Patients averaged two opioids and three prescribers; 80% of prescriptions were from primary care.
    • Inadequate monitoring noted: 31% urine drug testing, 5% opioid treatment agreements; limited effectiveness and adverse events observed.

    Conclusions:

    • Chronic opioid use is increasing among young veterans.
    • Young veterans often experience fragmented care with multiple prescribers and analgesics.
    • Enhanced staff training, dedicated clinics, and increased pain specialist involvement are recommended for improved opioid management.