Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Opioid Receptors: Overview01:22

Opioid Receptors: Overview

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...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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...
Drug Elimination: Overview01:18

Drug Elimination: Overview

Drug elimination involves many complex processes and does not necessarily differentiate between distribution and elimination. It is divided into two primary components: excretion and biotransformation.
Excretion refers to removing a drug from the body, either in its unchanged form or as its metabolites. Nonvolatile and polar drugs are primarily excreted through the kidneys, with other pathways including bile, sweat, saliva, and milk. Volatile drugs such as anesthetic gases are excreted via the...
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same journal

When Effect Estimates and Recommendations Diverge: A Methodological Perspective on Interventional Spine Pain Guidelines.

Pain medicine (Malden, Mass.)·2026
Same journal

Sociodemographic Factors, but Not Rurality, Explain Limited Variance in Fibromyalgia Severity: A Secondary Analysis of Two Randomized Clinical Trials.

Pain medicine (Malden, Mass.)·2026
Same journal

US and MRI Identification of Postoperative Ilioinguinal Neuropathy.

Pain medicine (Malden, Mass.)·2026
Same journal

Latent Classes of Pain Treatment Utilization at a Tertiary Pain Clinic: A Cross-Sectional Study.

Pain medicine (Malden, Mass.)·2026
Same journal

The Relationship between Multisensory Sensitivity and Pain Interference in Adolescents with Menstrual Pain: The Mediating Roles of Pain Catastrophizing and Fatigue.

Pain medicine (Malden, Mass.)·2026
Same journal

Genicular Nerve Radiofrequency Treatment for Chronic Knee Osteoarthritis Pain: A Systematic Review And Meta-Analysis of Randomized Controlled Trials Utilizing Image Guidance.

Pain medicine (Malden, Mass.)·2026

Related Experiment Video

Updated: Jul 23, 2026

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence
09:54

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence

Published on: March 8, 2020

5.4K

Opioid Tapering/Detoxification Protocols, A Compendium: Narrative Review.

David A Fishbain1,2,3

  • 1Departments of Psychiatry, Miller School of Medicine at the University of Miami, Miami, Florida, USA.

Pain Medicine (Malden, Mass.)
|April 16, 2021
PubMed
Summary

This review compiles and compares opioid tapering protocols to guide clinicians. The simplest method uses the current opioid, avoiding rotation errors and offering behavioral benefits.

More Related Videos

Demonstration of the Sequence Alignment to Predict Across Species Susceptibility Tool for Rapid Assessment of Protein Conservation
16:02

Demonstration of the Sequence Alignment to Predict Across Species Susceptibility Tool for Rapid Assessment of Protein Conservation

Published on: February 10, 2023

3.0K
Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
09:29

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods

Published on: August 4, 2022

2.4K

Related Experiment Videos

Last Updated: Jul 23, 2026

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence
09:54

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence

Published on: March 8, 2020

5.4K
Demonstration of the Sequence Alignment to Predict Across Species Susceptibility Tool for Rapid Assessment of Protein Conservation
16:02

Demonstration of the Sequence Alignment to Predict Across Species Susceptibility Tool for Rapid Assessment of Protein Conservation

Published on: February 10, 2023

3.0K
Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
09:29

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods

Published on: August 4, 2022

2.4K

Area of Science:

  • Pain Management
  • Addiction Medicine
  • Clinical Pharmacology

Background:

  • The opioid epidemic necessitates effective strategies for tapering chronic pain patients (CPPs) off opioids.
  • Lack of standardized tapering protocols contributes to rapid or forced opioid discontinuation.
  • Clinicians require clear guidance on managing opioid tapering in outpatient settings.

Purpose of the Study:

  • To compile and categorize published opioid tapering and detoxification protocols.
  • To compare the advantages and disadvantages of different protocols for outpatient use.
  • To address common clinical questions regarding opioid tapering.

Main Methods:

  • A narrative review of published literature was conducted using terms related to opioid tapering and detoxification.
  • Searches identified 1,922 abstracts, with 301 reviewed in detail.
  • 104 studies were included, and nine types of protocols were identified and compared.

Main Results:

  • Nine distinct opioid tapering protocols were identified and compared.
  • Protocols were organized into general types with their respective advantages and disadvantages.
  • Twenty-two common questions concerning opioid tapering were addressed.

Conclusions:

  • The simplest and most advantageous protocol involves tapering using the patient's current opioid.
  • This method avoids opioid rotation, thereby preventing potential errors.
  • Utilizing the current opioid offers additional behavioral advantages for patients undergoing tapering.