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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...
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Related Experiment Video

Updated: Nov 6, 2025

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
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General practice responses to opioid prescribing feedback: a qualitative process evaluation.

Su Wood1, Robbie Foy1, Thomas A Willis1

  • 1Leeds Institute of Health Sciences, University of Leeds, Leeds.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|May 12, 2021
PubMed
Summary

A feedback intervention successfully reduced opioid prescribing in primary care by engaging staff and adapting to practice needs. This approach reinforced efforts through credible data and patient benefits, addressing a key public health challenge.

Keywords:
Normalisation Process Theoryanalgesics, opioidfeedbackgeneral practiceprescribingprocess evaluationqualitative researchquality and safety

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Area of Science:

  • Public Health
  • Healthcare Quality Improvement
  • General Practice

Background:

  • Rising opioid prescribing in primary care poses significant public health risks, including increased psychosocial problems, hospitalizations, and mortality.
  • An evidence-based, bimonthly feedback intervention was implemented across 316 general practices in West Yorkshire to address this challenge.

Purpose of the Study:

  • To evaluate how general practice staff perceived and reacted to a feedback intervention aimed at reducing opioid prescribing.
  • To understand the process of implementing and embedding changes in opioid prescribing practices.

Main Methods:

  • A qualitative process evaluation using semi-structured interviews with primary care professionals.
  • Interviews were guided by Normalisation Process Theory (NPT) and data were coded to NPT constructs and thematically analyzed.
  • Participants were purposively recruited based on baseline prescribing and response to feedback.

Main Results:

  • Reducing opioid prescribing was a recognized priority among interviewed staff.
  • Feedback encouraged less structured practices to implement changes, while high achievers utilized existing quality improvement structures.
  • The non-prescriptive, credible feedback reports, coupled with positive experiences and observed patient benefits, facilitated practice engagement and adaptation.

Conclusions:

  • The feedback intervention effectively engaged general practice staff by addressing a critical issue and allowing flexible adaptation to diverse working methods.
  • Sustained practice efforts were reinforced by regular, credible comparative data and shared positive patient outcomes.
  • The intervention's scale, frequency, and duration likely contributed to widespread practice reach and impact.