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Analgesia and Pain Management01:25

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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...
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Substance Use Disorders Affecting Sleep01:24

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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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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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Drug Dependence01:17

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Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
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Drug Abuse and Addiction: Pharmacological Phenomena01:15

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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

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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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Intracranial Pharmacotherapy and Pain Assays in Rodents
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Pain Management and Substance Use Disorders.

Timothy Joseph Sowicz1, Peggy Compton2, Deborah Matteliano3

  • 1University of Arizona College of Nursing, Assistant Professor, Tucson, Arizona.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses
|October 6, 2022
PubMed
Summary
This summary is machine-generated.

Individuals with co-occurring pain and substance use disorder deserve dignified, evidence-based care. An integrated approach is recommended, prioritizing non-opioid and non-pharmacological pain management strategies.

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Area of Science:

  • Pain Management Nursing
  • Addiction Nursing
  • Integrated Care

Background:

  • Co-occurring pain and substance use disorder present complex challenges in patient care.
  • Existing approaches may not adequately address the integrated needs of these patients.
  • Professional nursing organizations advocate for a unified approach to management.

Purpose of the Study:

  • To outline a position statement for the integrated management of co-occurring pain and substance use disorder.
  • To advocate for dignified, evidence-based, and holistic care for affected individuals.
  • To provide recommendations for healthcare institutions and professionals.

Main Methods:

  • Development of a position statement by professional nursing societies.
  • Emphasis on evidence-based assessment and management strategies.
  • Integration of pain and addiction expertise in a multidisciplinary team approach.

Main Results:

  • Patients have a right to dignified and respectful treatment.
  • An integrated, holistic, and multidimensional approach is recommended for both conditions.
  • Prioritization of non-opioid and non-pharmacological pain management is advised.
  • Opioids should not be withheld when necessary for pain relief.
  • Minimizing relapse risk and involving patients and support persons in care planning are crucial.

Conclusions:

  • Healthcare institutions must establish supportive policies and procedures.
  • A team-based approach involving pain and addiction specialists is essential.
  • Comprehensive pain management must address substance use disorder concerns and relapse prevention.