Related Experiment Video
Updated: Aug 4, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Opioids in headache treatment. Is there a role?
1Department of Neurology, University of Kansas Medical Center, Kansas City, USA.
Neurologic Clinics
|February 1, 1997
Summary
Physicians must carefully screen headache patients requesting frequent opioid prescriptions due to risks of overuse and abuse. Psychological evaluation and multifaceted pain management are crucial for safe opioid prescribing in headache patients.
Area of Science:
- Neurology
- Pain Management
- Pharmacology
Background:
- Frequent opioid prescriptions for headache patients are common, driven by patient demand.
- Physicians must navigate complex federal and state legal guidelines for prescribing opioids.
- Assessing patient suitability for opioid therapy requires careful consideration of pain type, history, and psychological factors.
Purpose of the Study:
- To review the challenges and considerations for prescribing opioids to patients with frequent headaches.
- To highlight the importance of legal compliance and patient screening in opioid therapy for headaches.
- To discuss the role of psychological assessment and multifaceted pain management in mitigating risks associated with opioid use for headaches.
Main Methods:
- Review of existing literature and guidelines on opioid prescribing for non-malignant pain.
- Analysis of legal regulations pertaining to opioid prescription and addiction.
- Discussion of patient selection criteria, including substance abuse history and psychological evaluation.
- Examination of treatment strategies for different headache types (migraine vs. tension-type).
Main Results:
- Opioid prescribing for headaches is prevalent, necessitating physician awareness of legal frameworks.
- Patient history of substance abuse and psychological disturbances are significant risk factors for opioid overuse and treatment failure.
- Guidelines for non-malignant pain may not fully apply to headache patients due to the episodic nature of their pain.
- Formal psychological testing, such as the Minnesota Multiphasic Personality Inventory (MMPI), may aid in identifying at-risk patients.
- Multifaceted pain management, including patient education and close monitoring, is essential for safe opioid use.
Conclusions:
- Careful patient selection, legal adherence, and comprehensive pain management are vital for prescribing opioids to headache patients.
- Psychological assessment is crucial for identifying individuals at higher risk of opioid abuse or treatment failure.
- Tailoring treatment to specific headache types (migraine vs. tension-type) and monitoring usage patterns are critical for effective and safe pain management.
Related Concept Videos
01:22Opioid 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...
01:25Analgesia 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...
01:20Opioid 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...
01:15Opioid 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...
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
01:20Pain
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...