Morphine: Opioid Analysis

Pain is a common symptom that is associated with numerous medical issues, including musculoskeletal problems that physical therapist see on a day to day basis. There are several different ways to treat pain and one of them is to provide a means of releasing opioids in the body to alter the pain experience. In fact, there are three different types of opioids: naturally occurring (endogenous or exogenous substances such as natural endorphins or poppy), semisynthetic (exogenous substances that contain both natural and synthetic agents), and synthetic agents (man-made substances used to mimic the effect of natural substances) used to decrease the symptom of pain.1

Philippe Lucas’s article “Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain” recommends using cannabis instead of opiates to relieve chronic pain. He also proposes cannabis may be used to treat prescription opiate abuse by patients suffering from chronic pain and depicts cannabis as a medicine and not a gateway drug. Lucas suggests national governments abandon misinformation emphasizing drug prohibition and start supporting the claim that cannabis effectively treats a variety of illnesses including chronic pain, and is a possible “drug exit” for problematic substance abuse. Appeals to logos, ethos, and pathos are frequently present, creating the ideal balance of evidence and theory regarding medicinal cannabis and opiates.

At today's visit he is accompanied by his wife. He is awake, alert and oriented. He reports that his back pain has improved with the pain regimen he was started on last Friday. He complains of lower back pain that he describes as achy and constant; he rates his pain as a 7/10 in severity. He states that his pain doe not radiate, but it affects his mobility and impedes his ability to get out of bed by himself. His pain regimen is Morphine ER 15 mg p.o every 12 hours and oxycodone/apap 10/325 mg p.o every 4 hours as needed for breakthrough pain. He has taken 6 as needed breakthrough doses daily since Friday. He states that his pain has improved but his goal is to have his pain a little better than 7/10, then he will be able to perform his ADLS

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

Individuals who use Opioids are Addicts. The history of this very debatable topic is very educational and

This paper will examine the the nurses and pain assessment in the hospitalized patient. The paper will focus on pain and pain management and the need to assess pain. How much percentage of the population in the U.S. are experienced pain, and how much of the population abuse the pain medications. There are many barriers which hinder nurses from perform accurate pain assessment. These barriers are nurses experience, competence, perception and manipulation. Pain is subjective, but pain assessment tools and nurses’ perception may contraindicate with what the patients stated. Thus, the paper will try to find solution to accurate pain assessment during hospitalization, especially with abuse of opioid.

Rates of opioid-related overdose have been rapidly increasing in the United States. From 2010-2015, overdose deaths attributed to the use of illicit opioids has increased by over 200% (1). In 2016, the number of opioid-related deaths reached 64,070, the highest number ever recorded in the nation’s history and anticipated to increase (2). While opioid-related overdose had been largely caused by prescription opioid misuse, the problem is increasingly due to heroin and other illicit opioid use (3, 4). Increasingly, illicitly-manufactured fentanyl (IMF), an opioid much stronger than heroin, has become an increasingly common additive pervasive in the supply in the United States and has contributed to the steep rise in opioid-related overdose (5-8).

Opioid is the fastest addiction in Iowa. “These are not aspirin,” says Dale Woolery. You can’t mix these painkillers with any other pill or painkillers in fact. Opioid painkillers are 50 to 100 times stronger than any other painkiller, from prescription painkillers to illegal painkillers, which are a knockoff of Heroin. Opioid is in the class of most addicting and lethal pills.

Modern day America is plagued by a surplus of tragedy, most may have seen viral videos of these “zombies” slumped in cars or streets and yet it continues. In fact, this terrifying epidemic was created by drugs that were intended for pain relief, Opioids. This includes prescription pain relievers like oxycodone, morphine, methadone, and hydrocodone. Ironically, the well-known street drug, Heroin, is one of the most serious offenders of the Opioid crisis (Anderson). With each day, more mothers, fathers, sisters, and brothers are witnessing and losing loved ones from overdoses, which is why the focus of society absolutely needs to be on a path of action towards the rising deaths, excessive prescriptions and governmental influences in opioid addiction.

During the twentieth century, opioids were mainly used for the treatment of short-term pain or to comfort the suffering of terminally ill patients. Throughout the 2000s, Purdue actively marketed its controlled-release opioid Oxycontin as a safe and nonaddictive treatment for chronic pain. Other drug manufacturers soon followed suit, this move is what many public health experts believe is one of the root causes of the current opioid epidemic(McCoy,2014).

The misuse and abuse of prescription medications in the United States remains high, but few people are aware of just how big the problem really is. According to ASAM American Society of Addiction Medicine, "Drug overdose is the leading cause of accidental death in the US, with 55,403 lethal drug overdoses in 2015. Opioid addiction is causing this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and also overdose deaths relating to heroin". Opioids are drugs which are prescribed to relieve pain. With continued use, the pain-relieving effects lessen and pain can become worse, so the body can develop dependence on the use of opioid. Opioid dependence causes withdrawal symptoms, which makes it difficult to stop taking

Opioids are drugs taken for relieving pain. This drug has its effect on the human body through the reduction of the intensity of neuro-pain signals which are relayed to the brain (Opioids, 2009). Classic examples are the painkillers that include morphine, methadone, and hydrocodone among others. Pain is a physical suffering caused by illness or injury and may vary from steady to constant and throbbing to pulsating. It is not reasonable for anyone of us to except no pain except for those who suffer from anhydrases. This is an unusual genetic disorder that makes one unable to feel pain. Opioids play a significant role in the health system but they can be hazardous if used for pleasure or in a case of addiction. It is therefore important that

Opium always existed for centuries and it has been used in its raw form both medicinal and for pleasure. The origin of opium is in the Middle Eastern, when someone discovered its yearlong life, papaya somniferum produced a substance that, when eaten, eased pain and suffering (Hart, 297). The effects of opium has a huge reaction that its an epidemic, for causing many people to become addicted. Concerning that regulations on the production and administration of opium is necessary, in order to stop harmfully effecting people.

As mentioned briefly before, the placebo analgesia mechanism might work through the release of endogenous opioid analgesics, the body’s natural narcotics that are produced as a reaction to stress and pain. The reason for this belief is that studies have shown that naloxone, a narcotic antagonist, reduces the pain-killing effects of placebos. (2) (21) (22) Despite the fact that other studies have not found naloxone to have any effects on placebo responses, (23) (24) the opioid theory is the most widely accepted theory when it comes to the explanation of placebo pain-reduction. In opioid analgesia, the rostral anterior cingulate cortex (rACC) shows a high activity, as this brain region has many opioid receptors. If the placebo analgesia really

Diamorphine is used for pain control and known as an opioid Controlled Drug [CD], acting by blocking pain signals to the brain (BNF, 2015; NICE, 2016). Opioid medication is licenced for the management of moderate to severe pain however, long-term use can cause reliance of the drug yet when used to treat a terminal illness, there are no restrictions (Knott, 2013; Nice, 2016). Morphine’s most common side effects include nausea and vomiting, sedation, constipation, hypotension and sweating however, it can cause hallucinations which are important in the management of anxiety in palliative care (Everyday Health, 2016; Mann & Carr, 2009). Diamorphine causes less nausea and hypotension than morphine and the focus in palliative care is pain management which is more effective when avoiding pain, than in the relief of pain (Cancer Research UK, 2015).