Some opioids, like morphine and codeine, are derived from opium poppies while other opioids, like oxycodone (OxyContin), are semisynthetic chemicals isolated directly from opium poppies that have many of the same properties as morphine. Some other opioids with morphine-like properties such as fentanyl are purely synthetic chemicals that are made in laboratories. The opioids have important medical benefits in the treatment of pain; however, their beneficial analgesic effects also come with potentially dangerous effects. Opioids engender pain relief, addiction and overdose crises by acting at a common target, the mu opioid receptor in the brain.
H
eroin is the best known semisynthetic opioid. It was introduced in 1898 by the Bayer
pharmaceutical company for the over-the- counter treatment of cough. Heroin quickly became the iconic drug of abuse spurring three opioid epidemics in the United States: at the start of the 20th
century, in the 1970s
and again today. Heroin, illegal in the United States, remains a major part of global illegal drug trafficking, with most of the heroin in
www.datia.org
the US now coming from Mexico.1
Unlike
the second American opioid epidemic which was strictly heroin-based, today’s opioid epidemic was initially driven by a rapid rise in prescription opioids, but has become more expansive and includes heroin, new synthetic opioids like fentanyl, and prescription opioids that are used nonmedically (i.e., used without a valid prescription or in ways not prescribed). Individuals suffering from opioid addiction
oſten switch from one opioid to another based on availability and price since they all have similar effects, including euphoria and the risk of overdose. Although opioids long have been used
in medicine for the treatment of acute or end-of life pain, it was only in the past two decades and only in the US that opioids were widely prescribed for the treatment of chronic pain for outpatients of all ages for long periods of time and at high doses.
datia focus 7
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