Opioids

Escaping the drug crisis.

The opioid crisis is now an epidemic that involves both prescribed and illicit drugs. Tackling it is more urgent than ever.

Fresh strategies and targets for chronic pain could deliver much needed replacements for opioid-based painkillers.

Pharmacologist Yasmin Hurd sees promise in the cannabis-derived chemical cannabidiol for mitigating opioid dependence.

The opioid crisis is driving a rethink of pain relief in surgery.

Understanding how the opioid epidemic arose in the United States could help to predict how it might spread to other countries.

US efforts to control opioid prescriptions are having unintended effects on people with chronic pain.

A harrowing medical experience gave Travis N. Rieder more insight than he would have wished for into how people end up hooked on opioids.

Ideally, opioid addiction could be prevented altogether. But failing that, strategies to make drug use safer can curb opioid-related death.

To help solve the opioid epidemic, researchers must understand what makes dependence on these drugs so deadly.

Highlights from laboratory studies and clinical trials on opioids.

μ opioid receptors (MORs) expressed on primary afferent nociceptor neurons are responsible for two maladaptive side-effects of chronic opioid use: opioid tolerance and opioid-induced hyperalgesia (pain). A combination therapy of opioid receptor agonism plus peripheral-restricted MOR antagonism abrogates these side-effects while preserving opioid analgesia in rodent models of peri-operative and chronic pain.

Two new studies show that mechanisms mediating the opioid side effects of tolerance, hyperalgesia and physical dependence are mediated spinally and can be dissociated from analgesia. These side effects can be selectively targeted by clinically available drugs without affecting their pain-relieving effects.

Neonatal abstinence syndrome refers to the signs and symptoms in a neonate that are caused by the cessation of prenatal exposure (via placental transfer) to various substances. In particular, opioid use or misuse during pregnancy can lead to neonatal opioid withdrawal syndrome.

Studies show that gut microbial dysbiosis induced by chronic opioid use is linked to central opioid tolerance. Here, we suggest that a persistent decrease in gastrointestinal motility by opioids is a primary cause of gut microbial dysbiosis and that improving gastrointestinal transit might be a strategy in preventing opioid analgesic tolerance.