Opioids and opioid receptors; understanding pharmacological mechanisms as a key to therapeutic advances and mitigation of the misuse crisis

Opioids are a mainstay in acute pain management and produce their effects side (e.g., tolerance, opioid-use disorder immune suppression) by interaction with opioid receptors. I will discuss pharmacology some controversial areas of enquiry anaesthetic relevance. The main target is the µ (mu,MOP) receptor but other members family, δ (delta; DOP) κ (kappa; KOP) receptors also analgesic actions. These naloxone-sensitive. There important clinical development relating to Nociceptin/Orphanin FQ (NOP) receptor, an that not Better understanding drivers for may facilitate separation production safer drugs. bind orthosteric site can engage monomer or homo-, heterodimer Some ligands drive one intracellular pathway over another. This basis biased agonism (or functional selectivity). Opioid actions at be modulated allosterically positive allosteric modulators enhance action development. As well as targeting ligand-receptor transduction, modulating expression hence function tractable. evidence epigenetic associations different types substance misuse. long narrative defined ‘opioid crisis’ remove them could gather pace. deny use where they effective, access morphine relief low income countries.