Update on Opioid Addiction for Perioperative and Critical Unit Care: Anaesthesiologists Perspective

Citation: Hariharan U, Garg R (2015) Update on Opioid Addiction for Perioperative and Critical Unit Care: Anaesthesiologists Perspective. J Addict Med Ther Sci 1(2): 027-030. DOI: 10.17352/2455-3484.000007 027 sugar, starch, acetaminophen, procaine, quinine, steroids, clenbuterol (a banned beta-2 agonist) and sometimes even synthetic opioids like fentanyl, leading to a multitude of unpredictable effects. Meperidine, dextropropoxyphene, fentanyl, alfentanil, sufentanil, carfentanil, pentazocine and butorphanol are synthetic opioids (prepared in laboratory). Meperidine has significant abuse liability [3]. Its neurotoxic byproduct (1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine) has the potential to produce irreversible Parkinsonian-like syndrome. Fentanyl abuse was first noted amongst the medical community. Due its very high potency, its abuse is less common in non-health care addicts, due to fear of fatal overdose. Fentanyl and its analogues (especially the transdermal or the transmucosal preparations) can be injected, snorted, swallowed or smoked. In order to decrease the abuse potential of pentazocine, it is mixed with naloxone (an opioid anatagonist) to counter the morphine-like effects if its tablets are dissolved and injected. Methadone was initially synthesized due to shortage of morphine and later utilized for narcotic de-addiction. Since in high doses it can block the effects of heroin, it is ideal for detoxification and maintenance programs. It is being increasingly used for chronic pain management and it can be abused with other prescription agents like benzodiazepines and alcohol.