The lead article in this issue of Addiction Science & Clinical Practice focuses on the blessing and curse of opioids. Drs. Savage, Kirsh, and Passik offer invaluable practical advice, useful to both substance abuse clinicians and pain specialists, on negotiating the difficult clinical issues that arise as a result of opioids’ gift of powerful analgesia and their bane of addiction. While support...

A. The endogenous opioid system and natural reinforcement 1383 B. The endogenous opioid system and drugs of abuse 1387 C. Perspectives: extending studies to animal models of drug addiction 1393 IV. Genetic Manipulation of the Opioid System, Reinforcement, and Drug Dependence 1393 A. Opioid receptor knockout mice 1393 B. Opioid peptide knockout mice 1394 C. Conclusion 1395 D. Perspectives: towar...

Beginning in the late 1990s, a movement began within the pain management field focused upon the underutilization of opioids, thought to be a potentially safe and effective class of pain medication. Concern for addiction and misuse were present at the start of this shift within pain medicine, and an emphasis was placed on developing reliable and valid methods and measures of identifying those at...

BACKGROUND Addiction to opioids, or opioid dependence, encompasses the biopsychosocial dysfunction seen in illicit heroin injectors, as well as aberrant behaviours in patients prescribed opioids for chronic nonmalignant pain. OBJECTIVE To outline the management of opioid dependence using opioid pharmacotherapy as part of a comprehensive chronic illness management strategy. DISCUSSION The sa...

Opioid drugs like morphine and fentanyl are the gold standard for treating moderate to severe acute and chronic pain. However, opioid drug use can be limited by serious side effects, including constipation, tolerance, respiratory suppression, and addiction. For more than 100 years, we have tried to develop opioids that decrease or eliminate these liabilities, with little success. Recent advance...

BACKGROUND Bladder cancer is a major health problem, especially among men. Opium addiction can be an important risk factor. One important question is whether it can affect the age of onset of bladder cancer .We performed this study to evaluate this question. MATERIALS AND METHODS In a cross-section study, records of patients diagnosed with bladder carcinoma in Shahid Labbafinejad Medical Cent...

OBJECTIVE To evaluate the clinical observation that the number of individuals seeking opioid detoxification from oxycodone was increasing at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ont; and to identify the characteristics of individuals seeking opioid detoxification at CAMH. DESIGN Retrospective analysis of patient health records. SETTING Medical Withdrawal Management ...

The mu opioid receptor (MOR, OPRM)--the principal receptor involved in narcotic addiction--has been shown to display basal (spontaneous, constitutive) signaling activity. Interaction with other signaling proteins, such as calmodulin, regulates basal MOR activity. Providing a mechanism for long-lasting regulation, basal MOR activity potentially plays a key role in addiction, in combination with ...

The opioid system consists of three receptors, mu, delta, and kappa, which are activated by endogenous opioid peptides processed from three protein precursors, proopiomelanocortin, proenkephalin, and prodynorphin. Opioid receptors are recruited in response to natural rewarding stimuli and drugs of abuse, and both endogenous opioids and their receptors are modified as addiction develops. Mechani...