W-18 (4-chloro-N-[1-[2-(4-nitrophenyl)ethyl]-2-piperidinylidene]-benzenesulfonamide) and W-15 (4-chloro-N-[1-(2-phenylethyl)-2-piperidinylidene]-benzenesulfonamide) represent two emerging drugs of abuse chemically related to the potent opioid agonist fentanyl (N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide). Here, we describe the comprehensive pharmacological profiles of W-18 and W-15,...

Instituting drug holidays for chronic opioid using patients is becoming commonplace for pain practitioners initiating procedures such as intrathecal pump or spinal cord stimulator trials. As such, pain practitioners need to be adept in their management of acute opioid withdrawal. Successfully weaning an opioid dependent patient off of chronic opioids requires a thorough knowledge of the availab...

OBJECTIVE Intrathecal (IT) morphine improves pain control and decreases opioid requirements in children following thoracic and abdominal surgery. However, studies in children report variable durations of analgesia following IT morphine. The purpose of this study is to describe the duration of analgesia in children undergoing surgical correction of idiopathic scoliosis. DESIGN Retrospective ch...

Background: Methadone maintenance therapy (MMT) is considered as an efficient and effective treatment in management of high risk opioids addiction; although, concomitant use of other drugs may interfere with treatment course and outcome in MMT cases. This study aimed at evaluating patterns of drug use along with methadone based on self reported and urine analysis data in two MMT clinics. Method...

BACKGROUND Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs). Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI) hosp...

The endogenous opioid system, comprised of multiple opioid neuropeptide and receptor gene families, is highly expressed by developing neural cells and can significantly influence neuronal and glial maturation. In many central nervous system (CNS) regions, the expression of opioid peptides and receptors occurs only transiently during development, effectively disappearing with subsequent maturati...

OBJECTIVE There has been a sharp increase in the abuse of prescription opioid analgesics in the United States in the past decade. It has been asserted, particularly by several governmental and regulatory agencies, that the Internet has become a significant source of these drugs which may account to a great extent for the surge in abuse. We have studied whether this is correct. DESIGN We asked...

The primary goal of postmarketing surveillance is to provide information for risk assessment of a drug. Drugs affecting the central nervous system form a unique group of products for surveillance because they are often misused, abused, and diverted. These medications include opioid analgesics, stimulants, sedative-hypnotics, muscle relaxants, anticonvulsants and other drug classes. Their advers...

Perioperative use of opioids has many detrimental effects on health care outcomes and is currently accelerating the worldwide epidemic opioid addiction prescription overdose death. Due to excessive their side effects, a new strategy was developed in order achieve balanced general anesthesia, namely opioid-free anesthesia (OFA). This technic can be used most surgeries using alternative analgesic...

The most recent National Survey on Drug Use and Health showed a continuing trend in the nonmedical use of prescription medications, notably opioid analgesics, which accounted for 75% of prescription drug non-medical use in 2006. In 2006, in response to this growing “pharmacoepidemic,” the Office of National Drug Control Policy set a goal of reducing past month prescription drug abuse by 15% ove...