Opiates have been commonly used for the management of pain for many years. Despite this, there is a surprising lack of research into the effects of opiates on cognition, with far more research having been carried out on other classes of psychotropic drugs. This paper will outline why it is important to understand the cognitive effects of opiates, in particular the short acting opiates morphine ...

The popular view of the major function of the opiates is that they produce analgesia. Much evidence has been accumulated that the endogenous opiates play an integral role in the central regulation of appetite. We postulate that the major effect of the endogenous opiates is to induce the feeding drive with their analgesic properties representing an epiphenomenon. Am J Cli,, Nuir 1982;35:757-76l.

Opiates and cocaine both have effects on adrenal and gonadal function. Opiates suppress the hypothalamic-pituitary adrenal (HPA) axis, whereas cocaine leads to HPA activation. Opiates also cause gonadal dysfunction in both men and women. During withdrawal from opiates and cocaine, the HPA axis is activated which may reinforce relapse behavior. This review describes these hormonal effects and ex...

The authors discuss the effect of occupational exposure to opiates. A depressive influence of opiates on the respiratory system is well known. This effect results from stimulation of opioid kappa and delta receptors in the central nervous system leading to a decrease in spirometric parameters and degranulation of mast cells. The studies carried out in the USA indicated that 26% of the pharmaceu...

Opiates are among the most powerful analgesics and pain-relieving agents. However, they are potentially extremely addictive thereby limiting their medical use, making them exceedingly susceptible to abuse and adding to the global drug problem. It is believed that positive memories associated with the pleasurable effects of opiates and negative memories associated with dysphoria during opiate wi...

Exogenous cholecystokinin selectively antagonizes opiate analgesia, which suggests that endogenous cholecystokinin may act physiologically as an opiate antagonist and may play a role in opiate tolerance. The use of the selective cholecystokinin antagonist proglumide provided a test of these hypotheses in rats that were either inexperienced with or tolerant to opiates. Proglumide potentiated ana...

The rewarding effects of drugs of abuse are thought to be dependent on the mesocorticolimbic dopamine system, which originates in the ventral tegmental area (VTA) and projects into the nucleus accumbens (NAC) and other forebrain regions. Heroin, by inhibiting GABAergic interneurons in the VTA, induces local dopaminergic activation and release in the NAC terminals. The role of other basic neurot...

There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabino...