Opioids, addiction, and overdose

OxyContin

Quick bibliography: 5 reviews/recent articles on opioids, addiction, and overdose.

Classic review:

Paulozzi, L.J. (2012). Prescription drug overdoses: A review. Journal of Safety Research, 43 (4), 283-289. [Cited by]

Overdoses involving prescription drugs in the United States have reached epidemic proportions over the past 20 years. Host factors include male sex, middle age, non-Hispanic white race, low income, and mental health problems. Agent risk factors include use of opioid analgesics and benzodiazepines, high prescribed dosage for opioid analgesics, multiple prescriptions, and multiple prescribers. Environmental factors include rural residence and high community prescribing rates.”

Recent reviews/articles:

Babu, K. M., Brent, J., & Juurlink, D. N. (2019).  Prevention of Opioid Overdose. The New England Journal of Medicine, 380 (23), 2246-2255. [Cited by]

“In the time it takes to read this article, at least one person in the United States will have died from an opioid overdose. From 1999 through 2017, more than 700,000 U.S. residents died from a drug overdose; the majority of these events involved an opioid. Among persons between the ages of 24 and 34 years, one in five deaths is now related to opioid use.”

Darcq, E., & Kieffer, B. L. (2018). Opioid receptors: drivers to addiction? Nature Reviews. Neuroscience, 19 (8), 499-514.  [Cited by]

“Drug addiction is a worldwide societal problem and public health burden, and results from recreational drug use that develops into a complex brain disorder. The opioid system, one of the first discovered neuropeptide systems in the history of neuroscience, is central to addiction. Recently, opioid receptors have been propelled back on stage by the rising opioid epidemics, revolutions in G protein-coupled receptor research and fascinating developments in basic neuroscience. This Review discusses rapidly advancing research into the role of opioid receptors in addiction, and addresses the key questions of whether we can kill pain without addiction using mu-opioid-receptor-targeting opiates, how mu- and kappa-opioid receptors operate within the neurocircuitry of addiction and whether we can bridge human and animal opioid research in the field of drug abuse.

Rajabi, A., Dehghani, M., Shojaei, A., Farjam, M., & Motevalian, S. A. (2019). Association between tobacco smoking and opioid use: A meta-analysis. Addictive Behaviors, 92, 225-235.  [Cited by]

“This meta-analysis quantified the association of tobacco use and opioid use and opioid use disorders. Our study indicated that age at onset of smoking (under 14 years old) is associated with opioid use. Almost a third of opioid use and opioid use disorders in the world is attributable to tobacco smoking. Smoking cessation interventions are potentially useful in the reduction of opioid use and opioid use disorders.”

Volkow, N., Benveniste, H., & McLellan, A. T. (2018). Use and Misuse of Opioids in Chronic Pain. Annual Review of Medicine, 69, 451-465. [Cited by]

The prescribing of opioid analgesics for pain management—particularly for management of chronic noncancer pain (CNCP)—has increased more than fourfold in the United States since the mid-1990s. Yet there is mounting evidence that opioids have only limited effectiveness in the management of CNCP, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths. These concerns have led to critical revisiting and modification of prior pain management practices (e.g., guidelines from the Centers for Disease Control and Prevention), but the much-needed changes in clinical practice will be facilitated by a better understanding of the pharmacology and behavioral effects of opioids that underlie both their therapeutic effects (analgesia) and their adverse effects (addiction and overdose). With these goals in mind, this review first presents an overview of the contemporary problems associated with opioid management of CNCP and the related public health issues of opioid diversion, overdose, and addiction. It then discusses the pharmacology underlying the therapeutic and main adverse effects of opioids and its implications for clinical management of CNCP within the framework of recent clinical guidelines for prescribing opioids in the management of CNCP.”

For additional research about opioids, addiction, and overdose, please see the Science Primary Literature Database.

Questions?  Please let me know (engelk@grinnell.edu).

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