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Substance Use Disorder, Intentional Self-Harm, Gun Violence, and HIV/AIDS
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Derived from the opium poppy, opiates are natural chemical compounds with psychoactive properties best known for their pain-relieving effects. Opioid drugs are synthetic chemical compounds that produce opiate-type effects, which are physiologically highly addictive. Semi-synthetic opioids include oxycodone, hydrocodone, and oxymorphone, while synthetic opioids include methadone, tramadol, and fentanyl. The illegally produced street drug heroin is a synthesized version of the natural opioid morphine.
Alcohol, drugs, toxins and post-mortem toxicology
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Colin Smith, Christopher Milroy
Opioids consist of naturally occurring opiates and synthetic opioids, which are commonly abused recreational drugs that can lead to death from drug toxicity. While opiates such as opium, morphine and heroin (diamorphine – a semisynthetic opiate) were traditionally the most widely misused, now synthetic opioids are widely available and powerful opioids like fentanyl are now responsible for a significant proportion of drug-related deaths. Opioid abuse can result in a wide range of lesions within the nervous system. Some of these lesions may be directly caused by opioids, whereas many others are the result of the impurities mixed with the drug. Drugs may be taken orally, insufflated, injected or smoked. Many impurities can be introduced into the bloodstream and can travel to the brain or spinal cord. Non-sterile injection techniques can introduce infection that, via haematogenous spread, can lead to cerebral abscesses or meningitis. HIV infection may result in central nervous system pathology (see Chapter 18). Cerebral infarcts may be seen as a consequence of emboli of injected materials (Karch and Drummer 2016).
The Opioid Epidemic
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Opioids are natural or synthetic substances that bind to opiate receptors. An opiate is a drug derived from opium—from the poppy plant Papaver somniferum. Morphine, codeine, thebaine, and papaverine are examples of opiates. Semi-synthetic opioids include drugs such as hydrocodone, oxycodone, oxymorphone, hydromorphone, and heroin. Synthetic opioids include methadone, fentanyl, and tramadol.
Perceptions of Community Health Workers during Two Concurrent National Health Crises: Opioid Use Disorder and COVID-19
Published in Issues in Mental Health Nursing, 2022
Jose Zapata, Janna Lesser, Pamela Recto, Andrea Moreno-Vasquez, Annette Z. Idar
The onset of the COVID-19 pandemic in the midst of the American opioid epidemic was a recipe for a cataclysmic public health crisis. The pandemic has worsened the opioid epidemic, and other chronic health issues, by widening the separation between providers and services to those who are suffering from opioid use disorder (Haley & Saitz, 2020). The CDC reports that synthetic opioids appear to be the driving force causing the increase in overdose deaths (Centers for Disease Control & Prevention, 2020b). Recent data from the CDC shows that drug overdose deaths reached a record high in 2020 with more than 90,000 (Centers for Disease Control & Prevention, 2021b). Multiple factors have been identified as attributes to the increasing overdose death rate. Many individuals have become additionally vulnerable during the pandemic and may have been impacted by prodigious amounts of stress, unstable housing, and insecure drug supplies which worsened mental health (Khatri & Perrone, 2020).
Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users
Published in Journal of Psychoactive Drugs, 2020
Barak Shapira, Ronny Berkovitz, Paola Rosca, Yehuda Neumark
Incidentally, opioid-related deaths have been on the rise worldwide, and the UNODC estimated that more than three-quarters of deaths associated with drug use disorders in 2015 were due to opioid use (UNODC 2018). In the United States, opioid use, particularly of potent synthetic derivatives of the opioid fentanyl, has been labeled an “epidemic” by the Centers for Disease Control and Prevention (CDC 2018), 1.5% of all deaths between 2001–2016 were attributable to opioid use (Gomes et al. 2018). The rate of drug overdose deaths involving synthetic opioids, such as fentanyl and its analogs, doubled from 3.1/100,000 to 6.2/100,000 between 2015 and 2016 alone (CDC 2017). An increase in mortality due to opioid use has also been observed in Canada (Lucyk and Nelson 2017; Rudd et al. 2016). In Europe, the use of prescription opioids has also increased markedly, although not to the epidemic proportions of North America (van Amsterdam and van den Brink 2015). Synthetic opioids like oxycodone and fentanyl have also been described as both substitutes for, and precursors of intravenous heroin use (Compton, Jones, and Baldwin 2016; Mars et al. 2014). The epidemic has prompted various public and private jurisdictions to pursue lawsuits against opioid manufacturers, alleging deliberate misinformation of patients and clinicians about the real risks and harms of opioid use (Hodge and Gostin 2019).
Pharmacotherapeutic management of co-morbid alcohol and opioid use
Published in Expert Opinion on Pharmacotherapy, 2020
Lauren E. Hood, Jonna M. Leyrer-Jackson, M. Foster Olive
Misuse of opioids, a class of drugs including prescription pain relievers, heroin and related synthetic compounds (i.e. fentanyl), has risen at an alarming rate over the past few decades. Currently 1.7 million people within the United States currently suffer from opioid-related substance use disorders [5]. Nearly 8–12 percent of patients prescribed opioids develop an opioid use disorder [6], which contributes to the nearly 47,000 opioid overdose caused deaths annually [7]. While opioid use disorder encompasses many opioid drugs, the most commonly used are prescription opioids (i.e. analgesics such as oxycodone, hydrocodone, etc.), heroin, and synthetic opioids such as fentanyl. Opioid addiction is characterized by compulsive drug seeking and taking, an inability to limit intake despite negative consequences and intense drug craving [8], which is in most cases initiated during consumption of opioids prescribed to treat disorders such as chronic pain. Since opioid use within the United States and elsewhere remains an unprecedented crisis, development of effective treatments using pharmacotherapies remains a critical component for combating the opioid epidemic.