Opioids are widely and successfully used for control of pain, including pain arising from the viscera. Constipating, sedating, respiratory depressant and other effects of opioids, however, often limit their long-term use in the treatment of a variety of visceral pain states.

The 2022 Clinical Practice Guideline for Prescribing Opioids for Pain (2022 Clinical Practice Guideline) is based on systematic reviews of the scientific evidence, considering benefits and harms, values and preferences, and resource allocation.

The FDA defines an opioid-tolerant patient as receiving for 1 week or longer at least 60 mg oral morphine/day or an equianalgesic dose of another opioid. OME calculations facilitate monitoring changes in opioid utilization over time.

Jul 11, 2024 · Opioid use disorder (OUD) is defined as a pattern of compulsive use of opioids despite negative consequences, causing clinically significant impairment. OUD has reached epidemic proportions in the United States; opioid-related overdoses, driven predominantly by illicitly manufactured fentanyl, resulted in more than 80,000 deaths in 2021 [ 1 ].

Apr 29, 2023 · Opioids act both presynaptically and postsynaptically to produce an analgesic effect. Presynaptically, opioids block calcium channels on nociceptive afferent nerves to inhibit the release of neurotransmitters such as substance P and glutamate, which contribute to nociception.

These compounds have proven opioid effects and could mask the deleterious effects of gluten protein on gastrointestinal lining and function. Here we describe a putative mechanism, explaining how gluten could “mask” its own toxicity by exorphins that are …

May 11, 2021 · Three major opioid receptor families have been identified: mu-opioid receptor (MOR), delta-opioid receptor (DOR), and kappa-opioid receptor (KOR) . A nonclassical opioid receptor family, nociceptin receptor, was later added as the fourth member of …

This paper reviews and integrates evidence relating to food-derived opioid peptides in public health, focusing on casomorphins from dairy and gliadorphin peptides from cereals. The systemic nature of the evidence, which spans the gut, brain, and many internal organs, arises as a direct consequence of the widespread presence of opioid receptors ...

This article provides an overview of the basic physiology of opioids, reviews opioid pharmacology, and attempts to address several issues of current importance in the management of patients with established long-term opioid therapy.

Feb 1, 2025 · Medications for opioid use disorder (MOUD), such as methadone, buprenorphine, and naltrexone, have been shown to reduce opioid-related mortality and improve outcomes for those in carceral...