Talk:Opioid analgesic: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Sandy Harris
m (questions)
imported>Howard C. Berkowitz
No edit summary
Line 7: Line 7:


What about apomorphine? My understanding is it is neither analgesic nor addictive, but it does have some therapeutic uses. William Burroughs claimed it was the only treatment for morphine/heroin addiction that actually worked. He claimed to have tried all the others except electro-shock. That article was originally in Lancet, was included as an appendix in the edition of "Naked Lunch" I had. [[User:Sandy Harris|Sandy Harris]] 12:46, 1 June 2010 (UTC)
What about apomorphine? My understanding is it is neither analgesic nor addictive, but it does have some therapeutic uses. William Burroughs claimed it was the only treatment for morphine/heroin addiction that actually worked. He claimed to have tried all the others except electro-shock. That article was originally in Lancet, was included as an appendix in the edition of "Naked Lunch" I had. [[User:Sandy Harris|Sandy Harris]] 12:46, 1 June 2010 (UTC)
:Let me answer generally, and we can work some of this into the article.
:There is a specific class of cellular opioid receptors, on which opioid drugs have effects: agonist (stimulate or up-regulate), antagonist (depress or down-regulate), and, at the subclass (or perhaps particular site) level, agonist-antagonists or partial agonists. Some opioids have multiple effects on multiple receptors and sub-receptors
:*Mu-receptors are generally analgesic, euphoriant, respiratory depressant
:*Kappa-receptors tend to be dysphoric, act more in the spinal cord than brain, but are analgesic
:*Delta-receptors have less clear effects.
:Naloxone is a pure antagonist used as an antidote. Buprenorphine is a mixed agonist-antagonist, which, as opposed to morphine, is an analgesic in cats -- morphine is not an effective analgesic but instead makes them wildly excited. Buprenorphine, however, will induce withdrawal in a human opioid addict.
:Burroughs is out of date. Addiction treatment is complex, but tends to use long-acting mu agonists that produce minimal sedation and euphoria, such as methadone and l-alpha-acetylmethadone. Other, non-opioid drugs, such as alpha-adrenergic antagonists such as clonidine, help with withdrawal for both opioids and nicotine.  Apomorphine is now rarely used to produce vomiting.
:So, yes, "narcotic" is essentially legal. Opioid analgesic is a subset of opioids that has agonist effects on analgesic receptors. Not all opioids are analgesic. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:24, 1 June 2010 (UTC)

Revision as of 07:24, 1 June 2010

This article is developing and not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
To learn how to update the categories for this article, see here. To update categories, edit the metadata template.
 Definition Synthetic narcotic that has opiate-like activities, which induces analgesia by mimicking endogenous opioids, at opioid receptors in the brain. [d] [e]
Checklist and Archives
 Workgroup category Health Sciences [Please add or review categories]
 Subgroup category:  Pain management
 Talk Archive none  English language variant American English

Questions

I'd call this family of drugs "opiates". I understand "analgesic" but have never seen "opioid" before. Am I just hopelessly out of touch?

"narcotic" has one meaning in medicine & pharmacology, sometimes another in law. Cannabis may be legally a "narcotic" in some jurisdictions. Since narcotic redirects here, shouldn't we say something about that?

What about apomorphine? My understanding is it is neither analgesic nor addictive, but it does have some therapeutic uses. William Burroughs claimed it was the only treatment for morphine/heroin addiction that actually worked. He claimed to have tried all the others except electro-shock. That article was originally in Lancet, was included as an appendix in the edition of "Naked Lunch" I had. Sandy Harris 12:46, 1 June 2010 (UTC)

Let me answer generally, and we can work some of this into the article.
There is a specific class of cellular opioid receptors, on which opioid drugs have effects: agonist (stimulate or up-regulate), antagonist (depress or down-regulate), and, at the subclass (or perhaps particular site) level, agonist-antagonists or partial agonists. Some opioids have multiple effects on multiple receptors and sub-receptors
  • Mu-receptors are generally analgesic, euphoriant, respiratory depressant
  • Kappa-receptors tend to be dysphoric, act more in the spinal cord than brain, but are analgesic
  • Delta-receptors have less clear effects.
Naloxone is a pure antagonist used as an antidote. Buprenorphine is a mixed agonist-antagonist, which, as opposed to morphine, is an analgesic in cats -- morphine is not an effective analgesic but instead makes them wildly excited. Buprenorphine, however, will induce withdrawal in a human opioid addict.
Burroughs is out of date. Addiction treatment is complex, but tends to use long-acting mu agonists that produce minimal sedation and euphoria, such as methadone and l-alpha-acetylmethadone. Other, non-opioid drugs, such as alpha-adrenergic antagonists such as clonidine, help with withdrawal for both opioids and nicotine. Apomorphine is now rarely used to produce vomiting.
So, yes, "narcotic" is essentially legal. Opioid analgesic is a subset of opioids that has agonist effects on analgesic receptors. Not all opioids are analgesic. Howard C. Berkowitz 13:24, 1 June 2010 (UTC)