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The Right Opioid Dosing And Avoiding The Addiction Trap

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By Kevin Graham

The miracle of opioid pain relief is fatally limited by tolerance, addiction, and respiratory depression. Buprenorphine, when combined with a mu agonist, results in game-changing effects. Patients experience potent, dose-related analgesia from the agonist, but have NO euphoria. The therapeutic window is widened. Patients unable to control their use of a mu agonist alone gain that control when on buprenorphine. And most exciting, buprenorphine indefinitely anchors tolerance, maintaining analgesia WITHOUT DOSE ESCALATION. This finding offers huge implications for pain management and opioid dosing.

Opioids are compounds like morphine, opium, and heroin which cause alteration in the way the human mind perceives the world as well as altered sensations like the well-known feeling of being on top of the world. Among the most sought after effects of opioids (a misuse) are the hallucinogenic effects.

Because of methadone's slow release, individuals who seek a fast high might take a dose, not get a high then consume more. By the time they get high, in a few instances, they've already consumed too much. Odds of revival are a lot lower for overdose of methadone than for additional opiates because of the long lasting nature of the drug. If you believe somebody has overdosed on this drug, contact 911 and immediately get them emergency assistance.

Research shows narcotic use is higher among the less educated and unemployed. A recent report in the American Journal of Medicine specifically looked at fibromyalgia patients receiving opioids for their pain. There was an increased incidence of unemployment, disability payments, and history of substance abuse. Also, the statistics showed overall lower education and an increased incidence of unstable psychiatric disorders. The study was not small and contained over 450 patients, so the results were most likely valid despite potential statistical variances.

Methadone is a synthetic opioid mainly prescribed as a long range replacement therapy for dependence to opioids. While methadone was once administered strictly at licensed methadone rehabilitation detox hospitals and drug clinics, within the past several years the drug is being prescribed in a pill form for severe pain. As such, the drug now can be discovered on the street, and quickly has become a top cause of accidental overdose within recreational drug users.

Opioid-induced hyperalgesia is a condition that can result from long-term opioid use. It represents a heightened perception of pain and can make one feel worse with more pain sensation. The solution to this problem is a decrease or discontinuation of the medication which should be accomplished under medical supervision. The discontinuation can result in less pain than while on the medications.

Sleep is affected significantly by opioids. A large review of studies was published in Postgraduate Medicine looking at the effect of narcotics on sleeping patterns. What popped out? Well, opiate users displayed significant incidence of insomnia, arousals, and wakefulness.

A tolerance will develop as the body gets used to methadone treatment that will require methadone users to consume higher doses to experience their high. As very high doses don't offer the same effects, users are going to move forward with harder drugs.

Treatment of OIH can be time-consuming, perplexing, and stressful for both the physician and patient. Rotating to a different opiate class may help. Trying non-opioid medications and decreasing opiate dosing is often helpful, along with administering interventional pain treatments to reduce the need for medications or eliminate the need altogether.

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