Opioids

Suzanne Doyon

Pharmacology

Pharmacokinetics

C|inical...Eeatures

Diagnosis

Differential. . .Diagnosis Treatment speciai.considerations

Hospitalized. .Patients Withdrawal.. .States

Contaminants Medicaicompiications

Chapter References

The term opioids is an all-inclusive term for antagonists, endogenous and exogenous substances that possess morphine-like activity. Opioids are classified as natural, semisynthetic or synthetic (Table 1.6.1-1). The most commonly abused opioids are heroin and methadone. The National Institute of Drug Abuse estimates that approximately 2.5 million people have a history of heroin abuse in the United States. Heroin abuse has significantly increased over the last decade because of lower street costs and easy availability. Also, street purity has increased from about 10 percent in the past to 70 percent or greater today, making nasal insufflation rather than injection a viable method. Thus, heroin has seen increased popularity on college campuses and among the afluent, rising to the status of a glamour drug. The public perception of addiction is that heroin use occurs predominantly among impoverished minorities. Heroin addiction does affects minorities disproportionately; however, its use among Caucasians is widespread. From 1990 through 1995, heroin-related emergency department (ED) visits more than doubled to 76,000, as did the rate per 100,000 population (from 15 to 33), according to data from the Drug Abuse Warning Network (DAWN).

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