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DEFINITION
OPIOIDS
(Heroin,codeine,morphine,oxycodone,hydromorphone,
buprenorphine,pethidine,dextropropoxyphene,methadone,tramadol).
Opioid dependence is characterized by a cluster of cognitive, behavioural and
physiological features. The International Classification of Diseases, 10th
edition (ICD-10) identifies six such features:
a strong desire or sense of compulsion to take opioids
difficulties in controlling opioid use
a physiological withdrawal state
tolerance
progressive neglect of alternative pleasures or interests
because of opioid use
persisting with opioid use despite clear evidence of overtly
harmful consequences.
EPIDEMIOLOGY
NEUROBIOLOGICAL ASPECTS OF
OPIOID
DEPENDENCE
TREATMENTS
Three types of medications include:
1. Opioid agonist maintenance treatment,
which activate opioid receptors
2. Partial agonists which also activate opioid
receptors but produce a smaller response
3. Antagonists, which block the receptor and
interfere with the rewarding effects of opioids.
TREATMENTS
Oral methadone liquid and sublingual buprenorphine tablets are the medications
most widely used for opioid.
Psychosocial treatment
Psychosocial interventions including cognitive and
behavioural approaches and contingency management
techniques can add to the effectiveness of treatment, if
combined with agonist maintenance treatment and
medications for assisting opioid withdrawal. Psychosocial
services should be made available to all patients, although
those who do not take up the offer should not be denied
effective pharmacological treatment.
MANAGEMENT
MANAGEMENT
MANAGEMENT
MANAGEMENT
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