Opioids are medications that relieve pain. Opioid medications bind to the areas of the brain that control pain and emotions. Using opioids drives up levels of the feeling good hormone dopamine in the brain’s reward areas and an intense feeling of euphoria is produced. Medications that fall within this class include hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs.
Physical dependence is a physiological state of adaptation to a substance, the absence of which produces symptoms and signs of withdrawal. This dependence is the result of physical changes in the brain. Repeated exposure to escalating dosages of opioids alters the brain so that it functions more or less normally when the drugs are present and abnormally when they are not.
Two clinically important results of this alteration are opioid tolerance (the need to take higher and higher dosages of drugs to achieve the same opioid effect) and drug dependence (susceptibility to withdrawal symptoms). Withdrawal symptoms occur only in patients who have developed tolerance.
Normally, the body is able to produce enough endogenous opioids (for example, endorphins) to prevent withdrawal. But as tolerance increases, eventually the body’s ability to maintain this equilibrium is exceeded and the body becomes dependent on that external source.
Clinical Information Related to Opiate Dependence and Medical Marijuana
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