Talk:Opioid

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Unsourced[edit]

No source is actually provided and some of this is dubious. Is opium actually used clinically?? This subsection was in the "Society and culture' section but includes content that should be in the "Medical use" section, if it were sourced.

United States approval

The sole clinical indications for opioids in the United States, according to Drug Facts and Comparisons, 2005, are:

Evidence supports the use of low dose, regular oral opioids for the safe relief of breathlessness that is not responsive to disease-modifying treatments. This action appears to be a result of the effect on opioid receptors in the limbic system.

Opioids are not used for psychological relief.

Opioids are often used in combination with adjuvant analgesics (drugs which have an indirect effect on the pain). In palliative care, opioids are not recommended for sedation or anxiety because experience has found them to be ineffective agents in these roles. Some opioids are relatively contraindicated in renal failure because of the accumulation of the parent drug or their active metabolites (e.g. codeine and oxycodone). Age (young or old) is not a contraindication to strong opioids. Some synthetic opioids such as pethidine have metabolites which are actually neurotoxic and should therefore be used only in acute situations.

-- Jytdog (talk) 21:00, 31 May 2016 (UTC)

Vardanyan, R.S.; Cain, J.P.; Mowlazadeh Haghighi, S.; Kumirov, V.K.; McIntosh, M.I.; Sandweiss, A.J.; Porreca, F.; Hruby, V.J. (2017). “Synthesis and Investigation of Mixed μ-Opioid and δ-Opioid Agonists as Possible Bivalent Ligands for Treatment of Pain” J. Heterocyclic Chem., 54: 1228-1235. doi: 10.1002/jhet.2696. — Preceding unsigned comment added by Sagharmolazade (talkcontribs) 00:53, 20 June 2017 (UTC)

Speaking of Opium, what relevance does Opium have to opioids? I am not criticizing the mention of Opium here, I am saying that "opioid" seems to indicate Opium and the article should indicate the relevance or lack of relevance. If opioids are derived from Opium then have the drug companies prevented that from being stated here? Sam Tomato (talk) 16:56, 20 April 2018 (UTC)

Opioids are defined by their pharmacology, not by their origin. Most opioids are synthetic (or semi-synthetic) and not obtained from opium. But in any case, there is no reason to think that drug companies control the content of this page. -- Ed (Edgar181) 17:30, 20 April 2018 (UTC)

reference to Opioid Wikipedia[edit]

Vardanyan, R.S.; Cain, J.P.; Mowlazadeh Haghighi, S.; Kumirov, V.K.; McIntosh, M.I.; Sandweiss, A.J.; Porreca, F.; Hruby, V.J. (2017). “Synthesis and Investigation of Mixed μ-Opioid and δ-Opioid Agonists as Possible Bivalent Ligands for Treatment of Pain” J. Heterocyclic Chem., 54: 1228-1235. doi: 10.1002/jhet.2696.

Sagharmolazade (talk) 00:56, 20 June 2017 (UTC)

Lead[edit]

The lead currently talks about opioid use to induce euphoria but it doesn't say anything about opioid use to prevent withdrawal, which as I understand is also a major motivation for use. Would something like the following be appropriate?

Opioids are most often used medically to relieve pain. Opioids are also frequently used by people with opioid use disorder for their euphoric effects or to prevent withdrawal.

or perhaps more succinctly

Opioids are most often used medically to relieve pain. Opioids are also frequently used for their euphoric effects or to prevent withdrawal.

as some amount of people may use opioids as euphoriants but not do so frequently enough to develop addiction or dependence. Sizeofint (talk) 16:57, 18 July 2017 (UTC)

I think the 2nd option is better. But, prevention of withdrawal is medical treatment, and methodone type treatment is really to prevent relapse, not just withdrawal.
How about, 'Opioids are also used medically to relieve pain and to prevent relapse for opioid addicted patients. Opioids provide users with a sensation of euphoria and are highly addictive, and are frequently abused.'
Other comments on lead:
  1. First sentence 'morphine-like effects' to describe opiates is a circular definition. Maybe psychoactive effects?
  2. There should be more emphasis on the opioid epidemic in the lead, and a section in the body.
  3. Lead first paragraph doesn't mention that opoids are highly addictive.
  4. The sentences in the first paragraph comparing the terms opiate and narcotic should be moved to the text body (and are poorly written).
Teretylac (talk) 18:31, 19 July 2017 (UTC)
I think the 2nd is better. Some addicts use it to prevent withdrawal outside of treatment.Doc James (talk · contribs · email) 19:50, 19 July 2017 (UTC)
Agree with your middle two points. To your first point, morphine is generally considered the prototypical opioid[1] so in some ways the similarity of a drug to morphine determines if it is an opioid. I don't consider the information on opiates and narcotics too poorly written. I think the content is positioned there because readers frequently conflate the terms. I'm not opposed to moving it if there is a better spot. Sizeofint (talk) 21:14, 19 July 2017 (UTC)
I've moved it out of the lead to its own section before medical uses. My thought is this placement can let the reader know what the article is about early on without sacrificing space in the lead for etymology. Sizeofint (talk) 22:17, 19 July 2017 (UTC)

References

Table of opioids, morphinan, heroin as Bayer brand name?[edit]

It keeps getting reverted to such, and the wikification link removed. I am changing it once more but it needs discussion now. Nagelfar (talk) 17:21, 16 October 2017 (UTC)

Updated charts. May need to refresh your cache to see 2015 column[edit]

http://refreshyourcache.com/en/cache

Windows: ctrl + F5
Mac/Apple: Apple + R or command + R
Linux: F5

--Timeshifter (talk) 14:51, 29 October 2017 (UTC)