Opioid use disorder

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natural opioids (such as codeine and morphine), semisynthetic opioids (oxycodone, hydrocodone, hydromorphone, and oxymorphone), and synthetic opioids like methadone. In the U.S., "the age-adjusted drug poisoning death rate involving opioid analgesics increased from 1.4 to 5.4 deaths per 100,000 population between 1999 and 2010. The second wave dates to around 2010 with the rapid increase in opioid overdoses due to heroin. By this time, there were already four times as many deaths by overdose than in 1999. The age-adjusted drug poisoning death rate involving heroin doubled from 0.7 to 1.4 deaths per 100,000 people between 1999 and 2011 and then continued to increase to 4.1 in 2015. The third wave of overdose deaths began in 2013, related to synthetic opioids, particularly illicitly produced fentanyl. While the illicit fentanyl market has continuously changed, the drug is generally sold as an adulterant in heroin. Research suggests that the rapid increase of fentanyl into the illicit opioid market has been largely supply-side-driven and dates to 2006. Decreasing heroin purity, competition from increased access to prescription medications, and dissemination of "The Siegfried Method" (a relatively simple and cost-effective method of fentanyl production) were major factors in street suppliers' inclusion of fentanyl in their products. The current, fourth wave, which began in 2016, has been characterized by

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birth weight, and larger head circumference without increased harm. Compared to methadone, it consistently results in improved birth weight and gestational age, though these findings should be interpreted with caution due to potential biases. Buprenorphine use also correlates with a lower risk of adverse neonatal outcomes, with similar risks of adverse maternal outcomes as methadone. Infants born to buprenorphine-treated mothers generally have higher birth weights, fewer withdrawal symptoms, and a lower likelihood of premature birth. Additionally, these infants often require less treatment for neonatal abstinence syndrome and have mothers who are more likely to start treatment earlier in pregnancy, leading to longer gestations and larger infants.

1220:. It can be given by many routes (e.g., intramuscular (IM), intravenous (IV), subcutaneous, intranasal, and inhalation) and acts quickly by displacing opioids from opioid receptors and preventing the activation of these receptors. Naloxone kits are recommended for laypersons who may witness an opioid overdose, for people with large prescriptions for opioids, those in substance use treatment programs, and those recently released from incarceration. Since this is a life-saving medication, many areas of the U.S. have implemented standing orders for law enforcement to carry and give naloxone as needed. In addition, naloxone can be used to challenge a person's opioid abstinence status before starting a medication such as 1785:

establishing an online directory for distributors of opioid antagonists, and expanding the number of eligible crimes committed by individuals with a substance use disorder that may be considered for diversion to a substance use treatment program. Until these laws were signed, incarcerated New Yorkers did not reliably have access to medication-assisted treatment and syringe possession was still a class A misdemeanor despite New York authorizing and funding syringe exchange and access programs. This legislation acknowledges the ways New York State laws have contributed to opioid deaths: in 2020 more than 5112 people died from overdoses in New York State, with 2192 deaths in New York City.

1571:(CBT) is a form of psychosocial intervention that systematically evaluates thoughts, feelings, and behaviors about a problem and works to develop coping strategies to work through those problems. This intervention has demonstrated success in many psychiatric conditions (e.g., depression) and substance use disorders (e.g., tobacco). But the use of CBT alone for OUD has declined due to lack of efficacy, and many rely on medication therapy or medication therapy with CBT, since both were found to be more efficacious than CBT alone. CBT has been shown to be more successful in relapse prevention than treatment of ongoing drug use. It is particularly known for its durability. 508: 1282:

universal relapse. This approach is seen as ineffective without plans for transition to long-term evidence-based addiction treatment, such as opioid agonist treatment. Though treatment reduces mortality rates, the first four weeks after treatment begins and the four weeks after treatment ceases are the riskiest times for drug-related deaths. These periods of increased vulnerability are significant because many of those in treatment leave programs during these periods. There is evidence that people with opioid use disorder who are dependent on pharmaceutical opioids may require a different management approach from those who take heroin.

571: 1736: 1592:, such as using incentives to reach certain goals (e.g., verified abstinence, usually in the form of urine drug testing). This form of psychotherapy has the strongest, most robust empirical support for treating drug addiction. Outpatient clients are shown to have improved medication compliance, retention, and abstinence when using voucher-based incentives. One way this is implemented is to offer take-home privileges for methadone programs. Despite its effectiveness during treatment, effects tend to wane once terminated. Additionally, the cost barrier limits its application in the clinical community. 1197:(opioid use disorder). Healthcare providers should strictly follow evidence-based guidelines, such as the CDC Clinical Practice Guideline for Prescribing Opioids for Pain, to ensure safe and appropriate use. Another way to prevent OUD is educating the public about the risks of prescription opioids and illegal substances like fentanyl. Awareness campaigns, community outreach programs, and school-based education initiatives can help people make informed decisions about opioid use and recognize the signs of addiction early on. 1825: 752: 720:, care providers should not treat opioid use disorder as the result of a weak moral character or will but as a medical condition. Some evidence suggests the possibility that opioid use disorders occur due to genetic or other chemical mechanisms that may be difficult to identify or change, such as dysregulation of brain circuitry involving reward and volition. But the exact mechanisms involved are unclear, leading to debate over the influence of biology and free will. 1255:, are effective for OUD risk mitigation. CDC guidance suggests the prescription of immediate-release opioids instead of opioids that have a long duration (long-acting) or opioids that are released over time (extended release). Other recommendations include prescribing the lowest opioid dose that successfully addresses the pain in opioid-naïve patients and collaborating with patients who already take opioid therapy to maximize the effect of non-opioid analgesics. 14754: 50: 1801: 709:. Scoring systems have been derived to assess the likelihood of opiate addiction in chronic pain patients. Healthcare practitioners have long been aware that despite the effective use of opioids for managing pain, empirical evidence supporting long-term opioid use is minimal. Many studies of patients with chronic pain have failed to show any sustained improvement in their pain or ability to function with long-term opioid use. 1887: 1455:

until the patient exhibits moderate withdrawal symptoms, as measured by a Clinical Opiate Withdrawal Scale, achieving a score of around 12. Alternatively, "microdosing" commences with a small dose immediately, regardless of withdrawal symptoms, offering a more flexible approach to treatment initiation. "Macrodosing" starts with a larger dose of Suboxone, a different induction strategy with its own set of considerations.

1853: 15399: 1611:(NA). NA's 12-step process is based on the 12-step facilitation of Alcoholic Anonymous (AA) and centers on peer support, self-help, and spiritual connectedness. Some evidence also supports the use of these programs for adolescents. Multiple studies have shown increased abstinence for those in NA compared to those who are not. Members report a median abstinence length of 5 years. 1841: 1878:

Americans have also been shown to benefit from the increased access due to telehealth programs introduced during the pandemic, despite increasing disparity gaps in other OUD-related outcomes. The DEA and HHS have extended telemedicine flexibility in regard to prescribing controlled substances such as buprenorphine for OUD through 31 December 2024.

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and certain prescription drugs. Men are at higher risk for opioid use and dependency than women, and men also account for more opioid overdoses than women, although this gap is closing. Women are more likely to be prescribed pain relievers, be given higher doses, use them for longer durations, and become dependent upon them faster.

1682:(MAT), counseling, and residential programs—can be overwhelming. Patients may have difficulty understanding which option best suits them, leading to confusion and potential disengagement from the treatment process. Withdrawal symptoms can be severe and uncomfortable, leading many people to relapse before they complete 808:

individuals from a Methadone Maintenance Treatment Program, those with the specific genetic variation showed higher mean heroin consumption by around double those without the SNP. This study helps to show the contribution of dopamine receptors to substance addiction and more specifically to opioid abuse.

744:), essential for motivating behaviors linked to survival and reproductive fitness, like seeking food and sex. This reward system encourages associative learning and goal-directed behavior. In addiction, substances overactivate this circuit, causing compulsive behavior due to changes in brain synapses. 1784:

signed legislation to combat the opioid crisis. This included establishing a program for the use of medication-assisted substance use disorder treatment for incarcerated individuals in state and local correctional facilities, decriminalizing the possession and sale of hypodermic needles and syringes,

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In 2017, the U.S. Department of Health and Human Services (HHS) announced a public health emergency due to an increase in the misuse of opioids. The administration introduced a strategic framework called the Five-Point Opioid Strategy, which includes providing access recovery services, increasing the

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First-line management involves the use of opioid replacement therapies, particularly methadone and buprenorphine/naloxone. Withdrawal management alone is strongly discouraged, because of its association with elevated risks of HIV and hepatitis C transmission, high rates of overdose deaths, and nearly

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receptors for each individual may help to elucidate part of the risk for opioid addiction and general substance abuse. Studies of the D2 Dopamine Receptor, in particular, have shown some promising results. One specific SNP is at the TaqI RFLP (rs1800497). In a study of 530 Han Chinese heroin-addicted

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Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification

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Since 2018, with the federal government's passing of the SUPPORT (Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act) Act, federal restrictions on methadone use for patients receiving Medicare have been lifted. Since March 2020, as a result

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overdose due to synthetic opioids like fentanyl mixed with stimulants such as methamphetamine or cocaine. In 2010, around 0.5% of opioid-related deaths were attributed to mixture with stimulants. This figure increased more than 50-fold by 2021, when about a third of opioid-related deaths, or 34,000,

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have also shown the possibility of decreased cravings and withdrawal symptoms. Ibogaine is illegal in the U.S. but is unregulated in Mexico, Costa Rica, and New Zealand, where many clinics use it for addiction treatment. Research has shown a minor mortality risk due to its cardiotoxic and neurotoxic

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Additionally, dosing naltrexone after recent opioid use can lead to precipitated withdrawal. Conversely, naltrexone antagonism at the opioid receptor can be overcome with higher doses of opioids. Naltrexone monthly IM injections received FDA approval in 2010 for the treatment of opioid dependence in

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While receiving opioid therapy, patients should be periodically evaluated for opioid-related complications and clinicians should review state prescription drug monitoring program systems. The latter should be assessed to reduce the risk of overdoses in patients due to their opioid dose or medication

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opioids, requiring a higher dose to achieve the same therapeutic effect. This points to a potential for greater addictive capacity in individuals who require higher dosages to achieve pain control. But evidence linking the 118A>G variant to opioid dependence is mixed, with associations shown in a

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was previously used to treat opioid dependence. In 2003 the drug's manufacturer discontinued production. There are no available generic versions. LAAM produced long-lasting effects, which allowed the person receiving treatment to visit a clinic only three times per week, as opposed to daily as with

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As of 2023, the Waiver Elimination (MAT Act), as part of Section 1262 of the Consolidated Appropriations Act, 2023 (or "Omnibus Bill"), removed the federal requirement for medical providers to obtain a waiver to prescribe buprenorphine, in an attempt to increase access to OUD treatment. Before this

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Deaths due to opioid use also tend to skew at older ages than deaths from use of other illicit drugs. This does not reflect opioid use as a whole, which includes younger people. Overdoses from opioids are highest among people between the ages of 40 and 50, in contrast to heroin overdoses, which are

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Motivational enhancement therapy (MET) is the manualized form of motivational interviewing (MI). MI leverages one's intrinsic motivation to recover through education, formulation of relapse prevention strategies, reward for adherence to treatment guidelines, and positive thinking to keep motivation

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in both extended-release and immediate-release form is also sometimes used for maintenance treatment as an alternative to methadone or buprenorphine in some European countries. Dihydrocodeine is an opioid agonist. It may be used as a second-line treatment. A 2020 systematic review found low-quality

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Methadone is a commonly used full-opioid agonist in the treatment of opioid use disorder. It is effective in relieving withdrawal symptoms and cravings in people with opioid addiction, and can also be used in pain control in certain situations. While methadone is a widely prescribed form of OAT, it

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Buprenorphine's role as a partial opioid receptor agonist sets it apart from full agonists like methadone. Its unique pharmacological profile makes it less likely to cause respiratory depression, thanks to its "ceiling effect". While the risk of misuse or overdose is higher with buprenorphine alone

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The period when initiating methadone and the time immediately after discontinuing treatment with both drugs are periods of particularly increased mortality risk, which should be dealt with by both public health and clinical strategies. ORT has proved to be the most effective treatment for improving

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Epidemiological research has shown that the COVID-19 pandemic accelerated the opioid crisis. The overarching trend of opioid overdose data has shown a plateau in deaths around 2017–18, with a sudden and acute rise in 2019 primarily attributed to synthetic opioids like fentanyl. In 2020, there were

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The U.S. epidemic in the 2000s is related to a number of factors. Rates of opioid use and dependency vary by age, sex, race, and socioeconomic status. With respect to race, the discrepancy in deaths is thought to be due to an interplay between physician prescribing and lack of access to healthcare

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can also receive treatment with methadone, naltrexone, or buprenorphine. Buprenorphine appears to be associated with more favorable outcomes compared to methadone for treating opioid use disorder (OUD) in pregnancy. Studies show that buprenorphine is linked to lower risks of preterm birth, greater

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Globally, the number of people with opioid dependence increased from 10.4 million in 1990 to 15.5 million in 2010. In 2016, the numbers rose to 27 million people who experienced this disorder. Opioid use disorders resulted in 122,000 deaths worldwide in 2015, up from 18,000 deaths in 1990. Deaths

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Buprenorphine can be administered either as a standalone product or in combination with the opioid antagonist naloxone. This inclusion is strategic: it deters misuse by preventing the crushing and injecting of the medication, encouraging instead the prescribed sublingual (under the tongue) route.

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kits, and being vigilant about suspicious prescriptions. Insurance programs can help limit opioid use by setting quantity limits on prescriptions or requiring prior authorizations for certain medications. Many U.S. officials and government leaders have become involved in implementing preventative

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Opioid withdrawal can occur with a sudden decrease in, or cessation of, opioids after prolonged use. Onset of withdrawal depends on the half-life of the opioid that was used last. With heroin this typically occurs five hours after use; with methadone, it may take two days. The length of time that

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Specifically, opiates in several CNS regions including NAc, and cocaine more selectively in NAc induce expression of certain adenylyl cyclase isoforms and PKA subunits via the transcription factor, CREB, and these transcriptional adaptations serve a homeostatic function to oppose drug action. In

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Telehealth played a large role in OUD treatment access, and legislation on telehealth continues to evolve. A study of Medicare beneficiaries with new-onset OUD showed that those who received telehealth services had a 33% lower risk of death by overdose. Minority groups such as Black and Hispanic

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review by Gomes et al. showed that estimated years of life loss (YLL) due to opioid toxicity in the U.S. increased by 276%. This increase was particularly felt by those ages 15 to 19, whose YLL increased nearly threefold. Younger male adults had the largest effect size. Other reviews of U.S. and

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Paralleling the variety of medical treatments, there are many forms of psychotherapy and community support for treating OUD. The primary evidence-based psychotherapies include cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), contingency management (CM), and twelve-step

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When initiating buprenorphine/naloxone therapy, several critical factors must be considered. These include the severity of withdrawal symptoms, the time elapsed since the last opioid use, and the type of opioid involved (long-acting vs. short-acting). A standard induction method involves waiting

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The current epidemic of opioid abuse is the most lethal drug epidemic in American history. The crisis can be distinguished by waves of opioid overdose deaths as described by the Centers of Disease Control and Prevention. The first wave began in the 1990s, related to the rise in prescriptions of

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One of methadone's benefits is that it can last up to 56 hours in the body, so if a patient misses a daily dose, they will not typically struggle with withdrawal symptoms. Other advantages of methadone include reduction in infectious disease related to injection drug use, and reduced mortality.

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gives prescribers specific recommendations for starting opioids, clinically appropriate use, and assessing risks associated with opioid therapy. Improving opioid prescribing guidelines and practices can help reduce unnecessary exposure to opioids, which in turn lowers the risk of developing OUD

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The incentive-sensitization theory differentiates between "wanting" (driven by dopamine in the reward circuit) and "liking" (related to brain pleasure centers). This explains the addictive potential of non-pleasurable substances and the persistence of opioid addiction despite tolerance to their

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family may also play a role in dependence and overdose due to variance in breakdown of opioids and their receptors. There are also multiple potential complications with combining opioids with antidepressants and antiepileptic drugs (both common drugs for chronic pain patients) because of their

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is an opioid receptor antagonist used for the treatment of opioid addiction. It is not as widely used as buprenorphine or methadone for OUD due to low rates of patient acceptance, non-adherence due to daily dosing, and difficulty achieving abstinence from opioids before beginning treatment.

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and healthcare expenditure. A review of UK hospital policies found that local guidelines delayed access to substitute opioids, for instance by requiring lab tests to demonstrate recent use or input from specialist drug teams before prescribing. Delays to access can increase people's risk of

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Though medications and behavioral treatments are effective forms for treating OUD, relapse remains a common problem. The medical community has looked to novel technologies and traditional alternative medicines for new ways to approach the issues of continued cravings and impaired executive

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Important considerations when initiating methadone include the patient's opioid tolerance, the time since last opioid use, the type of opioid used (long-acting vs. short-acting), and the risk of methadone toxicity. Methadone comes in different forms: tablet, oral solution, or an injection.

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typically protect bystanders who administer naloxone. In the U.S., at least 40 states have Good Samaritan laws to encourage bystanders to take action without fear of prosecution. As of 2019, 48 states give pharmacists the authority to distribute naloxone without an individual prescription.

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highest among people between the ages of 20 and 30. 21- to 35-year-olds represent 77% of people who enter treatment for opioid use disorder, but the average age of first-time use of prescription painkillers was 21.2 years in 2013. Among the middle class, means of acquiring funds include

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has shown functional and structural alterations in the brain. Chronic intake of opioids such as heroin may cause long-term effects in the orbitofrontal area (OFC), which is essential for regulating reward-related behaviors, emotional responses, and anxiety. Moreover, neuroimaging and

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confers a possible reduction of opioid use and with fewer depressive symptoms but overall more adverse effects compared to other forms of long-acting opioids. Retention in treatment was not found to be significantly different. It is used in Switzerland and more recently in Canada.

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compared to the buprenorphine/naloxone combination or methadone, its usage is linked to a decrease in mortality. Approved in the U.S. for opioid dependence treatment in 2002, buprenorphine has since expanded in form, with the FDA approving a month-long injectable version in 2017.

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bill, practitioners were required to receive a Drug Addiction Treatment Act of 2000 (DATA) waiver, also known as "x-waiver", before prescribing buprenorphine. There is also now no longer any limit to the number of patients to whom a provider may prescribe buprenorphine for OUD.

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genes, which encode the κ and δ receptors, respectively. Newer approaches shift away from analysis of specific genes and regions, and are based on an unbiased screen of genes across the entire genome, which have no apparent relationship to the phenotype in question. These

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A genetic basis for the efficacy of opioids in the treatment of pain has been demonstrated for several specific variations, but the evidence for clinical differences in opioid effects is ambiguous. There is an estimated 50% genetic contribution to opioid use disorder. The

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addicts not to seek help. Many people view addiction as a moral failing rather than a medical condition, which can lead to feelings of shame and isolation. This stigma can also affect family members, making it difficult for them to support their loved ones effectively.

1339:), which are taken under medical supervision. Buprenorphine/naloxone is usually preferred over methadone because of its safety profile, which is considered significantly better, primarily with regard to its risk of overdose and effects on the heart (QTc prolongation). 800:(RMTg), which negatively modulate dopamine neurotransmission. In other words, opioids inhibit the projections from the RMTg to the VTA, which in turn disinhibits the dopaminergic pathways that project from the VTA to the nucleus accumbens and elsewhere in the brain. 593:

major symptoms occur also depends on the opioid used. For heroin withdrawal, symptoms are typically greatest at two to four days and can last up to two weeks. Less significant symptoms may remain for an even longer period, in which case the withdrawal is known as

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Buprenorphine/naloxone formulations are available as tablets and films; these formulations operate efficiently when taken sublingually. In this form, buprenorphine's bioavailability remains robust (35–55%), while naloxone's is significantly reduced (~10%).

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high—which are based on a person's socioeconomic status, gender, race, ethnicity, sexual orientation, and readiness to recover. Like CBT, MET alone has not shown convincing efficacy for OUD. There is stronger support for combining it with other therapies.

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While over 100 variants have been identified for the opioid mu-receptor, the most studied mu-receptor variant is the non-synonymous 118A>G variant, which results in functional changes to the receptor, including lower binding site availability, reduced

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and giving those at risk naloxone to take home is beneficial. In 2020, the CDC estimated that nearly 3 million people in the U.S. were living with OUD and more than 65,000 people died by opioid overdose, of whom more than 15,000 were heroin overdoses.

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Manchikanti L, Singh VM, Staats PS, Trescot AM, Prunskis J, Knezevic NN, et al. (March 2022). "Fourth Wave of Opioid (Illicit Drug) Overdose Deaths and Diminishing Access to Prescription Opioids and Interventional Techniques: Cause and Effect".

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The severity can be classified as mild, moderate, or severe based on the number of criteria present. The tolerance and withdrawal criteria are not considered to be met for individuals taking opioids solely under appropriate medical supervision.

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Risk factors include a history of opioid misuse, current opioid misuse, young age, socioeconomic status, race, untreated psychiatric disorders, and environments that promote misuse (social, family, professional, etc.). Complications may include

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Canadian opioid data coinciding with the onset of COVID-19 suggested significant increases in opioid-related emergency medicine utilization, increased positivity for opioids, and surprisingly no to decreased change in naloxone dispensation.

304:. A useful standard for the relative strength of different opioids is morphine milligram equivalents (MME). It is recommended for clinicians to refer to daily MMEs when prescribing opioids to decrease the risk of misuse and adverse effects. 1910:

was one of the first approved opioid dependence drugs introduced in the U.S. in the early 2000s to combat opioid abuse. This discovery came after decades of research and led to the development of other drugs to fight opioid use disorders.

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Robertson JR, Raab GM, Bruce M, McKenzie JS, Storkey HR, Salter A (December 2006). "Addressing the efficacy of dihydrocodeine versus methadone as an alternative maintenance treatment for opiate dependence: A randomized controlled trial".

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certain brain regions, such as locus coeruleus, these adaptations mediate aspects of physical opiate dependence and withdrawal, whereas in NAc they mediate reward tolerance and dependence that drives increased drug self-administration.

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MacArthur GJ, van Velzen E, Palmateer N, Kimber J, Pharris A, Hope V, et al. (January 2014). "Interventions to prevent HIV and Hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness".

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are usually excluded from this requirement.) In practice, 40–65% of patients maintain abstinence from additional opioids while receiving opioid replacement therapy and 70–95% can reduce their use significantly. Medical (improper

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Young JR, Smani SA, Mischel NA, Kritzer MD, Appelbaum LG, Patkar AA (April–June 2020). "Non-invasive brain stimulation modalities for the treatment and prevention of opioid use disorder: a systematic review of the literature".

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Mohamadi A, Chan JJ, Lian J, Wright CL, Marin AM, Rodriguez EK, et al. (August 2018). "Risk Factors and Pooled Rate of Prolonged Opioid Use Following Trauma or Surgery: A Systematic Review and Meta-(Regression) Analysis".

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guidelines for the diagnosis of opioid use disorder require that the individual has a significant impairment or distress related to opioid uses. To make the diagnosis two or more of 11 criteria must be present in a given year:

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compared to methadone are unclear as of 2010. A Cochrane review found some evidence in opioid users who had not improved with other treatments. In Switzerland, Germany, the Netherlands, and the United Kingdom, long-term

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euphoric effects. Addiction surpasses mere avoidance of withdrawal, involving cues and stress that reactivate reward-driven behaviors. This is an important reason detoxification alone is unsuccessful 90% of the time.

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Long-term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain. In the United States, most heroin users begin by using prescription opioids that may also be bought illegally.

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Rehm J, Gschwend P, Steffen T, Gutzwiller F, Dobler-Mikola A, Uchtenhagen A (October 2001). "Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study".

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Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, et al. (January 2007). "Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction".

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While medical treatment may help with the initial symptoms of opioid withdrawal, once the first stages of withdrawal are through, a method for long-term preventative care is attendance at 12-step groups such as

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Homicide, suicide, accidents and liver disease are also opioid-related causes of death for those with OUD. Many of these causes of death are unnoticed due to the often limited information on death certificates.

9523:"Association of Receipt of Opioid Use Disorder-Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic" 1753:

availability of reversing agents for overdose, funding opioid misuse and pain research, changing treatments of people managing pain, and updating public health reports related to combating opioid drug misuse.

1624:(NIBS) for reducing cravings in OUD. These results are consistent with the use of NIBS for reducing cravings of other substances. Additionally, investigations into the anecdotal evidence of psychedelics like 6627:"Comparing rapid micro-induction and standard induction of buprenorphine/naloxone for treatment of opioid use disorder: protocol for an open-label, parallel-group, superiority, randomized controlled trial" 4755:

Laviolette SR, van der Kooy D (March 2001). "GABA(A) receptors in the ventral tegmental area control bidirectional reward signalling between dopaminergic and non-dopaminergic neural motivational systems".

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Christie C, Baker C, Cooper R, Kennedy CP, Madras B, Bondi FA. The president's commission on combating drug addiction and the opioid crisis. Washington, DC, US Government Printing Office, November 2017;1.

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Simha S, Ahmed Y, Brummett CM, Waljee JF, Englesbe MJ, Bicket MC (January 2023). "Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review".

8457:"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015" 1373:. In some countries (not the U.S. or Australia), regulations enforce a limited time for people on ORT programs that conclude when a stable economic and psychosocial situation is achieved. (People with 13606: 1205:

measures to decrease opioid usage in the United States. Targeted education of medical providers and government officials can lead to provisions affecting opioid distribution by healthcare providers.

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Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC (April 2014). "Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review".

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combinations. For patients receiving opioid therapy in whom the risks outweigh the benefits, clinicians and patients should develop a treatment plan to decrease their opioid dose incrementally.

12754: 12749: 12744: 12072: 10990: 10985: 10980: 8523:"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013" 2704: 2117: 8211: 1362:, also known as the "Omnibus Bill", removed the federal requirement for medical providers to obtain a waiver to prescribe buprenorphine, in an attempt to increase access to OUD treatment. 11470: 10440: 13327: 12453: 5267: 12187: 9716: 1664:

Availability of services: In many areas, especially rural regions, there is a lack of treatment facilities or qualified healthcare providers who specialize in opioid use disorder.

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the health and living condition of people experiencing illegal opiate use or dependence, including mortality reduction and overall societal costs, such as the economic loss from

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have been reported for every receptor and ligand coding gene in both coding sequences, as well as regulatory regions. Research on endogenous opioid receptors has focused around

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Seabra P, Sequeira A, Filipe F, Amaral P, Simões A, Sequeira R (June 2022). "Substance addiction consequences: Outpatients severity indicators in a medication-based program".

3514:"Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial" 1464:

often requires more frequent clinical visits compared to buprenorphine/naloxone, which also has a better safety profile and lower risk of respiratory depression and overdose.

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Han B, Polydorou S, Ferris R, Blaum CS, Ross S, McNeely J (10 November 2015). "Demographic Trends of Adults in New York City Opioid Treatment Programs--An Aging Population".

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Solhaug V, Molden E (October 2017). "Individual variability in clinical effect and tolerability of opioid analgesics - Importance of drug interactions and pharmacogenetics".

11465: 1852: 13778: 11881: 9700: 5574:"Evidence of Increased Age and Sex Standardized Death Rates Among Individuals Who Accessed Opioid Agonist Treatment Before the Era of Synthetic Opioids in Ontario, Canada" 13811: 13079: 12327: 11370: 1184:

effects on inducing CYP enzymes. Genotyping of CYP2D6 in particular may play a role in helping patients with individualized treatment for OUD and other drug addictions.

7260:"Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta-analysis of safety in the mother, fetus and child" 4609:"Reflections on: "A general role for adaptations in G-Proteins and the cyclic AMP system in mediating the chronic actions of morphine and cocaine on neuronal function"" 7780:

Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW (February 2008). "A meta-analytic review of psychosocial interventions for substance use disorders".

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Tran TH, Griffin BL, Stone RH, Vest KM, Todd TJ (July 2017). "Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women".

870:(mTORC2). As a result of downregulated signaling through these proteins, opiates cause VTA neuronal hyperexcitability and shrinkage (specifically, the size of the 8799:"Charting the fourth wave: Geographic, temporal, race/ethnicity and demographic trends in polysubstance fentanyl overdose deaths in the United States, 2010-2021" 839:

upon cessation of repeated exposure to a stimulus (e.g., drug intake). Dependence is a component of a substance use disorder. Opioid dependence can manifest as

13704: 13492: 10900: 8131:

Köck P, Froelich K, Walter M, Lang U, Dürsteler KM (July 2022). "A systematic literature review of clinical trials and therapeutic applications of ibogaine".

12578: 3681: 353: 270: 140: 9272: 4078:"Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: a 2-phase randomized controlled trial" 1694: 1519:

that is administered under the supervision of medical staff. Other countries where it is available include Spain, Denmark, Belgium, Canada, and Luxembourg.

14492: 10851: 10408: 9957: 8186: 3563:

Eriksen J, Sjøgren P, Bruera E, Ekholm O, Rasmussen NK (November 2006). "Critical issues on opioids in chronic non-cancer pain: an epidemiological study".

740:

characterized by compulsive drug use despite adverse consequences. Addiction involves the overstimulation of the brain's mesocorticolimbic reward circuit (

13699: 12573: 6250:"Barriers to management of opioid withdrawal in hospitals in England: a document analysis of hospital policies on the management of substance dependence" 7197: 6749: 5707: 2643: 233:, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. 13816: 10910: 15176: 14512: 11455: 10920: 1151:

number of study groups, but negative results in other groups. One explanation for the mixed results is the possibility of other variants that are in

6214: 4994:

Khokhar JY, Ferguson CS, Zhu AZ, Tyndale RF (2010). "Pharmacogenetics of drug dependence: role of gene variations in susceptibility and treatment".

12468: 11941: 9194: 13985: 13626: 13618: 12679: 12137: 12022: 11831: 11678: 9286: 8583: 14790: 13895: 13659: 11936: 9572:"Changes in Racial/Ethnic Disparities in Opioid-Related Outcomes in Urban Areas during the COVID-19 Pandemic: A Rapid Review of the Literature" 6391: 8867: 7012: 1247:

Clinical Practice Guideline for Prescribing Opioids for Pain-United States, 2022" provides recommendations related to opioid misuse, OUD, and

13674: 12999: 12884: 12277: 11632: 11295: 10955: 3054:"Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management" 6557: 3192:"An examination of psychiatric comorbidities as a function of gender and substance type within an inpatient substance use treatment program" 2763:"Trends in the Use of Methadone, Buprenorphine, and Extended-release Naltrexone at Substance Abuse Treatment Facilities: 2003–2015 (Update)" 1365:

The driving principle behind ORT is the patient's reclamation of a self-directed life. ORT facilitates this process by reducing symptoms of

13821: 13791: 13742: 13462: 13452: 12553: 12548: 12057: 8941:. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control Centers for Disease Control and Prevention 6042: 4804:

Nutt D, King LA, Saulsbury W, Blakemore C (March 2007). "Development of a rational scale to assess the harm of drugs of potential misuse".

1524:

evidence that dihydrocodeine may be no more effective than other routinely used medication interventions in reducing illicit opiate use.An

1434:

Buprenorphine and methadone work by reducing opioid cravings, easing withdrawal symptoms, and blocking the euphoric effects of opioids via

9724: 9621: 3417:

Kalso E, Edwards JE, Moore AR, McQuay HJ (December 2004). "Opioids in chronic non-cancer pain: systematic review of efficacy and safety".

13930: 13402: 13256: 12919: 12734: 12377: 11786: 10637: 10507: 8041:

Ward HB, Mosquera MJ, Suzuki J, Mariano TY (April 2020). "A Systematic Review of Noninvasive Brain Stimulation for Opioid Use Disorder".

1806:

U.S. yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit synthetic opioids.

1906:

Opioids have been used in the Near East for centuries. The purification of and isolation of opiates occurred in the early 19th century.

13841: 13831: 13024: 12037: 9698:

EMEA Public Statement on the Recommendation to Suspend the Marketing Authorisation for Orlaam (Levacetylmethadol) in the European Union

9125: 8626: 3282:"Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis" 1244: 1193: 13877: 13846: 13747: 13634: 13487: 13467: 13357: 13337: 13064: 12387: 11385: 11015: 4673: 1620:

functioning. While consensus on their efficacy has not been reached, a number of reviews have shown promising results for the use of

867: 577:

10 mg, number facing up; the squares in the image represent one half centimeter, so the pill is around 0.75 cm in diameter.

7517:"A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction" 13069: 12633: 12422: 11522: 10844: 9983: 9950: 2734: 1840: 1424: 713: 8679:

Hempstead K, Yildirim EO (June 2014). "Supply-side response to declining heroin purity: fentanyl overdose episode in New Jersey".

5459: 13557: 13482: 13477: 13412: 6017: 3901: 1200:

Large U.S. retail pharmacy chains are implementing protocols, guidelines, and initiatives to take back unused opioids, providing

1167:

While opioid receptors have been the most widely studied, a number of other genes have been implicated in OUD. Higher numbers of

920:, psychological dependence, and pleasure to create a mean score for dependence. Selected results can be seen in the chart below. 916:

A scale was developed to compare the harm and dependence liability of 20 drugs. The scale uses a rating of zero to three to rate

9697: 7954:

Gamble J, O'Lawrence H (Summer 2016). "An Overview of the Efficacy of the 12-Step Group Therapy for Substance Abuse Treatment".

2948: 15270: 11781: 10780: 9637:"History of the discovery, development, and FDA-approval of buprenorphine medications for the treatment of opioid use disorder" 8504: 9788:"Age related medication for addiction treatment (MAT) use for opioid use disorder among Medicaid-insured patients in New York" 9064: 8960: 8643: 8167: 15169: 10304: 7573: 6005: 3882: 3662: 3125: 2991: 2394: 2071: 1113:

studies yield a number of implicated genes, although many of them code for seemingly unrelated proteins in processes such as

890: 5859: 1472:

Methadone has a number of potential side effects, including slowed breathing, nausea, vomiting, restlessness, and headache.

14877: 3873:

Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.).

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Ferri M, Minozzi S, Bo A, Amato L (June 2013). "Slow-release oral morphine as maintenance therapy for opioid dependence".

5214: 14705: 14177: 14034: 11435: 10837: 9943: 9460:"A qualitative assessment of circumstances surrounding drug overdose deaths during early stages of the COVID-19 pandemic" 6072: 5544: 14783: 14567: 10811: 10658: 10107: 8400: 7753: 6301:"Opioid addiction and abuse in primary care practice: a comparison of methadone and buprenorphine as treatment options" 815:

neuropsychological studies demonstrate dysregulation of circuits associated with emotion, stress and high impulsivity.

4277:"Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms" 2969: 2162:"Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies" 697:

Treatment of withdrawal may include methadone and buprenorphine. Medications for nausea or diarrhea may also be used.

10360: 9225:"Medication treatment for opioid use disorder in the age of COVID-19: Can new regulations modify the opioid cascade?" 2963:

Kosten TR, Haile CN. Opioid-Related Disorders. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds.

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Transportation: For many, getting to treatment facilities can be challenging due to a lack of transportation options.

851: 17: 9864: 2762: 2228:"Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria" 1438:, and in the case of buprenorphine, a high-affinity partial opioid agonist, also due to opioid receptor saturation. 15162: 14630: 14497: 13199: 10413: 9412:"Trends in Opioid Toxicity-Related Deaths in the US Before and After the Start of the COVID-19 Pandemic, 2011-2021" 9353: 3856:

Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process.

3685: 3334:"Long-term opioid therapy for chronic noncancer pain: a systematic review and meta-analysis of efficacy and safety" 1431:

as effective at reducing injection, lowering risk for HIV/AIDS, and promoting adherence to antiretroviral therapy.

1175:

gene, PENK, have been associated with opiate dependence. There have been mixed results for the MCR2 gene, encoding

874:

is reduced). It has been shown that when an opiate-naive person begins using opiates in concentrations that induce

266: 7714:"The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review" 6704: 6348:

Orman JS, Keating GM (2009). "Buprenorphine/naloxone: a review of its use in the treatment of opioid dependence".

4327:

Bourdy R, Barrot M (November 2012). "A new control center for dopaminergic systems: pulling the VTA by the tail".

14710: 14700: 13194: 10370: 10279: 10262: 9349: 6676: 2944: 1686:

or engage fully in recovery programs. The fear of withdrawal often prevents people from seeking help altogether.

1278:

with the goal of reducing the person's risks and improving their long-term physical and psychological condition.

14732: 9094: 1812: 15199: 13119: 10764: 10419: 10013: 4551:"Resting-State Neuroimaging and Neuropsychological Findings in Opioid Use Disorder during Abstinence: A Review" 1072:

have been the subject of intensive activity in association studies. These studies test broadly for a number of

882: 797: 594: 547: 9317: 6892:(Report). Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health. 6756: 1918:

methadone. In 2001, levacetylmethadol was removed from the European market due to reports of life-threatening

1765:

and international dealers noticing a lack of enforcement in their transaction scams throughout the Caribbean.

15419: 15254: 14776: 14333: 10591: 8991: 8340:"Clinical Trial Design Challenges and Opportunities for Emerging Treatments for Opioid Use Disorder A Review" 7201: 1679: 1251:. It reports a lack of clinical evidence that "abuse-deterrent" opioids (e.g., OxyContin), as labeled by the 1110: 7092: 5895:

National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD): Report of Results and Recommendation

14562: 14547: 14535: 14475: 12317: 10273: 10238: 8936: 6561: 5435: 5276: 2530:"Racial Bias in the US Opioid Epidemic: A Review of the History of Systemic Bias and Implications for Care" 1948: 1942: 1568: 1387: 1343: 1252: 1093: 859: 324: 14094: 3241:"Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool" 265:, and problems meeting social or professional responsibilities. Diagnosis may be based on criteria by the 15280: 14160: 13887: 10804: 10668: 10597: 10585: 10243: 9997: 8842: 8405: 4895:"Implications of genome wide association studies for addiction: are our a priori assumptions all wrong?" 1794:

Charts of deaths involving specific opioids and classes of opioids - US National Institute on Drug Abuse

385:

Continued use despite opioids worsening physical or psychological health (i.e. depression, constipation)

15389: 15332: 14915: 14595: 14130: 13297: 13292: 12684: 12027: 11115: 10365: 10078: 10032: 9969: 7074: 6522:

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5299: 5102: 4944:"Personalized medicine and opioid analgesic prescribing for chronic pain: opportunities and challenges" 1831: 1118: 507: 312: 174: 162: 8238: 7119:"Dihydrocodeine for detoxification and maintenance treatment in individuals with opiate use disorders" 6418:"Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review" 788:

in the nucleus accumbens via the disinhibition of dopaminergic pathways as a result of inhibiting the

15084: 14660: 14590: 14542: 14502: 14382: 14236: 13317: 12307: 12032: 11350: 10674: 10468: 7352: 5660:"Standard Death Certificates Versus Enhanced Surveillance to Identify Heroin Overdose-Related Deaths" 3280:

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1640:. Used for three to five days of continuous treatment, NET delivers alternating current via surface 14343: 13287: 13229: 12689: 12448: 11693: 10233: 10197: 10131: 10115: 10068: 10041: 9918: 7016: 6608: 5239: 3141:

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93,400 drug overdoses in the U.S. with >73% (approximately 69,000) due to opioid overdose. One

781:, overuse of opioids leads to increased ΔFosB expression in the nucleus accumbens. Opioids affect 367:

Large amounts of time are spent trying to obtain opioids, use opioids, or recover from taking them

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2063: 2057: 1402:) issues that can arise from the use of illegal opioids are concurrently eliminated or reduced. 773:

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15024: 14665: 14485: 14452: 14377: 14372: 14165: 12694: 11708: 11683: 11582: 10739: 10700: 10531: 10429: 10309: 10249: 10228: 10187: 10176: 10120: 10023: 9988: 8927: 6705:"West Virginia Department of Human Health & Resources_Burea for Medical Services_Methadone" 5810:

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Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention

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may occur. Patient presenting with dilated pupils may still be experiencing an opioid overdose.

409: 327:, other forms of support from mental health professionals such as individual or group therapy, 226: 147: 8576: 8293:"Access to Treatment for Opioid Dependence in Rural America: Challenges and Future Directions" 7915:"Combining medically assisted treatment and Twelve-Step programming: a perspective and review" 6822:

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with caption: "photo illustration of 2 milligrams of fentanyl, a lethal dose in most people".

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type 2, implicating both protection and risk to heroin addiction. A number of enzymes in the

1176: 9459: 9300: 8427: 7994:"12-step interventions and mutual support programs for substance use disorders: an overview" 5401:"Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014" 5076:"CDC Guideline for Prescribing Opioids for Chronic Pain | Drug Overdose | CDC Injury Center" 3387: 2916: 2837:"Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014" 2789:"12-step interventions and mutual support programs for substance use disorders: an overview" 2160:

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1263: 1217: 15239: 14800: 14650: 14507: 14318: 14195: 14172: 14114: 14089: 14051: 10925: 10905: 10690: 10463: 10203: 10045: 9935: 7309:"Buprenorphine Compared with Methadone in Pregnancy: A Systematic Review and Meta-Analysis" 7198:"Bundesamt für Gesundheit – Substitutionsgestützte Behandlung mit Diacetylmorphin (Heroin)" 6799: 6782: 6625:

Wong JS, Nikoo M, Westenberg JN, Suen JG, Wong JY, Krausz RM, et al. (February 2021).

5959:"QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel" 5007: 4711: 4058: 2887: 2212: 1589: 1370: 894: 774: 12662: 12005: 10871: 7258:

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4404:"Genetics of Opioid Dependence: A Review of the Genetic Contribution to Opioid Dependence" 3649: 2862: 8: 15337: 14813: 14574: 14457: 14402: 14392: 14387: 14338: 13990: 13576: 13422: 13382: 12709: 12528: 12508: 11806: 11768: 11723: 10723: 10552: 10542: 10385: 10296: 10150: 10145: 10037: 10008: 9907: 8187:"Revolutionary Kentucky-based opioid use disorder treatment device receives FDA approval" 6690: 5400: 4700:"Ventral tegmental area BDNF induces an opiate-dependent-like reward state in naive rats" 2836: 1858:

U.S. yearly opioid overdose deaths involving psychostimulants (primarily methamphetamine)

1608: 1601: 1557: 1508: 1227: 1089: 917: 910: 886: 858:(VTA) has been shown to mediate opioid-induced withdrawal symptoms via downregulation of 840: 824: 559: 426: 328: 170: 9661: 9636: 9547: 9522: 9436: 9411: 8455:

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8372: 8339: 6721: 5127: 4715: 3998:

Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences

2596:"CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022" 1550: 166: 15361: 15234: 15219: 15093: 14987: 14947: 14909: 14901: 14868: 14847: 14757: 14720: 14695: 14685: 14480: 14417: 14397: 14099: 14020: 13522: 12829: 12518: 12252: 12142: 11796: 11476: 11260: 11100: 11060: 10863: 10537: 10479: 10268: 9814: 9787: 9774: 9598: 9571: 9503: 9427: 9249: 9224: 9171: 9145:"Demographic and Geospatial Analysis of Buprenorphine and Methadone Prescription Rates" 9144: 9046: 8743: 8718: 8547: 8522: 8481: 8456: 8268: 8110: 8066: 8018: 7993: 7890: 7865: 7841: 7824: 7805: 7689: 7664: 7633: 7598: 7541: 7516: 7492: 7465: 7430: 7405: 7381: 7356: 7284: 7259: 7240: 7143: 7118: 6994: 6950: 6937: 6912: 6848: 6823: 6653: 6626: 6442: 6417: 6373: 6325: 6300: 6276: 6249: 6248:

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6230: 6191: 6164: 6140: 6115: 6089: 5983: 5958: 5934: 5907: 5836: 5811: 5751: 5726: 5684: 5659: 5600: 5573: 5467: 5351: 5326: 5191: 5158: 5118: 5019: 4968: 4943: 4919: 4894: 4870: 4853: 4829: 4781: 4732: 4699: 4633: 4608: 4577: 4550: 4526: 4501: 4477: 4452: 4428: 4403: 4352: 4301: 4276: 4257: 4206: 4181: 4154: 4129: 4102: 4093: 4077: 4018: 3993: 3960: 3935: 3842: 3833: 3817: 3785: 3733: 3708: 3631: 3588: 3540: 3513: 3489: 3464: 3442: 3399: 3306: 3281: 3216: 3191: 3167: 3142: 2917:"[Table], Figure 4-4: Signs and Symptoms of Opioid Intoxication and Withdrawal" 2813: 2788: 2686: 2620: 2595: 2556: 2529: 2501: 2443: 2418: 2308: 2283: 2252: 2227: 2186: 2161: 2096: 1979:. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). 2004. 1503: 1497: 1415: 1081: 1077: 81: 70: 14768: 13307: 12463: 11703: 9912: 9745:"Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes" 9143:

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8898: 8622: 8538: 8472: 7466:"Therapeutic Approaches to Opioid Use Disorder: What is the Current Standard of Care?" 6982: 6316: 4817: 4419: 4373: 3350: 3333: 2384: 1993: 1636:

approved the NET (NeuroElectric Therapy) device, which reduces withdrawal symptoms by

15375: 15290: 15275: 15249: 15063: 15030: 14978: 14923: 14896: 14715: 14557: 14084: 13312: 12704: 12699: 12473: 11718: 11280: 10915: 10580: 10168: 9966: 9859: 9819: 9766: 9666: 9603: 9552: 9538: 9507: 9495: 9441: 9389: 9384: 9367: 9254: 9176: 9038: 8820: 8776: 8748: 8696: 8552: 8486: 8377: 8359: 8355: 8320: 8312: 8308: 8273: 8148: 8114: 8102: 8070: 8058: 8023: 7971: 7936: 7895: 7846: 7797: 7735: 7694: 7638: 7579: 7569: 7546: 7497: 7435: 7386: 7330: 7289: 7232: 7179: 7148: 7056: 7052: 6986: 6942: 6893: 6853: 6839: 6804: 6658: 6539: 6447: 6377: 6365: 6361: 6330: 6281: 6234: 6196: 6145: 5988: 5939: 5841: 5792: 5756: 5689: 5640: 5605: 5517: 5356: 5196: 5178: 5132: 5057: 5011: 4973: 4924: 4910: 4875: 4821: 4773: 4769: 4737: 4638: 4582: 4531: 4502:"The role of orbitofrontal cortex in drug addiction: a review of preclinical studies" 4482: 4433: 4344: 4306: 4249: 4211: 4197: 4159: 4107: 4023: 3965: 3909: 3878: 3847: 3777: 3738: 3658: 3623: 3580: 3545: 3494: 3434: 3391: 3355: 3311: 3297: 3262: 3257: 3240: 3221: 3207: 3172: 3121: 3075: 3017: 2987: 2940: 2818: 2678: 2625: 2561: 2493: 2448: 2390: 2349: 2313: 2257: 2191: 2067: 1977:

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction

1914: 1770: 1560:) and therapeutic housing for those with OUD is also an important aspect of healing. 898: 785: 770: 587: 237:

include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood.

234: 134: 65: 8520: 7809: 7244: 6998: 4785: 4356: 4261: 3635: 3592: 3480: 3446: 3403: 2690: 2505: 712:

According to position papers on the treatment of opioid dependence published by the

15424: 15368: 15125: 15045: 14248: 14145: 14125: 14079: 13712: 13649: 13472: 13188: 13114: 12839: 12568: 12322: 12162: 11876: 11135: 10770: 10254: 9840: 9809: 9799: 9778: 9756: 9656: 9648: 9593: 9583: 9542: 9534: 9487: 9431: 9423: 9379: 9244: 9236: 9166: 9156: 9072: 9050: 9030: 8810: 8738: 8730: 8688: 8600: 8542: 8534: 8476: 8468: 8367: 8351: 8304: 8292: 8263: 8253: 8140: 8094: 8050: 8013: 8005: 7963: 7926: 7885: 7877: 7836: 7793: 7789: 7725: 7684: 7676: 7628: 7618: 7614: 7610: 7536: 7528: 7515:

Dugosh K, Abraham A, Seymour B, McLoyd K, Chalk M, Festinger D (March–April 2016).

7487: 7477: 7425: 7417: 7376: 7368: 7320: 7279: 7271: 7224: 7175: 7171: 7138: 7134: 7130: 7048: 6978: 6954: 6932: 6928: 6924: 6843: 6835: 6794: 6648: 6638: 6531: 6437: 6429: 6357: 6320: 6312: 6271: 6261: 6222: 6186: 6176: 6135: 6131: 6127: 5978: 5970: 5929: 5919: 5831: 5827: 5823: 5784: 5746: 5742: 5738: 5679: 5671: 5632: 5595: 5585: 5507: 5346: 5338: 5186: 5170: 5122: 5114: 5103:"Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder" 5049: 5023: 5003: 4963: 4955: 4914: 4906: 4865: 4833: 4813: 4765: 4727: 4719: 4628: 4624: 4620: 4572: 4562: 4521: 4517: 4513: 4472: 4464: 4423: 4415: 4336: 4296: 4288: 4241: 4201: 4193: 4149: 4141: 4097: 4089: 4013: 4005: 3955: 3947: 3837: 3829: 3769: 3728: 3720: 3615: 3572: 3535: 3525: 3484: 3476: 3426: 3383: 3345: 3301: 3293: 3252: 3211: 3203: 3162: 3158: 3154: 3065: 2970:

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2808: 2800: 2670: 2615: 2607: 2551: 2541: 2483: 2438: 2430: 2303: 2295: 2247: 2239: 2181: 2173: 1637: 1621: 1355: 1172: 1058: 863: 9761: 9744: 9034: 8098: 7931: 7914: 7325: 7308: 4275:

Blum K, Werner T, Carnes S, Carnes P, Bowirrat A, Giordano J, et al. (2012).

3789: 1863: 15403: 15327: 15214: 14739: 14623: 14348: 13362: 12889: 12844: 12192: 12167: 11210: 11140: 10995: 10886: 10860: 10575: 10397: 10028: 10002: 9923: 9704: 8734: 8009: 7532: 7421: 5974: 5812:"Opioid agonist treatment for people who are dependent on pharmaceutical opioids" 5788: 5053: 4292: 4245: 3619: 2804: 2488: 2471: 2098: 1898:

Opiate misuse has been recorded at least since 300 BC. Greek mythology describes

1715: 1668: 1660:

Accessing appropriate treatment is often a significant barrier. Factors include:

1435: 1366: 1248: 1180: 1085: 1062: 1031: 906: 905:

among several classes of drugs of abuse. Upregulation of the same pathway in the

836: 832: 706: 553: 542: 502: 405: 393: 340: 250: 242: 104: 91: 14804: 13302: 12458: 11698: 8668:. Hyattsville, MD.: CDC, National Center for Health Statistics. 2017. p. 4. 7680: 7117:

Carney T, Van Hout MC, Norman I, Dada S, Siegfried N, Parry CD (February 2020).

6433: 6215:"Many hospital policies create barriers to good management of opioid withdrawal" 4959: 1485: 323:. Such treatment reduces the risk of death. Additionally, they may benefit from 15229: 15110: 15040: 14605: 14433: 14137: 14074: 13664: 12989: 12287: 12267: 12262: 12067: 11325: 11285: 11275: 11235: 11130: 11095: 11000: 10975: 10930: 10645: 10335: 10091: 9844: 9652: 9410:

Gomes T, Ledlie S, Tadrous M, Mamdani M, Paterson JM, Juurlink DN (July 2023).

9240: 8144: 7967: 7307:

Kinsella M, Halliday LO, Shaw M, Capel Y, Nelson SM, Kearns RJ (29 July 2022).

6889: 6872: 6643: 6583: 6266: 6226: 5327:"Treatment and Prevention of Opioid Use Disorder: Challenges and Opportunities" 5159:"Treatment and Prevention of Opioid Use Disorder: Challenges and Opportunities" 4340: 3951: 3758:"The neurobiology of addiction: implications for voluntary control of behavior" 3576: 3430: 3031: 3011: 2363: 2341: 1972: 1683: 1667:

Insurance coverage: People without insurance or those whose plans do not cover

1520: 1275: 1168: 1143: 1012: 993: 871: 778: 737: 388: 293: 87: 9804: 8660: 8258: 5636: 3994:"Review. The incentive sensitization theory of addiction: some current issues" 3773: 2299: 1834:

is a category dominated by illegally acquired fentanyl, and has been excluded.

15413: 15322: 15306: 15209: 15204: 15142: 15050: 15020: 14618: 14043: 13980: 13639: 13417: 13372: 13322: 13245: 13233: 12939: 12854: 12834: 12819: 12814: 12759: 12533: 12523: 12227: 12147: 11871: 11811: 11801: 11738: 11713: 11507: 11450: 11240: 11185: 11175: 11170: 11150: 11085: 11035: 11020: 10935: 10829: 9992: 9491: 9287:"NY Decriminalizes Syringe Possession as Part of Overdose Prevention Efforts" 8363: 8316: 7881: 7583: 5675: 5374: 5182: 4567: 2644:"A Prescriber's Guide to Medicare Prescription Drug (Part D) Opioid Policies" 2097:

Substance Use and Mental Health Services Administration (30 September 2014).

1943:"FDA approves first buprenorphine implant for treatment of opioid dependence" 1907: 1891: 1745: 1391: 1114: 741: 320: 186: 9896: 9301:"Products – Vital Statistics Rapid Release – Provisional Drug Overdose Data" 7730: 7713: 5924: 4723: 4044: 1419:

discharging themselves early against medical advice. ORT is endorsed by the

751: 15300: 14836: 13975: 13910: 13836: 13644: 13219: 13184: 12984: 12789: 12648: 12242: 12237: 12132: 12107: 12102: 11926: 11851: 11597: 11552: 11405: 11400: 11355: 11255: 11090: 11055: 11050: 10491: 9823: 9770: 9670: 9607: 9588: 9556: 9499: 9445: 9393: 9258: 9180: 9042: 8824: 8780: 8752: 8700: 8556: 8490: 8381: 8324: 8277: 8152: 8106: 8062: 8027: 7975: 7940: 7899: 7850: 7801: 7739: 7698: 7642: 7550: 7501: 7439: 7390: 7334: 7293: 7236: 7183: 7152: 7060: 6990: 6946: 6897: 6857: 6808: 6662: 6543: 6451: 6369: 6334: 6285: 6200: 6149: 5992: 5943: 5845: 5796: 5760: 5693: 5644: 5609: 5521: 5360: 5200: 5136: 5061: 5015: 4977: 4928: 4879: 4825: 4777: 4741: 4642: 4586: 4535: 4486: 4437: 4348: 4310: 4253: 4215: 4163: 4111: 4027: 4009: 3969: 3851: 3781: 3742: 3627: 3584: 3549: 3530: 3498: 3438: 3395: 3359: 3315: 3266: 3225: 3176: 3079: 3021: 2822: 2682: 2629: 2611: 2565: 2497: 2452: 2353: 2317: 2261: 2195: 1781: 1774: 1399: 811: 453: 15154: 8637: 8635: 8629:. Click on "Rising Rates" tab for a graph. See data table below the graph. 7866:"A review of Alcoholics Anonymous/ Narcotics Anonymous programs for teens" 7372: 6535: 6181: 5512: 5495: 3724: 2986:(5th ed.). American Psychiatric Association. 2013. pp. 547–549. 2674: 2434: 2215:. Substance Abuse and Mental Health Services Administration. October 2014. 1644:

placed trans-cranially at the base of the skull on each side of the head.

15354: 15137: 14891: 14841: 13905: 13882: 13796: 13722: 13689: 13669: 13547: 13532: 13527: 13517: 13507: 13427: 13397: 13392: 13237: 13209: 13204: 13174: 13159: 13149: 13129: 13124: 13084: 13049: 13039: 12994: 12974: 12959: 12954: 12924: 12869: 12864: 12859: 12804: 12779: 12764: 12739: 12729: 12719: 12714: 12628: 12623: 12618: 12603: 12543: 12538: 12513: 12372: 12362: 12342: 12302: 12297: 12272: 12257: 12222: 12217: 12117: 12092: 11986: 11981: 11971: 11961: 11951: 11886: 11816: 11773: 11617: 11547: 11517: 11502: 11487: 11460: 11425: 11410: 11395: 11380: 11345: 11335: 11305: 11290: 11265: 11230: 11225: 11215: 11205: 11165: 11160: 11120: 11110: 11045: 11030: 11005: 10965: 10950: 10940: 10731: 10682: 9786:

Neighbors CJ, Choi S, Healy S, Yerneni R, Sun T, Shapoval L (June 2019).

9195:"Use of Telemedicine While Providing Medication Assisted Treatment (MAT)" 9161: 8662:

Health, United States, 2016: With Chartbook on Long-term Trends in Health

8168:"The psychedelic ibogaine can treat addiction. The race is on to cash in" 7482: 7208: 6466:"Medications for Opioid Use Disorder – Treatment Improvement Protocol 63" 5725:

Amato L, Davoli M, Minozzi S, Ferroni E, Ali R, Ferri M (February 2013).

5590: 1378: 631: 537: 532: 514:. 2 mg (white powder to the right) is a lethal dose in most people. 488: 476: 470: 464: 376:

Continued use of opioids leading to social and interpersonal consequences

301: 262: 108: 43:

Opioid addiction, problematic opioid use, opioid abuse, opioid dependence

9879: 8836: 8834: 3757: 3465:"Opioid cessation and chronic pain: perspectives of former opioid users" 2546: 1721:

from all causes rose from 47.5 million in 1990 to 55.8 million in 2013.

1262:

For more specific mitigation strategies regarding opioid overdoses, see

15068: 15002: 14941: 14929: 14886: 14690: 14530: 14367: 14000: 13970: 13945: 13826: 13737: 13717: 13694: 13537: 13512: 13502: 13457: 13447: 13432: 13347: 13241: 13169: 13164: 13139: 13109: 13099: 13074: 13059: 13034: 13004: 12979: 12969: 12929: 12909: 12899: 12879: 12809: 12794: 12613: 12593: 12588: 12563: 12493: 12432: 12412: 12367: 12357: 12352: 12292: 12282: 12212: 12127: 11976: 11966: 11956: 11946: 11911: 11901: 11866: 11836: 11826: 11821: 11758: 11602: 11577: 11572: 11567: 11557: 11542: 11512: 11430: 11420: 11415: 11365: 11320: 11300: 11270: 11220: 11200: 11155: 11080: 10970: 10960: 10818: 10375: 10329: 9521:

Jones CM, Shoff C, Blanco C, Losby JL, Ling SM, Compton WM (May 2023).

8632: 6824:"Management of relapse in naltrexone maintenance for heroin dependence" 6601: 4658: 4656: 3070: 3053: 1480: 1407: 1221: 1073: 1066: 522:

Signs and symptoms of opioid overdose include, but are not limited to:

445: 332: 194: 181: 152: 74: 9102: 8815: 8798: 8054: 7623: 7596: 7346: 7344: 7275: 7228: 3929: 3927: 2888:"Data Brief 294. Drug Overdose Deaths in the United States, 1999–2016" 2243: 2177: 1342:

Buprenorphine/naloxone, methadone, and naltrexone are approved by the

909:

is also a mechanism responsible for certain aspects of opioid-induced

15120: 15103: 15073: 15035: 14997: 14957: 14934: 14857: 14821: 14059: 14047: 14042: 13955: 13950: 13900: 13872: 13801: 13762: 13757: 13732: 13727: 13654: 13562: 13552: 13442: 13352: 13266: 13224: 13214: 13154: 13144: 13134: 13104: 13094: 13089: 13044: 13014: 12894: 12874: 12774: 12769: 12724: 12643: 12638: 12598: 12583: 12558: 12488: 12427: 12397: 12347: 12337: 12332: 12197: 12087: 12052: 12047: 11991: 11916: 11896: 11891: 11861: 11791: 11753: 11733: 11728: 11668: 11652: 11642: 11587: 11497: 11445: 11440: 11375: 11330: 11310: 11190: 11180: 11025: 10712: 8831: 8692: 8521:

GBD 2013 Mortality and Causes of Death Collaborators (January 2015).

7597:

Huibers MJ, Beurskens AJ, Bleijenberg G, van Schayck CP (July 2007).

7357:"Buprenorphine versus Methadone for Opioid Use Disorder in Pregnancy" 5572:

Morin KA, Vojtesek F, Acharya S, Dabous JR, Marsh DC (October 2021).

1922:. In 2003, Roxane Laboratories, Inc. discontinued Orlaam in the U.S. 1699: 1641: 1512: 1403: 1332: 1156: 1147: 1146:. In theory, all these functional changes would reduce the impact of 733: 636: 574: 401: 316: 297: 238: 190: 49: 8623:

Opioid Data Analysis and Resources. Drug Overdose. CDC Injury Center

7350: 6870: 6116:"Alpha₂-adrenergic agonists for the management of opioid withdrawal" 5727:"Methadone at tapered doses for the management of opioid withdrawal" 4666:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

4653: 4468: 4145: 3605: 2914: 1092:, response to naltrexone treatment, personality traits, and others. 90:

to opioids, failure to meet obligations, trouble with reducing use,

15130: 15115: 15055: 15008: 14968: 14963: 14831: 14826: 13960: 13752: 13497: 13407: 13387: 13377: 13332: 13261: 13054: 12964: 12949: 12914: 12904: 12784: 12608: 12503: 12478: 12417: 12402: 12312: 12232: 12202: 12182: 12152: 12097: 12077: 12042: 11931: 11856: 11841: 11763: 11743: 11612: 11607: 11592: 11562: 11532: 11492: 11360: 11250: 11195: 11105: 11040: 11010: 10895: 10785: 10626: 10621: 10520: 10502: 10349: 10208: 9723:. U.S. Food and Drug Administration. 20 August 2013. Archived from 7758: 7341: 3924: 3875:

Molecular Neuropharmacology: A Foundation for Clinical Neuroscience

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U.S. yearly opioid overdose deaths involving prescription opioids.

1703: 1625: 1588:

Contingency Management Therapy (CMT) employs similar principles as

1374: 1336: 1213: 1201: 955: 925: 875: 804: 782: 617: 515: 511: 437: 336: 285: 281: 258: 58: 14227: 8641: 5773: 5418: 4697: 3709:"Neurobiologic Advances from the Brain Disease Model of Addiction" 3462: 2984:

Diagnostic and statistical manual of mental disorders : DSM-5

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Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R (November 2022).

2419:"Neurobiologic Advances from the Brain Disease Model of Addiction" 2386:

Diagnostic and statistical manual of mental disorders : DSM-5

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Substance Abuse and Mental Health Services Administration (SAMHSA)

766: 14201: 13925: 13806: 13684: 13367: 13251: 13029: 13019: 12247: 12177: 12112: 12062: 11921: 11673: 11647: 11637: 11622: 11527: 11340: 11315: 11065: 10945: 10751: 10452: 9576:

International Journal of Environmental Research and Public Health

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Noble M, Tregear SJ, Treadwell JR, Schoelles K (February 2008).

3279: 2055: 1886: 1556:

programs. Community-based support such as support groups (e.g.,

1142:

levels, altered signal transduction, and increased affinity for

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Diagnostic and Statistical Manual of Mental Disorders (5th ed.)

1864:

Effects of COVID-19 on opioid overdose and telehealth treatment

1707: 1653: 1516: 1428: 1395: 1328: 1324: 951: 921: 758:

which plays major role in addiction that is affected by opioids

526: 458: 364:

The individual is unable to decrease the number of opioids used

277: 230: 8395: 7992:

Donovan DM, Ingalsbe MH, Benbow J, Daley DC (26 August 2013).

6491:"What is Buprenorphine? | UAMS Psychiatric Research Institute" 4941: 4175: 4173: 3372: 3331: 3143:"Pharmacological therapies for management of opium withdrawal" 1678:

The variety of treatment modalities available for OUD—such as

1159:

patterns more specifically associated with opioid dependence.

14299: 14294: 14284: 14279: 14274: 14268: 14261: 14254: 14222: 14207: 13940: 13542: 13437: 13179: 12934: 12799: 12172: 12122: 12082: 11846: 11537: 11481: 11390: 11075: 11070: 8765: 6967: 6913:"Heroin maintenance for chronic heroin-dependent individuals" 6890:

Heroin Maintenance for Persons with Chronic Heroin Dependence

3936:"Neuronal Reward and Decision Signals: From Theories to Data" 612: 564: 10881: 9965: 9860:

Heroin information from the National Institute on Drug Abuse

9569: 7779: 4402:

Mistry CJ, Bawor M, Desai D, Marsh DC, Samaan Z (May 2014).

1671:

use disorder treatment may struggle to find affordable care.

1515:

and other medication options may be treated with injectable

1155:

with the 118A>G variant and thus contribute to different

777:

and amplifying compulsive drug-seeking behavior. Like other

382:

Using opioids despite being in physically dangerous settings

14217: 14212: 12944: 9142: 9057: 8337: 6299:

Bonhomme J, Shim RS, Gooden R, Tyus D, Rust G (July 2012).

5657: 4182:"Natural rewards, neuroplasticity, and non-drug addictions" 4170: 1441: 1139: 789: 373:

Difficulty fulfilling professional duties at work or school

9830: 9570:

Moran KM, Mullachery PH, Lankenau S, Bilal U (July 2022).

9273:"Hochul signs legislation package to combat opioid crisis" 7991: 7514: 7037: 6888:

Dalsbø TK, Steiro AK, Hammerstrøm KT, Smedslund G (2010).

6558:"Subutex and Suboxone Approved to Treat Opiate Dependence" 5658:

Horon IL, Singal P, Fowler DR, Sharfstein JM (June 2018).

5571: 4803: 4368: 4366: 3562: 2786: 2281: 1346:

for medication-assisted treatment (MAT). In the U.S., the

311:

People with an opioid use disorder are often treated with

14242: 9785: 9634: 9409: 9223:

Nunes EV, Levin FR, Reilly MP, El-Bassel N (March 2021).

9222: 9099:

Substance Abuse and Mental Health Services Administration

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Substance Abuse and Mental Health Services Administration

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Child and Adolescent Psychiatric Clinics of North America

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Hoffman KA, Terashima JP, McCarty D (25 November 2019).

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The stigma surrounding addiction can heavily influence

1224:, which is used in the management of opioid addiction. 8454: 8130: 6416:

Yokell MA, Zaller ND, Green TC, Rich JD (March 2011).

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The Journal of Bone and Joint Surgery. American Volume

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Sharma B, Bruner A, Barnett G, Fishman M (July 2016).

2159: 15387: 9520: 9065:"Facts & Faces of Opioid Addiction: New Insights" 7599:"Psychosocial interventions by general practitioners" 7355:, Jones HE, Connery HS, et al. (December 2022). 6415: 6113: 6018:"MAT Medications, Counseling, and Related Conditions" 5324: 5156: 4893:

Hall FS, Drgonova J, Jain S, Uhl GR (December 2013).

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Community reinforcement approach and family training

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Donovan DM, Ingalsbe MH, Benbow J, Daley DC (2013).

803:

The differences in the genetic regions encoding the

9368:"Treatment of overdose in the synthetic opioid era" 7956:

Journal of Health and Human Services Administration

7825:"Relapse Prevention and the Five Rules of Recovery" 7566:

Cognitive behavior therapy : basics and beyond

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U.S. yearly opioid overdose deaths involving heroin

1574: 1100:gene, which encodes the μ-opioid receptor, and the 14878: 9622:"Prescribing controlled substances via telehealth" 7257: 7159: 6910: 6458: 5714:. U.S. Food and Drug Administration. 2 March 2021. 5157:McCarty D, Priest KC, Korthuis PT (1 April 2018). 4227: 4225: 3861: 3706: 2416: 331:, and other peer support programs. The medication 9792:Substance Abuse Treatment, Prevention, and Policy 8921: 8919: 8678: 7711: 6744: 6742: 6163:Michels II, Stöver H, Gerlach R (February 2007). 6114:Gowing L, Farrell M, Ali R, White JM (May 2016). 6079: 5889: 5887: 5885: 5883: 5881: 5879: 5877: 5875: 5873: 5809: 5489: 5487: 5485: 3811: 3809: 3807: 3805: 3803: 3801: 3799: 3113: 2757: 2755: 2118:"Opioid Use and Opioid Use Disorder in Pregnancy" 1583: 245:are important components of opioid use disorder. 15411: 14003:(met-enkephalin releaser/degradation stabilizer) 10503:Acute intoxication from hallucinogens (bad trip) 9405: 9403: 9345: 9343: 9341: 9339: 9016: 9014: 8792: 8790: 8712: 8710: 8595: 8593: 8126: 8124: 7987: 7985: 7658: 7656: 7654: 7652: 7459: 7457: 7455: 7453: 7451: 7449: 6584:"Sublocade (buprenorphine) FDA Approval History" 6517: 6515: 6513: 6511: 5860:"Opioid substitution therapy or treatment (OST)" 5325:McCarty D, Priest KC, Korthuis PT (April 2018). 4499: 3991: 3707:Volkow ND, Koob GF, McLellan AT (January 2016). 3453: 2417:Volkow ND, Koob GF, McLellan AT (January 2016). 2412: 2410: 2408: 2406: 1614: 8618: 8616: 8614: 6911:Ferri M, Davoli M, Perucci CA (December 2011). 6864: 5262: 5260: 5035: 5033: 4989: 4987: 4847: 4845: 4843: 4799: 4797: 4795: 4602: 4600: 4598: 4596: 4450: 4397: 4395: 4222: 3005: 3003: 2965:Harrison's Principles of Internal Medicine, 19e 2589: 2587: 2585: 2583: 2581: 2579: 2577: 2575: 2348:. 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Department of Neuroscience. Archived from 3232: 3183: 3000: 2697: 2572: 2155: 2153: 2151: 2149: 2147: 2145: 2143: 2141: 2139: 1988: 1986: 1354:(OTPs), where methadone can be dispensed at 1162: 550:. People may be unresponsive or unconscious. 15184: 10508:Hallucinogen persisting perception disorder 9123: 8516: 8514: 8450: 8448: 7712:Vasilaki EI, Hosier SG, Cox WM (May 2006). 7603:The Cochrane Database of Systematic Reviews 7168:The Cochrane Database of Systematic Reviews 7123:The Cochrane Database of Systematic Reviews 6917:The Cochrane Database of Systematic Reviews 6783:"The Opioid Epidemic: Crisis and Solutions" 6305:Journal of the National Medical Association 6120:The Cochrane Database of Systematic Reviews 5816:The Cochrane Database of Systematic Reviews 5731:The Cochrane Database of Systematic Reviews 5268:"Naloxone for Treatment of Opioid Overdose" 4851: 4374:"Morphine addiction – Homo sapiens (human)" 4322: 4320: 3147:The Cochrane Database of Systematic Reviews 3109: 3009: 2954: 2863:"Disease of the Week – Opioid Use Disorder" 2728: 2726: 2268: 2207: 2205: 1410:can help treat the symptoms of withdrawal. 379:Decreased social or recreational activities 15177: 15163: 15094: 14988: 14948: 14848: 14791: 14777: 14035: 14021: 10852: 10838: 9958: 9944: 9865:Opioid Dependence Treatment and Guidelines 9742: 8961:"Opioid Addiction: 2016 Facts and Figures" 8627:Centers for Disease Control and Prevention 6524:American Journal of Health-System Pharmacy 5912:Journal of Neurosciences in Rural Practice 5562: 5466:. 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Commonly used drugs for ORT are 1218:emergency treatment of an overdose 1129:, and protein handling/modifying. 496: 25: 15436: 12820:Desmetramadol (desmethyltramadol) 12148:Desmetramadol (desmethyltramadol) 11101:Dextropropoxyphene (propoxyphene) 11086:Desmetramadol (desmethyltramadol) 10361:Caffeine-induced anxiety disorder 9853: 8992:"How Bad is the Opioid Epidemic?" 5664:American Journal of Public Health 5240:"Combat opioid abuse | Walgreens" 4420:10.2174/1573400510666140320000928 3762:The American Journal of Bioethics 3351:10.1016/j.jpainsymman.2007.03.015 2968:New York, NY: McGraw-Hill; 2014. 2600:MMWR. 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orders" 5318: 5292: 5232: 5207: 5150: 5094: 5068: 4899:Pharmacology & Therapeutics 4748: 4691: 4555:Frontiers in Human Neuroscience 4493: 4444: 4069: 4051: 3985: 3976: 3749: 3599: 3556: 3505: 3481:10.1097/j.pain.0000000000001493 3410: 3366: 3273: 3239:Webster LR, Webster RM (2005). 3134: 3045: 2945:Drug Enforcement Administration 2934: 2908: 2880: 2854: 2829: 2780: 2636: 2463: 2377: 1689: 1590:operant behavioral conditioning 1532: 1076:, including opioid dependence, 823:Opioid dependence can occur as 15200:Direct-to-consumer advertising 13120:Norbuprenorphine-3-glucuronide 10765:Sudden sniffing death syndrome 10420:Intravenous marijuana syndrome 10014:Post-acute-withdrawal syndrome 9124:DeVencentis P (24 July 2017). 8166:Sullivan K (24 January 2023). 7913:Galanter M (28 October 2016). 7794:10.1176/appi.ajp.2007.06111851 7615:10.1002/14651858.CD003494.pub2 7176:10.1002/14651858.CD009879.pub2 7135:10.1002/14651858.CD012254.pub2 6929:10.1002/14651858.CD003410.pub4 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use disorder (AUD)) 10274:Positional alcohol nystagmus 10239:Alcohol-related brain damage 9687:. 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US DEA ( 1881: 1728: 1713: 1599: 1548: 1495: 1301:Opioid replacement therapy 1289: 1119:transcriptional regulation 1086:methamphetamine dependence 792:-based projections to the 665:Increased body temperature 585: 538:Decreased body temperature 500: 339:is useful for treating an 313:opioid replacement therapy 235:Opioid withdrawal symptoms 163:Opioid replacement therapy 15346: 15315: 15263: 15192: 15085:Benzodiazepine dependence 15083: 14977: 14867: 14812: 14748: 14678: 14661:Supervised injection site 14604: 14591:Addiction recovery groups 14583: 14543:Heroin-assisted treatment 14521: 14503:Motivational interviewing 14466: 14445: 14432: 14357: 14326: 14317: 14186: 14113: 14067: 14058: 13911:Racecadotril (acetorphan) 13859: 13771: 13586: 13575: 13318:Buprenorphine/samidorphan 13275: 13230:Tricyclic antidepressants 12672: 12661: 12441: 12308:Mitragynine pseudoindoxyl 12015: 12004: 11661: 11351:Mitragynine pseudoindoxyl 10870: 10796: 10750: 10711: 10675:Benzodiazepine dependence 10659:Benzodiazepine withdrawal 10620: 10563: 10519: 10490: 10469:Prenatal cocaine exposure 10451: 10396: 10348: 10322: 10295: 10217: 10186: 10167: 10132:Gastrointestinal diseases 10130: 10106: 10099: 10090: 10056: 9976: 9873: 9805:10.1186/s13011-019-0215-4 8717:Ciccarone D (July 2021). 8259:10.1186/s12913-019-4751-4 6874:Chapter 4—Oral Naltrexone 5637:10.1001/archpsyc.58.5.503 5494:Schuckit MA (July 2016). 3774:10.1080/15265160601063969 3756:Hyman SE (January 2007). 3016:. StatPearls Publishing. 2300:10.1016/j.chc.2016.03.002 2099:"Substance Use Disorders" 1526:extended-release morphine 1421:World Health Organization 1352:opioid treatment programs 1323:), involves replacing an 1296:Heroin-assisted treatment 1163:Non-opioid receptor genes 943:Psychological dependence 901:is a common mechanism of 764:gene transcription factor 756:Mesocorticolimbic circuit 718:World Health Organization 671:Ptosis (drooping eyelids) 208: 200: 180: 158: 146: 139:Based on criteria in the 133: 123: 115: 98: 80: 64: 56: 47: 39: 34: 14344:Psychological dependence 14178:Digital media addictions 13896:Dexecadotril (retorphan) 13868:Enkephalinase inhibitors 13797:BTRX-246040 (LY-2940094) 13779:(Nphe)Nociceptin(1-13)NH 13695:Nociceptin (orphanin FQ) 10234:Alcoholic polyneuropathy 10198:Alcohol-related dementia 10116:Alcoholic cardiomyopathy 10069:Polysubstance dependence 10042:Psychological dependence 9492:10.1136/rapm-2022-103591 7882:10.1177/0163278709356186 7864:Sussman S (March 2010). 5676:10.2105/ajph.2018.304385 4568:10.3389/fnhum.2017.00169 2476:Anesthesia and Analgesia 1832:Non-methadone synthetics 1749:involved stimulant use. 1511:who do not benefit from 1094:Major and minor variants 903:psychological dependence 854:(BDNF) signaling in the 845:psychological dependence 829:psychological dependence 700: 518:is 19 mm (0.75 in) wide. 15186:Unnecessary health care 14646:Needle exchange program 14636:Managed alcohol program 14614:Category:Harm reduction 13594:(Arg14,Lys15)Nociceptin 12865:Dynorphin B (rimorphin) 11907:Nalorphine dinicotinate 10654:Benzodiazepine overdose 10286:Wernicke encephalopathy 10140:Alcoholic liver disease 10108:Cardiovascular diseases 9703:4 February 2017 at the 9366:Skolnick P (May 2022). 8216:School of Medicine News 5925:10.4103/0976-3147.91934 4724:10.1126/science.1168501 4329:Trends in Neurosciences 3934:Schultz W (July 2015). 2733:Hughes E (2 May 2018). 1502:Evidence of effects of 775:sensitizing drug reward 57:Molecular structure of 14666:Tobacco harm reduction 14486:Contingency management 14453:Alcohol detoxification 14166:Internet sex addiction 13210:Spiradoline (U-62,066) 13155:Pethidine (meperidine) 12348:Pethidine (meperidine) 12038:ADL-5747 (PF-04856881) 11684:4-Caffeoyl-1,5-quinide 11583:Tetrahydropapaveroline 11498:Pethidine (meperidine) 10740:Amphetamine dependence 10701:Barbiturate dependence 10532:Green Tobacco Sickness 10430:Amotivational syndrome 10310:Alcoholic lung disease 10250:Alcoholic hallucinosis 10229:Alcoholic hallucinosis 10177:Alcoholic ketoacidosis 10121:Alcohol flush reaction 9989:Substance intoxication 9589:10.3390/ijerph19159283 9318:"Overdose Death Rates" 9071:. 2015. Archived from 7718:Alcohol and Alcoholism 6169:Harm Reduction Journal 5425:Childs R (July 2015). 4010:10.1098/rstb.2008.0093 3531:10.1001/jama.2018.0899 2972:Accessed 9 March 2017. 2861:CDC (30 August 2022). 2612:10.15585/mmwr.rr7103a1 2284:"Opioid Use Disorders" 1973:"3 Patient Assessment" 1895: 1740: 1711: 1292:Opioid agonist therapy 1153:linkage disequilibrium 856:ventral tegmental area 794:ventral tegmental area 762:Overexpression of the 759: 578: 519: 491:(low body temperature) 425:Signs and symptoms of 410:substance use disorder 227:substance use disorder 148:Differential diagnosis 15296:Proton-pump inhibitor 15245:Quaternary prevention 15225:Unwarranted variation 14728:Motivational salience 14656:Stimulant maintenance 14641:Moderation Management 14553:Methadone maintenance 13901:Ecadotril (sinorphan) 13388:CERC-501 (LY-2456302) 13288:4',7-Dihydroxyflavone 12850:Dinalbuphine sebacate 12725:Alazocine (SKF-10047) 12449:4',7-Dihydroxyflavone 12408:Thiobromadol (C-8813) 12048:Alazocine (SKF-10047) 11694:4',7-Dihydroxyflavone 11674:2-(S)-N,N-(R)-Viminol 11146:Dinalbuphine sebacate 10435:Cannabis use disorder 10158:Auto-brewery syndrome 9685:Biological Psychology 9069:MAP Health Management 7731:10.1093/alcalc/agl016 7373:10.1056/NEJMoa2203318 7223:(7). Wiley: 824–839. 6564:(FDA). 8 October 2002 6182:10.1186/1477-7517-4-5 5513:10.1056/NEJMra1604339 4506:Biological Psychiatry 4045:"Opioid Use Disorder" 3940:Physiological Reviews 3725:10.1056/NEJMra1511480 2675:10.2106/JBJS.17.01239 2435:10.1056/NEJMra1511480 2342:"Opioid Use Disorder" 1994:"Commonly Used Terms" 1889: 1763:elder financial abuse 1738: 1697: 1549:Further information: 1209:Opioid-related deaths 1177:melanocortin receptor 754: 573: 510: 15420:Substance dependence 15316:Tools and situations 15264:Overused health care 15240:Prescription cascade 14651:Responsible drug use 14508:Motivational therapy 14173:Video game addiction 13758:Sunobinop (S-117957) 13493:N-Fluoropropyl-JDTic 12825:Diamorphine (heroin) 12158:Diamorphine (heroin) 11126:Diamorphine (heroin) 10926:Acetyldihydrocodeine 10906:7-Hydroxymitragynine 10901:7-Acetoxymitragynine 10691:Barbiturate overdose 10464:Cocaine intoxication 10204:Alcohol intoxication 10046:Substance dependence 9350:Overdose Death Rates 9162:10.7759/cureus.25477 9105:on 12 September 2016 8467:(10053): 1459–1544. 7483:10.2147/IJGM.S295461 6495:psychiatry.uams.edu/ 6221:. 16 November 2022. 5591:10.7759/cureus.19051 2921:www.ncbi.nlm.nih.gov 1648:Treatment challenges 1596:Twelve-step programs 1509:injecting drug users 946:Physical dependence 895:transcription factor 881:Upregulation of the 533:Decreased heart rate 473:(low blood pressure) 461:(pupil constriction) 408:are components of a 329:twelve-step programs 171:twelve-step programs 94:with discontinuation 15338:Withdrawal syndrome 15286:Opioid use disorder 14910:General anesthetics 14814:Nicotine dependence 14575:Twelve-step program 14458:Drug detoxification 14339:Physical dependence 13961:Ubenimex (bestatin) 13705:Nociceptin (1-13)NH 13313:β-Chlornaltrexamine 13283:4′-Hydroxyflavanone 12705:β-Chlornaltrexamine 12579:N-Benzylnaltrindole 12474:β-Chlornaltrexamine 12393:TAN-67 (SB-205,607) 12058:AR-M100390 (ARM390) 11719:β-Chlornaltrexamine 11689:4′-Hydroxyflavanone 10916:α-Chlornaltrexamine 10724:Stimulant psychosis 10609:Opioid use disorder 10553:Nicotine dependence 10543:Nicotine withdrawal 10386:Caffeine dependence 10146:Alcoholic hepatitis 10038:Physical dependence 10009:Neonatal withdrawal 9727:on 18 January 2017. 9696:EMEA 19 April 2001 9075:on 29 February 2020 8396:"One Pill Can Kill" 6977:(9291): 1417–1423. 6762:on 10 February 2017 6536:10.1093/ajhp/zxz105 4948:The Journal of Pain 4812:(9566): 1047–1053. 4716:2009Sci...324.1732V 4710:(5935): 1732–1734. 4679:on 26 November 2017 4004:(1507): 3137–3146. 3902:"Glossary of Terms" 2735:"The Pain Hustlers" 2547:10.7759/cureus.3733 1609:Narcotics Anonymous 1602:Twelve-step program 1558:Narcotics Anonymous 1228:Good Samaritan laws 918:physical dependence 911:physical dependence 887:signal transduction 841:physical dependence 837:withdrawal syndrome 825:physical dependence 647:High blood pressure 543:Decreased breathing 427:opioid intoxication 421:Opioid intoxication 219:Opioid use disorder 92:withdrawal syndrome 35:Opioid use disorder 15362:The Treatment Trap 15235:Overmedicalization 15220:Defensive medicine 15064:Opioid antagonists 14924:Opioid antagonists 14902:Hydrogen cyanamide 14869:Alcohol dependence 14733:Incentive salience 14721:Inhibitory control 14696:Category:Addiction 14686:Addiction medicine 14481:Relapse prevention 14418:Tanning dependence 13523:Norbinaltorphimine 12830:Diacetylnalorphine 12519:Diacetylnalorphine 12143:Desmethylclozapine 11797:Diacetylnalorphine 11477:Papaver somniferum 11061:Chloroxymorphamine 10538:Nicotine poisoning 10480:Cocaine dependence 10409:Cannabis arteritis 10269:Korsakoff syndrome 10169:Endocrine diseases 9624:. 16 October 2023. 9303:. 4 November 2021. 8575:has generic name ( 6075:. 10 January 2023. 5470:on 7 November 2017 3071:10.1111/jcpt.13114 1896: 1741: 1712: 1545:Behavioral therapy 1504:heroin maintenance 1498:Heroin maintenance 1416:drug-related crime 1358:. As of 2023, the 1082:alcohol dependence 1078:cocaine dependence 760: 579: 520: 416:Signs and symptoms 175:take home naloxone 167:behavioral therapy 71:Addiction medicine 15385: 15384: 15376:Overdosed America 15291:Psychoactive drug 15276:Antibiotic misuse 15250:Disease mongering 15152: 15151: 15031:Levacetylmethadol 14979:Opioid dependence 14897:Calcium carbimide 14766: 14765: 14716:Cognitive control 14674: 14673: 14558:Smoking cessation 14513:Physical exercise 14428: 14427: 14414:Non-drug stimuli 14313: 14312: 14157:Internet-related 14010: 14009: 13855: 13854: 13700:Nociceptin (1-11) 13571: 13570: 12700:14-Methoxymetopon 12657: 12656: 12574:Methylnaltrindole 12000: 11999: 11669:(3S,4S)-Picenadol 11281:Levacetylmethadol 10827: 10826: 10581:Opioid withdrawal 10344: 10343: 10318: 10317: 9933: 9932: 9721:FDA Safety Alerts 9416:JAMA Network Open 9324:. 20 January 2022 9289:. 7 October 2021. 9029:(13): 1660–1667. 8816:10.1111/add.16318 8809:(12): 2477–2485. 8533:(9963): 117–171. 8055:10.1111/ner.13108 7575:978-1-60918-504-6 7367:(22): 2033–2044. 7276:10.1111/add.13462 7270:(12): 2115–2128. 7229:10.1002/phar.1958 7204:on 13 March 2016. 7047:(12): 1752–1759. 6530:(15): 1097–1103. 5381:. 23 October 2017 5107:JAMA Network Open 4186:Neuropharmacology 4088:(12): 1238–1246. 3884:978-0-07-148127-4 3664:978-92-4-159115-7 3127:978-0-7817-7477-2 3013:Opioid Withdrawal 2993:978-0-89042-554-1 2669:(15): 1332–1340. 2396:978-0-89042-554-1 2244:10.1111/add.13326 2178:10.1136/bmj.j1550 2073:978-0-89042-555-8 1915:Levacetylmethadol 1771:COVID-19 pandemic 1356:methadone clinics 1307:), also known as 1133:118A>G variant 1049: 1048: 899:nucleus accumbens 786:neurotransmission 771:nucleus accumbens 588:Opioid withdrawal 479:(slowed movement) 467:(slow heart rate) 216: 215: 135:Diagnostic method 29:Medical condition 18:Opioid dependence 16:(Redirected from 15432: 15402: 15401: 15400: 15393: 15369:Selling Sickness 15179: 15172: 15165: 15156: 15155: 15126:Chlordiazepoxide 15100: 15096: 15046:Dihydroetorphine 14994: 14990: 14954: 14950: 14880: 14854: 14850: 14793: 14786: 14779: 14770: 14769: 14756: 14755: 14443: 14442: 14324: 14323: 14249:G9a-like protein 14065: 14064: 14037: 14030: 14023: 14014: 14013: 13890: 13817:Nociceptin (1-7) 13713:Norbuprenorphine 13650:Dihydroetorphine 13584: 13583: 13473:Methylnaltrexone 13383:Catechin gallate 13115:Norbuprenorphine 12840:Dihydroetorphine 12710:β-Funaltrexamine 12670: 12669: 12569:Methylnaltrexone 12509:Catechin gallate 12323:Norbuprenorphine 12163:Dihydroetorphine 12013: 12012: 11877:Methylnaltrexone 11769:Catechin gallate 11724:β-Funaltrexamine 11136:Dihydroetorphine 10879: 10878: 10854: 10847: 10840: 10831: 10830: 10771:Toluene toxicity 10255:Delirium tremens 10151:Zieve's syndrome 10104: 10103: 10097: 10096: 9960: 9953: 9946: 9937: 9936: 9871: 9870: 9848: 9839:(3): 1837–1853. 9827: 9817: 9807: 9782: 9764: 9729: 9728: 9713: 9707: 9694: 9688: 9683:James W. 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15381: 15342: 15328:Choosing Wisely 15311: 15259: 15215:Fee-for-service 15188: 15183: 15153: 15148: 15111:Benzodiazepines 15098: 15079: 14992: 14973: 14952: 14863: 14852: 14808: 14801:drug dependence 14797: 14767: 14762: 14744: 14740:Sober companion 14670: 14624:Reagent testing 14600: 14579: 14523: 14517: 14468: 14462: 14437: 14435: 14424: 14353: 14309: 14196:Transcriptional 14188: 14182: 14109: 14095:Methylphenidate 14090:Methamphetamine 14054: 14041: 14011: 14006: 13888: 13851: 13782: 13767: 13708: 13630: 13622: 13614: 13610: 13602: 13579: 13567: 13363:Binaltorphimine 13308:6β-Naltrexol-d4 13271: 12890:Ethylketazocine 12845:Dihydromorphine 12665: 12653: 12464:6β-Naltrexol-d4 12437: 12193:Ethylketazocine 12168:Dihydromorphine 12008: 11996: 11704:6β-Naltrexol-d4 11657: 11456:Oxymorphonazine 11211:Furanylfentanyl 11141:Dihydromorphine 10996:Benzhydrocodone 10885: 10883: 10874: 10866: 10861:Opioid receptor 10858: 10828: 10823: 10792: 10753: 10746: 10707: 10625: 10616: 10576:Opioid overdose 10559: 10515: 10486: 10447: 10392: 10340: 10314: 10291: 10220: 10213: 10190:system diseases 10189: 10182: 10163: 10126: 10086: 10058: 10052: 10029:Substance abuse 9972: 9964: 9934: 9929: 9928: 9882: 9856: 9851: 9738: 9736:Further reading 9733: 9732: 9715: 9714: 9710: 9705:Wayback Machine 9695: 9691: 9682: 9678: 9633: 9629: 9620: 9619: 9615: 9568: 9564: 9527:JAMA Psychiatry 9519: 9515: 9475: 9471: 9458: 9457: 9453: 9422:(7): e2322303. 9408: 9401: 9364: 9360: 9348: 9337: 9327: 9325: 9316: 9315: 9308: 9299: 9298: 9294: 9285: 9284: 9280: 9271: 9270: 9266: 9221: 9217: 9207: 9205: 9197: 9193: 9192: 9188: 9141: 9137: 9122: 9118: 9108: 9106: 9093: 9092: 9088: 9078: 9076: 9063: 9062: 9058: 9019: 9012: 9002: 9000: 8990: 8989: 8982: 8972: 8970: 8963: 8959: 8958: 8954: 8944: 8942: 8930: 8924: 8917: 8907: 8905: 8897: 8896: 8889: 8879: 8877: 8870: 8866: 8865: 8861: 8851: 8849: 8839: 8832: 8795: 8788: 8764: 8760: 8715: 8708: 8677: 8673: 8665: 8659: 8658: 8654: 8646: 8640: 8633: 8621: 8612: 8599: 8598: 8591: 8581: 8572: 8571: 8562: 8561: 8519: 8512: 8496: 8495: 8453: 8446: 8436: 8434: 8426: 8425: 8421: 8411: 8409: 8394: 8393: 8389: 8344:JAMA Psychiatry 8336: 8332: 8297:JAMA Psychiatry 8289: 8285: 8241: 8235: 8231: 8221: 8219: 8210: 8209: 8205: 8195: 8193: 8183: 8179: 8164: 8160: 8129: 8122: 8082: 8078: 8043:Neuromodulation 8039: 8035: 7990: 7983: 7952: 7948: 7911: 7907: 7862: 7858: 7821: 7817: 7778: 7774: 7764: 7762: 7752: 7751: 7747: 7710: 7706: 7661: 7650: 7609:(3): CD003494. 7595: 7591: 7576: 7562: 7558: 7513: 7509: 7462: 7447: 7402: 7398: 7349: 7342: 7305: 7301: 7256: 7252: 7217:Pharmacotherapy 7213: 7209: 7196: 7195: 7191: 7170:(6): CD009879. 7164: 7160: 7129:(2): CD012254. 7115: 7111: 7101: 7099: 7097:online.lexi.com 7091: 7090: 7086: 7073: 7072: 7068: 7036: 7032: 7022: 7020: 7011: 7010: 7006: 6966: 6962: 6909: 6905: 6886: 6882: 6869: 6865: 6820: 6816: 6779: 6775: 6765: 6763: 6759: 6752: 6748: 6747: 6740: 6730: 6728: 6720: 6719: 6715: 6707: 6703: 6702: 6698: 6689: 6688: 6684: 6675: 6674: 6670: 6623: 6619: 6611: 6607: 6606: 6602: 6592: 6590: 6582: 6581: 6577: 6567: 6565: 6556: 6555: 6551: 6520: 6509: 6499: 6497: 6489: 6488: 6484: 6474: 6472: 6464: 6463: 6459: 6414: 6410: 6400: 6398: 6392:"Buprenorphine" 6390: 6389: 6385: 6346: 6342: 6297: 6293: 6246: 6242: 6213: 6212: 6208: 6161: 6157: 6126:(5): CD002024. 6112: 6108: 6098: 6096: 6088: 6087: 6080: 6071: 6070: 6061: 6051: 6049: 6041: 6040: 6036: 6026: 6024: 6016: 6015: 6011: 6004: 6000: 5955: 5951: 5904: 5900: 5892: 5871: 5858: 5857: 5853: 5822:(9): CD011117. 5808: 5804: 5772: 5768: 5737:(2): CD003409. 5723: 5719: 5706: 5705: 5701: 5656: 5652: 5621: 5617: 5570: 5563: 5553: 5551: 5543: 5542: 5538: 5533: 5529: 5492: 5483: 5473: 5471: 5458: 5457: 5453: 5443: 5441: 5429: 5423: 5419: 5409: 5407: 5399: 5398: 5394: 5384: 5382: 5373: 5372: 5368: 5323: 5319: 5309: 5307: 5298: 5297: 5293: 5283: 5281: 5270: 5266: 5265: 5258: 5248: 5246: 5238: 5237: 5233: 5223: 5221: 5213: 5212: 5208: 5155: 5151: 5141: 5139: 5113:(2): e1920622. 5099: 5095: 5085: 5083: 5074: 5073: 5069: 5038: 5031: 4992: 4985: 4940: 4936: 4891: 4887: 4850: 4841: 4802: 4793: 4753: 4749: 4696: 4692: 4682: 4680: 4676: 4669: 4662: 4661: 4654: 4605: 4594: 4547: 4543: 4498: 4494: 4469:10.1038/nrn3119 4463:(11): 652–669. 4449: 4445: 4400: 4393: 4383: 4381: 4372: 4371: 4364: 4335:(11): 681–690. 4325: 4318: 4273: 4269: 4230: 4223: 4178: 4171: 4146:10.1038/nrn3111 4140:(11): 623–637. 4126: 4119: 4074: 4070: 4065:. 11 June 2021. 4057: 4056: 4052: 4043: 4042: 4035: 3990: 3986: 3981: 3977: 3932: 3925: 3915: 3913: 3900: 3899: 3892: 3885: 3871: 3862: 3814: 3797: 3754: 3750: 3705: 3701: 3691: 3689: 3688:on 14 June 2010 3680: 3679: 3672: 3665: 3654: 3648: 3647: 3643: 3604: 3600: 3561: 3557: 3510: 3506: 3461: 3454: 3415: 3411: 3371: 3367: 3330: 3323: 3278: 3274: 3237: 3233: 3188: 3184: 3153:(6): CD007522. 3139: 3135: 3128: 3112: 3087: 3050: 3046: 3036: 3034: 3028: 3008: 3001: 2994: 2982: 2981: 2977: 2962: 2955: 2939: 2935: 2925: 2923: 2913: 2909: 2899: 2897: 2890: 2886: 2885: 2881: 2871: 2869: 2859: 2855: 2845: 2843: 2835: 2834: 2830: 2785: 2781: 2771: 2769: 2761: 2760: 2753: 2743: 2741: 2731: 2724: 2714: 2712: 2703: 2702: 2698: 2658: 2654: 2646: 2642: 2641: 2637: 2592: 2573: 2526: 2513: 2468: 2464: 2415: 2404: 2397: 2383: 2382: 2378: 2368: 2366: 2360: 2338: 2325: 2280: 2269: 2224: 2220: 2211: 2210: 2203: 2158: 2137: 2127: 2125: 2116: 2115: 2106: 2095: 2080: 2074: 2054: 2013: 2003: 2001: 1992: 1991: 1984: 1971: 1970: 1966: 1956: 1954: 1941: 1940: 1933: 1928: 1884: 1866: 1859: 1856: 1847: 1844: 1835: 1828: 1819: 1816: 1807: 1804: 1733: 1727: 1718: 1716:Opioid epidemic 1692: 1650: 1617: 1604: 1598: 1586: 1577: 1566: 1553: 1547: 1535: 1500: 1494: 1478: 1461: 1444: 1436:cross-tolerance 1367:drug withdrawal 1298: 1288: 1272: 1241: 1211: 1190: 1181:cytochrome P450 1165: 1135: 1054: 1013:Benzodiazepines 907:locus coeruleus 893:(CREB), a gene 833:Drug dependence 821: 796:(VTA) from the 779:addictive drugs 731: 726: 707:self-medication 703: 695: 644:Fast heart rate 590: 584: 554:Pulmonary edema 505: 503:Opioid overdose 499: 497:Opioid overdose 494: 446:Desire to sleep 423: 418: 350: 341:opioid overdose 251:opioid overdose 105:Opioid overdose 30: 23: 22: 15: 12: 11: 5: 15438: 15428: 15427: 15422: 15407: 15406: 15383: 15382: 15380: 15379: 15372: 15365: 15358: 15350: 15348: 15344: 15343: 15341: 15340: 15335: 15330: 15325: 15319: 15317: 15313: 15312: 15310: 15309: 15303: 15298: 15293: 15288: 15283: 15278: 15273: 15267: 15265: 15261: 15260: 15258: 15257: 15252: 15247: 15242: 15237: 15232: 15230:Overmedication 15227: 15222: 15217: 15212: 15207: 15202: 15196: 15194: 15190: 15189: 15182: 15181: 15174: 15167: 15159: 15150: 15149: 15147: 15146: 15134: 15128: 15123: 15118: 15107: 15089: 15087: 15081: 15080: 15078: 15077: 15071: 15060: 15059: 15058: 15053: 15048: 15043: 15041:Dihydrocodeine 15038: 15033: 15028: 15011: 15006: 15000: 14983: 14981: 14975: 14974: 14972: 14971: 14966: 14961: 14944: 14939: 14938: 14937: 14932: 14920: 14919: 14918: 14906: 14905: 14904: 14899: 14894: 14889: 14873: 14871: 14865: 14864: 14862: 14861: 14844: 14839: 14834: 14829: 14824: 14818: 14816: 14810: 14809: 14796: 14795: 14788: 14781: 14773: 14764: 14763: 14761: 14760: 14749: 14746: 14745: 14743: 14742: 14737: 14736: 14735: 14725: 14724: 14723: 14713: 14708: 14703: 14698: 14693: 14688: 14682: 14680: 14676: 14675: 14672: 14671: 14669: 14668: 14663: 14658: 14653: 14648: 14643: 14638: 14633: 14628: 14627: 14626: 14616: 14610: 14608: 14606:Harm reduction 14602: 14601: 14599: 14598: 14593: 14587: 14585: 14584:Support groups 14581: 14580: 14578: 14577: 14572: 14571: 14570: 14565: 14555: 14550: 14545: 14540: 14539: 14538: 14527: 14525: 14519: 14518: 14516: 14515: 14510: 14505: 14500: 14495: 14490: 14489: 14488: 14483: 14472: 14470: 14464: 14463: 14461: 14460: 14455: 14449: 14447: 14446:Detoxification 14440: 14430: 14429: 14426: 14425: 14423: 14422: 14421: 14420: 14412: 14411: 14410: 14405: 14400: 14395: 14390: 14385: 14383:Benzodiazepine 14380: 14375: 14370: 14361: 14359: 14355: 14354: 14352: 14351: 14346: 14341: 14336: 14330: 14328: 14321: 14315: 14314: 14311: 14310: 14308: 14307: 14306: 14305: 14302: 14297: 14292: 14287: 14282: 14277: 14272: 14265: 14258: 14251: 14246: 14233: 14232: 14231: 14230: 14225: 14220: 14215: 14210: 14205: 14192: 14190: 14184: 14183: 14181: 14180: 14175: 14170: 14169: 14168: 14163: 14155: 14154: 14153: 14148: 14140: 14138:Palatable food 14135: 14134: 14133: 14128: 14119: 14117: 14111: 14110: 14108: 14107: 14102: 14097: 14092: 14087: 14082: 14077: 14071: 14069: 14062: 14056: 14055: 14040: 14039: 14032: 14025: 14017: 14008: 14007: 14005: 14004: 13994: 13993: 13988: 13983: 13978: 13973: 13964: 13963: 13958: 13953: 13948: 13943: 13938: 13933: 13928: 13923: 13918: 13913: 13908: 13903: 13898: 13893: 13891:-Phenylalanine 13885: 13880: 13875: 13863: 13861: 13857: 13856: 13853: 13852: 13850: 13849: 13844: 13839: 13834: 13829: 13824: 13819: 13814: 13809: 13804: 13799: 13794: 13789: 13784: 13780: 13775: 13773: 13769: 13768: 13766: 13765: 13760: 13755: 13750: 13745: 13740: 13735: 13730: 13725: 13720: 13718:Racemethorphan 13715: 13710: 13706: 13702: 13697: 13692: 13687: 13682: 13677: 13672: 13667: 13665:Levomethorphan 13662: 13657: 13652: 13647: 13642: 13637: 13632: 13628: 13624: 13620: 13616: 13612: 13608: 13604: 13600: 13596: 13590: 13588: 13581: 13573: 13572: 13569: 13568: 13566: 13565: 13560: 13555: 13550: 13545: 13540: 13535: 13530: 13525: 13520: 13515: 13510: 13505: 13500: 13495: 13490: 13485: 13480: 13475: 13470: 13465: 13460: 13455: 13450: 13445: 13440: 13435: 13430: 13425: 13420: 13415: 13410: 13405: 13400: 13395: 13390: 13385: 13380: 13375: 13370: 13365: 13360: 13355: 13350: 13345: 13340: 13335: 13330: 13325: 13320: 13315: 13310: 13305: 13300: 13295: 13290: 13285: 13279: 13277: 13273: 13272: 13270: 13269: 13264: 13259: 13254: 13249: 13227: 13222: 13217: 13212: 13207: 13202: 13197: 13192: 13182: 13177: 13172: 13170:Racemethorphan 13167: 13162: 13157: 13152: 13147: 13142: 13137: 13132: 13127: 13122: 13117: 13112: 13107: 13102: 13097: 13092: 13087: 13082: 13077: 13072: 13067: 13062: 13057: 13052: 13047: 13042: 13037: 13032: 13027: 13022: 13017: 13012: 13007: 13002: 12997: 12992: 12990:Levomethorphan 12987: 12982: 12977: 12972: 12967: 12962: 12957: 12952: 12947: 12942: 12937: 12932: 12927: 12922: 12917: 12912: 12907: 12902: 12897: 12892: 12887: 12882: 12877: 12872: 12867: 12862: 12857: 12852: 12847: 12842: 12837: 12832: 12827: 12822: 12817: 12812: 12807: 12802: 12797: 12792: 12787: 12782: 12777: 12772: 12767: 12762: 12757: 12752: 12747: 12742: 12737: 12732: 12727: 12722: 12717: 12712: 12707: 12702: 12697: 12692: 12687: 12682: 12676: 12674: 12667: 12659: 12658: 12655: 12654: 12652: 12651: 12646: 12641: 12636: 12631: 12626: 12621: 12616: 12611: 12606: 12601: 12596: 12591: 12586: 12581: 12576: 12571: 12566: 12561: 12556: 12551: 12546: 12541: 12536: 12531: 12526: 12521: 12516: 12511: 12506: 12501: 12496: 12491: 12486: 12481: 12476: 12471: 12466: 12461: 12456: 12451: 12445: 12443: 12439: 12438: 12436: 12435: 12430: 12425: 12420: 12415: 12410: 12405: 12400: 12395: 12390: 12385: 12380: 12375: 12370: 12365: 12360: 12358:Racemethorphan 12355: 12350: 12345: 12340: 12335: 12330: 12325: 12320: 12315: 12310: 12305: 12300: 12295: 12290: 12285: 12280: 12275: 12270: 12268:Levomethorphan 12265: 12263:Leu-enkephalin 12260: 12255: 12250: 12245: 12240: 12235: 12230: 12225: 12220: 12215: 12210: 12205: 12200: 12195: 12190: 12185: 12180: 12175: 12170: 12165: 12160: 12155: 12150: 12145: 12140: 12135: 12130: 12125: 12120: 12115: 12110: 12105: 12100: 12095: 12090: 12085: 12080: 12075: 12070: 12065: 12060: 12055: 12050: 12045: 12040: 12035: 12030: 12025: 12019: 12017: 12010: 12002: 12001: 11998: 11997: 11995: 11994: 11989: 11984: 11979: 11974: 11969: 11964: 11959: 11954: 11949: 11944: 11942:Naltrexonazine 11939: 11934: 11929: 11924: 11919: 11914: 11909: 11904: 11899: 11894: 11889: 11884: 11879: 11874: 11869: 11864: 11859: 11854: 11849: 11844: 11839: 11834: 11829: 11824: 11819: 11814: 11809: 11804: 11799: 11794: 11789: 11784: 11779: 11776: 11771: 11766: 11761: 11756: 11751: 11746: 11741: 11736: 11731: 11726: 11721: 11716: 11711: 11706: 11701: 11696: 11691: 11686: 11681: 11676: 11671: 11665: 11663: 11659: 11658: 11656: 11655: 11650: 11645: 11640: 11635: 11630: 11625: 11620: 11615: 11610: 11605: 11600: 11595: 11590: 11585: 11580: 11575: 11570: 11565: 11560: 11555: 11550: 11545: 11543:Racemethorphan 11540: 11535: 11530: 11525: 11520: 11515: 11510: 11505: 11500: 11495: 11490: 11485: 11473: 11468: 11463: 11458: 11453: 11448: 11443: 11438: 11433: 11428: 11423: 11418: 11413: 11408: 11403: 11398: 11393: 11388: 11383: 11378: 11373: 11368: 11363: 11358: 11353: 11348: 11343: 11338: 11333: 11328: 11323: 11318: 11313: 11308: 11303: 11298: 11293: 11288: 11286:Levomethorphan 11283: 11278: 11276:Leu-enkephalin 11273: 11268: 11263: 11258: 11253: 11248: 11243: 11238: 11236:Hydromorphinol 11233: 11228: 11223: 11218: 11213: 11208: 11203: 11198: 11193: 11188: 11183: 11178: 11173: 11168: 11163: 11158: 11153: 11148: 11143: 11138: 11133: 11131:Dihydrocodeine 11128: 11123: 11118: 11113: 11108: 11103: 11098: 11096:Dextromoramide 11093: 11088: 11083: 11078: 11073: 11068: 11063: 11058: 11053: 11048: 11043: 11038: 11033: 11028: 11023: 11018: 11013: 11008: 11003: 11001:Benzylmorphine 10998: 10993: 10988: 10983: 10978: 10973: 10968: 10963: 10958: 10953: 10948: 10943: 10938: 10933: 10931:Acetylfentanyl 10928: 10923: 10918: 10913: 10908: 10903: 10898: 10892: 10890: 10876: 10868: 10867: 10857: 10856: 10849: 10842: 10834: 10825: 10824: 10822: 10821: 10816: 10815: 10814: 10800: 10798: 10794: 10793: 10791: 10790: 10789: 10788: 10786:Inhalant abuse 10783: 10775: 10774: 10773: 10768: 10758: 10756: 10748: 10747: 10745: 10744: 10743: 10742: 10728: 10727: 10726: 10717: 10715: 10709: 10708: 10706: 10705: 10704: 10703: 10695: 10694: 10693: 10679: 10678: 10677: 10672: 10663: 10662: 10661: 10656: 10646:benzodiazepine 10642: 10641: 10640: 10631: 10629: 10618: 10617: 10615: 10614: 10613: 10612: 10603: 10602: 10601: 10595: 10589: 10583: 10578: 10569: 10567: 10561: 10560: 10558: 10557: 10556: 10555: 10547: 10546: 10545: 10540: 10535: 10525: 10523: 10517: 10516: 10514: 10513: 10512: 10511: 10505: 10496: 10494: 10488: 10487: 10485: 10484: 10483: 10482: 10474: 10473: 10472: 10466: 10457: 10455: 10449: 10448: 10446: 10445: 10444: 10443: 10438: 10432: 10424: 10423: 10422: 10417: 10411: 10402: 10400: 10394: 10393: 10391: 10390: 10389: 10388: 10380: 10379: 10378: 10373: 10368: 10363: 10354: 10352: 10346: 10345: 10342: 10341: 10339: 10338: 10336:Binge drinking 10333: 10326: 10324: 10320: 10319: 10316: 10315: 10313: 10312: 10307: 10301: 10299: 10293: 10292: 10290: 10289: 10283: 10277: 10271: 10266: 10260: 10259: 10258: 10252: 10241: 10236: 10231: 10225: 10223: 10215: 10214: 10212: 10211: 10206: 10201: 10194: 10192: 10184: 10183: 10181: 10180: 10173: 10171: 10165: 10164: 10162: 10161: 10155: 10154: 10153: 10148: 10136: 10134: 10128: 10127: 10125: 10124: 10118: 10112: 10110: 10101: 10094: 10088: 10087: 10085: 10084: 10083: 10082: 10073: 10072: 10071: 10062: 10060: 10054: 10053: 10051: 10050: 10049: 10048: 10035: 10021: 10020: 10019: 10018: 10017: 10011: 10000: 9995: 9980: 9978: 9974: 9973: 9963: 9962: 9955: 9948: 9940: 9931: 9930: 9927: 9926: 9915: 9900: 9883: 9878: 9877: 9875: 9874:Classification 9868: 9867: 9862: 9855: 9854:External links 9852: 9850: 9849: 9828: 9783: 9739: 9737: 9734: 9731: 9730: 9708: 9689: 9676: 9627: 9613: 9562: 9533:(5): 508–514. 9513: 9469: 9466:. August 2022. 9451: 9399: 9358: 9335: 9306: 9292: 9278: 9264: 9215: 9186: 9135: 9116: 9086: 9056: 9010: 8980: 8952: 8915: 8887: 8859: 8830: 8786: 8769:Pain Physician 8758: 8729:(4): 344–350. 8706: 8687:(6): 688–705. 8671: 8652: 8631: 8610: 8589: 8573:|author1= 8510: 8444: 8419: 8387: 8330: 8303:(4): 359–360. 8283: 8229: 8218:. 8 March 2019 8203: 8177: 8158: 8120: 8093:(2): 186–199. 8076: 8049:(3): 301–311. 8033: 7981: 7962:(1): 142–160. 7946: 7925:(2): 151–159. 7905: 7856: 7835:(3): 325–332. 7815: 7788:(2): 179–187. 7772: 7745: 7724:(3): 328–335. 7704: 7648: 7589: 7574: 7556: 7507: 7445: 7396: 7340: 7299: 7250: 7207: 7189: 7158: 7109: 7084: 7066: 7030: 7004: 6960: 6903: 6880: 6863: 6814: 6793:(1): 143–159. 6773: 6738: 6713: 6696: 6682: 6668: 6617: 6600: 6575: 6549: 6507: 6482: 6457: 6408: 6396:www.samhsa.gov 6383: 6356:(5): 577–607. 6340: 6291: 6240: 6206: 6155: 6106: 6094:www.samhsa.gov 6078: 6059: 6047:www.samhsa.gov 6034: 6022:www.samhsa.gov 6009: 5998: 5969:(4): 283–306. 5949: 5898: 5869: 5851: 5802: 5766: 5717: 5699: 5670:(6): 777–781. 5650: 5631:(5): 503–508. 5615: 5584:(10): e19051. 5561: 5536: 5527: 5506:(4): 357–368. 5481: 5451: 5417: 5392: 5366: 5337:(1): 525–541. 5317: 5291: 5256: 5231: 5206: 5169:(1): 525–541. 5149: 5093: 5067: 5029: 4983: 4954:(2): 103–113. 4934: 4905:(3): 267–279. 4885: 4864:(2): 111–118. 4839: 4791: 4747: 4690: 4652: 4613:Brain Research 4592: 4541: 4512:(3): 256–262. 4492: 4443: 4414:(2): 156–167. 4391: 4362: 4316: 4267: 4240:(6): 428–437. 4221: 4169: 4117: 4068: 4050: 4033: 3984: 3975: 3946:(3): 853–951. 3923: 3912:on 10 May 2019 3890: 3883: 3860: 3828:(4): 431–443. 3795: 3748: 3719:(4): 363–371. 3699: 3670: 3663: 3641: 3614:(7): 556–563. 3598: 3555: 3524:(9): 872–882. 3504: 3452: 3425:(3): 372–380. 3409: 3382:(2): 116–127. 3365: 3344:(2): 214–228. 3321: 3272: 3251:(6): 432–442. 3231: 3202:(2–3): 92–99. 3182: 3133: 3126: 3085: 3064:(5): 892–903. 3044: 2999: 2992: 2975: 2953: 2933: 2907: 2879: 2853: 2828: 2779: 2767:www.samhsa.gov 2751: 2739:New York Times 2722: 2711:. October 2015 2696: 2652: 2635: 2571: 2511: 2462: 2429:(4): 363–371. 2402: 2395: 2376: 2323: 2294:(3): 473–487. 2267: 2218: 2201: 2135: 2104: 2078: 2072: 2011: 1982: 1964: 1930: 1929: 1927: 1924: 1883: 1880: 1865: 1862: 1861: 1860: 1857: 1850: 1848: 1845: 1838: 1836: 1829: 1822: 1820: 1817: 1810: 1808: 1805: 1798: 1796: 1729:Main article: 1726: 1723: 1691: 1688: 1684:detoxification 1676: 1675: 1672: 1665: 1649: 1646: 1616: 1613: 1600:Main article: 1597: 1594: 1585: 1582: 1576: 1573: 1565: 1562: 1546: 1543: 1534: 1531: 1521:Dihydrocodeine 1493: 1490: 1488:opioid users. 1477: 1474: 1460: 1457: 1443: 1440: 1287: 1284: 1271: 1268: 1240: 1237: 1210: 1207: 1189: 1186: 1164: 1161: 1144:beta-endorphin 1134: 1131: 1053: 1050: 1047: 1046: 1043: 1040: 1037: 1034: 1028: 1027: 1024: 1021: 1018: 1015: 1009: 1008: 1005: 1002: 999: 996: 990: 989: 986: 983: 980: 977: 971: 970: 967: 964: 961: 958: 948: 947: 944: 941: 938: 935: 820: 817: 738:brain disorder 730: 727: 725: 722: 702: 699: 694: 693: 690: 687: 684: 681: 678: 677:Emotional pain 675: 672: 669: 666: 663: 660: 657: 654: 651: 648: 645: 642: 639: 637:Dilated pupils 634: 629: 626: 623: 620: 615: 609: 606: 603: 599: 586:Main article: 583: 580: 568: 567: 562: 557: 551: 545: 540: 535: 530: 501:Main article: 498: 495: 493: 492: 486: 485:Slurred speech 483: 480: 474: 468: 462: 456: 451: 448: 443: 440: 435: 431: 422: 419: 417: 414: 397: 396: 391: 386: 383: 380: 377: 374: 371: 368: 365: 362: 349: 346: 294:dihydrocodeine 214: 213: 210: 206: 205: 202: 198: 197: 184: 178: 177: 160: 156: 155: 150: 144: 143: 137: 131: 130: 125: 121: 120: 117: 113: 112: 102: 96: 95: 84: 78: 77: 68: 62: 61: 54: 53: 45: 44: 41: 37: 36: 28: 9: 6: 4: 3: 2: 15437: 15426: 15423: 15421: 15418: 15417: 15415: 15405: 15395: 15394: 15391: 15378: 15377: 15373: 15371: 15370: 15366: 15364: 15363: 15359: 15357: 15356: 15352: 15351: 15349: 15345: 15339: 15336: 15334: 15331: 15329: 15326: 15324: 15323:Deprescribing 15321: 15320: 15318: 15314: 15308: 15307:incidentaloma 15305:treatment of 15304: 15302: 15299: 15297: 15294: 15292: 15289: 15287: 15284: 15282: 15279: 15277: 15274: 15272: 15269: 15268: 15266: 15262: 15256: 15253: 15251: 15248: 15246: 15243: 15241: 15238: 15236: 15233: 15231: 15228: 15226: 15223: 15221: 15218: 15216: 15213: 15211: 15210:Overdiagnosis 15208: 15206: 15205:Overscreening 15203: 15201: 15198: 15197: 15195: 15191: 15187: 15180: 15175: 15173: 15168: 15166: 15161: 15160: 15157: 15144: 15143:Phenobarbital 15140: 15139: 15135: 15132: 15129: 15127: 15124: 15122: 15119: 15117: 15113: 15112: 15108: 15105: 15101: 15097: 15091: 15090: 15088: 15086: 15082: 15075: 15072: 15070: 15066: 15065: 15061: 15057: 15054: 15052: 15049: 15047: 15044: 15042: 15039: 15037: 15034: 15032: 15029: 15026: 15022: 15021:Buprenorphine 15019: 15018: 15017: 15016: 15012: 15010: 15007: 15004: 15001: 14999: 14995: 14991: 14985: 14984: 14982: 14980: 14976: 14970: 14967: 14965: 14962: 14959: 14955: 14951: 14945: 14943: 14940: 14936: 14933: 14931: 14928: 14927: 14926: 14925: 14921: 14917: 14916:Nitrous oxide 14914: 14913: 14912: 14911: 14907: 14903: 14900: 14898: 14895: 14893: 14890: 14888: 14885: 14884: 14883: 14882: 14875: 14874: 14872: 14870: 14866: 14859: 14855: 14851: 14845: 14843: 14840: 14838: 14835: 14833: 14830: 14828: 14825: 14823: 14820: 14819: 14817: 14815: 14811: 14806: 14802: 14799:Treatment of 14794: 14789: 14787: 14782: 14780: 14775: 14774: 14771: 14759: 14751: 14750: 14747: 14741: 14738: 14734: 14731: 14730: 14729: 14726: 14722: 14719: 14718: 14717: 14714: 14712: 14709: 14707: 14704: 14702: 14699: 14697: 14694: 14692: 14689: 14687: 14684: 14683: 14681: 14677: 14667: 14664: 14662: 14659: 14657: 14654: 14652: 14649: 14647: 14644: 14642: 14639: 14637: 14634: 14632: 14629: 14625: 14622: 14621: 14620: 14619:Drug checking 14617: 14615: 14612: 14611: 14609: 14607: 14603: 14597: 14594: 14592: 14589: 14588: 14586: 14582: 14576: 14573: 14569: 14566: 14564: 14561: 14560: 14559: 14556: 14554: 14551: 14549: 14546: 14544: 14541: 14537: 14534: 14533: 14532: 14529: 14528: 14526: 14520: 14514: 14511: 14509: 14506: 14504: 14501: 14499: 14496: 14494: 14491: 14487: 14484: 14482: 14479: 14478: 14477: 14474: 14473: 14471: 14465: 14459: 14456: 14454: 14451: 14450: 14448: 14444: 14441: 14439: 14431: 14419: 14416: 14415: 14413: 14409: 14406: 14404: 14401: 14399: 14396: 14394: 14391: 14389: 14386: 14384: 14381: 14379: 14376: 14374: 14371: 14369: 14366: 14365: 14363: 14362: 14360: 14356: 14350: 14347: 14345: 14342: 14340: 14337: 14335: 14332: 14331: 14329: 14325: 14322: 14320: 14316: 14303: 14301: 14298: 14296: 14293: 14291: 14288: 14286: 14283: 14281: 14278: 14276: 14273: 14271: 14270: 14266: 14264: 14263: 14259: 14257: 14256: 14252: 14250: 14247: 14245: 14244: 14240: 14239: 14238: 14235: 14234: 14229: 14226: 14224: 14221: 14219: 14216: 14214: 14211: 14209: 14206: 14204: 14203: 14199: 14198: 14197: 14194: 14193: 14191: 14185: 14179: 14176: 14174: 14171: 14167: 14164: 14162: 14159: 14158: 14156: 14152: 14149: 14147: 14144: 14143: 14141: 14139: 14136: 14132: 14129: 14127: 14124: 14123: 14121: 14120: 14118: 14116: 14112: 14106: 14103: 14101: 14098: 14096: 14093: 14091: 14088: 14086: 14083: 14081: 14078: 14076: 14073: 14072: 14070: 14066: 14063: 14061: 14057: 14053: 14049: 14045: 14044:Reinforcement 14038: 14033: 14031: 14026: 14024: 14019: 14018: 14015: 14002: 13999: 13996: 13995: 13992: 13989: 13987: 13986:Pronociceptin 13984: 13982: 13981:Proenkephalin 13979: 13977: 13974: 13972: 13969: 13966: 13965: 13962: 13959: 13957: 13954: 13952: 13949: 13947: 13944: 13942: 13939: 13937: 13934: 13932: 13929: 13927: 13924: 13922: 13919: 13917: 13914: 13912: 13909: 13907: 13904: 13902: 13899: 13897: 13894: 13892: 13886: 13884: 13881: 13879: 13876: 13874: 13871: 13869: 13865: 13864: 13862: 13858: 13848: 13845: 13843: 13840: 13838: 13835: 13833: 13830: 13828: 13825: 13823: 13820: 13818: 13815: 13813: 13810: 13808: 13805: 13803: 13800: 13798: 13795: 13793: 13790: 13788: 13785: 13783: 13777: 13776: 13774: 13770: 13764: 13761: 13759: 13756: 13754: 13751: 13749: 13746: 13744: 13741: 13739: 13736: 13734: 13731: 13729: 13726: 13724: 13721: 13719: 13716: 13714: 13711: 13709: 13703: 13701: 13698: 13696: 13693: 13691: 13688: 13686: 13683: 13681: 13678: 13676: 13673: 13671: 13668: 13666: 13663: 13661: 13658: 13656: 13653: 13651: 13648: 13646: 13643: 13641: 13640:Buprenorphine 13638: 13636: 13633: 13631: 13625: 13623: 13617: 13615: 13605: 13603: 13597: 13595: 13592: 13591: 13589: 13585: 13582: 13578: 13574: 13564: 13561: 13559: 13556: 13554: 13551: 13549: 13546: 13544: 13541: 13539: 13536: 13534: 13531: 13529: 13526: 13524: 13521: 13519: 13516: 13514: 13511: 13509: 13506: 13504: 13501: 13499: 13496: 13494: 13491: 13489: 13486: 13484: 13481: 13479: 13476: 13474: 13471: 13469: 13466: 13464: 13461: 13459: 13456: 13454: 13451: 13449: 13446: 13444: 13441: 13439: 13436: 13434: 13431: 13429: 13426: 13424: 13421: 13419: 13416: 13414: 13411: 13409: 13406: 13404: 13401: 13399: 13396: 13394: 13391: 13389: 13386: 13384: 13381: 13379: 13376: 13374: 13373:Buprenorphine 13371: 13369: 13366: 13364: 13361: 13359: 13356: 13354: 13351: 13349: 13346: 13344: 13341: 13339: 13336: 13334: 13331: 13329: 13326: 13324: 13323:Amentoflavone 13321: 13319: 13316: 13314: 13311: 13309: 13306: 13304: 13301: 13299: 13296: 13294: 13291: 13289: 13286: 13284: 13281: 13280: 13278: 13274: 13268: 13265: 13263: 13260: 13258: 13255: 13253: 13250: 13247: 13246:nortriptyline 13243: 13239: 13235: 13234:amitriptyline 13231: 13228: 13226: 13223: 13221: 13218: 13216: 13213: 13211: 13208: 13206: 13203: 13201: 13198: 13196: 13193: 13190: 13186: 13183: 13181: 13178: 13176: 13173: 13171: 13168: 13166: 13163: 13161: 13158: 13156: 13153: 13151: 13148: 13146: 13143: 13141: 13138: 13136: 13133: 13131: 13128: 13126: 13123: 13121: 13118: 13116: 13113: 13111: 13108: 13106: 13103: 13101: 13098: 13096: 13093: 13091: 13088: 13086: 13083: 13081: 13078: 13076: 13073: 13071: 13068: 13066: 13063: 13061: 13058: 13056: 13053: 13051: 13048: 13046: 13043: 13041: 13038: 13036: 13033: 13031: 13028: 13026: 13023: 13021: 13018: 13016: 13013: 13011: 13008: 13006: 13003: 13001: 12998: 12996: 12993: 12991: 12988: 12986: 12983: 12981: 12978: 12976: 12973: 12971: 12968: 12966: 12963: 12961: 12958: 12956: 12953: 12951: 12948: 12946: 12943: 12941: 12940:Hydromorphone 12938: 12936: 12933: 12931: 12928: 12926: 12923: 12921: 12918: 12916: 12913: 12911: 12908: 12906: 12903: 12901: 12898: 12896: 12893: 12891: 12888: 12886: 12883: 12881: 12878: 12876: 12873: 12871: 12868: 12866: 12863: 12861: 12858: 12856: 12855:Diprenorphine 12853: 12851: 12848: 12846: 12843: 12841: 12838: 12836: 12835:Difelikefalin 12833: 12831: 12828: 12826: 12823: 12821: 12818: 12816: 12815:Cyprenorphine 12813: 12811: 12808: 12806: 12803: 12801: 12798: 12796: 12793: 12791: 12788: 12786: 12783: 12781: 12778: 12776: 12773: 12771: 12768: 12766: 12763: 12761: 12760:Big dynorphin 12758: 12756: 12753: 12751: 12748: 12746: 12743: 12741: 12738: 12736: 12733: 12731: 12728: 12726: 12723: 12721: 12718: 12716: 12713: 12711: 12708: 12706: 12703: 12701: 12698: 12696: 12693: 12691: 12688: 12686: 12683: 12681: 12680:3CS-nalmefene 12678: 12677: 12675: 12671: 12668: 12664: 12660: 12650: 12647: 12645: 12642: 12640: 12637: 12635: 12632: 12630: 12627: 12625: 12622: 12620: 12617: 12615: 12612: 12610: 12607: 12605: 12602: 12600: 12597: 12595: 12592: 12590: 12587: 12585: 12582: 12580: 12577: 12575: 12572: 12570: 12567: 12565: 12562: 12560: 12557: 12555: 12552: 12550: 12547: 12545: 12542: 12540: 12537: 12535: 12532: 12530: 12527: 12525: 12524:Diprenorphine 12522: 12520: 12517: 12515: 12512: 12510: 12507: 12505: 12502: 12500: 12497: 12495: 12492: 12490: 12487: 12485: 12482: 12480: 12477: 12475: 12472: 12470: 12467: 12465: 12462: 12460: 12457: 12455: 12452: 12450: 12447: 12446: 12444: 12440: 12434: 12431: 12429: 12426: 12424: 12421: 12419: 12416: 12414: 12411: 12409: 12406: 12404: 12401: 12399: 12396: 12394: 12391: 12389: 12386: 12384: 12381: 12379: 12376: 12374: 12371: 12369: 12366: 12364: 12361: 12359: 12356: 12354: 12351: 12349: 12346: 12344: 12341: 12339: 12336: 12334: 12331: 12329: 12326: 12324: 12321: 12319: 12316: 12314: 12311: 12309: 12306: 12304: 12301: 12299: 12296: 12294: 12291: 12289: 12286: 12284: 12281: 12279: 12276: 12274: 12271: 12269: 12266: 12264: 12261: 12259: 12256: 12254: 12251: 12249: 12246: 12244: 12241: 12239: 12236: 12234: 12231: 12229: 12228:Hydromorphone 12226: 12224: 12221: 12219: 12216: 12214: 12211: 12209: 12206: 12204: 12201: 12199: 12196: 12194: 12191: 12189: 12186: 12184: 12181: 12179: 12176: 12174: 12171: 12169: 12166: 12164: 12161: 12159: 12156: 12154: 12151: 12149: 12146: 12144: 12141: 12139: 12138:Deltorphin II 12136: 12134: 12131: 12129: 12126: 12124: 12121: 12119: 12116: 12114: 12111: 12109: 12106: 12104: 12101: 12099: 12096: 12094: 12091: 12089: 12086: 12084: 12081: 12079: 12076: 12074: 12071: 12069: 12066: 12064: 12061: 12059: 12056: 12054: 12051: 12049: 12046: 12044: 12041: 12039: 12036: 12034: 12031: 12029: 12026: 12024: 12023:3CS-nalmefene 12021: 12020: 12018: 12014: 12011: 12007: 12003: 11993: 11990: 11988: 11985: 11983: 11980: 11978: 11975: 11973: 11970: 11968: 11965: 11963: 11960: 11958: 11955: 11953: 11950: 11948: 11945: 11943: 11940: 11938: 11935: 11933: 11930: 11928: 11925: 11923: 11920: 11918: 11915: 11913: 11910: 11908: 11905: 11903: 11900: 11898: 11895: 11893: 11890: 11888: 11885: 11883: 11880: 11878: 11875: 11873: 11872:Methocinnamox 11870: 11868: 11865: 11863: 11860: 11858: 11855: 11853: 11850: 11848: 11845: 11843: 11840: 11838: 11835: 11833: 11832:Ginsenoside R 11830: 11828: 11825: 11823: 11820: 11818: 11815: 11813: 11810: 11808: 11805: 11803: 11802:Diprenorphine 11800: 11798: 11795: 11793: 11790: 11788: 11785: 11783: 11780: 11777: 11775: 11772: 11770: 11767: 11765: 11762: 11760: 11757: 11755: 11752: 11750: 11747: 11745: 11742: 11740: 11737: 11735: 11732: 11730: 11727: 11725: 11722: 11720: 11717: 11715: 11712: 11710: 11707: 11705: 11702: 11700: 11697: 11695: 11692: 11690: 11687: 11685: 11682: 11680: 11679:3CS-nalmefene 11677: 11675: 11672: 11670: 11667: 11666: 11664: 11660: 11654: 11651: 11649: 11646: 11644: 11641: 11639: 11636: 11634: 11631: 11629: 11626: 11624: 11621: 11619: 11616: 11614: 11611: 11609: 11606: 11604: 11601: 11599: 11596: 11594: 11591: 11589: 11586: 11584: 11581: 11579: 11576: 11574: 11571: 11569: 11566: 11564: 11561: 11559: 11556: 11554: 11551: 11549: 11546: 11544: 11541: 11539: 11536: 11534: 11531: 11529: 11526: 11524: 11521: 11519: 11516: 11514: 11511: 11509: 11508:Phencyclidine 11506: 11504: 11501: 11499: 11496: 11494: 11491: 11489: 11486: 11483: 11479: 11478: 11474: 11472: 11469: 11467: 11464: 11462: 11459: 11457: 11454: 11452: 11451:Oxymorphazone 11449: 11447: 11444: 11442: 11439: 11437: 11434: 11432: 11429: 11427: 11424: 11422: 11419: 11417: 11414: 11412: 11409: 11407: 11404: 11402: 11399: 11397: 11394: 11392: 11389: 11387: 11384: 11382: 11379: 11377: 11374: 11372: 11369: 11367: 11364: 11362: 11359: 11357: 11354: 11352: 11349: 11347: 11344: 11342: 11339: 11337: 11334: 11332: 11329: 11327: 11324: 11322: 11319: 11317: 11314: 11312: 11309: 11307: 11304: 11302: 11299: 11297: 11294: 11292: 11289: 11287: 11284: 11282: 11279: 11277: 11274: 11272: 11269: 11267: 11264: 11262: 11259: 11257: 11254: 11252: 11249: 11247: 11244: 11242: 11241:Hydromorphone 11239: 11237: 11234: 11232: 11229: 11227: 11224: 11222: 11219: 11217: 11214: 11212: 11209: 11207: 11204: 11202: 11199: 11197: 11194: 11192: 11189: 11187: 11186:Ethylmorphine 11184: 11182: 11179: 11177: 11176:Endomorphin-2 11174: 11172: 11171:Endomorphin-1 11169: 11167: 11164: 11162: 11159: 11157: 11154: 11152: 11151:Diphenoxylate 11149: 11147: 11144: 11142: 11139: 11137: 11134: 11132: 11129: 11127: 11124: 11122: 11119: 11117: 11114: 11112: 11109: 11107: 11104: 11102: 11099: 11097: 11094: 11092: 11089: 11087: 11084: 11082: 11079: 11077: 11074: 11072: 11069: 11067: 11064: 11062: 11059: 11057: 11054: 11052: 11049: 11047: 11044: 11042: 11039: 11037: 11036:Butyrfentanyl 11034: 11032: 11029: 11027: 11024: 11022: 11021:Buprenorphine 11019: 11017: 11014: 11012: 11009: 11007: 11004: 11002: 10999: 10997: 10994: 10992: 10989: 10987: 10984: 10982: 10979: 10977: 10974: 10972: 10969: 10967: 10964: 10962: 10959: 10957: 10954: 10952: 10949: 10947: 10944: 10942: 10939: 10937: 10936:Acrylfentanyl 10934: 10932: 10929: 10927: 10924: 10922: 10919: 10917: 10914: 10912: 10911:ψ-Akuammigine 10909: 10907: 10904: 10902: 10899: 10897: 10894: 10893: 10891: 10888: 10880: 10877: 10873: 10869: 10865: 10862: 10855: 10850: 10848: 10843: 10841: 10836: 10835: 10832: 10820: 10817: 10813: 10810: 10809: 10807: 10806: 10802: 10801: 10799: 10795: 10787: 10784: 10782: 10779: 10778: 10776: 10772: 10769: 10766: 10763: 10762: 10760: 10759: 10757: 10755: 10749: 10741: 10738: 10737: 10735: 10733: 10729: 10725: 10722: 10721: 10719: 10718: 10716: 10714: 10710: 10702: 10699: 10698: 10696: 10692: 10689: 10688: 10686: 10684: 10680: 10676: 10673: 10670: 10667: 10666: 10664: 10660: 10657: 10655: 10652: 10651: 10649: 10647: 10643: 10639: 10636: 10635: 10633: 10632: 10630: 10628: 10623: 10619: 10610: 10607: 10606: 10604: 10599: 10596: 10593: 10590: 10587: 10584: 10582: 10579: 10577: 10574: 10573: 10571: 10570: 10568: 10566: 10562: 10554: 10551: 10550: 10548: 10544: 10541: 10539: 10536: 10533: 10530: 10529: 10527: 10526: 10524: 10522: 10518: 10509: 10506: 10504: 10501: 10500: 10498: 10497: 10495: 10493: 10489: 10481: 10478: 10477: 10475: 10470: 10467: 10465: 10462: 10461: 10459: 10458: 10456: 10454: 10450: 10442: 10439: 10436: 10433: 10431: 10428: 10427: 10425: 10421: 10418: 10415: 10412: 10410: 10407: 10406: 10404: 10403: 10401: 10399: 10395: 10387: 10384: 10383: 10381: 10377: 10374: 10372: 10369: 10367: 10364: 10362: 10359: 10358: 10356: 10355: 10353: 10351: 10347: 10337: 10334: 10331: 10328: 10327: 10325: 10321: 10311: 10308: 10306: 10303: 10302: 10300: 10298: 10294: 10287: 10284: 10281: 10278: 10275: 10272: 10270: 10267: 10264: 10261: 10256: 10253: 10251: 10248: 10247: 10245: 10242: 10240: 10237: 10235: 10232: 10230: 10227: 10226: 10224: 10222: 10216: 10210: 10207: 10205: 10202: 10199: 10196: 10195: 10193: 10191: 10185: 10178: 10175: 10174: 10172: 10170: 10166: 10159: 10156: 10152: 10149: 10147: 10144: 10143: 10141: 10138: 10137: 10135: 10133: 10129: 10122: 10119: 10117: 10114: 10113: 10111: 10109: 10105: 10102: 10098: 10095: 10093: 10089: 10080: 10077: 10076: 10074: 10070: 10067: 10066: 10064: 10063: 10061: 10059:substance use 10055: 10047: 10043: 10039: 10036: 10034: 10030: 10027: 10026: 10025: 10022: 10015: 10012: 10010: 10007: 10006: 10004: 10001: 9999: 9996: 9994: 9993:Drug overdose 9990: 9987: 9986: 9985: 9982: 9981: 9979: 9975: 9971: 9968: 9961: 9956: 9954: 9949: 9947: 9942: 9941: 9938: 9925: 9921: 9920: 9916: 9914: 9910: 9909: 9905: 9901: 9898: 9894: 9893: 9889: 9885: 9884: 9881: 9876: 9872: 9866: 9863: 9861: 9858: 9857: 9846: 9842: 9838: 9834: 9829: 9825: 9821: 9816: 9811: 9806: 9801: 9797: 9793: 9789: 9784: 9780: 9776: 9772: 9768: 9763: 9758: 9754: 9750: 9746: 9741: 9740: 9726: 9722: 9718: 9712: 9706: 9702: 9699: 9693: 9686: 9680: 9672: 9668: 9663: 9658: 9654: 9650: 9646: 9642: 9638: 9631: 9623: 9617: 9609: 9605: 9600: 9595: 9590: 9585: 9581: 9577: 9573: 9566: 9558: 9554: 9549: 9544: 9540: 9536: 9532: 9528: 9524: 9517: 9509: 9505: 9501: 9497: 9493: 9489: 9485: 9481: 9473: 9465: 9461: 9455: 9447: 9443: 9438: 9433: 9429: 9425: 9421: 9417: 9413: 9406: 9404: 9395: 9391: 9386: 9381: 9377: 9373: 9369: 9362: 9355: 9351: 9346: 9344: 9342: 9340: 9323: 9319: 9313: 9311: 9302: 9296: 9288: 9282: 9274: 9268: 9260: 9256: 9251: 9246: 9242: 9238: 9234: 9230: 9226: 9219: 9204:. 15 May 2018 9203: 9196: 9190: 9182: 9178: 9173: 9168: 9163: 9158: 9155:(5): e25477. 9154: 9150: 9146: 9139: 9131: 9127: 9120: 9104: 9100: 9096: 9090: 9074: 9070: 9066: 9060: 9052: 9048: 9044: 9040: 9036: 9032: 9028: 9024: 9017: 9015: 8999: 8998: 8993: 8987: 8985: 8969: 8962: 8956: 8940: 8938: 8929: 8922: 8920: 8904: 8900: 8894: 8892: 8876: 8869: 8863: 8848: 8844: 8837: 8835: 8826: 8822: 8817: 8812: 8808: 8804: 8800: 8793: 8791: 8782: 8778: 8775:(2): 97–124. 8774: 8770: 8762: 8754: 8750: 8745: 8740: 8736: 8732: 8728: 8724: 8720: 8713: 8711: 8702: 8698: 8694: 8690: 8686: 8682: 8675: 8664: 8663: 8656: 8645: 8638: 8636: 8628: 8624: 8619: 8617: 8615: 8606: 8602: 8596: 8594: 8585: 8578: 8566: 8558: 8554: 8549: 8544: 8540: 8536: 8532: 8528: 8524: 8517: 8515: 8506: 8500: 8492: 8488: 8483: 8478: 8474: 8470: 8466: 8462: 8458: 8451: 8449: 8433: 8429: 8423: 8407: 8403: 8402: 8397: 8391: 8383: 8379: 8374: 8369: 8365: 8361: 8357: 8353: 8349: 8345: 8341: 8334: 8326: 8322: 8318: 8314: 8310: 8306: 8302: 8298: 8294: 8287: 8279: 8275: 8270: 8265: 8260: 8255: 8251: 8247: 8240: 8233: 8217: 8213: 8207: 8192: 8188: 8181: 8173: 8169: 8162: 8154: 8150: 8146: 8142: 8138: 8134: 8127: 8125: 8116: 8112: 8108: 8104: 8100: 8096: 8092: 8088: 8080: 8072: 8068: 8064: 8060: 8056: 8052: 8048: 8044: 8037: 8029: 8025: 8020: 8015: 8011: 8007: 8003: 7999: 7995: 7988: 7986: 7977: 7973: 7969: 7965: 7961: 7957: 7950: 7942: 7938: 7933: 7928: 7924: 7920: 7916: 7909: 7901: 7897: 7892: 7887: 7883: 7879: 7875: 7871: 7867: 7860: 7852: 7848: 7843: 7838: 7834: 7830: 7826: 7819: 7811: 7807: 7803: 7799: 7795: 7791: 7787: 7783: 7776: 7761: 7760: 7755: 7749: 7741: 7737: 7732: 7727: 7723: 7719: 7715: 7708: 7700: 7696: 7691: 7686: 7682: 7678: 7674: 7670: 7666: 7659: 7657: 7655: 7653: 7644: 7640: 7635: 7630: 7625: 7620: 7616: 7612: 7608: 7604: 7600: 7593: 7585: 7581: 7577: 7571: 7567: 7560: 7552: 7548: 7543: 7538: 7534: 7530: 7527:(2): 93–103. 7526: 7522: 7518: 7511: 7503: 7499: 7494: 7489: 7484: 7479: 7476:: 2305–2311. 7475: 7471: 7467: 7460: 7458: 7456: 7454: 7452: 7450: 7441: 7437: 7432: 7427: 7423: 7419: 7415: 7411: 7407: 7400: 7392: 7388: 7383: 7378: 7374: 7370: 7366: 7362: 7358: 7354: 7347: 7345: 7336: 7332: 7327: 7322: 7318: 7314: 7310: 7303: 7295: 7291: 7286: 7281: 7277: 7273: 7269: 7265: 7261: 7254: 7246: 7242: 7238: 7234: 7230: 7226: 7222: 7218: 7211: 7203: 7199: 7193: 7185: 7181: 7177: 7173: 7169: 7162: 7154: 7150: 7145: 7140: 7136: 7132: 7128: 7124: 7120: 7113: 7098: 7094: 7088: 7080: 7076: 7070: 7062: 7058: 7054: 7050: 7046: 7042: 7034: 7018: 7014: 7008: 7000: 6996: 6992: 6988: 6984: 6980: 6976: 6972: 6964: 6956: 6952: 6948: 6944: 6939: 6934: 6930: 6926: 6922: 6918: 6914: 6907: 6899: 6895: 6891: 6884: 6876: 6875: 6867: 6859: 6855: 6850: 6845: 6841: 6837: 6833: 6829: 6825: 6818: 6810: 6806: 6801: 6796: 6792: 6788: 6784: 6777: 6758: 6751: 6745: 6743: 6727: 6723: 6717: 6706: 6700: 6692: 6686: 6678: 6672: 6664: 6660: 6655: 6650: 6645: 6640: 6636: 6632: 6628: 6621: 6610: 6604: 6589: 6585: 6579: 6563: 6559: 6553: 6545: 6541: 6537: 6533: 6529: 6525: 6518: 6516: 6514: 6512: 6496: 6492: 6486: 6471: 6467: 6461: 6453: 6449: 6444: 6439: 6435: 6431: 6427: 6423: 6419: 6412: 6397: 6393: 6387: 6379: 6375: 6371: 6367: 6363: 6359: 6355: 6351: 6344: 6336: 6332: 6327: 6322: 6318: 6314: 6310: 6306: 6302: 6295: 6287: 6283: 6278: 6273: 6268: 6263: 6259: 6255: 6251: 6244: 6236: 6232: 6228: 6224: 6220: 6219:NIHR Evidence 6216: 6210: 6202: 6198: 6193: 6188: 6183: 6178: 6174: 6170: 6166: 6159: 6151: 6147: 6142: 6137: 6133: 6129: 6125: 6121: 6117: 6110: 6095: 6091: 6085: 6083: 6074: 6068: 6066: 6064: 6048: 6044: 6038: 6023: 6019: 6013: 6007: 6002: 5994: 5990: 5985: 5980: 5976: 5972: 5968: 5964: 5960: 5953: 5945: 5941: 5936: 5931: 5926: 5921: 5917: 5913: 5909: 5902: 5896: 5890: 5888: 5886: 5884: 5882: 5880: 5878: 5876: 5874: 5865: 5861: 5855: 5847: 5843: 5838: 5833: 5829: 5825: 5821: 5817: 5813: 5806: 5798: 5794: 5790: 5786: 5782: 5778: 5770: 5762: 5758: 5753: 5748: 5744: 5740: 5736: 5732: 5728: 5721: 5713: 5709: 5703: 5695: 5691: 5686: 5681: 5677: 5673: 5669: 5665: 5661: 5654: 5646: 5642: 5638: 5634: 5630: 5626: 5619: 5611: 5607: 5602: 5597: 5592: 5587: 5583: 5579: 5575: 5568: 5566: 5550: 5546: 5540: 5531: 5523: 5519: 5514: 5509: 5505: 5501: 5497: 5490: 5488: 5486: 5469: 5465: 5461: 5455: 5439: 5437: 5428: 5421: 5406: 5402: 5396: 5380: 5376: 5370: 5362: 5358: 5353: 5348: 5344: 5340: 5336: 5332: 5328: 5321: 5305: 5301: 5295: 5280: 5278: 5269: 5263: 5261: 5245: 5241: 5235: 5220: 5216: 5210: 5202: 5198: 5193: 5188: 5184: 5180: 5176: 5172: 5168: 5164: 5160: 5153: 5138: 5134: 5129: 5124: 5120: 5116: 5112: 5108: 5104: 5097: 5081: 5077: 5071: 5063: 5059: 5055: 5051: 5047: 5043: 5036: 5034: 5025: 5021: 5017: 5013: 5009: 5005: 5001: 4997: 4990: 4988: 4979: 4975: 4970: 4965: 4961: 4957: 4953: 4949: 4945: 4938: 4930: 4926: 4921: 4916: 4912: 4908: 4904: 4900: 4896: 4889: 4881: 4877: 4872: 4867: 4863: 4859: 4855: 4848: 4846: 4844: 4835: 4831: 4827: 4823: 4819: 4815: 4811: 4807: 4800: 4798: 4796: 4787: 4783: 4779: 4775: 4771: 4767: 4763: 4759: 4751: 4743: 4739: 4734: 4729: 4725: 4721: 4717: 4713: 4709: 4705: 4701: 4694: 4675: 4668: 4667: 4659: 4657: 4649: 4644: 4640: 4635: 4630: 4626: 4622: 4618: 4614: 4610: 4603: 4601: 4599: 4597: 4588: 4584: 4579: 4574: 4569: 4564: 4560: 4556: 4552: 4545: 4537: 4533: 4528: 4523: 4519: 4515: 4511: 4507: 4503: 4496: 4488: 4484: 4479: 4474: 4470: 4466: 4462: 4458: 4454: 4447: 4439: 4435: 4430: 4425: 4421: 4417: 4413: 4409: 4405: 4398: 4396: 4379: 4375: 4369: 4367: 4358: 4354: 4350: 4346: 4342: 4338: 4334: 4330: 4323: 4321: 4312: 4308: 4303: 4298: 4294: 4290: 4286: 4282: 4278: 4271: 4263: 4259: 4255: 4251: 4247: 4243: 4239: 4235: 4228: 4226: 4217: 4213: 4208: 4203: 4199: 4195: 4191: 4187: 4183: 4176: 4174: 4165: 4161: 4156: 4151: 4147: 4143: 4139: 4135: 4131: 4124: 4122: 4113: 4109: 4104: 4099: 4095: 4091: 4087: 4083: 4079: 4072: 4064: 4060: 4054: 4046: 4040: 4038: 4029: 4025: 4020: 4015: 4011: 4007: 4003: 3999: 3995: 3988: 3979: 3971: 3967: 3962: 3957: 3953: 3949: 3945: 3941: 3937: 3930: 3928: 3911: 3907: 3903: 3897: 3895: 3886: 3880: 3876: 3869: 3867: 3865: 3857: 3853: 3849: 3844: 3839: 3835: 3831: 3827: 3823: 3819: 3812: 3810: 3808: 3806: 3804: 3802: 3800: 3791: 3787: 3783: 3779: 3775: 3771: 3767: 3763: 3759: 3752: 3744: 3740: 3735: 3730: 3726: 3722: 3718: 3714: 3710: 3703: 3687: 3683: 3677: 3675: 3666: 3660: 3653: 3652: 3645: 3637: 3633: 3629: 3625: 3621: 3617: 3613: 3609: 3602: 3594: 3590: 3586: 3582: 3578: 3574: 3570: 3566: 3559: 3551: 3547: 3542: 3537: 3532: 3527: 3523: 3519: 3515: 3508: 3500: 3496: 3491: 3486: 3482: 3478: 3474: 3470: 3466: 3459: 3457: 3448: 3444: 3440: 3436: 3432: 3428: 3424: 3420: 3413: 3405: 3401: 3397: 3393: 3389: 3385: 3381: 3377: 3369: 3361: 3357: 3352: 3347: 3343: 3339: 3335: 3328: 3326: 3317: 3313: 3308: 3303: 3299: 3295: 3291: 3287: 3283: 3276: 3268: 3264: 3259: 3254: 3250: 3246: 3245:Pain Medicine 3242: 3235: 3227: 3223: 3218: 3213: 3209: 3205: 3201: 3197: 3193: 3186: 3178: 3174: 3169: 3164: 3160: 3156: 3152: 3148: 3144: 3137: 3129: 3123: 3119: 3118: 3110: 3108: 3106: 3104: 3102: 3100: 3098: 3096: 3094: 3092: 3090: 3081: 3077: 3072: 3067: 3063: 3059: 3055: 3048: 3033: 3027: 3023: 3019: 3015: 3014: 3006: 3004: 2995: 2989: 2985: 2979: 2973: 2971: 2966: 2960: 2958: 2950: 2946: 2942: 2937: 2922: 2918: 2911: 2896: 2889: 2883: 2868: 2864: 2857: 2842: 2838: 2832: 2824: 2820: 2815: 2810: 2806: 2802: 2798: 2794: 2790: 2783: 2768: 2764: 2758: 2756: 2740: 2736: 2729: 2727: 2710: 2706: 2700: 2692: 2688: 2684: 2680: 2676: 2672: 2668: 2664: 2656: 2645: 2639: 2631: 2627: 2622: 2617: 2613: 2609: 2605: 2601: 2597: 2590: 2588: 2586: 2584: 2582: 2580: 2578: 2576: 2567: 2563: 2558: 2553: 2548: 2543: 2540:(12): e3733. 2539: 2535: 2531: 2524: 2522: 2520: 2518: 2516: 2507: 2503: 2499: 2495: 2490: 2485: 2481: 2477: 2473: 2466: 2459: 2454: 2450: 2445: 2440: 2436: 2432: 2428: 2424: 2420: 2413: 2411: 2409: 2407: 2398: 2392: 2388: 2387: 2380: 2365: 2359: 2355: 2351: 2347: 2343: 2336: 2334: 2332: 2330: 2328: 2319: 2315: 2310: 2305: 2301: 2297: 2293: 2289: 2285: 2278: 2276: 2274: 2272: 2263: 2259: 2254: 2249: 2245: 2241: 2237: 2233: 2229: 2222: 2214: 2208: 2206: 2197: 2193: 2188: 2183: 2179: 2175: 2171: 2167: 2163: 2156: 2154: 2152: 2150: 2148: 2146: 2144: 2142: 2140: 2124:. August 2017 2123: 2119: 2113: 2111: 2109: 2100: 2093: 2091: 2089: 2087: 2085: 2083: 2075: 2069: 2065: 2061: 2060: 2052: 2050: 2048: 2046: 2044: 2042: 2040: 2038: 2036: 2034: 2032: 2030: 2028: 2026: 2024: 2022: 2020: 2018: 2016: 1999: 1995: 1989: 1987: 1978: 1974: 1968: 1952: 1950: 1944: 1938: 1936: 1931: 1923: 1921: 1916: 1912: 1909: 1908:Buprenorphine 1905: 1901: 1893: 1892:buprenorphine 1888: 1879: 1875: 1872: 1854: 1849: 1842: 1837: 1833: 1826: 1821: 1814: 1809: 1802: 1797: 1795: 1792: 1791: 1790: 1786: 1783: 1778: 1776: 1772: 1766: 1764: 1758: 1754: 1750: 1747: 1746:polysubstance 1737: 1732: 1725:United States 1722: 1717: 1709: 1705: 1701: 1696: 1687: 1685: 1681: 1673: 1670: 1666: 1663: 1662: 1661: 1658: 1655: 1645: 1643: 1639: 1635: 1630: 1627: 1623: 1612: 1610: 1603: 1593: 1591: 1581: 1572: 1570: 1561: 1559: 1552: 1542: 1539: 1530: 1527: 1522: 1518: 1514: 1510: 1505: 1499: 1492:Other opioids 1489: 1487: 1482: 1473: 1469: 1465: 1456: 1452: 1448: 1439: 1437: 1432: 1430: 1426: 1422: 1417: 1411: 1409: 1405: 1401: 1397: 1393: 1392:mental health 1389: 1385: 1380: 1376: 1372: 1371:drug cravings 1368: 1363: 1361: 1357: 1353: 1349: 1345: 1340: 1338: 1334: 1330: 1326: 1322: 1318: 1314: 1310: 1306: 1302: 1297: 1293: 1283: 1279: 1277: 1267: 1265: 1260: 1256: 1254: 1250: 1246: 1236: 1232: 1229: 1225: 1223: 1219: 1215: 1206: 1203: 1198: 1195: 1185: 1182: 1178: 1174: 1171:flanking the 1170: 1160: 1158: 1154: 1149: 1145: 1141: 1130: 1128: 1124: 1120: 1116: 1115:cell adhesion 1112: 1107: 1103: 1099: 1095: 1091: 1087: 1083: 1079: 1075: 1071: 1068: 1064: 1060: 1044: 1041: 1038: 1035: 1033: 1030: 1029: 1025: 1022: 1019: 1016: 1014: 1011: 1010: 1006: 1003: 1000: 997: 995: 992: 991: 987: 984: 981: 978: 976: 973: 972: 968: 965: 962: 959: 957: 953: 950: 949: 945: 942: 939: 936: 933: 932: 929: 927: 923: 919: 914: 912: 908: 904: 900: 896: 892: 888: 884: 879: 877: 873: 872:neuronal soma 869: 865: 861: 857: 853: 848: 846: 842: 838: 834: 830: 826: 816: 813: 809: 806: 801: 799: 795: 791: 787: 784: 780: 776: 772: 768: 765: 757: 753: 749: 745: 743: 742:reward system 739: 735: 721: 719: 715: 710: 708: 698: 691: 688: 685: 682: 679: 676: 673: 670: 667: 664: 661: 658: 655: 652: 649: 646: 643: 640: 638: 635: 633: 630: 627: 624: 621: 619: 616: 614: 610: 607: 604: 601: 600: 598: 596: 589: 576: 572: 566: 563: 561: 558: 555: 552: 549: 546: 544: 541: 539: 536: 534: 531: 528: 525: 524: 523: 517: 513: 509: 504: 490: 487: 484: 481: 478: 475: 472: 469: 466: 463: 460: 457: 455: 452: 449: 447: 444: 441: 439: 436: 433: 432: 430: 428: 413: 411: 407: 403: 395: 392: 390: 387: 384: 381: 378: 375: 372: 369: 366: 363: 360: 359: 358: 355: 345: 342: 338: 334: 330: 326: 322: 321:buprenorphine 318: 314: 309: 305: 303: 299: 295: 291: 287: 283: 279: 274: 272: 268: 264: 260: 256: 252: 246: 244: 240: 236: 232: 228: 224: 220: 211: 207: 203: 199: 196: 192: 188: 187:Buprenorphine 185: 183: 179: 176: 172: 168: 164: 161: 157: 154: 151: 149: 145: 142: 138: 136: 132: 129: 126: 122: 118: 114: 110: 106: 103: 101: 100:Complications 97: 93: 89: 85: 83: 79: 76: 72: 69: 67: 63: 60: 55: 51: 46: 42: 38: 33: 27: 19: 15374: 15367: 15360: 15353: 15301:Polypharmacy 15285: 15138:Barbiturates 15136: 15109: 15092: 15062: 15013: 14986: 14946: 14922: 14908: 14876: 14846: 14837:Mecamylamine 14407: 14267: 14260: 14253: 14241: 14200: 14142:Sex-related 14104: 13997: 13976:Prodynorphin 13968:Propeptides: 13967: 13866: 13837:Thienorphine 13660:JNJ-19385899 13645:Cebranopadol 13627:Ac-RYYRIK-NH 13619:Ac-RYYRWK-NH 13303:6β-Naltrexol 13220:Thienorphine 13185:Salvinorin A 12985:Levallorphan 12790:Cebranopadol 12649:Thienorphine 12459:6β-Naltrexol 12243:JNJ-20788560 12238:Isomethadone 12133:Deltorphin I 12128:Deltorphin A 12108:Cebranopadol 12103:Casokefamide 11937:Naltrexazone 11927:Naloxonazine 11852:Levallorphan 11699:6β-Naltrexol 11598:Thienorphine 11553:Remifentanil 11475: 11406:Nicomorphine 11401:Nicodicodine 11356:Morphiceptin 11256:Ketobemidone 11091:Desomorphine 11076:DAMGO (DAGO) 11056:Cebranopadol 11051:Casokefamide 10803: 10730: 10681: 10644: 10608: 10492:Hallucinogen 10219:Neurological 9967:Psychoactive 9917: 9902: 9886: 9836: 9832: 9795: 9791: 9755:(1): 24–36. 9752: 9748: 9725:the original 9720: 9711: 9692: 9684: 9679: 9644: 9640: 9630: 9616: 9582:(15): 9283. 9579: 9575: 9565: 9530: 9526: 9516: 9486:(1): 37–43. 9483: 9479: 9472: 9463: 9454: 9419: 9415: 9375: 9371: 9361: 9326:. 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Retrieved 1946: 1913: 1903: 1897: 1876: 1870: 1867: 1793: 1787: 1782:Kathy Hochul 1779: 1777:in the U.S. 1775:telemedicine 1767: 1759: 1755: 1751: 1742: 1719: 1690:Epidemiology 1677: 1659: 1651: 1632:In 2024 the 1631: 1618: 1605: 1587: 1578: 1567: 1554: 1536: 1533:In pregnancy 1501: 1479: 1470: 1466: 1462: 1453: 1449: 1445: 1433: 1412: 1400:imprisonment 1364: 1359: 1341: 1320: 1316: 1312: 1308: 1304: 1300: 1299: 1280: 1273: 1261: 1257: 1242: 1233: 1226: 1212: 1199: 1191: 1169:(CA) repeats 1166: 1136: 1105: 1101: 1097: 1055: 915: 880: 849: 822: 812:Neuroimaging 810: 802: 761: 746: 732: 711: 704: 696: 668:Hyperalgesia 608:Muscle pains 591: 521: 482:Head nodding 454:Constipation 424: 398: 351: 310: 306: 275: 247: 222: 218: 217: 26: 15355:Overtreated 14892:Acamprosate 14842:Varenicline 14467:Behavioral 14378:Barbiturate 14373:Amphetamine 14151:Pornography 14146:Intercourse 14080:Amphetamine 14046:disorders: 13906:Kelatorphan 13883:Candoxatril 13772:Antagonists 13723:Racemorphan 13690:NNC 63-0532 13675:Lexanopadol 13670:Levorphanol 13548:Quadazocine 13533:Pawhuskin A 13528:Noribogaine 13518:Navacaprant 13508:Naltrindole 13428:Epicatechin 13393:Clocinnamox 13276:Antagonists 13238:desipramine 13205:Samidorphan 13175:Racemorphan 13160:Phenazocine 13150:Pentazocine 13130:Norketamine 13125:Noribogaine 13085:Nalfurafine 13050:Mirtazapine 13040:Metkefamide 13000:Lexanopadol 12995:Levorphanol 12975:Laudanosine 12960:ICI-204,448 12955:ICI-199,441 12925:Hemorphin-4 12885:Erinacine E 12870:Eluxadoline 12860:Dynorphin A 12805:Cyclazocine 12780:Butorphanol 12765:Bremazocine 12740:Asimadoline 12730:Allomatrine 12720:Akuammicine 12629:Quadazocine 12624:Pawhuskin A 12619:Noribogaine 12604:Naltrindole 12544:Epicatechin 12539:Eluxadoline 12514:Clocinnamox 12442:Antagonists 12373:Samidorphan 12363:Racemorphan 12343:Oxymorphone 12303:Mitragynine 12298:Metkefamide 12278:Lexanopadol 12273:Levorphanol 12258:Laudanosine 12223:Hydrocodone 12218:Hemorphin-4 12118:Cyclazocine 12093:Butorphanol 12068:β-Endorphin 11987:Samidorphan 11982:Quadazocine 11972:Pawhuskin A 11962:Noribogaine 11952:Naltrindole 11887:Naldemedine 11817:Epicatechin 11774:Clocinnamox 11662:Antagonists 11633:Tubotaiwine 11618:Trimebutine 11548:Racemorphan 11518:Piritramide 11503:Phenazocine 11488:Pentazocine 11461:Oxymorphone 11426:Oliceridine 11411:Norketamine 11396:Nicocodeine 11381:Naltalimide 11346:Mitragynine 11336:Metkefamide 11306:Loxicodegol 11296:Lexanopadol 11291:Levorphanol 11266:Laudanosine 11231:Hydrocodone 11226:Hodgkinsine 11216:Hemorphin-4 11206:Frakefamide 11166:Embutramide 11161:Dynorphin A 11121:Eluxadoline 11111:Dimenoxadol 11046:Carfentanil 11031:Butorphanol 11006:Bezitramide 10976:β-Endorphin 10966:Anileridine 10956:Akuammidine 10951:Akuammicine 10921:α-Narcotine 10732:amphetamine 10683:barbiturate 9328:10 November 8880:18 November 8412:15 November 6731:10 November 6593:10 November 6500:17 November 6475:20 November 6401:10 November 6052:10 November 6043:"Methadone" 6027:10 November 5405:www.cdc.gov 5310:20 November 5304:www.cdc.gov 5080:www.cdc.gov 5048:: 193–200. 4063:pcssnow.org 3768:(1): 8–11. 2872:16 November 2846:16 November 2841:www.cdc.gov 2772:16 November 2606:(3): 1–95. 2369:16 November 1998:www.cdc.gov 1706:powder (on 1698:A two 1379:hepatitis C 889:pathway by 866:(AKT), and 847:, or both. 831:, or both. 689:Alexithymia 632:Goose bumps 489:Hypothermia 477:Hypokinesis 471:Hypotension 465:Bradycardia 302:hydrocodone 263:hepatitis C 109:hepatitis C 40:Other names 15414:Categories 15069:Naltrexone 15003:Lofexidine 14942:Topiramate 14930:Naltrexone 14887:Disulfiram 14691:Allen Carr 14531:Drug rehab 14522:Treatment 14438:management 14434:Treatment 14368:Alcoholism 14349:Withdrawal 14319:Dependence 14237:Epigenetic 14189:mechanisms 14122:Financial 14115:Behavioral 14052:dependence 14001:Kyotorphin 13946:Spinorphin 13827:SB-612,111 13822:Nocistatin 13792:BAN-ORL-24 13743:SCH-486757 13738:SCH-221510 13577:Nociceptin 13538:PF-4455242 13513:Naringenin 13503:Naltrexone 13463:LY-2795050 13458:LY-2459989 13453:LY-2444296 13448:LY-2196044 13433:Hyperoside 13348:Aticaprant 13242:imipramine 13165:Proxorphan 13140:Oxilorphan 13110:Niravoline 13100:Nalorphine 13075:Nalbuphine 13060:Moxazocine 13035:Metazocine 13005:Lofentanil 12970:Ketazocine 12930:Herkinorin 12910:Gemazocine 12900:Fedotozine 12880:Eptazocine 12810:Cyclorphan 12795:Ciprefadol 12614:Naringenin 12594:Naltrexone 12589:Nalorphine 12564:LY-2196044 12554:ICI-174864 12549:ICI-154129 12494:Bevenopran 12469:α-Santolol 12433:Zenazocine 12413:Tonazocine 12368:RWJ-394674 12353:Proglumide 12293:Metazocine 12283:Lofentanil 12213:Fluorophen 11977:Rimonabant 11967:Oxilorphan 11957:Naringenin 11947:Naltrexone 11912:Naloxazone 11902:Nalorphine 11867:LY-2196044 11837:Hyperoside 11827:Gemazocine 11822:Eptazocine 11759:Bevenopran 11603:Tianeptine 11578:Tapentadol 11573:Sufentanil 11568:Sinomenine 11558:Salsolinol 11513:Piminodine 11431:Oxycodegol 11421:Octreotide 11416:Nufenoxole 11366:Nalbuphine 11321:Meptazinol 11301:Loperamide 11271:Lefetamine 11221:Herkinorin 11201:Fluorophen 11156:Dipipanone 11081:Dermorphin 10971:Apparicine 10961:Alfentanil 10884:(abridged; 10864:modulators 10713:Stimulants 10376:Caffeinism 10330:Alcoholism 10003:Withdrawal 9378:: 108019. 9235:: 108196. 8852:2 November 8252:(1): 884. 8139:: 108717. 7765:2 November 7624:2066/52984 7102:2 November 6766:2 November 6677:"UpToDate" 6568:1 November 6260:(1): 151. 6099:9 November 5554:4 February 5549:CVS Health 5474:2 November 5444:2 November 5385:2 November 5375:"Naloxone" 5284:7 November 5249:3 November 5224:3 November 5219:CVS Health 5086:3 November 3916:9 February 3037:21 October 2346:StatPearls 1926:References 1714:See also: 1642:electrodes 1496:See also: 1481:Naltrexone 1476:Naltrexone 1408:lofexidine 1350:certifies 1327:, such as 1290:See also: 1286:Medication 1270:Management 1239:Mitigation 1222:naltrexone 1188:Prevention 1074:phenotypes 1067:endogenous 1065:and their 850:Increased 819:Dependence 622:Runny nose 611:Increased 582:Withdrawal 406:dependence 394:Withdrawal 333:naltrexone 243:dependence 204:16 million 195:naltrexone 182:Medication 153:Alcoholism 75:psychiatry 15121:Lorazepam 15104:Clonidine 15074:Nalmefene 15036:Methadone 15025:+naloxone 14998:Clonidine 14958:Clonidine 14935:Nalmefene 14881:inhibitor 14858:Clonidine 14822:Bupropion 14469:therapies 14358:Disorders 14060:Addiction 14048:addiction 13956:Tynorphin 13951:Thiorphan 13931:Opiorphan 13873:Amastatin 13802:J-113,397 13763:TH-030418 13733:Ro65-6570 13728:Ro64-6198 13655:Etorphine 13563:Zyklophin 13553:Taxifolin 13443:LY-255582 13403:Cyclofoxy 13353:Axelopran 13267:Xorphanol 13257:U-54,494A 13225:Tifluadom 13215:TH-030418 13145:Oxycodone 13135:Oripavine 13105:Naltriben 13090:Nalmefene 13045:Mianserin 13015:Lufuradom 12920:GR-103545 12895:Etorphine 12875:Enadoline 12775:Butorphan 12770:BRL-52537 12735:Apadoline 12644:Taxifolin 12639:SoRI-9409 12599:Naltriben 12584:Nalmefene 12559:LY-255582 12489:Axelopran 12428:Xorphanol 12398:TH-030418 12378:SB-235863 12338:Oxycodone 12333:Oripavine 12198:Etorphine 12088:Butorphan 12053:Amoxapine 11992:Taxifolin 11917:Naloxegol 11892:Nalmefene 11862:LY-255582 11792:Cyprodime 11787:Cyclofoxy 11754:Axelopran 11734:Alvimopan 11729:Akuammine 11714:α-Gliadin 11653:Xorphanol 11643:Valorphin 11588:TH-030418 11446:Oxycodone 11441:Oripavine 11376:Nalmexone 11331:Methadone 11311:LS-115509 11191:Etorphine 11181:Eseroline 11026:Butorphan 10887:full list 10819:Chocolate 10221:disorders 9798:(1): 28. 9508:252753865 9130:USA Today 9095:"Opioids" 8803:Addiction 8364:2168-622X 8317:2168-622X 8115:216247971 8071:211122521 7584:698332858 7264:Addiction 7041:Addiction 6726:Drugs.com 6637:(1): 11. 6588:Drugs.com 6378:209147406 6235:253608569 5244:Walgreens 5183:0163-7525 5002:: 39–61. 4619:: 71–74. 3692:28 August 3032:NBK526012 2364:NBK553166 2232:Addiction 2172:: j1550. 1700:milligram 1669:substance 1629:effects. 1513:methadone 1486:abstinent 1459:Methadone 1404:Clonidine 1333:methadone 1157:haplotype 1148:exogenous 1090:psychosis 940:Pleasure 897:, in the 734:Addiction 729:Addiction 724:Mechanism 692:Dysphoria 662:Bone pain 653:Shakiness 602:Agitation 575:Oxycodone 442:Confusion 402:Addiction 389:Tolerance 348:Diagnosis 317:methadone 298:oxycodone 239:Addiction 201:Frequency 191:methadone 159:Treatment 119:Long term 88:tolerance 66:Specialty 15404:Medicine 15131:Oxazepam 15116:Diazepam 15009:Ibogaine 14969:Phenibut 14964:Baclofen 14832:Lobeline 14827:Cytisine 14758:Category 14679:See also 14524:programs 14403:Nicotine 14393:Cannabis 14388:Caffeine 14327:Concepts 14187:Cellular 14131:Shopping 14126:Gambling 14100:Nicotine 13842:Trap-101 13832:SR-16430 13753:SR-16435 13607:(PheΨ(CH 13587:Agonists 13498:Naloxone 13408:Dezocine 13378:Catechin 13333:Apigenin 13262:U-69,593 13055:Morphine 13025:MB-1C-OH 12965:Ketamine 12950:Ibogaine 12915:GR-89696 12905:Fentanyl 12785:BW373U86 12673:Agonists 12663:κ-opioid 12609:Naloxone 12504:Catechin 12479:Apigenin 12418:Tramadol 12403:Thebaine 12313:Morphine 12233:Ibogaine 12203:Fentanyl 12183:DPI-3290 12153:Dezocine 12098:BW373U86 12078:Biphalin 12043:ADL-5859 12016:Agonists 12006:δ-opioid 11932:Naloxone 11857:Lobeline 11842:Ibogaine 11764:Catechin 11744:Apigenin 11613:Tramadol 11608:Tilidine 11593:Thebaine 11563:SC-17599 11533:Propiram 11493:Pericine 11436:OM-3-MNZ 11361:Morphine 11251:Ketamine 11196:Fentanyl 11106:Dezocine 11041:BW373U86 11011:Biphalin 10896:3-HO-PCP 10882:Agonists 10872:μ-opioid 10752:Volatile 10627:hypnotic 10622:Sedative 10521:Nicotine 10398:Cannabis 10350:Caffeine 10209:Hangover 10057:Combined 9824:31238952 9771:28541119 9701:Archived 9671:36994370 9662:10040330 9608:35954640 9557:36988913 9548:10061313 9500:36202619 9446:37418260 9437:10329206 9394:34637841 9259:33221125 9181:35800815 9043:26584180 8825:37705148 8781:35322965 8753:33965972 8701:23740651 8557:25530442 8491:27733281 8406:Archived 8382:36449315 8373:10297827 8325:24500040 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