This document discusses opioid use disorder and its effects. It notes that opioids like opium, heroin, and morphine are highly addictive substances. Long term opioid use can lead to dependence and addiction through binding to mu opioid receptors in the brain. Withdrawal symptoms include flu-like symptoms like nausea and craving for the drug. Diagnosis involves examining pupils, testing urine for opioids, and observing for withdrawal symptoms. Treatment involves medication-assisted therapy with drugs like methadone or buprenorphine, counseling, and psychosocial support to prevent relapse.

1. OPIOID USE DISORDER
Mr.Visanth V S
Asso.Professor
IGSCON, Amethi

2. OPIOID USE DISORDER
• Dried exudates obtained from unripe seed capsules of
Papaver somniferum has been used and abused for
centuries.
• The natural alkaloids of opium and their synthetic
preparations are highly dependence.
• This group includes several narcotic substances like
opium, heroin, morphine, codeine, pethidine,
methadone, and pentazocine.
• Synthetic preparations are highly dependence
producing.
• These drugs are mainly used as an analgesic, but long
term use can produce dependency.

3. • The most important dependence producing derivatives are
morphine and heroin.
• They both like majority of dependence producing opioids
bind to μ (mu) opioid receptors.
• The other opioid receptors are k (kappa, e.g. for pentazocine),
δ (delta), σ (sigma, e.g. for phencyclidine), ε (epsilon) and λ
(lambda).
• Heroin or di-acetyl-morphine is about two times more potent
than morphine in injectable form.
• Apart from the parenteral mode of administration, heroin can
also be smoked or ‘chased’ ( chasing the dragon), often in an
impure form (called ‘ smack’ or ‘ brown sugar’ in India).
Contd…..

4. • Natural Alkaloids of
Opium
– Morphine
– Codeine
– Thebaine
– Noscapine
– Papaverine
OPIOID DERIVATIVES
• Synthetic Compounds
• Heroin
• Nalorphine
• Hydromorphone
• Methadone
• Dextropropoxyphene
• Meperidine (Pethidine)
• Cyclazocine
• Levallorphan
• Diphenoxylate

5. • Psychological Effects
– Euphoria
– Relaxation
– Hyperactivity
– Drowsiness
– Analgesia
– Reduced sexual
desire
INTOXICATION OF OPIOID
• Physical Effects
– Pin-point pupil
– Bradycardia
– Reduced appetite
– Constipation
– Respiratory depression
• With increase in dosage tolerance develops rapidly.

6. Withdrawal of opioid drugs rarely threatens life and does
not produce serious effects.
 The features are flu like symptom include;
Lacrimation
Running nose
Muscle and joint pain
Cold and hot flushes
Nausea, vomiting and diarrhea
Piloerection
 Intense craving for the drug is a notable feature. This
symptom starts 6 hours after the last dosage and peaks within
36-48 hours.
WITHDRAWAL OF OPIOID

7. Complications due to illicit drug (contaminants):
Parkinsonism, peripheral neuropathy, amblyopia,
transverse myelitis.
With IV users it may develop;
 AIDS
 hepatitis
Endocarditis
Septicemia
acute local infections (cellulitis, thrombophlebitis).
Involvement in criminal activities
Complications

8. Proper History
Examination (pin-point pupils during
intoxication or withdrawal symptoms)
Laboratory tests.
Naloxone challenge test (to precipitate
withdrawal symptoms).
Urinary opioids testing
Gas chromatography-mass spectroscopy (GC-MS)
Serum electrolytes
FBC
Diagnosis

9. • Opioid overdose can be life threatening and needs
immediate management.
• Naloxone is the antidote used for the detoxification
of the opioid overdose.
• IV administration of 2mg Naloxone, followed by a
repeat injection in 5-10 minutes, due to its short half-
life repeated doses may be needed every 1-2 hours.
• Maintain patent airway
• Administer oxygen
• Administer IV fluids for the excretion of the drug
• Monitor vital signs
Treatment-Opioid Intoxication

10. • Symptomatic treatment is given
• Methadone, clonidine can be used for
maintenance
Treatment-Opioid Withdrawal

11. • Dietary management
• Treat complications
• Antidepressants can be used if the client
develops with depressive features
• Supportive psychotherapy
• Counseling
• Group therapy
• Family therapy
• Supportive groups
Other Treatment

12. This is a very important step in the post-
detoxification phase, in the absence of
which relapse rates can be very high.
Rehabilitation should be at both
occupational and social levels.
Psychosocial Rehabilitation

13. THANK YOU