01:830:364 Lecture Notes - Lecture 11: Pain Management, Oxycodone, Fentanyl
9 Apr 2017
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Document Summary
During heroin withdrawal, due to reduced enkephalin output combined with the absence of heroin, gabaergic interneurons are less inhibited, resulting in more inhibition of vta. Due to depressed firing rates of vta-nac neurons. Heroin addicts experience overwhelming pain, intense feelings of dysphoria, negative mood, and physical distress. Addicts report that during withdrawal they are wracked with intolerable pain and. Intense cravings for the drug"s effects during periods of abstinence. waves of extreme anxiety. The need for the drug is all-consuming, often provoking dangerous and desperate actions, to obtain opiates or the money to purchase it. A syndrome of characteristic physiological responses are evident during periods of opiate abstinence. Dependence/withdrawal symptoms are particularly intense during the first 48-72 hours of a period of abstinence and begin to subside after 96 hours (4 days). Despite the unpleasantness, the mortality rate accompanying opiate withdrawal is very low (less than 1%). Tolerance develops more slowly to the respiratory depression effect than opiates other effects.
