Opiates: Human Psychopharmacology

Addiction Motivation Reformulated: An Affective Processing Model of Negative Reinforcement.

“…Not only does it appear likely that homoreflexive associations are ubiquitous (Dworkin, 1993), but also it appears likely that exteroceptive cues are not strongly contingent with withdrawal exacerbation in the addicted individual (because few exteroceptive cues are uniquely contingent with falling drug levels). Moreover, withdrawal symptoms are gradually emergent, with full-blown withdrawal not manifest for hours after drug abstinence (e.g., Mansky, 1978), which may further compromise contingencies with exteroceptive cues. 3 In summary, research suggests that incipient growth in negative affect may be signaled by the first inklings of negative affect responses per se (e.g., responses producing anxiety) or by any internal response to falling drug levels that is a reliable harbinger of negative affect (e.g., mild tremor).…”

Anaesthesia for daycase gynaecological laparoscopy: a survey of clinical practice in the United Kingdom

“…Ninety per cent of consultant anaesthetists use inhalational agents for maintenance of anaesthesia in daycase laparoscopy patients, 50% do not employ any form of adjunctive local anaesthetic technique while a small proportion (6%) do not use NSAIDs wherever possible. Since the principal reasons for overnight admission following daycase gynaecological laparoscopy are pain, nausea and vomiting, dizziness and delayed mobilisation [3,4], we feel that these areas warrant further discussion.…”

“…Pruritus is a subjective unpleasant sensation arising from irritation of the nociceptor fibres in the superficial layers of the skin which provokes the urge to scratch. It is common following opioid administration and may be more unpleasant than the pain itself [1][2][3][4]. While pruritus has been reported following intravenous or intramuscular administration, it has been suggested that it is most common following intrathecal or epidural administration of opioids [5,6].…”

“…However, laparoscopy under general anaesthesia, particularly when sterilisation is performed, can be associated with significant morbidity in the form of pain, nausea and vomiting, dizziness and delayed mobilisation [3,4]. Consequently a number of these patients require admission to hospital for overnight stay.…”

Treatment of Sickle Cell Anemia

“…According to pharmacology texts (1,2), 80-100 mg of meperidine given subcutaneously are equivalent to 10 mg of morphine, and the analgesia they produce lasts 2-4 hr ( Table 1). The effects of 10 mg of morphine last 4-5 hr, as do those of oxycodone, while the analgesic effect of methadone lasts [3][4][5] hr.…”