Psychopharmacology 3e Chapter 11 Outline

The Opioids


Narcotic Analgesics

The opium poppy has a long history of use
Minor differences in molecular structure determine behavioral effects
Bioavailability predicts both physiological and behavioral effects
Opioids have their most important effects on the CNS and on the gastrointestinal tract
Box 11.1 Clinical Applications Saving a Life: Naloxone for Opioid Overdoses

Opioid Receptors and Endogenous Neuropeptides

Receptor binding studies identified and localized opioid receptors
Four opioid receptor subtypes exist
Several families of naturally occurring opioid peptides bind to these receptors
Box 11.2 The Cutting Edge Science in Action
Opioid receptor–mediated cellular changes are inhibitory

Opioids and Pain

The two components of pain have distinct features
Opioids inhibit pain transmission at spinal and supraspinal levels
Other forms of pain control depend on opioids

Opioid Reinforcement, Tolerance, and Dependence

Animal testing shows significant reinforcing properties
Dopaminergic and nondopaminergic components contribute to opioid reinforcement
Long-term opioid use produces tolerance, sensitization, and dependence
Box 11.3 Of Special Interest The Opioid Epidemic
Several brain areas contribute to the opioid abstinence syndrome
Neurobiological adaptation and rebound constitute tolerance and withdrawal
Environmental cues have a role in tolerance, drug abuse, and relapse

Treatment Programs for Opioid Use Disorder

Detoxification is the first step in the therapeutic process
Treatment goals and programs rely on pharmacological support and counseling