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Poppies, pain and pleasure: Unraveling opioid use and misuse in Hispanics. Chairs : Keith Trujillo & Silvia L. Cruz. OPIOIDS, OPIATES. Papaver somniferum. Opioid effects are like a “rebozo”. Or a quilt…. Intertwined, but dissectible…. PLEASURE. ANALGESIA. ADDICTION. TOLERANCE.
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Poppies, pain and pleasure: Unraveling opioid use and misuse in Hispanics Chairs: Keith Trujillo & Silvia L. Cruz
OPIOIDS, OPIATES Papaver somniferum
Intertwined, but dissectible… PLEASURE ANALGESIA ADDICTION TOLERANCE
Some opioid effects • Analgesia • Reward/Pleasure • Constipation • Respiratory depression • Immunomodulation • Miosis • Modulation of gene expression
Processes associated with repeated opiate administration Tolerance Addiction Physical dependence
Dissecting tools • Opiate agonists, antagonists, inverse agonists • Endogenous opioids • Receptor subtypes • Schedules of drug administration • Other drugs • KNOWLEDGE
Tolerance is not an all-or-none event • It develops at different rates and with different intensity on various effectors. • Higher doses and shorter interval doses contribute to a higher degree of tolerance. • Tolerance can be prevented and/or attenuated with pharmacological interventions.
Tolerance Nausea Reward/Pleasure Analgesia Constipation Respiratory depression Miosis (time)
Addiction Behavioral components Environmentalfactors Neurobiological changes
Some facts: • Physical dependence is not synonymous with drug addiction. • Tolerance can occur without physical dependence. • People do become addicted to opiates, but addiction does not arise from proper use of opiates for pain management. • Opiate use and abuse are influenced by social and environmental factors.
Symposium • Neurobiology of Opiate Actions. Rafael Maldonado, Ph.D. • Pharmacotherapy of Opiate Addiction. Gerardo Gonzalez, M.D. • Pain and Clinical Use of Opiates in Hispanic Populations. Guadalupe R. Palos, R.N., L.M.S.W, Dr.PH. • Cultural and contextual influences of opiate abuse among U.S. Hispanics. Avelardo Valdez, Ph.D.