Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 7OpioidsSTEPHEN L. DILTS, JR.STEPHEN L. DILTSOpioids constitute the group of compounds whose pharmacological effectsduplicate those of morphine. They are commonly used medically as an adjunctto anesthesia, for the relief of pain, for the prevention of an abstinence syndrome,and for cough suppression. Opioids also are abused for their intoxicatingeffects.The history of opioid use goes back thousands of years in human history.The Ebers Papyri from approximately 7000 B.C. refer to the use of opium inchildren suffering from colic (Deneau & Mule, 1981). In the Victorian era, theuse of laudanum was socially acceptable. In the present day, opioids use is stringentlyregulated, especially in the United States; however, demand by addictsresults in the existence of a “black market” characterized by crime, disease, poverty,and loss of personal and social productivity. The sexually promiscuousintravenous heroin user is at high risk to contract and effectively spread thedeadly acquired immune deficiency syndrome (AIDS) virus, as well as venerealand other infectious diseases, such as hepatitis C. High overall death rates areassociated with opioid abuse, approximately 10–15 per 1,000 in the UnitedStates (Jaffe, 1989). The Drug Abuse Warning Network (Substance Abuse andMental Health Services Administration, 1995) indicates an alarming increasein the use of opioids, especially prescription drugs such as oxycodone.138