Opioid Drugs, Part 2: Addiction and Overdose
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- Опубліковано 4 січ 2019
- Opioid drugs are a well-known class of drug due to both their ability to kill pain and kill people. Watch part 2 of this two-part series to learn how opioid drugs can cause addiction and overdose, as well as a bit of the history behind the opioid epidemic in North America.
Watch Part 1 here: • Opioid Drugs, Part 1: ...
Two great articles about the opioid crisis:
The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy (www.ncbi.nlm.nih.gov/pmc/arti...)
The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction (www.annualreviews.org/doi/ful...)
Mechanism of cAMP
Two key functions of cAMP have been discovered in neurons. The first is the activation of ion channels to let positive charge into cells, called a “pacemaker current”, which depolarizes the neuron to activate it. Increased cAMP makes it easier for ion channels to open. Without cAMP, it is harder for these channels to open, resulting in less positive charge entering the neuron to depolarize and activate it. The second function of cAMP in neurons is to increase neurotransmitter release. Certain neurotransmitters are released via a protein kinase A dependent pathway, which is initiated by cAMP. Without cAMP, these neurotransmitters are not released. These two functions combined point to cAMP acting as a neuron activator, and thus when opioids decrease cAMP levels, neuron function is also inhibited.
Methadone and Buprenorphine Mechanisms
Methadone (Dolophine) is a long-acting opioid receptor activator that does not cause as much euphoria as morphine. Patients with opioid use disorder patients can enroll in a “methadone maintenance” program, in which they receive a dose of methadone every day. This prevents withdrawal symptoms and unsafe activities obtaining and administrating illicit drugs, helping patients get their lives back on track. Its ability to activate NMDA receptors may also be a reason why this drug is effective at eliminating addiction, tolerance, and withdrawal, but the true mechanisms are still being investigated.
Buprenorphine is a partial agonist of the opioid receptor. This means at low doses it can activate the receptor, but at high doses it inhibits the receptor. Thus, the risk of overdose is limited with buprenorphine and thus can also be used to wean patients off of opioids, albeit slower than methadone.
References:
Kosten TR, George TP. 2002. The neurobiology of opioid dependence: implications for treatment. Science and Practice Perspectives, 1(1): 13-20
Kolodny A, Courtwright D, et al. 2015. The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annual Review of Public Health, 36: 559-574
Williams JT, Christie MJ, Manzoni O. 2001. Cellular and synaptic adaptations mediating opioid dependence. Physiological Review, 81(1):299-343
These videos really make biology much easier to learn
10/10
My "friend" somehow found himself in the "severe" classification of OUD and is just now realizing it. He said thanks for the video!
Happy new year everyone! I was hoping to get this done before January but alas I overestimated myself. Sorry for the very long wait and thanks for all your patience and support in 2018. Here's to looking forward to another year of med videos! I'm planning on posting another video in February, so stay tuned :)
Hey there. You're an absolute blessing, I got nominated for a scholarship and this video came out just in time. I was given the prompt of what issue I would like to resolve and how I could do it while attending my school. I chose the opioid epidemic because I have lost a parent to it and plan to major in neuroscience. Can I is this video as a point of reference? Do you think you could help me have me a more in depth understanding of this concept so I am well versed in this subject? Any help would be greatly appreciated
@@cerealcrusader7096 Very sorry for your loss, and all the best to your goal to become a neuroscientist. Absolutely you can use this video as a reference, but I have to admit I've only provided a very brief history on the opioid crisis due to time constraints. The full story is super interesting and I would recommend some other readings that are definitely helpful in understanding the opioid crisis better. The two articles in the video description are good starts, and the book "Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic" provides a more in-depth story of Purdue Pharma. "Dopesick: Dealers, Doctors, and the Drug Company That Addicted America" was recently published that also provides a very detailed history of the opioid epidemic in the United States from multiple perspectives. Hope these materials help, and good luck with your scholarship application!
Man please post more often😪...These videos are gold
So underated channel
@@Medicurio and Katherine: fwiw, my mother was the first woman thyroid and thoracic surgeon in the United States and was a screaming drug addict. Her favorites were Seconal and perhaps benzos such as Librium (also courtesy of the Sackler cartel), which always seemed to be lying around the house. Katherine, I am so sorry for your loss. You are young and have the awareness to make a great life for yourself. It's only now that I'm in my 60s that I realize the full extent of how my life was royally fucked up by the addiction of my mother and possibly grandfather (also a doctor and a prof at P&S). Medicurio, thank you so much for these clips. I'm hoping to find some mechanistic proof of how these drugs interfere with the normal social behavior of mother-child, couple, etc. Would love to see you do a clip on that. My non scientific assumption is that the receptors in the VTA that normally express social bonding are downregulated to the point that the drug user cannot find pleasure in wired behaviors such as gazing at your infant or communicating with your spouse. Thanks for the reference to the books. btw I have some wonderful ephemera from the 50s or 60s that they used to send to doctors: a beautiful Starry Night ad for a sleep aid, non-addictive, to help your patients relax and get restorative slumber. What was the drug? Phenobarbital.
Where's the video? :)
Went down a rabbit hole tonight. Thank you for explaining why naloxone doesn't have the same effect as an opioid like fentanyl even though it binds to the same receptors. Most explanations I found skipped over that. All they said was naloxone binds to the receptors in place of fentanyl and I was thinking "Wait, but how is that different than what fentanyl does?"
Now I know binding to a receptor ≠ activating a receptor!
Drug addiction and withdrawal are certainly a lot to overcome, to say that least. I feel for anyone dealing with it, and I am cheering for them, whether they are actively trying to be/are sober or not, to have true happiness and health
Life liberty & the pursuit of happiness means the right for adults to enjoy any molecules of their choice in the world without fear of being investigated! arrested! kidnapped! or thrown into a cage by tyrants with badges & guns!
Humans have used Opiates for thousands of years without “addiction” issues until Harry Anslinger of the Federal Bureau of Dangerous Drugs got involved! The FBODD would become the DEA they applied the Nazi’s anti-drug ideologies here in the USA in the 1940’s. So the Number of Opiate Addictions exploded immediately after that happened…wonder why….
Six months waiting for this video, it was worth it. Thank you Medicurio.
Great video, especially liked the addition of the background of the crysis and what can be done against it. Well researched, I'm willing to wait a while for this quality content :)
I’ve been waiting for this vid for so long I’m so happy it’s up. Thanks Medicurio, very cool, keep it up, proud of ya.
I absolutely love the amount of detail and information on this video.
Admittedly, this channel is one of my best sources for learning the mechanisms of the drugs and diseases.
Thank you very much for putting this videos up for me and other aspiring medical students to learn, really!
I was just prescribed hydrocodone, and frankly I don’t need it, even the nurses said I don’t, actually they said “You shouldn’t need to take it, but it’ll help you sleep”. I mean I get I just got out of surgery from a jaw infection but I’m fine with ibuprofen as for now, now I get the whole opioid epidemic...
Yeah, but what happens when it starts hurting at 11 PM and gets worse and worse and you have no on to call after the Advil stops working? I have had a lot of dental work and have had this exact same thing happen to me because I went to a dentist who was trying to fix the opioid epidemic, and thus I was miserable for 2 days trying to get something more effective. I see why doctors and dentists give out preventative opioids in cases like yours. IMO this is not a problem they can 'fight' ethically until we get better non opioid pain meds that work the same or better as them. IMO if a doctor treats 10 patients and doesn't give opioids but 1 person out of that 10 end up suffering and in pain, that doctor has failed that one patent.
Yes there are instances of pill mills and crooked doctors and I am not talking about them. I am taking about legit doctors that are finding it harder and harder to treat pain because they are being assigned a task that is not in the best interest of their patients, and is far beyond the scoop of what their job is. I also hate the fact that personal responsibility is non existent in this conversation every time it happens.
Dont use it unless
Thanks for good quality content, usually I get bored studying about the analgesic drug, but this was a very smooth and calm learning experience
I had brain surgery a few years ago in an area heavily effected by the opioid crisis, and the doctors gave me 250 pills of percoset. I never took any. My neurosurgeon advised me to smoke weed instead despite his inability to prescribe it, and high cbd indica strains helped manage my pain without destroying my life like opioids did to so many people around me.
@@viracocha You say that but that's how my best friend in highschool started. He got percs for wisdom teeth removal and eventually progressed to heroin, and now he's dead so I'm rather skeptical
This channel deserves MORE SUBS!
This channel is incredible. I hope it gets millions of followers, your content is easy to understand yet covers such complicated topics. 10/10!! You rock!
Thanks! Glad you like them!
Bro, these videos just made me understand very well how the Opioids work. I started with my Anasthesie postgrade and i had doubts with the way they work. Thank you very much. Really. Thank you!
great job; the best graphic/visual lecture in short form on this topic out there
I've been waiting!! Thank you💕
Welcome back :) Take whatever time you need to irl, even if you have an irregular upload schedule.
I disagree with your proposal for uses beside non- cancer pain. Temporary use for post surgery pain should also remain allowed. However, for chronic pain it should be avoided. If I end up with chronic pain and a doctor recommends it, I would turn it down since that seems like addiction would become unavoidable.
Amen ! I am finally off Methdone now trying too come off of Oxycodone. I had 3 back surgeries and I have been on oxycontin, Roxycodone, Morphine, Methadone, Percocet. My body is now hooked as is my brain. I told my Pain Dr I want off. I do have severe Spondylitis in my back, I can barely walk however I am so tired of Dr's, receiving prescriptions, side affects. I am 58 years old yet I feel worse than most 90 year Olds. I constantly tell people do not take strong opioid pain medication unless one has cancer. I wish I would have never started.
Medicurio is such an awesome channel, keep it up! 🙂
This two-parter is by far the best video series I have ever seen on opioids. Fantastic work.
This was really well done and informative. Thanks for the video!
It’s a great gift to make the complex understandable thank you for this information.
great explanation ,now i understand the chemistry behind addiction better . thank you :)
AMAZING VIDEO! I never understood opiods properly before this! Thankyou so much, please keep making more pharmacology videos :)
Such a great video explaining effects of opioid drugs. Very very good.
Please make a video like this on benzodiazepines.
Great ideia!!! Cant find any good material!
Came from TierZoo recommendation. Just subbed. Hope you come back with more content!
Another Great video as usual.
Wonderful two-part presentation. Very
well done.
It appears that there
are still few genuine
pain
'killing' medications-
proper to date. Strangely
enough, just about everything people use for both acute and chronic pain
do not actually target the pain or even the symptoms at all. The list of said pain relievers is near endless. They are probably more accurately referred to as counter-irratints. It may sound odd, even counter intuitive, but aspirin may be the best authentic pain reliever. Symptoms themselves are actually targeted by aspirin.
Whether your using weed, watching a good comedy, or using a strong prescription medication, the pain is not being targeted, your brain is.
People are different, so whatever is used is best something which is tailored to the individual, but good luck. And don't get me wrong, for many suffer's aspirin alone ain't gonna make it. I know-I know.
It's so super to see someone go the length to help explain what it is that is really going-on in thier bodies whilst suffering.
Really Great, thanks so much.
Wt a crystal clear concept🤩 . Plzz keep uploading more videos. Indeed! helpful.
Awesome explanation, to say thanks is not enough.
Hey.. I really liked this video.... I mean i had read the mechanisms before.. But i could understand this even better after your explanation.....
Plz keep making more videos
Love love😘
Hey thank you very much please keep making such great videos. You're the best
Very good video. A bit too much for your average viewer to process but awesome video. Deserves more views!
Great work as always
Best explanation ever. Thank you very much.
Guess who's back, back again
AA's back, tell a friend
So helpful and very clear explanation!!!! Thank you so much!
You're such a great content creator! I love your simple but very beautiful animations and drawings! It could be used very effectively to replace boring video courses without loosing content density! If you ever think about expanding your viewers to Portuguese speaking countries, count me in to help with the translation ;)
Loved your presentation....thank you sooo very much
Amazing detail, thank you!
Amazing channel thank you for these vids they are brilliant x
So simple, so excellent presentation.
very informative and helpful. thank you!
I really enjoyed that video on caffeine you made! Can you make one on the effects of amphetamine stimulants on the brain and how they compare to caffeine?
here after watching the tv show on purdue pharma and the opiod crisis, it's incredible
Amazing video... Keep making more... Thanks...
Please make a video on Benzodiazepines class of Drugs
thankyou soo much, i realy appreciate your work.
such a great video. Thank you
Nicely explanation with simple & easy way 🙏🙏
Such a great video, thank you!
Hey, your content is really great, but if i had to give some feedback maybe use some music in the background, or even make the arial font something a little more exciting to keep your viewers more interested :)
it's awesome learning...
such a great video!
Thank you so much 💜.
Thank you!
this is also so great thank you so much
Awesome videos , thanks alot .bless u.
your video is so wonderful. Thanks so much
cant wait to see your next video.
Very good video
thnks alot.... love from india🇮🇳
Thanks so much for your video! Can you make a video about THC, Psilocybin and Mescaline? It would be really cool to learn more about hallucinogens. :))
Pls make a video abt high blood pressure pls...
Thank you🙂
you should make a video on crohn’s disease
Great video! There is only one mistake about dopamine.
Dopamine does not cause please!!
This disinhibition in the VTA is only important for the drug seeking behaviour, craving, and relapse.
Please make more videos...
THis is amazing!
what happens if you hit all 11 criteria? im 4.5 months clean now tho
Please cover the human immune system and then how HIV meds work.
These are great videos! One remark about the opioid crisis that I think should be mentioned: The commercial basis of healthcare -it is an 'industry' in the US has a lot to do with the origins and persistance of the crisis. Patients pay for their health care and expect pain-free treatment. If they don't get what they want, they'll go to the next doctor: The competition. So, doctors are competing on patient experience mostly. They get a perverse incentive to prescribe unnecessarily high levels of pain medication; otherwise they'll suffer in turnover! It is a too-high degree of commercial thinking in American healthcare that lies at the basis of the opioid crisis.
What abt covering depression and how anti depressants work
Normally, loperamide doesn't cross the blood brain barrier, but in high doses it does. So there are people that abuse it due to its accessibility.
What happened to Ketoprofen for pain relief? I used it for mild to severe pain and it worked and was not a drug that was an addictive drug. Great content and the history is of the problem is fascinating.
Ketoprofen is an nonsteroid anti-inflammatory (NSAID) that is in the same family as other NSAIDs like aspirin and ibuprofen (Advil). From what I understand it is still available and used. It definitely is less potent than opioids for pain relief though and is usually only used for, as you suggested, mild/moderate pain and maybe severe pain for some.
Come back!!
How dangerous to use opioids with benzodiazepines addiction?!
How long can live using it?!
I teach nursing and would like to use this as part of a continuing education course. How would I do this?
Hello, when you use the video please cite this channel (e.g. provide a link), or even better, embed this video into your course so your students can watch it directly from this channel.
IMO the only way to fix the problem is alternate meds that are on the same level or even better at controlling pain. It's a big ask to assign the role of fixing this problem to doctors who's job it is to reduce pain and suffering. It's like taking a fireman's hose away and giving him a squirt gun to go fight a fire. Sure there are illegal and corrupt pill mills out there that should be dealt with, but I think most doctors are doing the best job they can with what they have.
damn, youre amazing
Medicurio isn't dead! Huzzah!
about that...
Yeah...
No Skill Intended ummm id like to add an asterisk
I was on methadone at one point. Never again. However, I do take Hydrocodone as prescribed on a daily basis for a degenerative disk disorder in my lower lumbar. My pain doctor is great and wanted to prescribe me Percocet instead of Hydrocodone. I told him that the Norco works fine and no need to change it.
Just because you’re prescribed something doesn’t mean you have to take it. Also, whose fault is it if you take more than the prescribed amount?
13:20 where do i buy the plushie
Greaaaaattt
BIG BRAIN
Sent by TIERZOO
Opioids: Time to slow your breathing till you stop *BOI*
Naloxone: *aRe YoU sUrE aBoUt ThAt?*
❤️❤️❤️❤️❤️❤️❤️❤️
Just tell me can it before cured?🥺 I don't wanna lose my man😭😭😭
🙏🙏🙏🙏
11:49 LMAO !!
None cancer pain? What exactly are you saying.
Opioids are not recommended for chronic non-cancer pain, for example recurrent migraines or arthritis, because of the risk of developing addiction with long term use which can interfere with their daily function (other painkillers like aspirin or tylenol are used instead). However, opioids are commonly used for patients with terminal cancer which can be extremely painful, in which the focus is more on palliative care. In these situations, addiction isn't a huge worry if the patient is only going to live for a few mlre months, though some patients opt out of opioid therapy as they do not want to feel sedated and "in a fog" as they reach the end of their life. Sometimes opioids can also be used short term, like after breaking a bone, but in those cases opioid use has to be carefully monitored to prevent chronic use and development of addiction. Hope that answers your question!
Then there is Carfentanyl. But that's a pain killer for large animals. Definitely not for human consumption.
I like how they ignore the fact that withdraw pain is the cure to the epidemic
IBOGAINE
I love opioids and benzodiazepines together, I'm on 6mgs of xanax and 50mgs of hydrocodone feeling like I just been injected by a anesthesia nurse who is prepping me for surgery lol I feel marvelous.