Chapter 9.0: Opioids
agonist: a drug that partially or fully activates specific neurotransmitter receptors, creating a partial or full response that would be triggered by another drug (e.g., illicit or misused substances); used as a substitute for the problematic substances.
analgesic: having the ability to relieve pain (usually refers to a drug).
analogs: having a chemical structure similar to another compound but different in one or more component, often developed and distributed as means of circumventing laws restricting manufacture/distribution of the drug for which it is an analog.
antagonist: a drug that blocks another substance’s action by binding to the neurotransmitter sites and preventing its action.
benzodiazepines: synthetically produced drugs with a tranquilizing effect on the brain, commonly prescribed to treat anxiety, sleep disorders, and alcohol withdrawal; potentially addictive, and may be misused themselves.
buprenorphine: a prescribed opioid medication (narcotic) used to treat opioid use disorder; may be combined with naloxone (e.g., Suboxone®). [not to be confused with bupropion, see below] (partial mu-opioid receptor agonist).
bupropion: an antidepressant medication that also may be used to treat nicotine dependence by reducing cravings and withdrawal effects. [not to be confused with buprenorphine, see above]
carfentanil (or carfentanyl): an extremely powerful, addictive synthetic opioid originally intended for large animal veterinary practice.
detoxification (detox): an initial step in treating substance misuse/substance use disorders during which the substances of concern are withdrawn from the body under supervision, the person is medically stabilized, withdrawal symptoms are managed, and longer-term treatment is encouraged.
disulfiram: an alcohol antagonist drug that produces unpleasant physical reaction to alcohol consumption/exposure; serves as a deterrent to drinking (avoiding the punishing consequences); may also be used in pharmacotherapy with cocaine misuse where it likely serves as a cocaine agonist in the dopamine reward system instead.
endogenous: originating inside the body.
exacerbated: meaning that something is made worse.
exogenous: originating outside the body.
fentanyl: an extremely powerful, addictive synthetic opioid, often mixed with other substances, with a strong presence in illicit drug trafficking but originally intended for prescription pain management in human and veterinary medicine.
heroin: a powerful, addictive opioid derived from morphine (naturally derived from opium poppy), produced in various forms (e.g., white powder, brown powder, black tar) and having no recognized medical use in the U.S. (Schedule I drug by the DEA).
medication adherence: the extent to which an individual uses medication as prescribed (adheres to a treatment plan involving medication).
medication assisted treatment (MAT): use of prescription medications under medical supervision to treat substance use disorders of various types and deter relapse through management of cravings and withdrawal symptoms and/or interrupting the substance-use reward system; recommended that behavioral interventions accompany MAT.
medication management (MM): a specific type of intervention designed to support adherence to a medication-involved intervention protocol.
methadone: a synthetic long acting opioid agonist drug used to treat opioid use disorder by reducing cravings and withdrawal symptoms, as well as blocking the effects of other opioids that might be used; because of its addictive potential, it remains a Schedule II drug by the DEA.
methadone maintenance therapy (MMT): an integrated treatment protocol for recovery from opioid use disorder, combining long-term prescribing of methadone in combination with behavioral counseling and other social services to support recovery.
naloxone: an opioid antagonist drug with low addictive potential used both in the immediate reversal of opioid overdose (causing immediate withdrawal) and in longer-term medication assisted treatment of opioid use disorder.
naltrexone: an opioid/opiate antagonist that blocks positive effects from using opioids or alcohol, decreasing the desire to use these substances in the future. [Not to be confused with naloxone, see above]
narcotics: drugs designed for pain management/relief; the term now commonly refers to illicitly used/trafficked opioids.
neonatal abstinence syndrome (NAS): term commonly used for neonatal withdrawal syndrome (see below).
neonatal withdrawal syndrome (NWS): a cluster of symptoms frequently observed in newborn infants who have been prenatally exposed to opioids, triggered by separation from the source of these substances via the placenta causing the infant to experience substance withdrawal.
nicotine replacement therapy (NRT): medications or devices that deliver controlled amounts of nicotine that can be gradually tapered to help a person stop using nicotine products (e.g., cigarettes) by minimizing the cravings and withdrawal symptoms associated with cessation efforts; considered a harm reduction approach if the medication or device eliminates the risks associated with smoking or otherwise consuming the nicotine-containing products.
opiates: psychoactive substances that interact with opioid receptors and are produced from natural sources (e.g., opium, morphine, codeine); opiates are now considered to fall under the broader opioid category.
opioids: psychoactive substances that interact with opioid receptors; may be “natural,” synthetic, or partially/semi-synthetic in origin.
opioid agonist: a substance or drug that activates opioid receptors resulting in some (partial agonist) or all (full agonist) opioid effects—heroin, methadone, morphine are full opioid agonists and buprenorphine is a partial agonist.
opioid antagonist: a substance or drug that blocks opioid receptors thereby interfering with opioid effects—naloxone is an opioid antagonist.
opioid use disorder (OUD): a diagnostic label applied when 2 or more of 11 criteria listed in the DSM-5 are met within the same 12-month period, with degree of severity determined by the total number of criteria met.
persistence: how long a substance remains active in the body; related to the pharmacokinetic principle of drug half-life.
pharmacotherapy: use of (prescribed) medications, in this context, for the purpose of treating substance misuse/substance use disorder.
polydrug misuse: using two or more psychoactive substances in combination, usually with the intent of achieving a particular effect; alcohol is commonly involved in polydrug use scenarios.
stabilization: one major goal of the detoxification (detox) process aimed at ensuring a person is medically and mentally stable without additional use of previously misused substances.
Suboxone®: a medication combining buprenorphine and naloxone, used in treating opioid misuse/use disorder.
varenicline: a partial nicotine agonist medication used in treating nicotine addiction.