Opioid classification

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Classification of the narcotic analgesics is based on their activity at the opioid receptor sites. Although five categories of opioid receptors have been identified, only three of these receptors affect the action of the narcotic... 

Dhawan BN, Cesselin F, Raghubir R et al. International Union of Pharmacology XII. Classification of Opioid Receptors. Pharmacol Rev 1997 48 567-592. 

OFFICIAL NAMES Methadone, Dolophine STREET NAMES Fizzies, dollies, dolls DRUG CLASSIFICATIONS Schedule II, opioid narcotic analgesic... 

Delta Receptors. There has been considerable interest in 6 opioid agonists because they exhibit antinociceptive effects without the side effects associated with p, opioid receptor agonists. Antinociceptive activity was first demonstrated with 6-selective opioid peptides (see Ref 218 for a review), and more recently with nonpeptidic 6-selective agonists (see Refs. 219-222 for reviews). Of particular interest is the activity of 6 agonists in inflammatory and neuropathic pain (220). Delta opioid receptors also modulate fx opioid receptors and, as discussed earlier, one classification of 6 opioid receptor subtypes was based on their association with p, opioid receptors. There is now considerable evidence that interaction between the two receptor types can alter the activity of p. opioid agonists. Delta agonists... 

Most clinicians consider the use of opioids to be the next logical step in the management of acute pain. The classification of these agents, their equianalgesic doses, and dosing guidelines are outlined in Tables 58-7 and 58-8. 

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