Opiate Analgesics [General Monograph]

The prescription of opiate analgesics for the symptomatic management of acute pain, moderate to severe, and chronic cancer pain, moderate to severe, requires a thorough psychological assessment and diagnosis of the pain disorder, its cause, and its effects on the mental health of the patient. The opiate analgesics act primarily on the CNS. The perception of and emotional response to pain is modified when opiate analgesics bind with stereospecific receptors in the CNS. Opiate analgesics are absorbed rapidly after oral, rectal, intramuscular, intranasal, subcutaneous, or transdermal administration. Following oral ingestion, most opiate analgesics undergo significant first-pass hepatic metabolism. Opiate analgesics are addicting and habituating. Long-term opiate analgesic pharmacotherapy, or regular personal use, is associated with addiction and habituation. Opiate analgesic overdosage requires emergency symptomatic medical support of body systems, particularly respiratory function, with attention to increasing opiate analgesic elimination. Mixed opiate analgesic agonists/antagonists act primarily at the kappa receptors.