ABSTRACT
This chapter discusses millennial trends in prescription opiate analgesic and heroin use, including: medical use; embryo/fetus, neonate, infant, and child exposure; and adolescent and young adult illicit/recreational use. Pharmacologically, the opiate analgesics—for over a century—have been traditionally referred to as narcotic analgesics reflecting their major therapeutic indication—to relieve pain. The opiate analgesics have an interesting mechanism of action. “Pure” opiate analgesics appear to exert their analgesic action primarily at the mu receptors found in the brain, spinal cord, and intestinal tract. Different opiate analgesics, once absorbed into the systemic circulation, have different distribution characteristics. Morphine and other opiate analgesics are largely metabolized into several inactive products by the liver before being excreted by the kidneys. Opiate analgesic drug–drug interactions are relatively common. The opiate analgesics are associated with many undesired, or harmful, effects and toxicities that can affect virtualy every body system.
