TY - CHAP M1 - Book, Section TI - Opiate & Opioid Overdose A1 - Smollin, Craig A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. Y1 - 2022 N1 - T2 - Current Medical Diagnosis & Treatment 2022 AB - Prescription and illicit opiates and opioids (morphine, heroin, codeine, oxycodone, fentanyl, hydromorphone, etc) are popular drugs of misuse and abuse and the cause of frequent hospitalizations for overdose. These drugs have widely varying potencies and durations of action; for example, some of the illicit fentanyl derivatives are up to 2000 times more potent than morphine. Poisonings and fatalities have been reported due to the illicit use of fentanyl and the presence of fentanyl and its derivatives in counterfeit medications. All of these agents decrease central nervous system activity and sympathetic outflow by acting on opiate receptors in the brain. Tramadol is an analgesic that is unrelated chemically to the opioids but acts on opioid receptors. Buprenorphine is a partial agonist-antagonist opioid used for the outpatient treatment of both chronic pain and opioid addiction (Table 5–6). Kratom (Mitragyna speciosa) is an herbal supplement with agonist activity at mu opioid receptors. While it has been marketed as a “safe” and natural treatment for patients with opioid use disorder, overdose is associated with both agitation and drowsiness and in severe cases seizures, hallucinations, and respiratory depression. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1184179828 ER -