Opioids: Pharmacology, Physiology, and Clinical Implications in Pain Medicine

Andrew Friedman; Lorifel Nabong

doi:10.1016/j.pmr.2020.01.007

Opioids: Pharmacology, Physiology, and Clinical Implications in Pain Medicine

Phys Med Rehabil Clin N Am. 2020 May;31(2):289-303. doi: 10.1016/j.pmr.2020.01.007.

Authors

Andrew Friedman¹, Lorifel Nabong²

Affiliations

¹ Physical Medicine and Rehabiliation, Virginia Mason Medical Center, 1100 9th Avenue, Seattle, WA 98111, USA; University of WA, Seattle, WA, USA. Electronic address: Andrew.friedman@virginiamason.org.
² Virginia Mason Medical Center, 1100 9th Avenue, Seattle, WA 98111, USA.

PMID: 32279731
DOI: 10.1016/j.pmr.2020.01.007

Abstract

Opioid receptors and opioid agonists are widespread throughout nature. Endogenous opioids mediate complex functions in animals and in humans. The opioid system in humans plays a central role in pain control and is a key mediator of hedonic homeostasis, mood, and well-being. This system also regulates responses to stress and several peripheral physiologic functions, including respiratory, gastrointestinal, endocrine, and immune systems. This article provides an overview of the basic physiology of opioids, reviews opioid pharmacology, and attempts to address several issues of current importance in the management of patients with established long-term opioid therapy.

Keywords: Opioids; Pain management; Pharmacology; Physiology.

Publication types

Review

MeSH terms

Analgesics, Opioid / pharmacology*
Chronic Pain / drug therapy*
Humans
Pain Management / methods*
Receptors, Opioid / physiology*

Substances

Analgesics, Opioid
Receptors, Opioid