Key opioid-related terms Opioid : any psychoactive chemical resembling morphine, including opiates, and binding to opioid receptors in the brain. This term describes opioid and opiates. Opiate : “natural” opioids derived from the opium poppy (e.g., opium, morphine, heroin). Semi-synthetic opioids : analgesics containing both natural and manufactured compounds (e.g., oxycodone, hydrocodone, hydromorphone, oxymorphone). Synthetic opioids : fully-human-made compounds (e.g., methadone, tramadol, and fentanyl).
TYPES OF PAIN
Differentiating between nociceptive and neuropathic pain is critical because the two respond differently to pain treatments. Neuropathic pain, for example, may respond poorly to both opioid analgesics and non-steroidal anti-inflammatory (NSAID) agents. 14 Other classes of medications, such as anti-epileptics, antidepressants, or local anesthetics, may provide more effective relief for neuropathic pain. 15
Another important dimension of pain is its effects beyond strictly physiological functioning. Pain is currently viewed as a multi-dimensional, multi- level process similar in many ways to other disease processes which may start with a specific injury but which can lead to a cascade of events that can include physical deconditioning, psychological and emotional burdens, and dysfunctional behavior patterns that affect not just the sufferer, but their entire social milieu (illustrated in Figure 2). 16
Figure 2. The biopsychosocial model of pain 16
Although pain is expected after injury or surgery, the patient pain experience can vary markedly. The intensity of pain can be influenced by psychological distress (e.g., depression or anxiety), heightened illness concern, or ineffective coping strategies regarding the
ability to control pain and function despite it. 17 It may also be shaped by personality, culture, attitudes, and beliefs.
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Book Code: MDAZ1124
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