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A methadone clinic is a medical facility where medications for opioid use disorder (MOUD) are dispensed-—historically and most commonly methadone, although buprenorphine is also increasingly prescribed. Medically assisted drug therapy treatment is indicated in patients who are opioid-dependent or have a history of opioid dependence. [1]
Prescription drug monitoring programs, or PDMPs, are an example of one initiative proposed to alleviate effects of the opioid crisis. [1] The programs are designed to restrict prescription drug abuse by limiting a patient's ability to obtain similar prescriptions from multiple providers (i.e. “doctor shopping”) and reducing diversion of controlled substances.
Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic.It is 30 to 50 times more potent than heroin and 100 times more potent than morphine; [11] its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries.
The metabolic half-life is 8 to 59 hours (approximately 24 hours for opioid-tolerant people, and 55 hours for opioid-naive people), as opposed to a half-life of 1 to 5 hours for morphine. [12] The length of the half-life of methadone allows for the exhibition of respiratory depressant effects for an extended duration of time in opioid-naive people.
The difference between an opioid and an opioid agonist is that opioids induce more intense effects and stay in the brain for a short amount of time. [3] Conversely, an opioid agonist induces minimal effects and stays in the brain for a long time, which prevents the opioid user from feeling the effects of natural or synthetic opioids. [3]
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Opioids act upon opioid receptors that are coupled to inhibitor G protein coupled receptors (GPCR). These receptors fall into 3 classes: μ (mu), δ (delta), and κ (kappa) receptors. [36] More than 70% of opioid receptors are μ receptors, predominantly located on the central terminals of nociceptors in the dorsal horn of the spinal cord.
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