Skip to main content
SpringerLink
Log in

Opioids: History, Pathophysiology, and Stewardship for Hospitalists

  • Chapter
  • First Online:
Clinical Approaches to Hospital Medicine

  • 820 Accesses

Abstract

The most effective strategy for the treatment of opioid use disorder is that of prevention. The first opioid epidemic in America dates to more than 100 years ago, during the Civil War era. Physicians at the time coined the term “morphinism” to explain the liberal injection of morphine in the sick and in wounded soldiers leading to their dependency for years to come. This chapter discusses the historical origins of the current opioid epidemic and treatment guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Courtwright DT. Opiate addiction as a consequence of the civil war. Civ War Hist. 1978;24(2):101–11. https://doi.org/10.1353/cwh.1978.0039.

    Article  CAS  PubMed  Google Scholar 

  2. Sneader W. The discovery of heroin. Lancet. 1998;352(9141):1697–9. https://doi.org/10.1016/S0140-6736(98)07115-3.

    Article  CAS  PubMed  Google Scholar 

  3. Robins LN, Davis DH, Nurco DN. How permanent was Vietnam drug addiction? Am J Public Health. 1974;64(Suppl 12):38–43. https://doi.org/10.2105/ajph.64.12_suppl.38.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hall W, Weier M. Lee Robins' studies of heroin use among US Vietnam veterans. Addiction. 2017;112(1):176–80. https://doi.org/10.1111/add.13584.

    Article  PubMed  Google Scholar 

  5. Portenoy RK, Foley KM. Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986;25(2):171–86. https://doi.org/10.1016/0304-3959(86)90091-6.

    Article  PubMed  Google Scholar 

  6. Van Zee A. The promotion and marketing of oxycontin: commercial triumph, public health tragedy. Am J Public Health. 2009;99(2):221–7. https://doi.org/10.2105/AJPH.2007.131714.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Scalpel S. The joint commission deserves some blame for the opioid crisis. Mo Med. 2016;113(6):449.

    PubMed  PubMed Central  Google Scholar 

  8. Quinlan J, Cox F. Acute pain management in patients with drug dependence syndrome. Pain Rep. 2017;2(4):e611. https://doi.org/10.1097/PR9.0000000000000611.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Louisiana Commission on Preventing Opioid Abuse. The opioid epidemic: evidence based strategies legislative report. 2017. Retrieved from: https://ldh.la.gov/assets/docs/BehavioralHealth/Opioids/LCPOAFinalReportPkg20170331.pdf.

  10. Baumgartner JC, Radley DC. The Drug overdose mortality toll in 2020 and near-term actions for addressing it. The Commonwealth Fund. 2021. Retrieved from: https://www.commonwealthfund.org/blog/2021/drug-overdose-toll-2020-and-near-term-actions-addressing-it.

  11. Kalivas PW, O'Brien C. Drug addiction as a pathology of staged neuroplasticity. Neuropsychopharmacology. 2008;33(1):166–80. https://doi.org/10.1038/sj.npp.1301564.

    Article  CAS  PubMed  Google Scholar 

  12. Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of addiction. N Engl J Med. 2016;374(4):363–71. https://doi.org/10.1056/NEJMra1511480.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Schwartzman RJ, Grothusen J, Kiefer TR, Rohr P. Neuropathic central pain: epidemiology, etiology, and treatment options. Arch Neurol. 2001;58(10):1547–50. https://doi.org/10.1001/archneur.58.10.1547.

    Article  CAS  PubMed  Google Scholar 

  14. Hooten WM. Chronic pain and mental health disorders: shared neural mechanisms, epidemiology, and treatment. Mayo Clin Proc. 2016;91(7):955–70. https://doi.org/10.1016/j.mayocp.2016.04.029.

    Article  PubMed  Google Scholar 

  15. Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.

    Article  PubMed  Google Scholar 

  16. Gupta K, Prasad A, Nagappa M, Wong J, Abrahamyan L, Chung FF. Risk factors for opioid-induced respiratory depression and failure to rescue: a review. Curr Opin Anaesthesiol. 2018;31(1):110–9.

    Article  PubMed  Google Scholar 

  17. Saklad M. Grading of patients for surgical procedures. Anesthesiology. 1941;2(3):281–4. https://doi.org/10.1097/00000542-194105000-00004.

    Article  Google Scholar 

  18. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain – United States. MMWR Recomm Rep. 2016;65(1):1–49. https://doi.org/10.15585/mmwr.rr6501e1.

    Article  PubMed  Google Scholar 

  19. Cantrill SV, Brown MD, Carlisle RJ, Delaney KA, Hays DP, Nelson LS, O'Connor RE, Papa A, Sporer KA, Todd KH, Whitson RR, American College of Emergency Physicians Opioid Guideline Writing P. Clinical policy: critical issues in the prescribing of opioids for adult patients in the emergency department. Ann Emerg Med. 2012;60(4):499–525. https://doi.org/10.1016/j.annemergmed.2012.06.013.

    Article  PubMed  Google Scholar 

  20. Substance Abuse and Mental Health Services Administration. Opioid overdose prevention TOOLKIT. 2018. Retrieved from: https://store.samhsa.gov/sites/default/files/d7/priv/sma18-4742.pdf.

  21. Wardhan R, Chelly J. Recent advances in acute pain management: understanding the mechanisms of acute pain, the prescription of opioids, and the role of multimodal pain therapy. F1000Res. 2017;6:2065. https://doi.org/10.12688/f1000research.12286.1.

    Article  PubMed  PubMed Central  Google Scholar 

  22. American Society of Anesthesiologists Task Force on Acute Pain M. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on acute pain management. Anesthesiology. 2012;116(2):248–73. https://doi.org/10.1097/ALN.0b013e31823c1030.

    Article  Google Scholar 

  23. Maund E, McDaid C, Rice S, Wright K, Jenkins B, Woolacott N. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review. Br J Anaesth. 2011;106(3):292–7. https://doi.org/10.1093/bja/aeq406.

    Article  CAS  PubMed  Google Scholar 

  24. Wong I, St John-Green C, Walker SM. Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Paediatr Anaesth. 2013;23(6):475–95. https://doi.org/10.1111/pan.12163.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Varrassi G, Pergolizzi JV, Dowling P, Paladini A. Ibuprofen safety at the Golden anniversary: are all NSAIDs the same? A narrative review. Adv Ther. 2020;37(1):61–82. https://doi.org/10.1007/s12325-019-01144-9.

    Article  PubMed  Google Scholar 

  26. Castellsague J, Riera-Guardia N, Calingaert B, Varas-Lorenzo C, Fourrier-Reglat A, Nicotra F, Sturkenboom M, Perez-Gutthann S, Safety of Non-Steroidal Anti-Inflammatory Drugs P. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012;35(12):1127–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Masso Gonzalez EL, Patrignani P, Tacconelli S, Garcia Rodriguez LA. Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum. 2010;62(6):1592–601. https://doi.org/10.1002/art.27412.

    Article  CAS  PubMed  Google Scholar 

  28. Ennis ZN, Dideriksen D, Vaegter HB, Handberg G, Pottegard A. Acetaminophen for chronic pain: a systematic review on efficacy. Basic Clin Pharmacol Toxicol. 2016;118(3):184–9. https://doi.org/10.1111/bcpt.12527.

    Article  CAS  PubMed  Google Scholar 

  29. Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010;110(4):1170–9. https://doi.org/10.1213/ANE.0b013e3181cf9281.

    Article  CAS  PubMed  Google Scholar 

  30. Jibril F, Sharaby S, Mohamed A, Wilby KJ. Intravenous versus oral acetaminophen for pain: systematic review of current evidence to support clinical decision-making. Can J Hosp Pharm. 2015;68(3):238–47. https://doi.org/10.4212/cjhp.v68i3.1458.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Duehmke RM, Derry S, Wiffen PJ, Bell RF, Aldington D, Moore RA. Tramadol for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;6:CD003726. https://doi.org/10.1002/14651858.CD003726.pub4.

  32. Lassen D, Damkier P, Brosen K. The pharmacogenetics of tramadol. Clin Pharmacokinet. 2015;54(8):825–36. https://doi.org/10.1007/s40262-015-0268-0.

    Article  CAS  PubMed  Google Scholar 

  33. Shah K, Stout B, Caskey H. Tramadol for the management of opioid withdrawal: a systematic review of randomized clinical trials. Cureus. 2020;12(7):e9128. https://doi.org/10.7759/cureus.9128.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Jones JL, Mateus CF, Malcolm RJ, Brady KT, Back SE. Efficacy of ketamine in the treatment of substance use disorders: a systematic review. Front Psych. 2018;9:277. https://doi.org/10.3389/fpsyt.2018.00277.

    Article  Google Scholar 

  35. Shin HJ, Na HS, Do SH. Magnesium and pain. Nutrients. 2020;12(8):2184. https://doi.org/10.3390/nu12082184.

    Article  CAS  PubMed Central  Google Scholar 

  36. Kamp J, Van Velzen M, Olofsen E, Boon M, Dahan A, Niesters M. Pharmacokinetic and pharmacodynamic considerations for NMDA-receptor antagonist ketamine in the treatment of chronic neuropathic pain: an update of the most recent literature. Expert Opin Drug Metab Toxicol. 2019;15(12):1033–41. https://doi.org/10.1080/17425255.2019.1689958.

    Article  CAS  PubMed  Google Scholar 

  37. Hah J, Mackey SC, Schmidt P, McCue R, Humphreys K, Trafton J, Efron B, Clay D, Sharifzadeh Y, Ruchelli G, Goodman S, Huddleston J, Maloney WJ, Dirbas FM, Shrager J, Costouros JG, Curtin C, Carroll I. Effect of perioperative gabapentin on postoperative pain resolution and opioid cessation in a mixed surgical cohort: a randomized clinical trial. JAMA Surg. 2018;153(4):303–11. https://doi.org/10.1001/jamasurg.2017.4915.

    Article  PubMed  Google Scholar 

  38. Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, Gilron I, Haanpaa M, Hansson P, Jensen TS, Kamerman PR, Lund K, Moore A, Raja SN, Rice AS, Rowbotham M, Sena E, Siddall P, Smith BH, Wallace M. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14(2):162–73. https://doi.org/10.1016/S1474-4422(14)70251-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Evoy KE, Morrison MD, Saklad SR. Abuse and misuse of pregabalin and gabapentin. Drugs. 2017;77(4):403–26. https://doi.org/10.1007/s40265-017-0700-x.

    Article  CAS  PubMed  Google Scholar 

  40. Oldfield V, Perry CM. Oxycodone/ibuprofen combination tablet: a review of its use in the management of acute pain. Drugs. 2005;65(16):2337–54. https://doi.org/10.2165/00003495-200565160-00011.

    Article  CAS  PubMed  Google Scholar 

  41. Derry S, Derry CJ, Moore RA (2013) Single dose oral ibuprofen plus oxycodone for acute postoperative pain in adults. Cochrane Database Syst Rev (6):CD010289. https://doi.org/10.1002/14651858.CD010289.pub2.

  42. Kandarian BS, Elkassabany NM, Tamboli M, Mariano ER. Updates on multimodal analgesia and regional anesthesia for total knee arthroplasty patients. Best Pract Res Clin Anaesthesiol. 2019;33(1):111–23. https://doi.org/10.1016/j.bpa.2019.02.004.

    Article  PubMed  Google Scholar 

  43. Emelife PI, Eng MR, Menard BL, Myers AS, Cornett EM, Urman RD, Kaye AD. Adjunct medications for peripheral and neuraxial anesthesia. Best Pract Res Clin Anaesthesiol. 2018;32(2):83–99. https://doi.org/10.1016/j.bpa.2018.06.011.

    Article  PubMed  Google Scholar 

  44. Williams L, Iteld L. Moving toward opioid-free breast surgery: regional blocks and a novel technique. Clin Plast Surg. 2021;48(1):123–30. https://doi.org/10.1016/j.cps.2020.09.003.

    Article  PubMed  Google Scholar 

  45. Garland EL, Brintz CE, Hanley AW, Roseen EJ, Atchley RM, Gaylord SA, Faurot KR, Yaffe J, Fiander M, Keefe FJ. Mind-body therapies for opioid-treated pain: a systematic review and meta-analysis. JAMA Intern Med. 2020;180(1):91–105. https://doi.org/10.1001/jamainternmed.2019.4917.

    Article  PubMed  Google Scholar 

  46. Dydyk AM, Jain NK, Gupta M. Opioid use disorder. In: StatPearls. Treasure Island. 2021.

    Google Scholar 

  47. Moore KE, Roberts W, Reid HH, Smith KMZ, Oberleitner LMS, McKee SA. Effectiveness of medication assisted treatment for opioid use in prison and jail settings: a meta-analysis and systematic review. J Subst Abus Treat. 2019;99:32–43. https://doi.org/10.1016/j.jsat.2018.12.003.

    Article  Google Scholar 

  48. Preuss CV, Kalava A, King KC. Prescription of controlled substances: benefits and risks. In: StatPearls. Treasure Island. 2021.

    Google Scholar 

  49. D'Onofrio G, Melnick ER, Hawk KF. Improve access to care for opioid use disorder: a call to eliminate the X-waiver requirement now. Ann Emerg Med. 2021;78(2):220–2. https://doi.org/10.1016/j.annemergmed.2021.03.023.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Madden EF. Intervention stigma: how medication-assisted treatment marginalizes patients and providers. Soc Sci Med. 2019;232:324–31. https://doi.org/10.1016/j.socscimed.2019.05.027.

    Article  PubMed  Google Scholar 

  51. McElrath K. Medication-assisted treatment for opioid addiction in the United States: critique and commentary. Subst Use Misuse. 2018;53(2):334–43. https://doi.org/10.1080/10826084.2017.1342662.

    Article  PubMed  Google Scholar 

  52. Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003;35(2):253–9. https://doi.org/10.1080/02791072.2003.10400007.

    Article  PubMed  Google Scholar 

  53. Cisewski DH, Santos C, Koyfman A, Long B. Approach to buprenorphine use for opioid withdrawal treatment in the emergency setting. Am J Emerg Med. 2019;37(1):143–50. https://doi.org/10.1016/j.ajem.2018.10.013.

    Article  PubMed  Google Scholar 

  54. Kapuganti A, Turner T, Thomas CJ. Evaluation of buprenorphine/naloxone dose and use of sedating supportive medication on treatment outcomes in veterans with opioid use disorder. Ment Health Clin. 2017;7(6):271–5. https://doi.org/10.9740/mhc.2017.11.271.

    Article  PubMed  Google Scholar 

  55. National Academies of Sciences E, Medicine, Health, Medicine D, Board on Health Sciences P, Committee on Pain M, et al. In: Phillips JK, Ford MA, Bonnie RJ, editors. Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use. Washington, D.C., 2017. https://doi.org/10.17226/24781.

Download references

Author information

Authors and Affiliations

  1. Hospital Medicine, Ochsner Health, New Orleans, LA, USA

    Marianne Maumus

  2. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA, USA

    Daniel Zumsteg

  3. The University of Queensland-Ochsner Clinical School, New Orleans, LA, USA

    Dileep Mandali

Authors
  1. Marianne Maumus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Zumsteg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dileep Mandali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marianne Maumus .

Editor information

Editors and Affiliations

  1. Ochsner Health, New Orleans, LA, USA

    Kevin Conrad

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Maumus, M., Zumsteg, D., Mandali, D. (2022). Opioids: History, Pathophysiology, and Stewardship for Hospitalists. In: Conrad, K. (eds) Clinical Approaches to Hospital Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-95164-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-95164-1_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95163-4

  • Online ISBN: 978-3-030-95164-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation