1. Copyright Notice
This presentation is copyrighted by the Psychopharmacology Institute.
Subscribers can download it and use it for professional use.
The contents of the presentation may be modified, but the Psychopharmacology Institute logo must remain visible in all slides.

2. What is an Opioid Use Disorder?
Joji Suzuki, MD
Director, Division of Addiction Psychiatry
Department of Psychiatry,
Brigham and Women’s Hospital
Assistant Professor of Psychiatry,
Harvard Medical School

3. Outline Opiates vs opioids
Papaver Somniferum and the beginning of pharmaceutical opioid formulations
Heroin:
First tried as substitution treatment
Opioid of choice in 70’s and 80’s
Preparation and routes of administration

4. Outline Opiates vs opioids
Papaver Somniferum and the beginning of pharmaceutical opioid formulations
Heroin:
First tried as substitution treatment
Opioid of choice in 70’s and 80’s
Preparation and routes of administration

5. Outline Opiates vs opioids
Papaver Somniferum and the beginning of pharmaceutical opioid formulations
Heroin:
First tried as substitution treatment
Opioid of choice in the 70’s and 80’s
Preparation and routes of administration

6. Outline Opiates vs opioids
Papaver Somniferum and the beginning of pharmaceutical opioid formulations
Heroin:
First tried as substitution treatment
Opioid of choice in the 70’s and 80’s
Preparation and routes of administration

7. Nomenclature: Opiates vs Opioids

8. Compounds that activate opioid receptors
Opioids:
Compounds that activate opioid receptors
Opiates: Compounds derived from Papaver Somniferum
Morphine
Codeine

9. Compounds that activate opioid receptors
Opioids:
Compounds that activate opioid receptors
Opiates: Compounds derived from Papaver Somniferum
Morphine
Codeine

10. Semisynthetic opioids
Heroin (diacetylmorphine)
Oxycodone
Hydromorphone
Buprenorphine
Naloxone
Hydrocodone
Naltrexone

11. Semisynthetic opioids
Heroin (diacetylmorphine)
Oxycodone
Hydromorphone
Buprenorphine
Naloxone
Hydrocodone
Naltrexone
Structurally related to morphine and codeine
Cross reaction with morphine urine tests

12. Synthetic opioids Meperidine Methadone Fentanyl
Negative on morphine tests
Not structurally related to morphine and codeine

13. Naturally occurring opioids
Endorphins
Salvinorin A (hallucinogenic mint-family plant)

14. Analgesia
Euphoria
Cough suppression
Constricted pupils
Constipation
Sedation
Respiratory depression
Hormonal changes
Nausea
Mu receptors
Dysphoria
Hallucinations
Kappa receptors
Convulsant
Delta receptors

15. Analgesia
Euphoria
Cough suppression
Constricted pupils
Constipation
Sedation
Respiratory depression
Hormonal changes
Nausea
Mu receptors
Dysphoria
Hallucinations
Kappa receptors
Convulsant
Delta receptors

16. Analgesia
Euphoria
Cough suppression
Constricted pupils
Constipation
Sedation
Respiratory depression
Hormonal changes
Nausea
Mu receptors
Dysphoria
Hallucinations
Kappa receptors
Convulsant
Delta receptors

17. Next: From P. Somniferum to Heroin