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Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance. As opium and opioids have been traditionally used as painkillers, the exact mechanisms of their adverse reactions over repeated use are multifactorial and not fully understood. Older adults suffer from cancer and non-cancer chronic pain more than younger adults, due to the physiological changes related to ageing and their reduced metabolic capabilities and thus show an increased number of adverse reactions to opioid drugs. All clinically used opioids are µ-opioid receptor agonists, and the major adverse effects are directly or potentially connected to this receptor. Multifunctional opioid ligands or peripherally restricted opioids may elicit fewer adverse effects, as shown in preclinical studies, but these results need reproducibility from further extensive clinical trials. The current review aims to overview various mechanisms involved in the adverse effects induced by opioids, to provide a better understanding of the underlying pathophysiology and, ultimately, to help develop an effective therapeutic strategy to better manage pain.

Item Type:	Substantial Review
Keywords:	pain, opioids, analgesia, morphine, analgesia, chronic pain, behaviour, adverse effects, tolerance
Research Division:	Biomedical and Clinical Sciences
Research Group:	Pharmacology and pharmaceutical sciences
Research Field:	Pharmaceutical sciences
Objective Division:	Health
Objective Group:	Clinical health
Objective Field:	Efficacy of medications
UTAS Author:	Paul, AK (Dr Alok Paul)
UTAS Author:	Gueven, N (Dr Nuri Guven)
ID Code:	147578
Year Published:	2021
Web of Science® Times Cited:	6
Deposited By:	Pharmacy
Deposited On:	2021-11-09
Last Modified:	2021-11-15
Downloads:	0