TY - CHAP M1 - Book, Section TI - OPIOID-RELATED DISORDERS A1 - Kosten, Thomas R. A1 - Haile, Colin N. A2 - Hauser, Stephen L. A2 - Josephson, S. Andrew Y1 - 2018 N1 - T2 - Harrison's Neurology in Clinical Medicine, 4e AB - Opiate analgesics have been abused since at least 300 B.C. Nepenthe (Greek “free from sorrow”) helped the hero of TheOdyssey, but widespread opium smoking in China and the Near East has caused harm for centuries. Since the first chemical isolation of opium and codeine 200 years ago, a wide range of synthetic opioids have been developed, and opioid receptors were cloned in the 1990s. Two of the most important adverse effects of all these agents are the development of opioid use disorder and overdose. The 0.1% annual prevalence of heroin dependence in the United States is only about one-third the rate of prescription opiate use and is substantially lower than the 2% rate of morphine users in Southeast and Southwest Asia. Prescription opiates are primarily used for pain management, but due to ease of availability, adolescents procure and use these drugs with dire consequences. In 2011, for example, 11 million individuals in the United States used nonmedically prescribed pain killers that were linked to over 420,000 emergency department visits and nearly 17,000 overdose deaths. Although these rates are low relative to other abused substances, their disease burden is substantial, with high rates of morbidity and mortality; disease transmission; increased health care, crime, and law enforcement costs; and less tangible costs of family distress and lost productivity. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - neurology.mhmedical.com/content.aspx?aid=1147191918 ER -