Opioid dependence


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Opioid dependence

Psychological disorders

Mood disorders

Major depressive disorder


Bipolar disorder

Seasonal affective disorder

Premenstrual dysphoric disorder

Anxiety disorders

Generalized anxiety disorder

Social anxiety disorder

Panic disorder



Obsessive-compulsive disorders

Obsessive-compulsive disorder

Body focused repetitive disorders

Body dysmorphic disorder

Stress-related disorders and abuse

Post-traumatic stress disorder

Physical and sexual abuse

Psychotic disorders

Schizoaffective disorder

Schizophreniform disorder

Delusional disorder


Cognitive and dissociative disorders



Dissociative disorders

Eating disorders

Anorexia nervosa

Bulimia nervosa

Personality disorders

Cluster A personality disorders

Cluster B personality disorders

Cluster C personality disorders

Somatoform and factitious disorders

Somatic symptom disorder

Factitious disorder

Substance use disorders and drugs of abuse

Tobacco dependence

Opioid dependence

Cannabis dependence

Cocaine dependence

Alcohol use disorder

Sleep disorders


Nocturnal enuresis


Night terrors

Narcolepsy (NORD)

Sexual dysfunction disorders

Erectile dysfunction

Male hypoactive sexual desire disorder

Orgasmic dysfunction

Female sexual interest and arousal disorder

Genito-pelvic pain and penetration disorder

Pediatric disorders

Attention deficit hyperactivity disorder

Disruptive, impulse control, and conduct disorders

Learning disability

Fetal alcohol syndrome

Tourette syndrome

Autism spectrum disorder

Rett syndrome

Shaken baby syndrome



Psychiatric emergencies


Serotonin syndrome

Neuroleptic malignant syndrome

Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review


Opioid dependence


0 / 10 complete

USMLE® Step 1 questions

0 / 6 complete

High Yield Notes

11 pages


Opioid dependence

of complete


USMLE® Step 1 style questions USMLE

of complete

A 2-day-old female neonate is examined in the newborn nursery to evaluate poor feeding. The infant was born vaginally to a 28-year-old woman who did not receive consistent prenatal care during her pregnancy. The pregnancy was complicated by intrauterine growth restriction. The infant was breastfed normally until two hours ago when she became tachypneic and restless. Temperature is 37.8°C (100°F), pulse is 170/min, respirations are 85/min, and blood pressure is 60/35 mmHg. Physical examination shows increased tone in all extremities. The patient appears diaphoretic and has a high-pitched cry and occasional sneezes. There are no dysmorphic facial features. Which of the following best describes the underlying etiology of this infant’s presentation?  


Content Reviewers


Tanner Marshall, MS

Jake Ryan

Rishi Desai, MD, MPH

Kelly Mackenzie, MA

Robyn Hughes, MScBMC

Worldwide, opioids are the most common cause of drug related deaths.

The number of individuals who use them has quadrupled in the last 20 years, with an uptick in heroin use, an even bigger uptick in prescription opioid use, and a large number of people using both.

Because of their potential for addiction and overdose, opioids are regulated substances in many countries.

As a class, opioids share one thing in common—they bind to opioid receptors in the brain, spinal cord, and gastrointestinal tract.

Some are endogenous, meaning that they are produced naturally by the body, like endorphin, short for endogenous morphine.

But others are exogenous, meaning that they come from the environment, like heroin and morphine, which come from the opium poppy—a flowering plant that oozes a milky white liquid—while others like fentanyl are synthesized in the laboratory.

To understand how opioids work, let’s zoom into a region of the brain tissue that has opioid receptors.

Normally, in the absence of endorphins, inhibitory neurons secrete a neurotransmitter that prevents nearby neurons from releasing the neurotransmitter dopamine.

Now, let’s say someone goes to play a rigorous game of badminton.

Exercise releases endorphins which activate the three major opioid receptors located on the inhibitory neurons, called the mu, kappa, and delta receptors.

As endorphins bind to these receptors, they block the inhibitory neuron from releasing neurotransmitters, allowing the dopamine secreting neurons to freely unload dopamine.

The dopamine then gets picked up by a third neuron in the same area.

When dopamine release takes place in pain processing regions of the brain like the thalamus, brainstem, and spinal cord, the result is feeling less pain.


Opioid dependence is a medical condition characterized by compulsive use of opioids despite knowing the underlying danger, and developing withdrawal syndrome when opioid use stops. Opioids include drugs like morphine, heroin, codeine, oxycodone, hydrocodone, etc. The treatment for opioid dependence involves a combination of therapy and medications, with support from family and friends.


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  2. "Harrison's Principles of Internal Medicine" McGraw Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "Pharmacological therapies for management of opium withdrawal" Cochrane Database of Systematic Reviews (2018)
  5. "An examination of psychiatric comorbidities as a function of gender and substance type within an inpatient substance use treatment program" Drug and Alcohol Dependence (2011)
  6. "Cellular basis of memory for addiction" Dialogues in Clinical Neuroscience (2013)

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