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A structural analog (analogue in Commonwealth English), also known as a chemical analog or simply an analog, is a compound having a structure similar to that of another compound, but differing from it in respect to a certain component. It can differ in one or more atoms, functional groups, or substructures, which are replaced with other atoms, groups, or substructures. A structural analog can be imagined to be formed, at least theoretically, from the other compound. Structural analogs are often isoelectronic.
Despite a high chemical similarity, structural analogs are not necessarily functional analogs and can have very different physical, chemical, biochemical, or pharmacological properties. In drug discovery either a large series of structural analogs of an initial lead compound are created and tested as part of a structure–activity relationship study or a database is screened for structural analogs of a lead compound.
Chemical analogues of illegal drugs are developed and sold in order to circumvent laws. Such substances are often called designer drugs. Because of this, the United States passed the Federal Analogue Act in 1986. This bill banned the production of any chemical analogue of a Schedule I or Schedule II substance that has substantially similar pharmacological effects, with the intent of human consumption.
Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo meaning “below”) to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis. Hypoventilation is not synonymous with respiratory arrest, in which breathing ceases entirely and death occurs within minutes due to hypoxia and leads rapidly into complete anoxia, although both are medical emergencies. Hypoventilation can be considered a precursor to hypoxia and its lethality is attributed to hypoxia with carbon dioxide toxicity.
As a side effect of medicines or recreational drugs, hypoventilation may become potentially life-threatening. Many different central nervous system (CNS) depressant drugs such as ethanol, benzodiazepines, barbiturates, GHB, sedatives, and opioids produce respiratory depression when taken in large or excessive doses, or mixed with other depressants. Strong opiates (such as fentanyl, heroin, and morphine), barbiturates, and certain benzodiazepines (short acting ones and alprazolam) are known for depressing respiration. In an overdose, an individual may cease breathing entirely (go into respiratory arrest) which is rapidly fatal without treatment. Opioids, in overdose or combined with other depressants, are notorious for such fatalities.
Respiratory stimulants such as nikethamide were traditionally used to counteract respiratory depression from CNS depressant overdose, but offered limited effectiveness. A new respiratory stimulant drug called BIMU8 is being investigated which seems to be significantly more effective and may be useful for counteracting the respiratory depression produced by opiates and similar drugs without offsetting their therapeutic effects. If the respiratory depression occurs from opioid overdose, usually an opioid antagonist, most likely naloxone, will be administered. This will rapidly reverse the respiratory depression unless complicated by other depressants. However an opioid antagonist may also precipitate an opioid withdrawal syndrome in chronic users. Mechanical ventilation may still be necessary during initial resuscitation.
Oxycodone addiction is a serious and escalating problem around the world. Oxycodone, in particular, is one of the most abused prescription narcotics on the market. This semi-synthetic painkiller has been a godsend for many people suffering with serious pain, but it can be highly addicting.
Most people who become dependent upon oxycodone are not at fault. No one who takes this medication for therapeutic reasons sets out to become physically and/or psychologically dependent upon it. Opiate-based medications can cause a person to develop a tolerance to the drug. This essentially means that people become used to the medication and escalating dosages are required over time for pain relief.
People deserve compassion and understanding when they make the decision to seek oxycodone detox. Many of them have tried several times to get off the drug but they realize an unmanaged withdrawal is too much to handle on their own. Some people become so desperate they’ll do just about anything to avoid withdrawal.
New restrictions are causing a desperate demand from those dependent on prescription opiate painkillers. People addicted to opioids are willing to go to great lengths to obtain their drugs, such as getting them without a prescription.
What Do the New Opioid Laws Mean for Patients in Need of Pain Relief?
Overdoses from painkiller opioids kill more than 115 people per day in the United States. One of the main reasons is that doctors have been prescribing more than patients need. Pain specialists underestimated the power and adverse consequences of long-term opioid intakes. Although there are exceptions for patients suffering from terminal diseases or those in extreme pain, there are strict limitations of the amounts doctors can prescribe for temporary pain from surgery, injury, or illness.
Opioid Laws Varies by State
While These Laws Vary State By State, They Mostly Exclude These Prescription Limitations for Patients with Long-Term Illnesses, in Palliative or Hospice Care. The new limits are often seven days for patients post-surgery, injury and curable illnesses, or acute pain. However, some states like Florida, Kentucky, and Minnesota are even stricter. They demand specific documentation if more than three days of opioid prescription is necessary for a particular patient. Furthermore, some states like Florida now requires doctors and pharmacists to take courses on opioid prescription. They also have an available drug database they need to consult before prescribing opioids to ensure the patient has not acquired an additional medicine elsewhere.
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Earlier this year, the FDA rejected a drug called Moxduo, a combination of morphine and oxycodone. As of October 6, 2014, the DEA reclassified Hydrocodone products from schedule III to a more restricting schedule II classification. Filmmaker Sean Dunne created the film “Oxyana” a documentary based on the oxycodone epidemic. The movie takes place in the coalmining town of Oceana, West Virginia. It features a young man that claimed to pay $1000 to an out of state doctor in Washington, D.C., to receive a one-month prescription of (450) 30mg oxycodone pills.
Experts suggests that the addiction of oxycodone is a stage-wise process. In simple words, there are a number of red flags before reaching a point of opioid addiction. For example, Himmelsbach1 suggested that opioid abusers develop tolerance and habituation first before reaching the third and final stage of physical opiate addiction. Tolerance is when a person experiences that the previous dose is not sufficient or helpful at alleviating symptoms and needs a higher dose to achieve similar degree of euphoria/relief. Similarly, habituation is when you develop a craving and psychic dependence to continue the intake of drug and by increasing influence on the brain receptors.
According to government data, prescription opioids are responsible for more than 200,000 American deaths over the past 20 years. There are dozens of prescription painkillers on the market, but one stands out as particularly deadly: oxycodone. Addiction medicine experts say that oxycodone is the most addicting prescription opioid. Let’s uncover what makes oxycodone so highly addictive and how to get treatment for prescription painkiller abuse.
History of Oxycodone Use
German scientists first created oxycodone in 1916, but it did not become widely used until decades later. Oxycodone is a synthetic opioid, meaning it is made in a laboratory rather than from a natural source such as poppies. In the United States, Purdue Pharma got FDA approval to sell a sustained-release version of oxycodone in 1995. Called Oxycontin, the prescription painkiller hit the U.S. market in 1996. Sales soared from $48 million in 1996 to nearly $1.1 billion in 2000. This corresponded with an aggressive marketing campaign by Purdue Pharma, which minimized the potential dangers of Oxycontin use.
In years between oxycodone’s discovery in 1916 and its commercial debut in the U.S. in 1995, scientists learned a lot about its properties. Decades before Oxycontin was introduced, pain medicine doctors knew that oxycodone could be highly addictive. For example, in 1976, a pain medicine doctor named John Bonica, MD, said, “We find the risk of addiction [to oxycodone] greater than that attributed to morphine.” Sadly, these warnings were ignored as millions of doses of oxycodone were given to Americans to treat chronic pain. Told by doctors that the drug was fine for long-term use with minimal side effects, patients were shocked to find themselves addicted to pain relievers.
What Makes Oxycodone Highly Addictive?
Oxycodone is part of a class of medications called opioids. Opioids include morphine, hydrocodone (Vicodin), meperidine (Demerol), and hydromorphone (Dilaudid).
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All opioids enter the bloodstream and travel throughout the body, including crossing into the brain. Normally, when you hurt yourself, a pain signal travels from the affected body part into the brain. When opioids bind to receptors in your body, they block that pain signal from traveling. This effectively prevents your brain from feeling pain. In addition to blocking pain, opioids act directly on the central nervous system (brain and spinal cord). They cross into the brain and bind to a type of opioid receptor called mu receptors.
Who Is At Risk for Becoming Addicted to Oxycodone?
The opioid epidemic has touched the lives of millions of people in the United States. This leads many to wonder, “could it happen to me?” The answer is that yes, opioid addiction happens to men and women of all ages, racial and ethnic backgrounds, and socioeconomic situations. But not everyone who is prescribed oxycodone will become addicted to it.
One of the reasons that oxycodone is the most addicting prescription opioid is that doctors widely prescribe it. Doctors like to prescribe oxycodone because it has excellent painkilling effects and relatively few side effects. If you’re concerned about oxycodone addiction, one option is to ask your doctor for a non-opioid pain management solution. Other types of medications, physical therapy, acupuncture, and biofeedback are good pain management solutions.
Oxycodone is also more likely to be addictive for certain groups of people. For example, everyone has enzymes called cytochrome P450s that live in their cells. Cytochrome P450 is responsible for breaking down drugs like opioids. However, there are different types of P450 enzymes. Some people have swift versions that clear opioid drugs from the body quickly, while others have slower versions. Your genes determine what type of enzymes you have, and that can affect your vulnerability to addiction. Researchers have identified certain people who are particularly likely to become addicted to oxycodone because of how these enzymes break it down.
Treatment Options for Oxycodone Addiction
The good news for people addicted to oxycodone is that there are effective treatments. Opioid withdrawal can be unpleasant and even dangerous. That is why experts recommend that you avoid quitting oxycodone “cold turkey.” Many people who try to do this return to using prescription painkillers because of the difficult withdrawal symptoms. Medical detox protocols allow you to undergo withdrawal in a safe,
Once you complete detox, you are ready to address the root causes of addiction. In addition to a biological predisposition to substance abuse, emotional and psychological factors often play a role in addiction. Untreated depression, anxiety, trauma, and other mental health problems cause some people to abuse drugs like oxycodone to numb their pain. That is why it is important to receive aftercare to guide you through the early stages of recovery from oxycodone addiction.
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