Dopamine and addiction – the difference between wanting and liking

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Dopamine is important for reward, but is it directly related to pleasure? Research suggests that dopamine is more important for ‘wanting’ (motivational drive) than for liking. You might have a pathological ‘wanting’ your drug of choice, even after you have long stopped ‘liking’ it. Opioids and endocannabinoids may be more important for liking. In this […]

Pain needs painkillers – right?

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Overprescribing of opioid painkillers has caused harm to many people. Problems include addiction, loss of social functioning and increasingly, though still relatively uncommonly in the UK, to death. Concerns have been raised about deaths associated with tramadol in particular. I’ve written before about the lack of evidence of effectiveness for opiates in chronic pain, but it […]

Tramadol Abuse

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Drug treatment used to seem so simple. Clients had a drug of choice, lets say alcohol, heroin or cocaine, and they came to treatment for help for that drug. Now they have a drug of choice AND whatever medication they are being prescribed. Treatment is suddenly so much more complicated. Those drugs are things like pregabalin, […]

Deaths from prescription opioids ‘epidemic’

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The White House is holding a summit on opiate addiction. Why? MNT reports alarming statistics around deaths involving prescribed painkillers. In the first ever review of existing research into the topic, researchers have uncovered exactly how much deaths due to such drugs – which outnumber deaths from heroin and cocaine combined – have increased. According to the […]

Tramadol Abuse – death toll rising

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Drug treatment used to seem so simple. Clients had a drug of choice, lets say alcohol, heroin or cocaine, and they came to treatment for help for that drug. Now they have a drug of choice AND whatever medication they are being prescribed. Treatment is suddenly so much more complicated. Those drugs are things like pregabalin, […]

The British red face – the UK and drugs

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The publication of the European Drug Report last week, covered by Vice, highlighted that Europe likes drugs – but also that the UK is up there again and again near the top of the league for consumption. I guess it’s because we keep our own drug figures in Scotland, but the boffins at the snappily titled […]

Poor performance: sexual dysfunction on ORT

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Opiates seem to reduce the libido, it’s a common complaint in opiate users and those on replacement treatment. They seem to do this through suppressing testosterone and other key hormones. SMMGP reviews a couple of papers on the association between opioid replacement therapy (ORT) and sexual dysfunction. In the first, relatively small, Indian study, 60 sexually active men […]

Do opioids work for chronic pain? Sorry, we haven’t a clue

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Jason Schwartz highlights a Keith Humphreys post on the challenges of assessing opioids for long term non-cancer pain. With millions of people in the UK prescribed regular opiates on repeat prescriptions for chronic pain and these drugs fraught with dependence dangers, you’d think there would have to be a solid evidence base that they work. Not a bit […]

Tramadol Abuse

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Drug treatment used to seem so simple. Clients had a drug of choice, lets say alcohol, heroin or cocaine, and they came to treatment for help for that drug. Now they have a drug of choice AND whatever medication they are being prescribed. Treatment is suddenly so much more complicated. Those drugs are things like pregabalin, […]