Opioid related disorders

In Sanskrit opium is known as ‘ahi phen’; in Northeast India it is referred to as ‘kani’. India, surrounded on both sides by the infamous routes of illicit transport, namely the Golden Triangle (Burma-Thailand-Laos) and the Golden Crescent (Iran-Afghanistan-Pakistan) has been particularly severely affected. More recently, a fourth receptor type, OFQ/N (ORL-1), has been accepted as part of an extended family of opioid receptors. About 90% with opioid dependence have additional psychiatric illness. The initial euphoria is followed by a period of sedation, known in street parlance as “nodding off.” Adverse effects include potential transmission of hepatitis and human immunodeficiency virus (HIV) through the use of contaminated needles. Physical dependence, as evidenced by tolerance or withdrawal, is a criterion that is neither necessary nor sufficient for the diagnosis of opioid dependence. Besides abstinence and harm minimisation, goals of the treatment include improving social and occupational functioning and improving quality of life.