Euphoria is an exaggerated feeling of elation. Opioids activate the mu and kappa receptors and initially induce feelings of euphoria. Although opioids create euphoria and decrease pain perception, their pleasurable effect contributes to drug abuse.
Opioids stimulate the oculomotor nerve and cause miosis by constricting the pupils to "pinpoint" sizes. Keep bright lights during the daytime to compensate for impaired vision related to miosis.
Opioids depress the central nervous system (CNS). Symptoms include drowsiness, mental clouding, impaired attention and memory, slurred speech, and psychomotor retardation. Patients should be advised to avoid hazardous activities, such as driving.
Yawning is an initial reaction to abstinence syndrome in patients highly dependent on opioids. Although the exact mechanism of yawning remains undetermined, a greater presence of opioid neurotransmitters decreases the frequency of yawning. Therefore, the sudden absence of opioids results in increased yawning.
The side effect of goosebumps leads to the term “Cold Turkey” with sudden cessation of opioids. Gooseflesh, or piloerection, is an involuntary reflex caused by sympathetic stimulation. During opioid withdrawal, the body attempts to compensate by overly stimulating the sympathetic system.
With sudden opioid cessation, the body develops sympathetic hyperactivity, exemplified by diaphoresis or sweating.
Rhinorrhea can occur with abstinence syndrome in patients highly dependent on opioids. The patient will experience sympathetic hyperactivity as the body tries to compensate for lack of opioid stimulation. Rhinorrhea is a symptom caused by excessive sympathetic activity.
Opioid abuse leads to constant physiological stimulation. During opioid withdrawal, the body reacts by manifesting with physical symptoms, such as uncontrollable kicking movements.
Opioid intoxication may be treated with the narcotic antagonist naloxone (Narcan). This medication is a competitive antagonist at opioid receptors and can reverse the opioid effects, such as sedation, euphoria, and analgesia. Naloxone will also create an immediate withdrawal reaction.
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