Opioid Dependence: Neuro-Biology, Clinical Features, Diagnosis and Management

Abstract

Opioids have been in use since centuries, but there is a growing concern regarding its illicit use among the youth, especially in India. Activation of mesolimbic reward pathway and dysfunction of the frontal inhibitory mechanisms contribute to the additive nature of opioids. The main goal of the management is detoxification, relapse prevention and adaptive and social rehabilitation. Management comprises of pharmacological and non pharmacological methods. Among the pharmacological methods, opioid substitution treatment (OST) has garnered wide recognition, with Buprenorphine being the most widely used agent. Methadone, naltrexone, clonidine and slow release oral morphine are other agents.