Is Morphine Medicine's Biggest Misnomer?

Raffa, Robert B.; Pergolizzi, Joseph V.

doi:10.1345/aph.1r133

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…According to newer literature, these conclusions are still valid. Raffa and Pergolizzi () reviewed the effects of morphine on sleep architecture without discussing dose–effect relationships: decrease in the number and duration of rapid eye movement (REM) periods, delay in the onset of the first REM period and increase in the waking state and reduction in slow‐wave sleep in healthy adults. According to Kohberg et al.…”

Section: Assessmentmentioning

confidence: 99%

Update of the Scientific Opinion on opium alkaloids in poppy seeds

Knutsen¹,

Alexander²,

Barregård³

et al. 2018

EFS2

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Poppy seeds are obtained from the opium poppy (Papaver somniferum L.). They are used as food and to produce edible oil. The opium poppy plant contains narcotic alkaloids such as morphine and codeine. Poppy seeds do not contain the opium alkaloids, but can become contaminated with alkaloids as a result of pest damage and during harvesting. The European Commission asked EFSA to provide an update of the Scientific Opinion on opium alkaloids in poppy seeds. The assessment is based on data on morphine, codeine, thebaine, oripavine, noscapine and papaverine in poppy seed samples. The CONTAM Panel confirms the acute reference dose (ARfD) of 10 lg morphine/kg body weight (bw) and concluded that the concentration of codeine in the poppy seed samples should be taken into account by converting codeine to morphine equivalents, using a factor of 0.2. The ARfD is therefore a group ARfD for morphine and codeine, expressed in morphine equivalents. Mean and high levels of dietary exposure to morphine equivalents from poppy seeds considered to have high levels of opium alkaloids (i.e. poppy seeds from varieties primarily grown for pharmaceutical use) exceed the ARfD in most age groups. For poppy seeds considered to have relatively low concentrations of opium alkaloids (i.e. primarily varieties for food use), some exceedance of the ARfD is also seen at high levels of dietary exposure in most surveys. For noscapine and papaverine, the available data do not allow making a hazard characterisation. However, comparison of the dietary exposure to the recommended therapeutical doses does not suggest a health concern for these alkaloids. For thebaine and oripavine, no risk characterisation was done due to insufficient data. However, for thebaine, limited evidence indicates a higher acute lethality than for morphine and the estimated exposure could present a health risk.

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Section: Assessmentmentioning

confidence: 99%

Update of the Scientific Opinion on opium alkaloids in poppy seeds

Knutsen¹,

Alexander²,

Barregård³

et al. 2018

EFS2

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“…Addictions to non-opioid substances may indicate a risk for opioid abuse [41] . The literature reports on potential risk factors for opioid misuse and abuse, and screening tools [42][43][44][45][46] . Buprenorphine is considered to have lower potential for abuse than equianalgesic strong opioids [10] .…”

Section: Abuse Potentialmentioning

confidence: 99%

Analgesia for Moderate Chronic Non-Cancer Pain : Low Dose Transdermal Buprenorphine A Novel Option in Mexico

Pergolizzi¹

2016

JAS

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Pain medicine has come a long way since the now-famous three-rung "pain ladder" proposed by the World Health Organization (WHO) in 1988. The WHO pain ladder recommended treating cancer pain based solely on intensity and although it allowed for combination therapy and adjuvant agents, it stopped short of specifying them or ofering guidance on their use [1]. It also did not address non-cancer pain. The role of opioid analgesics Opioid agents are efective pain relievers, but haveassociated side efects such as constipation, dizziness, somnolence, nausea, etc., plus carry an abuse

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Is Morphine Medicine's Biggest Misnomer?

Cited by 2 publications

References 9 publications

Update of the Scientific Opinion on opium alkaloids in poppy seeds

Update of the Scientific Opinion on opium alkaloids in poppy seeds

Analgesia for Moderate Chronic Non-Cancer Pain : Low Dose Transdermal Buprenorphine A Novel Option in Mexico

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