Opioid Dependence

1 The Problems of Opioid and Other Drug Dependencies.- Prevalence and Complications.- Nonopioid Drug-Dependence Syndromes.- Barbiturate, Nonbarbiturate Sedative, and "Minor Tranquilizer" Dependence.- Alcohol Dependence.- Amphetamine Dependence.- Cocaine Dependence.- Hallucinogen Dependence.- Cannabis (Marijuana, Hashish) Dependence.- Tobacco Dependence.- References.- 2 The Etiology of Opioid Dependence.- Definitions and Dynamics.- Personality Studies.- Socioenvironmental Studies.- Mode of Spread of Opioid Dependence.- Prognosis.- References.- 3 Opioid Analgesics and Opioid Antagonists.- Opioid Analgesics.- Morphine.- Effects of Single Doses in the Nontolerant State.- Tolerance and Physical Dependence.- Heroin.- Methadone.- Meperidine.- Codeine.- d-Propoxyphene.- Pentazocine.- Opioid Antagonists.- Nalorphine.- Effects of Single Doses in the Drug-Free State.- Tolerance and Physical Dependence.- Opioid-Antagonistic and Opioid-Blocking Actions in the Nontolerant State.- Opioid-Antagonistic and Opioid-Blocking Actions in the Tolerant State.- Cyclazocine.- Naloxone and Naltrexone.- References.- 4 Opioid Receptors and Endogenous Opioid Peptides.- Opioid Receptors.- Endogenous Opioid Peptides (Enkephalins and Endorphins).- Possible Functions of Enkephalins and Endorphins.- Analgesia.- Physical Dependence.- Mental Disorders.- References.- 5 Mechanisms of Opioid Analgesia.- The Nature of Pain and Its Relief by Morphine.- Sites of Morphine's Antinociceptive Actions in the Central Nervous System.- Spinal Cord.- Brain Stem.- Cerebral Cortex.- References.- 6 Theories of Tolerance to and Physical Dependence on Opioids.- General Theories of Tolerance to and Physical Dependence on Morphine.- Homeostatic Counteradaptation.- Cellular Counteradaptation.- Dual Action.- Theories of the Mechanisms of Counteradaptation to the Agonistic Effects of Drugs.- Disuse Supersensitivity.- Pharmacological Redundancy.- New Receptors.- Enzyme Expansion.- Immune Mechanisms.- Learning Factors.- References.- 7 Conditioning Processes in Opioid Dependence and in Relapse.- Operant Conditioning of Opioid-Acquisitive Behavior.- Classical Conditioning of the Opioid Agonist-Abstinence Cycle and Interoceptive Conditioning of Opioid-Seeking Behavior.- Classical Conditioning of the Opioid-Antagonist-Precipitated Opioid-Abstinence Syndrome.- Occurrence of Classically Conditioned Responses in Street Addicts.- Implications of Conditioning Factors for Relapse and Treatment.- References.- 8 Diagnosis and Treatment of Opioid Dependence.- Diagnosis.- Physical Dependence.- Opioid Use.- Treatment.- Opioid Poisoning.- Opioid Dependence.- Detoxification.- Detoxification Followed by Narcotic-Antagonist Maintenance.- Methadone Maintenance (with or without Eventual Detoxification).- Levomethadyl Maintenance.- References.