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Pethidine: Difference between revisions
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One of pethdine's metabolites, norpethidine has little to no opioid action, but is know to cause seizures. Pethidine should not be taken during [[Benzodiazepine#Discontinuation|benzodiazepine withdrawals]] as this can potentially cause [[seizure]]s. In 1984, Libby Zion, a teenager was brought to the emergency room due to a "flu-like" ailment. She was previously prescribed and taking phenelzine, a [[MAOI |monoamine oxidase inhibitor]], which in combination caused fatal serotonin syndrome.<ref> Serotonin Syndrome and the Libby Zion Affair | http://epmonthly.com/article/serotonin-syndrome-and-the-libby-zion-affair/ </ref> | One of pethdine's metabolites, norpethidine has little to no opioid action, but is know to cause seizures. Pethidine should not be taken during [[Benzodiazepine#Discontinuation|benzodiazepine withdrawals]] as this can potentially cause [[seizure]]s. In 1984, Libby Zion, a teenager was brought to the emergency room due to a "flu-like" ailment. She was previously prescribed and taking phenelzine, a [[MAOI |monoamine oxidase inhibitor]], which in combination caused fatal serotonin syndrome.<ref> Serotonin Syndrome and the Libby Zion Affair | http://epmonthly.com/article/serotonin-syndrome-and-the-libby-zion-affair/ </ref> | ||
It is strongly recommended that one use [[responsible | It is strongly recommended that one use [[responsible substance use|harm reduction practices]] when using this drug. | ||
===Tolerance and addiction potential=== | ===Tolerance and addiction potential=== | ||
As with other [[opioids]], the chronic use of pethidine can be considered [[Addiction potential::extremely addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[Opioids#Discontinuation|withdrawal symptoms]] may occur if a person suddenly stops their usage. | As with other [[opioids]], the chronic use of pethidine can be considered [[Addiction potential::extremely addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[Opioids#Discontinuation|withdrawal symptoms]] may occur if a person suddenly stops their usage. | ||
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Tolerance to many of the effects of pethidine [[Time to full tolerance::develops with prolonged and repeated use]]. The rate at which this occurs develops at different rates for different effects, with tolerance to the constipation-inducing effects developing particularly slowly for instance. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about [[Time to half tolerance::3 - 7 days]] for the tolerance to be reduced to half and [[Time to zero tolerance::1 - 2 weeks]] to be back at baseline (in the absence of further consumption). Pethidine presents cross-tolerance with [[Cross-tolerance::all other [[opioids]]]], meaning that after the consumption of pethidine all [[opioid]]s will have a reduced effect. | Tolerance to many of the effects of pethidine [[Time to full tolerance::develops with prolonged and repeated use]]. The rate at which this occurs develops at different rates for different effects, with tolerance to the constipation-inducing effects developing particularly slowly for instance. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about [[Time to half tolerance::3 - 7 days]] for the tolerance to be reduced to half and [[Time to zero tolerance::1 - 2 weeks]] to be back at baseline (in the absence of further consumption). Pethidine presents cross-tolerance with [[Cross-tolerance::all other [[opioids]]]], meaning that after the consumption of pethidine all [[opioid]]s will have a reduced effect. | ||
The risk of fatal opioid overdoses rise sharply after a period of cessation and [[relapse]], largely because of reduced tolerance.<ref>Why Heroin Relapse Often Ends In Death - Lauren F Friedman (Business Insider) | http://www.businessinsider.com.au/philip-seymour-hoffman-overdose-2014-2</ref> To account for this lack of tolerance, it is safer to only dose a fraction of one's usual [[dosage]] if relapsing. It has also been found that the environment one is in can play a role in opioid tolerance. In one scientific study, rats with the same history of heroin administration were significantly more likely to die after receiving their dose in an environment not associated with the | The risk of fatal opioid overdoses rise sharply after a period of cessation and [[relapse]], largely because of reduced tolerance.<ref>Why Heroin Relapse Often Ends In Death - Lauren F Friedman (Business Insider) | http://www.businessinsider.com.au/philip-seymour-hoffman-overdose-2014-2</ref> To account for this lack of tolerance, it is safer to only dose a fraction of one's usual [[dosage]] if relapsing. It has also been found that the environment one is in can play a role in opioid tolerance. In one scientific study, rats with the same history of heroin administration were significantly more likely to die after receiving their dose in an environment not associated with the substance in contrast to a familiar environment.<ref>Siegel, S., Hinson, R., Krank, M., & McCully, J. (1982). Heroin “overdose” death: contribution of drug-associated environmental cues. Science, 216(4544), 436–437. https://doi.org/10.1126/science.7200260</ref> | ||
===Dangerous interactions=== | ===Dangerous interactions=== | ||
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{{LegalStub}} | {{LegalStub}} | ||
*'''United States:''' Pethidine is a Schedule II Controlled Substance.<ref>DEA Controlled Substances | https://www.deadiversion.usdoj.gov/schedules/orangebook/e_cs_sched.pdf</ref> | *'''United States:''' Pethidine is a Schedule II Controlled Substance.<ref>DEA Controlled Substances | https://www.deadiversion.usdoj.gov/schedules/orangebook/e_cs_sched.pdf</ref> | ||
*'''United Kingdom:''' Pethidine is a Class A, Schedule 2 | *'''United Kingdom:''' Pethidine is a Class A, Schedule 2 substance in the United Kingdom.<ref>UK Controlled Drugs | https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation</ref> | ||
==See also== | ==See also== | ||