Session 17

Prescription opioid abuse and misuse are a serious problem in the US; however, the situation in Europe is less clear, but recently collected data including by the GTNet international network are highly interesting. The increasing availability of maintenance treatments for heroin addiction represents another source of abuse. Experimental studies and clinical observations in human poisonings are able to identify possible mechanisms of toxicity, some of them being common to the different opioids and others specific of each marketed opioid molecule like codeine, methadone, buprenorphine and tramadol. To reduce opioid-related deaths, vast programs rendering naloxone kits available for bystanders are now developed in several European countries, like in the US. In addition, recent strategies to increase opioid-related antinociceptive properties and overcome major side-effects involve the creation of multifunctional compounds which contain hybridized structures (including the combination of opioids with other bioactive neurotransmitters and peptide hormones involved in pain perception) as well as the consideration of new route of administration. This workshop will review all these aspects of the epidemiology of opioid-related poisonings, their involved mechanisms of toxicity, the scientific research and the Governmental policies to reduce their resulting toxicity. Interaction with the public is important due to the highly debated issues.