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## Meet the editor

After completing her studies in Pharmacy at the University of Granada, Pilar Almela joined a PhD program in Experimental Biomedical Sciences at the University of Murcia in the Department of Pharmacology, under Professor Laorden's supervision, where she studied different pathway involvement in the adaptive changes observed during morphine dependence. Her training was completed with stays at research centers in USA, France,

United Kingdom and Spain. Results from her laboratory have given rise to numerous international publications. These findings can improve the knowledge of mechanisms involved in addiction and establish new prevention and treatment strategies. In 2019, she became an Associate Professor at the Department of Pharmacology, focusing her current research on the design of new nanoparticulate systems for morphine administration.

Contents

**Section 1**

*by Pilar Almela*

*by Pamela Bolyanatz*

Other Uses of Morphine *by Shrenik Ostwal*

and Opiate Addiction

Memory in Mice

*and María Luisa Laorden*

*and Marta Rodríguez-Arias*

**Section 2**

**Section 3**

**Preface XI**

General Considerations **1**

**Chapter 1 3**

Opioid Uses **11**

**Chapter 2 13**

**Chapter 3 25**

Pathophysiology and Therapeutic Strategies for Opioid Addiction **39**

**Chapter 4 41**

**Chapter 5 53**

**Chapter 6 73**

Introductory Chapter: Opioid Analgesics - History, Uses and Risks

A New Paradigm: Prevention of Central Sensitization in Pain

Role of Glucocorticoid Receptor in the Relation between Stress

Corticotrophin-Releasing Factor (CRF) through CRF1 Receptor Facilitates the Expression of Morphine-Related Positive and Aversive

*by Pilar Almela, Juan A. García-Carmona, Elena Martínez-Laorden,* 

Present and Future Pharmacological Treatments for Opioid Addiction

*by Maria Carmen Blanco-Gandía, Sandra Montagud-Romero* 

*by Javier Navarro-Zaragoza, María Victoria Milanés* 

*María V. Milanés and María L. Laorden*

Management through Minimizing Opioid Exposure

## Contents


*and Marta Rodríguez-Arias*

Preface

Over the past two decades, some countries have observed an increase in the use of opioid drugs for pain management, including non-oncological pain. The use of prescription opioids is sometimes justified to decrease or abolish the nociceptive sensation but the misuse of this kind of drug, the rise in heroin consumption, and the escalation in the abuse of high-potency synthetic opioids, such as fentanyl, have

Nowadays, morphine and other opioid drugs are widely used for pain relief in many conditions but their use is associated with potential complications. For example, opioids can produce a rebound effect and cause more pain instead of relief and they have a high chance of generating tolerance, dependence, and addiction, a brain disease induced by repeated or chronic use of these drugs that causes adaptive or allostatic changes (i.e. cellular or system adaptations) that modify the neuronal circuitry, inducing a "drug-dependent" state. This state persists even after drug consumption and affects the feeling of well-being, learning, stress, decision-making,

This book is written by international scientists with expertise in psychobiology, addiction, and pain management, and addresses different aspects of opioids, such as understanding central pain and central sensitization for better patient care, effectiveness of morphine in other conditions apart from pain control,

neurobiological mechanisms associated with opioid addiction, and pharmacological

With this book culminates an intense project in which I would first like to highlight the involvement of all authors who have contributed to a text of great quality and scientific rigor. I would like to thank Ms Romina Rovan, Ms Rozmari Marijan and Ms Manuela Gabric, the Author Service Managers for this book at IntechOpen, for their assistance during book preparation. Finally, I would also like to dedicate this book to my mentor, Professor María Luisa Laorden, and to my family, without

> **Pilar Almela Rojo** Associate Professor,

Faculty of Medicine, University of Murcia,

Spain

Department of Pharmacology,

any of them, it would not have been possible to get here.

led to the declaration of an opioid epidemic.

and self-control.

treatments for this disease.
