Paper I
2023 January (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Pharmacological management of Opium (Morphine) dependence.

Q84 marksShort Answers

Answer

  • Acute withdrawal (detoxification): Methadone or Buprenorphine — long-acting opioid agonists/partial agonists substituted for the short-acting drug of abuse, then gradually tapered, converting an unpredictable withdrawal into a controlled, gradually reduced exposure; Clonidine (alpha-2 agonist) reduces autonomic withdrawal symptoms (sweating, tachycardia, hypertension) by suppressing the noradrenergic surge that drives them.
  • Maintenance therapy: Methadone maintenance or Buprenorphine maintenance — long-term substitution reducing craving and illicit use, given under supervised programs.
  • Relapse prevention: Naltrexone — a long-acting opioid receptor antagonist blocking the euphoric effect of any opioid used while on therapy, used once the patient is opioid-free.
  • Overdose management: Naloxone — rapid-acting opioid antagonist, reverses acute overdose/respiratory depression.
  • Psychosocial support/counseling alongside pharmacotherapy improves outcomes.

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