Evidence map›Paper›PMID 34832873›Full record

ReviewPharmaceuticals (Basel, Switzerland)2021

Opioid Analgesia and Opioid-Induced Adverse Effects: A Review.

Alok K Paul, Craig M Smith, Mohammed Rahmatullah, Veeranoot Nissapatorn, Polrat Wilairatana, Mariana Spetea, Nuri Gueven, Nikolas Dietis

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Pharmaceuticals (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 160 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
160citing papers in PubMed, 3 pooled it
16.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

160 citing papers in PubMed, 3 syntheses or guidelines pooled it, 252 citations in OpenAlex.

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  9. Monotherapy vs. combination paracetamol and tramadol for cancer-related pain in the emergency department: a comparative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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100 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 5 countries.

Alok K PaulSchool of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia.ORCID 0000-0002-6090-2407
Craig M SmithSchool of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3216, Australia.
Mohammed RahmatullahDepartment of Biotechnology & Genetic Engineering, University of Development Alternative, Dhanmondi, Dhaka 1207, Bangladesh.
Veeranoot NissapatornSchool of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD) and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand.
Polrat WilairatanaDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.ORCID 0000-0002-2730-7788
Mariana SpeteaDepartment of Pharmaceutical Chemistry, Institute of Pharmacy and Center for Molecular Biosciences (CMBI), University of Innsbruck, Innrain 80-82, 6020 Innsbruck, Austria.ORCID 0000-0002-2379-5358
Nuri GuevenSchool of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia.ORCID 0000-0003-3782-767X
Nikolas DietisMedical School, University of Cyprus, Nicosia 1678, Cyprus.
University of Tasmania · AUDeakin University · AUMahidol University · THUniversität Innsbruck · ATUniversity of Cyprus · CYUniversity of Development Alternative · BDWalailak University · TH

Funding

Austrian Science Fund FWF I 2463Austrian Science Fund FWF I 4697Austrian Science Fund FWF TRP 19
6 · The paper itself

Abstract

Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance. As opium and opioids have been traditionally used as painkillers, the exact mechanisms of their adverse reactions over repeated use are multifactorial and not fully understood. Older adults suffer from cancer and non-cancer chronic pain more than younger adults, due to the physiological changes related to ageing and their reduced metabolic capabilities and thus show an increased number of adverse reactions to opioid drugs. All clinically used opioids are μ-opioid receptor agonists, and the major adverse effects are directly or potentially connected to this receptor. Multifunctional opioid ligands or peripherally restricted opioids may elicit fewer adverse effects, as shown in preclinical studies, but these results need reproducibility from further extensive clinical trials. The current review aims to overview various mechanisms involved in the adverse effects induced by opioids, to provide a better understanding of the underlying pathophysiology and, ultimately, to help develop an effective therapeutic strategy to better manage pain.

Indexed as

adverse effectsanalgesiabehaviourchronic painmorphineopioidstolerance

Identifiers

PMID34832873
PMCPMC8620360
OpenAlexW3211040763

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.