Opioids Case Study

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Dr. Gregory House is a 55-year-old single man; he lives in an apartment by himself and is the head of Diagnostic Medicine at Princeton-Plainsboro Teaching Hospital. Dr. Houses’ father was abusive in some instances he would make House take a cold bath and sleep outside thus leading to a very strained relationship between the two. Additionally, Dr. Houses ' relationship with his mother was tainted by her cheating on his father. In his mid-30’s, Dr. House suffered an infarction in his leg (necrosis of the muscle in his leg caused by obstruction of circulation). In order to treat him, doctors removed the dead muscle in his leg. Although this saved Dr. House 's life and prevented the need for the leg to be amputated, it left him with severe chronic …show more content…
Opioids can cause respiratory depression that can progress to death and this can occur in multiple ways. First, opioids are known to act directly on the medulla and pons, which are critical areas for respiration specifically involved in rhythm generation (Pattison, 2008). Additionally, Opioids effect in the brainstem appears to be linked to their ability to interfere with chemoreception in key respiratory areas (medulla and pons) (Pattison, 2008). For example, there is strong evidence that Opioids block the transmissions between the carotid bodies and the solitary nucleus in the brainstem thus causing slow and irregular rhythms leading to both hypoxia (decreased O2 in the blood) and hypercapnia (increased Co2 in the blood) ( Pattison, 2008). Furthermore, opiates can also cause the heart rate to slow down. In an experimental study conducted by Cahalan et al. (1987) on the heart rate response 81 healthy patients undergoing elective surgery were given narcotics prior/during surgery. The group that received morphine or fentanyl (both opiates) presented with a significantly decreased heart rate (Cahalan, 1987). The suspected mechanisms behind this effect are the vasogenic effects of these substances. Research has also demonstrated that opioids interact with the regulatory centers in the brain stem as well as the heart and the blood vessels to cause a heart …show more content…
House started using Vicodin because he is trying to self-medicate. The self-medication hypothesis of drug abuse states that drug users discover that each drug relieves a range of painful emotional states or experience control over their emotions (Khantzian, 1997). One can assume that House is emotionally damaged from the dysfunctional early relationship with his parents. These early life experiences lead to his damaged personality, his characteristic deep-seated unhappiness, cynicism, and most likely to his fear of intimacy, and lack of regard for societal values. Thus, these early life events predisposed him to further psychological damage caused by other trauma. After his physical injury to his leg, Dr. House experienced distress and suffering. Both these subjective states are known motivators to self-medicate with substances of abuse. (Khantzian, 1997). Furthermore, I believe that Dr. House is ultimately depressed from losing the function of his leg, and his girlfriend at the same time. Epidemiological and clinical data indicate that there is significant evidence of depression and trying to self-medicate with drugs(Markou, 1998). Therefore, because his challenging youth and lack of support and coping strategies, Dr. House is unable to deal with his emotions effectively. Since opiates produce a sedation like effect, I believe that Dr. House is using it so that he does not have to deal with these feeling in his day-to-day

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