Signs and symptoms
Signs and symptoms include:
Drug seeking behavior
Increased use over time
Legal or social ramifications secondary to drug use
Multiple prescriptions from different providers
Multiple medical complications from drug use (HIV/AIDS, hospitalizations, abscesses)
Opioid cravings
Withdrawal symptomsAddiction and dependence are components of a substance use disorder and addiction represents the more severe form. Opioid dependence can occur as physical dependence, psychological dependence, or both. Withdrawal
Opioid withdrawal can occur with a sudden decrease in, or the cessation of, opioids after prolonged use. Onset of withdrawal depends on which opioid was used last. With heroin this typically occurs five hours after use, while with methadone it might not occur until two days later. The length of time that major symptoms occur also depends on the opioid used. For heroin withdrawal, symptoms are typically greatest at two to four days, and can last for up to two weeks. Less significant symptoms may remain for an even longer period, in which case the withdrawal is known as post-acute-withdrawal syndrome. Treatment of withdrawal may include methadone and buprenorphine. Medications for nausea or diarrhea may also be used. Opioid intoxication
Signs and symptoms of opioid intoxication include:

Opioid overdose
Signs and symptoms of opioid overdose include, but are not limited to:
Pin-point pupils may occur. Patient presenting with dilated pupils may still be experiencing an opioid overdose. Decreased heart rate
Decreased body temperature
Decreased breathing
Altered level of consciousness. People may be unresponsive or unconscious. Pulmonary edema (fluid accumulation in the lungs)
Shock
Death

Cause
Opioid use disorder can develop as a result of self-medication.
WD repeat domain phosphoinositide-interacting protein 4 (WIPI-4) is a protein that in humans is encoded by the WDR45 gene. Mutations in this gene cause a distinct form of Neurodegeneration with brain iron accumulation (NBIA) called Beta-propeller protein-associated neurodegeneration (BPAN). Function
WIPI-4 is a member of the WD repeat protein family. WD repeats are minimally conserved regions of approximately 40 amino acids typically bracketed by gly-his and trp-asp (GH-WD), which may facilitate formation of heterotrimeric or multiprotein complexes. Members of this family are involved in a variety of cellular processes, including cell cycle progression, signal transduction, apoptosis, and gene regulation. This gene WDR45 has a pseudogene at chromosome 4q31.3. Multiple alternatively spliced transcript variants encoding distinct isoforms have been found for this gene, but the biological validity and full-length nature of some variants have not been determined. Role in disease
De novo loss of function mutations in WDR45 were identified by exome sequencing in 20 patients with progressive neurodegeneration and evidence of iron on brain MRI scans. The mutations cause an X-linked dominant form of NBIA now called Beta-propeller protein-associated neurodegeneration (BPAN). A name for the disease before the gene was identified was called static encephalopathy of childhood with neurodegeneration in adulthood (SENDA), though this term is no longer used. There are no current treatments for BPAN, though medications and therapies can be used to treat symptoms. See also
WIPI protein family

References


== Further reading ==