DISCUSSION POST REPLY: Opioid Dependence: A 28 year-Old Male with Opioid Dependence: Substance abuse is a medical illness that is characterized by significant impairment in the overall health…


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A 28 year-Old Male with Opioid Dependence: Substance abuse is a medical illness that is characterized by significant impairment in the overall health of the affected individual. According to Dugosh et al. (2016), in most cases, they range in severity, duration, and complexity, which can be mild and severe. Opioid use is of rising concern in the United States, but there are effective methods that can be used by healthcare professionals, which are effective medications available for the treatment of opioid dependency.

Efferent and Afferent Nerve Pathways

Yam et al. (2018) argue that the efferent pathways carry signals from the central nervous system, and this is the signals that the body sends to tell the brain to perform actions for instance blinking. On the other hand, efferent nerve pathways play a very critical role in the body in that they come from outside stimuli and let the brain understand what they are sensing, for instance, any changes in temperature (Yam et al., 2018).

Somatogenic Pain

Somatogenic pain is a condition that arises from somatogenic lesions that occurs from trauma, infection, or any other external factors (Poberezhnyi et al., 2018). In this case, the patient might experience pain as a result of addiction and, in extreme cases, can lead to reduced quality of life.


Hyperalgesia arising from opioid use causes increased sensitivity to feeling pain and the extreme response to pain, and this can occur as a result of damage to the nerves of chemical changes (Dave, 2018). In this case, the patient is under the influence of opioids, which might lead to the condition.

Naloxone Functions

According to Miller et al. (2022), naloxone is an opioid receptor antagonist which binds to opioid receptors and reverses or blocks the effects of opioids. Therefore, in this case, the patient’s naloxone function can work in reducing overdose deaths.


Case Study 

A 55-year-old male presents after a fall in his backyard.  His primary diagnosis is a 12 year battle with Parkinson’s Disease. 

Parkinson’s disease (PD) is a heterogeneous progressive neurodegenerative disorder, which typically affects older adults; it is predicted that by 2030 about 3% of the world population above 65 years of age is likely to be affected (Appeadu, M. and Gupta, V., 2022). Bradykinesia means slowness of movement and speed (or progressive hesitations/halts) as movements are continued. It is one of the cardinal symptoms of Parkinson’s disease (PD).

You must have bradykinesia plus at least either tremor or rigidity for a Parkinson’s diagnosis to be considered ((Bradykinesia (Slowness of Movement), 2022). Bradykinesia can be particularly frustrating because it is often unpredictable. One moment you can move easily, while in the next moment you may need help (Bradykinesia (Slowness of Movement), 2022). 

Postural instability in PD is the inability to balance due to loss of postural reflexes specifically, balance reaction, adoption of a flexed posture, and trunk rotation. These motor impairments are caused by dopaminergic neuronal deficits, comorbid white matter disease, and cholinergic system degeneration (Appeadu and Gupta, 2022) 

The Extrapyramidal and Pyramidal tracts are the pathways by which motor signals are sent from the  brain to lower  motor neurones. The lower motor neurones then directly innervate  muscles to produce movement (Extrapyramidal and Pyramidal Tracts, 2022). Pyramidal tracts: Conscious control of muscles from the cerebral cortex to the muscles of the body and face (Extrapyramidal and Pyramidal Tracts, 2022). 

Extrapyramidal tracts: Originate in the  brainstem, carrying motor fibres to the spinal cord. They are responsible for the unconscious, reflexive or responsive control of musculature, eg  muscle tone,  balance,  posture and locomotion. The  reticulospinal tract is one of the most important extra-pyramidal tracts for controlling the activity of lower motor neurons (Extrapyramidal and Pyramidal Tracts, 2022). 

When we talk about myelinated neuron, this simply means that the axon is covered by myelin sheath. If the axon is covered with myelin sheath, the nerve impulse is faster. If we talk about unmyelinated neuron, this means the axon is not covered by this myelin sheath. This then means that the conduction of nerve impulse is slower (Differences Between Myelinated and Unmyelinated Neurons | Difference Between, 2022).

To further understand myelin sheath, myelin is considered an electrical insulator. Its purpose is to speed the transmission of nerve impulse. Myelin sheath is lipoproteinaceous substance that envelopes the vertebrates axons whose size is bigger than .5mcm in diameter (Differences Between Myelinated and Unmyelinated Neurons | Difference Between, 2022).     

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Cathy, CS.