It's not an opioid, it has no effect on opioid receptors. The receptors it does affect are not associated with recreational effects. In fact the psychoactivity it does produce is generally considered dysphoric, hallucinations, delusions, etc. It has to be administered via a spinal pump. Attempts to administer it via other routes is either ineffective or the side effects become more prominent than the analgesia. It is considered an absolute last option, used only where opioids are ineffective or no longer tolerated. You'll get morphine in your pump before Prialt.
I figured, I was just speculating. Anyways, these are the side-effects of Prialt, and they sound absolutely terrible:
The most common side effects are dizziness, nausea, confusion, nystagmus and headache. Others may include weakness, hypertonia, ataxia, abnormal vision, anorexia, somnolence, unsteadiness on feet, vertigo, urinary retention, pruritis, increased sweating, diarrhea, nausea, vomiting, asthenia, pyrexia, rigors, sinusitis, muscle spasms, myalgia, insomnia, anxiety, amnesia, nystagmus, tremor, memory impairment and induced psychiatric disorders. Other side effects which are less frequent but still clinically significant include auditory and visual hallucinations, thoughts of suicide, acute renal failure, atrial fibrilation, cardiovascular accident, sepsis, new or worsening depression, paranoia, disorientation, meningitis and seizures. Therefore, it is contraindicated in people with a history of psychosis, schizophrenia, clinical depression, and bipolar disorder. Recent incidents suggesting a link between intrathecal ziconotide treatment and increased risk of suicide have led to calls for strict and ongoing psychiatric monitoring of patients to avoid suicide occurring in vulnerable individuals. There is no known anti-dote.
