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Opiates

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Codeine (poppy head) was isolated in 1832 ... Lasts 3 to 5 days. Tearing of the eyes. Runny nose. Sweating. Dilated pupils. Loss of appetite ... – PowerPoint PPT presentation

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Title: Opiates


1
Opiates
2
Narcotics
  • A drug that in therapeutic doses diminishes
    sensibility, relieves pain, and produces sleep,
    but in large doses causes stupor, coma or
    convulsions any drug with properties similar to
    morphine, identified as a narcotic drug by
    federal law.
  • Goulds Medical dictionary

3
Source
  • Opium poppy
  • Papaver somniferum L
  • Papaver Greek for poppy
  • Somniferum Latin to dream or sleep
  • Grows in India, Turkey, China, Mexico, SW Asia,
    Afghanistan

4
Harvest
  • Petals fall from the opium seed pod
  • Approximately two weeks later unripe pods are
    incised
  • Opium oozes out and dries in about 24 hours
  • Then collected by hand

5
Yields
  • Four kilos of opium per acre
  • 80 mgs per plant
  • 10 kilos of opium yield about 1 kilo of morphine
    and morphine to heroin is a 1 to 1 conversion

6
Opium derivatives
  • Opium
  • Morphine
  • Codeine
  • Thebaine

7
Semi Synthetic Derivatives
  • Heroin diacetylmorphine
  • Eythylmorphine Dionine
  • Dihydrocodeine Paracodin
  • Hydromorpone Dilaudid
  • Dihydrocodeinone Kycodan
  • Oxycodone - Percodan

8
Synthetics
  • Meperidine Demorol
  • Methadone Methadon, Dolophine

9
  • Earliest recorded use of opiates, circa 1500 BC
    in the Ebers papyrus
  • Pharmacology book (Biruni 1000 AD) describing
    opiate dependence
  • Early 16th century, Paracelsus created laudanum,
    a mixture of wine and opium

10
  • Dr. Thomas Sydenham (The English Hippocrates)
    modified laudanum mixture, John Bell Hood
  • Morphine was isolated by Frederich Serturner in
    1806
  • Codeine (poppy head) was isolated in 1832
  • English developed trade with China in the 19th
    century through the East India Company

11
  • English developed trade with China in the 19th
    century through the East India Company
  • China had the problem of increasing opium
    addiction and banned the importation of opium
  • This lead to the Opium War in 1840 to 1842 in
    which England took control of Hong Kong

12
  • 1853 the hypodermic needle was invented
  • U. S. Civil War lead to the Soldiers Disease
  • Heroin was transformed in 1874, thought to be 3X
    more powerful than morphine

13
  • Influx of Chinese laborers caused an increase in
    opium smoking
  • 1890 Heroin was marketed by the Germans, may be
    derived from the German heroisch meaning heroic,
    dynamic or powerful

14
  • Opiate abuse developed in the mid-19th century
  • Harrison Act in 1914 (drugs secured by a
    physician)
  • WWII heroin use increased in the lower classes

15
  • 1960s saw an increase in the use of heroin as
    well as other drugs
  • Vietnam war created the opportunity for increased
    use of heroin among U.S. military personnel
  • In the 1970s black tar from Mexico became
    available

16
  • Current use includes upper middle class use
    with purity of heroin increasing (40 to 60 )

17
Effects of Opium Derivatives
  • Primarily an analgesic
  • Constricted pupils, DRE
  • Depressed respiration
  • Constipation
  • Nausea
  • Drowsiness
  • Euphoria

18
  • Apathy
  • Decreased sexual drive
  • Tolerance
  • Physical dependency

19
Dosage form and use (heroin)
  • White powder
  • Brown powder
  • Black tar smoked
  • Snorted
  • Injected
  • Skin popping
  • Smoked

20
Chemical Characteristics
  • Raw opium contains 10 morphine and small amounts
    of codeine
  • Heroin is produced by the addition of 2 acetyl
    molecules thus producing diacetylmorphine
  • Fentanyl (pain reliever) resulted in improved
    anesthesia

21
  • Narcotic antagonists (Naloxone) can reverse
    overdoses

22
Mechanism of Action
  • Leu-enkephalin and metenkephhalin act like
    morphine
  • Endorphins found in brain tissue
  • Midbrain (pain reception site) interaction
  • Endorphins are released by the pituitary and
    perhaps act in the spinal column but have an
    unsubstantiated effect on the brain

23
Dependence Potential
  • Tolerance develops with narcotic drugs
  • Psychological dependence
  • Behavior reinforcement of needle usage

24
Withdrawal
  • Peaks in 24 to 36 hours
  • Lasts 3 to 5 days
  • Tearing of the eyes
  • Runny nose
  • Sweating
  • Dilated pupils

25
  • Loss of appetite
  • Gooseflesh Cold Turkey
  • Restlessness
  • Irritability
  • Tremor, convulsions
  • Insomnia

26
  • Depression
  • Nausea and vomiting
  • Cramps and diarrhea
  • Muscle spasms Kicking the habit

27
Toxicity Potential
  • Acute toxicity effects,
  • Respiration
  • Decreased mental ability
  • Nausea/vomiting

28
Chronic Toxicity
  • Sores at injection sites
  • HIV/AIDS
  • Hepatitis
  • No long-term change in tissues or organs

29
Treatment
  • Narcotic antagonists
  • Methadone
  • LAAM (L-alpha-acetyl-methadol)
  • Buprenorphine
  • Heroin/morphine maintenance
  • Rapid opioid detoxification
  • Delancy Street

30
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