Narcotics: Opioid Analgesics

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Narcotics Opioid Analgesics

• PPR 130

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Characteristics

• 4 categories
• Natural substances
• Semi-synthetic narcotics
• Synthetic products
• Endogenous opioids
• Narcoticsrelief of pain, fear, anxiety
• Consist usedependence

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Common Side Effects

• Constipation
• Constriction of pupils
• Irregular breathing
• Feeling of euphoria
• If user is not in pain, therapeutic does may
  produce mental distress and nausea.

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Natural Origin

• Opium-opium poppy, mother drug
• Morphine-opium, sedative and analgesic
• Codeine-morphine, often legal (tylenol w/)
• Thebaine-minor component of opium
• Not used medically in the U.S.
• Stimulant, rather than depressant, effects

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Semisynthetic

• Hydromorphone (Dilaudid)
• Derived from morphine
• More potent than morphine
• Highly abused drug
• Oxycodone (Percodan)
• Derived from thebaine
• More potent than codeine
• The active drug in Percodan
• OxyContin

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Semisynthetic cont.

• Etorphine
• Derived from thebaine
• More potent than morphine as an analgesic,
  sedative, and respiratory depressant
• High danger of overdose

7
Semisynthetic cont.

• Heroin
• Derived from morphine
• Powerful dependence-90 of opioid abuse
• Possession is illegal
• Most dangerousChina White
• Mainlining leads to a rush intense euphoria
• Users rapidly develop tolerance
• Life-endangering physical dangers
• Individuals continuewithdrawal

8
Synthetic

• Meperidine (Demerol)- resembles morphine due to
  pain relief properties
• Designer analogue (MPTP), nerve damaging
• Propoxyphene (Darvon)- mild pain relief
• Fentanyl- an analgesic and anesthetic in which
  designer heroins have been formulated.

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Endogenous

• Endogenous-made within the body
• Endogenous opioids-the morphine within
• Enkephalins- in the head resembles narcotic
  effects naturally produced in the brain.
• Endorphins morphine within these chemicals
  found in the pituitary which is hundred times
  more potent than morphine.

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Endogenous cont.

• Some say, drug dependence may be an endorphin
  deficiency.
• Endorphins help to elevate pain (fight or flight)
• Placebo relief (clinical trial)
• Acupuncture (stimulates endorphins)
• Mental illness (chemical imbalances)
• Runners high (natural high)

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Historical and Legal Views

• Opium use dates back to 3000 B.C
• Serturner extracted morphine in 1806
• Bayer produced heroin-1898
• Pure Food and Drug Act-1906 (assure purity)

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Legal cont.

• Harrison Narcotics Act of 1914
• Established government narcotics control
• Outlawed non-medical use of heroin
• Permitted prescription of narcotics
• Mistakenly classified cocaine as narcotic, a
  stimulant
• Eventually forbade dispensing narcotics to known
  addicts

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Legal cont.

• Importation of heroin outlawed in 1924
• Establishment of Public Health Service hospital
  farms for treatment of drug addiction
• Comprehensive Drug Abuse Prevention and Control
  Act of 1970
• Consolidated drug laws, reduced illegal drug use,
  created the Controlled Substances Act, creating
  five schedules of drugs using potential for abuse
  and medical use.

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Treatment

• In-patient treatments centers involving
  detoxification in the 1930s.
• Current therapies
• Detox
• Therapeutic communities
• Psychotherapeutic approaches (mental)
• Narcotics Anonymous
• Acupuncture
• Maintenance therapy minimal use on less harmful
  substance (heroinmethadone)

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Treatment cont.

• Methadone (a synthetic narcotic)
• Has same effects of heroine and morphine
• Less chance of abuse and dependency
• Meth has twenty four hours of effects compared to
  heroin at four hours
• Prevents the high and withdrawal symptoms
• Narcotic antagonists used to treat opioid
  dependence

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Discussion

• How do each of you feel about the therapies used
  in narcotic rehab?
• What do you feel is the most effective form of
  treatment?
• Any other comments about narcotics?