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R&E Meeting: Opiates & Opioids
Presented by VN Cares and Pre-Pharmacy Club
5.4.16
Opiates
- Drugs derived from sap of Opium poppy plant
- Ex: morphine and codeine (depressants used to treat pain)
o Processed from sap  paste  powder
- Has 2 hydroxyl functional group
Opioid
- Semi-synthetic and synthetic compounds that yield morphine like effects
- Interact with morphine receptors
- Ex: heroin, endorphin (derived from Opiates themselves
- Endogenous opioids – proteins synthesized by body (endorphins)
- Has 2 acetyl functional group
Heroin
- Primary forms found in black tar and powdered
- Seed pod of Asian Black Poppy Plant
- Produced in Asia Triangle and Afghanistan
- Can be injected, smoked, snorted (not recommended)
- Abuse can lead to miscarriages, heart attacks, HIV/AIDS, tolerance
Administration
- Routes of entry and time until effect
o Injection (subcutaneous or intravenous) – 1 min
o Inhalation (smoking) – 1 min
o Snorting (powdered form, mucus membranes ) – 8 min
o Orally – 20 min
- Absorption and excretion mainly through kidney and urinary system
Effects
- Pain relief, drowsiness, muscle relaxant, decreased anxiety
- Side effects: reduced heart rate and breathing, nausea, organ damage
Withdrawal syndromes
- Flu –like symptoms : nausea, stomach cramps,
- Worst case symptoms: insomnia, suicidal thoughts, coma
Tolerance
- Developed and sustained
- Take more drug in a dose to produce the same effect compared to the first time taken
- Key factor = how much drug is used within drug, how often drug is administered,
physiology of patient taking drug (height and weight)
- Not permanent through decreasing use
Treatment
- Behavioral counseling (Harm Reduction)
o Seeks to combat social effects from drug abuse such as social family relationship,
unemployment
o Creating safe environment
-
Antagonist treatment (ex: Buprenorphine)
Physiology behind methadone (antagonist drug):
o Binds to opioid receptors and eliminates withdrawal symptoms
o Most effective known treatment to opiate addiction
o Side effects of methadone: drowsiness, lack of sleep
o Health care professionals recommend this better than the other drug and their side
effects mentioned previously
Legality
- 1970 Controlled Substance Act
o Heroin is Schedule I Drug – needs license to access
- 2000 Drug Addiction Treatment Act
o Made legal for physicians to get drug to treat patients with narcotic addiction
o Patients can be treated in private compared to going out to specific areas
- 2006 Bill H.R. 6344
o Illegal for individuals to have except when used by physicians when treatment of
withdrawal symptoms, pain, addiction
Why opiates?
- 13-20 million people worldwide use opiates/opioids recreationally
- 210 million prescriptions for legal opiates/opioids
- 2000-13: heroin deaths increased 272% (tripled)
- Knowing health effects and treatments to effectively diagnosis patient’s symptoms and
guide patients to wellness