Download Chapter 9 - Opiates A

Chapter 5
Narcotics:
Opium, Heroin, and
Synthetic Opiates
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Opiates
• Opiates are a form of narcotic drug that
include opium and three natural
components that can be extracted from
it: morphine, codeine, and thebaine.
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Figure 5.1
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Opium in History
• A drug with a very long history, opium
has been used for medicinal and
recreational purposes for approximately
5,000 years.
• During the nineteenth century, opium
even figured in global politics as the
instigating factor for the Opium War
fought between China and Britain.
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Opium in History
• At the time, opium use was widespread
in Britain and the United States at all
levels of society.
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Morphine and the
Advent of Heroin
• The discovery of morphine in 1803 as the
principal active ingredient in opium
revolutionized medical treatment of pain and
chronic diseases.
• At the end of the nineteenth century, heroin
was introduced by the Bayer Company in
Germany.
• Initially, it was believed that heroin lacked the
dependence-producing properties of
morphine.
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Opiates and Heroin
in American Society
• The abuse potential of morphine and
especially of heroin was not fully realized until
the beginning of the twentieth century.
• Social and political developments in the
United States after the passage of the
Harrison Act in 1914 drove heroin
underground, where it acquired a growing
association with criminal life.
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Opiates and Heroin
in American Society
• Heroin abuse became associated with
African American and other minority
communities in urban ghettos after
World War II; later, the drug revolution
and the military involvement in Vietnam
during the 1960s and 1970s brought the
issue of heroin abuse to a wider
population.
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Effects on the Mind
and the Body
• The effects of narcotic drugs such as
heroin include euphoria, analgesia,
gastrointestinal slowing, and respiratory
depression.
• Respiratory depression is the major risk
factor for heroin intake.
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How Opiates Work
in the Brain
• Since the 1970s, we have known that
the effects of morphine and similar
drugs are the result of the activation of
morphine-sensitive receptors in the
brain.
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Figure 5.2
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How Opiates Work
in the Brain
• Three families of chemical substances
produced by the brain bind to these
receptors.
• These chemicals are collectively known
as endorphins.
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Patterns of Heroin Abuse
• Chronic heroin abuse is subject to
tolerance effects over time.
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Table 5.1
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Patterns of Heroin Abuse
• Withdrawal effects include intense
craving for heroin and physical
symptoms such as diarrhea and
dehydration.
• One of the major problems surrounding
heroin abuse is the unpredictability in
the content of a heroin dose.
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Table 5.2
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Treatment for Heroin Abuse
• Treatment for heroin abuse includes
short-term detoxification and long-term
interventions that address the
continuing craving for the drug and
physical dependence factors in the
body.
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Treatment for Heroin Abuse
• Methadone-maintenance programs
focus primarily on the physiological
needs of the heroin abuser, whereas
therapeutic communities and support
groups focus on his or her long-term
reintegration into society.
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Opiate Use, Misuse,
and Abuse
• In medical settings, narcotic drugs have
been extremely helpful in the treatment
of pain, in the treatment of dysentery,
and in the suppression of coughing.
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Table 5.3
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Opiate Use, Misuse,
and Abuse
• Side effects of opiate-based medications
include respiratory depression, intestinal
spasms, and sedation.
• There has been great concern since the
late 1990s that prescription pain relievers
have been diverted to nonmedical
purposes and are subject to abuse.
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Opiate Use, Misuse,
and Abuse
• Three medications of this type are
OxyContin, Vicodin, and Percocet.
• More than half of young adults who
have used a prescription pain reliever
for nonmedical reasons report that the
drug was obtained free from a friend or
relative.
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