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OPIATES Mr. Prall INTRODUCTION What are Opiates? Opiates – Any drug derived from opium. One of the oldest drugs used by man. They were used in prehistoric times where teas were prepared from opium poppies. INTRODUCTION Opiates vs Opioids Opiates - Alkaloids derived from the opium poppy. Opium is a strong pain relieving medication, and a number of drugs are also made from this source. Opioids - Synthetic or partly-synthetic drugs that are manufactured to work in a similar way to opiates. Their active ingredients are made via chemical synthesis. Opioids may act like opiates when taken for pain because they have similar molecules. -Opiates are a natural pain remedy -Opioids are a synthetic pain remedy INTRODUCTION CONT. All opiates cause a pleasant drowsy state in which all cares are forgotten, and there is a decreased sensation of pain. Opiates affect the release of many hormones and neurotransmitters, including those involved in the regulation of sexual behavior. In 2006, an estimated 20.4 million Americans aged 12 or older were current (past month) illicit Opiate users, meaning they had used an illicit Opiate during the month prior to the survey interview. This estimate represents 8.3 percent of the population aged 12 years old or older. WHERE DO THEY COME FROM? Opium farmers cut the developing seed pod of the opium poppy, and collect the gummy fluid that oozes out of the cut over the next few days. Gum opium – Sap is dried into a ball and used directly. Opium powder – Sap is dried and pounded into a powder. Afghanistan is the largest supplier of opium. HOW PEOPLE TAKE OPIATES Most opiate drugs enter the bloodstream easily from many routes because they dissolve in fatty substances and so can cross into cells. Heroin and fentanyl represent one extreme-they are so fatsoluble that they can be absorbed across the mucus lining of the nose. Most other opiates are not quite that fat-soluble and cannot be absorbed well after snorting. If opium poppy is heated into a vapor it can be smoked. “opium pipe” – A pipe designed for the vaporization and inhalation of opium. OPIUM PIPE HOW OPIATES MOVE THROUGH THE BODY The rate at which opiates enter the brain depends on how the user takes them. *Fastest way – Inject the drug directly into the bloodstream. The second fastest way is to smoke it. When opiates are injected or smoked peak levels in the brain occur within minutes. HOW OPIATES WORK Pain relievers work with your cells, your body nerves endings, your nervous system, and your brain. When your cells are injured they release prostaglandins. When prostaglandin is released, nerve endings pick it up and send it to the brain and CNS. When you take a pill, like ibuprofen, it keeps injured or damaged cells from releasing prostaglandin. This can happen either at the site of injury, in the brain, or in the spinal cord. EFFECTS OF OPIATES For most of the following drugs listed, the effects are basically the same, or similar. If injected, user gets an immediate rush. Act like a depressant, or downer. Lowered heart rate and decreased blood pressure Slowed breathing Drowsiness TYPES OF OPIATES Heroin Morphine Codeine Hydromorphone Oxycodone Hydrocodone Meperidine (Demerol) Fentanyl Each type has a different type of efficiency… HIGH EFFICIENCY Heroin Morphine Hydromorphone Meperidine (Demerol) Fentanyl MEDIUM EFFICIENCY Hydrocodone Oxycodone LOW EFFICENCY Codeine Propoxyphene EFFICIENCY OF OPIATE DRUGS PRESCRIPTION PAINKILLERS In 2007, 2.5 million Americans abused prescription drugs for the first time, compared to 2.1 million who used marijuana for the first time. Among teens, prescription drugs are the most commonly used drugs next to marijuana, and almost half of the teens abusing prescription drugs are taking painkillers. Why are so many young people turning to prescription drugs to get high? By survey, almost 50% of teens believe that taking prescription drugs is much safer than using illegal street drugs. PRESCRIPTION PAINKILLERS CONT. What are the most commonly abused painkillers? Oxycodone (often sold as oxycontin) Percocet (Perc 30s) Vicodin Demerol and Darvocet (Darvocet was pulled off the markets in 2010 because of heart issues) Codeine In 2012 there were 259 million prescriptions for opioids in the United States! HEROIN Heroin – A white, odorless, bitter crystalline compound, that is derived from morphine and is a highly addictive narcotic. Heroin is a “downer”, or depressant, which affects the brain’s pleasure systems and interferes with the brain’s ability to perceive pain. Heroin can be injected (most common), snorted, and smoked. Street names – White junk, smack, big H, diesel, dope, poppy, H. 9.2 million Americans have used it in their life! HEROIN CONT. Quotes “Heroin cut me off from the rest of the world. My parents kicked me out. My friends and my brothers didn’t want to see me anymore. I was all alone.” — Suzanne “From the day I started using, I never stopped. Within one week I had gone from snorting heroin to shooting it. Within one month I was addicted and going through all my money. I sold everything of value that I owned and eventually everything that my mother owned. Within one year, I had lost everything. “I was raped, beaten, mugged, robbed, arrested, homeless, sick and desperate. I knew that nobody could sustain a lifestyle like that very long and I knew that death was imminent. If anything, death was better than a life as a junkie.” —Alison “I sold my car, lost my job, was kicked out of my mother’s house, was $25,000 in credit card debt, and living on the streets of Camden, New Jersey. I lied, I stole, I cheated. SHORT-TERM EFFECTS Appear soon after a single dose, and then disappear after a few hours. After use the user feels a state of “euphoria”. After the state of euphoria the user goes “on the nod”, a wakeful and drowsy state. Mental functioning is clouded Constricted pupils LONG-TERM EFFECTS Chronic users develop: Collapsed veins Infection of heart lining and valves Liver disease Pulmonary diseases and complications In addition to the effects of the drug itself, street heroin may have additives that do not really dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. MORPHINE Used to treat moderate to severe pain. Morphine was first isolated from opium in 1805 by German pharmacist Wilhelm Serturner. Dangerously addicting. The name comes from the mythological god Morpheus, who was the son of sleep and god of dreams. Can be taken either orally or injected. MORPHINE CONT. Street names are: Dreamer Miss emma Morf Never combine with alcohol…DEATH can easily occur! Morphine was given to U.S. medics during WWII. Medics would administer morphine to soldiers who were wounded in battle. MEPERIDINE *Meperidine is also known as Demerol. Unlike morphine, it can be used post-surgery. Demerol is used during labor. Usually taken as a pill, but can also be injected. Can cause cardiac arrest… This drug was found in one famous celebrity who passed away in 2009. Who was it? OXYCODONE Brand name for oxycodone is…oxycontin. Street names: Oxy Hillbilly heroin Oxycotton Oxycontin first came to the U.S. in 1939, but it wasn’t until Purdue Pharma began manufacturing OxyContin in the United States in 1996 that it became widely used. OXYCODONE CONT. Oxycodone is the drug name of the opiate. It is also known as “OxyContin”. *OxyContin is highly addictive, and one of the strongest painkillers available! Usually taken orally in pill or tablet form. Can provide pain relief for up to 12 hours. OxyContin most commonly exists in tablet form. These round pills come in 10mg, 20mg, 40mg, 80mg and 160mg dosages. OXYCODONE SHORT-TERM EFFECTS… The most serious risk associated with OxyContin, is respiratory depression. Because of this, OxyContin should not be combined with other substances that slow down breathing, such as alcohol. Toxic overdose and/or death can occur by taking the tablet broken, chewed, or crushed. OXYCODONE LONG-TERM EFFECTS… Using OxyContin chronically can result in increased tolerance to the drug in which higher doses of the medication must be taken to receive the initial effect. OxyContin abuse is no different from heroin, cocaine, or alcohol abuse. ROXICODONE Roxicodone – A combination between oxycodone and hydrochloride. *Often referred to as Roxy. A quick release, last 2-3 hours. Users will either snort, smoke, or swallow it. Top pills are “Roxy 30s”. They cost $30-$40 a pill. DESOMORPHINE Desomorphine – An opiate derivative from codeine. Known as Krokodil. Homemade versions start with codeine, and then “cooked” like meth would be to create its own concoction; krokodil. Other chemicals can be added during the “cooking” process. Gasoline, paint thinner, butane, iodine, and red phosphorous (matches). DESOMORPHINE CONT. Taken by injection. A high lasts approximately 90 minutes. Originated in Russia in early 2000s. Started to hit the United States in 2013. Is a cheap drug; costs a couple bucks. Also referred to as “Flesh eating drug”. Life expectancy is 2-3 years. Why is it called krokodil? It causes an addicts skin to become green, scaly, and bumpy like a crocodile’s. CODEINE Used to treat mild pain. Another name given to it is methylmorphine. Codeine may be habit-forming and should be used only by the person it was prescribed for. Usually combined with other pain killers such as or acetaminophen and aspirin. It may impair your thinking. *Never take with alcohol. Tylenol with codeine…contains acetaminophen. FENTANYL Fentanyl – A fast acting narcotic that is sometimes abused for its heroin-like effect. 40-50 times stronger than pure heroin (not cut like street heroin). As little as two milligrams (2 grains of salt) will kill you. Currently being mixed into heroin and contributes to most heroin deaths. Fentanyl Patch – Given to cancer patients to relieve long term pain. SUBOXONE Suboxone is used to treat opiate addiction. Comes in the form of a pill. Basically the same thing at subutex. Helps prevent heroin addicts from relapsing by blocking the opioid receptors in the brain. Metadone vs Suboxone Methadone – Easily abused. Taken at a clinic under supervision Suboxone – Hard to abuse, and taken home. A heroin recovery drug. *It is not a pain medication! SUBOXONE CONT. Introduced on the market in 2002. Often referred to as the “miracle drug” for individuals suffering from opiate addiction. NALOXONE Known as *Narcan Known as a “save shot”, or “rescue shot”, because of its ability to bring a person back from an overdose. Used in people experiencing an overdose. Can be injected into the muscle, or squirted into the person’s nose. Only works if opioids are present in the system, and does not prevent an overdose. Effects only last 20-90 minutes, so the person will still need medical attention. NALOXONE CONT. Where can you get it? 20 states currently allow drugstores to sell it to an individual without a prescription. (CVS, Rite-Aid, and Walgreens). Pennsylvania is one of the 20. https://www.youtube.com/watch?v=UASuPWT0bvI THE END!