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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