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Chapter 8
Narcotics
Historical Perspectives
The term narcotics is from the Greek
word meaning stupor
Throughout history opium figured
prominently in wars, economic vitality
of countries, medicine and in the
work of lyricists and authors
1800’s
Opium plentiful in the United States
mainly due to more than 70,000
Chinese workers coming to the United
States to build railroads and with
them came a penchant for smoking
opium
Morphine use escalated during the 19th
century – it was used to relieve pain,
diarrhea and dysentery
Civil War soldiers routinely injected
them selves with morphine and
thousands became addicted
Laudanum was widely sold
By the late 1800s an estimeated 4.59
per 1,000 people were dependent on
opiates
In 1914 the Harrison Act was passed
regulating narcotic use
During the 1930s morphine abuse
exceeded heroin abuse in the United
States. By the following decade
heroin addiction was greater
Extent of Narcotic Use
Among Americans aged 12 or older, 3.7
million are estimated to have used
heroin at least once
In the United States more than 800,000
people are addicted to heroin and
other narcotics
Characteristics of Narcotics
Opiates refers to a family of drugs with
characteristics similar to opium
Opiate and Opioid are terms used
interchangeable and they may be
natural or synthetic
Crude opium is found in the Papaver
somniferum
Morphine and codeine both are natural
products of crude opium
Heroid is a semi-synthetic (di-acetyl
morphine)
Synthetic opiates are chemically
constructed rather than naturally
produced – an example is fentanyl, a
powerful opiate stronger than heroin
Other synthetic opiates include
meperidine (Demerol), propoxyphene
hydrochloride (Darvon) and
Methadone.
Oxycontin is a strong opoid that offers
long pain relief. A popular drug in
Appalachia and has been referred to
as “hillbilly heroin”
Physical and Psychological Effects
Opiates mimic endorphins in the brain
Physical Effects
-drowsiness
-vomiting
-nausea
-difficulty concentrating
Psychological effects
relief of anxiety, hostility, feelings of
inadequacy and aggression
Dependency
Physical dependence, psychological
dependence, and tolerance develop
quickly
Withdrawal symptoms can include
diarrhea, insomnia, muscle aches and
pains, dysphoria, anxiety, and
stomach cramps
Toxicity
Narcotics are capable of depressing the
respiratory system to the point of
death
Death from an overdose of heroin is
slow. People who die quickly from an
overdose are likely to die from
anaphylactic shock
Medical Benefits
Analgesia
Gastrointestinal difficulties
Cough Suppressant
Treatment
Detoxification
Gradual withdrawal from narcotics
and use of drugs such as clonidine,
naltrexone, and naloxone, and
methadone.
Naloxone and Naltrexone: Narcotic
antagonists (negates the effects of
heroin)
Methadone
Since 1960 methadone has been the
drug used most frequently to treat
heroin addiction
Methadone blocks the craving for
opiates
Methadone has been viewed as
substituting one narcotic for another
– so the life of a methadone patient is
not easy
Methadone maintenance has several
advantages
-can be orally administered
-easy to monitor
-eliminates the need for needles
-reduces risk of overdosing
In 1993 the FDA approved an
alternative to methadone called
levo-alpha-acetylmethadol (LAAM)
a long-acting drug that can bock the
withdrawal symptoms from narcotics
for up to 3 days
Narcotics Anonymous
Modeled on the principles of Alcoholics
Anonymous, Narcotics Anonymous
(NA) is a self help group to help
people who are addicted to heroin
and other narcotics to stay clean and
sober
Summary
 The term narcotics is from a Greek
word meaning stupor
 Opiates refers to a family of drugs
with characteristics similar to opium
 Morphine is a natural component of
crude opium
 Heroin is a semi-synthetic drug made
from morphine
 There are medical benefits to
narcotics
 Narcotics are highly addicting
 Oxycontin is a time-released narcotic
 Methadone maintenance is an option
for heroin rehabilitation
 Narcotic Anonymous is a support
group helping narcotics to remain
clean and sobr