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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
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1800s
 Opium plentiful in the United States mainly due
to more than 70,000 Chinese workers coming
to the United States to build railroads
 With the influx of Chinese workers came a penchant
for smoking opium
 Morphine use escalated during the 19th century
 Used to relieve pain, diarrhea, and dysentery
Historical Perspectives
 Civil War soldiers routinely injected themselves
with morphine and thousands became
addicted.
 Laudanum was widely sold.
 By the late 1800s, an estimated 4.59 per 1,000
people were dependent on opiates.
 In 1914 the Harrison Act was passed regulating
narcotic use.
Historical Perspectives
During the 1930s morphine abuse exceeded
heroin abuse in the United States:
 By the following decade, heroin addiction was greater
Extent of Narcotic Use
 According to government estimates in 2006,
338,000 Americans had used heroin in the
previous month.
 In the United States, more than 800,000
people are addicted to heroin and other
narcotics.
Opioid-Related Drug Misuse Deaths
Characteristics of Narcotics
 Opiates refers to a family of drugs with
characteristics similar to opium
 Opiate and opioid are terms used
interchangeably
 They may be natural or
synthetic
Characteristics of Narcotics
 Crude opium is found in the Papaver
somniferum.
 Morphine and codeine are natural products of
crude opium.
Heroin
Semi-synthetic (di-acetyl morphine)
Synthetic Opiates
 Chemically constructed rather than naturally
produced
 An example is fentanyl
 a powerful opiate stronger than heroin
Synthetic Opiates
Other synthetic opiates include:
 Meperidine (Demerol)
 Propoxyphene hydrochloride (Darvon)
 Methadone
Oxycontin is a strong opioid that offers longlasting pain relief
 Popular in Appalachia and has been referred to as
“hillbilly heroin”
Physical Effects of Opiates
Opiates mimic endorphins in the brain.
Physical Effects:
 Drowsiness
 Vomiting
 Nausea
 Difficulty concentrating
Psychological effects of Opiates
Psychological effects:
 Relief of anxiety
 Hostility
 Feelings of inadequacy
 Aggression
Dependency
Physical dependence, psychological
dependence, and tolerance develop quickly.
Withdrawal symptoms can include:
 Diarrhea
 Insomnia
 Muscle aches and pains
 Dysphoria
 Anxiety
 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 use
Drugs such as clonidine, naltrexone, naloxone, and
methadone
Naloxone and Naltrexone: narcotic
antagonists
Negates the effects of heroin
Methadone
 Has been the drug used most frequently to
treat heroin addiction since 1960
 Blocks the craving for opiates
 Methadone has been viewed as substituting
one narcotic for another.
 The life of a methadone patient is not easy.
Advantages of Methadone maintenance




Can be orally administered
Easy to monitor
Eliminates the need for needles
Reduces risk of overdosing
levo-alpha-acetylmethadol (LAAM)
 In 1993 the FDA approved an alternative to
methadone called levo-alpha-acetylmethadol
(LAAM).
 A long-acting drug that can block 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 which strives to help people
who are addicted to heroin and other narcotics
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.
Summary
 There are medical benefits to narcotics.
 Narcotics are highly addicting.
 Oxycontin is a time-released narcotic.
 Methadone maintenance is an option for heroin
rehabilitation.
 Narcotics Anonymous is a support group helping
narcotics to remain clean and sober.