soc 204 chapter 8 narcotics

SOC 204 Drugs & Society

Goldberg Chapter 8 Narcotics

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8%

42%

50% A. Awesome!B. I’m keeping up.C. I’m lost…help!

Narcotics

OpioidsOpiates

Do you know someone who has used opioids recreationally in the last 30 days?

39%

17%

43% A. NoB. Yes, one personC. Yes, more than one person

Opium

Morphine Codeine Heroin

At one time, heroin was given to morphine addicts to help them break their addiction to morphine.

9%

91% A. TrueB. False

1914 Harrison ActMade opioids difficult to obtainOral use declinedCost and risk increasedView of addicts changed

Vietnam

Use among troops was about 10-15%Most users stopped upon returning to US

Review: Which two compounds are in the opium plant resin?

A. Oxycontin and heroin

B. Morphine and heroinC. Morphine and

codeineD. Hydrocodone and

codeine

Oxyco

ntin and heroin

Morphine and heroin

Morphine and codeine

Hydroco

done and codeine

0% 0%

77%

23%

Review: What impact did the Harrison Act have on opium use?

A. Opium use increased

B. Opium was no longer readily available

C. Illegal IV use decreased

D. Oral use increasedOpium use

incre

ased

Opium was n

o longer r

ea...

Illegal IV

use decre

ased

Oral use in

crease

d

0% 0%0%0%

Review: Upon returning to the US, soldiers who used opiates in Vietnam:

A. 70% were arrested for illegal drug use

B. 67% became homeless

C. 95% stopped using the drug

70% were arre

sted fo

r ill...

67% became homeless

95% stopped usin

g the drug

0%

95%

5%

Synthetic Prescription NarcoticsOxycodone (OxyContin, Percodan, Percocet)Hydrocodone (Vicodin, Lortab, Lorcet)Diphenoxylate (Lomotil)Fentanyl (Duragesic)Propoxyphene (Darvon)Hydromorphone (Dilaudid)Meperidine (Demerol)Methadone

Narcotic Doses

Drug Therapeutic Dose Tolerant Dose Lethal DoseMorphine 15-30 mg 100 mg 500 mg

Heroin 10-15 mg 60 mg 200 mg

Fentanyl 25 micrograms 2 mg

OxyContin 10 mg 40 mg 160 mg

1 mg = 1000 micrograms

Pharmacology

Raw opium is about 10% morphine, smaller amount of codeine

Heroin is made by adding two acetyl groupsAllows passing through blood-brain barrier faster

Mouse Party Enkephalins – adrenal gland Endorphins – pituitary gland

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Medical UsesPain reliefTreatment of intestinal disorders

Cough suppressant

Physical Effects

Drowsiness (nodding out), vomiting, nausea, and difficulty concentrating

EuphoriaGradually anesthetizing sensationsDifficulty urinating, constipationConstricted pupils

Emotional EffectsRelief from anxiety, hostility, feelings of inadequacy, and aggression

Difficulty regulating inhibitions and frequently make risky decisions

Social EffectsAlienated from and hostile toward friends and family

Correlated with criminal behavior, unemployment, and violence

Review: Heroin’s effects do not include:

0%

76%

10%

14% A. SleepinessB. EuphoriaC. AgitationD. Pain relief

Review: which of the following is NOT a medical use for narcotics?

A. Cough suppressant

B. Stop diarrheaC. Induce sleepD. Pain relief

Cough su

ppressant

Stop diarrhea

Induce sle

ep

Pain re

lief

9% 5%

64%

23%

DependencyAbout half of narcotic abusers become dependent:TolerancePositive reinforcementNegative reinforcementCan develop in less than two weeksAverage addiction is six to eight years (aging out)

Acute ToxicityBehavioral

Respiratory depression can be fatalSynergistic effect when combined with

depressants

Opioid Triad Coma Depressed respiration Pinpoint pupils

Chronic ToxicityBlood borne pathogensContaminantsInfections

Which is an example of chronic physiologic toxicity?

A. Making bad decisions while high

B. Committing crimes to obtain the drug

C. Acquiring an HIV infection through use of unclean needles

D. Depressed respiration

Making bad decisions w

h...

Committing c

rimes t

o ob...

Acquirin

g an HIV in

fecti..

Depressed re

spira

tion

13% 13%

65%

9%

WithdrawalFactors affecting the difficulty of withdrawal:

Social support networkDesire to stopPhysical environment during withdrawalAlternative opiates

Signs Heroin orMorphine

Methadone

Craving for drugs, anxiety 6 24

Yawning, perspiration, running nose, teary eyes 14 34-48

Increase in above signs plus pupil dilation, goose bumps, tremors, hot and cold flashes, aching bones and muscles, loss of appetite

16 48-72

Increased intensity of above, plus insomnia; raised blood pressure; increased temperature, pulse rate, respiratory rate and depth; restlessness; nausea

24-36

Increased intensity of above, plus curled-up position, vomiting, diarrhea, weight loss, spontaneous ejaculation or orgasm, hemoconcentration, increased blood sugar

36-48

(hours after last dose)

Narcotic Withdrawal

Opioid Antagonists/AgonistsNaloxone - NarcanSuboxone

Naloxone & BuprenorphineMethadone

Opinion: Do you agree with the use of suboxone or methadone to help a person quit using opioids?

11%

89% A. YesB. No

Which drug has the most dangerous withdrawal syndrome?

A. HeroinB. MorphineC. LSDD. Alcohol

Heroin

MorphineLSD

Alcohol

45%

55%

0%0%

I think Needle Exchange Programs are a good idea.

A. TrueB. False

TrueFa

lse

0%0%