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 soldBy 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 effectsrelief of anxiety, hostility, feelings ofinadequacy 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

AnalgesiaGastrointestinal difficultiesCough 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