#6 Opiate Explanation Summary

Opiates / Narcotics

Opium, morphine, heroin (black tar heroin), codeine (cough syrups), Dilaudid (hydromorphone), Numorphan, Demerol, Mepergan, Darvon, Percocet/Percodan, Talwin, Pentazone, Propoxyphyene, Fentanyl (China white), Vicodin, Lorcet/Lortab (hydrocodone), Methadone, Oxycontin (oxycodone), Buprenorphine

IV, Oral (Rx), smoking, subcutaneous (chipping), snorting

Physiological Effects : short term

reduces pain,

suppresses cough,

decreases bowel motility

depresses respiration,

pupil contraction

nausea - sometimes vomiting

Psychological Effects - short term

euphoria - rush –

relief from anxiety and tension - twilight state

reduces emotional pain

some people feel disoriented, anxious and depressed

Physiological Effects - long term

Increased tolerance, tissue dependence

constipation, difficulty urinating

decreased sex drive, decreased hormone levels in males and females

Liver damage (especially prevalent in abuse of drugs that combine opiates with acetaminophen).

(complications from IV use = malnutrition and infections, collapsed veins, liver damage, hepatitis B and C; HIV/AIDS)

Psychological Effects - long term

Less and less euphoria - now taking drug to feel normal

(Positive reinforcement vs

Negative reinforcement)

Craving and drug seeking behavior

Unable to stop-relapse

Overdose

Anxiety, paranoia, irregular heartbeat

Dangerous increase in body temp

respiratory depression = slow onset, quickly remedied with naloxone

seizures, coma, death

Withdrawal / Detox

Not life threatening

4-6 hours: yawning, runny nose, sweating, tearing, craving

12 hours: goose bumps, dilated pupils, loss of appetite, muscle tremors, irritability

24-72 hours: insomnia, yawning, muscle weakness, nausea/vomiting, diarrhea, chills/fever, abdominal pain, flushing, muscle spasms, “kicking”

Drug Interactions

opioid and analgesic additive effect for pain relief (RX: Darvon, Percodan etc)

Speedball: (street) heroin and cocaine or amphetamine injected (antagonist)

opiates and alcohol – synergists

naloxone- antagonist, antidote for overdose

Treatment

High incidence of relapse - takes many attempts to quit

8-12 months inability to tolerate stress or discomfort

Medical Assisted Treatment = Replacement Therapy

Methadone Maintanance, suboxone/buprenorophine

Buprenorpnine: 2006: newest addition:

Long acting partial agonist that acts on the same receptors, relieving drug cravings

Vivitrol- long acting opiate given as a monthly injection

http://www.samhsa.gov/medication-assisted-treatment