OPIATES—MORPHINE AND HEROIN

 

 Opiates are made from a white liquid found in the seedpod of the Asian poppy plant, called opium.  Opiates are referred to as narcotics.  They can cause a quick, strong feeling of pleasure and then a feeling of well-being and drowsiness.  Using opiates repeatedly can cause a dependence on or addiction to opiates.  The most frequently abuses opiates are Heroin and Morphine. 

 

            Narcotic analgesics act upon the central nervous system, and some of their side effects are caused by actions in the central nervous system.  If a narcotic is used for an extended period of time, it may become habit-forming, or addictive.  Physical dependence on a narcotic may cause withdrawal side effects when one stops taking the medicine. 

 

            Morphine is a narcotic analgesic.  Narcotic analgesics are administered to relieve pain.  Some are used before or during surgery as an adjunct to the anesthetic.  Codeine and Hydrocodone are sometimes administered to relieve coughing.  Methadone is used to assist some people in controlling their dependence on heroin.  Narcotic analgesics may also be administered in other cases, at the doctor’s discretion. 

 

            These medicines can only be obtained by prescription from a medical doctor or a dentist. For some of these drugs, prescriptions cannot be refilled and a new prescription must be obtained from the doctor or dentist each time the medicine is needed.  In the case of Methadone, other rules and regulations may apply, particularly when it is being used to treat narcotic dependence. 

 

 

MORPHINE

 

Morphine is a natural substance found in the opium poppy.  It is a powerful narcotic analgesic that is used primarily in the management of severe pain.  Second only to heroin, morphine has the greatest danger of dependence of the narcotic analgesics commonly used. 

 

Morphine is legally available in water-soluble salt forms, the most common of which are morphine sulfate and morphine hydrochloride.  These are bitter-tasting, fine, white crystalline powders.  Both can dissolve in water and somewhat in alcohol. 

 

Morphine can be taken orally in tablet form, by smoking or sniffing, or by injection.  Those who are dependent on morphine prefer the injection method.  When injected, particularly intravenously, morphine can cause a feeling of intense euphoria as well as a state of well-being and relaxation of about 4 to 5 hours duration.  Regular use can cause the user to develop a tolerance to these effects.  Physical and psychological dependence can rapidly develop, and withdrawal symptoms upon abrupt cessation of use.  Many of the withdrawal symptoms resemble those caused by a case of severe flu. 

 

Morphine is not frequently found in the street drug culture.  However, if it is, the street names for morphine are M, morph, and Miss Emma.  Mostly because it is available in hospitals, there have been a number of documented cases of morphine dependence among health care professionals.

 

Effects of Morphine

 

            The effects of morphine use can include the following symptoms and conditons:

 

·        Suppressed feeling of pain

·        Euphoria

·        Drowsiness

·        Lethargy

·        Relaxation

·        Difficulty concentrating

·        Decreased/ increased physical activity, depending on the user

·        Mild anxiety or fear

·        Constriction of pupils of the eyes

·        Blurred vision

·        Impaired night vision

·        Suppressed cough reflex

·        Reduced respiratory rate

·        Nausea and vomiting

·        Constipation

·        Loss of appetite

·        Decreased gastric motility

·        Slight drop in body temperature

·        Sweating

·        Reduced libido

·        Prickly or tingling sensation on the skin

 

Symptoms of Morphine Overdose

 

            Many of the following are symptoms of morphine overdose:

 

·        Muscle spasms

·        Convulsions

·        Respiratory problems

·        Pinpoint pupils

·        Bluish colored lips and fingernails

·        Stomach or intestinal spasms

·        Nausea and vomiting

·        Constipation

·        Weak pulse

·        Low blood pressure

·        Palpitations

·        Drowsiness

·        Coma

 

Morphine Withdrawal

 

            Morphine addiction develops quickly with continuous use of the drug.  Morphine’s addictive nature causes the user to crave Morphine and focus his or her activities around obtaining and taking Morphine.  The drug’s ability to activate the brain’s reward mechanisms and its ability to chemically change the normal functioning of these systems is what causes morphine addiction.  Also, Morphine reduces a person’s level of consciousness, impairing the ability to think and be fully present. 

 

            Morphine withdrawal symptoms can include the following:

 

·        Restlessness

·        Excessive shedding of tears

·        Runny nose

·        Yawning

·        Perspiration

·        Goose flesh

·        Restless sleep

·        Dilation of pupils of the eyes

·        Muscle twitching and spasms

·        Kicking movements

·        Severe aches in the abdomen, back, and legs

·        Abdominal and muscle cramps

·        Hot and cold flashes

·        Insomnia

·        Vomiting

·        Diarrhea

·        Acute nasal decongestion

·        Severe sneezing

·        Increased body temperature

·        Increased blood pressure

·        Increased respiratory rate

·        Increased heart rate

 

Morphine withdrawal symptoms reach their peak in 36 to 72 hours.  Without treatment, the symptoms occur from 5 to 7 days, but the craving for morphine could continue for months. 

 

Treatment of Morphine Overdose

 

            At home, do not induce vomiting.  Perform mouth-to-mouth resuscitation if the person stops breathing and have someone call 911. 

 

            In an emergency room, some of these treatments may be performed, after which the person should recover within 24 to 72 hours. 

 

·        Gastric cleansing

·        Administration of activated charcoal

·        Administration of a laxative

·        Administration of one or more doses of a counteracting drug

·        Monitoring of breathing

·        Treating of symptoms

·        Administration of hydrochloride intravenously

 

 

HEROIN

 

            Heroin is processed from Morphine, a naturally occurring substance extracted from the seedpod of the Asian poppy plant.  Heroin is an illegal, highly addictive drug.  It is the most abused and the most rapidly acting opiate.  Heroin is typically sold as a white or brownish-colored powder or as a black sticky substance (black tar heroin).  Most street heroin is diluted (cut) with other drugs or with substances such as powdered milk, starch, or quinine.  It can also be cut with strychnine or other poisons.  Some of the street names associated with Heroin are smack, H, skag, and junk.  Heroin abusers risk overdose or death because they do not know the actual strength of the drug or its true contents.  Heroin use also poses other problems due to the transmission of HIV and other diseases due to sharing needles or other injection equipment.  Heroin was reported as being the leading illicit drug among treatment admissions and that the number of admissions has been increasing. 

 

            Statistically, it has been reported that 2.4 million people have used heroin at some time in their lives.  Many of the newer users include members of the middle class aged 18 or older, both urban and suburban dwellers.  The latest reports suggest that there is an increasing incidence of new Heroin users (snorters) in the younger age groups, often among women.  It is feared that these young Heroin snorters may start to inject the drug because of increased tolerance, nasal soreness, or declining or unreliable purity.  Then, of course, injection use would expose them to the risk of contracting HIV/AIDS. 

 

            Heroin is usually injected, sniffed/snorted, or smoked.  A heroin user may inject up to four times a day.  Intravenous injection provides the greatest intensity and fastest onset of euphoria (7 to 8 seconds).  Intramuscular injection provides a relatively low onset of euphoria (5 to 8 minutes).  Upon being snorted or smoked, peak effects of heroin are usually felt within 10 to 15 minutes.  Injection remains the most predominant method of heroin use among addicted users seeking treatment.  However, researchers have observed that heroin users have begun to shift to the sniffing and smoking methods.  In fact, sniffing/snorting heroin is now a widely reported means of taking heroin among the users admitted for drug treatment in various metropolitan areas of the country.  However, all three forms of heroin administration are considered to be addictive.   

 

Short-Term Effects of Heroin Use

 

            Shortly following injection or inhalation, heroin enters the bloodstream and then the brain.  In the brain, the heroin is converted to morphine, which binds to the natural opioid receptors.  Abusers typically report feeling a surge (rush) of pleasurable sensation.  The intensity of the rush depends on of how much heroin is taken and how rapidly it drug enters the brain and binds to the opioid receptors.  Heroin is particularly addictive since it enters the brain so quickly.  The rush is frequently accompanied by warmness and flushing of the skin, dry mouth, and heaviness in the extremities and possible nausea, vomiting, and intense itching. 

 

            After the initial effects, abusers are usually drowsy for several hours and mental function is clouded by the drug’s effect on the central nervous system.  Cardiac functions slow and respiration severely slows, sometimes to the point of death.  Pregnant users of heroin can also experience spontaneous abortion.  Heroin overdose is especially risky on the street, where the user cannot know with accuracy the amount and purity of the drug.   

 

            To summarize, the short-term effects of heroin use include but are not limited to:

 

·        Rush

·        Depressed respiration

·        Clouded mental functioning

·        Nausea and vomiting

·        Suppressed of pain

·        Spontaneous abortion

·        Overdose

 

Long-Term Effects of Heroin Use

 

            Addiction is one of the most detrimental long-term effects of heroin use.  Addiction is a chronic condition characterized by physical changes in the brain.  It is also a relapsing condition characterized by compulsive drug seeking and use.  The profound degrees of tolerance and physical dependence resulting from heroin use lead to compulsive use and abuse.  Once addicted, the heroin abuser’s main purpose in life revolves around seeking and using drugs. 

 

            In addition to the short-term effects of heroin use, the long-term effects are:

 

·        Addiction

·        Depression

·        Infectious diseases like HIV/AIDS and hepatitis B and C

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