OPIATES

1. Mr. Prall OPIATES

2. What are Opiates? Opiates – Any drug derived from opium. One of the oldest drugs used by man. They were used in prehistoric times where teas were prepared from opium poppies. Opioids carry the risk of addiction, which is why they are “scheduled” drugs (Schedule I). They are abused both in overdoses when prescribed and used outside of prescriptions to get high, often accompanied with alcohol. Introduction

3. All opiates cause a pleasant drowsy state in which all cares are forgotten, and there is a decreased sensation of pain. Feelings are most intense after injection. Opiates affect the release of many hormones and neurotransmitters, including those involved in the regulation of sexual behavior. In 2006, an estimated 20.4 million Americans aged 12 or older were current (past month) illicit Opiate users, meaning they had used an illicit Opiate during the month prior to the survey interview. This estimate represents 8.3 percent of the population aged 12 years old or older. Introduction cont.

4. Opium farmers cut the developing seed pod of the opium poppy, and collect the gummy fluid that oozes out of the cut over the next few days. • Gum opium – Sap is dried into a ball and used directly. • Opium powder – Sap is dried and pounded into a powder. • Afghanistan = 90% of all worldwide production. (DEA 2005) Where do they come from?

5. Most opiate drugs enter the bloodstream easily from many routes because they dissolve in fatty substances and so can cross into cells. Heroin and fentanyl represent one extreme-they are so fat-soluble that they can be absorbed across the mucosal lining of the nose. Most other opiates are not quite that fat-soluble and cannot be absorbed well after snorting. If opium poppy is heated into a vapor it can be smoked. “opium pipe” – A pipe designed for the vaporization and inhalation of opium. How people take opiates

6. Opium pipe

7. The rate at which opiates enter the brain depends on how the user takes them. *Fastest way – Inject the drug directly into the bloodstream. The second fastest way is to smoke it. When opiates are injected or smoked peak levels in the brain occur within minutes. The faster the buzz the greater the danger of death by overdose, because drug levels in the brain can rise so quickly. How opiates move through the body

8. Heroin Morphine Codeine Hydromorphone Oxycodone Hydrocodone Meperidine Fentanyl Each type has a different type of efficiency… Types of opiates

9. High Efficiency Medium Efficiency LOW EFFICENCY • Heroin • Morphine • Hydromorphone • Meperidine (Demerol) • Fentanyl • Hydrocodone • Oxycodone • Codeine • Propoxyphene Efficiency of opiate drugs

10. Heroin – A white, odorless, bitter crystalline compound, that is derived from morphine and is a highly addictive narcotic. Heroin is a “downer”, or depressant, which affects the brain’s pleasure systems and interferes with the brain’s ability to perceive pain. Heroin can be injected (most common), snorted, and smoked. Street names – White junk, smack, big H, diesel, dope, poppy, H. 2.4 million Americans have used it in their life. Heroin

11. Appear soon after a single dose, and then disappear after a few hours. After use the user feels a state of “euphoria”. After the state of euphoria the user goes “on the nod”, a wakeful and drowsy state. Mental functioning is clouded Slowed and slurred speech Slower gait (movement/demeanor) Constricted pupils Drooping eyelids Vomiting Short-term effects

12. Chronic users develop: • Collapsed veins • Infection of heart lining and valves • Abscesses • Cellulites • Liver disease • Pulmonary diseases and complications • In addition to the effects of the drug itself, street heroin may have additives that do not really dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Long-term effects

13. Used to treat moderate to severe pain. Works by dulling the pain perception center in the brain. Morphine was first isolated from opium in 1805 by German pharmacist Wilhelm Serturner. Dangerously addicting. The name comes from the mythological god Morpheus, who was the son of sleep and god of dreams. Can be taken either orally or injected. Morphine

14. Street names are: • Dreamer • Miss emma • Morf • Morphine will not be used post-surgery, only if the individual was using it prior to the surgery. • Never combine with alcohol…DEATH can easily occur! • Morphine was given to U.S. medics during WWII. Medics would administer morphine to soldiers who were wounded in battle. Morphine cont.

15. *Meperidine is also known as Demerol. • Similar to morphine where is dulls the pain perception center of the brain. • Unlike morphine, it can be used post-surgery. • Demerol is used during labor. • Usually taken as a pill, but can also be injected. • Can cause cardiac arrest… • This drug was found in one famous celebrity who passed away in 2009. Who was it? Meperidine

16. Brand name for oxycodone is…oxycontin. • Street names: • Oxy • Hillbilly heroin • Oxycotton • Kicker • Oxycontin first came to the U.S. in 1939, but it wasn’t until Purdue Pharmabegan manufacturing OxyContin in the United States in 1996 that it became widely used.  Oxycodone

17. Oxycodone is the drug name of the opiate. It is also known as “OxyContin”. OxyContin is highly addictive! Usually taken orally in pill or tablet form. Can provide pain relief for up to 12 hours. Classified as a Schedule II controlled substance OxyContin most commonly exists in tablet form. These round pills come in 10mg, 20mg, 40mg, 80mg and 160mg dosages. OxyContin was marketed for the first time beginning in 1996. Oxycodone cont.

18. The most serious risk associated with OxyContin, is respiratory depression. Because of this, OxyContin should not be combined with other substances that slow down breathing, such as alcohol. Toxic overdose and/or death can occur by taking the tablet broken, chewed, or crushed. Other common side effects include constipation, nausea, sedation, dizziness, vomiting. Oxycodone short-term effects…

19. Using OxyContin chronically can result in increased tolerance to the drug in which higher doses of the medication must be taken to receive the initial effect. Physically addictive which causes withdrawal symptoms which include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes. OxyContin abuse is no different from heroin, cocaine, or alcohol abuse. Oxycodone Long-term effects…

20. Used to treat mild pain. Another name given to it is methylmorphine. Codeine may be habit-forming and should be used only by the person it was prescribed for. Never share codeine with another person. It may impair your thinking. *Never take with alcohol. Tylenol with codeine…contains acetaminophen. Codeine

21. It is used to relieve moderate to mild pain. Brand names are Darvon, Darvon-N, and Dolene. Used as a cough suppressant. Weaker than morphine, codeine, and hydrocodone. Approved by the FDA in August of 1957. Taken orally as a capsule or tablet. Propoxyphene

22. Propoxyphene increases pain tolerance and decreases discomfort but the presence of pain still is apparent. • Side effects: • Depress breathing • Dizziness • Sedation • Nausea • Vomiting Propoxyphene cont.