1 / 34

Using Opiates Wisely

Using Opiates Wisely. November 9, 2012 Linda M. Keegan Moraine Park Technical College. What are Opiates?. Also called… Narcotic Analgesics. “Narcotic”=. Naturally occurring substances derived from the opium poppy and their synthetic substitutes. . These drugs….

ryo
Télécharger la présentation

Using Opiates Wisely

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Using OpiatesWisely November 9, 2012 Linda M. Keegan Moraine Park Technical College

  2. What are Opiates?

  3. Also called… Narcotic Analgesics

  4. “Narcotic”= Naturally occurring substances derived from the opium poppy and their synthetic substitutes.

  5. These drugs… • Are referred to as the opioid (or opiate) narcotics because of their association with opium. • They have similar pharmacological features, including: * Abuse potential * Pain relieving affects (analgesics) * Cough suppression * Reduction of intestinal movement (useful in reducing severe diarrhea)

  6. The Opium Poppy… • Papaversomniferum=from which opium and its naturally occurring narcotic derivatives are obtained. • This plant has been cultivated for millennia. • The Greek god of sleep, Hypnos, and the Roman god of sleep, Somnus, were portrayed as carrying containers of opium pods.

  7. Did You Know?

  8. Did You Know? • Narcotics are among the most potentanalgesics available today. • The most common clinical use of these drugs is as analgesics to relieve pain. • These drugs affect proteins – called endorphins-- in the brain, spinal cord and adrenal glands. • Through an activation process, receptors in the body alter the perception of pain in the “pain center” of the brain.

  9. Did You Know? • Even though opioid narcotics have a history of being abused, they continue to be important therapeutic agents. • Addiction to prescription narcotic analgesics rarely happens when these medications are used properly to treat pain. • Their clinical use usually is limited to the treatment of moderate to severe pain.

  10. Did You Know? • Opioid narcotics also are used to treat conditions not related to pain. • These drugs suppress the coughing center of the brain, so they are effective antitussives (such as Codeine). • Opioid narcotics slow the movement of materials through the intestines (to relieve diarrhea). • Paregoric contains an opioid narcotic substance and is commonly used to treat severe diarrhea.

  11. There are many different kinds of sedative-hypnotic drugs.  • Some drugs=treat specific medical conditions • Some drugs=require a prescription • Some drugs=over-the-counter • Some drugs=alcohol and opioid narcotics, such as heroin

  12. In Short… All Sedative-Hypnotic drugs produce central nervous system depression.

  13. Principal Side Effects of Opiates Drowsiness, Mental Clouding Respiratory Depression Nausea, Vomiting Constipation Inability to Urinate Constricted Pupils Drop in Blood Pressure Physical Dependence, Withdrawal

  14. Prescription and Illicit Opiates • Schedule I * Heroin • Schedule II • Codeine (also Schedule III, V) • Fentanyl • Hydromorphone • Methadone • Meperidine • Morphine (also Schedule III)

  15. Prescription and Illicit Opiates • Schedule III • Buprenorphine • Narcotics combined with nonsteroidal anti-inflammatory drugs • Schedule IV • Pentazocine • Unscheduled • Tramadol

  16. Street Names for Heroin Smack Horse Junk Dust Harry Shit Brown Sugar Black Tar Mexican Mud China White Scat Scag

  17. Mainline=to inject a drug of abuse intravenously

  18. Abuse of Opiates Tolerance develops rapidly. Psychological dependence can develop. Physical dependence invariably accompanies steep tolerance. Cross tolerance and cross dependence develop.

  19. A Closer Look at Heroin • When first used, heroin can cause unpleasant, dysphoric effects…and • euphoric effects. • Euphoria gradually overcomes the aversive effects…and • Positive feelings increase with narcotic use, leading to psychological dependence. • Physical dependence occurs with frequent daily use.

  20. Possible Signs of Overdose • Low and shallow breathing • Clammy skin • Convulsions • Coma • Possible Death

  21. Symptoms of Withdrawal from Heroin, Morphine and Methadone • Craving for drugs, anxiety • Yawning, perspiration, runny nose, tears • Pupil dilation, goose bumps, muscle twitches, aching bones and muscles, hot and cold flashes, loss of appetite • Increased intensity of preceding symptoms, insomnia, raised blood pressure, fever, faster pulse, nausea…and more

  22. Health Risks From the Abuse of Heroin Medical consequences of chronic heroin injection use include: • Scarred and/or collapsed veins, • Bacterial infections of the blood vessels and heart valves, • Abscesses (boils) and other soft-tissue infections, and • Liver or kidney disease. • Lung complications may result from poor health in general and from heroin’s depressing effects on respiration.

  23. Health Risks From the Abuse of Heroin “…Sharing of injection equipment or fluids can lead to some of the most severe consequences of heroin abuse – infections with hepatitis B and C, HIV, and a host of other blood-borne viruses, which drug abusers can then pass on to their sexual partners and children.” --National Institute on Drug Abuse

  24. Treatment Approaches to Opiate Abuse and Dependence Medically Based Replacement Therapies (such as buprenorphine): “These medications, along with effective behavioral treatments and outreach efforts, have not only reduced injection drug use in this country, but have also helped reduce the spread of HIV/AIDS – from a peak of more than 25,000 new cases in 1993 to fewer than 10,000 cases in 2003.”-- National Institute on Drug Abuse

  25. Other Benefits… “Methadone maintenance treatment has important benefits for addicted individuals and for society.” • “Reduced or stopped use of injection drugs… • Reduced risk of overdose and of acquiring or transmitting diseases… • Reduced mortality… • Possible reduction in sexual risk behaviors, although evidence on this point is conflicting… • Reduced criminal activity… • Improved family stability and employment potential…and • Improved pregnancy outcomes.” –- Centers for Disease Control and Prevention

  26. BEWARE! • The information on anesthesia-assisted rapid opioid detoxification is not promising. While some websites applaud this treatment, other websites stress the problems and advise against it. • From a cursory search, it appears that the so-called “rapid detox” is marketed to persons in need, even though there are grave concerns. This appears to be a questionable money-making practice.

  27. Talk with Your Medical Provider • There are differing opinions about various aspects of replacement therapies. • There are pros and cons of any one particular therapy, based on the needs of any one person, compared with other strategies. • For an overview of key points to consider, check out the HBO websites: http://www.hbo.com/addiction/thefilm/centerpiece/617_segment_6.html http://www.hbo.com/addiction/treatment/343_treating_opiate_addiction.html

  28. Other Ways to Manage Pain?

  29. For specific conditions, check out the CDC website http://www.cdc.gov/arthritis/resources/spotlights/arthritis-video.htm Includes these links: • Arthritis Basics • Data and Statistics • Funded Science • State Programs • Publications • Interventions • Policy/Partnerships • Resources

  30. Internet References • http://www.drugabuse.gov/publications/topics-in-brief/buprenorphine-treatment-opiate-addiction-right-in-doctors-office • http://www.drugabuse.gov/sites/default/files/bupren.pdf • http://www.hbo.com/addiction/thefilm/centerpiece/617_segment_6.html • http://www.hbo.com/addiction/treatment/343_treating_opiate_addiction.html

  31. Internet References • http://www.cdc.gov/IDU/facts/MethadoneFin.pdf • http://www.amcp.org/data/jmcp/S14-S21.pdf • http://www.ncbi.nlm.nih.gov/pubmed/17315418 • http://www.ncbi.nlm.nih.gov/pubmed/15917502 • http://www.ncbi.nlm.nih.gov/pubmed/10584915 • http://www.ncbi.nlm.nih.gov/pubmed/18355989 • http://www.drugabuse.gov/sites/default/files/rrheroin.pdf

  32. Internet References • http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6126a5.htm?s_cid=mm6126a5_w • http://www.cdc.gov/arthritis/resources/spotlights/arthritis-video.htm • http://www.choosehelp.com/detox/problems-with-rapid-opiate-detox • http://www.bioline.org.br/pdf?jp04076 • http://www.amcp.org/data/jmcp/S14-S21.pdf

  33. Book Resource • Hanson, G. R., Venturelli, P. J., & Fleckenstein, A. E. (2012). Drugs and Society. Burlington, MA: Jones & Bartlett Learning. • http://www.go.jblearning.com/hanson11

  34. Need Help? Call… 211 or 911

More Related