1. Chapter 8 Narcotics

2. 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

3. 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 19 th century – it was used to relieve pain, diarrhea and dysentery

4. Civil War soldiers routinely injected them selves with morphine and thousands became addicted Laudanum was widely sold By 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

5. During the 1930s morphine abuse exceeded heroin abuse in the United States. By the following decade heroin addiction was greater

6. 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

7. 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

8. Crude opium is found in the Papaver somniferum Morphine and codeine both are natural products of crude opium

9. 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

10. 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”

11. Physical and Psychological Effects Opiates mimic endorphins in the brain Physical Effects -drowsiness -vomiting -nausea -difficulty concentrating

12. Psychological effects relief of anxiety, hostility, feelings of inadequacy and aggression

13. Dependency Physical dependence, psychological dependence, and tolerance develop quickly Withdrawal symptoms can include diarrhea, insomnia, muscle aches and pains, dysphoria, anxiety, and stomach cramps

14. 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

15. Medical Benefits Analgesia Gastrointestinal difficulties Cough Suppressant

16. 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)

17. Methadone Since 1960 methadone has been the drug used most frequently to treat heroin addiction Methadone blocks the craving for opiates

18. Methadone has been viewed as substituting one narcotic for another – so the life of a methadone patient is not easy

19. Methadone maintenance has several advantages -can be orally administered -easy to monitor -eliminates the need for needles -reduces risk of overdosing

20. 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

21. 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

22. 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

23.  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