NOTE TO READER: Here we introduce the potent, federally regulated pain killers of great therapeutic potential yet infamous reputation. Where would the fracture patient be without morphine? How much better off would society be without heroin? All of these drugs have serious addiction and misuse potential. NARCOTICS are defined as powerful drugs that can relieve serious pain without causing loss of consciousness or sensory perception, although in larger doses they can cause stupor or insensibility.OPIATES SUCH AS morphine and codeine are found in the opium poppy, a plant that grows in the Middle East and Southwest Asia. Mexico and South America are also sources of U.S. heroin.
HEROIN, banned in the U.S. even though it is a powerful pain reliever and cough suppressant, does not occur in nature; it is prepared illiticly by acetylation of morphine. Addiction (physical dependence) to heroin afflicts millions of people worldwide, and the FDA estimates the national U.S. addict population to be over 500,000. Heroin by injection (mainlining) produces a euphoric rush that is nearly irresistible. Of course, people can become addicted to morphine and other opiates. When a narcotic addict is abruptly denied his drug he can suffer a painful physical and mental crisis termed a WITHDRAWAL SYNDROME. Tolerance to opiates and opioids typically develops, and the user must take ever larger doses to receive the same effect.
OxyContin is a long-acting (12 hour) form of the well known drug, oxycodone. It is a pure agonist opioid whose main action is analgesia. That means it is a potentially dangerous, addictive drug that relieves pain. Actually, wide spread abuse of OxyContin is now documented.
METHADONE MAINTENANCE is designed to help the heroin addict gradually kick his addiction, or to offer him a free narcotic so he won't have to steal and fence to buy his drug on the street. However, methadone, a synthetic opioid, is itself an addicting drug. Far more additional information on all of these topics is offered in my book, "Drugs and the Human Body", 7th edition, Prentice Hall publishers. ISBN 0-13-177321-6.
PHARMACOLOGY of OPIATES. Narcosis is defined as depression of the CNS leading to analgesia, drowsiness, changes in mood, mental clouding, apathy, lethargy, and ultimately unconsciousness.Given in 5 - 20-mg doses every 4 hours, morphine can ease severe pain while the patient remains awake. Codeine is only about one-twelfth as potent a narcotic pain reliver as morphine, but it is a better cough suppressant. All opiates can depress respiration, constrict the pupil of the eye, reduce peristalsis, and thus act as antidiarrheals.
Remarkably, the human body produces its own natural pain killers. Termed BETA-ENDORPHINS, these peptides are released when we are traumatized by great pain. It is now believed they are also released during acupuncture.
NARCOTIC ANTAGONISTS such as Narcan (naloxone) and naltrexone are synthetic molecules designed to block the pharmacological effects of narcotics by occupying the narcotic human receptor sites. Actually, Narcan has saved the lives of heroin addicts who have overdosed.
SYNTHETIC OPIOIDS include meperidine (Demerol), methadone, propoxyphene (Darvon), pentazocine (Talwin) and fentanyl (Sublimaze). All use the same receptor sites as morphine and all have serious addiction liability.