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Three major classes of depressant drugs
- opioids/opiates
- sedative-hypnotics
- alcohol
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opiates
drugs refined from raw opium. opium is the milky fluid of the unripe seed pod of the opium poppu (papaver somniferum)
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major opiates found in opium are
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semi-synthetic opiates (chemical variationsof morphine and codeine)
- diacetylmorphine (heroin)
- hydrocodone (vicodin)
- oxycodone (oxycontin)
- hydromorphone (dilaudid)
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opioids (fully synthetic)
- methadone
- meperidine
- propoxyphene
- fentanyl
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oral ingestion
opium was originally chewed, eaten or mixed with liquids and swallowed
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smoking
16th century explorers and traders introduced the pipe to Europe and Asia
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_______ blockading its ports from ________ trading ships selling opium
- China
- English
- (opium wars, 1839-1842 and 1856-1860)
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refinement of morphine, codeine and heroin
- 1805 morphin was isolated from opium
- 1874 chemists altered the morphine molecule to produce hroin (diacetylmorphine)
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injection 1853
development of the hypodermic needle (1853)
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snorting
today over half of all heroin addics in treatment started their habit by insufflations (snorting)
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1906
Pure Food and Drug Act
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1914
Harrison Narcotics Act
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United States consumes only __% of the world supply of opium
3%
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Afganistan grew __% of the worlds opium
92%
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only other significant grower of opium is the Golden Triangle consisting of _________, __________, and ________
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In US most heroin comes from
Mexico and Columbia
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Physicians prescribe opioids to
- deaden pain
- control coughing
- stop diarrhea
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Pain
Substance P is the neurotransmitter released by neurons in spinal cord pain pathways to signal tissue damage.
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During intense pain
neurons release endorphins and enkephalins that block the release of Substance P and dampen pain sensation
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Opiate/Opioid drugs are able to...
bind to and activate endorphin receptors and mimic our natural pain reduction system
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Endorphins also
dampen mental pain such as fear and anxiety producing a calm and detached mood
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Cough suppression
opioids bind to receptors in the brain stem that control the cough reflex
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Control of Diarrhea
opioid drugs reduce gastric secretions and slow contractions of smooth muscles lining the intestines so that life-threatening fluid loss is reduced
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Side Effects of Opioid Drugs
- constipation
- pupil constriction
- drooping eyelids
- relaxed muscle tone
- dry, itchy skin
- vomiting
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Tolerance
people seeking mental effects such as euphoria might need 10 times their original dosage after a month of regualr use
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Withdrawal Symptoms
- fever, chills, and goose bumps
- intestinal cramps and diarrhea
- bone and joint pain
- muscle cramps
- insomnia
- intense craving
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Withdrawal from short-acting drugs like heroin and morphin,
produces the sudden onset of severe symptomes which begin 8-10 hours after the last doese and peak within 48 hours.
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If the fetus becomes tissue dependent for heroin
birth suddenly cuts the newborn's drug supply and withdrawal symptoms appear.
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Overdose
severe respiratory depression is the major cause of overdose death with opioids
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Symptoms of opioid overdose
- blue lips and pale or bluish skin
- slow shallow breaths with fluid rattles or gasps
- very constricted pupils that look like pin pricks
- skin feels cold and clammy
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in some overdoses an injection of an
opioid receptor antagonist such as naloxon narcan
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Dirty and shared needles cause
- hepatitis B or C
- endocarditus
- flesh-eating bacteria
- Hiv virus that causes AIDS
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Dilution
heroin is always cut street drugs can vary from 0-99% pure
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Heroin
(diacetylmorphine) use is a world-wide problem
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types of heroin incllude
- china white
- persian brown
- black tar (often smoked)
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Codeine
not as strong as morphine generally used for relief of moderate pain or to control coughs
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Methadone
(dolophine) long lasting opioid which is taken orally to reduce hroin craving and reduce withdrawal symptoms
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Hydromorphone
(dilaudid) semi synthetic opioid refined from morphine it is 8 TIMES MORE POTENT THAN MORPHINE
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Oxycodone
(oxycontin) time release form of oxycodone
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hydrocodone
(vicodin) today is the most abused oral pain reliever
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Meperidine
(demerol) short acting opioid usually injected
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Fentanyl
(sublimaze) most powerful pain killer available (50-100 times stronger than morphine)
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Designer heroin
street versions of fentanyl known as china white are made without controls and can be very dangerous
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Naloxone and Naltrexone
opioid receptor antagonist which block the effects of opioids and can be used to reverse a heroin overdose
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