Opiates are classified as narcotics and are obtained from the flower of the opium poppy plant. Opiates have been used by people for a thousand years for recreational and medicinal uses. Some opiates are obtained naturally from the opium, but some are made in the laboratory to have a similar chemical structure as the natural opium.
Opiates are inclusive of licit drugs such as fentanyl, morphine, and illicit drugs like heroin. Whatsoever, they all function in the same way by suppressing the central nervous system. The following are three classifications of opiates;
I. Natural opiates
Just as the name implies, they are obtained naturally from the opium poppy plant. Natural opiates come directly from the milky sap found in the seedpods of the opium poppy plant. Many people think that natural opiates are harmless, but they still have the potential of causing health complications such as depression and respiratory problems.
Throughout history, opiates have been used to offer anesthetic effects for managing migraines, cancers, nervous disorders, and many other complications. Morphine is commonly prescribed to relieve pain, but people use it to experience the euphoric effects or get high.
II. Synthetic opiates
Although they work and produce effects like natural opiates, synthetic opiates are man-made and are mostly used to treat opiate addiction. They are processed in the lab using chemicals which are not present in the poppy plant or morphine. The chemicals used vary from a pharmacy to another and also from one drug to another. Synthetic opiates include fentanyl, levorphanol, methadone, propoxyphene, alfentanil, and codeine.
III. Semi-synthetic opiates
These are partial derivatives of natural opiates such as morphine. Semi-synthetic opiates have the same effects as other opiates but are considered as safer alternatives. They include oxycodone, hydrocodone, and oxymorphone. Heroin, the most abused opiate belongs in this class and is derived from morphine. Synthetic opiates and natural opium alkaloids are used in the process of making semi-synthetic opiates.
History of Opiates
Opiates are among drugs that have a long and researched history for centuries across the globe. Since civilization societies have been dealing with a dilemma of the medicinal properties of opiates and the euphoric effects that leads to abuse and misuse of the drug. According to Atlantic, the earliest natural source of opiates was obtained in 3400BC. The leaves were cultivated in the lower Mesopotamia. The opium plant was named as ‘Hul Gil’ or ‘the ‘joy plant’ by the Sumerians.
Between 460-357BC the ‘father of medicine or Hippocrates acknowledged the opium plant uses as a narcotic. He further prescribed people to drink the juice of the poppy combined with the nettle’s seed. Alexander the Great planted the plant when he was expanding is empire back then. Romans, Arabs, and Greeks used opium plant as a sedative. Opium found itself in Europe through the Arabic traders who transported it to the Far East. In Europe, people used it to cure various diseases and psychological complications.
Opiates in the 1800s
Friedrich Wilhelm Adam Sertuner, a German chemist, in the year 1806 got a sample from the opium plant and labelled it ‘morphine’ in reference to the god of dreams known as Morpheus. Sooner, the US doctors started administering it to relieve pain and treat respiratory problems. During the civil war, morphine was mostly used as a pain reliever. Nevertheless, many soldiers developed dependence to opiates leading to the post-war morphine addiction which was referred to as ‘soldier’s disease.’
The Hypodermic needle was discovered in 1853, leading to the use of morphine to cure neuralgia during minor surgical procedures. This was the start of medical use of opiates. Heroin was derived from morphine in 1898. It was then given as cough suppressant by Bayer, a German chemical company. Doctors recommended it as a non-addictive replacement for morphine. Additionally, the United States by the end of the 19th century combined efforts to end the non-medicinal uses of the opiates.
Opiates in early 20th century
Congress in 1909 passed a bill that barred people from smoking opium. The Opium Exclusion Act is considered by many people as the formal start of the war against drug use in the US. In 1914, the Harrison Narcotics Tax Act was passed that directed tax implementation on opiates. It also required doctors and pharmacists to register for the distribution of opiates across the state.
In 1916 the German scientists at the University of Frankfurt invented oxycodone hoping that it will still give the analgesic effects of heroin and morphine, but not cause addiction. This was after Bayer had stopped mass production of the earlier substances. With mixed reactions about the addiction, uses of opiates, and the passage of the Heroin Act, in 1924, the sales of heroin stopped.
The Food and Drug Administration (FDA) was given powers to certify the safety of food and drugs in 1938. All drugs had to be verified as safe for human consumption before taken the market. Medicines that were derived from opiates like morphine, oxycodone, and codeine were still being administered in spite of their harm.
Opiates Use in the Mid-20th Century
This was marked as the period of major abuse and the rise of opiates like for instance, oxycodone was widely accessible after it was approved as Percodan, (a mixture of aspirin and oxycodone) by the FDA in 1950. It was the start of abuse of prescription drugs containing opiates in the US.
In 1960s a period of smuggling heroin rose dramatically in the US contributing to the presence of militants in Vietnam. World Health Organization (WHO) in the year 1969 discredited the belief that when morphine is used for medical purposes it inevitably causes addiction to patients. According to them, the morphine’s tolerance and addiction do not contribute to addiction.
The Controlled Substances Act of 1970 led to the consolidation of prescription narcotics or opioids drugs into five classifications or schedules. This was done according to drugs medicinal value, potential harm, and the capability of causing dependence or addiction. After the creation of the Drug Enforcement Agency in 1973, President Nixon formally initiated the war on drug use, which is still promoted up to date by the US.
In 1980s President Reagan asked Americans to join a national force in fighting against drugs use by any person, anywhere, and in any place. This led to ‘opiophobia’ or the fear of prescribing opioids to patients. However, with growing recognition of the use of opioids to manage all pains, prescription opioids largely hit the market in the 2000s.
Opiates in the 21st Century
In the 2000s a seismic shock ran through the state as Purdue aggressively marketed the distribution of Oxycontin claiming that it was safe for treating chronic pains. He claimed that it could not cause addiction since the drug would only be released to the body for 12hours. Besides, the Centers for Disease Control and Prevention (CDC) in 2016 issued guidelines on how to administer opioids in treating severe pains. Physicians for Responsible Opioid Prescribing led other health care organizations in petitioning a joint Commission for Accreditation of Health Care Organizations, which pushed for an end of the forced pain assessment. They suggested that the practice encouraged harmful pain control measures and caused excessive prescription of opioids.
Medics attempt to achieve a balanced approach in which patients suffering from chronic pains can be relived as well as reduce the probability of the negative impacts of the opiates.
Opiates vs. Opioids
Most people refer opiates as opioids and do not understand the difference between them. Historically, opiates is a term that is used to refer to a group of drugs that are obtained from the opium poppy plant such as morphine and codeine, but on the other hand, opioids are the synthetic counterparts which are man-made such as oxycodone, methadone, and Percocet. They mimic the natural effects of opium, but others are partially synthetic; they have some quantities of natural opium.
The two terms are used synonymously since they produce similar effects. They work by stimulating the receptors in the brain. Once they are activated they secret endorphins, which are responsible for positive feelings or good feelings. This makes the user experience relaxation and calmness, which can be highly addictive as one tries to maintain the feelings.
Nevertheless, it does not matter whether the substance was obtained naturally or synthetically made. Both opiates and opioids are harmful to the body and have an equal potential for abuse, tolerance, and addiction. Before taking any medication, it is always wise to discuss all the risks with your doctor.
Common Opiates
Opiates are prescribed by doctors for various medical purposes; however, there are two main classes of this drug; agonists and antagonists. Agonists are inclusive of fentanyl and morphine, and due to their intense effects, they are used mostly in hospitals. Besides, they have the highest potential for abuse and dependence.
On the other hand, antagonists which are inclusive of clonidine and buprenorphine do not have addictive or abuse risk. Henceforth, they are used in the detox process, part of the treatment plan for various drugs. The following are some Common Opiate Agonists;
a) Codeine
Although codeine has fewer risks as compared to its derivative, morphine, it still has addictive properties. It is a prescription medicine for treating mild pain. Codeine mostly is found in a tablet form and commonly found in cough syrups. Besides being an additive in cough syrups, there is no technical proof that it can suppress coughs. But, it treats diarrhea better, more also if it is caused by irritable bowel syndrome.
Cough syrup, coties, t-three’s, and schoolboy are some street names for codeine. Once in the body, the liver digests it to form morphine. It stimulates the brain’s reward region causing it to produce feelings of pleasure, well-being, and many other positive feelings. These feelings contribute to codeine abuse and later dependence. People innocently use codeine by taking a codeine-based cough syrup.
Also, since it is less controlled as compared to other opiates which are believed to be more harmful like Oxycontin, people can get and abuse it easily. Some countries monitor the purchase of the drug electronically to track how each customer buys it. The legal restrictions on codeine use in the US depend on its concentration in each medication.
Depending on the formula, cough syrups are either classified as schedule III or V. Besides being less dangerous, it produces similar effects with morphine-like euphoria, drowsiness, relaxation, and apathy.
Codeine Addiction
Just like all other opiates, codeine has a potential of addiction. Users develop tolerance at first and later become dependent on it. Although many people may use it for legitimate purposes like managing cough, it reaches a point where they need more of the medication to relieve a cough. Signs that a person is abusing methadone include weight loss, mood swings, clammy hands and feet constipation, and many others.
Moreover, many codeine users take to help in dealing with physical pain; they eventually use it to cope with emotional pain. People who consume the drug think that it is safe, but truth be told, it can lead to respiratory complications, blindness, and constipation. Addiction starts from the abuse of codeine either as a cough syrup or in pill form. Some addiction signs are isolation from friends and family, poor performance, lack of motivation, and needle track marks on the skin. Also, it is believed to be a gateway to other opiates like heroin and morphine.
Long use of codeine can cause lung infections, brain damage, irregular heart rates, and sleep disorders. Withdrawal symptoms of codeine are characterized by a runny nose, watery eyes, vomiting, muscle pains, loss of appetite, and stomach pains.
b) Methadone
Methadone is mostly used in treatment centers to reduce cravings for other opiates especially heroin. However, it is addictive on its own. It is a synthetic opioid that is given to relieve moderate and even severe pain. Methadone acts on opioid receptors just as morphine and heroin, hence the capability to stabilize patients and reduce the withdrawal symptoms during recovery.
The opiate is classified as schedule II, meaning that it can be legally used tough it can cause dependence. Although methadone can be used by heroin addicts who are recovering, they are at higher risk of abusing it since they are already used to opioid effects. Using methadone in other ways other than a prescription, they are abusing it.
Methadone does not create euphoric effects like heroin. It acts in the opposite way by blocking the signals responsible for pleasurable effects from the other opiates; however, people still use it illegally in search of the pleasurable sensations. Methadone is a depressant that acts by slowing down the brain. Combining it with alcohol, which is a depressant, can greatly lower your blood pressure and cause respiratory depression.
c) Oxycodone
Oxycodone is one of the most addictive prescription drugs. It is found in brand names such as Oxycontin and Percocet. Oxycodone is a strong pain reliever, though it is the most abused prescription drug around the globe. It offers more than the needed relief from pain especially to people struggling with terminal conditions. The transition from oxycodone abuse to dependence can be fast and yet very dangerous.
Most users start taking the prescribed quantity, but they later develop tolerance and require more of the drug to achieve the same relief.
Effects of Opiates
Opiates help in relieving pain, but they take a toll on almost every part of the body. Moreover, they have an added advantage of being relatively cheap. Opiates produce a high effect; the faster it is produced, the more intense it is. For instance, heroin produces very intense effects which are short-lived; 15-30minutes. Morphine produces much longer lasting effects; 4-6 hours.
Opiates have the following short-term effects;
• Pain relief and drowsiness.
• Euphoric feelings characterized by increased energy and positive feelings.
• Sedation and slowed breathing.
• Impaired judgement and slurred speech.
• Memory and attention loss.
• Confusion and constricted pupils.
• Slowed movements, nausea, and constipation.
Long-term Effects of Opiates
Because of the short-lived intense effects produced due to the interaction between opiates and the brain, they are extremely addictive and can cause addiction symptoms in less than three days after consumption. Long-term impacts can include;
• Liver damage, especially if they are used with acetaminophen.
• Brain damage caused by hypoxia or decreased oxygen supply.
• Addiction or tolerance.
• Nausea, vomiting, and constipation
• Abdominal bloating and weakened immunity.
• Sexual dysfunction and depression.
• Increased suicidal thoughts.
• Clogged blood vessels and coma.
Signs of opiates use/abuse
Opiates use shows both behavioral and physical signs; however, they affect people differently. A person may experience euphoric effects as it relieves pain, but to another, it might have negative side effects such as drowsiness and vomiting. For others, tolerance develops and they have to consume more and more.
Constipation and nausea are some obvious signs of opiates use. Some bodily signs can be seen while others can go untreated causing health complications and fatal disorders. Constricted or pinpoint pupils are one of the signs that are hard to ignore. Others signs of opiates abuse are;
• Dizziness and dehydration.
• Irregular heart rate and breathing.
• Pain relief and itchy skin.
• Lack of tolerance.
• Imbalance of hormones and loss of sexual desire.
• Dependence and severe weight loss.
Effects of Opiates on the Brain
Human beings and animals have opiate receptors in the brain which act as action sites for various opiates like morphine and codeine. But what is the purpose of the opiate receptors in the brain? It is because of the presence of neurotransmitters (internal) which act on the sites and produce the same signals to the body like those of opiates.
Opiates have chemicals that bind the receptors thus mimicking the effects of painkillers that are naturally found in the brain. They bind to the receptors in the central nervous system, spinal cord, and other parts of the body. By binding, they block the sensations of pain by working through the brain.
Opiates are capable of blocking pain and producing feelings of comfort or well-being. However, they have side effects such as nausea and confusion. Additionally, if consumed in larger quantities than the prescribed one, other effects such euphoria is produced which can lead to abuse and tolerance. The person’s brain is flooded with neurochemicals such as dopamine and serotonin which trigger reward and pleasure signals in the brain.
The sensations are stronger than those obtained from natural feelings of reward and pleasure. You can compare it with watching a match on the TV and watching it live in a field. The feelings can be strong such that they start to train the brain that they are they are more powerful than the naturally occurring. This makes the brain to keep seeking the drug and over time it begins to prefer the feelings to any other thing, causing tolerance and addiction.
Opiates Addiction and Treatment
Anyone who uses opiates whether medically or for other uses can become addicted. The only way to prevent addiction is to avoid all illicit drugs and use prescriptions as advised. Take pain relievers only after they have been prescribed by a doctor. Opiates are highly addictive, thus any unadvised use puts one at a risk of dependence.
Opiates addiction affects a person’s health, relationships, and other personal goals such as career objectives. The first step to opiates addiction treatment is detox that allows the body to get rid of the substance. Withdrawal symptoms such as delirium, tremors, and intense anxiety may occur. However, medications such methadone is given to ease them.
Conclusion
Opiates have been around for years due to their medicinal property of relieving pain. Nevertheless, they have negative side effects like confusion, anxiety, hallucinations, drowsiness, and many others. They are prescribed, but one should follow the doctor’s advice lest they risk tolerance and dependence.
People who are addicted to opiates risk death and other serious health conditions like brain damage and respiratory depression. Quitting abuse is the only way to avoid such risks and its dependence. Also, the abuse can lead to an overdose which is extremely dangerous and if not addressed medically it can be fatal. The good news is that many addicts recovered successfully from opiates addiction.