Opiates and opioids are drugs got from the opium poppy plant that are normally consumed for the excitement effect that they bring to the user. A more specific definition describes an opiate as a compound that contains narcotic alkaloid compounds which can be naturally occurring in opium or created synthetically. Most of the semi-synthetic opiates, which are generally referred to as narcotic drugs, are manufactured from the alkaloids such as morphine and codeine. On the other hand, opioids can either be artificial or semi-artificial and are used to serve the function of a natural opiate alkaloid (McLean 2003). They are mainly used for pain relieving purposes. It can therefore be said that the main difference between opiates and opioids is that opiates are natural organic substances with pharmaceutical effect on people and animals (McLean 2003). On the other hand, opioids are man-made organic compounds with same pharmaceutical effect. This article will focus on the use of opiates and opioids in the United States. It will look at the history of use of this drug in the US, the effects as well as their treatment if used by human beings.
Prescription drugs are the ones obtained through prescription from a medical physician. They are different from other counter drugs that are obtained without prescription. To acquire and use prescription drugs one requires getting an official written note from a recognized and qualified doctor. Prescription drugs treat physical and mental health problems (Wolny, 2008). Many people use prescription drugs for medical purposes; but the use have extended to other illegal uses. The illegal use of these drugs comprises use for recreational purposes. They become party drugs and are used without doctor’s prescription (Wolny, 2008).
Prescription drugs are of different type, depending on the purpose of use. They may include the pain relievers, depressants which are also referred to as tranquilizers or sedatives, and also, the stimulants. Depressants slow down the functions of the brain and the central nervous system. They are taken orally, sometimes in combination with other drugs, simply to alter the effects of those combination drugs. Stimulants are taken to boost the alertness, insight and body strength of users. They also increase the rate of blood pressure, increase the glucose found in the spleen and relax the paths for respiration (Wolny, 2008). Historically their use extended to treatment of respiratory problems like asthma, and other illnesses like obesity, neurological disorders, and a variety of others.
Opium is a product of a plant called the opium puppy, which was cultivated in Persia, Egypt and Mesopotamia. Research shows that man has used opium more than thirty thousand years ago. Today its use has been prohibited because of its effects. Opiates are pain reliving drugs; the study shows that if properly managed or taken exactly as prescribed, they can purpose well and even cause no adverse effects on the user (Wolny, 2008). In medical context, they reduce pain in patients during operation process. Examples of opiates include, and not limited to, Vicodin, oxycodon, morphine, fentanyl, codeine, and others.
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One of the commonly used opiates is the oxycontane. Oxycontane is a street name of oxycodone hydrochloride. It treats and manages extreme pain, especially pain deriving from cancer. It’s a strong opiate with a percentage of 42% to 87%. The opiate performs by overcoming pain in the next 12 hours after it have been taken (Brogan, 2008).
Vicodin contains a substance called the hydrocodone that puts it into the opiate category. Hydrocodone is a substance contained in the anti-cough medicines found in prescriptions of cough syrups. Other medicines that contain the hydrocodone are aspirin, ibuprofen, and drugs used for allergy medications. Vicodin adds up to 80 % of hydrocodone prescriptions. It does not have a lot of effect in terms of chemical strength and it is administered for less severe pains. Vicidon comes in tablets, capsules and in liquid form (Brogan, 2008).
Methadone is a product of the opiate plant that treats dependence of other drugs like heroin. It is a very effective pain reliever, especially in the management of neuropathic pain. Its oral bioavailability is 60% to 70%. It is found in serum proteins, especially the glycoprotein that is found in tablets that treat drug dependency (Dasgupta, 1958).
History of Opiate Use in USA
Drug use in USA dates back to 18th century, when doctors used morphine as a medical drug. It did not have any effects on patients until when the hypodermic needles were invented in 1840. It was used to treat soldiers for injuries and to reduce pain. Later, the public had access to the drug from the stores and pharmacies. They were mixed with other drugs which contained strong opium that would produce addictive effect. This became a problematic because of the illegal use of the opiates (Marcum, 2009). Later, there was the establishment of the clinics to control the use of opiates, due to the growing problems of drag use. The use of opiates was banned in 1914, after the formation of the Harrison Narcotics act. All the clinics that sold the opiates were closed down and the drugs were no longer in the market. They were only sold under prescription of doctors. This went after a few years when people started using them illegally by illicitly obtaining them. The supreme courts of USA ruled against production, possession, sale and distribution of these drugs. Those doctors who were caught prescribing the opiates to patients were tried and imprisoned. Over 3000 physicians faced imprisonment at that time.
For the decades, from 1930's to 1960's, many people suffered drug dependency and it became a problem that needed treatment. The only way to do that was the extended charge in hospitals. By 1970, the opiate use has increased significantly. It mostly revolved around black and Hispanic men and it affected them greatly, with some enormous ramifications. Opium production in USA was believed to be connected with Afghanistan and the Taliban. Later, the Taliban issued the ban on opium and ceased to produce it biologically in their labs. The year 2000 ban by the Taliban almost diminished the production and sales of the opiates in USA. It proved very successful, but later it waked when the worse happened with the Taliban.
The Taliban had established a well organized army which ensured the ban was effective. The ban ended slightly after the 2001 attack on the USA. George Bush, the then president of USA, commanded the Taliban to hand over the mastermind of the terrorist attacks, Osama Bin Laden. This followed with attacks by the USA army, which showed a disorganized Taliban government (Marcum, 2009). From there, opium production took another path where it increased and large amounts were produced. It did not increase just after 2001, but reached even greater heights by 2007.
Through a research by the National survey of Drug Use and Health shows that 1.6% of persons over the age of 12 reported using opiates in their lives. Opiate use in the cities of USA among males is three times bigger than that of women. Use of these drugs increased in 1990s due to the fact that the drugs became very cheap and easily available.
Most deaths occurring from use of opiates were from their side effects and overdoses; in 1948 there were 140 deaths that occurred due to overdose in King County. Researches indicate that the number of overdoses from opiates increased by 134%. In contrary, the number of population at the time increased by 11.3% (Marcum, 2009). The opiate related deaths in the same area increased from 3.1 per 100000 population in 1990 to 6.6 in 1999. In 1998, the death rate was 8.4 %. Most victims of fatal ovedoses where white males (DO, 2000). In 1999-2003, Chicago residents suffered a fatal accident of opiate usage of 80%; it is estimated that 45000 died at that time due to opiate related cases. In 2005, 18 347 deaths that occurred in USA were due to opiate consumption of narcotics and psychodysleptics (Marcum, 2009). Since 2001, 94000-128000 Americans died because of opiate related illnesses.
Today, the number of people addicted to the opiates is about 1 million according to the Office of National Drug Control. Other sources indicate that deaths that occur due to opiates may arise from poisoning from the drug. Unintentional poisoning deaths from opiates in the USA in both illicit and the licit drugs is 43% of the total drug deaths (Marcum, 2009). The percentage that arose from the use of semi-synthetic opiates like oxycodone and the hydrocodone was 54%. The rate of increase in sales matched the rate of increase in the deaths that occurred from the use of drugs. 32% of deaths were from the use of methadone while 13% were from the synthetic opiates like fentanyl.
West Virginia data showed that 93% of drug-related deaths that occurred in 2008 were opiate-related. Multiple pharmaceuticals were involved in 79% of deaths. Globally, the deaths that are reported to have been related to opiates are 104000-265000 per every year. In the United States, over one million people are currently addicted to opiates, heroin and cocaine (Marcum, 2009). Many years down the line, many famous people experienced addiction and died of opiate related and other drugs related causes. Regardless of the drug that they used, these people paid a big price for the use of these drugs. Some did drugs privately and others in the public, but at the end, all of them were exposed to the world. Some of the people, including Marcus Aurelius, a Rome emperor, did drugs for medical purposes but later became addicts. Charles Dickens, the authored of the book "A Tale of Two Cities" was addicted to opium until the time of his death, which was caused by massive stroke (Marcum, 2009). Others, including Billie Holiday, River Phoenix, Michael Jackson, Janis Joplin and the very recent death of Whitney Huston; all these celebrities died of drug related cases.
In 2008, Centre for Drug Control in USA found out that opiate pain relievers were responsible for over 74% of the drugs related deaths that occurred in the country.
Study has gone further to identify the reasons behind the deaths caused by opiates, with the most deaths involving methadone (Marcum, 2009). The number of deaths rises with the increase of the physicians who are prescribing drugs. They administer the opiates for pain, instead of using some more expensive opiate medication. Lack of skills to administer these medications has also contributed to these deaths (Marcum, 2009).
A study done in 2008 indicated that the increase in the distribution of these drugs and their presence in people’s homes also make the drugs readily available for abuse. The number of death keeps increasing each day due to the increase in drug dealers and suppliers.
Effects on the Brain and Addiction
Opiates and opioids are very addictive drugs. When used for a long time, the individual becomes tolerant to them. This implies that in order to attain the same level of excitement, dosage needs to be increased gradually. One of the dangers of using these drugs is that in case a person cuts off from using them for a while, it can result in death (Jaffe 1998). This occurs since their level of tolerance goes down for the same amount of drug they were using before they cut down on usage. On the other hand, in case a person has been using high dosage for some time and then halts suddenly, the person may experience a lot of discomfort.
When there is constant supply of opiate to the body, the brain adapts. This implies that the neurons have been inhibited and conditioned to respond in a certain manner upon administration of the drug. In case this drug is removed, neurons begin to pump out neurotransmitters once again (Jaffe 1998). Imbalance of these chemicals in the individual’s brain triggers the respective receptors in the nervous system to exhibit withdrawal signs.
Physical effects of Opiates
Physical effects of these drugs relate to the opiate used, its dosage and source, as well as the technique used to administer it. Use of opiates slows down the rate of heartbeat and breathing, as well as the activeness of the brain. There is also observed reduction in appetite and sexual drive. The body is found to sustain high levels of pain subjection (Al'Absi 2007). There is also increased risk of contaminating diseases such as AIDS and other sexually transmitted infections due to sharing of needles that are not sterilized.
When a person suddenly stops using opiates, he or she experiences withdrawal symptoms for a considerable amount of time. These symptoms include general body weakness, vomiting, sweating, shivering, diarrhoea and restlessness among others (Al'Absi 2007). It is worth noting that these symptoms are normally strongest from the first and third day, since the person stops administering the drugs. Nevertheless, they depend on the frequency and amount of drug taken, as well as the period it has been used. Previous research has established a correlation between problems of the gastrointestinal tract and long consumption of opiates. Use of opiates has motor effects on the human digestive track. High levels of morphine have been found to decrease the oesophageal movements and hence affect digestion.
In case of pregnant women, use of opiates can turn out very disastrous to the growing foetus. There is a very high risk of impulsive abortion, premature and still-births. The greatest danger that is implicated on the child is that infants who are born to mothers addicted to these types of drugs display similar withdrawal signs (McLean 2003). The symptoms can last for a number of weeks or even months. There are also recorded cases of abrupt death of infants born to opiate addicted women.
Psychological effects of Opiates
Opiates are proven to cause euphoric feeling, just like other depressants. Prolonged use of opiates causes a psychological dependence, such that the individual can not do without them. In fact, the drugs cause tolerance, such that the user develop craving for more of it so as to generate the euphoric effect. It is usually proposed that when the body’s chemical balance is interfered with, for instance during the drug usage, the body reacts to oppose the effect causing the imbalance so as to bring itself back to normal state(Bhagar and Schmetzer 2008). Higher dosage is therefore needed to bring the corrective measures. Such dependence on the drugs implies that the person has adapted to having the drug in the body, and in case he halts from using the drug, withdrawal symptoms arise.
Signs and Symptoms of Opiates Use
It is possible to note people that use opiates through the symptoms highlighted below. Users experience drowsiness, rigid eye pupils and poor vision. There are also visible marks from injection needles on their body parts, for example arms. Their noses are usually raw and exhibit redness mainly due to sniffing of heroin. Users also display signs of withdrawal and uneasiness. It will be normal to find substances such as cotton, needles, syringes and other items in the user’s area of residence (Jaffe 1998). These items are used for injection of the drug into the users’ body.
Ways in Which Opiates are Consumed
There are various ways in which people use opiates as outline below.
This method requires the user to inhale the drug through the nostrils. The drug is normally rolled on a paper or inhaled using a straw. It is easily absorbed into the blood through the soft tissue of the sinus cavity. It is preferred by those users who do not want to prick themselves with needles.
Opiate users vaporize it to inhale the resulting fumes rather than the smoke. It can also be smoked in a mixture of other drugs like marijuana (Dasgupta 2010).
This is the most common method of administering opiates. It is preferred to other methods due to the fact that the drug gets into the bloodstream immediately, thereby causing the ‘relieving effect’ almost instantaneously (Dasgupta 2010). Injections are done directly into the blood vessels or in the muscle tissues. The danger associated with this method is that the user is at high risk of contracting AIDS and other sexually transmitted diseases due to sharing of injection needles. Also, continued injection causes collapse and damage to blood veins.
Almost all types of opiates can be administered orally. However, it is not a common method of use in consumption of opiates due to the fact that the ‘rush’ is compromised on ingestion. There are various names that associated with opiates such as smack, poppy, chiva, tacata, morf, horse, junk, hazel, muzzle and many others (McLean 2003).
Treatment of Opiate-Addiction
Treatment of opiates is a process that involves giving compassionate care and medication to addicted opiate users. When medication is combined with other helpful services, patients who were earlier addicted to opiates are able to stop using the drugs and lead normal and fruitful lives. Support services include provision of counselling services to the patients while undergoing treatment to enhance faster recovery (Bhagar and Schmetzer 2008). It has been proven that addiction to heroin and other opiates can be effectively treated through proper medication procedures. Methadone is a synthetic compound that is normally used in treatment programs to treat people who are addicted to heroin. It helps to block the impact of heroin in a patient for a whole day with very effective results when applied at the recommended dosage (Bhagar and Schmetzer 2008). Additionally, naloxone is yet another compound that is used to treat cases of overdose by jamming the effects of morphine and other opiates.
Even pregnant mothers can be effectively treated from opiate addiction. They are given methadone compound for medication purposes in addition to prenatal care in order to provide a comprehensive rehabilitation program (Strang, Keaney and Witton 2005). When this program is administered well, it helps to reduce detrimental effects of opiate abuse, especially among pregnant women (Bhagar and Schmetzer 2008). Recently, a new compound known as buprenorphine has also shown effectiveness in treatment of addiction of heroin as well as other opiates. This compound offers less risk of addiction than methadone.
Apart from providing medication, opiate patients are required to be taken through effective behavioural rehabilitation programs. These programs follow various approaches such as home-based or outpatient systems. Use of either of the approaches depends on the convenience to the patient, facilities, convenience of the person providing the rehabilitation services among other factors.
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