Opiates are medications or drugs that are derived from the opium poppy, Papaver Somniferum. Opium first became widely available in the early 19th century as it was used as a commodity in trade with the countries of China and Great Britain. It was recognized for its value in pain relief to the medical community and quickly became a common prescription. In its prescribed form of laudanum, individuals had effective pain relief from injury, chronic and or terminal illness. It became apparent however, that misuse of the medication could result in addiction, mania and drastic changes in personality. This was the origin of the notorious “opium dens” that were prevalent in both Great Britain and the larger port cities of the United States. 1
As a classification of drugs, opiates are used widely today for the relief of moderate to severe pain. Common prescription names of opiates are as follows:
- Codeine
- Morphine
- Oxycontin
- Dilaudid
- Percocet
- Vicodin
Complete listing of opiates can be found at : http://www.drugabuse.gov/by/6drugs-abuse
Opiates attach to specific proteins called opiate receptors that are located in the brain, spinal column, gastrointestinal, and other organs in the body. This results in a reduction in the perception of pain and a generalized soothing feeling. In higher concentrations the individual can experience drowsiness, confusion, nausea, and depressed respiration. A general lethargy is also common and can lead to marked changes in activity and productivity. Gross and fine motor skills are also diminished and often can cause falls and other forms of injury. (2)
Physicians prescribe opiates for short term needs of patients whose pain is expected to resolve within the acceptable time constraints of the healing process. If the medication is used as dispensed, it is unlikely that dependence or addiction will develop. Dependence begins when more of the opiate is required to achieve pain relief or the desired state of euphoria. This is due to the fact that when in pain, the brain produces a larger amount of endorphins, which in turn activate the opiate receptors. This triggers the brain to “request” more of the opiate to satisfy the need of the receptors. As a result, the individual finds themselves taking more of the drug to achieve the same result. If the physician and patient recognize this, a short term tapering down of the medication is often suggested. In this best case scenario, addiction may be averted. (3)
In reality, the best case scenario does not happen for the majority of individuals.
Opiates are readily available without a prescription from friends, family members or on the street. It is well established that there is a conduit from The Appalachian region to Florida for distribution of black market drugs. A documentary by Marianna von Zeller illustrated how easy it is for hundreds of thousands of units to reach anyone who has the desire and money for the product. Several individuals from other states who may have legitimate needs (or previous prescriptions) will carpool to Florida to visit the dozens of “pain management” clinics. The individual pays cash for diagnostics such as a CT scan and is dispensed upwards of 500 doses of opiates at a time. Multiply this times several patients in a trip and the total amount is staggering. Upon returning to the home area, the distribution is quick, efficient and the process is repeated as often as demand dictates. This has been dubbed the “Oxycontin Express” and in 2009, it was estimated that 85% of all oxycontin in the United States originated in Florida. Thankfully the Federal Government and The State of Florida are working to monitor and close down these “walk in pain management clinics”. (4)
Another dangerous aspect of opiates is their ability to be entered into the body in various ways. They can be ingested orally in pill or liquid form, injected into the bloodstream and smoked. When the transmission method into the body is altered from its original state, the effects are often enhanced, but the length of time the effects last is diminished. It is easy to understand how an individual lands in a situation of using more and more of the opiate.
Opiates are often mixed with other substances such as alcohol, as again, it is readily available. The effects of alcohol and opiates magnify each other as they affect similar systems in the brain and central nervous system. There are numerous instances in the literature of a person, “just going to sleep and never waking up” after ingesting the combination. (5)
It is obvious that opiate use, dependence, addiction is an extremely easy situation to develop. What is difficult is being able to recognize the dangers of opiate use and addiction. In order to recover from opiate addiction, an individual needs access to an individualized treatment system and support from family and friends. The choice of treatment modality is often decided by cost and access, not unfortunately by the seriousness of the addiction or medical need for intervention.
Citations:
- Wikipedia History of opiates
- NIDA
- NIDA
- Vanguard, Marianna von Zeller, 2009 Oxycontin Express
- NIDA
