Opiates and Pain

PAIN

Spinal Cord

Substance P

BRAIN

Opiates

OPIATES

Codeine Heroin Dilaudid Percodan

Morphine

Opium

Synthetic Opiates

Methadone Demerol Darvon

Opiates

Primary use: Used medicinally to relieve pain

High potential for abuse; Causes relaxation with immediate “rush”

Detectable in urine up to 48 hours after use.

Dependence:

Physiological High

Pyschological High

Opiates Drug Route Duration

Opium oral/smoke 3 - 6 hrs.

Morphine oral/smoke/inject 3 - 6 hrs.

Codeine oral/inject 3 - 6 hrs.

Heroin sniff/smoke/inject 3 - 6 hrs.

Methadone oral/inject 12 - 24 hrs.

Immediate Effects

Euphoria

Drowsiness

Pain reduction

Long-Term Effects

Respiratory and circulation depression

Dizziness

Lowered libido

Constipation

Weight loss

Coma

Death

Opiates

Symptoms of Overdose 1. Slow, shallow breathing

2. clammy skin

3. Convulsions

4. Coma

5. Death

Treatment: Narcan (opiate antagonist)

Opiates

Withdrawal Syndrome:

Watery eyes, Runny nose, Cramps,

Diarrhea, Loss of Appetite, Nausea

Tremors, Chills, Sweating, Goose bumps

Symptoms begin 6 to 10 hours following withdrawal, peak at 36 to 48 hours, subside after 6 to 10 days

Methadone Maintenance

- Most common treatment for opiate dependent individuals

- Started in 1960’s

- Opiates are not considered a power drug - few crimes associated while the users is under the influence. Therefore, total abstinence need not be an objective of treatment.

Methadone Maintenance

- Individual is given a daily oral dose of methadone that prevents the occurrence of withdrawal.

- When properly prescribed it does not produce euphoria or tranquilizing effect.

- Individual may remain of methadone maintenance indefinitely.

Rapid Anesthesia - Aided Detoxification

(RAAD) 1. IV Administration of Narcan (opiate

antagonist)

2. Person is under a general anesthesia

procedures last several hours

3. Person receives on-going doses of opiate antagonist for cravings