Transcript Chapter 9

Drugs and Our Society
CJUS/HPE 151
Chapter 5: The Major Narcotics:
Opium, Morphine, and Heroin
1.
Opium / opium derivatives / semisynthetic
- opium poppy / synthetics
- Greek word: “stupor”
- dull senses / relieve pain
a. Opiate receptors of brain
- endorphins
- receptors activated
- heroin / morphine
(1) Discussion
- morphine-like effect
(2) Cocaine / coca leaves
- classified narcotics
- Uniformed Controlled Substances Act
(a) Neither bind to receptors
- nor morphine-like effects
- stimulants as discussed
(b) Narcotics
- produce morphine-like effect
(3) Most important characteristics
- powerful analgesic
- reduce pain
(a) Cough suppressant
- alleviate diarrhea
- induce anesthesia
(b) Therapeutically:
- tension / anxiety / aggression
(4) 1000’s of years
- sedating / painkilling / sleep-inducing
- Greeks / Romans / Egyptians / Assyrians
b. ‘Papaver somniferum’
- source: non-synthetic narcotics
- Mediterranean: 5000 BC
- cultivated around the world
(1) Milky fluid from incisions
- unripe seedpod
- air-dry
- scrapped by hand
- produces opium
(a) Modern method
-
industrial straw process
alkaloids extracted
mature / dried plant
liquid / solid / powder
fine brownish powder
(b) 500 tons legally imported
- legitimate medical use
(2) Synthetic narcotics (laboratory)
- no synthetic susceptible to abuse
- clandestine drugs / medical use drug
2.
Foreign sources
- entire supply
- unlike cocaine: South America
- opium three source regions
- Southeast-Southwest Asia / South America
a. 1996: ‘Golden Triangle’
- Myanmar (Burma) / Laos / Thailand
(1) Extent of narcotic use
- profits: $300 billion yearly
- world’s opium
(a) 2,560 metric tons (5,120,000 lbs)
- Myanmar
(b) 200 metric tons (400,000 lbs)
- Laos
(c) 30 metric tons (60,000 lbs)
- Thailand
(2) Afghanistan
- 3,656 metric tons
- Myanmar / Afghanistan majority
- Myanmar / Laos
(3) Latin America
- primary supplier for US
- Columbia = 60 %
- Mexico = 24 %
(a) Mexico
- hold
- trafficking in western US
- drug cartels
(b) 2 % illicit opium,
- entire crop for US
b. Opium poppy ‘field’
- 60,000 / 120,000 plants
- 2.46 acres / hectare
(1) Flower 90 days
- 3 to 8 flowers per plant
- continues several weeks
- early spring full bloom
(a) Petals drop
- size of chicken egg
- two weeks
(b) Mature
- ready to harvest
(2) 3 - 4 bladed instrument (iron / glass)
-score the pod
- one millimeter
- 2 or 3 times / afternoon
- white latex drip on surface
(a) Oxidizes / darkens / thickens
- over night
- morning: flat iron blade
- 80 milligrams
(b) Black to brown
- after drying
- quality: brown and sticky
- 3 to 9 kilos acre
(3) 40 alkaloids identified
- most = salts
- most important: morphine
- average content: 9 % to 14 %
- Turkish opium: 21 %
- druggist’s opium
(a) Other alkaloids:
- codeine: 0.5 / 2.5%
- noscapine: 4 / 8 % (cough
suppressant)
- papervine: 0.5 / 2.5 % (muscle
relaxant)
- thebaine: 0.5 / 2.0 %
(b) Alkaloids: removed in processing
- clandestine chemistry not ideal
- 45 % of alkaloids
- left in raw opium
3.
Purification process
a. Raw opium in boiling water
- dissolves alkaloids
- solids remain
- impurities: scooped out / filtered
(1) Liquid reheated / low flame
- evaporates the water
- thick, dark paste / dried in sun
(b) 20 % lighter / 20 % purer
b. Extraction process
- stirred in large drum / boiling water
- completely dissolved
- slake lime / fertilizer lime mixed in
(1) Convert morphine to soluble salt
- becomes insoluble in cold water
- other alkaloids do not react
- solution cooled / morphine remains
- other chemicals settle / brown sludge
(a) Codeine somewhat soluble
- some remains in solution
- called ‘morphenate’
(b) Morphine solution filtered
- rice sacks / burlap bags
- reheated / not boiled
(c) Ammonium chloride added
- 1/14th mass of opium
- pH solution: 8 / 9 cooled
(2) Morphine base settles to bottom
-
poured off / cloth filters
chunks morphine base
squeezed / set out to dry
coffee-colored powder
(3) Hydrochloric acid / activated charcoal
- heated = morphine hydrochloride
- filtered: remove charcoal / impurities
(a) Sun dry = morphine hydrochloride
- fine white powder
- pressed: 1 kilogram (kg) bricks
c. Convert to heroin
(1) Morphine base
- acetic anhydride / 3 times mass
- heated: 185 degrees / not boiled
(2) Stainless steel / enamel pot
- lid clamped down
- cook 5 hours
(3) Filter: soda ash / chloroform
- 700 grams heroin per kilo morphine
Narcotic Abusers
1.
2.
In the United States, there are more than
800,000 people addicted to heroin
- as well as other narcotics / but primarily
heroin
National Household Survey
- estimated more than 1.4 million Americans
have tried heroin at least once
- most are chronic users who are older and
inject the drug
- the number of younger users is growing and
are more likely to snort or smoke heroin
3.
4.
Narcotic abusers, cont
Most young people are considered occasional
or controlled users
- they are called ‘chippers’
- using only once in awhile or on weekends
- and take narcotics in a controlled way
- this contradicts the commonly held notion
that a person is either an abstainer or addict
Controlled user pattern
- seldom use the drug more than once a day
- can keep opiates around without using them
- do not use opiates to alleviate depression
5.
6.
Narcotic abusers, cont
seldom, if ever, binged on opiates
knew the opiate source or dealer
took opiates for recreation or relaxation
did not take opiates to escape from life’s
daily hassles
Patterns of use
- patterns of narcotics use do deviate sharply
- it is difficult to know the exact extent
67 % of heroin addicts are male
- 33 % female
Narcotic abusers, cont
7.
8.
- 69 % are Caucasian
- 31 % of other minority races
1/3rd of all addicts live in New York City
- 40 % are Caucasian
- 40 % are African-American
- 20 % are other minorities
- 25 % (1/4th) are females
The majority of new users are middle-income
- they inhale heroin rather than injecting it
- young blacks in NYC are deliberately
avoiding it
Narcotic abusers, cont
9.
Viet Nam War
- it is estimated that 10 % to 15 % of US
troops were addicted to heroin
- it was 95 % pure / inexpensive / sold openly
- primarily smoked with tobacco or marijuana
Licit and Illicit Uses
1.
2.
3.
Two primary pain-killing drugs are derived
from opium
- morphine and heroin
Opiates
- 3 natural components can be extracted from
opium
- morphine / codeine / and thebaine
Opiate derivatives
- from morphine you derive heroin / Dilaudid
/ Numorphan
- from Thebaine: Percodan / etrophine
Licit and illicit, cont
Synthetic opiates
- methadone / Demerol / Darvon / Orlaam
- they are unrelated to morphine
- but produce opiate-like effects
5. Methadone
- invented by a German scientist during WWII
- chemically unlike morphine or heroin
- produces many of the same effects
6. Introduced into the United States in 1947
- used to treat narcotic addiction
- used as an oral solution tablet, but also injectable
4.
Licit and Illicit, cont
7.
8.
- it is almost as effective administered orally- it is a Schedule II drug
Methadone is taken every 24 hours (once per
day)
- it blocks the effects of heroin
- while discouraging continued use
In chronic administration tolerance develops
- a person can become dependent
- withdrawal develops more slowly
- symptoms are less severe
Characteristics of Narcotics
1.
2.
3.
4.
Opiates are narcotics
- many times you hear all illegal drugs are
narcotics
Opium
- comes from the opium poppy
- papaver somniferum = the “plant of joy”
It was cultivated in the Middle East and Asia
- grows to a height of 3 to 4 feet
- has white / red / or purple flowers
After petals fall, an egg-shaped pod is left
Characteristics, cont
5.
6.
- slits are made on the sides of the pod
- a white, milky sap comes out
Once dried, a brown, thick gummy resin forms
- this is opium
- the poppy only as 10 days to manufacture
opium
Morphine
- Frederich Serturner, a German chemist
synthesized morphine from opium in 1803
- he called it ‘morphium,’ named for
Morpheus, the Greek god of dreams
7.
8.
Characteristics, cont
Effects occur more rapidly than opium
- it is 10 times more potent and the most
effective drug for severe pain
- morphine sets the standard, and all other
analgesics are measured by it
- taken orally it is not very effective
- it builds in the spleen / liver / kidney / lungs
Codeine:
- another alkaloid isolated 30 years later
- a Greek word meaning ‘poppy head’
- which can also result in dependency
Codeine
Another alkaloid that was isolated 30 years later
- it is a Greek word meaning ‘poppy head’
- codeine can also result in dependency
2. Codeine is the most widely used, naturally occurring
narcotic in medical treatment in the world
- this alkaloid is also found in opium, but most of it
used in the US is produced from morphine
- it is usually prescribed for the relief of moderate
pain and cough suppression
- it can be in liquid form (Tylenol w/ Codeine)
- in tablet form (a single drug or a combination)
- or for severe pain, it can be injected
1.
Thebaine
1.
2.
A minor constituent of opium
- it is a Schedule II drug (as is codeine)
- chemically similar to morphine and codeine
It produces stimulatory effects rather than
depressant effects
- the US uses most of the drugs derived from
Thebaine
- such as Naloxone and Oxycodone
Heroin
1.
2.
Synthesized from morphine in 1874
- derived from the German word meaning
“heroic”
- promoted as a cure for morphine addiction
- later, morphine was touted as a cure for
heroin addiction
Manufactured by Bayer, a pharmaceutical
company in Germany
- and touted as a cure for coughs / bronchitis
/ and tuberculosis
- newspaper articles: a new type of aspirin
Heroin, cont
3.
- believed to be nonaddicting
- now we know: it is twice as addicting as
morphine
It is administered in several ways: smoked /
sniffed / and injected
- injected and smoked: the effects are rapid
- effects not as great when sniffed
- it is ineffective when ingested
- but more people sniff and smoke rather
than inject
Heroin, cont
4.
It is 3 to 10 times more powerful than
morphine
- because it is much more lipid-soluble
- it reaches the brain more quickly with higher
concentrations
Synthetic Opiates
1.
2.
3.
They are chemically constructed rather than
naturally produced
- elicit effects behaviorally similar to morphine
- but they bear little chemical resemblance
The differ in duration / action / potency /
intensity / and effectiveness
- example: Demerol / Dolophine (methadone)
/ Percodan / Talwin / and Darvon
- drugs that are available only by prescription
Fentanyl
- a synthetic opiate stronger than heroin
Synthetics, cont
4.
5.
- it has similar analgesic effects
- is either injected or snorted to be effective
- called “China white”
Oxycontin
- from 1996 to 2000, painkiller prescriptions
grew dramatically
- they tripled in sales to $1.8 billion
This is when oxycontin gained much attention
- a particularly strong painkiller
- it blocks pain signals from the nerves
Synthetics, cont
6.
7.
- it takes fewer pain pills and lasts 3 times
longer
Oxycontin and Percodan
- account for around 6,500 ER visits each year
- and possibly hundreds have died
The abuse is acute in the Appalachia region
- this is why it is called “hillbilly heroin”
Physical and Psychological Effects
of Narcotics
1.
2.
3.
95 % of all narcotic abuse in the US is heroin
- the impact on each individual can vary
- due to quantity / purity / administration /
interval / and tolerance
Endorphins
- are naturally produced chemical substances
- that alter sensory perception and reaction
Feelings derived from narcotics can be
induced naturally by release of endorphins
Effects, cont
4.
5.
They regulate a person’s response to stress
and pain
- it is the same chemical that produces the
“runners high”
Many dangers are associated with narcotics
- most arise from their illicit status
- physical problems: using unclean and/or
unsafe environments, and from people
associated with drugs (murder / assaults)
- unregulated industry: contaminated
drugs / mixed drugs / what it is ‘cut’ with:
sugars / starches / quinine / strychnine
Effects, cont
6.
- how administered: sharing needles with
those who have a medical illness (hepatitis /
AIDS-HIV)
- using dirty needles resulting in abscesses /
heart inflammation / blood poisoning
Physical effects
- narcotics cause drowsiness / vomiting /
nausea / difficulty concentrating / pupils
constrict / lower body temperature / dilated
blood vessels / lower blood pressure / and
abdominal pain (muscle cramps)
Effects, cont
7.
8.
Psychological effects
- the use of narcotics does effect both social
and emotional health
- can result in depression / mood changes /
wanting to sleep / anger / suspicion / not
trusting / want to be alone / embarrassment
Withdrawal symptoms
- drugs block the physical effects of heroin
- they do not eliminate psychological desire
- majority of those entering treatment relapse