Opiates, sometimes referred to as narcotics, are a group of drugs which are used medically to relieve pain, but also have a high potential for abuse. Some opiates come from a resin taken from the seed pod of the Asian poppy. This group of drugs includes opium, morphine, heroin, and codeine. Other opiates, such as meperidine (Demerol), are synthesized or manufactured.
Opium appears as dark brown chunks or as a powder and is usually smoked or eaten. Heroin can be a white or brownish powder which is usually dissolved in water and then injected. Most street preparations of heroin are diluted, or “cut,” with other substances such as sugar or quinine. Other opiates come in a variety of forms including capsules, tablets, syrups, solutions, and suppositories. Heroin (“junk” “smack”) accounts for 90 percent of the opiate abuse in the United States.
Sometimes opiates with legal medicinal uses also are abused. They include pethidine, morphine, meperidine, paregoric (which contains opium), and cough syrups that contain codeine [or a synthetic narcotic, such as dextromethorphan]. Opiates tend to relax the user. When opiates are injected, the user feels an immediate “rush.” Other initial and unpleasant effects include restlessness, nausea, and vomiting. The user may go “on the nod,” going back and forth from feeling alert to drowsy. With very large doses, the user cannot be awakened, pupils become smaller, and the skin becomes cold, moist, and bluish in color. Breathing slows down and death may occur.
There are a number of synthetic opiates which are used as painkillers such as pethidine and methadone which is often prescribed for heroin and opiate addiction. Collectively opiates and synthetic opiates are called opioids. Opioids powders can be swallowed or dissolved in water and injected, particularly into a vein which maximizes the effect. Heroin is sometimes sniffed, or the fumes from the heated powder is inhaled (this method is sometimes called “chasing the dragon”).
Most opiates are taken orally, except heroin, which is in powder form. Heroin users generally begin sniffing the drug and gradually advance to injecting. The powder is dissolved in water and heated to produce a liquid. The user then injects the substance either subcutaneously or intravenously. Subcutaneous injection (“skin popping”) is when a heroin solution is injected into the layers of skin, usually in the arms or thighs. Intravenous injection (“mainlining”) is when the heroin is injected into a vein.
The effects of injecting heroin are felt within minutes and last three to four hours, depending on the dosage. The large majority of heroin is illegally manufactured and imported, which originates largely from the Indian sub-continent. When sold at street level it is likely to have been diluted or cut with a variety of similar powders. The main dilutant is glucose. However, the practice of using other substances such as caffeine, flour and talcum powder is a constant danger to users.
Long-term use of opioids causes tolerance to develop so that in order to achieve the same degree of euphoria, larger and larger doses must be taken. When people have been off the drug for some time their tolerance decreases and a common cause of death results from a user taking the same amount of drug used before they stopped or cut down. When high doses have been taken for several weeks, a sudden withdrawal causes symptoms of discomfort similar to flu. These include aches, sweating and chills, tremor, sneezing and yawning and muscular spasms, all or some of which usually commence between 8 and 24 hours after the last dose of heroin. Although these effects usually fade within 7 to 10 days, feelings of weakness and loss of well being can last for several months. Physical dependence is easier to overcome than psychological dependence, which some long-term users develop, although dependence of any kind is not a certainty. Some people can use heroin on an occasional basis and not become addicted. Prolonged usage can cause physical damage to the body, although not necessarily from the drug itself. Repeated injections with dirty needles can result in diseases such as Hepatitis, AIDS and Tetanus, especially when sharing needles. There is also a risk of using impure drugs which have been mixed with unknown substances. Repeated sniffing of heroin damages the nose. Apathy and reduced appetite caused by drug use can lead to disease as a result of a poor diet, self neglect and bad housing conditions. The increasing cost of satisfying tolerance / dependence can lead to money problems which can result in self neglect and major social problems.
Common psychological effects of opiate use
Like other depressants, opiates produce a tranquil and euphoric effect. Users who inject an opiate such as heroin may also experience a “rush” as the drug circulates through the body. Some users combine opiates with a stimulant such as cocaine. This is called “speed balling.” The stimulant keeps the user from falling asleep; the opiate reduces the hyperactive effects often caused by stimulants. Psychological dependence is probable with continued use of opiates. When a user becomes dependent, finding and using the drug becomes the main focus of life. Opiates induce tolerance: the need for more of the drug in order to produce the same effects.
Common physical effects of opiate use
The physical effects of opiates depend on the opiate used, its source, the dose and the method used. Opiates slow breathing, heart rate and brain activity. Opiates depress appetite, thirst and sexual desire. The body’s tolerance to pain is increased. Potential contamination, using opiates in combination with other drugs, and using un-sterile needles all increase the danger of opiates. Use of un-sterile needles can lead to hepatitis, tetanus or AIDS. Regular opiate users who abruptly stop using the drug experience withdrawal symptoms four to six hours following the last dose. Symptoms include uneasiness, diarrhoea, abdominal cramps, chills, sweating, nausea, runny nose and eyes, irritability, weakness, tremors and insomnia. The intensity of these symptoms depends on how much of the drug was taken, how often and for how long. These symptoms are usually strongest 24 to 72 hours after onset and can persist for seven to 10 days.
Common effects of opiate use on pregnancy
Opiates are harmful to a developing foetus. Pregnant women who are dependent on opiates have a higher risk for spontaneous abortions, breech deliveries, premature births and stillbirths. Babies born to opiate-addicted mothers often have withdrawal symptoms similar to adults. These symptoms may last several weeks or months. Researchers have also found an increased risk of Sudden Infant Death Syndrome (SIDS) among babies born to heroin-addicted mothers.
Common signs and side effects of opiate use
Some signs and symptoms of opiates include: lethargy, drowsiness, constricted pupils and reduced vision, shallow breathing, needle or track marks on inner arms or other parts of the body from injecting needles, redness and raw nostrils from sniffing heroin, excessive perspiration, shaking, vomiting, chills.
Opiate addiction treatment programs
Opiates are highly addictive drugs. Recovery and rehabilitation from opiate addiction may require a treatment program ranging from certified addiction counselling to treatment at a residential alcohol and drug rehab centre, depending on the extent of the addiction and a number of other factors.
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