1. Opiates and Pain PAIN Spinal Cord Substance P BRAIN Opiates

2. OPIATES Synthetic Opiates MethadoneDemerolDarvon

3. 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: PhysiologicalHigh Pyschological High

4. Opiates DrugRouteDuration Opium oral/smoke3 - 6 hrs. Morphineoral/smoke/inject3 - 6 hrs. Codeine oral/inject3 - 6 hrs. Heroinsniff/smoke/inject3 - 6 hrs. Methadone oral/inject 12 - 24 hrs.

5. Immediate Effects Euphoria Drowsiness Pain reduction

6. Long-Term Effects Respiratory and circulation depression Dizziness Lowered libido Constipation Weight loss Coma Death

7. Opiates Symptoms of Overdose 1. Slow, shallow breathing 2. clammy skin 3. Convulsions 4. Coma 5. Death Treatment: Narcan (opiate antagonist)

8. 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

9. 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.

10. 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.

11. 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