1. © Copyright 2011, Pearson Education, Inc. All rights reserved. Chapter 5 Narcotics: Opium, Heroin, and Synthetic Opiates

2. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiates Opiates are a form of narcotic drug that include opium and three natural components that can be extracted from it: morphine, codeine, and thebaine.

3. © Copyright 2011, Pearson Education, Inc. All rights reserved. Figure 5.1

4. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opium in History A drug with a very long history, opium has been used for medicinal and recreational purposes for approximately 5,000 years. During the nineteenth century, opium even figured in global politics as the instigating factor for the Opium War fought between China and Britain.

5. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opium in History At the time, opium use was widespread in Britain and the United States at all levels of society.

6. © Copyright 2011, Pearson Education, Inc. All rights reserved. Morphine and the Advent of Heroin The discovery of morphine in 1803 as the principal active ingredient in opium revolutionized medical treatment of pain and chronic diseases. At the end of the nineteenth century, heroin was introduced by the Bayer Company in Germany. Initially, it was believed that heroin lacked the dependence-producing properties of morphine.

7. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiates and Heroin in American Society The abuse potential of morphine and especially of heroin was not fully realized until the beginning of the twentieth century. Social and political developments in the United States after the passage of the Harrison Act in 1914 drove heroin underground, where it acquired a growing association with criminal life.

8. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiates and Heroin in American Society Heroin abuse became associated with African American and other minority communities in urban ghettos after World War II; later, the drug revolution and the military involvement in Vietnam during the 1960s and 1970s brought the issue of heroin abuse to a wider population.

9. © Copyright 2011, Pearson Education, Inc. All rights reserved. Effects on the Mind and the Body The effects of narcotic drugs such as heroin include euphoria, analgesia, gastrointestinal slowing, and respiratory depression. Respiratory depression is the major risk factor for heroin intake.

10. © Copyright 2011, Pearson Education, Inc. All rights reserved. How Opiates Work in the Brain Since the 1970s, we have known that the effects of morphine and similar drugs are the result of the activation of morphine-sensitive receptors in the brain.

11. © Copyright 2011, Pearson Education, Inc. All rights reserved. Figure 5.2

12. © Copyright 2011, Pearson Education, Inc. All rights reserved. How Opiates Work in the Brain Three families of chemical substances produced by the brain bind to these receptors. These chemicals are collectively known as endorphins.

13. © Copyright 2011, Pearson Education, Inc. All rights reserved. Patterns of Heroin Abuse Chronic heroin abuse is subject to tolerance effects over time.

14. © Copyright 2011, Pearson Education, Inc. All rights reserved. Table 5.1

15. © Copyright 2011, Pearson Education, Inc. All rights reserved. Patterns of Heroin Abuse Withdrawal effects include intense craving for heroin and physical symptoms such as diarrhea and dehydration. One of the major problems surrounding heroin abuse is the unpredictability in the content of a heroin dose.

16. © Copyright 2011, Pearson Education, Inc. All rights reserved. Table 5.2

17. © Copyright 2011, Pearson Education, Inc. All rights reserved. Treatment for Heroin Abuse Treatment for heroin abuse includes short-term detoxification and long-term interventions that address the continuing craving for the drug and physical dependence factors in the body.

18. © Copyright 2011, Pearson Education, Inc. All rights reserved. Treatment for Heroin Abuse Methadone-maintenance programs focus primarily on the physiological needs of the heroin abuser, whereas therapeutic communities and support groups focus on his or her long-term reintegration into society.

19. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiate Use, Misuse, and Abuse In medical settings, narcotic drugs have been extremely helpful in the treatment of pain, in the treatment of dysentery, and in the suppression of coughing.

20. © Copyright 2011, Pearson Education, Inc. All rights reserved. Table 5.3

21. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiate Use, Misuse, and Abuse Side effects of opiate-based medications include respiratory depression, intestinal spasms, and sedation. There has been great concern since the late 1990s that prescription pain relievers have been diverted to nonmedical purposes and are subject to abuse.

22. © Copyright 2011, Pearson Education, Inc. All rights reserved. Opiate Use, Misuse, and Abuse Three medications of this type are OxyContin, Vicodin, and Percocet. More than half of young adults who have used a prescription pain reliever for nonmedical reasons report that the drug was obtained free from a friend or relative.