Opiates
Opiates are an addictive drug, and its use is a serious
problem in America.
Opium appears either as dark brown chunks or in powder form, and is generally
eaten or smoked. Heroin usually appears as a white or brownish powder, which is
dissolved in water for injection. Most street preparations of heroin contain
only a small percentage of the drug, as they are diluted with sugar, quinine,
or other drugs and substances. Other opiate analgesics appear in a variety of
forms, such as capsules, tablets, syrups, elixirs, solutions, and
suppositories. Street users usually inject opiate solutions under the skin
("skin popping") or directly into a vein or muscle, but the drugs may
also be "snorted" into the nose or taken orally or rectally.
Opiates have been used both medically and non-medically for
centuries. A tincture of opium called laudanum has been widely used since the
16th century as a remedy for "nerves" or to stop coughing and
diarrhea. By the early 19th century, morphine had been extracted in a pure form
suitable for solution. With the introduction of the hypodermic needle in the
mid-19th century, injection of the solution became the common method of
administration.
Heroin was introduced in 1898 and was heralded as a remedy
for morphine addiction. Although heroin proved to be a more potent pain killer
(analgesic) and cough suppressant than morphine, it was also more likely to
produce dependence. Of the 20 alkaloids contained in opium, only codeine and
morphine are still in widespread clinical use today. In this century, many
synthetic drugs have been developed with essentially the same effects as the
natural opium alkaloids.
Opiates are associated with serious health conditions,
including fatal overdose, spontaneous abortion, collapsed veins, and,
particularly in users who inject the drug, infectious diseases, including
HIV/AIDS and hepatitis.
The short-term effects of opiates appear soon after a single
dose and disappear in a few hours. After an injection of an opiate such as heroin,
the user reports feeling a surge of euphoria ("rush") accompanied by
a warm flushing of the skin, a dry mouth, and heavy extremities. Following this
initial euphoria, the user goes "on the nod," an alternately wakeful
and drowsy state. Mental functioning becomes clouded due to the depression of
the central nervous system.
Long-term effects of opiates such as heroin appear after
repeated use for some period of time. Chronic users may develop collapsed
veins, infection of the heart lining and valves, abscesses, and liver disease.
Pulmonary complications, including various types of pneumonia, may result from
the poor health condition of the abuser, as well as from opiates depressing
effects on respiration.
When an individual uses opiates regularly, tolerance
develops. This means the abuser must use more opiates to achieve the same
intensity of effect. As higher doses are used over time, physical dependence
and addiction develop. With physical dependence, the body has adapted to the
presence of the drug and withdrawal symptoms may occur if use is reduced or
stopped.
Withdrawal from opiates can be exceptionally painful. In
regular opiate abusers, withdrawal may occur as early as a few hours after the
last administration. Withdrawal from opiates produces drug craving,
restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold
flashes with goose bumps ("cold turkey"), kicking movements
("kicking the habit"), and other symptoms. Major withdrawal symptoms
peak between 48 and 72 hours after the last dose and subside after about a
week. Sudden withdrawal by heavily dependent users who are in poor health is
occasionally fatal. However, heroin withdrawal is considered less dangerous
than alcohol or barbiturate withdrawal.
