Drugs and Our Society

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Drugs and Our Society

• CJUS/HPE 151
• Chapter 5 The Major Narcotics Opium, Morphine,
  and Heroin

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• Opium / opium derivatives / semi-synthetic
• - 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

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• (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

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• - powerful analgesic
• - reduce pain
• (a) Cough suppressant
• - alleviate diarrhea
• - induce anesthesia
• (b) Therapeutically
• - tension / anxiety / aggression
• (4) 1000s of years
• - sedating / painkilling / sleep-inducing
• - Greeks / Romans / Egyptians / Assyrians

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• 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

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• - 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

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• 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
• - worlds opium

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• (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

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• (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

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• 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

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• (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

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• (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
• - druggists opium

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• (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

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• 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
• (a) Opium left / putty-like consistency

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• (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

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• (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

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• - 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

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• 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

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Narcotic Abusers

• 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

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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

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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 lifes
  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

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Narcotic abusers, cont

• - 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

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Narcotic abusers, cont

• 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

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Licit and Illicit Uses

• 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

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Licit and illicit, cont

• Synthetic opiates
• - methadone / Demerol / Darvon / Orlaam
• - they are unrelated to morphine
• - but produce opiate-like effects
• Methadone
• - invented by a German scientist during WWII
• - chemically unlike morphine or heroin
• - produces many of the same effects
• Introduced into the United States in 1947
• - used to treat narcotic addiction
• - used as an oral solution tablet, but also
  injectable

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Licit and Illicit, cont

• - 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

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Characteristics of Narcotics

• 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

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Characteristics, cont

• - 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

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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

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Codeine

• Another alkaloid that was isolated 30 years later
• - it is a Greek word meaning poppy head
• - codeine can also result in dependency
• 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

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Thebaine

• 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

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Heroin

• 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

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Heroin, cont

• - 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

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Heroin, cont

• 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

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Synthetic Opiates

• 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

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Synthetics, cont

• - 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

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Synthetics, cont

• - 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

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Physical and Psychological Effects of Narcotics

• 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

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Effects, cont

• They regulate a persons 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

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Effects, cont

• - 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)

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Effects, cont

• 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