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Opioids & Opiates

Opioids are lipid soluble and once they enter the blood they are turned into metabolites and then exit the body through urine.  The brain has opioid receptors which are called endorphins which store synaptic vesicles.  Endorphins get released into the blood via the pituitary gland and are then distributed to the entire body.  Opioids produce analgesia which in turn makes a person comfortably sleepy.  Analgesia is what helps a person lose sensation to pain.

Opioids originate from poppy.  Poppy is a plant with a 10 day life cycle and opium is what comes out of the pods of the poppy plant.  Morphine and Codeine are two main ingredients that come from opium and heroin is partially synthetic.  Poppy plants have been around since before 4200 B.C. and were originally used to treat medical conditions.  They were also often used for social and religious purposes.

Scientists have discovered that opioids block incoming sensory information and also reduce the emotional part of pain that is found in the frontal cortex where there are more opioid receptors.  This is why opioids effectively reduce all types of pain including acute and chronic pain and all sensations that are related.

Opioids are extremely addictive for many reasons.  When opioids enter the blood they advance to the blood brain barrier and activate the opioid receptors in the brain.  There are three types of receptors, mu, kappa, and delta.  These receptors, when activated, distribute a pleasant feeling or relief to pain throughout the body.  These receptors are naturally occurring in the brain and will activate all on their own when the body is under stress or feeling pain.  This is the body’s natural ability to release endorphins to help with pain management.  When a person takes opioids, they are helping the body produce those feelings in a much larger quantity.  When on opioids, the body is virtually pain free.  If the body was not in pain to begin with, the body will feel extremely euphoric and pleasant.  The body will start to feel the withdrawal a few hours later and those unpleasant feelings will immediately stop after taking another dose of opioids.  This is one of the main reasons that opioids are so addictive.  Pretty quickly, the body will start building a tolerance so the need for a higher dosage is in the body’s demand.  The longer a person is taking opioids, the harder it is to withdrawal.  Opioids also reduce the aversive emotional aspect of pain.  So addiction with opioids is physical and psychological.  Once the physical part of the withdrawal is gone, there is still the psychological part that is much harder to overcome.

Unlike other drugs, the health effects of an opioid addict are few but there are some harmful acute and chronic effects that take place.  Some acute effects include depression of breathing and pinpoint pupils.  Overdose is possible and when this happens, basically a person just falls into a coma and dies from the depression of breathing.  Some chronic effects include lower sperm count in men and constipation.  There are also links to cancer.  The reason for this is that opioids stop the body from repairing damaged DNA molecules which in turn can cause the molecules to turn into to cancer.  Specifically when a person smokes opioids there is a direct link to bladder cancer.

Because withdrawal from heroin is so excruciating, doctors wanted a way to be able to eliminate or help patients relieve some of the stress of withdrawal.  Methadone was created to do just that.  Methadone blocks the pleasant effects heroin would have on the body if an addict tried to take heroin.  Methadone is safer for a few reasons.  First, it can be taken orally and it prevents the horrible withdrawal symptoms heroin has on the body.  However, there is a lot of pressure put on methadone patients.  The fact that they have to go into a clinic every day to receive this pill or they will be sick plays a huge role in the successfulness of using methadone to treat a heroin addiction.  For some users, it may not be possible to get to a clinic every single day and what if the patient wants to lead a normal life and go on vacations or have similar experiences?  Also, it is difficult to completely withdrawal from methadone and can produce the same yucky side effects that heroin does such as constipation and body sweats.

Three types of opioids are heroin, morphine, and codeine.  Heroin can be administered in many different ways.  It can be taken intranasaly, injected, or inhaled (chasing the dragon).  Heroin is only semi synthetic.  That means it partially comes from morphine.  Basically, once it hits the brain it turns into morphine.  The difference is that it crosses the blood brain barrier about 10 times faster than morphine does. Heroin cause endorphins to release into the blood by the pituitary gland and it is then released through the entire body. Heroin produces an analgesia which makes a person sleepy but not actually falls asleep. There are opioid receptors in the frontal cortex which reduce the emotional part of pain when heroin is administered. It also blocks incoming sensory information. When a person is addicted to heroin they tend to lead a lifestyle that revolves around obtaining the drug to avoid withdrawal.  Heroin is typically given to a person by the first time by a trusted friend and not someone who is trying to coerce them into developing a habit.  Some people never get addicted, some stop using after a period of time, but most end up in treatment because of the addiction.

Morphine was named after a Greek God and has been around since the early 1800s.  Morphine today is typically used in the medical field to treat pain.  It enters the body and absorbs slowly.  It doesn’t get to the brain very fast therefore it easier for the medical professional to keep the levels in the body constant.  People do get addicted to morphine but since heroin reinforces the pleasure at a faster rate most addicts choose the heroin over morphine.

Codeine is very legal and is available in the U.S. through prescription.  Codeine is natural active ingredient in opium.  It is less likely for a person to be addicted to codeine because of its slow absorption.