Opiates - University of California, Los Angeles Opiates.pdf · 2019-02-15 · • Thrombosis of major vessels and errosive bleeding • Large open ulcers, and gangrene • Respiratory

OpiatesBy Neal Deot & Adrina Kocharian

Background on Opiates

Opiates derived from poppy

Some types of Opiates Heroin Morphine Codeine

Background on Opiates What are they used for? Some are medically

prescribed as a long-term pain killer

Some are non-medically used as a drug to get high

What primary effect do they have? Analgesia

KrokodilUCLA Brain Institute Outreach

Introduction to Krokodil Consists of Desomorphine Desomorphine is similar to

morphine It was intended to be

created as another prescription pain killer

Had very potent and severe effects so it was removed from market

In Russia it resurfaced Homemade krokodil

morphine

desomorphine

Legality Schedule 1 Drug

Absolutely prohibited in the United States

Controlled internationally under Single Convention on Narcotic Drugs of 1961

So How Do People Get a Hold of It?

Krokodil is made from Codeine, which is legal

It is cooked and combined with extremely toxic chemicals

Red phosphorous

Gasoline

Hydrochloric Acid

Paint thinner

EffectsHigh Effects

Same drug effects as other opioids Analgesia Sedation Muscle

Relaxation Euphoria

Side Effects Venous damage and skin and soft issue infections

Rapidly followed by tissue necrosis and gangreneScaly, gray-green dead skin forms

• Thrombosis of major vessels and errosive bleeding• Large open ulcers, and gangrene• Respiratory depression • Skin and soft tissue infections to bone• Meningitis• Rotting gums and tooth loss• Bone infection, decayed structure of jaw and

other facial bones• Limb rotting• Pneumonia• Sepsis• Coronary artery rupture • Sores and ulcers on forehead and skull• Gangrenous wounds• Speech impediments• Motor skill impairment• Rotting ears, nose, and lips• Liver and kidney injury

Pharmacology About 10 times more potent than heroin

Faster onset so more instant gratification

Stronger effect than morphine and heroin

The high typically lasts longer than heroin high

Hard to know exact details

Mode of Action

Inhibitory GABA

dopamine

NO DOPAMINE IN SYNAPSE

Mode of Action

Inhibitory GABA

Krokodil

Dopamine

DOPAMINE IN SYNAPSE

Effects of Withdrawal Physical/ psychological

Feeling horrible physical and psychological pain

Anxiety

Increased sensitivity to pain

Diarrhea

Runny nose

Treatment in Addiction Antagonist Therapy

Overdoses are treated with a drug called Naloxonewhich blocks the receptor to which desomorphinebinds

Later, patients are maintained with Naltrexone

OpioidReceptor

N

N

N

N

N

N

Pre-Synaptic Neuron

Treatment for Addiction Subsitution Therapy

Given a medication that binds to the same receptor but induces a milder effect

So it’s less harmful and reduces horrible withdrawal

OpioidReceptor

B

B

B

B

B

B

B = buprenorphine

Pre-Synaptic Neuron

Heroin

Background Artificially produced from morphine

Gets into brain FASTER(“the rush”)

Was used for pain relief but TOO ADDICTIVE

Is Schedule 1 (MOST ILLEGAL)

Effects Extreme euphoric rush (lasts 15-45min)

Followed by relaxation state (1-3 hours)

Pain relief

Cough suppressant

Constipation

Death

stop breathing

dirty needle (HIV)

Mode of Action Slows down neuron (brain cell) firing

Increases dopamine levels

High + relaxed

Depressant

Pharmacokinetics High begins within 30 min Lasts up to 5 hours Methods Injection (fastest, shortest lasting)

Crosses blood brain barrier FAST Faster onset = more addictive Breakdowns into morphine

Orally (slowest, longest lasting) Smoked Snorted

Withdrawal Strong comedown

Anxiety and depression

Dependence

Receptors are desensitized so you need MORE to feel high again

Treatment Naltroxone

IMMEDIATE ACTION: prevents overdose

Kicks morphine off the receptors

Methadone (substitution)

longer lasting and less comedown

Instead of stopping use, it slows it

Suboxone (substitution)

feels good if ingested but bad if injected

Relevance

Robert Downey Junior (ex-user)

Philip Seymour Hoffman (death)

Chris Farley (death)