Soc 204 Goldberg Chapter 8 Narcotics

SOC 204 Drugs & Society

Goldberg Chapter 8 Narcotics

Did you realize our class discussion on methadone is Wed?

A. Yep, I’m ready!

B. I do now.

C. Aren’t those usually on Fridays?

Yep, I’m re

ady!

I do now.

Aren’t those

usually

on ...

33%

17%

50%

Narcotics

Do you know someone who has used opioids recreationally in the last 30 days?

A. No

B. Yes, one person

C. Yes, more than one person

No

Yes, one perso

n

Yes, more

than one perso

n

68%

20%12%

Opium

At one time, heroin was given to morphine addicts to help them break their addiction to morphine.

A. True

B. False

True

False

0%

100%

Morphine Codeine Heroin

1914 Harrison ActMade opioids difficult to obtainOral use declinedCost and risk increasedView of addicts changed

Vietnam

Use among troops was about 10-15%Most users stopped upon returning to US

Review: Which two compounds are in the opium plant resin?

A. Oxycontin and heroin

B. Morphine and heroin

C. Morphine and codeine

D. Hydrocodone and codeine

Oxyco

ntin and heroin

Morp

hine and heroin

Morp

hine and codeine

Hydroco

done and codeine

0% 0%

92%

8%

Review: What impact did the Harrison Act have on opium use?

A. Opium use increased

B. Opium was no longer readily available

C. Illegal IV use decreased

D. Oral use increased Opium use

incre

ased

Opium was n

o longer r

ea...

Illegal IV

use decre

ased

Oral use

incre

ased

0% 0%0%

100%

Review: Upon returning to the US, soldiers who used opiates in Vietnam:

A. 70% were arrested for illegal drug use

B. 67% became homeless

C. 95% stopped using the drug

70% were arre

sted fo

r ill...

67% became homeless

95% stopped usin

g the dru

g

0%

96%

4%

Prescription NarcoticsHydrocodone & OxyContin

Narcotic Doses

Drug Therapeutic Dose Tolerant Dose Lethal Dose

Morphine 15-30 mg 100 mg 500 mg

Heroin 10-15 mg 60 mg 200 mg

Fentanyl 25 micrograms 2 mg

OxyContin 10 mg 40 mg 160 mg

1 mg = 1000 micrograms

Pharmacology

Raw opium is about 10% morphine, smaller amount of codeine

Heroin is made by adding two acetyl groupsAllows passing through blood-brain barrier faster

Mouse Party Enkephalins Endorphins

<iframe height='390' frameborder='0' width='420' style='border: 1px solid #ddd;' src='http://ezproxy.wwcc.edu:2048/login?url=http://digital.films.com/OnDemandEmbed.aspx?Token=40018&aid=7539&loid=63489&Plt=FOD&w=400&h=340'>&nbsp;</iframe>      

http://ezproxy.wwcc.edu:2048/login?url=http://digital.films.com/PortalPlaylists.aspx?aid=7539&xtid=45461

Medical UsesPain reliefTreatment of intestinal disorders

Cough suppressant

Physical Effects

Drowsiness (nodding out), vomiting, nausea, and difficulty concentrating

EuphoriaGradually anesthetizing sensationsDifficulty urinating, constipationConstricted pupils

Emotional EffectsRelief from anxiety, hostility, feelings of inadequacy, and aggression

Difficulty regulating inhibitions and frequently make risky decisions

Social EffectsAlienated from and hostile toward friends and family

Correlated with criminal behavior, unemployment, and violence

Review: Heroin’s effects do not include:

A. Sleepiness

B. Euphoria

C. Agitation

D. Pain relief

Sleepiness

Euphoria

Agitation

Pain re

lief

8%0%

88%

4%

Review: which of the following is NOT a medical use for narcotics?

A. Cough suppressant

B. Stop diarrhea

C. Induce sleep

D. Pain relief

Cough su

ppressa

nt

Stop diarrh

ea

Induce sl

eep

Pain re

lief

0% 0%

76%

24%

DangersTolerancePhysical dependencePsychological dependenceAcute & chronic toxicity

DependencyAbout half of narcotic abusers become dependent:Positive reinforcementNegative reinforcementCan develop in less than two weeks if they take

increasing amounts of narcoticsAverage addiction is six to eight years (aging out)

Toxicity

Respiratory depression can be fatal Synergistic effect when combined with depressants

Opioid Triad Coma Depressed respiration Pinpoint pupils

Blood borne pathogensContaminants

WithdrawalFactors affecting the difficulty of withdrawal:

Social support networkDesire to stopPhysical environment during withdrawalAlternative opiates

Signs Heroin orMorphine

Methadone

Craving for drugs, anxiety 6 24

Yawning, perspiration, running nose, teary eyes 14 34-48

Increase in above signs plus pupil dilation, goose bumps, tremors, hot and cold flashes, aching bones and muscles, loss of appetite

16 48-72

Increased intensity of above, plus insomnia; raised blood pressure; increased temperature, pulse rate, respiratory rate and depth; restlessness; nausea

24-36

Increased intensity of above, plus curled-up position, vomiting, diarrhea, weight loss, spontaneous ejaculation or orgasm, hemoconcentration, increased blood sugar

36-48

(hours after last dose)

Narcotic Withdrawal

Opioid Antagonists/AgonistsNaloxone - NarcanSuboxone

Naloxone & Buprenorphine

Methadone

Opinion: Do you agree with the use of suboxone or methadone to help a person quit using opioids?

A. Yes

B. No

YesNo

25%

75%

Which drug has the most dangerous withdrawal syndrome?

A. Heroin

B. Morphine

C. LSD

D. Alcohol

Heroin

Morp

hineLS

D

Alcohol

54%

36%

0%

11%

Because needle exchange programs have been shown to reduce the transmission of HIV infection, the federal government provides funding for needle exchange programs in selected large cities.

A. True

B. False True

False

33%

67%