1
Opiates Factsheet
Opiates Factsheet
Lindsey Rasmussen
Physiological Complications & Psychopharmacology
2
Opiates Factsheet
Definition/Description
Opiates are (1) naturally occurring substances derived from the opium poppy; or (2)
synthetic or semi-synthetic substances created to mimic the effects of natural opiates. All
opiates, whether naturally occurring or synthetically equivalent, have similar
pharmacological features: the potentiality for abuse and the ability to relieve pain,
suppress cough, and/or reduce intestinal movement, which can reduce severe diarrhea
(but can also cause constipation).
Types
Natural: opium and its naturally occurring derivatives (ex. morphine and codeine).
Semisynthetic: chemical alterations of natural opiates; a hybrid of natural and
“manmade” opiates (ex. heroin, hydrocodone, oxycodone, and buprenorphine).
Synthetic: created from chemicals other than opium and its derivatives; fully “manmade”
opiates (ex. methadone and fentanyl).
Prescription & Street Names
Natural
codeine
morphine
opium (illicit)
cough syrup, T-three’s, schoolboy
dreamer, M, Miss Emma, monkey, white stuff
big O, black stuff, block, gum, hop
Semisynthetic
buprenorphine
diphenoxylate
heroin (illicit)
hydrocodone
hydromorphone
oxycodone
oxymorphone
nalbuphine
bupe, sub(s)
Lotomil (trade name)
black tar, China white, dope, H, horse, smack
vikes, viko, norco, hydro
D, dillies, dust, footballs, juice
OC, oxy, oxy cotton, hillbilly heroin, percs
Mrs. O, octagons, stop signs, O bomb
Nubain (street and trade name)
Synthetic
dextromethorphan
fentanyl
loperamide
meperidine
methadone
pentazocine
propoxyphene
tramadol
CCC, candy, DM, DXM, robo, triple C, velvet
apache, china girl, dance fever, friend, tango
Imodium (trade name)
demmies, pethidine
amidone, chocolate chip cookies, fizzies
yellow footballs
footballs, N’s, pinks, 65’s
Ultram (trade name)
3
Opiates Factsheet
Therapeutic Uses
Analgesics: opiates are most commonly used to relieve pain. They are very effective
analgesics, but can also cause significant side effects. Therefore, the clinical use of opiates
tends to be limited to the treatment of moderate to severe pain.
Antitussives: opiates can be used to effectively suppress coughing. Codeine is commonly
included in prescription cough medicine.
Anti-diarrheal: opiates also slow the movement of materials through the intestines so
can be used to relieve diarrhea. This property is also responsible for the opiate side effect
of constipation.
Effects of Abuse
Opiates affect the following systems of the body: pain, stress, temperature, respiration,
endocrine and gastrointestinal activity, mood, and motivation. Therefore, in addition to
relieving pain, cough suppression, and reducing diarrhea, opiates also cause an array of
physiological effects, such as euphoria, decreased anxiety, drowsiness, mental clouding,
respiratory depression (suppressed breathing is usually the cause of death resulting from
overdose), constipation, inability to urinate, itching, pinpoint pupils, a drop in blood
pressure, nausea, and vomiting. Furthermore, both prescription and illicit opiates cause
similar effects, dependency, withdrawal symptoms, overdose, and even death.
Withdrawal Effects
Opiate withdrawal (or dope-sick) refers to a wide range of symptoms that result after
stopping or significantly reducing the use of opiates after heavy, prolonged use. Symptoms
of opiate withdrawal can include any or all of the following: agitation, anxiety, aching bones
and muscles, insomnia, intense cravings, runny nose, sweating, hot and cold flashes, raised
blood pressure, faster pulse, yawning, stomach cramps, diarrhea, dilated pupils, loss of
appetite, nausea, and vomiting.
Withdrawal symptoms are not life threatening, but are very uncomfortable and can begin
anywhere from 4 hours (heroin) to 24 hours (methadone) after the last use. Overall, the
severity, intensity, and timeframe of withdrawal vary according to the purity and strength
of the drug used as well the user’s personality. However, even after withdrawal symptoms
have subsided, usually after 4 to 5 days, the compulsion to use remains strong.
4
Opiates Factsheet
Health Risks of Abuse
Opiate abuse is associated with serious health conditions, including fatal overdose, and
especially in users who inject, collapsed veins and the spread of infectious diseases such as
HIV/AIDS and hepatitis. Women who use heroin or other opiates during pregnancy often
give birth to babies who are physically dependent and thus have to be treated for
withdrawal symptoms. There is also evidence that the use of heroin during pregnancy
increases the likelihood of sudden infant death syndrome (SIDS). Overall, addicts in general
tend to neglect their health and safety in favor of the drugs.
Treatment Approaches
General approaches for the treatment of opiate abuse and/or dependency are rapid detox,
replacement therapy, and the use of naloxone or naltrexone. Rapid detox is a controversial
method in which the addict is placed under anesthesia and is injected with large amounts
of opiate-blocking drugs, with the thought that this will speed up the return of the user’s
body to normal functioning and upon waking is no longer physically addicted to opiates.
Follow-up care is recommended. However, no independent studies have been carried out
to determine this treatment’s effectiveness, therefore the risks of this procedure
significantly outweighs the potential, unproven benefits.
Replacement therapy involves using methadone or buprenorphine in the treatment of
opiate addiction. The thought is that opiate abuse causes significant and long lasting
chemical changes in the brain and the majority of opiate addicts require medication to
correct these changes. Methadone and buprenorphine alleviate withdrawal symptoms and
suppress cravings, but these medications by themselves are not nearly as effective as when
they are part of a comprehensive treatment plan that includes mental health care,
counseling, and self-help groups.
Naloxone and the related drug naltrexone are antagonists and thus prevent opiates from
having an effect by blocking or reversing their effects. Naloxone is also a useful antidote in
the treatment of opiate overdoses. However, if these drugs are not used carefully they can
also precipitate severe withdrawal symptoms in opiate-dependent people.
5
Opiates Factsheet
References
Hanson G. R., Venturelli, P. J., & Fleckenstein, A. E. (2012). Drugs and society (11th ed.).
Burlington, MA: Jones & Bartlett Learning.
National Institute on Drug Abuse (2011). Commonly abused prescription drugs chart.
Retrieved from http://www.drugabuse.gov/drugs-abuse/commonly-abusedprescription-drugs-chart.
National Institute on Drug Abuse. Facts on opioids [PDF Document]. Retrieved from
http://teens.drugabuse.gov/peerx/pdf/PEERx_Toolkit_FactSheets_Opiods.pdf.
National Institute on Drug Abuse (2011). Research reports: Prescription drugs: Abuse and
Addiction. Retrieved from http://www.drugabuse.gov/publications/researchreports/prescription-drugs.
Street names for opiates. Retrieved from http://www.opiaterehabtreatment.com/
street-names-opiates.
The American Heritage Stedman’s Medical Dictionary. Opiate. Retrieved from
http://dictionary.reference.com.
U.S. Department of Justice. Drugs and chemicals of concern. Retrieved from
http://www.deadiversion.usdoj.gov/drugs-concern.html.