Heroin and opiates

Opiates are narcotic analgesics (from the Greek narcotikos meaning benumbing and analgesia meaning painlessness), and they remain 

Research into the properties of opiates has provided more insights into the processes that make up psychopharmacological actions than any other class of drug this is because opiates bind to receptor sites that are affected by endorphins - the brain s indigenous opiates. These endorphins are implicated in pain thresholds, natural highs and our capacity for addiction to opiates. 

As use became more widespread, opium developed into a valuable commodity and worldwide trade grew. Although opium smoking is firmly affixed by folklorists to 

The most common illicitly used opiate in modern times is heroin (known on the street as smack , H , skag or junk ). In a survey of British schoolchildren aged 15 and 16 in 1999, 3.4% of boys and 3.7% of girls reported having tried heroin, though large 

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Heroin and other opiates are controlled under the Misuse of Drugs Act making it illegal to possess them or to supply them to other people without a prescription. Heroin is treated as a Class A drug where the maximum penalties are 7 years imprisonment and a fine for possession and life imprisonment and a fine for supply. 

Table 1 provides the urinalysis test results for the 4,847 arrestees, While PCP was tested for by an EMIT test only, cocaine, opiates and methadone were tested for by both EMIT and thin layer chromatography (TLC). (The EMIT test for opiates is not specific to morphine, the metabolite of heroin, and can detect the recent use of a variety of opiates. A specimen positive for opiates is most likely to indicate the use of heroin in this population, however.) Our analyses will use only the results from the EMIT tests, because we have learned that the TLC general drug screen is less sensitive for detecting recent use of these illicit street drugs (Wish et al. 1983 Wish et al. 1984). 

Methadone A synthetic opiate used in the maintenance therapy of former heroin and morphine dependents. 

The analysis of codeine, morphine, 6-monoacetylmorphine (6-MAM, a metabohte of heroin), and cocaine is important for many toxicology labs to determine illicit drug use. When analyzing opiates in urine samples, frequently the matrix chosen for drug screening, the conjugated metabolites must be hydrolyzed however, this process can break down 6-MAM (Christophersen et al., 1987). These compounds can be derivatized to increase sensitivity, and both BCD and NPD are used for these assays. Derivatizations used include reaction with N-methyl-N-trimethylsilyltrifluoroacetamide followed by GC-FID (Lin et al., 1994) or with N,0-bis(trimethylsilyl)trifluoroacetamide (Christophersen et al., 1987 Lee and Lee, 1991), PFPA (Christophersen et al., 1987), or heptafluorobutyric anhydride (HFBA) followed by GC-ECD. All these methods show good sensitivity and selectivity. 

It has been shown that after stress or injury, the brain produces and releases its own natural version of opiates to control pain and ease anxiety. People with PTSD continue to produce elevated levels of natural opiates after the trauma has passed. In addition, there exists an increased use of heroin and other opiate-based drugs of abuse among patients with PTSD. Once more, it is difficult to determine whether these elevated natural opiates existed before the disorder developed. 

As previously mentioned, the detection period for a drug depends on a number of factors, including the type of opiate, the type of sample, the frequency of drug use, metabolic rate, age, body mass, drug tolerance, and overall health. Generally speaking opium can be detected for 5-7 days after its use. Other opiates such as heroin and codeine have significantly shorter detection periods (Table 10.3). 

Gerra G, Marcato A, Caccavari R et al. (1995). Clonidine and opiate receptor antagonists in the treatment of heroin addiction. Journal of Substance Abuse Treatment, 12, 35-41. 

The increase in illicitly manufactured heroin is at least consistent with the view that the clinics, in the attempt to avoid supplying the black market, went too far the other way and erred on the side of too restrictive prescribing. It is important to note that this does not mean that, in the very different situation of the late 1980s, an increasing liberalisation of opiate prescribing would necessarily have any significant impact on the extent of the illicit market. However, now that there is a relatively reliable black market in heroin, and very little (particularly for new patients) at the clinics, there is less incentive to enter treatment harm reduction can therefore be offered to a smaller proportion of users via this setting. 

Drug takers using the service have typically been in their twenties and early thirties (with a mean age of 28). During the first twelve months of operation 57 per cent of clients had problems with opiates (mainly heroin) and 22 per cent with stimulants (mainly amphetamine sulphate). A large number (57 per cent) took their drugs by injection. Half of the team s contacts took place in clients homes, half in their own premises. Some in-patient contacts are made in the local psychiatric hospital, some in the regional detoxification unit at... 

Buprenorphine, another synthetic opioid, is a more recently approved medication for treating addiction to heroin and other opiates. It can be prescribed in a physician s office. 

Changes in the use of heroin and other opiates, 2005 (or latest year available)... 

More than half (57 %) of all seizure cases involved cannabis (herb, resin, oil, plants and seeds). Opiates (opium, morphine, heroin, synthetic opiates and poppy seeds), accounted for 17 per cent, with heroin alone accounting for 14 per cent of the total. This is followed by seizures of the amphetamine-type stimulants (12 %). About half of these seizures (or 5.5 % of the total) is accounted for by methamphetamine, followed by amphetamine (2.5 %) and ecstasy (2%) the rest (2 %) includes Captagon tablets (Near East) and Maxiton Forte (Egypt), ephedrone (methcathinone) and various undefined amphetamines. Coca products account for 9 percent of global seizure cases the bulk of coca related seizure cases concern cocaine (8 % of total). 

In 2006, out of all opiates that left Afghanistan, 53 per cent went via Iran, 33 per cent via Pakistan and 15 per cent via Central Asia (mainly Tajikistan). If only heroin and morphine are considered, the bulk is estimated to have left Afghanistan via Pakistan (48%), followed by Iran (31%) and Central Asia (21%)3... 

About 71 per cent of the worlds 15.6 million opiates users abuse heroin. This amounts to 11 million people. The proportions, however, vary significantly by region. Whereas almost all opiates consumers in Africa reportedly use heroin, only one third consume that substance in Oceania. This particular pattern is due to difficulties in accessing heroin and the availability of synthetic opiates. 

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