Heroin constipation

Users of fentanyl analogues report that these drugs produce a rapid rush or euphoria that is similar to that felt with heroin, followed by a sedated, dream-like state. As analgesics, they also produce a profound loss of pain sensation and have common unwanted side effects such as sleepiness and constipation. However, because they are so potent, fentanyl analogues can... 

Opium Street Names Auntie Emma, big O. black stuff, block, gum, hop, ope, tar (brand generic called tincture of opium, laudanum, paregoric (CUT), B O suppositories [C1H]) Use Some medical uses (antidiarrheal, antitussive, antispas-modic) illegally used to produce morphine and heroin can be swallowed or smoked Actions Narcotic contains morphine Effects Pain relief, euphoria, drowsiness/N, constipation, confusion, sedation, resp depression and arrest, tolerance, addiction, unconsciousness, coma, death... 

In the second study there were 174 patients in two similar experimental groups in whom injectable rather than inhaled heroin was used (5). A response to treatment was defined as at least a 40% improvement in physical, mental, or social domains of quality of life, if not accompanied by a substantial (over 20%) increase in the use of another illicit drug, such as cocaine or amphetamines. After 12 months those who took methadone and heroin (smoked or injected) had significantly better outcomes. The incidences of adverse effects (constipation and drowsiness) were similar in all the groups. However, owing to the limitations of the study and the complex nature of drug dependence, the therapeutic outcomes could not be justifiably and solely attributed to the specific drug(s). 

The analgesic methadone (Fig. 12.25) was discovered in Germany during the Second World War and has proved to be a useful agent comparable in activity to morphine. Unfortunately, methadone retains morphine-like side-effects. However, it is orally active and has less severe emetic and constipation effects. Side-effects such as sedation, euphoria, and withdrawal are also less severe and therefore the compound has been given to drug addicts as a substitute for morphine (or heroin) in order to wean them... 

Volunteer postaddicts who receive subcutaneous or oral methadone daily develop partial tolerance to the nauseant, anorectic, miotic, sedative, respiratory-depressant, and cardiovascular effects of methadone. Tolerance develops more slowly to methadone than to morphine in some patients, especially with respect to the depressant effects this may be related in part to cumulative effects of the drug or its metabolites. Tolerance to the constipating effect of methadone does not develop as fully as tolerance to other effects. The behavior of addicts who use methadone parenterally is strikingly similar to that of morphine edicts, but many former heroin users treated with oral methadone show virtually no overt behavioral effects. 

The medical addict usually confines himseK to morphine, but criminal addicts more frequently employ heroin and cocaine when available (Simon, 76). The danger of heroin lies in the ease ivith which addiction occurs, the intense euphoria which often supplants subjective depression, and the absence of unpleasant effects such as vomiting and constipation. The heroin addict is difficult to treat, usually relapses after apparent cure, and often represents a dangerous, asocial, and criminal type of personality. The morphine addict takes morphine in order to feel normal and prevent the appearances of withdrawal symptoms but the heroin addict continues his drug for the euphoric excitation it affords (69). 

Papaverine is an inhibitor of cyclic nucleotide phosphodiesterase, producing vasodilatory effect. The acute toxic effects relative to phenanthrene-type opium alkaloids (e.g., morphine, heroin) are low and the symptoms are not the same. Papaverine is neither a narcotic nor an addictive substance. Excessive doses may produce drowsiness, headache, facial flushing, constipation, nausea, vomiting, and liver toxicity. 

Methadone is frequently used to treat heroin, codeine, hydrocodone, oxycodone, and morphine addictions. Methadone when used as prescribed, is safe and effective and does not cause euphoric sensations but does relieve physical withdrawal symptoms and reduces physiologic cravings. Methadone does have side effects which may be intolerable to some patients. They include constipation, water retention, drowsiness, skin rash, excessive sweating, and change in sex drive. Methadone has been used successfully in the treatment of opioid addiction for over 30 years. 

Observational studies The use of naltrexone implants in 23 prison inmates before release from prison reduced the frequency of benzodiazepine and/or heroin use and criminality at 6 months after release but was associated with adverse reactions [18. Pruritus and rash at the implantation site were reported by two patients. Headache, nausea, reduced appetite, sleep disorders, restlessness, and irritability were reported by more than half of the patients. Constipation, diarrhea, and muscle/joint pains were uncommon. There were no serious adverse events. 

R Morphine Heroin Oxymorphone Hydrocodone Fentanyl, etc. Endomorphins Central depression Anrilgesia euphoria respiratory depression bradycardia hypothermia constipation physical dependence... 

---