Heroin morphine addiction

Opium has been used as a medicine for hundreds of years, inevitably creating countless addicts. Scientists have conducted a never-ending search for effective cures for opium addiction, morphine addiction (morphinism), and heroin addiction. For most of its history, opium addiction was treated as a disease with no cure, and doctors concerned themseives with treating the symptoms of addiction rather than the root cause. As a result, other opiates were used to lessen the effects of withdrawal. The addict is placed on a regimen of opiates that slowly decrease over time, weaning the addict from his or her addiction. This process of treatment is still used today. 

Many addicts, however, report that weaning themseives off of methadone is just as bad as coming off of heroin or morphine addiction. Ultimately, primary treatments for opiate addiction rely on replacing one drug for another and are essentially palliative treatments. The user is never cured and will always be tormented by the specter of addiction. 

Several medical societies in the United States at that time offered heroin as a safe means of treating morphine addiction. Articles appearing in American medical journals early in the twentieth century spoke highly of heroin s ability to soothe the painful aches, shakes, and vomiting experienced by recovering morphine addicts, and it was widely used as a step down cure. 

Because any opiate derivative will suffice to soothe heroin cravings associated with withdrawal, methadone, a synthetic opiate that has no sedating side effects, has been an effective treatment for heroin and morphine addiction for more than 30 years. The medication is taken orally and suppresses narcotic withdrawal for a period of 24 to 36 hours. Methadone can be taken continuously for 10 years or longer with no harmful side effects. 

Heroin was even proposed as a way to cure morphine addicts. This turns out to be a recurring theme in the story of narcotics to hopeful physicians, a new version brought to market appeared to be free of abuse potential, until enough people used it to prove otherwise. 

F This act strictly regulated the legal supply of certain drugs but actually served to shift opium and morphine addicts to heroin (which became easier to obtain on the black market). 

Most morphine addicts today have some source of clinical supply. .. Doctors sometimes get strung out themselves, for example. Street morphine is rare, and usually available only after a drug store heist, etc. It s weaker than Heroin, of course, but adequate as a junk substitute in times of need. 

Many researchers are working to understand why drugs like morphine and heroin are addictive. Studies with cells in culture have suggested one mechanism for morphine tolerance and addiction. Normally, when the cell receptors bind to enkephalins, this signals the cell to decrease the production of a chemical messenger called cyclic AMP, or simply cAMP. (This compound is very closely related to the nucleotide adenosine-5 -monophosphate.) The decrease in cAMP level helps to block pain and elevate one s mood. When morphine is apphed to these cells they initially respond by decreasing cAMP levels. However, with chronic use of morphine the cells become... 

Fugelstad A, AWner J, Brandt L et al. (2003). Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users. Addiction 98, 463-470. 

In that same year, drug enforcement agencies seized only 23 metric tons of heroin worldwide.5 Heroin, formed by simple acetylation of natural morphine,6 was synthesized in an attempt to alleviate morphine addiction, but ironically, it proved to be many times more addictive, and therefore, more profitable on the illicit market. Controlling illicit... 

A recent nationwide survey in the U.S. found only 2% of respondents were very likely or somewhat likely to try cocaine were it legalized, while 4% declared themselves very likely to tty legalized marij uana, and an additional 6% somewhat likely to try the drug (Nadelmann 1992). At the turn of the century, with a free market in all inebriating drugs, it is estimated that only 4% of the U.S. population was addicted to the heroin, morphine, cocaine and the other drugs openly sold in... 

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). 

In former morphine addicts methadone was as potent as morphine in inducing euphoria. The euphoria lasted longer than morphine euphoria. Former addicts could not distinguish the effects of methadone intravenously from those of heroin or dilaudid. 

Methadone has a long duration of action and is less sedating than morphine. It is used orally for maintenance treatment of heroin or morphine addicts in whom it prevents the buzz of intravenous drugs (see also Chapter 31),... 

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. 

According to Oberst (315, 317) a conjugation with glucuronic acid appears to be one of the principal mechanisms involved in the elimination of morphine (LXXII) and its derivatives, heroin (LXXIII) and codeine (LXXIV). In morphine addicts there is a rise in the glucuronic acid output in the urine that is proportional to the dose of the drug. 

Oberst (317) found that heroin (3,6-diacetylmorphine) (LXX) is de-acetylated to morphine which is then excreted in the free and conjugated forms by man. Morphine addicts excrete some 40 to 50 per cent of injected heroin hydrochloride as conjugated morphine and an additional 7 per cent as free morphine. A morphine addict was found to require only half as much heroin as morphine to satisfy physical dependence. When heroin and morphine were administered in doses having equal satisfying power (i.e., 1 2) 7 per cent of either drug was excreted as free morphine, and about 50 per cent as conjugated morphine. 

Enkephalins are peptides that bind specific receptor proteins the brain cells to reduce pain. Enkephalin receptor proteins have a high affinity for opiates, including heroin, morphine, and structurally similar substances. These pain rehevers are highly addictive, and the misuse of opiates causes thousands of deaths every year. 

An opium alkaloid Although it is an excellent analgesic its use is restricted because of the potential for addiction Heroin is the diacetate ester of morphine )... 

Introduced in 1898, heroin was heralded as a nonaddictive alternative to morphine. Subsequent clinical experience showed it to be highly addictive and preferred by addicts over morphine (13). Heroin is approximately ten times more potent than morphine, with quicker onset and shorter duration of... 

---