Morphine addiction

Wikler, W.A. Pescor, F.T., Classical conditioning of a morphine abstinence phenomenon, reinforcement of opioid drinking behavior and relapse in morphine-addicted rats, Psycho-pharmacologia 10, 255, 1967. 

Isbell, H., Belleville, R. E., Fraser, H. F., Wilker, A., and Logan, C. R. (1956) Studies on lysergic acicl diethylamide (LSD-25). I. Effects in former morphine addicts and development of tolerance during chronic intoxication. Arch. Neurol. Psychiatry, 76 468-478. 

Opioid addiction Striatum from 129P3/J SWR/J C57BL/6J Inbred mouse lines opioid resistant, opioid sensitive Markers for susceptibility to morphine addiction [32]... 

Morley JE, Yamada T, Walsh JH, Lamers CB, Wong H, Shulkes A, Damassa DA, Gordon J, Carlson HE, Hershman JM. (1980). Morphine addiction and withdrawal alters brain peptide concentrations. Life Sci. 26(26) 2239-44. 

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. 

Many of these nostrums were advertised to cure a myriad of diseases, but probably failed to cure any. However, they certainly created countless alcoholics and morphine addicts. By the early 1900s, concern regarding patent medicines was on the rise and the medical profession soon formally discredited their production. These measures unfortunately came too late to curb the infiltration of opium into American society. 

It is inactive orally because of high first pass metabolism in liver. Metabolised by glucuronidation in liver. The main use of naloxone is in the treatment of acute opioid overdose (acute morphine poisoning). It also precipitates withdrawal syndrome when administered to morphine addicts. The constricted pupils of addicts dilate after administration of naloxone. This has been used as a diagnostic tool for opioid addiction. 

It is a pure antagonist and chemically related to naloxone. It is more potent than naloxone and because of its longer duration of action, it can be used as maintenance drug for morphine addicts. It has no euphoric effect and no physical dependence liability. It is effective orally. It is also claimed to be beneficial in decreasing craving for alcohol in alcoholics. Side effects include gastrointestinal disturbances and muscular pain. 

Figure 28.1. Advertisement for cocaine tooth medicine from 1885. Cocaine was extensively used in the latter part of the 19th century in medicines, as a stimulant, as an anesthetic, and to treat morphine addiction. Source-. National Library of Medicine of the National Institute of Health.

Some of the historical aspects relating to cocaine are very interesting. For example Sigmund Freud recommended cocaine to cure morphine addiction and the original concoction known as Coca Cola had "the real thing". 

Meanwhile, opium had been joined by other narcotics. Back in 1805 a German pharmacist s assistant had discovered how to isolate its main ingredient, morphine. A preparation of morphine is about 10 times as potent as raw opium. In 1832, another morphine derivative called codeine was isolated. By the 1850s, a more effective way to administer these powerful narcotics was developed—the hypodermic needle. During the American Civil War, battlefield surgeons had one effective way to relieve the pain of a shattered limb or punctured lung—an injection of morphine. Soldiers who survived their wounds after this treatment often became addicted to the drug. Morphine addiction was thus sometimes referred to as the soldier s disease. ... 

Meanwhile, some medical researchers, including Sigmund Freud, began for a time to tout the advantages of medicinal cocaine as a stimulant for depressed or lethargic patients and even as a cure for morphine addiction. In 1884, Freud, treating his own bout of depression with cocaine, reported feeling... 

Ethanol. As with morphine addiction, tolerance to alcohol is developed, and a lack of ethanol produces withdrawal symptoms. Tire principal route of metabolism of ethanol (both ingested and the small amount of endogenous alcohol) is believed to be oxidation in the liver to the chemically reactive acetaldehyde (p. 774),874/875 which is further oxidized to acetate. Some theories of alcoholism assume that addiction, and possibly also the euphoric feeling experienced by some drinkers, results from a metabolite of ethanol in the brain. For example, acetaldehyde could form alkaloids (Eq. 30-5).876... 

Cocaine is so rewarding that its users prefer it to sex, food, and water, thus overriding basic survival drives. In experiments, laboratory animals will self-administer cocaine to the point of severe toxicity, physical exhaustion, and even death. Many human users support their habit by selling cocaine or by stealing from friends and coworkers. Even Sigmund Freud, who wrote a scholarly and quite accurate treatise on cocaine s effects in Uber Coca (1884), got carried away and claimed his use of the drug cured his morphine addiction. In fact, it simply became a second addiction for him. 

Good health and productive work are thus not incompatible with addiction to morphine. As an example may be cited of the case of a physician who was a morphine addict for 62 years and exhibited no evidence of mental or physical deterioration due to the drug, when carefully studied at the age of 84. 

Meperidine shows certain relationships to both morphine and atropine in its action. Similar to morphine, it exerts a generalized depression of the CNS but, in ordinary doses, does not affect the cough reflex. Similar to morphine, it induces euphoria, and its continued use leads to tolerance and addiction. However, its euphoric and sedative effects are less than that of morphine addiction due to meperidine is more serious than that due to morphine. Meperidine is an effective analgesic,... 

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. 

Simonata, M. The neurochemistry of morphine addiction in the neocortex. TIPS 17 (1996) 410-415. 

During the Civil War, morphine was so widely used to relieve the suffering of soldiers that morphine addiction later was called the soldier s disease..— The addiction that came with frequent use of opium and morphine became more widely recognized, and what had been called "God s Medi cine" showed a downside. But most of the estimated million Americans who were addicted in 1890 did not know they were addicted. 

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