Opium tolerance

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). 

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... 

Nevertheless, long before the structure of morphine was realized, its analgesic properties were recognized and applied to medicine. Since morphine was in the pure form, it was far more effective than crude opium as an analgesic. But there was also a price to be paid—the increased risks of addiction, tolerance, and respiratory depression. 

Karl Marx viewed religion as the opium of the people, a response to economic injustice. Moral problems were defined as societal problems. Religion was exploited by oppressors to make people tolerate being poor. The twentieth century was the bloodiest of all time, and is believed by many to have resulted from the decline of religious beliefs. 

Tolerance. The patient has a decreased physiologic response after repeated administration of the dmg. This is common with tobacco, opium alkaloids, nitrites, and ethyl alcohol. The dosage must be increased to achieve the pharmaceutical response. 

Narcotic Componnd that prodnces stnpor. Many opium derivatives are examples of strong narcotics. Narcotics can affect the central nervous system (CNS) and the gastrointestinal tract. The CNS effects include analgesia, euphoria, sedation, respiratory depression, and antitussive action. Chronic use of narcotics develops tolerance to the compounds and physical dependence. 

Many short-chain peptides are important biochemicals. For example, enkephalins and endorphins (Figure 15.12) are referred to as natural opiates because they moderate pain in the same manner as opium derivatives. Our bodies synthesize enkephalins and endorphins to moderate pain, and our pain threshold is related to levels of these neuropeptides in our central nervous system. Individuals with a high tolerance for pain produce more of these neuropeptides and consequently tie up more receptor sites than normal hence, they feel less pain. A dose of heroin temporarily bonds to a high percentage of the sites, resulting in httle or no pain. Gontinued use of heroin causes the body to reduce or cease its production of enkephalins and endorphins. If use of the narcotic is stopped, the receptor sites become empty, and withdrawal symptoms occur. 

Sublingual buprenorphine has been proposed as an effective and well-tolerated treatment for neonatal abstinence syndrome. In a randomized trial, infants with neonatal abstinence syndrome, who had been born to mothers taking maintenance methadone, were randomized to either sublingual buprenorphine 13-39 micrograms/ kg per day ( = 13) or standard-of-care oral neonatal opium solution ( = 13) [29 ]. Buprenorphine administration was associated with a 31% reduction in length of treatment and a 29% reduction in the length of hospital stay. One infant had seizures after buprenorphine, but it was not clear whether buprenorphine was causal. 

There is a similarity between the use of opium with its complex mixture of alkaloids for the treatment of diarrhoea and the use of Rauwolfia serpentina extracts for the treatment of hypertension. The alkaloid combination of the Rauwolfia extract is more effective and better tolerated than reserpine alone because the effects of the centrally acting reserpine are facilitated by other alkaloids which are capable of causing dilation of peripheral blood vessels. 

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