Drugs and Our Society

Drugs and Our Society CJUS/HPE 151 Chapter 5: The Major Narcotics: Opium, Morphine, and Heroin

Opium / opium derivatives / semi-synthetic - opium poppy / synthetics - Greek word: “stupor” - dull senses / relieve pain a. Opiate receptors of brain - endorphins - receptors activated - heroin / morphine (1) Discussion - morphine-like effect

(2) Cocaine / coca leaves - classified narcotics - Uniformed Controlled Substances Act (a) Neither bind to receptors - nor morphine-like effects - stimulants as discussed (b) Narcotics - produce morphine-like effect (3) Most important characteristics

- powerful analgesic - reduce pain (a) Cough suppressant - alleviate diarrhea - induce anesthesia (b) Therapeutically: - tension / anxiety / aggression (4) 1000’s of years - sedating / painkilling / sleep-inducing - Greeks / Romans / Egyptians / Assyrians

b. ‘Papaver somniferum’ - source: non-synthetic narcotics - Mediterranean: 5000 BC - cultivated around the world (1) Milky fluid from incisions - unripe seedpod - air-dry - scrapped by hand - produces opium (a) Modern method

- industrial straw process - alkaloids extracted - mature / dried plant - liquid / solid / powder - fine brownish powder (b) 500 tons legally imported - legitimate medical use (2)Synthetic narcotics (laboratory) - no synthetic susceptible to abuse - clandestine drugs / medical use drug

Foreign sources - entire supply - unlike cocaine: South America - opium three source regions - Southeast-Southwest Asia / South America a. 1996: ‘Golden Triangle’ - Myanmar (Burma) / Laos / Thailand (1) Extent of narcotic use - profits: $300 billion yearly - world’s opium

(a) 2,560 metric tons (5,120,000 lbs) - Myanmar (b) 200 metric tons (400,000 lbs) - Laos (c) 30 metric tons (60,000 lbs) - Thailand (2) Afghanistan - 3,656 metric tons - Myanmar / Afghanistan majority - Myanmar / Laos

(3) Latin America - primary supplier for US - Columbia = 60 % - Mexico = 24 % (a) Mexico - hold - trafficking in western US - drug cartels (b) 2 % illicit opium, - entire crop for US

b. Opium poppy ‘field’ - 60,000 / 120,000 plants - 2.46 acres / hectare (1) Flower 90 days - 3 to 8 flowers per plant - continues several weeks - early spring full bloom (a) Petals drop - size of chicken egg - two weeks

(b) Mature - ready to harvest (2) 3 - 4 bladed instrument (iron / glass) -score the pod - one millimeter - 2 or 3 times / afternoon - white latex drip on surface (a) Oxidizes / darkens / thickens - over night - morning: flat iron blade - 80 milligrams

(b) Black to brown - after drying - quality: brown and sticky - 3 to 9 kilos acre (3) 40 alkaloids identified - most = salts - most important: morphine - average content: 9 % to 14 % - Turkish opium: 21 % - druggist’s opium

(a) Other alkaloids: - codeine: 0.5 / 2.5% - noscapine: 4 / 8 % (cough suppressant) - papervine: 0.5 / 2.5 % (muscle relaxant) - thebaine: 0.5 / 2.0 % (b) Alkaloids: removed in processing - clandestine chemistry not ideal - 45 % of alkaloids - left in raw opium

Purification process a. Raw opium in boiling water - dissolves alkaloids - solids remain - impurities: scooped out / filtered (1) Liquid reheated / low flame - evaporates the water - thick, dark paste / dried in sun (a) Opium left / putty-like consistency

(b) 20 % lighter / 20 % purer b. Extraction process - stirred in large drum / boiling water - completely dissolved - slake lime / fertilizer lime mixed in (1) Convert morphine to soluble salt - becomes insoluble in cold water - other alkaloids do not react - solution cooled / morphine remains - other chemicals settle / brown sludge

(a) Codeine somewhat soluble - some remains in solution - called ‘morphenate’ (b) Morphine solution filtered - rice sacks / burlap bags - reheated / not boiled (c) Ammonium chloride added - 1/14th mass of opium - pH solution: 8 / 9 cooled (2) Morphine base settles to bottom

- poured off / cloth filters - chunks morphine base - squeezed / set out to dry - coffee-colored powder (3) Hydrochloric acid / activated charcoal - heated = morphine hydrochloride - filtered: remove charcoal / impurities (a) Sun dry = morphine hydrochloride - fine white powder - pressed: 1 kilogram (kg) bricks

c. Convert to heroin (1) Morphine base - acetic anhydride / 3 times mass - heated: 185 degrees / not boiled (2) Stainless steel / enamel pot - lid clamped down - cook 5 hours (3) Filter: soda ash / chloroform - 700 grams heroin per kilo morphine

Narcotic Abusers • In the United States, there are more than 800,000 people addicted to heroin - as well as other narcotics / but primarily heroin • National Household Survey - estimated more than 1.4 million Americans have tried heroin at least once - most are chronic users who are older and inject the drug - the number of younger users is growing and are more likely to snort or smoke heroin

Narcotic abusers, cont • Most young people are considered occasional or controlled users - they are called ‘chippers’ - using only once in awhile or on weekends - and take narcotics in a controlled way - this contradicts the commonly held notion that a person is either an abstainer or addict • Controlled user pattern - seldom use the drug more than once a day - can keep opiates around without using them - do not use opiates to alleviate depression

Narcotic abusers, cont - seldom, if ever, binged on opiates - knew the opiate source or dealer - took opiates for recreation or relaxation - did not take opiates to escape from life’s daily hassles • Patterns of use - patterns of narcotics use do deviate sharply - it is difficult to know the exact extent • 67 % of heroin addicts are male - 33 % female

Narcotic abusers, cont - 69 % are Caucasian - 31 % of other minority races • 1/3rd of all addicts live in New York City - 40 % are Caucasian - 40 % are African-American - 20 % are other minorities - 25 % (1/4th) are females • The majority of new users are middle-income - they inhale heroin rather than injecting it - young blacks in NYC are deliberately avoiding it

Narcotic abusers, cont • Viet Nam War - it is estimated that 10 % to 15 % of US troops were addicted to heroin - it was 95 % pure / inexpensive / sold openly - primarily smoked with tobacco or marijuana

Licit and Illicit Uses • Two primary pain-killing drugs are derived from opium - morphine and heroin • Opiates - 3 natural components can be extracted from opium - morphine / codeine / and thebaine • Opiate derivatives - from morphine you derive heroin / Dilaudid / Numorphan - from Thebaine: Percodan / etrophine

Licit and illicit, cont • Synthetic opiates - methadone / Demerol / Darvon / Orlaam - they are unrelated to morphine - but produce opiate-like effects • Methadone - invented by a German scientist during WWII - chemically unlike morphine or heroin - produces many of the same effects • Introduced into the United States in 1947 - used to treat narcotic addiction - used as an oral solution tablet, but also injectable

Licit and Illicit, cont - it is almost as effective administered orally-- it is a Schedule II drug • Methadone is taken every 24 hours (once per day) - it blocks the effects of heroin - while discouraging continued use • In chronic administration tolerance develops - a person can become dependent - withdrawal develops more slowly - symptoms are less severe

Characteristics of Narcotics • Opiates are narcotics - many times you hear all illegal drugs are narcotics • Opium - comes from the opium poppy - papaver somniferum = the “plant of joy” • It was cultivated in the Middle East and Asia - grows to a height of 3 to 4 feet - has white / red / or purple flowers • After petals fall, an egg-shaped pod is left

Characteristics, cont - slits are made on the sides of the pod - a white, milky sap comes out • Once dried, a brown, thick gummy resin forms - this is opium - the poppy only as 10 days to manufacture opium • Morphine - Frederich Serturner, a German chemist synthesized morphine from opium in 1803 - he called it ‘morphium,’ named for Morpheus, the Greek god of dreams

Characteristics, cont • Effects occur more rapidly than opium - it is 10 times more potent and the most effective drug for severe pain - morphine sets the standard, and all other analgesics are measured by it - taken orally it is not very effective - it builds in the spleen / liver / kidney / lungs • Codeine: - another alkaloid isolated 30 years later - a Greek word meaning ‘poppy head’ - which can also result in dependency

Codeine • Another alkaloid that was isolated 30 years later - it is a Greek word meaning ‘poppy head’ - codeine can also result in dependency • Codeine is the most widely used, naturally occurring narcotic in medical treatment in the world - this alkaloid is also found in opium, but most of it used in the US is produced from morphine - it is usually prescribed for the relief of moderate pain and cough suppression - it can be in liquid form (Tylenol w/ Codeine) - in tablet form (a single drug or a combination) - or for severe pain, it can be injected

Thebaine • A minor constituent of opium - it is a Schedule II drug (as is codeine) - chemically similar to morphine and codeine • It produces stimulatory effects rather than depressant effects - the US uses most of the drugs derived from Thebaine - such as Naloxone and Oxycodone

Heroin • Synthesized from morphine in 1874 - derived from the German word meaning “heroic” - promoted as a cure for morphine addiction - later, morphine was touted as a cure for heroin addiction • Manufactured by Bayer, a pharmaceutical company in Germany - and touted as a cure for coughs / bronchitis / and tuberculosis - newspaper articles: a new type of aspirin

Heroin, cont - believed to be nonaddicting - now we know: it is twice as addicting as morphine • It is administered in several ways: smoked / sniffed / and injected - injected and smoked: the effects are rapid - effects not as great when sniffed - it is ineffective when ingested - but more people sniff and smoke rather than inject

Heroin, cont • It is 3 to 10 times more powerful than morphine - because it is much more lipid-soluble - it reaches the brain more quickly with higher concentrations

Synthetic Opiates • They are chemically constructed rather than naturally produced - elicit effects behaviorally similar to morphine - but they bear little chemical resemblance • The differ in duration / action / potency / intensity / and effectiveness - example: Demerol / Dolophine (methadone) / Percodan / Talwin / and Darvon - drugs that are available only by prescription • Fentanyl - a synthetic opiate stronger than heroin

Synthetics, cont - it has similar analgesic effects - is either injected or snorted to be effective - called “China white” • Oxycontin - from 1996 to 2000, painkiller prescriptions grew dramatically - they tripled in sales to $1.8 billion • This is when oxycontin gained much attention - a particularly strong painkiller - it blocks pain signals from the nerves

Synthetics, cont - it takes fewer pain pills and lasts 3 times longer • Oxycontin and Percodan - account for around 6,500 ER visits each year - and possibly hundreds have died • The abuse is acute in the Appalachia region - this is why it is called “hillbilly heroin”

Physical and Psychological Effects of Narcotics • 95 % of all narcotic abuse in the US is heroin - the impact on each individual can vary - due to quantity / purity / administration / interval / and tolerance • Endorphins - are naturally produced chemical substances - that alter sensory perception and reaction • Feelings derived from narcotics can be induced naturally by release of endorphins

Effects, cont • They regulate a person’s response to stress and pain - it is the same chemical that produces the “runners high” • Many dangers are associated with narcotics - most arise from their illicit status - physical problems: using unclean and/or unsafe environments, and from people associated with drugs (murder / assaults) - unregulated industry: contaminated drugs / mixed drugs / what it is ‘cut’ with: sugars / starches / quinine / strychnine

Effects, cont - how administered: sharing needles with those who have a medical illness (hepatitis / AIDS-HIV) - using dirty needles resulting in abscesses / heart inflammation / blood poisoning • Physical effects - narcotics cause drowsiness / vomiting / nausea / difficulty concentrating / pupils constrict / lower body temperature / dilated blood vessels / lower blood pressure / and abdominal pain (muscle cramps)

Effects, cont • Psychological effects - the use of narcotics does effect both social and emotional health - can result in depression / mood changes / wanting to sleep / anger / suspicion / not trusting / want to be alone / embarrassment • Withdrawal symptoms - drugs block the physical effects of heroin - they do not eliminate psychological desire - majority of those entering treatment relapse

Drugs and Our Society