Hydromorphone: Therapeutic use, Treatment. Hydromorphone rehab.

Last modified: Sunday, 31. May 2009 - 4:16 pm

Official names: Dilaudid, Dilaudid-Hp, Hydrostat
Street names: Drugstore heroin, dillies, little d, lords, bigd, d’s, delats, delaud, delantz, delida
Drug classifications: Schedule II, narcotic analgesic

 

Key terms

ANALGESIC: A type of drug that alleviates pain without loss of consciousness.
HYPNOTIC: A drug that induces sleep by depressing the central nervous system.
NARCOTIC: A natural or synthetic drug that has properties similar to opium or opium derivatives.
N EU ROPATHIC: Relating to a disease of the nerves.
OPIATE: Drug derived directly from opium and used in its natural state, without chemical modification. Opiates include morphine, codeine, thebaine, noscapine, and papaverine.
PHYSICAL DEPENDENCE: A condition that may occur after prolonged use of an opiate, but differing from addiction because the user is dependent on the drug for pain relief, rather than emotional or psychological relief.
PSYCHOSIS: A severe mental disorder characterized by the loss of the ability to distinguish what is objectively real from what is imaginary, frequently including hallucinations.
STYPTIC: The contraction of a blood vessel or the containment of a hemorrhage.
WITHDRAWAL: A group of symptoms that may occur from suddenly stopping the use of a substance such as alcohol or other drugs after chronic or prolonged ingestion.

 

Overview

Hydromorphone is a semi-synthetic prescription drug that has similar pain-relieving properties to that of morphine and codeine. It is classified as an opioid or narcotic analgesic. It is an effective treatment for moderate-to-severe pain and is sometimes used in patients with a non-productive cough. It is used to treat several types of pain, including headache, cancer pain, and back pain.
Hydromorphone is formed by making a slight alteration to the morphine molecule. The primary active ingredient in hydromorphone is thebaine. Thebaine is one of several compounds called alkaloids that are found in all narcotic analgesics. Thebaine is a word based on the name of the ancient Egyptian city of Thebes. The residents of Thebes are known to have harvested significant amounts of opium from the poppy plant variety known as Papaver somniferum. Hydromorphone provides pain relief by bonding with specific pain receptors in the body. The pain-relieving effects of hydromorphone are very similar to those provided by morphine, but hydromorphone is actually more potent.
Hydromorphone is in the opiate family of drugs. The opiates and their semi-synthetic and synthetic descendants are big business for legal and illegal entities. Some 30 million prescriptions and orders are written annually in the United States alone for controlled substances, many of these for narcotic analgesics. A large part of the international illicit drug trade involves the sale of drugs in the opiate family. A substantial amount of crime committed in the world is linked with this drug trade and with illicit drug use.
History
Hydromorphone and its natural opioid relatives have been used to relieve pain, treat a variety of ailments, and create euphoric feelings at least as far back as the time of the ancient Greeks. In early Greek history, the priests controlled the use of opium and ascribed to it supernatural powers. In the fifth century bc, Hippocrates, the “father of medicine,” dismissed the supernatural attributes of opium. Hippocrates believed opium had cathartic, narcotic, hypnotic, and styptic properties. He believed that all diseases had a natural origin and could be cured by natural therapies. All of the natural opiates historically were derived from opium poppy plants. The liquid extracted from the poppy seeds was typically dried to create a concentrated powder. These extracts were then smoked, eaten, or drunk.
From the world of the ancient Greeks, word of the powerful properties of opium spread quickly to the Romans. The Romans not only used opium as a painkiller and for religious rites, but also considered it an excellent poison. In the case of suicide, it was considered a pleasant means to exit this world. Somnus, the Roman god of sleep, was often depicted as a small boy who carried around poppy flowers and an opium horn. After the collapse of the Roman Empire, the use and knowledge of opium spread to the Islamic world, where considerable study of the drug was performed.
After many centuries of declining use, opium began to reappear in Europe around the beginning of the Renaissance. Opiate use steadily increased over the next few centuries, reaching a new high in the nineteenth century. It was widely used by artists and writers during the Romantic Era.
Opium was first cultivated and processed in England during the ninteenth century. It was commonly used as a sedative and painkiller. However, it was also used to treat fever and diarrhea. At this time in history, diarrhea was a major killer. Opium, with its constipating effects, proved to be effective in treating various types of serious diarrhea, especially that associated with cholera. The problem of addiction to opiates, long recognized even at this time, was largely ignored.
The active components of opium were not isolated until the first half of the nineteenth century. The first of these components to be isolated was morphine, named for Morpheus, the Greek god of dreams. Soon after, other alkaloids in the poppy were isolated, such as codeine in 1832, narceine in 1832, thebaine in 1835, and papaverine in 1848. The later invention of the hypodermic needle allowed opium to be delivered in greater concentrations and with greater rapidity to patients in severe pain. Morphine injections were used to treat a variety of complaints, including menstrual pain, eye inflammation, and rheumatism. Unfortunately, it also led to greater abuse of the drug for non-medicinal uses.
Heroin was first created in 1874 by boiling a solution of morphine and acetic anhydride. Heroin is an extremely concentrated form of opiate that was initially hailed as a miracle drug. Heroin acts quickly in the body, where it is immediately converted into morphine. Heroin is more fat-soluble and, because of this, can enter the central nervous system much more readily than morphine. It has five to eight times the analgesic power of morphine, but it was originally sold as a cough suppressant and treatment for respiratory ailments. Heroin was widely used in the United States and Europe in small quantities in cough lozenges and elixirs.
All of the opiates were legal and freely-available drugs in the United States and most other countries until the early part of the twentieth century. It was at this point that opiates began to be taxed and regulated not only in the United States but also throughout the world. The twentieth century was characterized by a division of the opiate family into the legal production of compounds, such as morphine, codeine, and hydromorphone for legitimate medical purposes and, on the other hand, the illegal production and distribution of heroin and other illicit narcotics for recreational purposes. The legitimate production of narcotic analgesics has led to innovative and effective means to alleviate pain as well as to ensure the purity and safety of the given drug. The legitimate pharmaceutical industry has also developed drugs to help treat various types of opiate addiction.
Most of the illegal opiates, especially heroin, enter the United States through the Mexican border. According to some law enforcement officials, heroin use may be supplanted in future years by increased use of prescription narcotics, provided that they continue to be available. As a result, the distribution and use of prescription narcotics is closely monitored by state and federal law enforcement agencies. Illicit hydromorphone abuse has not reached the same epidemic levels as Oxy-Contin but remains a problem and a concern for drug enforcement authorities.

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