Opium: Mental and Physiological effects
Last modified: Saturday, 20. June 2009 - 2:26 pm
Opium has been used for centuries for its analgesic (pain-relieving) properties. The opium derivative morphine has long been considered the standard narcotic to which all pain-relieving drugs are compared. These narcotics act on the central nervous system, relieving pain by interrupting pain messages in the brain or spinal cord. Opiates bind to special receptor sites in different parts of the brain and body that are active in transmitting pain signals.
Opium derivatives also have antitussive effects, meaning they suppress the cough reflex. Because of this effect, codeine is a frequently used ingredient in cough syrups. Opiates also slow digestion by slowing messages to the smooth muscles and reducing intestinal secretions. This effect makes them useful in treating diarrhea, but may also lead to constipation, a common problem for those who abuse opium. Additionally, users’ heart rate, blood pressure, and respiration slow.
Other central nervous effects of opium and its derivatives include drowsiness, sedation, nausea, weakness, faintness, agitation, restlessness, nervousness, and decreased sex drive. Users may become very sleepy. In some rare cases, effects may include delirium and insomnia. Long-term narcotic use can lead to addiction, depression, difficulty sleeping or concentrating, agitation, tremors, seizures, and an increased sensitivity to pain. An extremely dangerous effect of these drugs is their depressive effect on the respiratory system, which may lead to unconsciousness, coma, and sometimes a rapid death. Users may also experience mood changes, euphoria, dysphoria (feeling unwell or unhappy), mental cloudiness, disorientation, or hallucinations.
These potential effects are impacted by such factors as circumstances of use (e.g., medical use supervised by medical professionals versus abuse), dosage, and route of administration. In general, effects increase as drug potency increases. The onset of these effects ranges from an immediate response to the drug to the user experiencing the impact 30-60 minutes later. The duration of their effects lasts from three to seven hours.
All opium derivatives are addictive and have the potential to be abused. For abusers, these substances produce a strong dependence, a complex concept. In simple terms, long-term opiate use changes the workings of nerve cells in the brain. These cells come to need the drug. The body needs the drug or it will experience effects from the drug’s withdrawal. However, many myths surround opiate withdrawal. While it has been described as tortuous (a perspective often perpetuated by the media), other reports equate it to a severe case of the flu. Common withdrawal symptoms include cramps, a runny nose, chills, and muscle aches that are generally over in 24-48 hours.
Tolerance also develops with continued use, meaning that larger doses are needed to achieve the same psychoactive effect. Dosage, route of administration, and medical versus nonmedical use also play a role here. For example, abusers develop a psychological dependence on the drug. They develop a craving for the drug once it is removed. However, this craving does not generally develop among patients taking opioids for relief of severe pain. Pain patients do not continue to seek the drug to satisfy the cravings experienced by abusers. However, like abusers, pain patients do build up a tolerance to the drug. Also, like abusers, they may experience symptoms of physical withdrawal when they stop using the drug.
Harmful side effects
When using opium and its derivatives, the most obvious risk is coma or death from respiratory failure. Medical professionals are well aware of the potential side effects of opiates and administer them according to strict guidelines. However, overdoses and negative side effects also may occur when taking prescribed drugs; prescription drugs may be diverted from medical use to abuse. Strong painkillers such as Vicodin and OxyContin are likely candidates for abuse. However, for users of street drugs, risks may be especially pronounced.
One group at risk for experiencing unwanted side effects from any drug use are pregnant women. Opioids cross the placenta and some are excreted in breast milk. Some types of prescription opioids may be used during pregnancy on a short-term basis under the direction of a medical professional. Ultimately though, pregnant women should always be guided by the advice of their physicians.
Patients who experience severe pain, either chronically from an illness or short-term from an injury or surgery, are another group with a special interest in the side effects of narcotics. One medical controversy revolves around the extent to which physicians should use powerful narcotics to relieve a patient’s suffering. The fear that patients would become addicted (opiophobia) led to cases of doctors under-prescribing pain medication. Research has shown, however, that these fears are largely unfounded. Doctors have also been accused of over-prescribing these medications, leading to additional fears among physicians that Legal consequences could result if they liberally prescribe opiate derivatives for patients in severe pain. An unfortunate result was that some patients were not prescribed the strong medicines necessary to alleviate their pain. This controversy led to guidelines from the federal Agency for Health Care Policy and Research addressing pain treatments. Additionally, research is underway seeking compounds that will result in effective pain-relief with smaller doses or no euphoric high.
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