HaCKeRz KrOnIcKLeZ 3/HaCKeRz_KrOnIcKLeZ.iso/drugs/faq-opioid-1

Internet Message Format | 1996-05-06 | 20KB

From: [e-mail]
Newsgroups: alt.drugs
Subject: OPIOID FAQ (1st draft)
Message-ID: <[e-mail]>
Date: 30 Jan 94 04:33:35 GMT


    Ok this is the first draft of the opioid FAQ I put together. It is by
no means complete and any contribution would be appriciated. Please send all
info to my mail box at [e-mail].  Most of the information is there
and any missing or incorrect info is in the FAQ just let me know.

    Here it is....


OPIOID FREQUENTLY ASKED QUESTIONS FILE

Editor: Mike Hamilton <[e-mail]>
Last Update: 10 Jan. 94
Newsgroup : alt.drugs

********** Article Separation

                   ** Contents **

Glossary on terms used in FAQ

Opioid Info:
Natural (known as opiates):
    Morphine
    Codeine
Semi-Synthetic (known as opioids):
    Heroin
    Hydrocodone (Hycodan)
    Hydromorphone (Dilaudid)
    Meperidine (Demerol)
    Oxycodone (Percodan)
Synthetic (also known as opioids):
    Fentanyl (Sublimaze)
    Methadone (Dolophine)
    Propoxyphene (Darvon)
    Pentazocine (Talwin)

Opioid Addiction and Withdrawal

**********

    The FAQ will use morphine as the standard opioid and base all other
opioids in relation to it. (Kinda like class inheritance in C++).

**********

A little glossary to start the FAQ:

opiate  - narcotic analgesic derived from a natural source(opium poppy)
opioid  - narcotic analgesic that is either semi or fully synthetic
    - also refers to entire family of both opiates and opioids
IM      - intramuscular injection
SC      - subcutaneous injection

**********

               **  Morphine  **

Synopsis
    Morphine is naturally occurring substance in the opium poppy,
    Papaver somniferum.  It is a potent narcotic analgesic, and its
    primary clinical use is in the management of moderately severe
    and severe pain.  After heroin, morphine has the greatest
    dependence liability of the narcotic analgesics in common use.
    Morphine is administered by several routes (injected, smoked,
    sniffed, or swallowed); but when injected particularly
    intravenously, morphine can produce intense euphoria and a general
    state of well-being and relaxation.  Regular use can result in
    the rapid development of tolerance to these effects.  Profound
    physical and psychological dependence can also rapidly develop,
    and withdrawal sickness upon abrupt cessation of heroin use; many
    of the symptoms resemble those produced by a case of moderately
    severe flu.

    Morphine is infrequently encountered in the North American street
    drug culture.  However, mainly because of its availability in
    hospitals, there have been several documented cases of morphine
    dependence among health professionals.

Drug Source
    Morphine is isolated from crude opium, which is a resinous
    prep of the opium poppy, Papaver somniferum.

Trade Name
    Roxinal, MS Contin, Morphine Sulfate

Street Names
    "M", morph, Miss Emma

Drug Combinations
    Use of morphine plus cocaine, as well as of morphine plus
    methamphetamine, has been reported.  However, such combinations
    are not frequently encountered.

Medical Uses
    * symptomatic relief of moderately severe to severe pain;
    * relief of certain types of difficult or labored breathing;
    * suppression of severe cough (rarely);
    * suppression of severe diarrhea (e.g., that produced by cholera).


Physical Appearance
    Morphine is legally available only in the form of its water-soluble
    salts.  Most common are morphine sulfate and morphine hydrochloride.
    Both are fine white crystalline powders, bitter to the taste.  Both
    are soluble in water and slightly soluble in alcohol.

Dosage
~~~~~~
Medical
    For moderate to severe pain the optimal intramuscular dosage is
    considered to be 10 mg per 70 kg body weight every four hours.
    The typical dose range is from 5 to 20 mg every four hours,
    depending on the severity of the pain.  The oral dose range is
    between 8 and 20 mg; but with oral administration morphine has
    substantially less analgesic potency (approximately one-tenth of
    the effect produced by subcutaneous injection) because it is
    rapidly destroyed as it passes through the liver immediately
    after absorption.  The intravenous route is employed primarily
    for severe post-operative pain or in an emergency; in this case
    the dose range is between 4 and 10 mg, and the analgesic effect
    ensues almost immediately.

Nonmedical
    Irregular or intermittent users (who are not substituting the drug
    for another narcotic analgesic) may start and continue to use doses
    within the therapeutic range (e.i., up to 20 mg).  However, regular
    users who employ morphine for its subjectively pleasurable effects
    frequently increase the dose as tolerance develops.  To take several
    hundred milligrams per day is common, and there are reliable reports
    of up to four or five grams (4000 - 5000 mg) per day.


Routes Of Administration
    Morphine may be taken orally in tablet form, and can also injected
    subcutaneously, intramuscularly, or intravenously; the last is the
    route preferred by those who are dependent on morphine.

Short Term Use
~~~~~~~~~~~~~~

Low Doses (single doses of 5 - 10 mg administered by S.C or IM injection in
non-tolerant users)

CNS, behavioral, subjective:
    suppression the sensation of and emotional response to pain;
    euphoria; drowsiness, lethargy, relaxation; difficulty in
    concentrating; decreased physical activity in some users and
    increased physical activity in others; mild anxiety or fear;
    pupillary constriction, blurred vision, impaired night vision,
    suppression of cough reflex.

Respiratory:
    slightly reduced respiratory rate.

Gastrointestinal:
    nausea and vomiting; constipation; loss of appetite; decreased
    gastric motility.

Other:
    slight drop in body temperature; sweating; reduced libido; prickly
    or tingling sensation on the skin (particularly after intravenous
    injection).

Duration
    4 - 5 hours

Dependency Potential
    high, continued use results in both psychological and physical
    dependency

**********

                **  Codeine  **

Drug Source
    Codeine is found in opium in concentrations between %0.1 and %2.
    Because of the small concentration found in nature, most codeine
    found in medical products is synthesized from morphine via the
    methylation of the hydroxyl group found on the second non-aromatic
    ring.

Trade Name
    There are no commercial name for products containing only
    codeine in US. Found under common name of codeine.
    Canada does have a codeine only syrup available under
    Paveral. Mainly found in combination products.

Street Name
    T-three's (Tylenol #3 w/ codeine), schoolboy, cough syrup

Medical Uses
    * relief of mild to moderate pain
    * relief of non-productive cough
    * relief of diarrhea

Drug Combinations
    Sold under many name brand products, the most popular being the
    Tylenol with Codeine series, the number on the tablet corresponds
    to the amount of codeine and caffeine found in the each tablet.

    Tylenol #1 w/ codeine -  8 mg codeine, 15 mg caffeine
    Tylenol #2 w/ codeine - 15 mg codeine, 15 mg caffeine
    Tylenol #3 w/ codeine - 30 mg codeine, 30 mg caffeine
    Tylenol #4 w/ codeine - 60 mg codeine, no caffeine

    note: all tablets contain same amount of acetaminophen (300 mg)

    Fiorinal (aspirin, caffeine, barbital, codeine)

    Many other brand name product combinations.

Physical Appearance
    Tylenol w/ codeine series are imprinted with number on one side and
    other side is Tylenol label(McNeil).

Controlled Substance Status
    As a single product codeine is a schedule II controlled substance
    in the US.
    When combined with other non-controlled substance, and depending
    on amount per dose unit, codeine combined products range from
    schedule III to V.
    Canada has OTC codeine products available if product has no more
    than 8 mg of codeine per unit dose. Some US areas may have codeine
    preps available OTC, but usually require release form.
    As an interesting fact, a travelers handbook noted that Greece has
    banned codeine in that country (no idea on what it's status is now)
    so be careful when traveling there.

Dosage
~~~~~~
Medical
    Pain relief : 30mg - 220mg oral or equivalent dose SC or IM

    Diarrhea relief : 10mg - 20mg orally

    Cough suppressant : 5mg - 15mg orally

Nonmedical
    Doses can range from 30mg up to 400mg. LD50 for codeine is 800mg in
    a average nontolerant person.
    At doses of > 250mg adverse effects tend to arise, including intense
    itching, flushed skin, dizziness, sedation, nausea and vomiting

Routes Of Administration
    Usually taken orally but can be injected IM or SC. The IV route is
    not recommended as reactions such as facial swelling, pulmonary
    edema and convulsions can occur.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    Effects begin at 30mg and tend to mimic those of morphine, except
    sedation and euphoria are less intense.

Respiratory:
    same as morphine but less intense.

Gastrointestinal:
    same as morphine but nausea and vomiting are less common and
    constipation less severe.

Other:
    alleocodone is a schedule II drug, and when combined
    with other non-controlled drugs, is found from schedule III-IV.

Dosage
~~~~~~
Medical
    as a cough suppressant 5mg - 10mg
    for pain relief 10mg - 30mg

Nonmedical
    doses are similar to those for pain relief

Routes Of Administration
    Usually taken orally but can be inject via three routes. Unknown if
    hydrocodone can be sniffed or smoked. Sniffing is likely possible.


Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    Has similar effects as morphine but less sedation and euphoria

Respiratory:
    Less depression than morphine.

Gastrointestinal:
    Less likely to cause nausea and vomiting than morphine.

Other:
    Hydrocodone is a weaker opioid than morphine but still a effective
    opioid with similar potency to oxycodone.

Duration
    3 - 4 hours

Dependency Potential
    moderately low, much less potential than morphine

**********

                 **  Hydromorphone  **

Drug Source
    Synthetically produced from morphine.

Trade Name
    Dilaudid

Street Name
    Dillies

Medical Uses
    * relief of moderate to severe pain
    * relief of severe cough

Drug Combinations
    most commonly used as a single product

Physical Appearance
    usually bought as tablets, or injectable solution

Controlled Substance Status
    Hydromorphone, like most single product opioids, is a schedule II
    opioid.

Dosage
~~~~~~
Medical
    for pain relief 1mg - 2mg

Nonmedical
    same as pain relief doses

Routes Of Administration
    Can be administered orally, by three routes of injection, and
    by sniffing. Unknown if smoking is an effective route.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    Hydrocodone has effects similar to morphine, except euphoria is
    similar to codeine, nausea and vomiting is quite rare, and
    sedation is practically non-existent

Respiratory:
    Hydrocodone depresses respiration minimally.

Gastrointestinal:
    Hydromorphone effects GI tract very little.

Other:
    Although hydromorphone's euphoria pales with other opioids
    it's abuse potential comes from the fact the rush experienced
    from IV use is very similar to heroin's.

    Hydromorphone is one of the most used opioids in the relief of
    pain for the terminally ill.  The reasons being it's minimal
    side effects, and high potency.

Duration
    3 - 4 hours

Dependency Potential
    moderately high

**********

                  **  Meperidine  **

Drug Source
    Meperidine is completely synthetic and can be produced with
    dichlorodiethyl methylamine and benzyl cyanide.

Trade Name
    Demerol

Street Name
    Demmies

Medical Uses
    * originally found to be useful for muscle spasms but the
      discovery of it's analgesic properties has resulted in
      it's almost exclusive use for relief of moderate to severe
      pain

Drug Combinations
    usually found as a single product, with few combination products.
    Is found in combination with acetaminophen in Demerol APAP

Physical Appearance
    Demerol tablets are small white tablets with the name
    Winthrop on one side

Controlled Substance Status
    Schedule II substance in US

Dosage
~~~~~~
Medical
    pain relief is achieved with approx. 50mg - 150mg injected
    or 200mg - 300mg oral

Nonmedical
    doses similar to those used in medical settings are used in
    recreational use.

Routes Of Administration
    orally, three injection routes, and sniffing are possible,
    unknown if smoking is possible

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    same as morphine but less sedation, less intense euphoria

Respiratory:
    respiratory depression tends to be less common and less intense
    than morphine

Gastrointestinal:
    nausea and vomiting are reportedly common with oral use, but
    less when administered via injection

Duration
    3 - 4 hours

Dependency Potential
    reported to be less than or equal to that of morphine

**********

                 **  Oxycodone  **

Drug Source
    synthesized from codeine

Trade Name
    only found as a compound product combined with aspirin or
    acetaminophen. Available in Canada as a single product in
    the form of a suppository

Street Name
    Percs

Medical Uses
    * relief of moderate to severe pain

Drug Combinations
    Percodan is aspirin and oxycodone
    Percocet is acetaminophen and oxycodone

Physical Appearance
    Percodan tablets are color coded according to quantity of oxycodone
    in each tablet, the pink have ~2.5mg and the orange and green having
    twice as much

Controlled Substance Status
    Schedule II in US

Dosage
~~~~~~
Medical
    10 - 20mg oral for pain relief
    5 - 15mg injection

Nonmedical
    Doses similar to those used in a medical setting are used

Routes Of Administration
    Can be administered orally, three injection routes, sniffed
    and possibly smoked.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    Same as morphine but milder.

Respiratory:
    Less respiratory depression than morphine

Gastrointestinal:
    Less constipating than morphine

Duration
    3 - 4 hours

Dependency Potential
    Moderate

**********

                  **  Fentanyl  **

Drug Source
    Synthetically produced

Trade Name
    Sublimaze

Street Name
    China white

Medical Uses
    Mainly relief of moderate to severe pain and as a surgical
    anesthetic

Drug Combinations
    none

Physical Appearance
    Found as a injectable solution, and a transdermal patch

Controlled Substance Status
    Schedule II in US

Dosage
~~~~~~
Medical
    50ug - 200ug

Nonmedical
    same range as medical use

Routes Of Administration
    can be administered via three injection routes, sniffed and smoked

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    euphoria is less than morphine

Respiratory:
    same as morphine but has potential to cause respiratory muscles
    to go into spasm and result in respiratory arrest

Gastrointestinal:
    less constipating that morphine

Duration
    1 - 2 hours

Dependency Potential
    moderately high

**********

                  **  Methadone  **

Drug Source
    synthetically produced

Trade Name
    Dolophine

Street Name
    Dollies

Medical Uses
    occasionally used for pain relief, but main use is in opioid
    withdrawal treatment as a substitute drug

Drug Combinations
    none

Physical Appearance
    found as a fruity solution for oral use, in wafers, and tablets
    also found as a injectable solution

Controlled Substance Status
    Schedule II in US

Dosage
~~~~~~
Medical
    3 - 5mg provides same pain relief as 10mg morphine

Nonmedical
    rarely used non-medically, but doses used are approx. same
    as medical doses

Routes Of Administration
    can be injected via three routes, taken orally, unknown if
    methadone can be smoked, can be sniffed

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    Oral use provides little euphoria and tends to block opioid
    receptors in brain, so commonly used as a maintenance drug
    during rehab.

Respiratory:
    Produces little depression in contrast to morphine

Gastrointestinal:
    produces constipation of less intensity than morphine

Other:
    Developed by Nazi Germany during WWII as Germany was unable
    to acquire adequate supplies of morphine.

Duration
    first dose last approx. 8 hours and subsequent doses last 18 - 24
    hours.

Dependency Potential
    oral use provides little euphoria so little abuse potential in
    that form. When injected, methadone give very similar effects to
    morphine so has similar addiction potential.

**********

                  **  Propoxyphene  **

Drug Source
    Synthetically produced with similar structure to that of methadone

Trade Name
    Darvon, Darvon N

Street Name
    none

Medical Uses
    for relief of mild pain

Drug Combinations
    Darvon compound is aspirin and propoxyphene

Physical Appearance
    Darvon N as pink oval pills

Controlled Substance Status
    Schedule III in US

Dosage
~~~~~~
Medical
    range from 50mg - 150mg of hydrochloride

Nonmedical
    similar to medical dose ranges.

Routes Of Administration
    can be taken orally, three possible injection routes, no info
    on possible intranasal or smoked administration

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
     oral use provides very little euphoria, mild sedation;
     at larger doses sedation becomes quite prominent and symptoms
     such as staggering and slurred speech become apparent.

Respiratory:
    little respiratory depression in medical dose range

Gastrointestinal:
    little effect on GI tract

Other:
    IV use is reported to give rush similar to heroin;
    poor analgesic with standard dose providing less pain relief
    than standard aspirin dose

Duration
    3 - 4 hours

Dependency Potential
    low

**********

                  **  Pentazocine  **

Drug Source
    synthetically produced

Trade Name
    Talwin

Street Name
    yellow footballs

Medical Uses
    for relief of moderate to moderately severe pain

Drug Combinations
    Talwin NX - pentazocine and nalaxone (opioid antagonist)

Physical Appearance
    usually found in orange-yellow tablets

Controlled Substance Status
    Schedule III

Dosage
~~~~~~
Medical
    50mg - 100mg for pain relief

Nonmedical
    similar to medical dosage

Routes Of Administration
    can be taken orally, three injection routes, and sniffed
    possibly smoked

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
    poor opioid, very little euphoria, mainly just sedates and
    clouds mind, little recreational use

Respiratory:
    less depression than morphine

Gastrointestinal:
    very little constipation or nausea, vomiting occurs

Other:
    as a opioid agonist/antagonist has potential to cause
    psychotic effects such as hallucinations, severe confusion

Duration
    3 - 4 hours

Dependency Potential
    moderate potential, similar to hydrocodone

**********

            Opioid Dependence And Withdrawal

    Opioids have specific withdrawal and dependence characteristics
common to all opioids, varying according to the specific drug.  All opioids
cause both physical and psychological dependence with prolonged use.

    Depending on the opioid in question withdrawal can become evident
after continued use in as little time as 2 weeks or as long as 2 months.

    Withdrawal is commonly overstated by media and tends to be similar
to bad case of flu.  This is due to the fact that most opioid users don't
tend to be able to acquire enough drug to result in severe withdrawal.  It
must be noted that physical symptoms may be similar to flu, psychological
symptoms can be quite painful.  Depression, mood swings, hypersensitivity
to pain are some common symptoms.  Opioid withdrawal DOES NOT endanger life
as does alcohol and other depressant withdrawal.


**********

    If anyone has any info that they would like to share with me
and possibly have included in this FAQ, please send all mail to my
mailbox at [e-mail]

** End of FAQ