These opiate medications are metabolized similarly but differ in their absorption (low for heroin and high for propoxyphene) and their half-life.Īll prescription opiates act primarily on the mu receptor (named after morphine) with much less action at the other receptors. Additional opiates include semi-synthetic and synthetic drugs produced by alteration in the chemical structure of the basic poppy products, such as semi-synthetic drugs, eg, heroin, hydromorphone (Dilaudid) and oxycodone (Oxycontin) synthetic drugs include propoxphene (Darvon), meperidine (Demerol), hydrocodone (Vicodin), and others.
The major opiates include natural substances, such as opium, morphine and codeine (extracted from opium). Biological Mechanisms Underlying Addiction and Dependence They may also lie or do illegal activities to obtain their drugs. Being "unavailable" and not invested in the relationship is common, as is physical and mental abuse. These patients' relationships may suffer because they are preoccupied with maintaining their addiction at the expense of their family and friends. Patients with drug addictions may allocate their income for drugs at the expense of required items. Loss of employment and subsequent financial problems.Occupational Difficulties as a Result of Addiction
As a result, the pain source can become worse, with further destruction of tissue and increased neurological damage. Because addictive opiate use is not linked to a pain source, the usual signal, to refrain from behaviors that aggravate the underlying source of pain, is dulled or absent because of effects of the narcotic medications on the perception of pain. Medical problems can be aggravated by the misuse of opiate medications, which can mask important normal pain pathways. Psychological Consequences (Chemically Induced) The pattern of addictive use becomes evident in the behavioral constellation beginning with preoccupation with acquiring followed by compulsive use and finally a pattern of relapse. Paradoxically, pain from addictive use develops because opiate medications become of central importance to one's life, despite development of adverse consequences. Addiction is a compulsion to use opiate medications that is not necessarily linked to a pain state from an identifiable cause, eg, neurological pain. The principle behavior manifestation of the presence of addiction is loss of control over the use of these medications, which results in excessive and continuous use in the presence or absence of pain from other sources. Signs and Symptoms of Dependence on Opiate Medications
In 1999, approximately 4 million people were using prescription drugs nonmedically, which is about double the 2.1 million people who use heroin and cocaine. We have seen a 5-fold increase in the incidence of narcotic medication use for nonmedical purposes from the 1980s to the late 1990s and 2000. There has been a sharp increase in new users of prescription drugs for nonmedical purposes, particularly painkillers, among teenagers and young adults 12 to 17 years old (2.9 percent increase), and 18 to 25 years old (3.7 percent increase). This misuse of prescription medicines affects many people, particularly older adults, adolescents, and women. The National Household Survey on Drug Abuse demonstrates that 2.6 million people misuse pain relievers, including hydrocodone and oxycodone. Scope of Dependence on Opiate Medications
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