What are Opiates Anyway?

Ok, it’s in the news and everywhere.  It’s a crisis, an epidemic; the sky is falling, but what are opiates?  Why is this a big deal? Why should we be worried?

To answer that,  we need to go to the science.

The three main opiates are Morphine, Codeine, and Thebaine.  These come from the milky “latex” of the opium poppy plant (Papaver somniferum).  This plant was cultivated for its medicinal and recreational properties for more than 6,000 years. All of these opiates work by binding to opioid receptors in the brain and spinal cord to give the pain-relieving effects that patients need and at higher doses, the euphoric effects that abusers seek.

I’m sure you have heard of Morphine, one of the most effective drugs known for the relief of severe pain. Morphine has been around since 1803 and is the principal ingredient in opium. It was praised as a miracle drug for the injured soldiers during the Civil War. It wasn’t until after the war that doctors realized it’s massive addictive qualities. By the end of the war, approximately 400,000 U.S. soldiers were addicted.

In 1874 the German pharmaceutical company Bayer synthesized a previously unknown drug called heroin from morphine. Then in 1898 marketed as a cough suppressant and morphine substitute for children suffering from coughs and colds.

Then there is Codeine, which is medically prescribed for the relief of moderate pain and as a cough suppressant.  Although it only contains 2% of the opium, once it hits the liver it is converted to the addictive Morphine.

Finally, let’s talk about Oxycodone. In 1916 it was synthesized from Thebaine as part of an effort to find a non-addictive drug unlike the ones that were used for medicine before World War I like heroin and Morphine.  Today Oxycodone is one of the more prescribed opiates in the system, and when a patient can’t get Oxycodone, they turn to heroin.

Opiates come in lots of different flavors but are all equally addictive. You can find them in short-acting 6-hour medications like Tylenol 3 & 4, Oxycodone, and Percocet.  You can also find them in long-acting narcotics like Oxycontin and the Fentanyl Patch, which are like short-acting narcotics but modified at a higher dose for a longer duration. The FDA at one time encouraged long-acting narcotics because they thought it would be a deterrent to addiction, but addicts have found many ways to circumvent this system allowing for rapid ingestion of large quantities.

An epidemic or crisis is almost never caused by just one thing that goes wrong, but a confluence of events that together equal the problem.  Now it’s time to fix it.

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