After finishing this chapter, students should be able to understand:
Opium was used in its raw form for centuries, both medicinally and for pleasure.
Opium had significant influences on medicine, literature, and world politics through the 1800s.
Dependence on opiates has been recognized for a long time, but no concerted effort to control dependence was tried until the patent medicine era of the late 1800s, combined with opium smoking by Chinese Americans, led to federal regulations in the early 1900s.
The typical opiate abuser changed from being a middle-aged, middle-class woman using narcotics by mouth to being a young, lower-class man using heroin by intravenous injection.
Various synthetic narcotics are now available along with the natural products of the opium poppy. These drugs all act at opioid receptors in the brain.
Opioid receptors are normally acted on by the naturally occurring opioid-like products of the nervous system and endocrine glands, endorphins and enkephalins.
The narcotic overdose triad consists of coma, depressed respiration, and pinpoint pupils. Death occurs because breathing ceases.
Illicit heroin comes primarily from Southeast Asia, Southwest Asia, and Mexico.
Opioid dependents have been offered a wide variety of treatments, but the most effective in reducing crime and relapse has been methadone maintenance.
A longer-acting synthetic opiate, LAAM, is now available for maintenance treatment.
Although the British continue to make heroin available for pain relief and treatment of dependent individuals, most British dependent individuals in treatment are now maintained on methadone.
