FACT SHEET TWENTY SEVEN

        OPIATES

What are Opiates?

Opiates are central nervous system depressants which are used medically to relieve pain. Opiates are derived from a resin of the poppy plant, which grows in many countries through out the world. The poppy plant is grown extensively in former eastern Europe and many drugs now coming into western Europe are produced from the waste products of the commercially grown poppies in Poland and the former Soviet Union etc.

The resin from the poppy plant can be converted into opium, heroin, codeine and morphine. Methadone is an opiate substitute and is synthesised from the raw materials found in the opium poppy. Methadone is prescribed for people who are dependant on opiates, either as part of a reducing regime or for maintenance purposes.

Opiates have a high potential for abuse and are found in a variety of forms including powders, liquids, tablets, syrups and capsules. Some opiates such as morphine and codeine are prescribed by doctors, they are used to relieve pain, coughs and diarrhoea. Other opiates, the popular street drugs such as heroin, are very potent and are the opiates most commonly abused.

Most opiates are taken orally, except for heroin, which is in a powder form. Heroin can be sniffed, smoked, but the heroin user is characterised as someone who injects the drug. This is achieved by dissolving the powder in water over heat which produces a liquid. The heroin user than injects this liquid intravenously or by subcutaneous injection. 

Subcutaneous injection ('skin popping') is when a heroin solution is injected into the layers of the skin usually in the arms or the thighs. Intravenous injection ('mainlining') is when the heroin solution is injected directly into the human blood vessel. The effects of injecting heroin are felt within minutes and lasts between three and four hours depending on the dosage.

Street Heroin can be a white or brownish powder, It is locally known as 'brown'. It is usually diluted or 'cut' with sugar, milk powder, quinine, brick dust or in fact anything to increase the bulk amount which is sold on to the user. This means that the street product is of unknown purity and strength.

Psychological Effects of Opiates

Like other depressants, opiates produce a tranquil and euphoric effect, users who are injecting opiates such as heroin may also experience a rush as the drug circulates through the body. Some users combine opiates with a stimulant such as cocaine, this called 'Speedballing'. The stimulant keeps the user from falling asleep; the opiate reduces the hyperactive effect often caused by stimulants.

Psychological dependence is probable with the continued use of opiates, when the user becomes dependant finding and using the drug becomes the main focus of their lives. Opiates induce tolerance: the need for more of the drug to produce the same effect.

Physical Effects of Opiate Use

The physical effects of opiates depends on the opiate used, its source, the dose and the method of use. Opiates slow breathing, heart rate and brain activity, they depress appetite, thirst and sexual desire. The body's tolerance to pain is increased.

Potential contamination, using opiates in combination with other drugs, and using unsterile needles and injecting equipment all increase the dangers of opiates. Using unsterile needles and injecting equipment can lead to infection with hepatitis, HIV / AIDS and other blood borne diseases. 

Regular opiate users who abruptly stop using the drug experience withdrawal symptoms four to six hours following the last dose. Symptoms include a sense of unease, diarrhoea, stomach cramps, chills, sweating, nausea, runny nose and eyes, irritability, feeling weak and shaky and sleep disturbance. The intensity of these symptoms depends on how much of the drug was taken, how often and for how long. These symptoms are usually strongest 24-72 hours after onset and may persist for seven to ten days. Sometimes sleeplessness and craving for the drug can last for several months.

Effects on Unborn Children

Opiates are harmful to the developing foetus, pregnant women who are dependant on opiates have a higher risk of spontaneous abortions, breech deliveries premature birth and still birth. Babies born to addicted mothers often have withdrawal symptoms like those of adults which may last for weeks or months. Research indicates an increased risk of sudden infant death syndrome (SIDS) among babies born to heroin addicted mothers.

There are four basic approaches to treating opiate addiction:

Detoxification. Supervised withdrawal from the drug in a hospital or on an outpatient basis depending on the user's circumstances.

Therapeutic Community (first-stage treatment) Users live in a highly structured drug free environment with the emphasis on a programme of activities designed to address the psychological dependence on opiate and other mood altering drugs.

Outpatient Day Programmes Using a combination on individual counselling and group work the psychological dependency is addressed and preparation for a drug free life is a core activity.

Methadone Maintenance  The Patients receive methadone daily as a substitute for the opiates. Methadone does not produce the same high as heroin, however, it prevents craving for the drug and withdrawal symptoms. Methadone is available in liquid or capsule form and it may be prescribed daily or weekly depending on the needs of the individual. It may collected from the patient's local pharmacist.

Signs and Symptoms of Opiate Use

The following are signs and symptoms often associated with opiate use: