You have to think…
How do opioids work in your body?
Why do human beings like to abuse opioids?
Does your body release opioid-like substances?
Describe the principal pharmacological effects of
narcotics and their main therapeutic uses.
Identify the major side effects of narcotics.
Describe the association of AIDS with heroin abuse.
Describe narcotic dependence, tolerance, addiction,
& withdrawal symptoms.
Describe how designer drugs have been associated
Narcotic: a CNS depressant that produces
insensibility or stupor
Analgesics: drugs that relieve pain without
Opioid: relating to the drugs that are derived from
Antitussive: drugs that block coughing
Speedballing: combining heroin and cocaine
The history of narcotics
Opium in antiquity in the eastern Mediterranean
Opium in China & Asia
American opium use:
Morphine was used to treat pain,
& fatigue during the Civil War.
"The Poppy Goddess,
Patroness of Healing" is
about three feet high
with three poppies in the
front of her tiara. Some
that this female deity,
crowned with poppy
pods, presided over an
opium-smoking cult on
Crete over 3,5000 years
Opium use in China & Asia
The opium poppy probably reached China about
the 7th century A.D. through the efforts of Arab
Opium War from 1839 to 1842.
The importation of opium from India to China
continued to increase until 1908.
Opium use in Taiwan (Formosa).
Opium Poppy Cultivation in Southeast Asia.
Golden Triangle region of Southeast Asia
In 1839 China
attempted to halt the
illegal importation of
opium by British
Opium smoking in China (1858) (Guangzhou), shown
here. Britain won the
battle easily, and
China was forced to
cede the island of
Hong Kong to Britain.
1882 engraving of the British opium warehouse in Patna, India
In 1900 a new
Factory was completed
in Taihoku and equipped
with the latest facilities.
In 1922 this factory was
producing around 50,000
kg of prepared opium
and 4,000 kg of
Unpacking opium cases at the Government Opium Factory in
Opium smoker, northern Thailand.
Shan heroin refinery in Thailand
Opium Poppy Cultivation in
Opium Poppy Cultivation and
Heroin Processing in Southeast Asia
The Golden Triangle Area of Mainland Southeast Asia is ideally
suited for the cultivation of opium poppy. Although the poppy
plant will grow remarkably well in this climate, soil, and humidity
with little to no effort, farmers in this region, nonetheless, expend
a considerable amount of time and effort caring for their crop.
Poppy farmers typically spend 6 months of the year in their poppy
fields, nurturing and safeguarding their family’s primary cash
crop. In contrast, the synthesis of heroin from opium takes only a
day or two. But heroin chemists or, more precisely, heroin “cooks,”
in Mainland Southeast Asia must possess a higher level of
knowledge and skills than the poppy farmers who produce the
opium. In addition, the owners and operators of such heroin
laboratories must provide an elaborate support system of cash,
armed protection, chemicals, equipment, transportation, and
access to reliable wholesale heroin buyers.
American opium use
Morphine was used via hypodermic syringe to treat pain,
dysentery, & fatigue during the Civil War.
Opiate addition: soldier’s or army disease
By 1900, 1 million Americans were dependent on opiates.
In 1914, the Harrison Narcotic Act was passed.
Heroin, heroic drug, was as a cough suppressant by
Bayer in 1898. It was banned from U.S. in 1924.
During the Vietnam War, 40% of the U.S. soldiers used
Heroin smoking became popular in the mid-1980s in
response to AIDS epidemic.
Narcotic analgesics (morphine): they are
potent analgesics against almost all type of
Antitussives (codeine): they suppress the
coughing center of the brain
Miosis: pinpoint pupil
GI tract: constipation; to relieve diarrhea
Emesis: morphine stimulates the
chemoreceptor trigger zone in postrema
Severe respiratory depression
Drowsiness, mental clouding
Nausea, vomiting, itching
Blood pressure drop
Abuse, tolerance, dependence, &
Schedule classification of narcotics
Codeine II, III, IV
Narcotics combined with NSAIDs
Heroin combination: quinine (bitter taste), alcohol, cocaine
Heroin addicts: death occur by overdoses; combined with
alcohol or barbiturates; infected with AIDS or hepatitis
Heroin and crime: antisocial behavior
Patterns of heroin abuse: adolescents and young adults
Methods of administration: sniffing, injecting, smoking,
Heroin addicts and AIDS
Heroin and pregnancy
Short- & long-term effects of heroin use
"Rush“, depressed respiration, clouded mental
functioning, nausea and vomiting, suppression of
pain, spontaneous abortion
Addiction, infectious diseases, for example,
HIV/AIDS & hepatitis B and C, collapsed veins,
bacterial infections, infection of heart lining and
valves, arthritis and other rheumatologic problems
Symptoms of withdrawal from
heroin, morphine, & methadone
Craving for drugs; anxiety
Yawning打呼, perspiration出汗, running nose, tears
Pupil dilation, muscle twitches, aching bones &
muscles, loss of appetite
Insomnia, raised BP, fever, nausea
Curled-up position, vomiting, diarrhea, foot kicking
Treatment of heroin dependence
Stops using heroin
No longer associates with dealers or users of
Avoids dangerous activities associated with heroin
Improves employment status
Refrains from criminal activity
Is able to enjoy normal family and social
Fentanyls: >200X potency of morphine
Hydromorphone: an analgesic and cough suppressant
Oxycodone: a moderate narcotic analgesic
Meperidine: 1/10 potency of morphine
Buprenorphine: to treat narcotic abuse & dependence
Codeine: treatment of moderate pain & cough
Pentazocine: slighter potent than codeine
Propoxyphene: ½ potency of codeine
MPTP: a designer tragedy, Parkinson-like disease
It relieves moderate to intense pain since it was first
isolated in 1803.
Heroin : morphine : codeine=24 : 12 : 1
Side effects: constricted pupils, respiratory arrest,
drowsiness, constipation, nausea, blurred vision, etc
The first exposure of morphine is unpleasant, with
nausea & vomiting, followed euphoric response in
The effects of heroin and morphine are almost identical.
It was first synthesized in Germany in 1943, World War
Its physiological effects are the same as those of
heroin and morphine
Treatment of narcotic withdrawal and dependence
Psychological dependence, tolerance, and then
physical dependence and addition if repeated use
Methadone reduces the cravings associated with
heroin use and blocks the high from heroin, but it does
not provide the euphoric rush.
Its longer action and a less intense withdrawal
Dextromethorphan: treatment of cough
It is mixed with drugs such as alcohol, cocaine, &
amphetamine, to give unusual psychoactive
It relieves some of the physical effects of opiate
withdrawal (vomiting & diarrhea).
Naloxone/naltrexone: narcotic antagonists
Naloxone is a useful antidote in the treatment of
Dextromethorphan produces a feeling of
disassociation or intoxication, but its abuse can lead
to psychotic behavior. In the long term, overdose of
DM can cause depression, memory problems, &
Naloxone has an extremely high affinity for μ-opioid
receptors in the central nervous system. Naloxone is a μ-
opioid receptor competitive antagonist, and its rapid
blockade of those receptors often produces rapid onset of
withdrawal symptoms. Naloxone also has an antagonist
action, though with a lower affinity, at κ- and δ-opioid
Opium smuggling didn’t just make money. At times, opium
was money. Opium built empires and had a hand in financing
much of the world’s infrastructure.