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This is a FAQ that was found on the web. http://www.hyperreal.com/drugs/faqs/FAQ-Opioid It talks about many pain relief drugs.

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OPIOID FAQ (1st draft)

Ok this is the first draft of the opioid FAQ I put together. It is by no means complete and any contribution would be appriciated. Please send all info to my mail box at mdh@debug.cuc.ab.ca. Most of the information is there and any missing or incorrect info is in the FAQ just let me know.

Here it is....

OPIOID FREQUENTLY ASKED QUESTIONS FILE

Editor: Mike Hamilton
Last Update: 10 Jan. 94
Newsgroup : alt.drugs

********** Article Separation

                               ** Contents **

Glossary on terms used in FAQ

Opioid Info:

Natural (known as opiates): Morphine, Codeine

Semi-Synthetic (known as opioids): Heroin, Hydrocodone (Hycodan), Hydromorphone (Dilaudid), Meperidine (Demerol), Oxycodone (Percodan)

Synthetic (also known as opioids): Fentanyl (Sublimaze), Methadone (Dolophine), Propoxyphene (Darvon), Pentazocine (Talwin)

Opioid Addiction and Withdrawal

**********
The FAQ will use morphine as the standard opioid and base all other opioids in relation to it. (Kinda like class inheritance in C++).

**********

A little glossary to start the FAQ:

opiate  - narcotic analgesic derived from a natural source(opium poppy)

opioid  - narcotic analgesic that is either semi or fully synthetic
          - also refers to entire family of both opiates and opioids

IM      - intramuscular injection
SC      - subcutaneous injection

**********
**  Morphine  **

Synopsis: Morphine is naturally occurring substance in the opium poppy, Papaver somniferum. It is a potent narcotic analgesic, and its primary clinical use is in the management of moderately severe and severe pain. After heroin, morphine has the greatest dependence liability of the narcotic analgesics in common use. Morphine is administered by several routes (injected, smoked, sniffed, or swallowed); but when injected particularly intravenously, morphine can produce intense euphoria and a general state of well-being and relaxation. Regular use can result in the rapid development of tolerance to these effects. Profound physical and psychological dependence can also rapidly develop, and withdrawal sickness upon abrupt cessation of heroin use; many of the symptoms resemble those produced by a case of moderately severe flu.

Morphine is infrequently encountered in the North American street drug culture. However, mainly because of its availability in hospitals, there have been several documented cases of morphine dependence among health professionals.

Drug Source
        Morphine is isolated from crude opium, which is a resinous
        prep of the opium poppy, Papaver somniferum.

Trade Name
        Roxinal, MS Contin, Morphine Sulfate

Street Names
        "M", morph, Miss Emma

Drug Combinations
        Use of morphine plus cocaine, as well as of morphine plus
        methamphetamine, has been reported.  However, such combinations
        are not frequently encountered.

Medical Uses
        * symptomatic relief of moderately severe to severe pain;
        * relief of certain types of difficult or labored breathing;
        * suppression of severe cough (rarely);
        * suppression of severe diarrhea (e.g., that produced by cholera).


Physical Appearance
        Morphine is legally available only in the form of its water-soluble
        salts.  Most common are morphine sulfate and morphine hydrochloride.
        Both are fine white crystalline powders, bitter to the taste.  Both
        are soluble in water and slightly soluble in alcohol.

Dosage
~~~~~~
Medical
        For moderate to severe pain the optimal intramuscular dosage is
        considered to be 10 mg per 70 kg body weight every four hours.
        The typical dose range is from 5 to 20 mg every four hours,
        depending on the severity of the pain.  The oral dose range is
        between 8 and 20 mg; but with oral administration morphine has
        substantially less analgesic potency (approximately one-tenth of
        the effect produced by subcutaneous injection) because it is
        rapidly destroyed as it passes through the liver immediately
        after absorption.  The intravenous route is employed primarily
        for severe post-operative pain or in an emergency; in this case
        the dose range is between 4 and 10 mg, and the analgesic effect
        ensues almost immediately.

Nonmedical
        Irregular or intermittent users (who are not substituting the drug
        for another narcotic analgesic) may start and continue to use doses
        within the therapeutic range (e.i., up to 20 mg).  However, regular
        users who employ morphine for its subjectively pleasurable effects
        frequently increase the dose as tolerance develops.  To take several
        hundred milligrams per day is common, and there are reliable reports
        of up to four or five grams (4000 - 5000 mg) per day.


Routes Of Administration
        Morphine may be taken orally in tablet form, and can also injected
        subcutaneously, intramuscularly, or intravenously; the last is the
        route preferred by those who are dependent on morphine.

Short Term Use
~~~~~~~~~~~~~~

Low Doses (single doses of 5 - 10 mg administered by S.C or IM injection in
non-tolerant users)

CNS, behavioral, subjective:
        suppression the sensation of and emotional response to pain;
        euphoria; drowsiness, lethargy, relaxation; difficulty in
        concentrating; decreased physical activity in some users and
        increased physical activity in others; mild anxiety or fear;
        pupillary constriction, blurred vision, impaired night vision,
        suppression of cough reflex.

Respiratory:
        slightly reduced respiratory rate.

Gastrointestinal:
        nausea and vomiting; constipation; loss of appetite; decreased
        gastric motility.

Other:
        slight drop in body temperature; sweating; reduced libido; prickly
        or tingling sensation on the skin (particularly after intravenous
        injection).

Duration
        4 - 5 hours

Dependency Potential
        high, continued use results in both psychological and physical
        dependency

**********

                            **  Codeine  **

Drug Source
        Codeine is found in opium in concentrations between %0.1 and %2.
        Because of the small concentration found in nature, most codeine
        found in medical products is synthesized from morphine via the
        methylation of the hydroxyl group found on the second non-aromatic
        ring.

Trade Name
        There are no commercial name for products containing only
        codeine in US. Found under common name of codeine.
        Canada does have a codeine only syrup available under
        Paveral. Mainly found in combination products.

Street Name
        T-three's (Tylenol #3 w/ codeine), schoolboy, cough syrup

Medical Uses
        * relief of mild to moderate pain
        * relief of non-productive cough
        * relief of diarrhea

Drug Combinations
        Sold under many name brand products, the most popular being the
        Tylenol with Codeine series, the number on the tablet corresponds
        to the amount of codeine and caffeine found in the each tablet.

        Tylenol #1 w/ codeine -  8 mg codeine, 15 mg caffeine
        Tylenol #2 w/ codeine - 15 mg codeine, 15 mg caffeine
        Tylenol #3 w/ codeine - 30 mg codeine, 30 mg caffeine
        Tylenol #4 w/ codeine - 60 mg codeine, no caffeine

        note: all tablets contain same amount of acetaminophen (300 mg)

        Fiorinal (aspirin, caffeine, barbital, codeine)

        Many other brand name product combinations.

Physical Appearance
        Tylenol w/ codeine series are imprinted with number on one side and
        other side is Tylenol label(McNeil).

Controlled Substance Status
        As a single product codeine is a schedule II controlled substance
        in the US.
        When combined with other non-controlled substance, and depending
        on amount per dose unit, codeine combined products range from
        schedule III to V.
        Canada has OTC codeine products available if product has no more
        than 8 mg of codeine per unit dose. Some US areas may have codeine
        preps available OTC, but usually require release form.
        As an interesting fact, a travelers handbook noted that Greece has
        banned codeine in that country (no idea on what it's status is now)
        so be careful when traveling there.

Dosage
~~~~~~
Medical
        Pain relief : 30mg - 220mg oral or equivalent dose SC or IM

        Diarrhea relief : 10mg - 20mg orally

        Cough suppressant : 5mg - 15mg orally

Nonmedical
        Doses can range from 30mg up to 400mg. LD50 for codeine is 800mg in
        a average nontolerant person.
        At doses of > 250mg adverse effects tend to arise, including intense
        itching, flushed skin, dizziness, sedation, nausea and vomiting

Routes Of Administration
        Usually taken orally but can be injected IM or SC. The IV route is
        not recommended as reactions such as facial swelling, pulmonary
        edema and convulsions can occur.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        Effects begin at 30mg and tend to mimic those of morphine, except
        sedation and euphoria are less intense.

Respiratory:
        same as morphine but less intense.

Gastrointestinal:
        same as morphine but nausea and vomiting are less common and
        constipation less severe.

Other:
        alleocodone is a schedule II drug, and when combined
        with other non-controlled drugs, is found from schedule III-IV.

Dosage
~~~~~~
Medical
        as a cough suppressant 5mg - 10mg
        for pain relief 10mg - 30mg

Nonmedical
        doses are similar to those for pain relief

Routes Of Administration
        Usually taken orally but can be inject via three routes. Unknown if
        hydrocodone can be sniffed or smoked. Sniffing is likely possible.


Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        Has similar effects as morphine but less sedation and euphoria

Respiratory:
        Less depression than morphine.

Gastrointestinal:
        Less likely to cause nausea and vomiting than morphine.

Other:
        Hydrocodone is a weaker opioid than morphine but still a effective
        opioid with similar potency to oxycodone.

Duration
        3 - 4 hours

Dependency Potential
        moderately low, much less potential than morphine

**********

                             **  Hydromorphone  **

Drug Source
        Synthetically produced from morphine.

Trade Name
        Dilaudid

Street Name
        Dillies

Medical Uses
        * relief of moderate to severe pain
        * relief of severe cough

Drug Combinations
        most commonly used as a single product

Physical Appearance
        usually bought as tablets, or injectable solution

Controlled Substance Status
        Hydromorphone, like most single product opioids, is a schedule II
        opioid.

Dosage
~~~~~~
Medical
        for pain relief 1mg - 2mg

Nonmedical
        same as pain relief doses

Routes Of Administration
        Can be administered orally, by three routes of injection, and
        by sniffing. Unknown if smoking is an effective route.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        Hydrocodone has effects similar to morphine, except euphoria is
        similar to codeine, nausea and vomiting is quite rare, and
        sedation is practically non-existent

Respiratory:
        Hydrocodone depresses respiration minimally.

Gastrointestinal:
        Hydromorphone effects GI tract very little.

Other:
        Although hydromorphone's euphoria pales with other opioids
        it's abuse potential comes from the fact the rush experienced
        from IV use is very similar to heroin's.

        Hydromorphone is one of the most used opioids in the relief of
        pain for the terminally ill.  The reasons being it's minimal
        side effects, and high potency.

Duration
        3 - 4 hours

Dependency Potential
        moderately high

**********

                              **  Meperidine  **

Drug Source
        Meperidine is completely synthetic and can be produced with
        dichlorodiethyl methylamine and benzyl cyanide.

Trade Name
        Demerol

Street Name
        Demmies

Medical Uses
        * originally found to be useful for muscle spasms but the
          discovery of it's analgesic properties has resulted in
          it's almost exclusive use for relief of moderate to severe
          pain

Drug Combinations
        usually found as a single product, with few combination products.
        Is found in combination with acetaminophen in Demerol APAP

Physical Appearance
        Demerol tablets are small white tablets with the name
        Winthrop on one side

Controlled Substance Status
        Schedule II substance in US

Dosage
~~~~~~
Medical
        pain relief is achieved with approx. 50mg - 150mg injected
        or 200mg - 300mg oral

Nonmedical
        doses similar to those used in medical settings are used in
        recreational use.

Routes Of Administration
        orally, three injection routes, and sniffing are possible,
        unknown if smoking is possible

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        same as morphine but less sedation, less intense euphoria

Respiratory:
        respiratory depression tends to be less common and less intense
        than morphine

Gastrointestinal:
        nausea and vomiting are reportedly common with oral use, but
        less when administered via injection

Duration
        3 - 4 hours

Dependency Potential
        reported to be less than or equal to that of morphine

**********

                             **  Oxycodone  **

Drug Source
        synthesized from codeine

Trade Name
        only found as a compound product combined with aspirin or
        acetaminophen. Available in Canada as a single product in
        the form of a suppository

Street Name
        Percs

Medical Uses
        * relief of moderate to severe pain

Drug Combinations
        Percodan is aspirin and oxycodone
        Percocet is acetaminophen and oxycodone

Physical Appearance
        Percodan tablets are color coded according to quantity of oxycodone
        in each tablet, the pink have ~2.5mg and the orange and green having
        twice as much

Controlled Substance Status
        Schedule II in US

Dosage
~~~~~~
Medical
        10 - 20mg oral for pain relief
        5 - 15mg injection

Nonmedical
        Doses similar to those used in a medical setting are used

Routes Of Administration
        Can be administered orally, three injection routes, sniffed
        and possibly smoked.

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        Same as morphine but milder.

Respiratory:
        Less respiratory depression than morphine

Gastrointestinal:
        Less constipating than morphine

Duration
        3 - 4 hours

Dependency Potential
        Moderate

**********

                              **  Fentanyl  **

Drug Source
        Synthetically produced

Trade Name
        Sublimaze

Street Name
        China white

Medical Uses
        Mainly relief of moderate to severe pain and as a surgical
        anesthetic

Drug Combinations
        none

Physical Appearance
        Found as a injectable solution, and a transdermal patch

Controlled Substance Status
        Schedule II in US

Dosage
~~~~~~
Medical
        50ug - 200ug

Nonmedical
        same range as medical use

Routes Of Administration
        can be administered via three injection routes, sniffed and smoked

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        euphoria is less than morphine

Respiratory:
        same as morphine but has potential to cause respiratory muscles
        to go into spasm and result in respiratory arrest

Gastrointestinal:
        less constipating that morphine

Duration
        1 - 2 hours

Dependency Potential
        moderately high

**********

                              **  Methadone  **

Drug Source
        synthetically produced

Trade Name
        Dolophine

Street Name
        Dollies

Medical Uses
        occasionally used for pain relief, but main use is in opioid
        withdrawal treatment as a substitute drug

Drug Combinations
        none

Physical Appearance
        found as a fruity solution for oral use, in wafers, and tablets
        also found as a injectable solution

Controlled Substance Status
        Schedule II in US

Dosage
~~~~~~
Medical
        3 - 5mg provides same pain relief as 10mg morphine

Nonmedical
        rarely used non-medically, but doses used are approx. same
        as medical doses

Routes Of Administration
        can be injected via three routes, taken orally, unknown if
        methadone can be smoked, can be sniffed

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        Oral use provides little euphoria and tends to block opioid
        receptors in brain, so commonly used as a maintenance drug
        during rehab.

Respiratory:
        Produces little depression in contrast to morphine

Gastrointestinal:
        produces constipation of less intensity than morphine

Other:
        Developed by Nazi Germany during WWII as Germany was unable
        to acquire adequate supplies of morphine.

Duration
        first dose last approx. 8 hours and subsequent doses last 18 - 24
        hours.

Dependency Potential
        oral use provides little euphoria so little abuse potential in
        that form. When injected, methadone give very similar effects to
        morphine so has similar addiction potential.

**********

                              **  Propoxyphene  **

Drug Source
        Synthetically produced with similar structure to that of methadone

Trade Name
        Darvon, Darvon N

Street Name
        none

Medical Uses
        for relief of mild pain

Drug Combinations
        Darvon compound is aspirin and propoxyphene

Physical Appearance
        Darvon N as pink oval pills

Controlled Substance Status
        Schedule III in US

Dosage
~~~~~~
Medical
        range from 50mg - 150mg of hydrochloride

Nonmedical
        similar to medical dose ranges.

Routes Of Administration
        can be taken orally, three possible injection routes, no info
        on possible intranasal or smoked administration

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
         oral use provides very little euphoria, mild sedation;
         at larger doses sedation becomes quite prominent and symptoms
         such as staggering and slurred speech become apparent.

Respiratory:
        little respiratory depression in medical dose range

Gastrointestinal:
        little effect on GI tract

Other:
        IV use is reported to give rush similar to heroin;
        poor analgesic with standard dose providing less pain relief
        than standard aspirin dose

Duration
        3 - 4 hours

Dependency Potential
        low

**********

                              **  Pentazocine  **

Drug Source
        synthetically produced

Trade Name
        Talwin

Street Name
        yellow footballs

Medical Uses
        for relief of moderate to moderately severe pain

Drug Combinations
        Talwin NX - pentazocine and nalaxone (opioid antagonist)

Physical Appearance
        usually found in orange-yellow tablets

Controlled Substance Status
        Schedule III

Dosage
~~~~~~
Medical
        50mg - 100mg for pain relief

Nonmedical
        similar to medical dosage

Routes Of Administration
        can be taken orally, three injection routes, and sniffed
        possibly smoked

Short Term Use
~~~~~~~~~~~~~~
CNS, Behavioral, Subjective:
        poor opioid, very little euphoria, mainly just sedates and
        clouds mind, little recreational use

Respiratory:
        less depression than morphine

Gastrointestinal:
        very little constipation or nausea, vomiting occurs

Other:
        as a opioid agonist/antagonist has potential to cause
        psychotic effects such as hallucinations, severe confusion

Duration
        3 - 4 hours

Dependency Potential
        moderate potential, similar to hydrocodone

**********
Opioid Dependence And Withdrawal

Opioids have specific withdrawal and dependence characteristics common to all opioids, varying according to the specific drug. All opioids cause both physical and psychological dependence with prolonged use.

Depending on the opioid in question withdrawal can become evident after continued use in as little time as 2 weeks or as long as 2 months.

Withdrawal is commonly overstated by media and tends to be similar to bad case of flu. This is due to the fact that most opioid users don't tend to be able to acquire enough drug to result in severe withdrawal. It must be noted that physical symptoms may be similar to flu, psychological symptoms can be quite painful. Depression, mood swings, hypersensitivity to pain are some common symptoms. Opioid withdrawal DOES NOT endanger life as does alcohol and other depressant withdrawal.

**********

If anyone has any info that they would like to share with me and possibly have included in this FAQ, please send all mail to my mailbox at mdh@debug.cuc.ab.ca

** End of FAQ


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