Opioid Replacement Therapy Research Paper

Heroin is a painkilling drug that is made from the Papaverum Somniferum, also known as the opium poppy plant. All opiates are addictive painkillers. Heroin starts as a milky sap of the opium poppy. The sap is then dried and becomes a gum. After washing the gum, it becomes opium. Morphine and codeine are two painkilling alkaloids that

The drug was first created in 1898 as a medicine to relieve pain to those who were suffering from illnesses. However, it was eventually pulled from the market due to its severe and unwanted side effects. Heroin is made from a milky substance found inside the poppy plant. Pure heroin is as much as eight times stronger than that of morphine (Encyclopedia Britannica, 2017).

Opioids are classified as opium like compounds; some (ex. codeine and morphine) exist naturally in opium, which is a gummy substance derived from the seedpod of the opium poppy, indigenous to Southern Asia. Other opioids are of the synthetic category, such as methadone or fentanyl (opioidaddictionsource.com). Though the use of prescription opioids may be well intended, due to their effect on the brain chemistry, it is fairly common for one to become addicted to them; America is amidst a raging prescription opioid epidemic, in fact.

Opioids are drugs that come from opium. Opium is the dried latex which comes from the opium poppy seed. These drugs create an euphoric effect on the brain. They attach to receptors in the brain to release opium. There are four classes of opioids. Endogenous opioids which the body release on its own at moments of joy. Opium alkaloid, semi-synthetic opioids, and fully-synthetic opioid which are all human made chemically in labs.

Correspondingly, pharmaceutical opioids are not the only narcotics consumers can get their hands on. It is said that heroin, an illegal but natural opiate, “... scheduled 1 controlled substance in the United States…” (AmericanAddictionCenters) Taking heroin puts consumers at a high risk for addiction and abuse. Although heroin is a very dangerous drug it does dull pain, impair cognition and the senses, increase sedation, and slow functions of central nervous system. It is stated that “... heroin is the fastest-acting opiate.” (AmericanAddictionCenters). Heroin is described as a brown, or white powder or sticky substance that may be snorted, smoked, or injected, giving consumers a sense of “rush” or “high” that comes very rapid and very intense. Due to the fact that prescription opioids are becoming more expensive and less accessible many people turn to heroin, a much cheaper opiate. Not to mention, but three out four consumers who first started off by taking prescription medication who then became abusive of them now look towards the “high” of heroin. It's no coincidence that opioids, illegal or not can cause severe damage to the consumer that may even lead to deaths due to overdose. Above all, “heroin and other opioid drugs interact with the dopamine levels in the brain,which is what causes the burst of pleasure associated with their use.” (AmericanAddictionCenters) Clearly the abuse of any drug leads to drug tolerance, dependence, and last but foremost addiction.

Today all across America people are buying and selling prescription drugs and street drugs that are killing our youth and our elders. Opiates directly affect the central nervous system. Narcotics commonly known as "opiates attach to specific proteins called opioid receptors and can be found in the brain, spinal cord and gastrointestinal tract. When

Opioid use has to begin somewhere. Patients that are prescribed opioids for pain treatment run a risk of developing dependency on the prescribed medications. Numerous individuals who take the opioids for extended amounts of time may begin to progress towards higher tolerances of the prescribed medicines. Due to this higher tolerance, individuals may feel like they need to take more than what was prescribed. Eventually this can lead to craving opioids in order to function or to “feel better” throughout the day. In fact, it has been estimated that between twenty-one and twenty-nine percent of patients that are prescribed opioids for chronic pain misuse them and close to ten percent develop an opioid use disorder (https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis, 2017). “Some people experience a euphoric response to opioid medications, and it is common that people misusing opioids try to intensify their experience by snorting or injecting them” (https://www.samhsa.gov/disorders/substance-use, 2015). This means of drug intake, generally leads to the exploration of more easily acquired drugs with stronger effects.

These drugs that are converted from opium are: morphine, heroin, codeine, oxycontin, to name but a few. Unfortunately, each of these narcotics are habit forming, meaning they have the power to become addicting if a person takes them over a period of time.

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

The use of opioid-based prescription medications to treat non-terminal chronic pain can cause side effects from short term use, and is overly common and ineffective. Firstly, opioid usage can induce negative short-term effects. According to William A. Darity, Jr., short-term opioid usage causes negative effects such as “euphoria, drowsiness, and impaired motor and cognitive functioning” (“Drugs”). The short term effects of the opioids may cause the patient to isolate him or herself socially due to being self-conscious about his or her friends and peers seeing the individual in their current condition. Due to his or her fragile emotional state, however, if the patient isolates him or herself during a time in which he or she should have increased

Opioid addiction is a condition that is preventable as well as one which individuals display several noticeable risk factors before the actual addiction prognosis to the point of causing death. There is a strong correlation between the early misuse of prescription opioids, which are prescribed for non-cancer pain management, and the development of a dependence on such opioids. Early detection of risk factors such as the misuse of opioids that are prescribed will help indicate that a patient is developing an addiction.1 Physicians, nurses, pharmacists, and other healthcare providers must closely monitor patients and the rate at which opioids are consumed as well as refilled.

Opioid abuse is a growing epidemic within the United States. Not only are people abusing the prescription forms of opioids (such as oxycodone - OxyContin, hydrocodone - Vicodin, codeine, and morphine) by taking more than they are supposed to, but they are also being bought, sold, and used on the streets illegally; such as heroin. Opioids are highly addicting because of the high they can induce in a person, causing a dependence and yearning for continued use (NIDA, n.d.) In 2007, the United States was responsible for over 99 percent of the global consumption of hydrocodone and 83 percent of the global consumption of oxycodone (United Nations Publications, 2009).

Opioid use disorders are directly linked to major consequences for individuals as well as society. Opioids include drugs such as Vicodin, oxycodone, morphine, and heroin among others (CITE). Currently, estimates show there are about 20 million people abusing or addicted to opioids countrywide (Bell, 2014). Opioid use can cause decrease quality of life as it is a common cause of familial conflict, homelessness, incarceration, life threatening illness, and death by overdose.

To minimize harming patients and to optimize the quality of life for people that are taking opioids, doctors should consider the following strategies; symptomatic management of adverse effects, altering the route of administration, opioid rotation, and dose reduction. Symptomatic management entails treating opioid-induced side effects with a medication that targets that specific symptom. Altering the route of administration might include a switch to a medication that can be administered transdermally, such as fentanyl. Opioid rotation is when you switch out one opioid for another and it’s normally done to improve pain control and/or reduce any adverse effects. Dose reduction is exactly what it says, reducing the dose to minimize drowsiness,

Opioids can be divided into three categories: Opiates, Semi-Synthetic Opioids, and Synthetic Opioids. Opiates are derived directly from opium poppies. They include drugs such as Morphine and Codeine. Semi-Synthetic Opioids are derived from Opiates. They include many prescription painkillers such as Hydrocodone, Hydromorphone, Oxycodone, and Oxymorphone. However, this category also includes the illegal street drug Heroin. The third category is Synthetic Opioids, which are not derived from opiates and include drugs such as Fentanyl, Buprenorphine, and Methadone.