From Heroin to Fentanyl

Fentanyl and heroin

Opioid Addiction

You might get confused over terms as you read about opium, opiates and opioids. Heroin, morphine, opium and codeine are opiates produced from the opium poppy plant. The other painkillers you read or hear about or ones prescribed usually by a doctor, such as Percocet, Demerol, Oxycodone, etc., are likely opioid pain killers – opioids are synthetic drugs. So, opium has to do with the poppy plant, opiates are produced from opium and opioids are synthetic, opiate-like drugs. As bad as opiates are for those who become addicted, opioids like Fentanyl are becoming worse.

The drug Fentanyl is an opioid, a synthetic, opiate-like drug that is 50 times more potent than heroin and 100 times more potent than morphine. In some areas of the US, Fentanyl is now a larger problem than heroin. According to this NY Times article, in certain New England areas, illicit Fentanyl is coming from Mexico. Although Fentanyl is great for pain relief if applied properly by medical professionals, it’s high risk to buy it off the street because it’s so potent.

The strange part is that when addicts hear about someone overdosing from a strong drug like Fentanyl, they’ll seek it out, thinking they won’t use so much as to kill them, but knowing they’ll get what they consider good product. Addiction and thrill seeking override good judgement. This is from the article:

“It’s just everywhere,” Heather Sartori, 38, a former nurse who is on methadone after years of shooting up heroin, said as she sat at a busy McDonald’s here. “It would be really hard to navigate through this city without being touched by it.”

She said she had lost several friends to fentanyl and called Lawrence’s drug-infested landscape “the treacherous terrain where the ghosts of the fallen linger.”

“It’s cheaper, and the high is better, so more addicts will go to a dealer to get that quality and grade,” she said, even if it means they could die.

“That is the phenomenon of the addicted mind,” she said. “It’s beyond the scope of a rational thinker to understand.”

Hopefully, as the opiate/opioid problem spreads, more resources will arise to intervene, educate and provide treatment. This is not a new problem – opium, opiates and opiate-like drugs have been a problem since opium poppy plants were first discovered thousands of years ago. Today, though, in the 21st century, there are answers to the problem. Also, opiate/opioid addiction should always be considered in the context of addiction in general — still, alcoholism does far more damage to society than opiate/opioid addiction. We’ve come a long way treating addiction, but there’s still a lot that needs to be done.


Opiates and pain

Opiate addiction

Do opiates work long term?

Most people have no idea how long opiates have been used as a mood altering drug or as a pain-killer. Below is from the Atlantic:

The earliest reference to opium growth and use is in 3400 B.C. when the opium poppy was cultivated in lower Mesopotamia. The Sumerians referred to the opium poppy as “Hul Gil” – the “Joy Plant,” and would pass the plant and its euphoric effects on to the Assyrians, who in turn passed it on to the Egyptians.1

Around 460-357 B.C., Hippocrates, the “father of medicine,” acknowledged opium’s usefulness as a narcotic and styptic in treating internal diseases, diseases of women and epidemics. He prescribed drinking the juice of the white poppy mixed with the seed of nettle.2

Alexander the Great introduced opium to India near 330 B.C., and the Arabs, Greeks and Romans used it as a sedative.2

Approximately 220-264 A.D., the noted Chinese surgeon Hua To of the Three Kingdoms used opium preparations and Cannabis indica for his patients to swallow before undergoing major surgery.3

During the Middle Ages opium was banned from the east, but soon enough a German chemist named Friedrich Wilhelm Adam Sertürner isolated morphine from opium. The name Morphine comes from the god of dreams, Morpheus.

In the early 20th century, regulations started prohibiting the import of opium to smoke, and then more and more regulations have led to the present control over opiates. Of course regulations haven’t prevented a black market for illegal opiates. Opiate use is on the rise in the US, especially prescribed pain-killers which are legal but just as dangerous. The brain doesn’t distinguish between an opiate bought on the street or the opiate prescribed by a doctor.

As for opiates and pain, a person in physical pain might have good reasons for taking opiate medication, but once addicted the use of opiates is no longer for pain, unless we’re talking about the pain of withdrawal. Most research has shown that long term use of opiates for chronic pain is likely counter-productive, so anyone using opiates for years to deal with pain might be misled or might have a problem with opiates and should seek help. Medication-assisted withdrawal is showing much success if the medication is taken properly. Withdrawal from opiates can last for a long time if the person has used opiates heavily for a long time, so recovery has to be managed for the long term.