Monday, June 30, 2008

Opiate Addiction

You've never touched drugs in your life and you go to the Doctor one morning only to be told that that your urine sample shows you've been smoking heroin or possibly injecting a little too much morphine. How'd that happen? As you talk to the Doctor about your food intake over the last two days: banana, bagel, strawberry...wait, wait what type of bagel did you have? A poppy seed bagel. That explains it! But, how? To answer this question, one would have to know that there are two types of poppy seeds. Those derived from opium poppy plants which can imitate heroin. There are also other poppies that have nothing to do with opiates. Piece of advice: if you’re going in for a drug screen for that job you’ve always wanted, avoid having a morning bagel. Perhaps the next question one would have is:

What is an opiate?

An opiate is a drug derived from the opium plant. The main opiates are morphine, codeine, heroin, thebaine, and papaverine. Morphine and heroin have the same chemical structure which is why morphine use can show up in a urine screen as heroin, especially when small amounts have been used. Having said this, out of the two drugs, heroin is more potent because it can enter the brain faster than morphine. Both drugs act as analgesics and sedatives producing a relaxing effect.

Morphine

Morphine is the most important and prevalent form of opium. It is responsible for side effects such as coma, respiratory difficulties, or cardiac problems. A lethal dose is considered 120- 125 mg which is approximately two grams of opium. Even though morphine is the most prevalent form of opium, codeine, which is made from morphine, is utilized most frequently.

Codeine

Codeine works the same way as morphine, in that depending on the way it is extracted and from what plant, one gets a stronger or lesser effect.

Thebaine and Papaverine

Studies have been done to try to determine how much thebaine and papaverine are in opium plants. As of now, Iranian samples have the highest percentage. Thebaine is the most potent, poisonous and dangerous opium alkaloid and isn’t used often. However, it has been converted into other narcotics that are used medically such as: oxycodone, oxymorphone and hydrocodone. Papaverine is used often for anything from erectile dysfunction to heart spasms. It is used so often in fact, that supplies often run short.

How do you get these drugs from a poppy plant?

How potent morphine, heroin or codeine is depends not only on the type of opium poppy utilized but also on the moisture content of the plant. How much morphine is expressed from a plant depends on how wet the plant is and on how much opium is produced by that plant. It also depends on what country the plant has been obtained. For instance in Greece, Bulgaria and Turkey, each capsule is bled one time, making the plant more potent. In countries like India and Afghanistan the capsules are bled four or five times on different days until they give no more juice. The less juice there is the less potent the drug. After the plants are bled they are then mixed together. This is why usually Indian opium is not as potent as Turkish and Greek opiums.

Most legal morphine is used to manufacture codeine. Morphine can also be utilized to make drugs such as apomorphine (used as an emetic—to stop people from vomiting), dihydromorphine (analgesic- to stop pain), hydromorphone (to relieve pain, commercial form is Dilaudid).

Are opiates dangerous?

If one looks back historically, derivatives of the opium poppy have been used for centuries as it is a very effective analgesic. This is not to imply however, that use of the opium is safe or advisable in excess. Some of the side effects of opiates include:

• psychological and physical dependence
• Body as a whole- muscle spasticity
• Respiratory- difficulty breathing, slow, shallow and labored breathing, stopped breathing (sometimes fatal within 2-4 hours)
• Eyes, ears, nose and throat- pinpoint pupils
• Gastrointestinal- constipation, spasms of the stomach and intestinal tract.
• Heart and blood vessels- low blood pressure
• Nervous system- drowsiness, disorientation, coma

Isn’t Methadone an Opiate as well?

Yes, methadone is a liquid form of opiates usually used to help stop heroin use. When de-toxing from heroin use, it is imperative that one be careful and be monitored. Otherwise, use of methadone can also be addictive.

What Is so Addictive About Heroin?

Heroin imitates endorphins, causing a feeling of euphoria. For this reason it is used as both a pain killer and as a recreational drug. However, frequent administration of the drug leads to a high potential for causing addiction. Withdrawal is also highly likely. If one uses heroin continuously for three days and then stops abruptly it is possible to have symptoms of withdrawal. This occurs much faster than with other pain killers like oxycodone and hydrocodone.

What should I do if I know someone who is addicted to an opiate?
Opiate addiction warrants immediate attention by individuals that are familiar with how to cope with the addiction. As mentioned prior, opiate addiction does cause serious adverse effects which can be life threatening and should be taken seriously.

What about those poppy seeds?

Back to the original question, if someone tests positive for an opiate, and they know they’ve never taken such drugs, what do they do? A study was conducted in 1998 where a subject was tested for urine morphine concentrations after eating two poppy seed rolls.

When the urine was tested, the concentration was almost three times the cut off set by the Substance Abuse and Mental Health Services Administration.

So, how do I prove I never used an opiate?

Don’t worry, there are secondary tests. Thebaine is a natural part of opiates and doesn’t show up in products processed from opium poppy plants. So, if a urine sample that tests positive for opiates also tests positive for thebaine, the urine opiates were from eating poppy seeds, not drug use. Having said this, your best bet is to avoid bagels for a few days before that new employment drug screen.

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