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Opiates are powerful pain relievers derived from poppy plant chemicals called alkaloids. Thebaine, codeine, and morphine are the psychoactive alkaloids that produce the analgesic and sedative effects of opiates. Pure opiates include:
Opium (street names Gee, O, and Skee): Opium is a Schedule II drug that is no longer used medicinally for treating pain. Opium is typically smoked alone or combined with methamphetamine or marijuana.
Codeine (street names Schoolboy, Captain Cody, Lean): Depending on packaging methods, codeine can be a Schedule II, III, or IV drug that is prescribed primarily for treating severe cough. When used illegally, codeine is often combined with alcohol or drugs.
Morphine (street names Miss Emma, M, and Monkey): prescribed to relieve acute or chronic pain, morphine is more addictive than codeine or opium but slightly less addictive than fentanyl or heroin.
The term “opiates” is often used interchangeably with the term “opioids,” although opiates technically are meant to delineate only naturally derived painkillers such as heroin, morphine and codeine. Opioids, on the other hand, refer to all natural, semisynthetic, and synthetic opioids.
Why Do Doctors Prescribe Opiates?
Codeine and Tylenol 3
Available as a prescription in liquid or pill form, codeine is intended to alleviate mild to moderate pain associated with post-surgical procedures, chronic diseases, or physical injury. Codeine is also an antitussive (cough reducer) that decreases activity in the brain area (upper brain stem) that regulates coughing. Tylenol with codeine (Tylenol 3) is another commonly prescribed pain reliever that eases moderately severe pain due to dental work, post-surgery complications, injuries, or other causes of acute pain.
Morphine
Morphine is only prescribed for severe pain and suffering associated with hospice patients and end-of-life events. The use of morphine is valuable for easing the pain and anxiety experienced by palliative patients who are facing terminal diagnoses.
Morphine sold by drug dealers is usually cut with fentanyl or other synthetic opioids to increase potency and profit for the dealer. Bought in pure form, morphine is much more expensive than fentanyl, and dealers would be unable to sell it to addicts.
Is Opium Available by Prescription?
No. Doctors do not prescribe opium in its pure form but do prescribe synthetic opium derivatives, such as oxycodone, hydrocodone, and morphine. Indigenous people in Afghanistan, Pakistan, and Thailand are known to still smoke opium in its unadulterated form.
5 Long-Term Effects of Opiates on the Body
Anyone taking prescription opiates is at risk for addiction. In fact, most opiate addictions begin when the person develops a tolerance for the drug. Once the prescription runs out and the attending physician refuses to write more prescriptions, the individual often turns to street dealers to appease cravings and withdrawal symptoms. Prescription opiate addicts may also write fake prescriptions, engage in criminal activity to obtain opiates, and start injecting opiates to achieve a more intense high.
Serious damage to the nervous system, the brain, and vital organs is possible after abusing opiates for only one or two years. One of the most commonly seen chronic effects of opiate addiction impacts the part of the brain called the frontal lobe.
Frontal Lobe Damage and Opiate Addiction
The largest of the brain’s four lobes in the cerebral cortex, the frontal lobe lies behind the forehead and is responsible for supporting your ability to remember, create, engage in abstract (complex) thought, make rational judgments, and behave in a socially appropriate manner. The frontal lobe also controls voluntary movements, which are movements that the brain “tells” the body to initiate (riding a bicycle, typing on a keyboard, walking, etc).
A multitude of neuropsychological data indicates that opiate addiction can cause serious deficits in a person’s capacity to remember, focus on tasks, regulate their emotions, and control movements. Opiate addicts suffer frontal lobe damage due to an overall degeneration of brain cells and their connections to other brain cells. Significant decreases in this “functional connectivity” among neurons may further lead to shrinking of the amygdala and the volume of the brain’s white matter. These same studies also found that the longer someone remains addicted to opiates, the more damage occurs to the functional and structural aspects of the brain.
Heart Problems and Opiate Addiction
In 2016, researchers published the results of a 13-year study involving subjects prescribed an opiate painkiller and subjects prescribed a non-opiate painkiller. Much to the surprise of the researchers, the subjects taking opiate medicates had a much higher risk of death caused by arrhythmia and other cardiovascular issues–64 percent higher, in fact. While the association between heart damage and opiate addiction is still being investigated, experts speculate that one of the reasons behind opiate use and an increased risk for serious cardiovascular involves addicts with preexisting conditions, such as diabetes, high blood pressure, or unknown heart disease.
Opiate Addiction and the Immune System
Chronic abuse of opiates significantly reduces the ability of the immune system to fight infections by inhibiting the production of antibodies and white blood cells. The interaction of opiates with nervous system receptors allows opiates to act like proteins (cytokines) responsible for inflammation. Since this interaction makes the body “think” it is fighting an infection, the immune system of an opiate addict is constantly under stress and vulnerable to bacterial, viral, and parasitic infections.
Bone Health and Opiate Addiction
Concern over the impact of opiate use in older people with severe osteoarthritis has led to further research into the long-term effect of opiates on bone health. Studies have consistently found that opiates inhibit the production of bone cells (osteoblasts) and osteocalcin (needed for bone strength) and reduce the production of testosterone essential for bone density. Early onset of osteoporosis in opiate addicts is further exacerbated by tobacco use, alcohol abuse, and HIV infection.
Dangers from Long-term Opioid Therapy
Millions of people rely on prescription opioid therapy to relieve chronic pain and may not be addicted to painkillers. In other words, these people take their medications as prescribed by their physicians and do not abuse them by taking more opioids than prescribed. Although opiates can reduce pain and improve quality of life by making pain manageable, long-term opioid therapy can also have harmful effects on the body. For example, evidence indicates that chronic opioid therapy causes one or more of the following:
- Sleep-disordered breathing, such as upper airway resistance, shallow breathing (hypopnea), pausing of breathing (apnea), and extreme snoring
- Constipation severe enough that it requires the continual use of laxatives
- HPA dysregulation symptoms (cognitive issues, thyroiditis, anxiety, depression, fatigue, low or high blood sugar, inability to remember things)
- Dysfunction of the liver, kidneys, and/or heart
Managing chronic pain is almost as difficult as trying to recover from opiate addiction. While individuals with chronic pain could not imagine living without their pain medication, the resulting health consequences of long-term opiate therapy may not only increase the cost of medical care but also inadvertently diminish quality of life.
FHE provides evidence-based treatment programs for people dealing with opiate addiction, chronic pain, and the repercussions from long-term opioid therapy. Contact us today for information about these programs and how they have been successful in treating opiate addiction and dependence.
