Opioids are psychoactive chemicals that relieve pain by binding to opioid receptors in the brain. They are considered to be one of the oldest drugs that encompass analgesic effects, which when taken will immediately control emotions and diminish the effects of painful stimuli.
Opioids originally came from the opium poppy plant (Papaver somniferum), which was first cultivated around 3,400 B.C. This plant is also found in Europe, North America, South America, and Asia and is referred to as the "common garden poppy".
The opium poppy grows up 1.2 meters with flowers that have various attractive colors like white, pink, red, and purple. Their seeds also vary in color from white to blue.
Today, opioids can be found in several painkillers like morphine, heroin, thebaine, codeine, papaverine, and noscapine. To detect the presence of opioids in the body, drug testing may be administered through an opiate drug test kit.
The opium poppy first got its name "opius" (a Greek word for "little juice"), where the word "opioids" basically got its name from. Back then, opioids were used by Romans and Greeks to induce sleep and produce constipation. Two prominent Greek physicians, Hippocrates and Galen made use of the opium poppy to relieve headaches, coughing, asthma, and sadness, as well as to experience euphoria.
In 1805, a German chemist Friedrich Serturner discovered morphine by isolating the opium poppy. By 1853, Alexander Wood invented the hypodermic syringe and developed the intravenous route of administration for morphine, which was commonly administered to wounded soldiers during the Civil War.
However, people later discovered the addictive effects of opioids. Most of the soldiers began craving for the drug and the instance was referred to as the Soldier's Disease.
Opioids are substances that act on the opioid receptors in the body that are responsible for relieving pain. These substances are often used as an anesthetic agent for surgery and chronic pain treatment. They come in the form of tablets, capsules or liquids. Examples of opioids include:
An opioid is a highly potent substance can be a very potent substance that can alter the brain’s function, which can lead to psychological and physical dependence. Opioid addicts develop pathologically strong cravings to obtain and use the drug.
Opioids were then considered the "gold standard" of treatment since Civil War, which provided genuine relief from severe pain. However, this changed in the 1990s.
Pharmaceutical companies started promoting the use of opioids in the long-term treatment of chronic pain. It was well accepted by medical professionals as they saw it as the “miracle wonder” to finally end the sufferings of an individual with severe pain. Therefore, doctors started prescribing them, brushing aside that it contains an addictive property.
By 2012, doctors prescribed their patients with at least a month’s supply of opioids in a single prescription.
Did you know that in Kermit, West Virginia (which has a population of 400 residents) sold 3 million opioids in a single year?
In 1968, more than 5,100 drug overdoses in the country. This has jumped to about 64,026 in 2006. There were approximately 175 deaths per day, which can be truly disturbing.
In 2016, it was reported that at least 12 states have more pain prescriptions in circulation that the overall population. While doctors may have seen an improvement in managing the pain of their patients, at least 25% of these patients were believed to have misused their medications which resulted in addiction.
A frightful event in West Virginia happened in 2016 when it was reported that there at least 26 drug overdoses in 4 hours. Another 312 overdose cases were reported from Ohio, with a majority of them caused by prescription drug abuse.
The number of deaths could not be feasibly handled by the morgues, leading them to purchase refrigerators so that there would be a place for these dead bodies to be placed.
It is believed that prescription drug overdose is the most common cause of death in people under the age of 50 years old. How are we going to stop this from happening?
The states with the highest rates of opioid abuse:
Other Types of Opioids
Most people have known opiates to be a synonym of opioids, but the two basically differ from each other. Opiates refer to the drugs that are derived from the opium poppy plant, while opioids refer to the drugs that are created to mimic the effect of opium.
In other words, opioids are synthetic opiates. Although they resemble the same effect on humans, they are chemically different.
Today, the term "opioids" is used to call the entire family of opiates including natural, synthetic, and semi-synthetic.
This term refers to the dried latex that comes from the opium poppy plant. It is obtained by scratching the immature seed to obtain the white sap that leaks out of the seed. This later dries into a sticky yellowish residue that is scraped from the fruit and is used to make a variety of painkillers:
Morphine
This is the most common and abundant opium alkaloid found in the opium poppy plant. It comprises 12 to 17 percent of the weight of the dried sap of opium poppy.
Morphine is basically administered intravenously, subcutaneously, or via intramuscular to treat chronic pain. Its analgesic effects can last from 3 to 4 hours.
However, morphine is habit-forming, and most people who use the drug basically end up being dependent on it. This is why morphine belongs to a group of commonly abused prescription drugs.
A person who is medically treated by morphine may get a positive drug test result on a prescription drug test like HairConfirm Prescription Hair Drug Test. Longer association with morphine may cause several adverse effects, which include constipation, gastric pains, damage to coronary arteries, asphyxia, and death. Quitting morphine in an instant may also cause severe withdrawal symptoms.
Codeine
This drug is an isomer of methylated morphine, also known as 3-methylmorphine. Codeine is the second most abundant opium alkaloid, which makes up roughly 2 percent of the dried sap. Compared to morphine, codeine is more prevalent in the Iranian poppy plant and is determined for its antidiarrheal usage.
Codeine is also used to treat mild and severe pain and is commonly found as content in some cough medicines.
However, because of its addictive effects, codeine has become one of the most commonly abused prescription drugs by teenagers. Young people are concocting "Sizzurp" mixtures using codeine promethazine syrup and alcohol or juice. At first, codeine creates the feeling of happiness and contentment from pain. A longer association may cause various side effects such as itching, nausea, vomiting, drowsiness, dry mouth, urinary irritation, constipation, and frequent mood swings.
Thebaine
Thebaine is basically a minor constituent of opium. It got its name from the ancient city of Egypt called Thebai. However, unlike the others, this drug is not used medically but is used to create more effective opiate narcotics such as Oxycodone, Buprenorphine, and Naloxone.
In the United Kingdom, Thebaine is considered to be a Class A drug, a group of the most dangerous yet largely abused drugs such as cannabis and cocaine. This drug is also labeled as Schedule II in the United States.
Papaverine
Papaverine is another opium alkaloid but unlike the others, this drug is not used to treat pain but is basically used as a relaxant after surgeries.
Papaverine is also used to treat spasms especially those that occur inside the gastrointestinal tract, bile ducts, and urethra as well as a remedy for erectile dysfunction. By this, the drug is directly applied or injected into penile tissues which immediately relax muscle tissues, thereby resulting in an erection.
Longer association with papaverine can be dangerous to health though. Its adverse effect can start from simple constipation, severe sweating, and loss of appetite for contagious hepatitis and even aggravated circumstance of cerebral vasospasm.
Opioids may fall under any of four classifications, which are named according to how they are derived and used in a variety of situations:
Naturally-Occurring Opioids
Naturally-occurring opiates primarily come from the dried sap of the opium poppy plant. This includes opium alkaloids such as morphine and codeine (used to treat mild to severe pain), and thebaine (converted industrially to make up more effective analgesics like Oxycodone).
Most of the drugs that are made from the naturally occurring opiates such as Astramorph PF morphine are prescription drugs or drugs that cannot be taken out without any prescription. Longer association of the naturally occurring opioids can actually be addictive, which is why some patients become dependent on it. Some teenagers, however, simply use the drug for recreational purposes.
Endogenous Opioids
These are the types of opioids that are produced in the body such as endorphins, enkephalins, dynorphins, and endomorphins.
Synthetic Opioids
Synthetic opioids refer to opiates that are only made in laboratories emulating the effects of real opiates. These false opiates are considered to be less addictive and are often prescribed by doctors to treat pain than the real ones. Unlike the naturally occurring opiates, these do not immediately draw positive opiate drug test result.
Some examples of synthetic opioids include:
The most common one is fentanyl which is actually sold in pharmacies under different brand names such as Sublimaze, Actiq (fentanyl lollipop form), Duragesic, Fentora, Onsolis, and Instanyl. These drugs are commonly prescribed by doctors to treat pains caused by cancer treatment.
There are at least 10 million Americans recorded every week to use synthetic opioids for different purposes. A survey shows 33 million of which misuse the drugs. These are mostly composed of teenagers, who merely take synthetic opioids for recreational purposes; some of these drugs are not even included in federal drug testing.
This issue poses an urge for the government to take action for the current federal regulation on drug testing. Since not all synthetic opioids are included in the standard opiate panel for both DOT and Non-DOT purpose, discussions were made about the revisions in the DHHS Mandatory Guidelines for Federal Workplace Drug Testing Programs. During the meeting, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced to accept the recommendations of the Drug Testing Advisory Board (DTAB) to revise the DHHS Mandatory Guidelines.
Semi-Synthetic Opioids
These drugs are basically created from various chemical manipulations of the sap extracted from the opium poppy plant. These are the substances that have already undergone certain processes in order to create more effective medicines that resemble the same effects such that of the naturally occurring opiates.
Two most common examples of semi-synthetic opioids include hydrocodone and oxycodone. Both resemble a morphine-like effect and are usually prescribed to patients suffering from severe pain. However, because of their highly addictive characteristic that lures people to abuse the drugs, both hydrocodone and oxycodone are now labeled as Schedule II drugs, which belong to the most dangerous yet commonly abused prescription drugs among teenagers. In these cases, drug tests for teenagers should be administered.
Some other examples of semi-synthetic opioids include heroin, oxymorphone, desomorphine, nicomorphine, dipropanoylmorphine, benzylmorphine, and ethylmorphine.
The DHHS Mandatory Guidelines now expands the standard DOT drug testing panel to include the additional Schedule II prescription drugs. The new federal guidelines also include oral fluid as an alternative specimen for Federal Drug-Free Workplace Programs (DFWP) testing.
The pure opium poppy plant has been greatly used as a remedy for pain even long before the discovery of morphine. With the advent of medical machinery, today the dried sap of the opium poppy plant has been converted into a variety of prescription medicines used to relieve pain such as paracetamols and analgesics.
Opioids are basically contained in some medicines and are prescribed by doctors to treat mild to severe pain. Their main function is to bind to the opioids receptor in the brain and prevent the body from feeling the throbbing of muscle tissues.
The hydrocodone and oxycodone are most commonly used to treat pain after a surgery or to remedy the pains of excruciating cancer treatments as well as dental and injury-related pain. Codeine, however; is only to treat mild pains and is also used to relieve coughs and diarrhea.
The discovery of the addictive effects of opioids marked a significant change in opioids usage. Although modern technology has converted the drug into useful medicines such as codeine and morphine, its addictive nature has lured people to abuse the drugs.
Nowadays, opioids are still prescribed by doctors in order to treat mild to severe pain, but at the same time used by teens and adults for recreational use. This is the reason why many countries have joined together to promulgate the U.N. Commission on Narcotic Drugs, which actually put opioids into a few of the prohibited drugs. With this, any person who is caught using the drug, unless it is prescribed by doctors, will face some criminal liabilities.
Furthermore, in some other countries like South America, the opium poppy plants are used as decorations. In some parts of the country, the opium poppy is cultivated even without legal controls while the seeds, despite containing morphine, codeine, and many other alkaloids, are made into colorful house decorations. In some cases, opioids are also topped with bread and cookies to add flavor or boiled in order to make a bitter tea.
According to research, teens are very prone to opiate drug addiction, especially during high schools and college years when they begin to separate from their parents.
According to the National Survey on Drug Use and Health (NSDUH), drugs are commonly smuggled at school and are easily obtainable from friends and colleagues.
More than 2,500 teenagers between 12 to 17 years old abuse opioids for the first time each day. And since 1992, the number of children abusing opioids has tripled in number.
The two most commonly abused forms of opioids are prescription painkillers and heroin. However, prescription painkillers have shown to be the favorite of most children.
In a survey done in 2006, more than 2.1 millions kids with age between 12 and 13 years old were found to be abusing prescription killers. In fact, they abused more than they abuse cocaine, heroin, and methamphetamine combined.
The states with the highest percentage of teenage drug users:
States with the lowest percentage of teenage drug users:
The availability of perilous pastries has also lured teens to abuse opioids without being caught.
In truth, some bakeries make use of the poppy seeds as flavorings to their bread and cakes. Bakers top one gram of poppy seeds, which contain 33 micrograms of morphine and 14 micrograms of codeine.
In North America, they make used of the poppy seed oil to bake rusk, bagels, and cakes. In Europe, bakers sprinkle poppy seeds on top of their white bread pastries to create the popular bun known as Cozonac, which is traditional Romanian sweet bread.
These baked goodies are sometimes used as medicines, but in some places, they are simply sold naturally like any other ordinary bread. However, their availability has actually added more reasons for the youth to abuse opioids. What is even more appalling is the prevalent act of neglecting its forthcoming dangers.
According to research, eating two rolls of opium poppy bread may cause a positive opiate drug test result since one roll already contains 0.76 grams of poppy seeds. Likewise, a slice of cake that contains 5 grams of poppy seeds can also test positive for opioids within 24 hours. Frequent eating of perilous pastries can actually make a person more addicted to opioids.
Cheese, fentanyl, syrup, and soda
Cheese made from heroin is actually another type of opioids, created by a combination of heroin and cold medication drugs like Tylenol and the antihistamine diphenhydramine (an active ingredient in Benadryl). In Dallas, Texas, the widespread distribution of cheese samples has actually caused severe addiction to the youth, as well as great tragedy in schools where a number of students died from its withdrawal symptoms.
Cheese has a very strong potency that appears from 6 to 24 hours. This is also the reason why it is termed by many as "starter heroin".
Fentanyl is another one of the most common medicines for pain derived from the original opium poppy plant and is said to be four times more potent than morphine. It is used to treat pains caused by cancer treatment but is commonly abused by many people to calm and soothe emotions. The lollipop fentanyl or Actiq lollipop is known to be mostly eaten by children.
In 1990, heroin sodas and syrups were made popular by the hip-hop community especially in Houston Texas. Back then, codeine and promethazine were mixed into soft drinks and cola to produce opiate sodas. Today, these types of drinks are known as Purple Drink, Sizzurp, or Lean.
Whether taking opioids for medical or recreational reasons, it may produce varying effects on both physical and psychological aspects of a person. Medical effects of opioids are good. When they are medically used, they alter the person's perception of pain and relieve the muscles and tissues from feeling the ache.
However, since opioids are highly addictive drugs, taking opioids for longer medications may cause physical addiction. This is clearly manifested in a person who cannot go through such pain without taking opioids. This physical addiction may also lead to a series of psychological effects, which are considered as negative.
There are many ways to detect whether or not a person is using opioids for recreational purposes. These symptoms may also occur when a person is going under opiate medication but some may also lead to a suspicious opiate abuse, which can become strong grounds for opiate drug testing.
The following are symptoms of opiate abuse and addiction:
Abusing opioids can reflect in the eyes of the abuser. Unlike cocaine that makes the person's eyes alert and highly suspicious, opiates make the person's pupils look extremely constricted. This is the reason why people who abuse opiates are termed as "pinned" because their pupils look almost invisible due to their small size.
However, what abusers may actually neglect behind its euphoric effect are the dangers that opiates can cause to the central nervous system. Since prescription medications like Oxycontin and Vicodin suppress the central nervous system causing the function of the brain and the body to slow, taking a larger dosage of the drugs can be very dangerous to the health.
The following are the adverse effects of opiates on health:
Once an individual is hooked, it may be difficult for the person to quit. Therefore, once their “legal supplies” ran out, they turn to illegal opioids such as heroin. Many addicts have become associated with various crimes and estranged from family and friends as they become more and more desperate in feeding their addiction. This results in losing relationships, jobs, and their lives.
Abruptly stopping the use of opioids results in these common side effects:
Drug testing for opiates can be performed in three ways:
Opiate medication can cause positive opiates when a person undergoes an opiate drug test, but this positive result may be a false positive. In this case, a person may not face any liabilities. In this case, people who are on opioid medication should inform authorities about their condition before any drug test comes up with results.
The following medications will yield positive drug tests results for Opiates:
6-acetylmorphine (6-AM) is the drug metabolite of heroin, which can be detected through the opiate drug test done on a person who uses heroin for recreational purposes. 6-AM basically serves as confirmatory for heroin abuse in order to prevent false positive results.
Drug testing detects the drug metabolite within 2 to 4 days while 6-AM itself is already detectable 3 to 5 minutes after injection. The metabolite has a short half-life of 36 minutes, which can be detected in urine after 8 hours of heroin usage.
It is important to note that 6-AM is not a metabolite of morphine and codeine but complications may occur when heroin is mixed with codeine and morphine.
To avoid false positive results, SAMHSA has mandated a specific drug cut-off levels for every drug testing method. This is the minimum residue of drugs that must be confirmed in the sample in order for a person to be labeled as positive. By then, a person may be required to explain the drug positivity or face some liabilities.
In the past, the agency mandated that all drug screening laboratories should use a 300 ng/mL cut-off level of drug metabolites when using urine drug tests. However, due to frequent false-positive results and the increasing number of teens abusing drugs as well as the existence of the different detox methods, it was later on revised.
The new federal cut-off level for 6-MAM is now at 10 ng/mL. The confirmatory test cut-off is more than 2,000 ng/mL. For opiates in general, the new federal cut-off is 300 ng/mL for the initial test and 2000 ng/mL for the confirmatory test. For codeine and morphine, initial test cut-off level is 120 ng/mL while the confirmatory should be 2000 ng/mL.
Meanwhile, the Department of Transportation (DOT) is currently tasked to mobilize these changes. According to SAMHSA, it could take a few months before the new changes can affect DOT drug testing policies. More debates and deliberation will also help figure the pros and cons, as well as settle out the new changes.
Drug testing may be done in pre-employment, random, post-accident, and mobile collection options for regulated DOT and traditional testing. Despite the fact that drug abuse largely contributes to workplace accidents and youth absenteeism at schools, it remains a controversial issue.
The following are the advantages of opiate drug testing:
Meanwhile, here are the disadvantages of conducting opiate drug testing:
Just like any kind of drug overdose, opioid abuse is a life-and-death situation that needs immediate medical attention.
For opioid overdose, one of the drugs of choice these days is Naloxone. It is an opioid receptor antagonist – it blocks the opioid from getting through the system, but does not help cure the addiction.
Complications that may arise from drug overdose include the following:
The best solution for an opioid overdose may be the use of Methadone, a safer and legal drug to help a user overcome addiction. In time, a user may be able to give up his addiction to opioids and hopefully get back to normalcy once again.
Solving the opioid drug abuse crisis may not be easy without the help of everyone. Drug addiction is not a problem of the government alone but by everyone. To prevent the next generation from being victimized by such illegal substances, stricter measures should be imposed and a more widespread information campaign should be done.
