747 lines
21 KiB
Plaintext
747 lines
21 KiB
Plaintext
Newsgroups: alt.drugs
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OPIOID FREQUENTLY ASKED QUESTIONS FILE
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Newsgroup : alt.drugs
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********** Article Separation
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** Contents **
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Glossary on terms used in FAQ
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Opioid Info:
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Natural (known as opiates):
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Morphine
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Codeine
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Semi-Synthetic (known as opioids):
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Heroin
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Hydrocodone (Hycodan)
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Hydromorphone (Dilaudid)
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Meperidine (Demerol)
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Oxycodone (Percodan)
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Synthetic (also known as opioids):
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Fentanyl (Sublimaze)
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Methadone (Dolophine)
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Propoxyphene (Darvon)
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Pentazocine (Talwin)
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Opioid Addiction and Withdrawal
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**********
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The FAQ will use morphine as the standard opioid and base all other
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opioids in relation to it. (Kinda like class inheritance in C++).
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**********
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A little glossary to start the FAQ:
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opiate - narcotic analgesic derived from a natural source(opium poppy)
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opioid - narcotic analgesic that is either semi or fully synthetic
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- also refers to entire family of both opiates and opioids
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IM - intramuscular injection
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SC - subcutaneous injection
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**********
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** Morphine **
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Synopsis
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Morphine is naturally occurring substance in the opium poppy,
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Papaver somniferum. It is a potent narcotic analgesic, and its
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primary clinical use is in the management of moderately severe
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and severe pain. After heroin, morphine has the greatest
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dependence liability of the narcotic analgesics in common use.
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Morphine is administered by several routes (injected, smoked,
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sniffed, or swallowed); but when injected particularly
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intravenously, morphine can produce intense euphoria and a general
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state of well-being and relaxation. Regular use can result in
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the rapid development of tolerance to these effects. Profound
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physical and psychological dependence can also rapidly develop,
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and withdrawal sickness upon abrupt cessation of heroin use; many
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of the symptoms resemble those produced by a case of moderately
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severe flu.
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Morphine is infrequently encountered in the North American street
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drug culture. However, mainly because of its availability in
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hospitals, there have been several documented cases of morphine
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dependence among health professionals.
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Drug Source
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Morphine is isolated from crude opium, which is a resinous
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prep of the opium poppy, Papaver somniferum.
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Trade Name
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Roxinal, MS Contin, Morphine Sulfate
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Street Names
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"M", morph, Miss Emma
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Drug Combinations
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Use of morphine plus cocaine, as well as of morphine plus
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methamphetamine, has been reported. However, such combinations
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are not frequently encountered.
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Medical Uses
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* symptomatic relief of moderately severe to severe pain;
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* relief of certain types of difficult or labored breathing;
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* suppression of severe cough (rarely);
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* suppression of severe diarrhea (e.g., that produced by cholera).
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Physical Appearance
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Morphine is legally available only in the form of its water-soluble
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salts. Most common are morphine sulfate and morphine hydrochloride.
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Both are fine white crystalline powders, bitter to the taste. Both
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are soluble in water and slightly soluble in alcohol.
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Dosage
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~~~~~~
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Medical
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For moderate to severe pain the optimal intramuscular dosage is
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considered to be 10 mg per 70 kg body weight every four hours.
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The typical dose range is from 5 to 20 mg every four hours,
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depending on the severity of the pain. The oral dose range is
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between 8 and 20 mg; but with oral administration morphine has
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substantially less analgesic potency (approximately one-tenth of
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the effect produced by subcutaneous injection) because it is
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rapidly destroyed as it passes through the liver immediately
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after absorption. The intravenous route is employed primarily
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for severe post-operative pain or in an emergency; in this case
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the dose range is between 4 and 10 mg, and the analgesic effect
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ensues almost immediately.
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Nonmedical
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Irregular or intermittent users (who are not substituting the drug
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for another narcotic analgesic) may start and continue to use doses
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within the therapeutic range (e.i., up to 20 mg). However, regular
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users who employ morphine for its subjectively pleasurable effects
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frequently increase the dose as tolerance develops. To take several
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hundred milligrams per day is common, and there are reliable reports
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of up to four or five grams (4000 - 5000 mg) per day.
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Routes Of Administration
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Morphine may be taken orally in tablet form, and can also injected
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subcutaneously, intramuscularly, or intravenously; the last is the
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route preferred by those who are dependent on morphine.
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Short Term Use
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~~~~~~~~~~~~~~
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Low Doses (single doses of 5 - 10 mg administered by S.C or IM injection in
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non-tolerant users)
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CNS, behavioral, subjective:
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suppression the sensation of and emotional response to pain;
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euphoria; drowsiness, lethargy, relaxation; difficulty in
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concentrating; decreased physical activity in some users and
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increased physical activity in others; mild anxiety or fear;
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pupillary constriction, blurred vision, impaired night vision,
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suppression of cough reflex.
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Respiratory:
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slightly reduced respiratory rate.
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Gastrointestinal:
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nausea and vomiting; constipation; loss of appetite; decreased
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gastric motility.
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Other:
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slight drop in body temperature; sweating; reduced libido; prickly
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or tingling sensation on the skin (particularly after intravenous
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injection).
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Duration
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4 - 5 hours
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Dependency Potential
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high, continued use results in both psychological and physical
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dependency
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**********
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** Codeine **
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Drug Source
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Codeine is found in opium in concentrations between %0.1 and %2.
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Because of the small concentration found in nature, most codeine
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found in medical products is synthesized from morphine via the
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methylation of the hydroxyl group found on the second non-aromatic
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ring.
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Trade Name
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There are no commercial name for products containing only
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codeine in US. Found under common name of codeine.
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Canada does have a codeine only syrup available under
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Paveral. Mainly found in combination products.
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Street Name
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T-three's (Tylenol #3 w/ codeine), schoolboy, cough syrup
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Medical Uses
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* relief of mild to moderate pain
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* relief of non-productive cough
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* relief of diarrhea
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Drug Combinations
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Sold under many name brand products, the most popular being the
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Tylenol with Codeine series, the number on the tablet corresponds
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to the amount of codeine and caffeine found in the each tablet.
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Tylenol #1 w/ codeine - 8 mg codeine, 15 mg caffeine
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Tylenol #2 w/ codeine - 15 mg codeine, 15 mg caffeine
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Tylenol #3 w/ codeine - 30 mg codeine, 30 mg caffeine
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Tylenol #4 w/ codeine - 60 mg codeine, no caffeine
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note: all tablets contain same amount of acetaminophen (300 mg)
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Fiorinal (aspirin, caffeine, barbital, codeine)
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Many other brand name product combinations.
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Physical Appearance
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Tylenol w/ codeine series are imprinted with number on one side and
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other side is Tylenol label(McNeil).
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Controlled Substance Status
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As a single product codeine is a schedule II controlled substance
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in the US.
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When combined with other non-controlled substance, and depending
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on amount per dose unit, codeine combined products range from
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schedule III to V.
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Canada has OTC codeine products available if product has no more
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than 8 mg of codeine per unit dose. Some US areas may have codeine
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preps available OTC, but usually require release form.
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As an interesting fact, a travelers handbook noted that Greece has
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banned codeine in that country (no idea on what it's status is now)
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so be careful when traveling there.
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Dosage
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~~~~~~
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Medical
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Pain relief : 30mg - 220mg oral or equivalent dose SC or IM
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Diarrhea relief : 10mg - 20mg orally
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Cough suppressant : 5mg - 15mg orally
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Nonmedical
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Doses can range from 30mg up to 400mg. LD50 for codeine is 800mg in
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a average nontolerant person.
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At doses of > 250mg adverse effects tend to arise, including intense
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itching, flushed skin, dizziness, sedation, nausea and vomiting
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Routes Of Administration
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Usually taken orally but can be injected IM or SC. The IV route is
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not recommended as reactions such as facial swelling, pulmonary
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edema and convulsions can occur.
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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Effects begin at 30mg and tend to mimic those of morphine, except
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sedation and euphoria are less intense.
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Respiratory:
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same as morphine but less intense.
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Gastrointestinal:
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same as morphine but nausea and vomiting are less common and
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constipation less severe.
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Other:
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alleocodone is a schedule II drug, and when combined
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with other non-controlled drugs, is found from schedule III-IV.
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Dosage
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~~~~~~
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Medical
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as a cough suppressant 5mg - 10mg
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for pain relief 10mg - 30mg
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Nonmedical
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doses are similar to those for pain relief
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Routes Of Administration
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Usually taken orally but can be inject via three routes. Unknown if
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hydrocodone can be sniffed or smoked. Sniffing is likely possible.
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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Has similar effects as morphine but less sedation and euphoria
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Respiratory:
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Less depression than morphine.
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Gastrointestinal:
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Less likely to cause nausea and vomiting than morphine.
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Other:
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Hydrocodone is a weaker opioid than morphine but still a effective
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opioid with similar potency to oxycodone.
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Duration
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3 - 4 hours
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Dependency Potential
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moderately low, much less potential than morphine
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**********
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** Hydromorphone **
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Drug Source
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Synthetically produced from morphine.
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Trade Name
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Dilaudid
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Street Name
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Dillies
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Medical Uses
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* relief of moderate to severe pain
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* relief of severe cough
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Drug Combinations
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most commonly used as a single product
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Physical Appearance
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usually bought as tablets, or injectable solution
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Controlled Substance Status
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Hydromorphone, like most single product opioids, is a schedule II
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opioid.
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Dosage
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~~~~~~
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Medical
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for pain relief 1mg - 2mg
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Nonmedical
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same as pain relief doses
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Routes Of Administration
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Can be administered orally, by three routes of injection, and
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by sniffing. Unknown if smoking is an effective route.
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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Hydrocodone has effects similar to morphine, except euphoria is
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similar to codeine, nausea and vomiting is quite rare, and
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sedation is practically non-existent
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Respiratory:
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Hydrocodone depresses respiration minimally.
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Gastrointestinal:
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Hydromorphone effects GI tract very little.
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Other:
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Although hydromorphone's euphoria pales with other opioids
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it's abuse potential comes from the fact the rush experienced
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from IV use is very similar to heroin's.
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Hydromorphone is one of the most used opioids in the relief of
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pain for the terminally ill. The reasons being it's minimal
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side effects, and high potency.
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Duration
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3 - 4 hours
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Dependency Potential
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moderately high
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**********
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** Meperidine **
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Drug Source
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Meperidine is completely synthetic and can be produced with
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dichlorodiethyl methylamine and benzyl cyanide.
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Trade Name
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Demerol
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Street Name
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Demmies
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Medical Uses
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* originally found to be useful for muscle spasms but the
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discovery of it's analgesic properties has resulted in
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it's almost exclusive use for relief of moderate to severe
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pain
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Drug Combinations
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usually found as a single product, with few combination products.
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Is found in combination with acetaminophen in Demerol APAP
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Physical Appearance
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Demerol tablets are small white tablets with the name
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Winthrop on one side
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Controlled Substance Status
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Schedule II substance in US
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Dosage
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~~~~~~
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Medical
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pain relief is achieved with approx. 50mg - 150mg injected
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or 200mg - 300mg oral
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Nonmedical
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doses similar to those used in medical settings are used in
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recreational use.
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Routes Of Administration
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orally, three injection routes, and sniffing are possible,
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unknown if smoking is possible
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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same as morphine but less sedation, less intense euphoria
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Respiratory:
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respiratory depression tends to be less common and less intense
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than morphine
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Gastrointestinal:
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nausea and vomiting are reportedly common with oral use, but
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less when administered via injection
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Duration
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3 - 4 hours
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Dependency Potential
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reported to be less than or equal to that of morphine
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**********
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** Oxycodone **
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Drug Source
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synthesized from codeine
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Trade Name
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only found as a compound product combined with aspirin or
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acetaminophen. Available in Canada as a single product in
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the form of a suppository
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Street Name
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Percs
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Medical Uses
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* relief of moderate to severe pain
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Drug Combinations
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Percodan is aspirin and oxycodone
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Percocet is acetaminophen and oxycodone
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Physical Appearance
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Percodan tablets are color coded according to quantity of oxycodone
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in each tablet, the pink have ~2.5mg and the orange and green having
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twice as much
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Controlled Substance Status
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Schedule II in US
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Dosage
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~~~~~~
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Medical
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10 - 20mg oral for pain relief
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5 - 15mg injection
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Nonmedical
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Doses similar to those used in a medical setting are used
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Routes Of Administration
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Can be administered orally, three injection routes, sniffed
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and possibly smoked.
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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Same as morphine but milder.
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Respiratory:
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Less respiratory depression than morphine
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Gastrointestinal:
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Less constipating than morphine
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Duration
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3 - 4 hours
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Dependency Potential
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Moderate
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**********
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** Fentanyl **
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Drug Source
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Synthetically produced
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Trade Name
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Sublimaze
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Street Name
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China white
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Medical Uses
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Mainly relief of moderate to severe pain and as a surgical
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anesthetic
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Drug Combinations
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none
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Physical Appearance
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Found as a injectable solution, and a transdermal patch
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Controlled Substance Status
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Schedule II in US
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Dosage
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~~~~~~
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Medical
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50ug - 200ug
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Nonmedical
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same range as medical use
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Routes Of Administration
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can be administered via three injection routes, sniffed and smoked
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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euphoria is less than morphine
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Respiratory:
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same as morphine but has potential to cause respiratory muscles
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to go into spasm and result in respiratory arrest
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Gastrointestinal:
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less constipating that morphine
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Duration
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1 - 2 hours
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Dependency Potential
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moderately high
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**********
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** Methadone **
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Drug Source
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synthetically produced
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Trade Name
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Dolophine
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Street Name
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Dollies
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Medical Uses
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occasionally used for pain relief, but main use is in opioid
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withdrawal treatment as a substitute drug
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Drug Combinations
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none
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Physical Appearance
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found as a fruity solution for oral use, in wafers, and tablets
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also found as a injectable solution
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Controlled Substance Status
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Schedule II in US
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Dosage
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~~~~~~
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Medical
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3 - 5mg provides same pain relief as 10mg morphine
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Nonmedical
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rarely used non-medically, but doses used are approx. same
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as medical doses
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Routes Of Administration
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can be injected via three routes, taken orally, unknown if
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methadone can be smoked, can be sniffed
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Short Term Use
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~~~~~~~~~~~~~~
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CNS, Behavioral, Subjective:
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Oral use provides little euphoria and tends to block opioid
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receptors in brain, so commonly used as a maintenance drug
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during rehab.
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Respiratory:
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Produces little depression in contrast to morphine
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Gastrointestinal:
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produces constipation of less intensity than morphine
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Other:
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Developed by Nazi Germany during WWII as Germany was unable
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to acquire adequate supplies of morphine.
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Duration
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first dose last approx. 8 hours and subsequent doses last 18 - 24
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hours.
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Dependency Potential
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oral use provides little euphoria so little abuse potential in
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that form. When injected, methadone give very similar effects to
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morphine so has similar addiction potential.
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**********
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** Propoxyphene **
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Drug Source
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Synthetically produced with similar structure to that of methadone
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Trade Name
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Darvon, Darvon N
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Street Name
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none
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Medical Uses
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for relief of mild pain
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Drug Combinations
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Darvon compound is aspirin and propoxyphene
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Physical Appearance
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Darvon N as pink oval pills
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Controlled Substance Status
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Schedule III in US
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Dosage
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~~~~~~
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Medical
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range from 50mg - 150mg of hydrochloride
|
|
|
|
Nonmedical
|
|
similar to medical dose ranges.
|
|
|
|
Routes Of Administration
|
|
can be taken orally, three possible injection routes, no info
|
|
on possible intranasal or smoked administration
|
|
|
|
Short Term Use
|
|
~~~~~~~~~~~~~~
|
|
CNS, Behavioral, Subjective:
|
|
oral use provides very little euphoria, mild sedation;
|
|
at larger doses sedation becomes quite prominent and symptoms
|
|
such as staggering and slurred speech become apparent.
|
|
|
|
Respiratory:
|
|
little respiratory depression in medical dose range
|
|
|
|
Gastrointestinal:
|
|
little effect on GI tract
|
|
|
|
Other:
|
|
IV use is reported to give rush similar to heroin;
|
|
poor analgesic with standard dose providing less pain relief
|
|
than standard aspirin dose
|
|
|
|
Duration
|
|
3 - 4 hours
|
|
|
|
Dependency Potential
|
|
low
|
|
|
|
**********
|
|
|
|
** Pentazocine **
|
|
|
|
Drug Source
|
|
synthetically produced
|
|
|
|
Trade Name
|
|
Talwin
|
|
|
|
Street Name
|
|
yellow footballs
|
|
|
|
Medical Uses
|
|
for relief of moderate to moderately severe pain
|
|
|
|
Drug Combinations
|
|
Talwin NX - pentazocine and nalaxone (opioid antagonist)
|
|
|
|
Physical Appearance
|
|
usually found in orange-yellow tablets
|
|
|
|
Controlled Substance Status
|
|
Schedule III
|
|
|
|
Dosage
|
|
~~~~~~
|
|
Medical
|
|
50mg - 100mg for pain relief
|
|
|
|
Nonmedical
|
|
similar to medical dosage
|
|
|
|
Routes Of Administration
|
|
can be taken orally, three injection routes, and sniffed
|
|
possibly smoked
|
|
|
|
Short Term Use
|
|
~~~~~~~~~~~~~~
|
|
CNS, Behavioral, Subjective:
|
|
poor opioid, very little euphoria, mainly just sedates and
|
|
clouds mind, little recreational use
|
|
|
|
Respiratory:
|
|
less depression than morphine
|
|
|
|
Gastrointestinal:
|
|
very little constipation or nausea, vomiting occurs
|
|
|
|
Other:
|
|
as a opioid agonist/antagonist has potential to cause
|
|
psychotic effects such as hallucinations, severe confusion
|
|
|
|
Duration
|
|
3 - 4 hours
|
|
|
|
Dependency Potential
|
|
moderate potential, similar to hydrocodone
|
|
|
|
**********
|
|
|
|
Opioid Dependence And Withdrawal
|
|
|
|
Opioids have specific withdrawal and dependence characteristics
|
|
common to all opioids, varying according to the specific drug. All opioids
|
|
cause both physical and psychological dependence with prolonged use.
|
|
|
|
Depending on the opioid in question withdrawal can become evident
|
|
after continued use in as little time as 2 weeks or as long as 2 months.
|
|
|
|
Withdrawal is commonly overstated by media and tends to be similar
|
|
to bad case of flu. This is due to the fact that most opioid users don't
|
|
tend to be able to acquire enough drug to result in severe withdrawal. It
|
|
must be noted that physical symptoms may be similar to flu, psychological
|
|
symptoms can be quite painful. Depression, mood swings, hypersensitivity
|
|
to pain are some common symptoms. Opioid withdrawal DOES NOT endanger life
|
|
as does alcohol and other depressant withdrawal.
|
|
|
|
|
|
**********
|
|
|