Drug Types 23those laws expanded the dictionary definition ofnarcoticand made it a syn-
onym for all controlled drugs.
Although opiates have various medical uses, the main therapeutic appli-
cation is pain control. Other common uses are for fighting coughs and reduc-
ing diarrhea. Some other therapeutic uses of specific opiates are given in this
book’s alphabetical listings of drugs.
The chance of medical opiate usage turning a person into an addict is slim.
Very few persons receiving medical opiates find them attractive, and almost
all patients who enjoy opiates already have a drug abuse problem. Researchers
examined records of 11,882 patients who received narcotics and found 4 with
a subsequent addiction problem who lacked a prior drug addiction history.^41
The chance of developing dependence is higher, but a patient can be weaned
off opiates in ways that avoid withdrawal symptoms.
Illicit users of opiates generally seek to achieve a mental state of indifference
in which problems and frustrations no longer feel bothersome. A person high
on opiates is oblivious to the world and unlikely to bother anyone. Some users
experience euphoria.
Classic unwanted actions from opiates are constipation, urinary difficulty,
low blood pressure, and breathing trouble. MAOI drugs, described earlier,
may interact dangerously with opiates. In contrast to such problems, a desir-
able drug interaction is that opiates may boost pain relief from aspirin.
Originally the phrase “being hooked on a drug” referred to being so reso-
nant with (that is, dependent on) an opiate that a withdrawal syndrome oc-
curred if dosage stopped. Symptoms of opiate withdrawal are similar to those
of influenza: sweats, goose bumps, muscle aches, cramps, runny nose, diar-
rhea, and sleep difficulties. Although conscienceless and irresponsible addicts
may be particularly short-tempered and dangerous if undergoing withdrawal,
for other persons the experience is miserable, but not horrible, and usually
lasts only a few days. Traditionally those few days are the extent of with-
drawal, but some authorities believe a subsequent stage of withdrawal occurs
in which a person experiences aches, insomnia, and grouchiness for several
months. Such symptoms, however, may simply be signs that the psychological
buffer provided by opiate use is no longer available.
Drug addiction “maintenance” programs are designed to supply enough
drug to hold off withdrawal but not enough to produce recreational sensa-
tions. Unless participants supplement the legal dosage with illicit supplies,
such persons will not experience opiate effects enjoyed by addicts. Someone
on a maintenance dose can adequately perform job duties and safely operate
a motor vehicle. Performance may not be as sharp as in a drug-free state, but
performance is in the normal range.
Opiates have a wide range of effects on fetal behavior. If a pregnant woman
uses opiates regularly the fetus soon adapts to the presence of the drug and
seems to develop normally, although an infant can be born resonant with (that
is, dependent on) the drug and undergo withdrawal. Intermittent use of opi-
ates is more damaging to a fetus than regular use, with the changing drug
environment causing extra stress as a fetus copes with one condition and then
another. Opiates cause fetal metabolism to increase, diverting energy away
from body development. Infants born to opiate users are commonly smaller