Products
Medicinal products containing preparations of opium, such as the opium tincture or an opium extract, are used less frequently. In contrast, the pure alkaloids such as morphine and codeine and related opioids are very commonly used medicinally, especially in pain management. Opium and the opioids are subject to narcotics laws.
Stem plant
The opium poppy L. from the poppy family (Papaveraceae) is native to the eastern Mediterranean region and has been used medicinally for thousands of years. For example, Dioscorides already mentions the main pharmacological effects in the Materia Medica.
Medicinal drug
The medicinal drug used is opium (Opium crudum), the milky juice obtained from the incised, immature capsules of L., dried in the air. The milky sap, which is initially white, quickly turns brownish due to oxidation. The pharmacopoeia requires a minimum content of morphine and codeine. Various preparations are made from opium:
- Adjusted opium powder
- Discontinued opium tincture Detailed information
- Discontinued opium dry extract
Opium is black-brown in color and has a characteristic odor and a bitter taste. It consists of pieces of different sizes, more or less soft and shiny, which become hard and brittle when dried.
Ingredients
The relevant constituents are the opium alkaloids:
The basic opium alkaloids are bound to organic acids such as meconic acid. They can be extracted from opium and semi-synthetically modified, for example, to the narcotic heroin (diacetylmorphine). Some opioids are produced fully synthetically and are not derived from the natural ingredients.
Effects
Opium has analgesic, depressant, sedative, hypnotic, antitussive, and psychoactive properties. The effects are primarily due to interaction with opioid receptors found in the brain, spinal cord, and peripheral nervous system, among others. Papaverine has spasmolytic effects. The effects of opium are similar to those of morphine, the main ingredient, but not exactly identical because it is a multisubstance mixture.
Indications for use
Preparations of opium and the pure alkaloids are used primarily for the treatment of pain. Other uses include irritable cough, smooth muscle spasms, and diarrhea.
Abuse
Opium and the opioids are abused as intoxicants because of their psychtropic, euphoric, and sedative properties. Opium and corresponding preparations can be ingested or smoked. When smoked, the effect is much faster. Because of the potential for dependence and destructive adverse effects, abuse is strongly discouraged.
Adverse effects
The possible side effects of opioids and opium include:
- Constipation, nausea, vomiting, dry mouth, loss of appetite.
- Central and psychiatric disorders such as dizziness, headache, fatigue, drowsiness, confusion, anxiety, euphoria, dysphoria.
- Small pupils (miosis)
- Respiratory depression
- Itching, rash, redness of the skin, sweating.
- Urinary retention
- Hyperalgesia: Paradoxically increased sensitivity to pain.
- Cardiovascular disturbances such as low blood pressure, slow heartbeat.
- Development of tolerance, dependence and addiction, withdrawal syndrome after discontinuation.
The pure opioids are potent agents and must be administered with caution. An overdose is life-threatening and manifests itself in respiratory paralysis, low blood pressure, low pulse, circulatory failure and coma. The potential for respiratory depression is especially feared. Opioid antagonists are administered as antidotes.