Narcotics (morphine, heroin) abuse

Chest | Physical Medicine and Rehabilitation | Narcotics (morphine, heroin) abuse (Disease)


Narcotics abuse in is one of the most common reasons people seek medical treatment. Doctors can prescribe several different drugs to relieve pain. The most potent pain-relieving drugs are narcotics.

Narcotics have many useful pain-relieving applications in medicine. They are used not only to relieve pain for people with chronic diseases such as cancer but also to relieve acute pain after operations. Doctors may also prescribe narcotics for painful acute conditions, such as corneal abrasions, kidney stones, and broken bones.

The abuse of narcotics occurs as a result of the euphoria and sedation that narcotics produce within the central nervous system. Abusers of intravenously injected heroin describe the effects as a rush or orgasmic feeling followed by elation, relaxation, and then sedation or sleep.

Psychological dependence refers to compulsive drug use in which a person uses the drug for personal satisfaction, often in spite of knowing the health risks.

Physical dependence occurs when a person stops using the narcotic but experiences a withdrawal syndrome (or set of symptoms)

Causes and Risk factors

When people use narcotics exclusively to control pain, it is unlikely that they become addicted or dependent on them. A patient is given a dosage of opioids strong enough to reduce their awareness of pain but not normally potent enough to produce a euphoric state.

Adequate pain control is the goal for the medical use of narcotics. Thus, patients or health-care professionals should not allow fear of addiction to interfere with using narcotics for effective pain relief. Narcotic drugs produce their effect by stimulating opioid receptors in the central nervous system and surrounding tissues.

Diagnosis and Treatment

Narcotics used for short-term medical conditions rarely require weaning since stopping the medication after a brief period rarely produces adverse effects. If circumstances allow, the dose for people using narcotics over an extended period of time for medical purposes is slowly lowered over a few weeks to prevent withdrawal symptoms. The goal is to wean individuals off narcotics so that they are pain-free or able to use a less potent nonnarcotic analgesic. Narcotics users can develop tolerance, as well as psychological and physical dependence to opioids when they take them over an extended period of time.

Tolerance refers to a decreased response to a drug, with increasing doses required to achieve comparable effects. ...

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