There are three types of controlled substances that are going to be discussed here. All of these are available as prescriptions, but are also abusable as well. The three types of substances that I am going to talk about are; Opioids, CNS Depressants and Stimulants. This will be a three part post-a-thon on each of the three different substances. The three substances are:
Opioids- Mainly used and prescribed to treat pain
CNS Depressants- Used and prescribed to treat anxiety and insomnia
Stimulants- Used and prescribed to treat ADD (Attention Deficit Disorder), ADHD (Attention Deficit Hyperactivity Disorder) and Narcolepsy
Prescriptions of these medications are popular around the world- especially in the United States, and many of these people are on prescription medications due to certain ailments. Medications aren’t used to cure a condition- but they do help make it a lot easier to cope with people’s everyday lives. Whether someone is suffering through severe chronic back pain or a sleep disorder that is severely deranging one’s life, these drugs can allow great functionality and a normal lifestyle.
Pain Killers (Opioids)
Pain killers make surgery a lot easier to perform (Hydromorphone, Morphine, etc), and the use of pain killers, specifically opioids, allow the patient to cope with any pain that is due to a surgical procedure. Many people that have to deal with pain on an everyday basis are prescribed certain painkillers so that they can lead productive lives. Different people experience different types of pain, so it’s hard to judge how much pain a person is in, but from testing one’s blood pressure to certain symptoms- a doctor can figure out how much pain a person is in. The reason that this is brought up is that some people abuse these pain medications. Even though most people take their pain medications as prescribed, some look to feel the “rush” that is experienced from taking opioids.
Opioids are commonly prescribed because of their analgesic effects, which simply means that they are used to alleviate pain by acting on the CNS (Central Nervous System). Official studies have shown that using opioids properly to manage pain rarely causes addiction. One who has been on opioids for a long duration can simply taper off of whatever medication they are on and not feel the discomfort that is likely from long-term pain management.
Breaking down stronger pain medications to weaker ones is fairly easy. Referred to as Narcotics- these medications are stronger than your basic over-the-counter pain medications. Popular narcotic pain killers range from Morphine down to Codeine, and it’s important to know which ones are right for a specific type of pain.
Morphine- is often used either before or after surgery to relieve severe pain. Morphine is the standard against which all other opioids are tested.
Codeine- is often used to treat milder pain. Even though Codeine is a narcotic pain killer, it’s widely used when an over-the-counter pain killer won’t work- mainly for simple aches and pains. Codeine is also widely prescribed for a severe cough, and is effective for this type of condition.
-These two medications are the two types of narcotics that are used to compare different opioids, etc. Other popular prescribed narcotic pain killers are as followed:
Vicodin (Hydrocodone w/ Acetaminophen)- is a widely popular narcotic pain reliever (opioid analgesic). Many doctors prescribe this narcotic because it’s not as powerful as other narcotics, but it still does the job as to alleviating pain. Hydrocodone is used to relieve moderate to moderately severe pain. Vicodin comes in two forms- which determine which class the drug is in. If hydrocodone is pure with no other non-narcotic agents, and contains more than 15 mg per dosage, it is classified as a Schedule II controlled substance- but if it does contain non-narcotic agents and is less than 15 mg in dosage, it is then classified as a Schedule III controlled substance.
Percocet (Oxycodone HCI w/ Acetaminophen)- is another widely popular narcotic pain reliever (opioid analgesic). In the USA, Oxycodone is prescribed for moderate to severe pain. Percocet has been tested to be about double the strength of Vicodin. Oxycodone is a schedule II controlled substance, both as a single agent as well as in combination with non-narcotic agents. This is due to its potency. Percocet is also known for its calming and relaxing effects (also known as euphoria), which increases the addicition potential in the patient. Percocet effectively alleviates pain, and it’s quickly becoming the most popular “breakthrough” narcotic pain killer prescribed.
OxyContin (Oxycodone HCI)- is a controlled-release form of oxycodone that is prescribed to treat moderate to severe chronic pain. OxyContin provides 12 hours of pain relief at a time, which is why it is used for chronic pain. OxyContin is available is many different strengths- and goes as high as 160 mg. Due to its high potential for abuse- OxyContin is closely monitored when it’s prescribed. Although it has high potential for abuse, OxyContin offers very effective relief for severe pain patients.
MS-Contin (Morphine Sulfate Controlled-Release)- is a time-released medication with morphine in it. MS-Contin is usually taken every 8-12 hours- and it is prescribed to manage moderate to severe chronic pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. MS-Contin is NOT intended for use on an as-needed basis- but should be used when a long-lasting narcotic pain medication is needed for more than a few days. MS-Contin’s dosages range from 15 mg to 200 mg- with 200 mg being used in opioid-tolerant and very severe pain patients only. Morphine Sulfate is a schedule II controlled substance- as well as a very effective long-acting pain reliever.
These pain killers (opioids) all have similar effects, but it should be noted that even though they are similar, different ones can affect one person in many different ways. In general- opioids act by binding to specific proteins known as opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach (or bind) to these receptors, they effectively change the way a person experiences pain. The term “euphoria” can also be defined by opioid receptors- as one of the side effects of opioids is euphoria (or a medically recognized emotional state related to extreme happiness and a sense of well-being). Opioid medications affect certain regions of the brain that mediate what we sense as pleasure.
The use of other medications, including controlled substances, may interact with each other and are only safe to use under a physician’s supervision. One of the side effects of opioid medications is slow breathing, so the use of substances such as alcohol, antihistamines, benzodiazepines, or barbiturates is dangerous.
Long-term use of opioids can lead to physical dependence, which means that the body adapts to the occurrence of the substance- and withdrawal symptoms can occur if the medication is stopped abruptly. Tolerance is also an issue here. If people are taking a certain narcotic pain medication for an extended period of time- they may need to take higher dosages of that same drug to obtain the same initial effects that they experienced when they first used it.
Physical dependence and addiction are not the same, so it’s important to know the differences of the two. Physical dependence can appear even with the appropriate long-term usage of the specific drug one is using. Addiction is defined as the progression of acute drug use leading to the development of drug-seeking behavior. Drug addicts will search high and low for their drug(s) of choice just to receive a high or mask their withdrawal symptoms.
Any person taking prescribed opioid medications should be medically supervised when stopping the drug(s). This is normally done by tapering a patient slowly off of the medication(s). One who suddenly stops taking opioid medications can suffer through withdrawal symptoms that include, but are not limited to:
yawning, sweating, anxiety, restlessness, insomnia, pupil dilation, chills, cold sweats, nausea, vomiting, cramps, diarrhea, muscle aches and pains, and involuntary leg movements (restless legs)
Any person who suddenly becomes addicted to prescription pain killers can be treated effectively. Options on treating addiction to prescription opioids are taken from research on treating heroin addiction. Four of the most popular treatments available are below:
Methadone- is a synthetic opioid that reduces the addict’s appetite for heroin and other opioids, as well as blocks the effects, eliminates withdrawal symptoms and mitigates cravings. MMT (Methadone Maintenance Treatment) is the program that patients go through to take care of their addiction to opioids. Methadone has been around for over 30 years- and it has successfully treated people addicted to opioids.
Buprenorphine- is another synthetic opioid drug with partial agonist and antagonist actions that was recently added to the market for treating addiction to heroin and other opioids. Two of the more popular drugs with buprenorphine in them are Subutex and Suboxone- both of these drugs are similar, but one (Suboxone) has naloxone in it, which is an opioid antagonist. This also discourages people from dissolving the tablet and injecting it. Subutex only has buprenorphine in it, and is also only used for a few days of treatment rather than Suboxone and its adequate maintenance program. Suboxone is the more popular ‘take home’ medication in this class.
Naloxone- is used to counter the effects of opioid overdose (heroin, morphine, etc). Naloxone blocks certain receptors in the CNS (Central Nervous System) from producing withdrawal symptoms, as well as not allowing any other opioids to bind to the receptors.
Naltrexone- is an opioid receptor antagonist that manages opioid dependence, as well as to prevent relapse. Naltrexone should not be confused with Naloxone. Naltrexone is primarily used for longer-term dependence control. In certain conditions, it may be recommended to perform a rapid detoxification (”rapid detox”), which in short-term means to rapidly detoxify the body from opioid dependency while the patient is under anesthesia.
