Opiates are categorized as narcotics, and distinctively derive from opium. Raw opium is present in the sap of the poppy seed pod and is transformed into many different narcotic drugs. Opium can be smoked, eaten, or injected. The duration of the effects can last up to thirty six hours. Smaller doses and different derivatives of opium have a decreased duration of effectiveness. It is important for us to understand the duration of different forms of opiates when analyzing the severity of possible drug addiction and possible overdose. Opium itself causes severe long lasting withdrawal symptoms as opposed to its derivative counterpart's morphine and heroin. Heroin withdrawal on the other hand is quite severe compared to methadone. The importance of understanding how opiate doses affect someone helps doctors prescribe pain medications and life saving respiratory inhibitors such as codeine and hydro-codone. At the same time misuse of these drugs can cause severe damage and even death to users.
Opiate overdose is possible from any derivative of the drug including prescribed medications such as codeine and hydro-codone. The most common form of overdose known as IV (intravenous) overdose is usually induced by new coming addicts that usually inject heroin, otherwise known as main-lining the drug into a vein. The problems that exist with injection are related to the fact that the drug can be easily overdosed by inexperienced users, on the basis that injection into a vein is instantaneous and irreversible. Overdose is always possible and more prominent among intravenous users.
The symptoms of opiate overdose are heightened effects of the drugs natural narcotic effects... Initially the drug works blocking receptors in the brain, many of which control involuntary organ and body functions. The drug has sedating effects and temporarily blocks neurotransmitters in the brain causing decreased breathing. During overdose the respiratory system shuts down known as apnea depriving the heart of oxygen, in turn starving the brain, and death occurs. The signs of a person using opiates can be easily detected by constricted pupils, flushing of the skin and sweating and skin irritation. The drug releases histamines in the body causing these symptoms. An overdose victim will have deeply dilated pupils, symptoms of apnea and a decreased heart rate. One problem with diagnosing opiate overdose is; unlike alcohol and other sedatives and ethers, opiates have little or no effect on the initial motor functions of the user. It is possible that opiate usage can go undetected with little signs of problem, especially if the person has built a tolerance to the effects of the drug. This in turn may promote the user to use higher dosages causing accidental overdose.
Treatment of overdose can be an extremely difficult process. As an EMT diagnosing opiate overdose can be based on many conditions and factors. Gathering as much information as possible to assist the clinical judgment may be necessary in taking the right actions. The patient may have an altered mental status or be totally unconscious. Limmer, Okeefe, and Dickinson state, “When dealing with drug abuse you must also protect yourself from substance itself” (477). “Intravenous users may posse's hypodermic syringes which pose a hazard of infectious disease transmission through accidental punctures” (477). Their may or may not be evidence or witnesses at the seen. As the vital signs drop below the standards it is important to contact Emergency medical services, open the airway of the victim, and compensate with artificial respirations. Limmer and O'Keefe and Dickinson suggest, “Stay alert for seizures, and be on guard for vomiting that could obstruct the airway” (477). This is known as the A and B of life, initially maintaining the airway and assisting with breathing long enough to administer counter agents. A new experimental drug known as radioactive Naloxone may be administered in one cubic centimeter dosages early on. This may promote natural respiration in an overdose victim. Snyder states findings when trying to battle an opiate overdose, Roughly 1,500 counts bound to the intestine when Candice added radioactive Naloxone alone” (62). The breakthrough with a counter agent used to coagulate opiates in the body would mean a higher chance of survival for overdose victims. Snyder states, “We were pleased to find that the relative potencies of opiates at the binding sites matched their pharmacological actions” (63). As an antagonist drug Naloxone is extremely effective. Snyder states findings, “ Most people breath about fifteen to twenty times a minute, but patients with opiate overdoses may breathe two or three times a minute. Injecting these patients with a minute dose of Naloxone almost miraculously reverses this depressed respiration rate.” “Within ten seconds of an intravenous Naloxone injection, formerly comatose patients will sit up, totally alert and almost normal” (50). The drug known as Naloxone may or may not be available for use among different ambulatory services. This may be based on statistic drug use and overdoses rates in a particular area.
