DRE: Narcotic Analgesics

Question 1

Define Narcotic

Answer 1

a drug derived from Opium, or produced synthetically, that relieves pain but also induces euphoria, alters mood, and produces sedation.

Question 2

Define Analgesic

Answer 2

a medication or drug that relieves pain.

Question 3

What are the types of Narcotic Analgesics?

Answer 3

1. Opiates (either contain or derived from Opium)
   a. Natural Alkaloids – substance found in another substance and can be isolated from it. “Alkaloids” synonymous with term “main ingredient.”
   b. Opium derivatives – obtained by chemically treating Opium Alkaloid.
2. Synthetics – Not derived from Opium at all but have similar or identical effects as Opium Alkaloids and derivatives.

Question 4

Name the 3 characteristics common to all Narcotic Analgesics

Answer 4

1. Relieve pain – produce analgesia
2. Produce withdrawal signs and symptoms
3. Suppress withdrawal signs and symptoms

Question 5

Name some commonly abused Opiates and their Derivatives

Answer 5

1. Powdered Opium
2. Morphine
3. Codeine
4. Dilaudid
5. Hydrocodone
6. Thebaine
7. Oxymorphone
8. Oxycodone
9. Buprenorphine

Question 6

Name some common synthetic opiates

Answer 6

1. Demerol
2. Methadone
3. Fentanyl

Question 7

Onset and Duration Effects of Narcotic Analgesics

Answer 7

1. Psychological Effects
   a. Heroin begins immediately after injection: feeling of pleasure/euphoria
   b. Relief from symptoms of withdrawal
   c. Relief from pain
2. Observable Signs
   a. Signs usually evident within 5-10 minutes after injection
   b. Nod head and move in/out of consciousness
   c. May display poor motor coordination, depressed reflexes and slowed breathing.

Question 8

Types of injections

Answer 8

1. Intramuscular
   a. Abbreviated as I/M
   b. “Intramuscular” is defined as administering by entering a muscle
2. Intravenous
   a. For medically drawing of blood or emergency medical procedures, the injection is made into a blood vessel (Intravenous)
   i. Veins are usually used
   ii. Arteries are deep, thus not lending themselves to injection
   b. Abbreviated as I/V
   c. “Intravenous” defined as entering a vein
3. Subcutaneous
   a. Subcutaneous (S/C) means just under the skin
   b. Commonly referred to as “skin popping”

Question 9

3. Consider this situation: A heroin addict injects what is, for him, a “normal” dose of the drug. One hour later a DRE examines the addict and finds he is not impaired. What is the most likely explanation for this?

Answer 9

The addict has developed a tolerance and is using his/her “normal” dose of the drug.

Question 10

4. What is another, more common, name for the drug called Diacetyl Morphine?

Answer 10

Heroin

Question 11

5. What is Methadone?

Answer 11

A drug used extensively in maintenance programs as a substitute for heroin.

Question 12

6. An analgesic is a drug that ______?

Answer 12

Relieves pain

Question 13

7. What is Oxycodone?

Answer 13

A semi-synthetic narcotic prescribed for chronic or long-lasting pain.