The term narcotic is believed to have been coined by the Greek physician Galen to refer to chemicals that numb or deaden (also referred to as narcosis, or "stupor", by the Greek physician Hippocrates). Galen listed mandrake root, altercus (eclata) seeds, and poppy juice (opium) as chief examples. Technically, a narcotic is a drug that binds to the opiate receptors in the central nervous system. In the United States legal context, narcotic refers to opium, opium derivatives, semi-synthetic or fully synthetic substitutes and cocaine or coca leaves. Chemically, cocaine is not a true narcotic (opioid). Also, law enforcement frequently generalizes confiscation of any illegal drugs under the term narcotics. As the example, marijuana and LSD are technically not narcotics as they are not opiates. Also, anabolic steroids are not narcotics. So for purposes of the remainder of the discussion, the term narcotic is synonymous with opiate drugs that produce morphine like effects.
Narcotics of natural origin are derived from the poppy plant Papaver somnferum. It is believed that this plant was grown as a source of opium as early as 5000 years B.C. The unripe seed pod of the poppy is cut, causing a milky fluid to seep from the pod. This is known as opium. It is collected and rendered into liquid, solid, or powder form. The street name is heroin. Morphine and codeine are derived from opium. It is also used to make dihydromorphone, hydromorphone, oxycodone, and many others. Thebaine is the most poisonous alkaloid found in opium. It can be converted into several other narcotics that have medical use such as hydrocodone, acetyldihydrocodeine, oxycodone, and oxymorphone. Synthetic opiates are produced entirely within the laboratory. Examples include meperidine, fentanyl, and pentazocine. Narcotics are primarily used for treatment of pain, cough suppression, acute diarrhea, and to induce anesthesia. They may be taken by mouth, absorbed transdermally (skin patches), or injected. When abused, they are often smoked, sniffed, or injected. The effect of a narcotic depends heavily on the dose, route of administration, and tolerance to the opiate class of medications from previous repetitive use. Not everyone that uses narcotics experiences the same euphoria. However, most individuals who use narcotics experience a general sense of well-being, reduced tension, anxiety reduction, and euphoria.
There are a number of side effects and the symptoms that can be seen in a person using narcotics. These may include drowsiness, itching, sleepiness, "nodding off", inability to concentrate, apathy, lessened physical activity, constriction of the pupils (pinpoint pupils), dilatation of the subcutaneous blood vessels causing flushing of the face and neck, constipation, nausea, vomiting and respiratory depression. In general, the higher the dosage of medication, the greater the side effect profile. At higher dosages there may be loss of motor coordination and slurred speech. These are especially evident when narcotics were taken in combination with alcohol or other sedatives. With progressive use, narcotic tolerance begins to develop. Tolerance is characterized by a short duration of action and decreased intensity of analgesia, euphoria and sedation. This creates the need to administer progressively larger doses of the narcotic to achieve the desired effect. As the dosage increases, the side effects generally increase as well. At higher dosages, the risk of respiratory depression and death also increase.
Withdrawal symptoms from narcotics can be extremely uncomfortable. Depending upon the total daily dose, the interval between doses, the duration of use, the health of the user and the personality of the user. The symptoms can range from mild to severe. Early symptoms include watery eyes, runny nose, yawning and sweating, and stomach cramps. With greater use, symptoms may also include restlessness, irritability, loss of appetite, tremors, chills, muscular pain, muscle spasms, kicking movements, abdominal cramping, "gooseflesh", and diarrhea. Severe depression and vomiting are possible. Heart rate and blood pressure may become elevated. Because many of these symptoms or so unpleasant, avoiding the withdrawal syndrome becomes a primary driving force in becoming "addicted to" narcotics.
The misuse of narcotics by the pregnant woman can have detrimental effects on the newborn infant. Neonatal drug withdrawal depends on the drug, the timing, and the amount of the last use. The symptoms relate to central nervous system (CNS) irritability and gastrointestinal (GI) dysfunction. CNS symptoms include seizures, irritability, inability to sleep, high-pitched crying, increased muscle tone, yawning and sneezing. GI problems include poor feeding, uncoordinated and constant sucking, vomiting, diarrhea, dehydration, and poor weight gain. In addition to these symptoms the newborn may also experience sweating, nasal stuffiness, fever, and temperature instability. The newborn can suffer withdrawal symptoms 48 to 72 hours or it may be delayed up to 4 weeks later, depending on the type of narcotic abused and larger doses (AAP, 1998). Some examples of commonly used or abused narcotics include hydrodocone, oxycodone, codeine, propoxyphene, methadone and heroin. (see DRUG INDEX for a more complete list).
American Academy of Pediatrics, (1998).
Neonatal drug withdrawal. Pediatrics, 101(6), 1079-1088.