Methadone Rehabilitation

Question by Salmon: What is the difference between opioids, opiates and benzodiazepines?

Best answer:

Answer by DGB
Opiate is an often-misused term. Any drug which affects the opioid receptors is often incorrectly labeled an opiate, however definitionally the opiates refer to alkaloids extracted from poppy pods and their semi-synthetic counterparts which bind to the opioid receptors. Basically to be called an opiate one has to either be a natural opioid receptor agonist or start the refining process with one of the natural alkaloid molecules. Once chemically altered, such as the process of converting Morphine into Heroin, the drug is then labeled a semi-synthetic opiate or semi-synthetic opioid – the terms can be used interchangeably. This distinction can be a little confusing since Morphine, Codeine and Thebaine are all pure alkaloids that bind to the Opioid receptors, but Papaverine, which is also a naturally occurring alkaloid inside the poppy pod is not an opiate because it does not act on the opioid receptors.
So Natural Opiates are Morphine, Codiene and Thebaine.
Semi-synthetic opiates (or semi-synthetic opioids) are Heroin (diamorphine), Oxycodone, Hydrocodone, Dihydrocodiene, Hydromorphone, Oxymorphone, Buprenorphine, Etorphine, Naloxone and Nicomorphine.

Opioid is a blanket term used for any drug which binds to the opioid receptors in the CNS. Opioids include all of the opiates as well as any synthesized drug that attaches itself to the CNS or gastrointestinal tract opioid receptors.
Synthetic Opioids include Methadone, Pethidine (Demerol), Fentanyl Alfentanil, Sufentanil, Remifentanil, Carfentanyl Pentazocine, Phenazocine, Tramadol, and Loperamide.

Effects

Opium, Opiates and Opioids all produce similar effects. At low doses they make highly effective painkillers, and at medium to high doses produce euphoria, nausea, sleepiness, “a warm fuzzy” feeling and a sense of peace. They are extremely addictive both mentally and physically and withdrawals from the drugs can be quite intense with effects including but not limited to suicidal thoughts, cold sweats, uncontrollable diarrhea, immobility, sleeplessness, abnormal body temperature and heartbeat and severe depression. Once addicted, these substances are extremely hard to get away from and are capable of ruining ones live completely. The severity of all addictions depend a lot upon the vulnerability of the user towards addiction in general. But none the less this class of substances are extremely dangerous in this regard and should be treated with the utmost respect.
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Benzodiazepines
Profile

Benzodiazepines are among the most commonly prescribed depressant medications in the United States today. More than 15 different types of benzodiazepine medications exist to treat a wide array of both psychological and physical maladies based on dosage and implications. To be characterized as such, each benzodiazepine displays one or more of the following drug actions: anxiety relief, hypnotic, muscle relaxant, anti-convulsant, or an amnesiatic (mild memory-loss inducer). Due to their sedative properties, benzodiazepines have a high potential for abuse, especially when used with other depressants such as alcohol or opiates.2 Benzodiazepines are classified as Schedule IV in the Controlled Substances Act.

Commonly prescribed benzodiazepines include Xanax (alprazolam), Librium (chlordiazepoxide), Valium (diazepam), and Ativan (lorazepam).3 Another benzodiazepine that has been the focus of a great deal of media attention is flunitrazepam, trade name Rohypnol, which is known widely as “the date-rape drug” due to its involvement in many sexual assault cases in recent years.

History

During the 1930’s, Leo Sternback discovered benzodiazepines while working for the Hoffman-LaRoche Company. However, the first benzodiazepine was not introduced to the general public until 1957, when Hoffman launched Librium, which is used primarily to relieve anxiety. Abuse of benzodiazepines was not specifically addressed until the 1980s, when they became among the most prescribed medications in America.

Methods of Use

Methods of use vary greatly depending on the purpose of the administered benzodiazepine. The most common method of ingestion is orally, in tablet or capsule form. Valium, Ativan, and Librium are also sometimes dispensed intravenously, while midazolam (Versed) is used exclusively as an intravenous medication. Ativan comes in a tablet form that can be dissolved under the tongue.

Back to TopPharmacology

Benzodiazepines affect a key neurotransmitter in the brain called gamma-amino butyric acid (GABA). This neurotransmitter has an inhibitory effect on motor neurons, thus the presence of GABA slows or stops neuronal activity. Benzodiazepines enhance the activity of GABA, effectively slowing nerve impulses throughout the body. The human nervous system has two different types of benzodiazepine receptors: one that causes the anti-anxiety effect, and one that elicits the sedative effect.

Although most benzodiazepines trigger the same physical effects, their dosage and absorption time into the bloodstream can vary widely. The medications are broken into two separate categories for classification-short-acting and long-acting. A short-acting benzodiazepine is cleared from the body in a short period of time, whereas long-acting benzodiazepines may either accumulate in the bloodstream or take a much longer period of time to leave the body. A particular benzodiazepine’s classification determines what it is prescribed for, as well as its potential for tolerance, dependence, and abuse.

Short Term Effects

Low to Moderate Doses
Benzodiazepines are prescribed for relaxation, calmness, and relief from anxiety and tension. In some cases side effects will occur; these vary widely depending on the type of benzodiazepine, the dose, and the person. They can include:

Impaired motor coordination
Drowsiness, lethargy, fatigue
Impaired thinking and memory
Confusion
Depression
Altered vision
Slurred speech, stuttering
Vertigo
Tremors
Respiratory depression
Nausea, constipation, dry mouth, abdominal discomfort, loss of appetite, vomiting, diarrhea

High Doses
At high doses benzodiazepines can cause extreme drowsiness. In addition to the adverse effects listed above, the following are also observed:

Slowed reflexes
Mood swings
Hostile and erratic behavior
Euphoria
Long Term Effects

Some benzodiazepines are eliminated from the body slowly. Thus, ingesting multiple doses over long periods of time can lead to significant accumulation in fatty tissues. The symptoms of over-sedation may not appear for a few days. Some include:

Impaired thinking, memory, and judgment
Disorientation
Confusion
Slurred speech
Muscle weakness, lack of coordination
Tolerance, Dependence & Withdrawal

Tolerance to certain benzodiazepines occurs most often in those who have used for 6 months or more. Physicians counteract the effects of tolerance by increasing dosage in small increments or by adding another benzodiazepine to the prescription. Users most often develop tolerance to the milder effects of the drug, such as sedation and impairment of motor coordination. A fair amount of cross-tolerance exists between benzodiazepines and other depressants such as alcohol and barbiturates, thus users may not feel the effects of these drugs as potently as they would otherwise.

To ease the symptoms of withdrawal, physicians recommend that users gradually reduce the amount of medication ingested until the dose is low enough that the individual will not feel discomfort. Withdrawal symptoms are most severe when a high dose of either a short-acting or intermediate-acting benzodiazepine is abruptly discontinued.

General benzodiazepines:

tranks, downers
Valium:

V’s
Xanax:

Z bars (xanax)

Whew!!! took me a while to type that for ya!!! LOL 😉