Opium

Opium is the air-dried milk juice of the opium poppy - Papaver somniferum - which is native to Central Europe. The milk juice (opium) contains a lot of alkaloids, i.e. a group with basic and nitrogen-rich compounds, including morphine and codeine. Opium has analgesic and cough-relieving properties. Opium can also be used to treat diarrhea . Unfortunately, opium is also taken as a narcotic, which is strongly discouraged due to its high potential for dependence and adverse effects. Opium in itself is a multi-substance mixture, which means that it contains many active ingredients. The main component of opium is morphine, which is known to be used in medicine. Morphine is therefore often mistakenly equated with opium, but this is not correct, because in addition to morphine, opium also contains other active ingredients such as thebaine, codeine, papaverine, xanthaline and noscapine. The natural active ingredients of opium(morphine, codeine, thebaine,...) are called opiates. Structurally similar, or similarly acting substances are called opioids.

Opium acts at opioid receptors (G-protein coupled receptors) located in the brain, spinal cord, and peripheral nervous system. There are 3 different classes of opioid receptors: the δ-opioid receptors, the κ-opioid receptors, and the μ-opioid receptors. The active ingredients of opium bind to these receptors, thus potassium channels open and voltage-gated calcium channels are prevented from opening. This in turn reduces neuronal excitability and prevents the release of pain neurotransmitters (pain messengers). Reduced release of these neurotransmitters results in pain suppression.

The μ-opioid receptor is thought to be responsible for the severe addictive effects.

Opium is primarily broken down in the liver, via the enzyme CYP 2D6. Any other drug that is also degraded via CYP 2D6 could interact with opium. The bioavailability of opium, that is, what percentage of the drug is available in the blood, is very low. Because of the numerous alkaloids in opium, such as morphine, codeine, etc., it is difficult to make statements about the half-life. Basically, the half-life, i.e. the time it takes the body to excrete half of the active ingredient, is between 3 and 10 hours.

Always take Opium exactly as described in the package leaflet or exactly as agreed with your doctor.

The usual recommended dose depends on the patient's clinical picture and is therefore determined individually. The maximum daily dose is 60 mg and the maximum single dose is 10 mg of opium tincture.

Opium should never be given to other people, certainly not to people with a history of drug abuse.

Abuse of opium can lead to addiction, overdose, or death.

The following side effects may occur:

Very common:

• Drowsiness
• constipation
• Dry mouth

Common:

• Difficulty urinating
• Dizziness
• Headache
• Pupil constriction
• Nausea and vomiting
• Loss of appetite
• Margin intestinal discomfort
• altered sense of taste or smell
• hives (urticaria)
• increased sweating
• cramping of the bronchial tubes
• weakened cough
• easy fatigability

Occasionally:

• Shortness of breath
• fatigue
• anxiety
• bluish discoloration of lips, fingers and toes (cyanosis)
• Seizures
• confusion
• swelling of legs and feet
• cardiac arrhythmias
• reddened face
• itching
• bladder and urethra spasms
• altered liver values

Rarely:

• Increase in pancreatic enzymes
• pancreatitis
• Kidney stones
• Gallstones
• Withdrawal symptoms
• Drop in blood pressure when rising from a sitting or lying position

Very rare:

• Difficulty breathing
• Muscle cramps
• pain
• increased sensitivity to pain
• blurred vision and double vision
• involuntary eye movements
• intestinal obstruction (ileus)
• malaise
• tremor
• high secretion of antidiuretic hormone
• absence of menstrual bleeding

Frequency unknown:

• Adrenal insufficiency
• Euphoria
• uncontrolled muscle movements
• dependence and addiction
• Discomfort
• restlessness
• decreased sexual desire
• decreased potency
• hallucinations
• fever

Taking opium can lead to addiction! In case of overdose death may occur due to respiratory paralysis!

Drug interactions may occur if the following medicines are taken at the same time:

• Alcohol
• sleeping pills
• anesthetics
• tricyclic antidepressants (MAO inhibitors)
• Parkinson's disease medications
• Antipsychotics
• Anti-nausea and anti-vomiting drugs
• drugs against allergies
• other opiate painkillers
• Medicines with a similar effect (e.g., buprenorphine, naltrexone)
• medicines used to treat alcohol abuse(disulfiram)
• Metronidazole
• medicines used to treat tuberculosis
• drugs used to treat blood clots(clopidogrel, prasugrel, ticagrelor)
• Amphetamines
• Loxapine
• Periciazines
• Flibanserin
• Desmopressin
• Sertraline
• Zidovudine
• Fluoxetine

Opium must NOT be taken in the following cases:

• allergy to opium or morphine
• in case of opiate addiction
• in case of glaucoma
• severe liver or kidney disease
• in case of alcohol withdrawal symptoms
• severe head injury
• intestinal paralysis with intestinal obstruction
• bronchial asthma
• with COPD
• with respiratory problems
• with cardiac insufficiency

Opium must not be used before the age of 18.

Pregnancy

In pregnancy, opium should only be taken after strict indication.

In the 1st trimester there is no evidence of risk of malformation, however there are almost no studies on this.

In the 2nd & 3rd trimesters , there are reports of decreased respiratory movements in the unborn baby. Opium should not be used under any circumstances during childbirth, as severe withdrawal symptoms may occur in the newborn. After prolonged use, including dependence, withdrawal symptoms in the newborn can also be expected. Permanent defects in the newborn cannot be ruled out. Furthermore, the risk of sudden infant death syndrome (SIDS) increases.

Opiate withdrawal during pregnancy may result in the death of the baby in the abdomen or premature labor. Therefore, withdrawal should never be done during pregnancy.

If use has occurred during pregnancy, be sure to seek a hospital with a neonatology unit for delivery.

Tramadol or buprenorphine may be considered as alternatives.

Breastfeeding

During breastfeeding, opium should also be taken only after strict indication . No serious side effects have been reported in infants. Opium should be used for as short a time as possible. Breastfeeding does not need to be restricted for single doses.

Again, tramadol and buprenorphine are better alternatives

The opium poppy (Papaver somniferum) has been used medicinally for thousands of years. Already in ancient times Dioscorides described its pharmacological effects. The poppy pod was the symbol of Morpheus, the god of dreams, Thanatos, the god of death, and Nyx, the goddess of night.

Poppy was already used as a useful plant in the Neolithic Age and is thus one of the oldest useful plants in the world.