Opiates are some of the most addictive and prevalent substances in the world. They include illegal drugs such as opium and heroin; they also encompass legal therapeutics like morphine and fentanyl. Despite the different names and uses, intoxication with an opiate substance results in a very similar clinical picture.
Pinpoint Pupils
Opiates cause constriction of the pupils of the eye, resulting in very small pupils that are referred to as "pinpoint pupils." The medical term for this characteristic appearance is "miosis," and it occurs frequently as tolerance does not develop to this effect.
Altered Mental Status
Opiate substances are very sedating, and can often depress brain function and result in lowered consciousness levels. This can obviously be very dangerous for someone operating automobiles or in charge of vital tasks at work, such as an air traffic controller. When first used, the user can be very excited due to euphoric effects, but with increasing doses, the level of consciousness inevitably decreases.
Decreased Breathing
Opiates affect the breathing centers in the brain, causing the user to breathe at a much slower rate than usual. With enough opiate use, breathing can cease completely; this is a frequent cause of death from overdose.
Itchiness
Opiates can cause the release of histamine within the body, which can cause widespread itching, hives, and flushing of the skin. Histamine is the same chemical that is released during allergic reactions, hence the very similar clinical picture.
Constipation
Opiates tend to slow gastrointestinal motility, causing a decreased amount of bowel movements. This is one of the reasons why low-grade opiates such as loperamide (also known as Immodium) are used as anti-diarrheal agents. This effect does not usually develop tolerance after continued use.
References
- "Miller's Anesthesia, 7th Edition"; Miller; 2009
- "Neurologic Clinics"; Neurologic Aspects of Drug Abuse; Goforth, Murtaugh, Fernandez; February 2010
- "Rosen's Emergency Medicine, 7th Edition"; Marx; 2009
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