Section I. BACKGROUND
11-1. GENERAL COMMENTS
Most people have legally used narcotic agents. Conditions characterized by a
degree of discomfort (that is, pain, diarrhea, or cough), often are treated with
medical personnel to be familiar with narcotic agents.
11-2. HISTORY OF NARCOTIC AGENTS
a. There is evidence that the opium poppy was used in Sumeria as early as
4000 B.C., and it is mentioned in the medical records of ancient Greece and Rome.
During the Dark Ages, it passed to the Arabs, who took it to China about 900 A.D. It
was either smoked or taken orally.
b. Opium was first used injectably around 1800; the U.S. Civil War saw the first
widespread use in this manner. Because of a lack of knowledge and caution, a
condition called "Soldier's Disease" was described--addiction. This coupled with the
large influx of Chinese laborers who smoked, and the ready availability of opium caused
a great deal of concern. There were no packaging or distribution laws; indeed, a
children's formulation was marketed called "Mrs. Winslow's Soothing Syrup." This
concern was an important factor in motivation for the Pure Food and Drug Act of 1906.
c. In 1805, a German Pharmacist's assistant isolated a pure alkaloid (a basic
substance found usually in plant parts) from opium that he called morphine. It was
subsequently found that opium contains two general categories of alkaloids; narcotics
(phenanthrene) such as morphine and codeine, and nonnarcotics (benzylisoquinoline)
11-3. PHARMACOLOGICAL EFFECTS OF THE NARCOTICS
Narcotics produce pharmacological effects when administered to a patient.
Some of these effects are desirable, while others are undesirable. Always remember
that the legitimate use of these agents is implied in our discussion.
a. Analgesic Effect. Analgesia means relief of pain without the loss of
consciousness. Analgesia is the most common use of narcotics. Although the exact
mechanism of action by which narcotics act is unknown, it is thought that analgesia is
obtained by the action of these agents on the cerebral cortex. The relief of pain is
enhanced because narcotics raise a patient's pain threshold and thus produce a