Narcotic Drugs
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The term narcotic (, from
ancient Greek Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic p ...
ναρκῶ ''narkō'', "to make numb") originally referred medically to any psychoactive compound with numbing or paralyzing properties. In the United States, it has since become associated with
opiates An opiate, in classical pharmacology, is a substance derived from opium. In more modern usage, the term ''opioid'' is used to designate all substances, both natural and synthetic, that bind to opioid receptors in the brain (including antagonist ...
and opioids, commonly
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...
and heroin, as well as derivatives of many of the compounds found within raw opium latex. The primary three are
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...
, codeine, and
thebaine Thebaine (paramorphine), also known as codeine methyl enol ether, is an opiate alkaloid, its name coming from the Greek Θῆβαι, '' Thēbai'' (Thebes), an ancient city in Upper Egypt. A minor constituent of opium, thebaine is chemically similar ...
(while thebaine itself is only very mildly psychoactive, it is a crucial precursor in the vast majority of semi-synthetic opioids, such as
oxycodone Oxycodone, sold under various brand names such as Roxicodone and OxyContin (which is the extended release form), is a strong, semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive and a commonly ...
or
hydrocodone Hydrocodone, also known as dihydrocodeinone, is an opioid used to treat pain and as a cough suppressant. It is taken by mouth. Typically it is dispensed as the combination acetaminophen/hydrocodone or ibuprofen/hydrocodone for pain severe eno ...
). Legally speaking, the term "narcotic" may be imprecisely defined and typically has negative connotations. When used in a legal context in the U.S., a narcotic drug is totally prohibited, such as heroin, or one that is used in violation of legal regulation (in this
word sense In linguistics, a word sense is one of the meanings of a word. For example, a dictionary may have over 50 different senses of the word "play", each of these having a different meaning based on the context of the word's usage in a sentence, as ...
, equal to any
controlled substance A controlled substance is generally a drug or chemical whose manufacture, possession and use is regulated by a government, such as illicitly used drugs or prescription medications that are designated by law. Some treaties, notably the Single ...
or
illicit drug The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent the recreational use of certain intoxicating substances. While some drugs are illegal to possess, many governments regulate the ...
). In the medical community, the term is more precisely defined and generally does not carry the same negative connotations. Statutory classification of a drug as a narcotic often increases the penalties for violation of drug control statutes. For example, although U.S. federal law classifies both
cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...
and amphetamines as "Schedule II" drugs, the penalty for possession of cocaine is greater than the penalty for possession of amphetamines because cocaine, unlike amphetamines, is classified as a narcotic.


United Nations


Single Convention on Narcotic Drugs, 1961

The adoption of this convention is regarded as a milestone in the history of the international drug ban. The Single Convention codified all existing multilateral treaties on drug control and extended the existing control systems to include the cultivation of plants that were grown as the raw material of narcotic drugs. The principal objectives of the convention are to limit the possession, use, trade, distribution, import, export, manufacture, and production of drugs exclusively for medical and scientific purposes, and to address drug trafficking through international cooperation to deter and discourage drug traffickers. The convention also established the International Narcotics Control Board, merging the Permanent Central Board and the Drug Supervisory Board. The 1961 Convention seeks to control over 116 drugs that it classifies as narcotic. These include: * plant-based products such as opium and its derivatives morphine, codeine, and heroin (the primary category of drug listed in the convention); * synthetic narcotics such as methadone and pethidine; and * cannabis, coca, and cocaine. The Convention divides drugs into four groups, or schedules, to enforce a greater or lesser degree of control for the various substances and compounds. Opium smoking and eating, coca leaf chewing, cannabis resin smoking, and the non-medical use of cannabis are prohibited. The 1972 Protocol to this Convention calls for increased efforts to prevent illicit production of, traffic in, and use of narcotics as defined by the convention, while highlighting the need to provide treatment and rehabilitation services to drug abusers.


INCB Yellow List

This document contains the current list of narcotic drugs under international control and additional information to assist governments in filling in the International Narcotics Control Board questionnaires related to narcotic drugs, namely, form A, form B and form C. In medicine, a chemical agent that induces stupor, coma, or insensibility to pain (also called narcotic analgesic). In the context of international drug control, "narcotic drug" means any drug defined as such under the 1961 Convention.


World Health Organization


Studies on the definition of ''counterfeit medicines'' in WHO member states

4. Assessment of the definitions of counterfeit medicines (or equivalent) in the Member States 4.2 The nature of legal definitions: the unambiguity requirement In order to avoid room for difference in interpretation, lawmakers (''codificators'') sometimes deviate from etymological (definiendum plus definientia) definitions. In doing so, they approach the term from the law enforcement point of view. The best example is the definition of ''narcotics'' in the United Nations Conventions. Narcotics are substances and preparations that induce drowsiness, sleep, stupor, insensibility, etc., and that these effects (and their rate) are complicated to prove, e.g. during litigation. Thus, the legal definition of a narcotic is whether or not it is listed on the Schedules of the convention. If it is on some of the Schedules, it is narcotic.


Lexicon of alcohol and drug terms published by the World Health Organization

The term usually refers to opiates or opioids, which are called narcotic analgesics. In common parlance and legal usage, it is often used imprecisely to mean illicit drugs, irrespective of their pharmacology. For example, narcotics control legislation in Canada, the US, and certain other countries includes cocaine and cannabis as well as opioids (see also conventions, international drug). Because of this variation in usage, the term is best replaced by one with a more specific meaning (e.g. opioid).


United States

Section 1300.01 Definitions relating to controlled substances: A 1984 amendment to 21 USC ( Controlled Substances Act), Section 802 expanded and revised definition of "narcotic drug", including within term poppy straw, cocaine, and ecgonine.


''US v. Stieren''

608 F.2d 1135


History

The term "narcotic" is believed to have been coined by the Greek physician
Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one ...
to refer to agents that numb or deaden, causing paralysis or loss of feeling. It is based on the Greek word ''ναρκωσις'' (narcosis)'','' the term used by
Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
for the process of numbing or the numbed state. Galen listed
mandrake root "Mandrake Root" is a song by Deep Purple that is featured on their debut album '' Shades of Deep Purple''. The title is in reference to the mandrake plant, but is also the name of a pre-Purple band that Blackmore was trying to form in German ...
, altercus (eclata), seeds, and poppy juice ( opium) as the chief examples. It originally referred to any substance that relieved pain, dulled the senses, or induced sleep. Now, the term is used in many ways. Some people might define narcotics as substances that bind at
opioid receptor Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. The endogenous opioids are dynorphins, enkephalins, endorphins, endomorphins and nociceptin. The opioid receptors are ~40% identical to somatostatin ...
s (cellular membrane proteins activated by substances like heroin or morphine), while others refer to any ''illicit'' substance as a narcotic. From a U.S. ''legal'' perspective, narcotics refer to opium, opium derivatives, and their semi-synthetic substitutes, though in U.S. law, due to its numbing properties, cocaine is also considered a narcotic. The definition encompassing "any illegal drug" was first recorded in 1926. Its first use as an adjective is first attested to c. 1600. There are many different types of narcotics. The two most common forms of narcotic drugs are
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...
and codeine. Both are synthesized from opium for medicinal use. The most commonly used drug for recreational purposes created from opium is heroin. Synthesized drugs created with an opium base for use in pain management are
fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocain ...
, oxycodone, tramadol, pethidine (Demerol), hydrocodone, methadone, and hydromorphone. New forms of existing pain medications are being created regularly. The newest formulation to come out was in 2014 when zohydro, an increased dosage formula of hydrocodone, was released; this is so far the strongest hydrocodone formulation created for pain management, on par with a moderate dose of oxycodone .


Analgesics

Analgesics An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It ...
are drugs that relieve pain. There are two main types: non-narcotic analgesics for mild pain, and narcotic analgesics for severe pain.


Narcotic analgesics

Narcotic analgesics tend to be
opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use ...
s. They bind to
opioid receptor Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. The endogenous opioids are dynorphins, enkephalins, endorphins, endomorphins and nociceptin. The opioid receptors are ~40% identical to somatostatin ...
s which are
G-Protein coupled receptor G protein-coupled receptors (GPCRs), also known as seven-(pass)-transmembrane domain receptors, 7TM receptors, heptahelical receptors, serpentine receptors, and G protein-linked receptors (GPLR), form a large group of evolutionarily-related p ...
s distributed in brain, spinal cord, digestive tract, peripheral neurons.


Mechanism

There are three types of opioid receptors: Mu ( μ-opioid receptors), delta, and kappa (
κ-opioid receptor The κ-opioid receptor or kappa opioid receptor, abbreviated KOR or KOP, is a G protein-coupled receptor that in humans is encoded by the ''OPRK1'' gene. The KOR is coupled to the G protein Gi/G0 and is one of four related receptors that bind op ...
). Endogenous opioids (
enkephalins An enkephalin is a pentapeptide involved in regulating nociception in the body. The enkephalins are termed endogenous ligands, as they are internally derived and bind to the body's opioid receptors. Discovered in 1975, two forms of enkephali ...
,
dynorphin Dynorphins (Dyn) are a class of opioid peptides that arise from the precursor protein prodynorphin. When prodynorphin is cleaved during processing by proprotein convertase 2 (PC2), multiple active peptides are released: dynorphin A, dynorphin ...
,
endorphin Endorphins (contracted from endogenous morphine) are chemical signals in the brain that block the perception of pain and increase feelings of wellbeing. They are produced and stored in an area of the brain known as the pituitary gland. Hist ...
) do not bind specifically to any particular opioid receptor. Receptor binding of the opioid causes a cascade leading to the channel opening and hyperpolarization of the neuron. The opioid receptors have the following channel types: Mu, K+ channel; l Delta, K+ channel; Kappa, Ca2+ channel. Hyperpolarization can lead to post-synaptic neural inhibition and presynaptic inhibition of neurotransmitter release. Post-synaptic neural inhibition can reduce analgesia and central hyperactivity may reduce its efficacy. The mechanism of Kappa receptors is slightly different than Mu and Delta, in that Ca2+ channels close instead of K+ channels, and K+ channels open in mu and delta.


See also

*
Commission on Narcotic Drugs The Commission on Narcotic Drugs (CND) is one of the functional commissions of the United Nations' Economic and Social Council (ECOSOC), and is the central drug policy-making body within the United Nations System. The CND also has important man ...
* East African drug trade *
Equianalgesic An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) betwee ...
*
Narcoterrorism Narcoterrorism, in its original context, is understood to refer to the attempts of narcotics traffickers to influence the policies of a government or a society through violence and intimidation, and to hinder the enforcement of anti-drug laws by t ...
*
Narcotics Anonymous Narcotics Anonymous (NA), founded in 1953, describes itself as a "nonprofit fellowship or society of men and women for whom drugs had become a major problem." Narcotics Anonymous uses a 12-step model developed for people with varied subst ...
*
Opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use ...
*
Prohibition of drugs The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent the recreational use of certain intoxicating substances. While some drugs are illegal to possess, many governments regulate the ...
*
War on drugs The war on drugs is a global campaign, led by the United States federal government, of drug prohibition, military aid, and military intervention, with the aim of reducing the illegal drug trade in the United States.Cockburn and St. Clair, 1 ...


References


External links


Pharmer.org
A non-profit site providing detailed descriptions of most narcotic analgesics

some of which are classified as "narcotics", in the U.S. Controlled Substances Act (CSA). Not all of the classified ones are chemically narcotic, as described at the top of this page. {{Authority control Opioids