Poppies, opium and morphine: Strong drugs from a small flower

The poppy is a pretty red plant that adorns many flower gardens and is mentioned in the poem “In Flanders Fields” by John McCrae. It is the iconic symbol of Remembrance Day in Canada.

There are 250 species in the poppy genus. All species in this genus contain minute amounts of morphine and other chemically related narcotic compounds. The red poppy (Papaver somniferum) contains the highest amount of morphine of any species in the genus. Morphine is a nitrogen-containing chemical. Nitrogen-containing chemicals are called alkaloids.

The poppy plant has been used in many cultures since antiquity. It was widely used in China, India and northern parts of South America. It was first mentioned in the Middle East regions of Samaria and Persia as far back as 5000 BC.

It was a popular merchandise traded along the Silk Road from eastern Asia to Europe.

Opium dens became popular venues where it was bought, distributed and smoked in long pipes and flasks. Opium was popularized for its pain relieving and anti-intestinal motility effects and ability to reduce anxiety and agitation during the American civil war.

Opium is the name given to the milky latex material in the poppy plant that contains alkaloids. The resinous and water-soluble material was originally derived from the mature, ripe poppy seed bulbs.

The word morphine is derived from Morpheus, the Greek God of sleep and dreams. Morphine was first isolated from the resin of the poppy seed bulb in 1805 by a German pharmacist. It was named for its ability to induce sleep and somnolence.

The main alkaloids found in the poppy plant are morphine, codeine, heroin and thebaine. Hydrocodone is made synthetically from codeine. Thebaine is used to synthetically make oxycodone. Fentanyl is a synthetic narcotic made from a lesser-known precursor found in the opium poppy. At least 50 different alkaloids, many with varying degrees of narcotic activity, have been isolated from the poppy plant.

The total alkaloid content of the poppy plant ranges from 0.1 to 2.5% in cultivated hybrids modified for increased alkaloid content. Forty per cent to 70% of the total alkaloid content is morphine. The remainder is made up of the 50 or so other alkaloids.

The biological purpose of morphine and related alkaloids in plants is believed to be the prevention of microbial and fungal infection.

In humans, morphine is a potent analgesic or pain-relieving medicine and is classified as a narcotic. Narcotics are a group of related compounds that also dull the senses and induce sleep. Morphine and related compounds are strong medicines to help relieve moderate to severe pain. They are also used to relieve coughs and diarrhea.

Morphine and other opiates bind to receptors deep in the brain called the limbic system that affect mood and emotions. The coupling of these alkaloids stimulates neurotransmitter, mainly dopamine release. The increased levels of dopamine in this region cause heightened moods, pleasure and euphoria. As the drug wears off the euphoric effect diminishes. Over time, with repetitive use of morphine and other narcotics to this part of the brain, it becomes sensitized to higher levels of dopamine. Addiction and craving results when the drug is not present at previous levels. A vicious cycle ensues and causes psychological and physical dependence.

Morphine also binds to pain centres in the midbrain that dampen sensory pain impulses in the spinal cord. It also binds to the cough reflex centre in the brain and relaxes muscles in the esophagus and lungs. It prevents muscle contractions in the intestines and stomach and slows transit time through the digestive system.

The potency of different narcotic alkaloids is typically compared to the analgesic or pain-relieving quality of morphine. Codeine is 0.1 times to 0.5 times as potent as morphine. Heroin or diamorphine is two to three times as potent as morphine. Oxycodone has about 1.5 times the analgesic potency as morphine. Hydrocodone is about 1.5 times as strong as morphine. Fentanyl is 50 to 100 times more potent than morphine. The synthetic drug carfentanil is estimated to be 10,000 times as potent as morphine.

Opiates, including morphine, are classified as “schedule 1 controlled” drugs in Canada and require a physician’s prescription. They are very good drugs to help control severe pain, especially in cancer patients. They should not be prescribed for slight or moderate painful conditions, where other non-narcotic analgesics, non-steroidal anti-inflammatories or NSAIDS and corticosteroids may be just as effective.

Opiates have a high potential for addiction and abuse.

The pharmaceutical industry is complicit in the widespread misuse of opiate analgesics. Aggressive marketing, prescriber kickbacks and misrepresenting the degree of addictive potential, side effects and potential benefits have been widely used to market opiates. A recent decision of the Supreme Court of Canada would allow provincial governments, territories and the federal government to seek reparations from the manufacturers of opiate pharmaceuticals for harms brought upon individuals who have used these drugs.

The province of British Columbia is leading the way to hold those accountable for the widespread use and abuse of opiate pharmaceuticals.

The information provided in this article does not, and is not intended to, constitute medical advice. All information and content are for general information purposes only.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.