Opioids and Kratom Quiz

Study Notes

Opioids are a class of drugs derived from opium poppy, used for pain relief
Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia, traditionally used to combat fatigue and improve work productivity
Different classes of opioids exist, including morphine analogs (closely related to morphine itself, diamorphine - a.k.a. heroin, codeine, nalorphine, levallorphan, naloxone) and synthetic derivatives (hydrocodone, dihydromorphinone – a.k.a., hydromorphone, pethidine, fentanyl, methadone, dextropropoxyphene, pentazocine, buprenorphine, etorphine)
Opioids act through specific G-protein coupled receptors, altering ion channels to affect neuronal activity, reducing pain and producing feelings of euphoria
Common prescription opioids: Hydrocodone, oxycodone (used for various pain conditions including dental and injury related pain), morphine (used often before and after surgery to relieve severe pain), codeine (often used for mild pain, also coughs and severe diarrhoea).
Opioid effects include pain reduction, euphoria, high risk of addiction and habituation.

Common side effects include drowsiness, confusion, nausea, vomiting, constipation, constricted pupils, slowed/depressed vital signs, changes in body temp, blood pressure and respiration rate, overdose, and death
Increased opioid efficacy is often correlated with an increased addiction liability
Heroin is a highly addictive opioid derived from opium poppy; comes in white or brown powder or black tar form
Heroin injection, snorting, or smoking is common, leading to quick brain absorption

Kratom leaf consumption has both stimulant effects (low dose) and opioid-like effects (high dose), causing psychotic symptoms and physiological/psychological dependence
Kratom affects the same opioid brain receptors as morphine, potentially resulting in addiction, abuse, and dependence
Kratom contains over 20 alkaloids, with mitragynine and 7-hydroxymitragynine as the main psychoactive ingredients
Mitragynine is a kappa-opioid receptor agonist, and more potent than morphine
Mitragynine/OH-mitragynine likely responsible for kratom's opioid-like effects
Kratom is commonly consumed through capsules, pills, extracts or chewed leaves/brewed as tea or smoked.

Physical signs include changes in appetite, pupil size (small during intoxication, large during withdrawal), nausea, vomiting, sweating, and shaking.
Behavioral signs include changes in personality/attitude, friends, activities, hobbies, poor attendance at school/work, increased isolation, secrecy, wearing long sleeved shirts, mood swings, irritability, nervousness, or nodding off, stealing.

Withdrawal symptoms vary based on stage (mild to severe) and include anxiety, drug craving, insomnia, gastrointestinal disturbance (GI), rhinorrhea (runny nose), pupillary dilation (mydriasis), diaphoresis/sweating, tachycardia, nausea, vomiting, hypertension, diarrhea, fever, chills, tremors, seizures, and/or muscle spasms.

Fatal overdoses involving kratom have been reported in the U.S. between July 2016 and June 2017, with apparent cause of contamination of kratom adulterated products or use of kratom with other potent substances.