Unlike products derived directly or indirectly from narcotics of natural origin, synthetic narcotics are produced entirely in the laboratory. The primary objective of laboratory production is to produce a drug that will have the analgesic properties of morphine while minimizing the potential for addiction. The products most widely available—hydrocodone, oxycodone, meperidine, and methadone—are still addictive however.
Hydrocodone and Oxycodone
Hydrocodone and oxycodone are two of the most commonly prescribed narcotic painkillers in the United States. Although they are designed to have less euphoric effect than morphine, they are still highly sought after by recreational users and addicts. Like morphine, these drugs have enough potential for abuse that they are classified as Schedule II substances. (See Table 2.1.)
In 2001 the drug OxyContin, produced by Purdue Pharma L.P., received an enormous amount of media attention. Although the active ingredient, oxycodone, has been around for a long time in drugs such as Percocet and Percodan, media and law enforcement noted a new wave of use. OxyContin, which is sold in high-dosage time-release pills, can be easily swallowed, chewed, or even crushed and injected, for a heroin-like high. The manufacturer, after DEA pressure, agreed to try to produce its product in ways that had less potential for abuse. As of 2003, however, abuse of OxyContin was still on the rise, according to the National Drug Intelligence Center.
First introduced in the 1930s, meperidine parallels morphine's pain-relieving strength. It is the most widely used drug for relief of moderate to severe pain and is frequently used during childbirth and after operations. Tolerance and dependence develop with chronic use, and large doses can result in convulsions. Demerol and Pethadal are meperidine products.
Methadone and Related Drugs
Methadone was first synthesized by German scientists during World War II because of a shortage of morphine. Although its chemical makeup is unlike that of morphine or heroin, it produces many of the same effects as those drugs. It was introduced to the United States in 1947 and became widely used in the 1960s to help treat narcotic addicts.
The effects of methadone last up to twenty-four hours, and the drug is almost as effective when administered orally as by injection. Tolerance and dependence can develop, and in some metropolitan areas, methadone has
become just another illegal drug. It has also emerged as an important cause of overdose deaths.
Levo-alpha-acetylmethadol (LAAM) is a closely related synthetic compound with an even longer duration of action (forty-eight to seventy-two hours), allowing for fewer clinic visits and eliminating take-home medication. In 1994 it was approved for use in the treatment of narcotic addiction. Another close relative of methadone is dextropropoxyphene, first marketed in 1957 under the trade name Darvon for the relief of mild to moderate pain. There is less chance of dependence, but also less pain relief. It has one-half to one-third the potency of codeine but is about ten times stronger than aspirin. Because of misuse, bulk dextropropoxyphene was placed in Schedule II, while preparations containing it are in Schedule IV. (See Table 2.1.)