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The semisynthetic derivatives in this group include hydromorphone, hydrocodone, oxymorphone, dihydrocodeine, oxycodone, and buprenorphine. The remaining two groups are synthetic chemicals such as the phenylpiperidines which include the meperidineas well as the fentanyl, and the pseudopiperidines which include methadone and propoxyphene (Havens et al 2007, 101). Heroine and morphine were used first as medicine in the 19th century and later used illicitly for recreational purposes. Previously, the dependence of heroin and other opioid drugs has proved difficult to counter successfully whereby the poor result has been accredited to environmental characteristics, patient characteristics as well as other powerful reinforcing effects of the same drugs.
The most common problems of opioid abuse are known to be nausea and constipation. These two side effects have been found to be difficult to deal with especially for constipation. The concept of agoinist-replecement therapy was introduced approximately forty years ago representing a breakthrough in opiod drugs management especially heroin. Developments in training have encompassed newer pharmacotherapies, Narcotics Anonymous and the psychosocial therapy (Davids & Gastpar 2004, 210).
These drugs tend to produce analgesia, mood changes, drowsiness as well as mental clouding but not all of these lead to loss of consciousness. Patients who report of pain claim that it is less intense and less discomforting which fades eventually after healing dosage of these drugs. Relief in pain is believed to be selective without affecting the other modalities of sense. Some patients are believed to experience euphoria. Vomiting, nausea, drowsiness, mental difficulties, apathy as well as the occurrence of decreased physical activities when given to pain free individual is common. The toxic effects and the subjective analgesic, which includes respiratory depression, may become more pronounced as the dose is
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