Thebaine

Uses

Drug manufacturers use thebaine to create semi-synthetic pain relievers, such as oxymorphone and oxycodone. Pharmaceutical companies also use thebaine to create therapeutic drugs, including naloxone, naltrexone and buprenorphine, which doctors use to treat overdoses and substance abuse problems.

Thebaine is not used in its alkaloid form for therapeutic or recreational purposes, but doctors and recreational drug abusers do use its derivatives to relieve pain or to get high.

General Drug Information

Drug manufacturers extract thebaine, codeine, morphine and other alkaloids from the opium poppy plant, Papaver somniferum. Because of their origin, scientists classify thebaine and these other alkaloids as opiates. Pharmaceutical companies use opiates like thebaine to create semi-synthetic opioid drugs.

Thebaine usually constitutes between 0.2 and 1.5 percent of raw opium, but amounts as high as 6 percent do occur.

Thebaine, sometimes called paramorphine, is a white, crystalline, alkaloid that is only slightly soluble in water.

Action

Thebaine, like other opiates and opioids, works by binding to opioid receptors in the central nervous system, or CNS. While morphine, codeine, and opioids produce relaxation and sedation by depressing the nervous system, thebaine stimulates the nervous system.

Warnings

High doses of thebaine can cause convulsions that resemble strychnine poisoning.

Strong doses of thebaine, like that found in poppy seed tea, can cause physical and psychological dependence.

Thebaine is about ten times stronger than morphine, and this alkaloid is about ten times as lethal as morphine sulfate. Thebaine is the most poisonous opiate alkaloid. Individuals should avoid contact with thebaine due to its toxicity.

Precautions

Patients should exercise caution when consuming products derived from thebaine, such as hydrocodone and hydromorphone products like OxyContin and Dilaudid. Thebaine and other opiate derivatives may cause the consumer to feel dizzy or drowsy. These effects can impair decision-making. Patients should not operate a motor vehicle or other heavy machinery while taking some products derived from thebaine.

Not all thebaine products depress the nervous system to cause drowsiness or otherwise impair the individual’s ability to think clearly. Patients should check with the prescribing physician to learn if they should expect drowsiness or other effects.

Anyone can suffer an allergic reaction to any drug, including thebaine derivatives. Patients should seek help at the first sign of an allergic reaction, which can produce symptoms such as skin rash or hives, itching, swelling of any body part, or wheezing or other breathing problems.

Contraindications

Thebaine products may not be right for everyone, especially those with any underlying medical condition. Thebaine may worsen these conditions, or an ailment may change the way thebaine works in some consumers. Patients should tell the prescribing physician about any significant illnesses before taking thebaine products, especially:

  • Addison's disease
  • Asthma, COPD, sleep apnea or other breathing disorders
  • Curvature of the spine
  • Enlarged prostate or urination problems
  • Epilepsy or other seizure disorder
  • Gallbladder disease
  • History of drug or alcohol addiction
  • History of head injury or brain tumor
  • Liver or kidney disease
  • Low blood pressure
  • Mental illness
  • Stomach or intestinal blockage
  • Trouble swallowing
  • Underactive thyroid

Pregnancy, Labor and Delivery, Breastfeeding

Many drugs derived from thebaine are FDA Pregnancy Category C drugs, meaning research has not yet established how these drugs might affect the consumer’s reproductive capabilities, a pregnant woman or fetus. A pregnant woman should not take thebaine products unless the benefits to the mother clearly outweigh the risks to her unborn baby.

Drug Interactions

Thebaine and its derivatives may interact with other medications to change the way each drug works. Patients should present a complete list of all their current prescription and non-prescription drugs before taking any thebaine product.

Side effects

Thebaine may cause convulsions.

Thebaine derivatives may cause different side effects, especially constipation and dependence. Physical and psychological dependence is possible anytime someone uses thebaine products and other opioids regularly for longer than a few weeks.

Overdose

It is possible to overdose on thebaine products. Overdose from thebaine and other prescription painkillers kill nearly 15,000 people every year in the United States. The number of prescription overdose deaths has skyrocketed in recent years, tripling from 1999 to 2008.
Thebaine overdose is a serious and potentially fatal medical emergency. Patients require immediate assisted from an emergency department. Witnesses or victims may also call poison control center at 1-800-222-1222 for emergency assistance.

Overdose of thebaine may cause convulsions. Overdose from thebaine products, such as oxycodone, can cause symptoms such as extreme drowsiness, weak muscles, confusion, cold and clammy skin, pinpoint pupils, shallow breathing, slow heart rate, fainting, and coma. Death may occur.

Abuse

Because it is not readily available and does not cause euphoria in its pure form, there is little risk for thebaine abuse. However, recreational drug abusers frequently target the derivatives of thebaine oxycodone and oxymorphone because of the way these drugs get the consumer high. The DEA classifies thebaine and many of its derivatives as schedule II drugs, meaning they pose a significant risk for abuse.

Withdrawal

Researchers have established thebaine may cause physical dependence that result in withdrawal symptoms when the consumer stops using thebaine. Withdrawal symptoms tend to appear in two waves, with the first set of symptoms beginning a few hours after the last dose of the thebaine product. Early withdrawal symptoms can include agitation, anxiety, muscle aches, watery eyes, a runny nose, sweating, yawning, and insomnia. Later, the individual may develop abdominal cramps, diarrhea, nausea and vomiting, dilated pupils, and goose bumps.

Detox

According to the Institute of Addiction Medicine, almost 2 million Americans are dependent on opiates like thebaine and their derivatives. Each of these individuals must participate in some form of detoxification to cleanse his body of the toxic effects of thebaine. Detoxification brings a drug-dependent person to a drug-free state. Detoxification from thebaine derivatives and other opioids can occur at home, hospital, outpatient clinic, with the help of a private physician, or at a specialized detoxification center.

Rapid detox is a safe and efficient approach to detoxification from thebaine and its derivatives. During rapid detox, a well-qualified anesthesiologist sedates and anesthetizes the patient before administering the usual detoxification and anti-withdrawal drugs so the patient dozes in a comfortable “twilight sleep” during the thebaine detoxification process.

Storage

Pharmacologists store thebaine in a sterile environment with controlled temperature and humidity levels. Patients should store thebaine products as directed and properly dispose of any unused medication when they no longer need it.

Miscellaneous information

Thebaine gets its name from an ancient city in Upper Egypt, Thebai.

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