Life and Death; You Choose

There is a measure of balance and homeostasis that all organisms must maintain.  The balance is positioned on a fine fulcrum that is precariously placed on the tip of point.  This must be maintained by careful manipulation.  Substance use for medicinal reasons or recreation has become as cavalier as a haircut or manicure.  If it feels good, do it.  There is great risk when a society does not differentiate between healing a sickness and causing a death.  I began searching for reasons to justify the use of morphine in order to help an old woman die in peace.  The article allows for reason to improve shallow breathing in acute respiratory failure.  Remifentanil is a postop analgesic and anesthesia which is in the subclass of opiates (epocrates.com).  The conclusion is that with use of this subclass it relaxes the cell walls and reduces tachypnea, which is rapid shallow breathing.  I have to admit that most of this article was over my head and I read it several times to grasp the bottom line.  The study was done in Italy in a hospital and gives some evidence that this is a typical practice done in hospice and end of life care.  The second article was on the addiction to opiates, “Biology of Opiates Affects Prevalence of Addiction, Options for treatment.”  The article points out that there are three major opiate receptors, M, K, and ∑ (Miller & Lyon, 2003, p. 559).  To my surprise these powerful pain medications are being prescribed as outpatient care and have now made in on the streets.  These include: codeine, oxycodone, hydrocodone, hydromorphone and morphine.  In a five year time from 1996 – 2000 a 239% increase in oxycodone emergency department mentions (Miller & Lyon, 2003, p. 561).  This is a powerful pain suppressant although due to the rebound effect I question the reasoning for its use as an analgesic in prescriptive pharmaceuticals.  This product should be banned along with the use of heroin and morphine.  The paper discusses the tolerance effects of intoxication and withdrawals and points out the differences between alcohol and opiates.  Alcohol tolerance increases 2-4 fold and opiates in comparison is 20-100 fold increase (Miller, 2003).  Withdrawal from opiates may be less life threatening than withdrawal from alcohol however the symptoms are some of the worst such as dysphoria, nausea, vomiting, muscle aches, lacrimation, rhinorrhea, pupillary dilation, sweating, diarrhea, yawning, fever, insomnia and intense drive to use more drugs particularly opiates (Miller & Lyon, 2003, p. 562).