Poppy

Generic name: Papaver Bracteatum, Papaver Somniferum L.
Brand names: Great Scarlet Poppy, Lipiodol, Oleum Papaveris Seminis, Opium Poppy, Poppyseed Poppy, Thebaine Poppy

Usage of Poppy

The pharmacologic effects of morphine alkaloids differ widely. Codeine and morphine are sedative analgesics and can relax smooth muscle tone, making them useful in the treatment of diarrhea and abdominal cramping. Codeine and its derivatives are used as antitussives. Papaverine relaxes involuntary smooth muscle and increases cerebral blood flow. Chemical modifications of the alkaloids enable different receptor-dependent activities to be elicited. The addictive characteristics of the opium alkaloids have been recognized for millenia.Ronsoni 1999, Kaplan 1994

Colovesical fistula

A few studies have evaluated the poppy seed test for the diagnosis of fistulae. Newer diagnostic methods have a varying success rate (70% to 80% for computerized tomography scans and 80% for radio-labeled chromium)Wensky 2006, Kwon 2008 while the poppy seed test and the charcoal test have been demonstrated to detect fistula in 100% of instances.Wensky 2006, Kwon 2008, Schwaibold 2001 Costs and acceptability of the poppy seed test (250 g seeds given orally) are more favorable.Kwon 2008

Hepatocellular cancer

Iodized poppy seed oil (Lipiodol) is used in imaging techniques in vascular hepatocellular cancer, because of the preferential accumulation of poppy seed oil in hepatocellular cancer cells. For this reason, iodized poppy seed oil is used as an adjuvant or vehicle to deliver chemotherapeutic agents (eg, cyclosporine A, cisplatin) to tumor sites.Buscombe 2002, Fujiyama 2003, Abe 2002

Iodine deficiency

Iodized poppy seed oil has been studied as a source of iodine in deficient individuals. Results varied compared with iodized salt and iodized peanut oil.Untoro 2006, Krist 2005, Huda 2001

Poppy side effects

Immunoglobulin E–mediated allergy to poppy seeds is rare(Oppel 2006) although case reports of anaphylactic reactions exist.(Oppel 2006, Gamboa 1997, Frantzen 2000, Crivellaro 1999) The poppy seed commonly used in confectionary is thermostable. In some patients, it may need to be ground in order to be allergenic.(Oppel 2006) Cross-sensitization with sesame seed, hazel nut, rye grain, kiwi fruit, and buckwheat has been reported.(Oppel 2006, Jensen-Jarolim 1999) A case report exists of bowel obstruction due to consumption of large quantities of poppy seeds.(Schuppener 2017)

Dependence requiring buprenorphine treatment has been documented in a 34-year-old man with a 5-year recent history of consuming poppy seed tea. His history included a 10-year overall history of opioid use disorder in which he transitioned from heroin to episodic use of pharmaceutical opioids, and ultimately the sole use of poppy seed tea for the last 5 years. Recovery was ultimately achieved with depot buprenorphine treatment.(Arunogiri 2021)

Before taking Poppy

Information regarding safety and efficacy in pregnancy and lactation is lacking. The seed is generally recognized as safe when used as food.

How to use Poppy

Clinical trials are lacking to guide dosage. Single oral doses of poppy seed 250 g have been used diagnostically.Schwaibold 2001

Attention has focused on the detection of morphine and codeine in urine following the ingestion of foods prepared with poppy seeds, and has resulted in confusion in testing for drugs of abuse.Chang 2012 Analysis for noscarpine, papverine, or thebaine may differentiate poppy ingestion from substance abuse.Chang 2012, Hayes 1987, Miller 1994, Paul 1996, Cassella 1997

Warnings

Adequate data are lacking. Thebaine has a median lethal dose of 20 mg/kg in mice. Toxicity of opium is documented,Duke 1985 as is toxicity from parenteral poppy seed tea.Monaghan 2013 Although large doses of thebaine can induce convulsions, no case of human thebaine abuse has been reported.Theuns 1986

What other drugs will affect Poppy

None well documented. A case report exists of a fatality in which the benzodiazepine fenazepam was used concurrently with poppy seed tea.(Bailey 2010)

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