Choosing an appropriate opiate detox program

Its quite a few factors that stay responsible behind choosing an appropriate opiate detox program and most important among them is the type and the amount of the narcotic an addict is using, the length of usage, age and whether the drug is used in combination with other intoxicants. Opiate detox procedures are lengthy affairs and irrespective of whether it is detoxification under sedation; the latter does lower the treatment span but not as drastically as advertised. The confusion arises since rapid opiate detox programs are considered a complete treatment for opiate dependence which it is not and half the treatment is bound to take less time. So you get to wash the body from insides and not the mind; it is the later psychotherapies that actually cut down the cravings. But then again, the intensity of rapid opiate detox depends upon individual addicts health condition, misjudging which, leads to life threatening conditions. Without a proper medical assessment by qualified professionals, you could just be facing something similar to a death sentence with a lethal injection. If not, then you may expect psychosis, delirium, arrhythmia and renal failure to set in before it could be realized that something is seriously wrong.

Truth remains that rapid opiate detox is a process intended for severe addicts who would succumb into the withdrawal pain under traditional detox treatment; the process brings down to intensity to tolerable limits so that treatments could be carried on with medications like methadone, LAAM (levo-alpha-acetylmethadol), Buprenorphine, Clonidine and the likes. That alone proves that rapid opiate detox is not a solution to opiate addiction itself, but just an initial stage to make a severely addicted person get started towards the proper treatment measures.

Of recent, it is the opiate agonist (mimics opiates though to a much lower intensity) drug lofexidine thats gaining prominence and taking out the risk factors off the opiate detox procedures. Others include Clonidine (administered through trans-dermal patches), which releases measured doses of the drug into the bloodstream, just enough to keep the withdrawal pains blunt and hence, tolerable; the downside of an opiate detox with this particular drug is the effects start at least 48 hours later and lowered blood pressure leading to sedation. This makes medical supervision a must for even these types of safe opiate detox methods. However, Clonidine in combination with Naltrexone reduces the risks up to a great extent; the alpha-2 adrenergic (relating to epinephrine; autonomic nerve action stimulant) agonist tackles opiate withdrawal symptoms better than with Clonidine alone.

So, how do you know if the process is following the right course of action? Take note of the following points:

i. Opiate detox is not just pushing medications into the veins; so psychotherapies helping a patient that the dependence is a problem are paramount prior to the initiation of a detox process. It also helps an addict to focus on the goal.

ii. The detox program is a prolonged one and doesnt get over in a week. Thats enough to free the body from remnants of opiates but not the mind; unless the physical detox is matched with post-detox psychotherapies (to develop the necessary mental strength for keeping the drugs away), you are heading the wrong way, most probably in wrong company. Else, expect a relapse within no time to start the opiate detox procedure once again.

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Opiates and opiate detox myths

An opiate is not a specific drug; its a class of drugs defined as narcotic comprising opium or an opium derivative. Invented as prescription drugs, opiates, nevertheless found way into recreational usage and currently are a massive problem the medical world is dealing with; more so, for opiate tolerance develops faster than one feeling symptoms surfacing. That applies to all from OxyContin and Oxycodone to Vicodin and Hydrocodone and the rest; however, the commercial presence of patches (e.g. Fentanyl) have eased up rigorous withdrawals to tolerable passing phases if used wisely in conjunction with the sedated opiate detox procedure. However, unlike traditional or long-term opiate detox therapies, rapid detox carries too many risks for people with severely deteriorated health conditions and might even lead to death by cardiac arrests.

That was clearing the myth on the rapid opiate detox process; now, the myths and facts on the most widely used opiates.

i. Heroin: People usually think it is less habit forming if smoked or snorted; however, it is equally deadly and addictive no matter how it is ingested. Its true that such modes eliminate the chances for HIV infection by avoiding the needle, but the same may occur while enjoying the high with unprotected sex. This proves that only detox measures are not sufficient to treat an addict; the diagnosis must be proper, also for any additional intoxicant the person may remain hooked to.

ii. Methadone: This is one reason why the rapid opiate detox method is gaining more popularity. Methadone (a synthetic narcotic resembling morphine and used for opiate detoxification and to maintain heroin addiction) is considered more harmful than any other opiate (even heroin); whereas fact remains that methadone is much safer if administered under medical supervision in controlled environments.

iii. Abstinence treats an opiate addiction effectively: Rapid opiate detox just flatters this wrong idea, often letting go off the post detox measures to bring things back to the square one. This is just one means by which detox centers with questionable reputation earn their bread; a complete cure would stop the inflow. A vicious circle follows.

iv. A rapid opiate detox session is the complete cure: Its a wrong notion; rapid opiate detox just clears the physical cravings and not the psychological one.

v. Withdrawal symptoms are completely eliminated with rapid detoxification: Wrong again! You dont feel the withdrawals as long as the anesthesia is in action, but theres no guarantee that youll come out of it before the detox is over, unless under the supervision of trained and qualified professionals. A quack may push you enough to keep you unconscious for just a day or forever; so stick to the rules and agree to what rapid detox was created for To minimize the intensity of withdrawals till a tolerable level could be achieved.

So, is ultra/rapid opiate detox safe? Yes and no; despite the process bringing in higher health risks, it can be called safe in the hands of trained professionals, who administer just enough to make a patient pass precisely through the withdrawal. Trying to use rapid opiate detox procedures as a complete cure is as good as being on the wrong end of the gun.

Use of Naltrexone in opiate detox

A largely used medication for rapid opiate detox, Naltrexone is favored since it blocks the opiate receptors while a patient stays unconsciousness under the influence of general anesthetics. The medication is administered orally and its use may extend to several months depending upon the severity of the dependence. Naltrexone implants are widely used for long-term administering; though its effects are dubious, but it provides for better medication compliance. Still, the efficacy of rapid opiate detox with Naltrexone stays questionable on treating long-term opiate dependence.

Naltrexone is N-cyclopropylmethyl derivative, best described as substituted oxymorphone with the tertiary amine methyl-substituent replaced with methyl-cyclopropane. Upon sustained release, naltrexone has shown results which could be termed as promising, but within a small segment of opiate addicts. However, the medication just treats physical dependence; for a complete effect, further psycho-social interventions are important.

Not only opiates, naltrexone finds its usage in treating alcohol dependence as well. However, Naltrexone is not Methylnaltrexone Bromide used for treating opiate-induced constipation; neither is it similar to naloxone used for emergencies such as an overdose. Naltrexone has a longer effect than naloxone, which makes Naltrexone a better choice for long-term opiate detox. However, Naltrexone treats ethanol dependence more effectively than opiate dependence, though the mechanism of action of the medicine is yet to be fully understood. It could be due to the modulation of the dopaminergic-mesolimbic pathway which is activated by ethanol.

Naltrexones most common side effects include nausea (noticed in around 10% of people), headache and fatigue (around 7%), dizziness (4% or less), insomnia (3% at most), anxiety and drowsiness (near about 2%). They are; however, mild and of short duration, though 5% to 10% of the patients have shown severe nausea and resulted in stopping the treatment. However, Naltrexone, if administered in amounts more than whats required may initiate liver toxicity; hence, liver function tests are important prior to the treatment begins.

Post-detox Naltrexone administering requires test doses of 25 mg for an hour; it gauges for any further opiate withdrawal symptoms. Without any problems appearing, another 25 mg are administered. The subsequent doses are as follows:

i. 50 mg daily for 5 consecutive days of a week and 100 mg on the 6^th day.

ii. 100 mg every alternate day.

iii. 150 mg every three days.

iv. 100 mg on the starting and the middle of the week, followed by 150 mg a day later.

v. 150 mg on the start of the week and 200 mg after two days.

However, this is on an average, since opiate detox and dependence treatment varies with the need of every patient. Besides, it is required keeping in mind that naltrexone may prove toxic, inflicting considerable liver damage, which makes periodic liver function tests an important part of an opiate detox program with naltrexone.

As the last notes, naltrexone alone doesnt immune the body against opiates; it just suppresses the analgesia and an opiates euphoric effects. Therefore, disulfiram is most commonly used as a combination drug, though it increases the chances for an increased liver toxicity, making a professional medical consultation paramount for outweighing the risks.

Explaining opiate detox in a nutshell

Before moving on to opiate detox, it is important knowing what opiates are. Medical explanation reveals opiates as narcotic alkaloids occurring naturally in the opium poppy (Papaver somniferum) latex sap (a SW Asian herb with grayish leaves and white/reddish flowers) though modern medical science and chemistry have been able to create its semi-/biosynthetic versions (benzylisoquinoline alkaloids); these are the chemical derivatives of the narcotic alkaloids.

The naturally occurring and biologically active opiates are morphine, thebaine, codeine and papaverine from which, synthetic opiates like heroin, hydrocodone and oxycodone are derived along with morphine, thebaine and codeine. However, noscapine and the rest (more or less 25 in the naturally occurring group) have nominal or no effects on the human CNS; hence, these will be kept out of the discussion.

Opiates, over time, make the body develop a tolerance, which shoots up the quantity of intake, requiring collective interventions to control the drugs intoxicating effects and their withdrawals. It requires purging the addictive substances from the body and freeing an individual under its influence. However, it is a process that despite lessening the drugs physical effects brings forth intense physical pain and psychological disturbances, making a relapse obvious most of the times. This is why a complete detoxification from opiates (or be it any other drug) requires post- opiate detox psychological measures and gradual tapering (with medications simulating the effects of the opiates) to numb the reward centers of the brain from the effects of the alkaloids.

One thing that must be kept in mind is an opiate detoxification program is nothing without the post-detox care dealing with an addictions psychological aspects; the care restores the normal psychosocial factors by curing the intermingled and complex, addiction-specific behavioral issues.

Detoxification from opiates can be done through several procedures; however, unless the following steps are covered, it shall be wise to search for a better alternative.

i. Evaluation: This initiates the opiate detox process and finds out the opiates that a person is currently addicted to. A blood test is, therefore; paramount, which also reveals related physical and psychological behaviors and helps physicians to design a detox procedure thats most suitable.

ii. Stabilization: This is a stage where the actual detoxification starts. This is either done through medications and anesthetics after explaining to a patient what he/she may expect while undergoing treatment and the recovery stage. The involvement of close friends and family members is considered important in this phase; they provide the required emotional support.

iii. Treatment: This brings a patient to the last step of a detox process and is also vital to alter his psychology and is different from stabilization, which deals with treating physical dependency.

Even for (ultra) rapid opiate detox (which is for patients so severely addicted that natural withdrawals may lead to coma or death), the above three steps are indispensable; however, one cant expect them in the run-of-the-mill detox centers. For such specialized approaches, its paramount that trained, qualified, specialized and certified medical practitioners stay present; else, its the cure that might turn partial wreckage to a complete ruin.

Dangers of rapid opiate detox

Lets be clear on this point first: Rapid opiate detox is very unsafe if not executed under the supervision of trained, qualified and certified medical professionals. With that much of info, it shall become easier for you to discriminate between quacks and those who are not.

The reason behind this form of detoxification is gaining popularity is understood; while conventional detoxification procedures for opiates is a grueling and brings on excruciating physical pain, with rapid detox, a person literally sleeps through the experience. The result is waking up fresh and free of opiate remnants, but there is a flip side to it. Being free from opiates or any other drugs is getting it out from the body and also from ones psyche; else the craving shall take a person back to where he belonged.

The new method is definitely making addicts willing to come out from opiates interested (and the number includes even those who didnt develop the addiction out of pain management programs), but theres a flip side to it (other than the risks imposed by untrained service providers), despite the complete recovery it promises. However, that is if the follow-up treatments (psychotherapies) are not integrated with the detox program; so weekend trippers and recreational users, how much ever you think it is an easy way out to spend the coming week as a normal person, youll be worsening the situation by developing a tolerance to the medication itself. That shall leave you with no option other than undergoing the traditional treatments, with a lot of extra pain to endure.

Now, a little bit on how the rapid opiate detox process works.

Rapid detox puts a complete end to withdrawal pains in a day or two (max three) for mild and moderate users) and a week to ten days for those who are severely addicted. It starts with an evaluation process, which reveals the type of opiate a person is addicted to and thus, figuring out the most suitable treatment pattern. The actual detox process starts after this, where the anesthesia is injected in required doses as well as the medications that intensify as well as accelerate the detoxification process. The sedation helps patients not to feel the otherwise unbearable pain sensations, removing the hesitation that keeps opiate dependents away from seeking medical aid. The last part is the follow-up medications (to check tolerance) and psychotherapies, which end the craving a person faces for the opiates and immunes his system from the drugs effects.

But it is also a fact that the increasing numbers of opiate abusers are taking advantage of the procedure and aiding the mushrooming of run-of-the-mill rapid detox setups; these are doing more harm than good under the disguise of providing an easy escape. Besides, there stay health risks associated; theres no doubt rapid detox brings immense benefits to people who are seriously addicted but it also inflicts massive shocks on the system. The intensified, accelerated opiate detox literally forces things out of the system, bringing it to a state which it has not experienced over a long period; in the absence of the stuff that made it keep going, the internal organs start behaving erratically, managing which, is not possible without knowing the subject completely. Hope that clears the importance of a rapid opiate detox under the supervision of qualified medical professionals, specially trained for this job only.

Turning disappointment into joy: From Service Dog to SURFice Dog

I want to share this with our readers. I know this video doesn’t have anything to do with drug addiction, but it is inspiring, very heartwarming and can remind all of us that we are special in some way. That all of us can overcome obstacles by having faith and moving forward while believing in ourselves.

Highest Rate Of Abuse Reported In Oklahoma

A new government report shows the number of overdose deaths from powerful painkillers have more than tripled over a decade.

Prescription painkillers such as OxyContin, Vicodin and methadone contributed to the deaths of nearly 15,000 people in 2008. That’s more than three times the 4,000 deaths in 1999.

According to the Centers for Disease Control and Prevention, nearly 5 percent of Americans ages 12 and older say they’ve abused prescription painkillers. The highest rate of abuse was reported in Oklahoma while the lowest was in Nebraska and Iowa.

Fatal overdoses were more likely in men and middle-aged adults.

The report was released Tuesday by the CDC.

For the complete CDC report visit: : http://cdc.gov/mmwr/

The Food and Drug Administration, FDA, has approved the drug Vivitrol for the treatment of opioid dependence according to a news release by them on 10-12-2010.

CDC Report on Prescription Painkiller Overdose is a Call To Action

By Grant Baldwin, PhD, MPH November 4, 2011

The CDC (Center for Disease Control), deals with the numbers and statistics affecting the public’s health every day. Rarely do these numbers reveal the full and tragic story they actually represent. The CDC’s report this week on prescription painkiller overdoses is one of these rare instances, confirming a story many of us have heard in communities across America.
Prescription painkillers (drugs like oxycodone, hydrocodone and methadone) killed nearly 15,000 people in 2008—one person every forty minutes. These were husbands and sons, mothers and daughters, often struggling with addiction for months or years before losing their lives. And the problem has never been worse. For every person who died of a prescription painkiller overdose in 1999, nearly four died in 2008. We are in the midst of an epidemic.
But the number of deaths isn’t the whole story. This sharp rise in prescription painkiller overdoses parallels a similarly large increase in painkiller sales. Four times as many prescription painkillers were sold in the U.S. last year than in 1999.
Astonishingly, in 2010 enough painkillers were prescribed to medicate every American adult around-the-clock for a month.
States can support prescription drug monitoring programs—electronic databases that track controlled substance prescriptions, which are promising tools for helping medical professionals identify patients who may be abusing these drugs. Health care providers can follow guidelines for safe painkiller prescribing and screen patients for warning signs of abuse. This is so important because we can reduce the number of people who are abusing and overdosing, while also ensuring that patients with pain are treated safely and effectively.
Individuals can also make an impact. More than half of all people who misuse prescription painkillers report getting their drugs from a family member or friend. Individuals must make sure to use prescription painkillers only as directed and to never share them with others. People should also take care to store their prescriptions safely, dispose of them properly and get help if they have substance abuse problems.
Preventing prescription painkiller overdoses is a CDC priority. The lives impacted by painkiller abuse and overdose can be found everywhere—a father who becomes addicted to painkillers after a work injury and overdoses, a teenager who takes an old bottle of painkillers from a relative’s medicine cabinet or a mother who loses a son to painkillers only to find her other child is also addicted. This week’s CDC report on prescription painkiller overdose is a call to action. This epidemic is affecting our own neighbors and communities. Working together, we can turn the tide and have the numbers tell a different story.

Painkiller 10 times stronger than Vicodin being developed – sparking addiction fears

Drug companies are developing a painkiller ten times stronger than Vicodin which addiction experts fear could spark a wave of abuse. Four companies have begun patient testing on the pills which are the first to contain the addictive ingredient hydrocodone in a pure form. If approved, it would mark the first time patients could legally buy pure hydrocodone as existing products combine the drug with nonaddictive painkillers such as acetaminophen.

The pharmaceutical firms claim the new drug will give doctors another tool to help patients manage pain. The companies also say patients will be more closely supervised. However addiction experts fear abusers will crush the pills into a fine powder and snort it to get high. Such practice is common with the painkiller oxycodone, currently the most-abused medicine in the U.S.

April Rovero, president of the National Coalition Against Prescription Drug Abuse told Fox news: ‘I have a big concern that this could be the next OxyContin. ‘We just don’t need this on the market.’

According to the DEA, there were 19,221 emergency room visits as a result of hydrocodone abuse in 2000. The figure was 86,258 in 2009. Between 2003 and 2007 in the state of Florida alone, hydrocodone caused 910 deaths and contributed to 1,803 others.

Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing told CBS: ‘You’ve got a person on your product for life, and a doctor’s got a patient who’s never going to miss an appointment, because if they did and they didn’t get their prescription, they would feel very sick. Abuse: Addicts crush pills such as oxycodone into a fine powder which they snort to get high. ‘It’s a terrific business model, and that’s what these companies want to get in on.’

The San Diego company Zogenix plans hopes to begin marketing its product, Zohyadro, in early 2013. Rival companies Perdue Pharma, Cephalon, and Egalet are developing their own versions. Zogenix chief executive Roger Hawley claims Zohydro will be a safer painkiller than Vicodin as Vicodin contains acetaminophen which can be dangerous to the liver.