Heroin
Methadone
Narcotics
Buprenorphine
Naltrexone
Rapid detoxification of heroin dependence by buprenorphine. (1/686)
AIM: To evaluate the clinical efficacy of buprenorphine (Bup) in treatment of acute heroin withdrawal. METHODS: Bup was given sublingually daily to 60 cases of heroin addicts in 3 groups: low, medium, and high doses. Withdrawal signs and symptoms of heroin were rated by Clinical Institute Narcotic Assessment. Craving for heroin during detoxification was assessed by Visual Analogue Scale. The side effects of Bup was assessed by Treatment Emergent Symptom Scale. RESULTS: The mean daily consumption of Bup in low, medium, and high group was 2.0, 2.9, and 3.6 mg, respectively. Bup not only suppressed objective signs and withdrawal symptoms for heroin withdrawal, but also reduced the duration for heroin detoxification over 7-8 d. CONCLUSION: Bup is an effective and rapid detoxification agent with fewer side effects for treatment of acute heroin withdrawal. (+info)Methadone treatment by general practitioners in Amsterdam. (2/686)
In Amsterdam, a three-tiered program exists to deal with drug use and addiction. General practitioners form the backbone of the system, helping to deal with the majority of addicts, who are not criminals and many of whom desire to be free of addiction. Distinctions are made between drugs with "acceptable" and "unacceptable" risks, and between drug use and drug-related crime; patients who fall into the former categories are treated in a nonconfrontational, nonstigmatizing manner; such a system helps prevent the majority of patients from passing into unacceptable, criminalized categories. The overall program has demonstrated harm reduction both for patients and for the city of Amsterdam. (+info)Recent developments in maintenance prescribing and monitoring in the United Kingdom. (3/686)
After a brief historical review of British drug legislation and public and governmental attitudes, this paper describes the wide range of policies and practices that have appeared since the explosion of illicit drug abuse in the 1960s. The spectrum goes from a reluctance to prescribe at all to maintenance on injectable opiates. Comparisons are made with differing attitudes to the availability of abortion in public health services. Compared with 5 years ago, about three times more methadone is being prescribed. There is a steady increase in prescriptions for injectable methadone but heroin maintenance is still rare. The "British System" permits great flexibility in the choice of opiates for maintenance. Some amphetamine-prescribing programmes also exist. Hair analysis for drugs to monitor levels of both prescribed and unprescribed drugs is a welcome and promising alternative to undignified and often misleading urine tests. (+info)A practical approach to determine cutoff concentrations for opiate testing with simultaneous detection of codeine, morphine, and 6-acetylmorphine in urine. (4/686)
BACKGROUND: Both the Department of Defense (DoD) and the Department of Health and Human Services (DHHS) currently require two confirmation tests to verify use of heroin, one test for total morphine and a separate test for 6-acetylmorphine (6-AM). Our aim was to determine appropriate free-codeine, free-morphine, and 6-AM cutoff concentrations that could be substituted for total-morphine, total-codeine, and 6-AM cutoff concentrations and to develop a less labor-intensive method for measuring codeine, morphine, and 6-AM. METHODS: Urine samples containing opiates were extracted, derivatized, and analyzed using gas chromatography-mass spectrometry with selective ion monitoring. RESULTS: The limits of detection for codeine, morphine, and 6-AM were 6, 5, and 0.5 microg/L, respectively. Recoveries were >90%. Quantification was linear over the concentration range of 6-1000 microg/L for codeine, 5-5000 microg/L for morphine, and 0.5-800 microg/L for 6-AM. Cutoff concentrations for confirmation of opiates were 100, 100, and 10 microg/L for free codeine, free morphine, and 6-AM. CONCLUSION: The proposed cutoff concentrations for free morphine and 6-AM provide better detection windows for morphine and heroin use than the cutoff concentrations for total morphine and 6-AM used at present. Detection of free codeine, instead of total codeine, simplifies interpretation of codeine use. The single-extraction method enables simultaneous, less labor-intensive analysis of morphine, codeine, and 6-AM. (+info)Relative potency of levo-alpha-acetylmethadol and methadone in humans under acute dosing conditions. (5/686)
levo-alpha-Acetylmethadol (LAAM) and methadone are full mu-opioid agonists used to treat opioid dependence. Current labeling indicates that LAAM is less potent than methadone. Clinical studies have not determined the relative potency of these drugs. This study compared the effects of acute doses of LAAM and methadone and also examined the ability of naloxone to reverse their effects. Five occasional opioid users received once weekly doses of either placebo, LAAM, or methadone (15, 30, or 60 mg/70 kg p.o.) in agonist exposure sessions and then received naloxone (1.0 mg/70 kg i.m.) 24, 72, and 144 h after agonist exposure. Subject-rated, observer-rated, and physiological measures were assessed regularly. Comparisons of physiological and subjective measures collected in agonist exposure sessions indicate that LAAM is not less potent than methadone under acute dosing conditions. For some measures, LAAM was significantly more potent. Three subjects who entered the study were withdrawn for safety reasons due to greater than anticipated and clinically relevant respiratory depression after receiving 60 mg of LAAM. Naloxone did not fully reverse the pupil constriction produced by 60 mg of LAAM. Acute agonist effects suggest that LAAM may be more potent than methadone and more potent than current labeling indicates. An accurate LAAM:methadone relative potency estimate will aid determination of adequate doses for opioid-dependent patients inducted onto LAAM and for methadone maintenance patients who choose to switch to more convenient thrice-weekly LAAM. (+info)Methadone dosing, heroin affordability, and the severity of addiction. (6/686)
OBJECTIVES: This study sought to track changes in US heroin prices from 1988 to 1995 and to determine whether changes in the affordability of heroin were associated with changes in the use of heroin by users seeking methadone treatment, as indexed by methadone dose levels. METHODS: Data on the price of heroin were from the Drug Enforcement Administration; data on methadone doses were from surveys conducted in 1988, 1990, and 1995 of 100 methadone maintenance centers. Multivariable models that controlled for time and city effects were used to ascertain whether clinics in cities where heroin was less expensive had patients receiving higher doses of methadone, which would suggest that these patients had relatively higher physiological levels of opiate addiction owing to increased heroin use. RESULTS: The amount of pure heroin contained in a $100 (US) purchase has increased on average 3-fold between 1988 and 1995. The average dose of methadone in clinics was positively associated with the affordability of local heroin (P < .01). CONCLUSIONS: When heroin prices fall, heroin addicts require more methadone (a heroin substitute) to stabilize their addiction--evidence that they are consuming more heroin. (+info)Failure of acetylmethadol in treatment of narcotic addicts due to nonpharmacologic factors. (7/686)
Acetylmethadol, a new narcotic substitute, has a longer duration of action than methadone. Seventeen subjects, former heroin users currently under methadone treatment, entered a study of the toxicity and efficacy of this drug. Only nine subjects completed the assessment phase of the study and began the acetylmethadol phase, and only one completed the 8-week study phase. Hence, no conclusions can be drawn about acetylmethadol's efficacy. The high attrition rate was unrelated to pharmacologic factors; the subjects were concerned that if this drug was effective there would be no methadone to take home and hence no opportunity to trade, sell or "play with" (that is, combine with other drugs) the latter. This study emphasizes the difficulty in determining the efficacy of specific drug treatments for opiate-dependent patients. (+info)Validity of drug use reporting in a high-risk community sample: a comparison of cocaine and heroin survey reports with hair tests. (8/686)
Hair specimens were collected from 322 subjects and analyzed as part of an experimental study administering household surveys during 1997 to a high-risk community sample of adults from Chicago, Illinois. Toxicologic results were compared with survey responses about recent and lifetime drug use. About 35% of the sample tested positive for cocaine, and 4% tested positive for heroin. Sample prevalence estimates of cocaine use based on toxicologic results were nearly five times the survey-based estimates of past month use and nearly four times the survey-based estimates of past year use. With the hair test results as the standard, cocaine and heroin use were considerably underreported in the survey. Underreporting was more of a problem for cocaine than for heroin. Among those who tested positive, survey disclosure of cocaine use was associated with higher levels of cocaine detected in hair. In general, when recent drug use was reported, it was usually detected in hair. When a drug was detected in hair, use was usually not reported in the survey. When heroin was detected in hair, cocaine was almost always detected as well. (+info)Heroin dependence, also known as opioid use disorder related to heroin, is a chronic relapsing condition characterized by the compulsive seeking and use of heroin despite harmful consequences. It involves a cluster of cognitive, behavioral, and physiological symptoms including a strong desire or craving to take the drug, difficulty in controlling its use, persisting in its use despite harmful consequences, tolerance (needing to take more to achieve the same effect), and withdrawal symptoms when not taking it. Heroin dependence can cause significant impairment in personal relationships, work, and overall quality of life. It is considered a complex medical disorder that requires professional treatment and long-term management.
Heroin is a highly addictive drug that is processed from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. It is a "downer" or depressant that affects the brain's pleasure systems and interferes with the brain's ability to perceive pain.
Heroin can be injected, smoked, or snorted. It is sold as a white or brownish powder or as a black, sticky substance known as "black tar heroin." Regardless of how it is taken, heroin enters the brain rapidly and is highly addictive.
The use of heroin can lead to serious health problems, including fatal overdose, spontaneous abortion, and infectious diseases like HIV and hepatitis. Long-term use of heroin can lead to physical dependence and addiction, a chronic disease that can be difficult to treat.
Methadone is a synthetic opioid agonist, often used as a substitute for heroin or other opiates in detoxification programs or as a long-term maintenance drug for opiate addiction. It works by changing how the brain and nervous system respond to pain signals. It also helps to suppress the withdrawal symptoms and cravings associated with opiate dependence.
Methadone is available in various forms, including tablets, oral solutions, and injectable solutions. It's typically prescribed and dispensed under strict medical supervision due to its potential for abuse and dependence.
In a medical context, methadone may also be used to treat moderate to severe pain that cannot be managed with other types of medication. However, its use in this context is more limited due to the risks associated with opioid therapy.
Narcotics, in a medical context, are substances that induce sleep, relieve pain, and suppress cough. They are often used for anesthesia during surgical procedures. Narcotics are derived from opium or its synthetic substitutes and include drugs such as morphine, codeine, fentanyl, oxycodone, and hydrocodone. These drugs bind to specific receptors in the brain and spinal cord, reducing the perception of pain and producing a sense of well-being. However, narcotics can also produce physical dependence and addiction, and their long-term use can lead to tolerance, meaning that higher doses are required to achieve the same effect. Narcotics are classified as controlled substances due to their potential for abuse and are subject to strict regulations.
Buprenorphine is a partial opioid agonist medication used to treat opioid use disorder. It has a lower risk of respiratory depression and other adverse effects compared to full opioid agonists like methadone, making it a safer option for some individuals. Buprenorphine works by binding to the same receptors in the brain as other opioids but with weaker effects, helping to reduce cravings and withdrawal symptoms. It is available in several forms, including tablets, films, and implants.
In addition to its use in treating opioid use disorder, buprenorphine may also be used to treat pain, although this use is less common due to the risk of addiction and dependence. When used for pain management, it is typically prescribed at lower doses than those used for opioid use disorder treatment.
It's important to note that while buprenorphine has a lower potential for abuse and overdose than full opioid agonists, it still carries some risks and should be taken under the close supervision of a healthcare provider.
Naltrexone is a medication that is primarily used to manage alcohol dependence and opioid dependence. It works by blocking the effects of opioids and alcohol on the brain, reducing the euphoric feelings and cravings associated with their use. Naltrexone comes in the form of a tablet that is taken orally, and it has no potential for abuse or dependence.
Medically, naltrexone is classified as an opioid antagonist, which means that it binds to opioid receptors in the brain without activating them, thereby blocking the effects of opioids such as heroin, morphine, and oxycodone. It also reduces the rewarding effects of alcohol by blocking the release of endorphins, which are natural chemicals in the brain that produce feelings of pleasure.
Naltrexone is often used as part of a comprehensive treatment program for addiction, along with counseling, behavioral therapy, and support groups. It can help individuals maintain abstinence from opioids or alcohol by reducing cravings and preventing relapse. Naltrexone is generally safe and well-tolerated, but it may cause side effects such as nausea, headache, dizziness, and fatigue in some people.
It's important to note that naltrexone should only be used under the supervision of a healthcare provider, and it is not recommended for individuals who are currently taking opioids or who have recently stopped using them, as it can cause withdrawal symptoms. Additionally, naltrexone may interact with other medications, so it's important to inform your healthcare provider of all medications you are taking before starting naltrexone therapy.
Benzylidene compounds are organic chemical compounds that contain a benzylidene group, which is a functional group consisting of a carbon atom double-bonded to a carbonyl group and single-bonded to a phenyl ring. The general structure of a benzylidene compound can be represented as R-CH=C(Ph)-O-, where R is an organic residue and Ph represents the phenyl group.
These compounds are known for their wide range of applications in various fields, including pharmaceuticals, agrochemicals, dyes, and perfumes. Some benzylidene compounds exhibit biological activities, such as anti-inflammatory, antimicrobial, and anticancer properties, making them valuable candidates for drug development.
It is important to note that the term 'benzylidene' refers only to the functional group and not to a specific class of compounds. Therefore, there are many different types of benzylidene compounds with varying chemical structures and properties.
Narcotic antagonists are a class of medications that block the effects of opioids, a type of narcotic pain reliever, by binding to opioid receptors in the brain and blocking the activation of these receptors by opioids. This results in the prevention or reversal of opioid-induced effects such as respiratory depression, sedation, and euphoria. Narcotic antagonists are used for a variety of medical purposes, including the treatment of opioid overdose, the management of opioid dependence, and the prevention of opioid-induced side effects in certain clinical situations. Examples of narcotic antagonists include naloxone, naltrexone, and methylnaltrexone.