But some people are suggesting that we can treat heroin addicts in ways other than helping them gain sobriety. These people are pushing to help heroin addicts become active members of society again, to work at a job, to see their family again, to live in a real home; all while still being a drug addict.

Methadone Treatment

A new study looks at treating addicts with the mainstream drug, methadone, vs. treating them with prescription heroin. The study took place in England, and has been such a new concept that it has not been allowed in the Unites States, even as a study yet. Methadone itself is controversial, because it in essence replaces heroin with another drug. Patients that receive methadone treatment do so because it blocks the effects of heroin, so that no high is experienced. Methadone also works to regulate dopamine receptors in the brain that are negatively affected by heroin. The idea is that if patients are on methadone, they can learn through therapy how to overcome the habit of doing heroin. Then, they can gradually be weaned off of methadone. But for many patients, the methadone becomes their crutch, and they stay on that drug for life. Without the severe ups and downs and side effects of heroin, these methadone patients are sometimes able to lead normal lives again.

Prescription Heroin

But for about 10% of these patients, methadone treatment doesn’t even work. These addicts go back to doing street heroin and drop out of treatment. So doctors and researchers in this study started giving a pure form of heroin, a “prescription heroin”, to patients that would otherwise fail treatment and go back to the streets. The argument is that at least they are getting a safe form of heroin in a controlled facility, free from disease or impurities.

It has to be said, however, that this is not a cure. You can’t give someone the drug they are addicted to, even if it comes from a doctor, and expect their lives to be better because of if it. Yes, these people may stop using illegal street heroin, but they are still living each day under the influence of the drug, and that doesn’t make them any more ready to enter society than if they were shooting up in an ally. The only thing it does is it hopefully keeps them from being so desperate for the drug and reduces the violence they otherwise might commit. But we can do better than this. We can find better ways to get these people off the drugs and living a stable life. 

Sources

Treating Long-Term Addicts With Medical Grade Heroin More Effective Than Methadone

Study: heroin better than methadone to kick habit

Prescription heroin helps addicts off street drugs

Methadone

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The drug targets the central nervous system and opioid-receptors in the brain to provide analgesic relief from pain. Methadone is a Schedule II narcotic under the United States Controlled Substances Act and has been a vehicle for potential drug abuse, addiction and misuse. There is a definite possibility several patients who take Methadone for withdrawal circumstances may develop a dependence which can lead to further abuse.

A Black Box warning was issued in 2006 for methadone, meant to alert healthcare professionals, patients and consumers about the chance of cardiac toxicities that may be associated with the drug.

Side Effects and Information

There can be a chance for developing a physical addiction or abuse when taking methadone. Patients who have a history of addiction or abusing other medications, alcohol, emotional problems may be at a higher risk for this. Different cases may apply to certain individuals, so speak with your personal doctor before stopping the drug.

Several serious side effects may occur when taking the medication. If any of these are experienced, please see a physician as soon as possible:

• Breathing that slows down
• Change in heart beat or chest pain
• Dizziness and confusion
• Drowsiness and faintness
• Hallucinations
• Shallow breathing

Do not combine methadone with any of the following medications, unless you have consulted with a medical doctor: anti-depressants, anxiety medications, muscle relaxers, narcotic pain medications, sedatives and sleeping pills.

By providing FDA alerts, drug information, interactions and drug side effects about prescription and over the counter medications, we can ensure an environment where patients have the best knowledge on their medical treatment and health.

Disclaimer:
This article is for purely informational purposes and does not intend to prevent, treat, or cure any disease. It was not written by a medical professional. If you have any questions about your own methadone use, or are considering using methadone contact your physician.

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Some people would call their approach a social experiment, or that the government is looking the other way or even encouraging drugs use. But for many, Vancouver’s handling of illegal drugs has been a life saver.

InSite

The city of Vancouver gives money every year to a community organization to operate a facility called InSite. This facility takes a very controversial approach to dealing with drug addicts. In fact, it is the only facility of its kind in North America. InSite is a building where drug addicts can go to shoot up “in safety”. Users must supply their own drugs, but are provided with clean needles and syringes, and are supervised by medical staff in case they overdose. InSite oversees an average of 491 injections per day, and many of its addicts come back repeatedly throughout the day to get their fix.

Supporters

The history of InSite has been plagued with conflict. Several legal challenges have threatened to close its doors, and parts of the Conservative federal government have worked to close InSite. But so far, the courts have ruled in favor of this facility. Supporters say that their primary goal is to reduce harm to addicts, by preventing the spread of disease and the risk of overdose. The British Columbia Ministry of Health Services provides money for InSite, and the police force in Vancouver says it helps them promote harm reduction. Supporters say because of InSite there are fewer crimes, fewer homicides, and fewer drug overdoses in Vancouver. InSite also offers counseling and treatment services to help the addicts that want to get clean.

Opponents

But the problem that most other people have with InSite is that it allows addicts to stay in their addiction. InSite helps addicts maintain a “functioning junkie” status. By taking away some of the dangers of substance abuse, InSite allows these people to continue using their drugs with few consequences. It encourages drug addicts to use drugs, and doesn’t seem to encourage often enough the benefits of detox and treatment. The benefit of facilities like InSite is that they prevent a number of overdoses. InSite staff intervened on 484 overdoses, lives that would have been lost had they not been at InSite. But these drug addicts, no matter how hard they try, cannot really function in society, and giving them the means to continue in their drug usage is not benefitting them in the long run. Last year, 411 people were admitted to detox at InSite. Maybe with more patients in a successful detox program, they would have fewer patients in their injection booths, and they would really save lives.

Sources

InSite

Vancouver’s ‘safe house’ for drug addicts draws controversy

Near Olympics, Vancouver’s (mostly) legal drug zone

Linda Robertson: Vancouver’s ‘real world,’ outside Olympic bubble

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But heroin addiction often happens to other, seemingly unlikely people as well, and it grips them just as hard as anyone. A new trend in high school students from the suburbs is to do heroin. Even with all the education and literature warning people about the risks of heroin use, an estimated 150,000 people began using heroin from the first time from 1995–2002. People start using heroin for a variety of reasons. Some people are looking for a stronger drug with more of an effect after using more moderate drugs for some time. Other people are pressured into trying heroin by friends or co-workers, and get hooked right away. Still other people are trying to escape from something difficult in their life, such as a bad relationship, loss of job, or money problems. Whatever the reason, individuals that experiment with heroin with the intent of stopping after a short time often find themselves months down the line, completely addicted.

Heroin, a derivative of morphine that comes from the poppy plant, is one of the most addicting illicit drugs. It is also one of the most contaminated drugs, with the dirtiest addiction practices. Users crave it so much that they will buy drugs off the street that are cut with all kinds of substances, even with strychnine or other poisons. The strength of heroin is rarely communicated to the user on the street, which puts heroin users at risk for overdose. Heroin addicts lose all concern for their body and physical health. The feeling of euphoria from doing their drug becomes the most important thing. Heroin addicts will use dirty needles to shoot up, or contaminated supplies to smoke or inject it. AIDS and hepatitis B and C are a result of unclean heroin practices.

Effects of Heroin

Chronic heroin users can rarely hide their addiction. While under the influence, heroin users will show slurred speech, droopy eyelids, and an overall slowness to their movements. Chronic users that shoot up will develop collapsed veins, clogged blood vessels, cellulites, and those that smoke or inhale it develop infections of the heart or lungs.

Treatment

There is treatment for heroin. The first step to recovery is detox, which can cause withdrawal symptoms such as nausea, body aches, insomnia, restlessness, and cold flashes. Detox medications can ease the symptoms and the cravings. A good treatment facility will have a long-term plan in place or heroin addicts trying to get clean. Counseling by trained professionals and support groups with others that are recovering will help an addict work toward staying sober.

Sources

http://www.treatmentsolutionsnetwork.com/heroin-rehab.html

http://www.drugabuse.gov/ResearchReports/heroin/heroin2.html#what

http://www.drugfree.org/portal/drug_guide/heroin

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How to Do Drugs Safely

The brochure was most likely created with a lot of good intentions, but probably not with as much thought. It gives almost friendly advice on how to stay safe when doing illegal drugs. Tips like “jump up and down before injecting in order to find your vein more easily” and “only shoot up with a friend in case something goes wrong” are among the ones that have people outraged. The pamphlet cost the city $32,000 to create and distribute, money that many taxpayers are furious to hear about. The main argument about the pamphlet is that is seems to be encouraging people to do drugs, as long as they can do it in a safe way.

The city’s health department does not agree. They state that the brochure was made for drug addicts, in order to prevent overdose and things like HIV and AIDS. It has been distributed at homeless shelters, jails, and syringe exchange programs, and the city says it has saved lives. But critics argue that those that are addicted to heroin know most of these things already, and you can’t really make injecting a poison into your body safe. It is dangerous and risky, and a brochure isn’t going to make the addiction any safer.

Preventing Drug Use

City officials also say that they have recognized that it is impossible to stop every drug user, and this is designed to at least prevent overdose and death. But this kind of sounds like they’ve given up. Sure, we need to admit that there is a big drug problem out there and that we can’t reach everyone, but that doesn’t mean we should blow $32,000 on a pointless campaign. Instead, maybe they should have spent that money on getting some of those people into treatment. It would be interesting to know how many drug addicts actually read the pamphlet and stayed “safe” because of it.

The brochure does have a help number on it and encourages the addict to get treatment. But “Take charge. Take care” seems to otherwise be handling the drug problem all wrong. There is a big problem with drugs in New York City and drug overdoses kill over 600 people a year. However, there are other programs, other literature, and other ways of informing the public of certain dangers that are more effective. These drug addicts, and everyone, need to be taught about the dangers of drugs, as well as tools to avoid using them in the first place.

Sources

NY health department takes flak for heroin manual

City Pamphlet on Heroin Use Criticized as a How-To Guide

NYC’s top drug prosecutor blasts ‘how-to’ pamphlet for IV drug users

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Unfortunately, there is not enough evidence to conclude that either way is better.  Numbers do show that the use of methadone is successful in getting patients to give up heroin, but then the patient does not really end up being drug-free because they are addicted to the methadone.

History of Heroin
Heroin has been around for a long time, and is currently grown around the world, with large supplies in the Middle East, Asia, and Latin America.  The drug had been a problem in the United States for decades, but the Nixon administration actively tried to diminish supplies of heroin when he declared a war on drugs in the 1970′s.  It was during this time that methadone maintenance treatments came to light, and experiments were done to measure its effectiveness.  However, incomplete data recording, complex situations of treatment, and inconclusive evidence have all aided in the differing of opinions that we have today.

Heroin Withdrawal
What we do know is that heroin is a hard drug to beat.  The addict’s body quickly becomes so dependent on the substance that to go without it would mean a severe withdrawal.  Nausea, vomiting, pain, sweating, fatigue, depression and insomnia are what an addict goes through when trying to quit.  But, if a patient is put on methadone when stopping the heroin, the symptoms are not nearly as bad.  The patient will need to work to withdraw from the methadone, but that can often happen over weeks or months.

Another thing we know is that addicts that are required to quit heroin without the use of medication are less likely to stay in treatment than those that are assisted by drugs such as methadone.  Perhaps it gets to be too big of a task before them to be rid of drugs completely, but whatever the reason, more heroin users will stay in treatment if it involves using methadone or another medication.

Methadone Treatment Facilities
Many drug treatment facilities have built their programs around these pieces of information.  By using medications such as methadone, physicians are able to ease the withdrawal symptoms and to keep the addict in treatment.  Facilities may not be able to come up with statistics that say their patients have completed their program and are clean and drug-free, but that they are heroin-free.  According to many, this is a better alternative.  Many facilities work to help their patients become responsible members of society, by keeping a job or taking care of their family, something heroin addicts find almost impossible.  For those patients that require the use of methadone to achieve those goals, the benefit of living a normal life is worth it.

Schneider, Eric The War on Drugs Redux 1-12-09

Mooney, Bette From Yale to Jail

Mattick, RP Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence

http://wwwdasis.samhsa.gov/teds05/TEDSD2k5Hi.htm

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First of all, it might be necessary to call a hotline to get immediate help for an addiction. This would be used when a person doesn’t know where else to go for help, or possibly someone is in immediate danger. If this is the case, the individual on the other end of the phone can give you valuable information about immediate treatment options.

Types of Facilities and Programs

If the decision is something that is thought about for a while and discussed, there are many different types of programs that might be useful. The first questions might be whether the facility offers residential, in-patient, or out-patient treatment, or a recovery house or long-term care. Some facilities are gender or age-specific, which might be particularly helpful to adolescents or females who might feel more comfortable in a setting with their peers.

It may be necessary for the treatment facility to have a detoxification program for the individual to rid their body of harmful substances while being monitored by a staff of medical professionals. After the physical dependency of the substance is addressed, the patient can begin counseling and treatment to manage the psychological dependency. Many treatment facilities have different activities to aid in this part of the recovery process. Things such as group therapy and family involvement have proven successful in treatment, as well as the 12-Steps for recovery. Some specialized facilities also provide programs such as equine therapy, recreational activities, cooking opportunities, and other things geared toward giving the mind and body something positive to focus on.

Recovery is an Ongoing Process

It is important for patients to be directed to long-term care to assist them in staying sober in the future. By learning about the risks of relapse and the skills needed to cope with stress and addiction triggers, an individual will be more likely to stay substance-free. A facility should provide follow-up services to give the recovering patient a support base when they move back into their lives. Recovery is an ongoing process. The groundwork is laid when an individual goes through treatment, but recovery continues on as the person is put back into their lives and families and has to effectively put what they learned into practice.

Entering into a treatment facility is a scary thing for most people. The unknown is hard to face. But the right facility can ease discomfort with their caring staff and positive programs. It still won’t be easy, but the goal is for the treatment to be successful. By working with counselors and staff to learn about oneself and taking accountability for the addiction, an individual can actually aid in the recovery process. So while you can expect treatment to be a challenge, it will hopefully be the best thing you’ve ever done.

Sources

T., Buddy Components of Effective Treatment Programs What Makes Alcohol Treatment Programs Work? January 22, 2008

http://en.wikipedia.org/wiki/Drug_rehabilitation

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Opiate Detoxification Medications

Buprenorphine is a medication that significantly reduces the cravings of opioids. When combined with naloxone, an opioid antagonist, the results seem to be even better. Naloxone reduces or prevents the effects of drugs such as heroin or prescription painkillers, making them much less desirable to the addict. Naloxone also prevents the patient from misusing the buprenorphine combination because those that would try to inject the drug for a high (instead of taking it orally as prescribed) would suffer severe withdrawal symptoms.

While these medications have been used for adults in many instances, there has been little research on the effectiveness among young people addicted to opioids. The overall number of adolescents that abuse drugs has decreased since 2002, and while this is a very positive trend, the number of painkillers and opioids abused among teens has increased.

Study on Treating Adolescents

Dr. David A. Fiellin of the Yale University School of Medicine reports that as many as 10 percent of ninth graders have used opioids, and that 200,000 to 400,000 adolescents have abused some of these drugs. It seems that drugs are even more readily available to teens today than alcohol, as teens are able to order drugs online or steal them from their parents’ medicine cabinets. Often drug addiction starts as a fun thing that teens try, and ends up as a lifetime of dependence on the substance.

The study done by Dr. George Woody of the University of Pennsylvania’s Department of Psychiatry is one of the first of its kind. As was reported this week, researchers found that those teens that were put on a buprenorphine/naloxone combination (Suboxone) for an extended period of time (12 weeks or longer) were more likely to stay opioid free than those only given the medication for a short period of time. When taken off the medication, the drug use went up. Even with detoxification and counseling, the individuals that were taken off the Suboxone were back to using drugs in a short period of time.
While more research needs to be done on this topic, it seems that Dr. Woody and his team of researchers have shown that Suboxone is an effective treatment in the addiction of opioids when used for an extended period of time. There are those that disagree with the use of drugs to treat drug addiction, but if it means these adolescents have a chance to continue their life free of opioid addiction, many think these more drastic measures are worth taking.

Sources

Reinberg, Steven Extended Therapy Helps Drug-Addicted Teens November 4, 2008

Carver, Alice Extended Therapy for Young Opioid Addicts Better than Short Term Detox, Study November 5, 2008

Opiate Detox

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Congress approves Mental Health Parity Act

Congress approved legislation last week that would change the way insurance providers handle claims for mental illness and substance abuse. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 provides “equity in the coverage of mental health and substance use disorders by ensuring that group health care plans do not charge higher co-payments, coinsurance, deductibles, and impose maximum out-of-pocket limits and lower day and visit limits.” Supporters of this measure include many in the House and Senate, businesses, insurance companies, and physicians. However, a few questions remained and until last week, it was uncertain whether or not the bill would pass before Congress went into recess this year. By attaching it to the Wall Street bailout bill, however, Congress was able to pass it quickly.

Help is needed

Help can’t come soon enough for many Americans struggling with drug or alcohol addiction. According to the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare, mental illness is the leading cause, and substance use is the second leading cause, of disability among adults. Many of these adults are not getting the help they need to recover from their mental illness, and often it is because of the high cost of treatment. Another reason is fear of discrimination from their employer if they do seek treatment.

Equal Coverage for an epidemic

With legislation such as the Mental Health Parity Act, those with a substance abuse disorder can be reassured that their insurers will not be able to set a cap on healthcare coverage for mental illness or substance abuse that isn’t set for other illnesses.

In order to deal with the epidemic of substance abuse, we need more good addiction treatment facilities, more affordable health care to addicts, and more support behind families dealing with substance abuse. Through the passage of this bill, those with addiction should be encouraged to move forward and seek treatment, so that we can work toward decreasing the incidence of drug and alcohol abuse.

Sources

Congresswoman Shea-Porter Hails Passage of Mental Health Parity Act September 24, 2008

Many State Reform Initiatives Are Neglecting Mental Illness, Says Study July 08, 2008

Layton, Lyndsey Congress Approves Mental Health Bill Private Insurers Would Provide More Benefits Sept. 24, 2008

Ault, Alicia Equal Coverage For Mental Health?
Many States Require Parity, and Congress May Order It Nationwide November 6, 2007

Curley, Bob Congress, Bush Approve Addiction and Mental Health Parity Legislation October 3, 2008

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The first, and second, parts of the above definition are about abstinence. The other three parts describe attributes. The person that displays these attributes is Sober, not just abstinent from chemicals, not just clean. His, or her, Sobriety is manifested in “all their affairs:”This person practices Sobriety, with a capital S.

This Sobriety with a capital S is manifested in the way people live their lives, not in what they say. Sobriety is life lived in the pursuit of simplicity, and “serenity;” a way of life that avoids “excess.” For excess is the way of addiction. Addiction is excess in everything. Excess in using chemicals, and in exaggerated thinking, and behaving. The addict is addicted to extremes, and drama, as much as he, or she, is addicted to a chemical. To incorporate the above described attributes into a Sober character is the antidote for addiction. And, the acquisition of this character is the foundation of recovery. As well as, the goal of any program, or therapy, that seeks to treat addiction.

To counter the addicted character, an addict must be confronted with a person that has developed a Sober character. A person that is capable of modeling what this character is. That is capable of displaying it in daily living. Capable of showing the addict how life can be lived Sober. Modeling for the addict new ways of dealing with the challenges of life from a Sober perspective.

Then, by observation, and practice, an addict begins to substitute old patterns of thinking, and behavior. Through exposure to a Sober character, they can begin to live “as if” they had this character. By ‘faking it, till they make it,” they get a sense of what Sober life is. When their new behaviors begin to yield responses that reinforce them, they become incorporated into a new pattern of dealing with life. Through this process, a new character is formed.

In the process of this new character formation, the presence of a Sober sponsor, mentor, or therapist is fundamental; the presence of a person that personifies Sobriety. If the sponsor, mentor, or therapist has not internalized, and manifest the attributes of Sobriety, all that the addict is exposed to is another role to play: The role of “recovering person.” Because addicts are adept at role playing, the modeling of a person who is clean, but not truly Sober, will invite the addict to create yet another persona, or mask. Recovery becomes a new way to act, speak, and relate to others, without true change, without authenticity.

Many in the recovering world have adopted the persona of a recovering addict. A person can become “clean,” if this is the price that he, or she, pays for sustaining new friendships, lovers, work, or status. For, they now belong to a community where respect, admiration, business opportunities, and popularity are founded on “clean time.” However; such a person is clean, not Sober. This kind of recovery is dangerous. It is dangerous to those who practice it, and for those who are seeking recovery.

A person with “clean time,” regardless of character development, is in a position to be a sponsor, a therapist, or even to run a treatment center. They can be in a position to dictate the process of addiction treatment. They can place themselves in a position of authority. They can be in a position of power. They can be in a position to do harm.

For, without the grounding influence of a Sober character, power, money, and status, become tools of the ego. They become tools for exploitation. They become means that allow the clean, but non-Sober addict to indulge in their addictive character traits. Under the guise of recovery, and “helping,” a clean, but non-Sober person can indulge in drama, chaos, blaming, and self-righteousness. They can exercise control over the lives of others, for self-gratification. They continue to act from the basis of their “defects of character,” even if they are not using chemicals. They harm themselves, and others.

The goal of the 12 Step programs, therapy, and all interventions of addiction treatment, is to “remove” these “defects of character;” not to find a new way to manifest them under the disguise of being “clean.” According to the founders of the 12 Step programs, in order to remove these defects of character, a person must engage in a spiritual path, seek a “spiritual solution.” A spiritual solution that is ancient, and Universal. A spiritual solution that has been taught by every spiritual master in history. This solution is to become free from the “bondage of self.”

What is this “bondage of self?” It is the bondage of a flawed self that the addict has constructed through the process of his, or, her life. Once this self became chronic, the addict constructed a character to protect it, to defend it. But, this self, and character are false. They were constructed as protections, and maladaptive strategies for survival. They cover up the true Self: the Self that was created by a Higher Power. So, every true spiritual path seeks the return to this true Self. Every true spiritual path offers a way, a method, and a program, to return to true living; to return to living life on “life’s terms,” to live Sober.

For, in Sobriety, life is again experienced, as it is. When the false self no longer rules a person, its demands for power, money, status, reputation, excess, drama, etc. no longer rule that person’s thoughts and actions. As a result, the person becomes free. The person is free to enjoy simplicity. Free to recognize the mystical of the everyday. And, through this recognition, a free person can find joy, pleasure, contentment, and fulfillment in the ordinary. They can again embrace life with the joy of a child at play, not because everything is perfect, but because it is all part of life; and life is good enough in its own terms. This is spiritual living. This is Sobriety.

This Sobriety is hard to attain. It is not easy to live Soberly in a culture that is increasingly hysterical. In a culture that prizes image above substance. We live in a culture of hysterical “personalities.” A culture of dramatic, “reality” television shows, screeching religious leaders, flashy gurus, “spiritual guides,” and shocking, instantaneous, psychotherapies. It is not surprising that the development of a Sober character is not a modern, or popular quest. However; for a recovering addict it is the essential quest. Just as it was for the suffering addicts that found their salvation in it, and prescribed it to future generations; as all spiritual seekers before them had done. In order for many to stay clean, many have to become Sober.

J. E. Lesende

Sober Definition From Answers.com

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