Opiate Overdose Research Paper
Methadone Treatment for Opioid Addiction
By: Vicki Wilson
Physiological and Medical Aspects of Substance Abuse
November 7, 2012
Vicki Wilson
Physiological and Medical Aspects of Substance Abuse
November 7, 2012
When people hear the term opiate abusers or the more frequently used street term drug addict (a horrible stereotype) that people think of first. A homeless, system milking, degenerate that is hooked on Heroin and sticks dirty needles in their arms, doing anything for money to get more drugs. Although many times that is where drug addiction can eventually lead a person, it doesn’t start that way. It starts in high school at a party or the soccer mom that hurts her back and got addicted to the Percocet’s she was prescribed …show more content…
by the doctor. Opiate addiction is under researched and the true numbers of those in our country addiction has only started coming to life in the past decade. Because of the stereotypes and stigmas places on opiates, there has been a battle waging between medical doctors, the Food and Drug Administration, addiction specialists and patients in pain. Due to the stigma and fear attached to the opiates, medical doctors continue to question the sincerity of patient pain and worry about the liability of prescription drug abuse. Other words many doctors question whether their patients are actually suffering in pain, which is subjective, and for years have been failing to adequately treat the pain because they don’t want to prescribe opiates. Although this is a legitimate concern it is unfair to the patient who are suffering acute or chronic, moderate to severe pain to be withheld relief of their pain. This however, has begun to change since The Joint Commission and other organizations have established pain as the fifth vital sign. Unfortunately, the statistics aren’t there yet due to lack of research and information on this topic. However, many doctors say yes or is it that the doctors are not working closely enough with addiction specialist in pain management to prevent those patients who had legitimate pain and got hooked and offered no help. The group of Opioid drugs includes; heroin and morphine and synthetic drugs with morphine-like action, such as codeine, meperidine (Demerol), and oxycodone (OxyContin is sustained-release oxycodone). These compounds are prescribed as painkillers, anesthetics, or cough suppressants. Typical signs and symptoms of opioid intoxication are; pupillary constriction, euphoria, slowness in movement, drowsiness, and slurred speech. The signs and symptoms of opiate dependence may be hard to identify if the person who is addicted is still living a normal life and conceals their addiction to those around them. Most people do not see the signs of opiate dependence until it is too late when the person has either overdosed or is in withdrawal due to lack of opiates in their system. Opiate overdose is usually seen when a family member or friend come upon the person lying lifeless not breathing and in turn go to an emergency room.
Opiate overdose has many cumulating factors that intertwine causing an actual overdose. Many believe that the rise of opiate overdoses is due to an increase in opiate addicts primarily heroin addicts. However, research shows that the reason for overdose rate increases is due to the following factors; fear of reporting an overdose, tolerance, and polysubstance use. Usually when a person overdoses the majority of the time it is due to injecting heroin. Most of the time it is a fellow heroin addict with them that fails to seek medical attention for that person while they still can, due to the fear that they will get in trouble and face legal consequences. Therefore, they just leave the person where ever they are and take off in fear. The second risk factor increasing the chances of an opiate overdose is tolerance. This is when a person builds, over time the need to use more of the substance at one time to gain the same effect. Or the addict increases use of other drugs to compensate for the decreased effectiveness of the opiate they have such a high tolerance for. Another risk factor is polysubstance abuse; this is when a person uses more than one drug in combination with other drugs, usually at the same time. Many addicts will mix alcohol and benzodiazepines together along with the opiate which in combined acts …show more content…
synergistically together with the opiate agonist creating serious and fatal respiratory depression. The signs of opiate overdose can range from nonfatal to fatal. Nonfatal overdose signs include; mental cloudiness, cooled and mottled skin, decreased heart rate, stupor or even coma, dilated pupils, and diminished response to painful stimuli. A more serious and fatal opiate overdose directly effects the respiratory center of the brain. These signs include, shallow respirations with a general decrease in respirations, and reduction of tidal volume that is significant, eventually causing breathing to stop all together. On the opposite spectrum opiate addicts often have to deal with withdrawal when they are unable to feed their bodies enough of or no opiates at all. The severity of withdrawal depends on how long the person has been opiate dependent and what types of opiates they were abusing. Withdrawal of opiates is divided into two categories, acute opiate withdrawal and protracted withdrawal. Acute withdrawal usually occurs 8 hours after last use of an opiate and peaks at 48 to 72 hours, lasting for up to 7 days. The most common physical signs of acute withdrawal are; sweating, yawning, and increase in overall vital signs, runny nose, restlessness, anxiety, muscle cramps, diarrhea, nausea, vomiting, dilated pupils, watery eyes, and goose bumps. There are also withdrawal issues that take place in the brain chemically with neurotransmitters. These neurotransmitters include; dopamine, serotonin, cholinergic, and noradrenergic transmitters. Protracted withdrawal on the other hand is longer lasting and involves the makeup of the brain, which has been altered due to prolonged opiate abuse which causes behavioral changes in the person. Due to the great impact that the use of opiates has on a person mentally, physically, emotionally, spiritually, and financially, it is of great importance that people, whether family and friends or medical personal step in to help others break the vicious cycle of unsafe behaviors. This can be done through management of opiate abuse techniques, some of which actually get the person “clean” or those interventions that help keep the active addict safer are considered harm reduction techniques. The first harm reduction methods used is education of the addict, which usually occurs in detox or at outreach programs on the street that are drug addict friendly. Education includes; using clean needles, what to do in the event of an overdose, proper way and where to inject one’s self and having safe sex.
Since around 2000 there have been programs set up called the needle-exchange. This is a building or mobile office, with staff, that addicts can go to and properly dispose of their used needle and in return get clean needles and a clean “works” kit. Along with this the addict also receives a card that they can carry on them stating they are a part of the needle-exchange program, so if caught by police with syringes they would not be charged for carrying paraphernalia. Now however, it was made possible in Massachusetts that everyone could go into a pharmacy and buy new insulin syringes without questions just identification to prove they are at least 18 years old. Although many who do not work in the field of addiction or who are not addicts disagree with this because they feel it is promoting drug use, it has shown to decrease the spread of hepatitis and AIDS. Over in other counties they go a step further and actually offer facilities that are staffed with medical personal, such as nurses where they can freely shoot up heroin under medical supervision and not get in trouble. This is known as injection rooms and is used in Switzerland, Germany, and the Netherlands for more than a decade. Another management technique used is heroin maintenance, where active addicts go daily to be injected with prescription heroin my medical personal. If one wants to get clean there are many methods to help the withdrawal and preventative relapse therapies.
The three methods of detoxification and withdrawal medication methods includes; the use of non-opiate medications, opiate agonists, and ultra-rapid opiate withdrawal. Non-opiate medications are usually used in detox facilities with acute withdrawal or for the management of withdrawal side effects. Some of these medications includes; clonidine, Librium, Ativan, NSAIDS, antidepressants, and benzodiazepines. Opiate agonist to treat withdrawal and for maintenance in the recovery phase is methadone, whether received in a detox center or at a methadone clinic. The last method used is for ultra-rapid withdrawal. This is where the patient is put under anesthesia and or sedated while their body goes through withdrawals and is then
detoxified.
After one completes the acute withdrawal process from opiates there are many of methods of treatment during the recovery phase, which a former active addict will always be in. These treatments include medications, psychological therapy or a combination of both. Medical interventions include the use of medication such as methadone, which is given by licensed nurses under the supervision of a doctor in a methadone clinic. Along with medical intervention it is pertinent that one completes therapy sessions and it is recommended that one attends self-help groups such as Narcotics Anonymous in conjunction with any other interventions used.
When we think of methadone we think of heroin addicts and we go right back to the stereotypes of what people think. Methadone is the most effective treatment for heroin addiction. The purpose of the methadone treatments is to reduce illegal heroin use and the crime, death, and disease associated with heroin addiction. This medication is to reduce or eliminate heroin use among addicts by stabilizing them on methadone for as long as it takes them to avoid returning to previous patterns of drug use. There are almost no negative health consequences of long-term methadone treatment, even when if continues for 15 or more years. Methadone treatment also gives the opportunity to teach drug users harm reduction techniques, such as, how to prevent HIV/AIDS, hepatitis, and other health problems that endanger drug users. A few facts about methadone treatment; reduces criminal behavior because they either reduce or stop buying and using illegal drugs; drastically reduces, and often eliminates, heroin use.
Methadone, also known as Diskets, Dolophine and Methadose, is a narcotic pain reliever and a synthetic opiate derivative. It is often compared to the drug morphine and is commonly used as part of a drug detoxification. Methadone is known to reduce symptoms of withdrawal in people who are addicted to heroin or other opiates. Methadone is what most people addicted to drugs use for treating their addiction because it lessens the effects of withdrawal without giving them the same high they would usually get, when they were using their drugs of choice. When addicts go in for methadone treatment it is not taken lightly, they have to meet certain criteria in order to be considered for methadone treatment. The criteria includes; drug testing, mandatory groups, counseling that they must attend, and may include more. Once they are on a methadone treatment plan, they must abide to all the guidelines with in their treatment plan.
It can be easy for someone to say “Just stop using,” or “just quit,” to someone who is pregnant and addicted to drugs. For women who are pregnant and struggling with addiction to heroin or other opiate drugs, before they became pregnant, methadone is a much safer alternative for themselves and their unborn baby. Deciding to go to methadone treatment while pregnant is controversial, but for many women and their babies, it is the healthiest and safest option. This does not mean that methadone during pregnancy does not come with risks. The babies born from mothers on methadone will not always show signs of exposure but among those that do, the most common issues are; smaller-than-average head circumference, lower birth weight and withdrawal symptoms, these issues are rarely long-term. There is not certain dosage for women on methadone during pregnancy. Many mistakenly believe that the less they take the better, but if they are feeling withdrawal symptoms, their unborn child does as well, and they may need to increase their dose. During pregnancy it is not uncommon throughout the pregnancy to increase the dosage because of increase weight and blood volume.
Many of women who are pregnant and on methadone suffer from guilt for being on methadone while pregnant and feeling that they are not doing what is best for their child, when in reality they are doing the best thing they can. Without methadone they could experience severe withdrawal that could end in miscarriage or fetal death, or may be unable to stop using their drug of choice. If the mothers detox during pregnancy without being on a methadone treatment plan, they could suffer from symptoms, such as; anxiety, irritability, sore and aching muscles, crying, teary eyes, sweating, abdominal pain and cramping, fever, diarrhea, pupil dilation, nausea and vomiting and seizures that could be life threatening.
Methadone also carries risks for the unborn child and cannot be detected until the child is born. A newborn experiencing withdrawal could also experience other symptoms, such as, shallow and rapid breathing, frequently sneezing and yawning, high muscle tone, intense and prolonged crying and gastrointestinal issues. If these symptoms happen the baby will need to detox and go through withdrawal, just like an adult would that was in treatment. If the baby needs to detox it should be in a supervised and controlled environment, for instance, a hospital, will reduce the chances of the baby experiencing any unnecessary stress or pain. If the baby is not being supervised during the detox period, the baby could suffer greatly and may experience dehydration, diarrhea, jaundice, respiratory difficulty and seizures.
In the hospitals the babies will be weaned off of the methadone by using a short-acting medication, such as, morphine which will help calm the symptoms of withdrawal. Every baby is different so it depends on the length of time the baby needs to detox, it could be a few day or a few weeks. In a perfect world, pregnant women would not need to be on methadone, but it can help increase the likelihood of a positive outcome for the mother and her unborn child.
If nothing else is taken from this paper please remember that an opioid addict is not a low life piece of scum. An addict can be the doctor that you receive your care from or that PTA mom next to you. Addicts are human beings just like everyone else but have a disease that has taken over. It takes a lot for people with addiction to come forward and ask for help, the last thing they need is for people they love and care about to turn their backs and want nothing to do with them. The last thing they need is the people around them telling them they can’t do it or that they are horrible people, because those are the reasons some people do not stay with treatment and resort back to drugs. Help an addict instead of judging and shunning them . It is easier to get clean and stay clean when you have your loved ones in your corner.
By: Vicki Wilson
Physiological and Medical Aspects of Substance Abuse
November 7, 2012
Vicki Wilson
Physiological and Medical Aspects of Substance Abuse
November 7, 2012
When people hear the term opiate abusers or the more frequently used street term drug addict (a horrible stereotype) that people think of first. A homeless, system milking, degenerate that is hooked on Heroin and sticks dirty needles in their arms, doing anything for money to get more drugs. Although many times that is where drug addiction can eventually lead a person, it doesn’t start that way. It starts in high school at a party or the soccer mom that hurts her back and got addicted to the Percocet’s she was prescribed …show more content…
by the doctor. Opiate addiction is under researched and the true numbers of those in our country addiction has only started coming to life in the past decade. Because of the stereotypes and stigmas places on opiates, there has been a battle waging between medical doctors, the Food and Drug Administration, addiction specialists and patients in pain. Due to the stigma and fear attached to the opiates, medical doctors continue to question the sincerity of patient pain and worry about the liability of prescription drug abuse. Other words many doctors question whether their patients are actually suffering in pain, which is subjective, and for years have been failing to adequately treat the pain because they don’t want to prescribe opiates. Although this is a legitimate concern it is unfair to the patient who are suffering acute or chronic, moderate to severe pain to be withheld relief of their pain. This however, has begun to change since The Joint Commission and other organizations have established pain as the fifth vital sign. Unfortunately, the statistics aren’t there yet due to lack of research and information on this topic. However, many doctors say yes or is it that the doctors are not working closely enough with addiction specialist in pain management to prevent those patients who had legitimate pain and got hooked and offered no help. The group of Opioid drugs includes; heroin and morphine and synthetic drugs with morphine-like action, such as codeine, meperidine (Demerol), and oxycodone (OxyContin is sustained-release oxycodone). These compounds are prescribed as painkillers, anesthetics, or cough suppressants. Typical signs and symptoms of opioid intoxication are; pupillary constriction, euphoria, slowness in movement, drowsiness, and slurred speech. The signs and symptoms of opiate dependence may be hard to identify if the person who is addicted is still living a normal life and conceals their addiction to those around them. Most people do not see the signs of opiate dependence until it is too late when the person has either overdosed or is in withdrawal due to lack of opiates in their system. Opiate overdose is usually seen when a family member or friend come upon the person lying lifeless not breathing and in turn go to an emergency room.
Opiate overdose has many cumulating factors that intertwine causing an actual overdose. Many believe that the rise of opiate overdoses is due to an increase in opiate addicts primarily heroin addicts. However, research shows that the reason for overdose rate increases is due to the following factors; fear of reporting an overdose, tolerance, and polysubstance use. Usually when a person overdoses the majority of the time it is due to injecting heroin. Most of the time it is a fellow heroin addict with them that fails to seek medical attention for that person while they still can, due to the fear that they will get in trouble and face legal consequences. Therefore, they just leave the person where ever they are and take off in fear. The second risk factor increasing the chances of an opiate overdose is tolerance. This is when a person builds, over time the need to use more of the substance at one time to gain the same effect. Or the addict increases use of other drugs to compensate for the decreased effectiveness of the opiate they have such a high tolerance for. Another risk factor is polysubstance abuse; this is when a person uses more than one drug in combination with other drugs, usually at the same time. Many addicts will mix alcohol and benzodiazepines together along with the opiate which in combined acts …show more content…
synergistically together with the opiate agonist creating serious and fatal respiratory depression. The signs of opiate overdose can range from nonfatal to fatal. Nonfatal overdose signs include; mental cloudiness, cooled and mottled skin, decreased heart rate, stupor or even coma, dilated pupils, and diminished response to painful stimuli. A more serious and fatal opiate overdose directly effects the respiratory center of the brain. These signs include, shallow respirations with a general decrease in respirations, and reduction of tidal volume that is significant, eventually causing breathing to stop all together. On the opposite spectrum opiate addicts often have to deal with withdrawal when they are unable to feed their bodies enough of or no opiates at all. The severity of withdrawal depends on how long the person has been opiate dependent and what types of opiates they were abusing. Withdrawal of opiates is divided into two categories, acute opiate withdrawal and protracted withdrawal. Acute withdrawal usually occurs 8 hours after last use of an opiate and peaks at 48 to 72 hours, lasting for up to 7 days. The most common physical signs of acute withdrawal are; sweating, yawning, and increase in overall vital signs, runny nose, restlessness, anxiety, muscle cramps, diarrhea, nausea, vomiting, dilated pupils, watery eyes, and goose bumps. There are also withdrawal issues that take place in the brain chemically with neurotransmitters. These neurotransmitters include; dopamine, serotonin, cholinergic, and noradrenergic transmitters. Protracted withdrawal on the other hand is longer lasting and involves the makeup of the brain, which has been altered due to prolonged opiate abuse which causes behavioral changes in the person. Due to the great impact that the use of opiates has on a person mentally, physically, emotionally, spiritually, and financially, it is of great importance that people, whether family and friends or medical personal step in to help others break the vicious cycle of unsafe behaviors. This can be done through management of opiate abuse techniques, some of which actually get the person “clean” or those interventions that help keep the active addict safer are considered harm reduction techniques. The first harm reduction methods used is education of the addict, which usually occurs in detox or at outreach programs on the street that are drug addict friendly. Education includes; using clean needles, what to do in the event of an overdose, proper way and where to inject one’s self and having safe sex.
Since around 2000 there have been programs set up called the needle-exchange. This is a building or mobile office, with staff, that addicts can go to and properly dispose of their used needle and in return get clean needles and a clean “works” kit. Along with this the addict also receives a card that they can carry on them stating they are a part of the needle-exchange program, so if caught by police with syringes they would not be charged for carrying paraphernalia. Now however, it was made possible in Massachusetts that everyone could go into a pharmacy and buy new insulin syringes without questions just identification to prove they are at least 18 years old. Although many who do not work in the field of addiction or who are not addicts disagree with this because they feel it is promoting drug use, it has shown to decrease the spread of hepatitis and AIDS. Over in other counties they go a step further and actually offer facilities that are staffed with medical personal, such as nurses where they can freely shoot up heroin under medical supervision and not get in trouble. This is known as injection rooms and is used in Switzerland, Germany, and the Netherlands for more than a decade. Another management technique used is heroin maintenance, where active addicts go daily to be injected with prescription heroin my medical personal. If one wants to get clean there are many methods to help the withdrawal and preventative relapse therapies.
The three methods of detoxification and withdrawal medication methods includes; the use of non-opiate medications, opiate agonists, and ultra-rapid opiate withdrawal. Non-opiate medications are usually used in detox facilities with acute withdrawal or for the management of withdrawal side effects. Some of these medications includes; clonidine, Librium, Ativan, NSAIDS, antidepressants, and benzodiazepines. Opiate agonist to treat withdrawal and for maintenance in the recovery phase is methadone, whether received in a detox center or at a methadone clinic. The last method used is for ultra-rapid withdrawal. This is where the patient is put under anesthesia and or sedated while their body goes through withdrawals and is then
detoxified.
After one completes the acute withdrawal process from opiates there are many of methods of treatment during the recovery phase, which a former active addict will always be in. These treatments include medications, psychological therapy or a combination of both. Medical interventions include the use of medication such as methadone, which is given by licensed nurses under the supervision of a doctor in a methadone clinic. Along with medical intervention it is pertinent that one completes therapy sessions and it is recommended that one attends self-help groups such as Narcotics Anonymous in conjunction with any other interventions used.
When we think of methadone we think of heroin addicts and we go right back to the stereotypes of what people think. Methadone is the most effective treatment for heroin addiction. The purpose of the methadone treatments is to reduce illegal heroin use and the crime, death, and disease associated with heroin addiction. This medication is to reduce or eliminate heroin use among addicts by stabilizing them on methadone for as long as it takes them to avoid returning to previous patterns of drug use. There are almost no negative health consequences of long-term methadone treatment, even when if continues for 15 or more years. Methadone treatment also gives the opportunity to teach drug users harm reduction techniques, such as, how to prevent HIV/AIDS, hepatitis, and other health problems that endanger drug users. A few facts about methadone treatment; reduces criminal behavior because they either reduce or stop buying and using illegal drugs; drastically reduces, and often eliminates, heroin use.
Methadone, also known as Diskets, Dolophine and Methadose, is a narcotic pain reliever and a synthetic opiate derivative. It is often compared to the drug morphine and is commonly used as part of a drug detoxification. Methadone is known to reduce symptoms of withdrawal in people who are addicted to heroin or other opiates. Methadone is what most people addicted to drugs use for treating their addiction because it lessens the effects of withdrawal without giving them the same high they would usually get, when they were using their drugs of choice. When addicts go in for methadone treatment it is not taken lightly, they have to meet certain criteria in order to be considered for methadone treatment. The criteria includes; drug testing, mandatory groups, counseling that they must attend, and may include more. Once they are on a methadone treatment plan, they must abide to all the guidelines with in their treatment plan.
It can be easy for someone to say “Just stop using,” or “just quit,” to someone who is pregnant and addicted to drugs. For women who are pregnant and struggling with addiction to heroin or other opiate drugs, before they became pregnant, methadone is a much safer alternative for themselves and their unborn baby. Deciding to go to methadone treatment while pregnant is controversial, but for many women and their babies, it is the healthiest and safest option. This does not mean that methadone during pregnancy does not come with risks. The babies born from mothers on methadone will not always show signs of exposure but among those that do, the most common issues are; smaller-than-average head circumference, lower birth weight and withdrawal symptoms, these issues are rarely long-term. There is not certain dosage for women on methadone during pregnancy. Many mistakenly believe that the less they take the better, but if they are feeling withdrawal symptoms, their unborn child does as well, and they may need to increase their dose. During pregnancy it is not uncommon throughout the pregnancy to increase the dosage because of increase weight and blood volume.
Many of women who are pregnant and on methadone suffer from guilt for being on methadone while pregnant and feeling that they are not doing what is best for their child, when in reality they are doing the best thing they can. Without methadone they could experience severe withdrawal that could end in miscarriage or fetal death, or may be unable to stop using their drug of choice. If the mothers detox during pregnancy without being on a methadone treatment plan, they could suffer from symptoms, such as; anxiety, irritability, sore and aching muscles, crying, teary eyes, sweating, abdominal pain and cramping, fever, diarrhea, pupil dilation, nausea and vomiting and seizures that could be life threatening.
Methadone also carries risks for the unborn child and cannot be detected until the child is born. A newborn experiencing withdrawal could also experience other symptoms, such as, shallow and rapid breathing, frequently sneezing and yawning, high muscle tone, intense and prolonged crying and gastrointestinal issues. If these symptoms happen the baby will need to detox and go through withdrawal, just like an adult would that was in treatment. If the baby needs to detox it should be in a supervised and controlled environment, for instance, a hospital, will reduce the chances of the baby experiencing any unnecessary stress or pain. If the baby is not being supervised during the detox period, the baby could suffer greatly and may experience dehydration, diarrhea, jaundice, respiratory difficulty and seizures.
In the hospitals the babies will be weaned off of the methadone by using a short-acting medication, such as, morphine which will help calm the symptoms of withdrawal. Every baby is different so it depends on the length of time the baby needs to detox, it could be a few day or a few weeks. In a perfect world, pregnant women would not need to be on methadone, but it can help increase the likelihood of a positive outcome for the mother and her unborn child.
If nothing else is taken from this paper please remember that an opioid addict is not a low life piece of scum. An addict can be the doctor that you receive your care from or that PTA mom next to you. Addicts are human beings just like everyone else but have a disease that has taken over. It takes a lot for people with addiction to come forward and ask for help, the last thing they need is for people they love and care about to turn their backs and want nothing to do with them. The last thing they need is the people around them telling them they can’t do it or that they are horrible people, because those are the reasons some people do not stay with treatment and resort back to drugs. Help an addict instead of judging and shunning them . It is easier to get clean and stay clean when you have your loved ones in your corner.