Category Archives: best-addiction-treatment-education

Proper use Opioids to Curb Addiction and Dependence

October 1, 2014

 

Better Use of Opioids to Curb Addiction and Dependence

opioidsThe opioid drugs have brought relief to many people that were suffering severe pain enough to even disable them. The use of these drugs however should be done with extreme caution as this is like a double aged knife. We talk of collateral damage here with this I mean that these drugs should be used in a manner that they are safe enough not to cause myriad problem such as addiction and dependence on these records.  Today there are millions of Americans who depend on these opioid drugs to overcome what might otherwise be agonizing, crippling pain. However, each year, the numbers of people who have become addicted to these drugs rise. The very same drugs that help them to overcome the pain are poising a great danger in their lives needless to mention the use of these drugs has led to death of many Americans. The main cause of these deaths is overdose. Prescription opioid overdoses caused more than 16,000 deaths in the United States in the year 2010 alone. This is for times the number of deaths that were recorded in 1999 to have been caused by prescription opioid overdose. In the past it was not  easy for both private and public health facilities to act on these unpleasant statistics but slowly they seem to lay strategies to curb the use of these opioid drugs and so far these strategies have shown positive results as very many lives have been saved not only in America but also in other continents.

The Centers for Disease Control and Prevention has cited Florida as one of the cities where the deaths have dropped owing to these strategies that have been employed by the health sector. The deaths dropped from 3201 as was in 2010 to 2666 in 2012. The report clarifies that most of these deaths were reduced due to reduction in prescription of these drugs to pain patients. There were fewer prescriptions to these opioid drugs as a result of in the policy that regulated the flow of these drugs. These policy changes led to a close of 250 of the state’s pill mills that were considered high volume pain medication dispensaries.

The United States remains far and away the world’s largest user of prescription opioids, with 259 million prescriptions written in 2012, according to the CDC — twice as many, per capita, as the next-largest consumer, Canada. A separate CDC report issued the same day as the Florida update showed that prescription rates vary widely among states. Now, when we take America out of the picture and we begin to find reasons why there are problems with the opioid medications we learn that one of the causes of these problems is;

Irresponsible prescription

Every patient entrusts his with the doctor, however in some situations this dependence may be abused either intentionally or unintentionally. Some doctors are opiophobiac and hence reluctant to give right doses to the patients while in some scenarios a patient may be handled by a doctor who is not experienced in pain treatment hence may either overdose or under dose the patient. Cases of overdose are a major cause of deaths from use of these pain drugs.

Another source of complication is, the patient may be afraid of these drugs as they are often portrayed negatively by the media. The fear of addiction and dependence may make a patient not to use the drugs as prescribed.

Due to the problems that were faced by both doctors and patients in dealing with the opioid medications, the universal precautions were developed to offer a structured rational approach to pain patients and serve “as a guide to start a discussion within the pain management and addictions communities. They are not promoted as complete precautionary measures but as a guide to opioid medications.

The difference between physical dependence, addiction and PSEUDO-ADDICTION

These three have different meanings. However they have always been confused causing fear among patients using these drugs. Physical dependence is the case that arises when a person has been using these drugs for some time. The body physically becomes dependent on these drugs so much that when you stop using them you will show signs of withdrawal. This is normal and happens with other medications not only with opiates.

Addiction on the other hand is a case when a person losses control of the drugs. He no longer can maintain the doses as prescribed but begins to take much more than the prescribed doses. In most cases those addicted to a drug will not accept that they are but will go through all hustles to satisfy their craving for the drug.

 What is pseudo-addiction?

opioidsWhen a pain patient on opioids begins behaving in a manner that most addicts do but in real sense he is not addicted, this is called pseudo-addiction. The patient will demand for more drugs because the doses he got have not settled the pain. They will even use more than the prescribed doses in a bid to cool the pain and are often early to request for more drugs since they overused the ones they were given to cool the pain . The difference between pseudo-addiction and addiction is the reason behind the need for more drugs; an addict needs more drugs to satisfy his craving while in pseudo-addiction a patient needs more drugs because of the pain.

You need more information to stay away from dependence on alcohol and drugs as these have crippled societies and that is why here at AWAREmed we are dedicated to finding the best solutions to addiction and dependence on substances. Dr. Dalal Akoury (MD) is always in the mood of helping any patient to be addiction free. Do not hesitate to call on her for help in managing any sort of chronic pain or any type of addiction as well as other diseases.

Better Use of Opioids to Curb Addiction and Dependence

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Opiophilia Replaced By Opiophobia

October 1, 2014

Opiophilia Replaced By Opiophobia the Pendulum Is Again In Motion

OpiophobiaThere are certain phenomena in the medical field that are rather hard to understand. We were brought up knowing that opioids and like substances were bad and should be avoided at all costs and we did that but as we grew and each of us went his way in matters there are mysteries that we met. As everybody else chose careers I chose to be here practicing medicine and I tell here my perception of opiates and like substances were changed here we use them as drugs especially as pain management drugs. To many people this may sound irrational. How do you use a drug that has dangerous effects to treat an illness? Don’t worry we had the same questions and curiously we waited to have these mysteries unraveled. We use these drugs in doses that are only able to address the pain and for a time that may not cause any serious health problems. However as patients were put on these drugs the whole medical industry work up to the realization that the use of these drugs in most cases resulted in the patients being addicted to the drugs and hence demanded more and more of these drugs. These drugs are rewarding in nature and so patients that are put on these drugs will automatically tend to crave for them. That is when opiophilia became a disease to be fought from all corners to help patients on these drugs to evade addiction and dependence on these drugs.

What is Opiophilia?

Opiophilia is a love of opioids, the love for opioids may not begin as a choice but may begin gradually when a patient is prescribed opiates to help him in pain management.  In the past the doctors had given a blind to the possibility of pain patients under opiate drugs to be addicted on these drugs as they believed that the dosage was not enough to make the develop dependence on these drugs. However as patients take these drugs they will become addicted as the drugs are rewarding in nature. This therefore means that before a doctor prescribes opiate to a chronic pain patient he should assess the patient and develop exit strategies that will help these patients avoid addiction.

Fortunately, the medical industry has fought opiophilia and better strategies have been put in place to ensure that patients on these drugs are safe. Opiophilia seems an already won battle. Apart from proper pain management by use of these drugs other natural ways of pain management have been embraced to help patients where necessary. These natural pain cures include Prolozone therapy, PRP and prolotherapy. These natural pain cures are now used worldwide to help patients with chronic pain.

The fight against opiophilia was won but that did not end all the problems associated with the use of opiates in managing pain in patients. Another disease came and replaced opiophilia and this is opiophobia.

Opiophobia is a disorder or affliction, so named because people affected have a great aversion to the use of prescription opioids for the treatment of pain, to the point where they will actually refuse to take or administer it. This is rather new disease in field of drugs and addiction. This term is also used to refer to instances when doctors fear or are unwilling to prescribe opioid medication to patients.

In most cases doctors who have had unwillingness to prescribe opioid medications are often counseled and so they go back to administer the drugs. Opiophobia should be addressed just as much as opiophilia since it is the opioid that goes deep in managing pain. This is because the only direct biologic pain-relief system in the human body is the endogenous opioid receptor system, consisting of endorphins and their tissue based action sites, or receptors. Using opioid based drug in pain offers instant relief and so the opiates still remain to be the best pain relief medication. The public as well as the doctors may be subject to opiophobia owing to the negative information that are spreading concerning the use of opiates in dealing with pain. The major concern of these groups is that they know that when a patient has used the opiates for a short term or long-term pain then he becomes addicted and will show symptoms of withdrawal once he stops using the drugs. This may be true but this is also true with other medications doesn’t a diabetic patient become dependent on insulin? Needless to mention several strategies have been put in place to ensure safe exit from the use of these drugs. When you are dependent on any drug for medical purposes. That is not abuse.

Because of opiophobia and opiophilia State regulators have been introducing legislation to severely curtail availability of opioid class of medication this unfortunately may be a disadvantage rather than an advantage as there are patients that are already dependent on these drugs needless to mention there is no alternative that has been put in place that can work effectively enough to replace opioid class of drugs in managing pain.

OpiophobiaExit strategy from opioid therapy

There is need for a safe exit strategy to help the patients evade any possible danger that may come from using the drug. However it is better for a doctor to formulate a safe exit strategy. He will be able to do so depending on such factors as; consistence of a patient’s behavior with drug addiction, patient’s willingness to cooperate with an outpatient-based opioid analgesic tapering plan, patient’s history with substances disorders. All these assessments will help the doctor to formulate a safer exit plan for the patient.

Here at AWAREmed we are dedicated to finding the best solutions to chronic illnesses and that is why Dr. Dalal Akoury (MD) is always in the forefront advocating for integrative medicine since it is only through integrative medicine that a person can be healed wholly. Do not hesitate to call on her for help in managing any sort of chronic pain as well as other diseases.

Opiophilia Replaced By Opiophobia the Pendulum Is Again In Motion

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Naltrexone and Alcoholism

September 30, 2014

Naltrexone promising for alcoholism and SUD

NaltrexonePeople addicted to alcohol and other substances may have certain behavioral changes that are not healthy for them and even for the people they live amongst. This therefore means that specific actions should be taken to offer them assistance as they fight addiction to be able to quite these unhealthy cognitive behaviors. Most people addicted to alcoholism and other substances of abuse will experience dysfunctional emotions, maladaptive behaviors and cognitive processes. All these need to be addressed to help the person to overcome. There are several therapies that can be used either singly or in collaboration with other therapies to help in this process. One of these therapies is the cognitive behavioral therapy often shortened as CBT.

Cognitive behavioral therapy (CBT) for substance use disorders has demonstrated efficacy when used as a monotherapy as well as when used with other treatment strategies.  There are articles that have been written that support the use of cognitive behavioral therapy, clinical elements of its application, novel treatment strategies for improving treatment response, and dissemination efforts. Although CBT for substance abuse is characterized by heterogeneous treatment elements such as operant learning strategies, cognitive and motivational elements, and skills building interventions across protocols several core elements emerge that focus on overcoming the powerfully reinforcing effects of psychoactive substances.  Apart from CBT there are also other methods that are used in treating people that are alcohol and other substances dependence. One of these options is the use of Naltrexone.

What is Naltrexone?

Naltrexone is a synthetic drug that is similar to morphine. It is used in treatment of alcohol and heroine addictions. It works by blocking opiate receptors in the nervous system. It helps people to stay away from alcohol as it lowers the cravings for alcohol.

Naltrexone is a medication that is FDA-approved for the treatment of alcohol dependence. Meta-analyses of studies on the impact of Naltrexone medication has demonstrated positive effects on outcomes this treatment was found to work even better in helping the addicts to abstain from taking alcohol. Based on the accumulated evidence of the effectiveness of this medication it received strong recommendations as evidence-based treatments for alcohol dependence in the National Quality Forum’s National Voluntary Consensus Standards for the Treatment of Substance Use Conditions, as well as the VA/Department of Defense Clinical Practice Guidelines for Management of Substance Use Disorders (SUD). Based on these guideline recommendations, the “VA Uniform Mental Health Services Handbook” states that naltrexone and another drug known as acamprosate should be offered and be made available to all Veterans diagnosed with alcohol dependence, if not medically contraindicated. Also noteworthy is that a recent meta-analysis of seven placebo-controlled randomized trials of a newer medication, topiramate, found it had a more positive overall effect size than that from the first seven trials of naltrexone. This therefore makes it is a very promising medication.

However with all the accumulated evidence, clinical practice guideline recommendations, and VA policy, implementation of these medications within the VA healthcare system has been low overall, and highly variable. Among the more than 200,000 VA patients with a documented alcohol dependence diagnosis, less than 6% have received an approved medication. The majority of VA patients with alcohol dependence diagnoses (65%) are never seen in specialty substance use disorder clinics. However, even among those seen in specialty clinics, prescribing rates remain below 10%, with rates varying from 0% to 21% across facilities. Extremely low prescribing rates and significant variation across facilities suggest that significant gaps exist in access to these medications. Owing to their effectiveness they should be made available to every patient.

In most cases the medications for alcohol and substance abuse dependence are approached as cocktail where various strategies are used in treatment of the patient. It is however recommended that naltrexone should be part of the treatment offered and made available to patients with alcohol dependence. This is because of their effectiveness in fighting alcohol as well as other substances dependence

The role of naloxone rescue in Heroin users

Naloxone is a drug that has found favor with most health experts owing to its effectiveness in fighting heroin overdose. For WHO it is an essential drug. The use of naloxone in health institutions is legal since it is approved by food and drug act (FDA).  Not long ago, the Food and Drug Administration approved a new hand-held auto-injector of naloxone. This device may be of great help to family members of heroin addicts as well as caregivers.

How does it work?

NaltrexoneIn case of and heroin overdose, the respiratory and central nervous systems are depressed to life-threatening levels and the addict may stop breathing. When this happens is no action is taken the patient may die. So when the person is treated with naloxone the drug will block the heroine receptors hence making it impossible for it to bind on the receptors that are located in the brain and spinal cord.

Finally, dependence to any substance is dangerous and so should be fought seriously. Here at AWAREmed we are dedicated to finding the best solutions to all addicts and that is why Dr. Dalal Akoury (MD) is always in the forefront advocating for integrative medicine since it is only through integrative medicine that a person can be healed wholly. Do not hesitate to call on her for help in managing any sort of drug addiction as well as other diseases.

Naltrexone promising for alcoholism and SUD

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Providing Understanding on Salvia divinorum and Kratom Mitragyna

September 28, 2014

Salvia divinorum and Kratom Mitragyna

Salvia divinorum is a plant from the mint family. It’s a species of sage and is grown in the Mazatec region of the Sierra Madre Mountains in Oaxaca, Mexico. It contains a substance called salvinorin-A, which is the most potent naturally occurring vision inducer. Salvia has large green leaves with white and purple flowers that typically grow in large clusters to more than 3 feet in height. The most effective component of this herb helps it in inducing hallucinations and today Salvia divinorum is the most potent naturally occurring hallucinogenic chemical. The use of Salvia divinorum began long ago among the people of Mexico. It was used for medicinal as well as spiritual purposes.

In Oaxaca, Mexico Salvia divinorum is a highly valued herb and they called it the “leaf of prophecy,” Diviner’s Sage, or Yerba de Maria because they believed it was the incarnation of the Virgin Mary. To them the Virgin Mary had reincarnated into Salvia divinorum and so you can picture how holy they treated this plant. The Mazatec people treat the plant with respect, praying to it before cutting it. American kids pretend it’s a party drug even though it doesn’t have the recreational effects of other drugs or alcohol. It’s best used for meditative states, spiritual purposes and exploring consciousness. Not for “partying.” It does not induce euphoria in those using it and so it is not suited as a party drug.

Salvia divinorum and Kratom Mitragyna

This herb can be used in various forms; it can be crushed and then the juice is then squeezed in a glass and mixed with water, it can be smoked and it can also be vaporized. The Mazatec people mostly chew and swallow fresh leaves re-hydrated dried leaves can be used as well. 26 leaves is a common dose, but the size of the leaves vary greatly. The effects come from the juice which is absorbed through mouth tissue, so it’s good to hold the leaves in your cheeks for as long as possible. This is to allow you to absorb more of the components of this herb. The Mazatec will sometimes crush the leaves on a stone into a pulp and squeeze the pulp to produce juice which is added to water, but this produces a weaker effect. It is also effective when vaporized, where the dosage should be 1 milligram or less. There are different ways of taking this herb and so every user can choose the method that works best for him.

Those who have taken Salvia can sometimes induce visions with spirals and recursions, loss of physical self, a feeling of being connected to the entire universe, a sense of understanding and peace, and severe distortions of time and space, sometimes traveling to other worlds or dimensions. It’s sometimes described as an entheogen, a word that comes from Greek, loosely translated as “making possible contact with the divine within.”

Salvia peaks in one to three minutes after smoking it and the effects when smoked last for five to 20 minutes. But taken orally, it’ll take 10 to 20 minutes to kick in and can last from 15 minutes to over 3 hours. So taking it orally is much better than smoking it. Most of those who try it for the first time roll it like cigarettes but this is not effective but instead leaves a person feeling dizzy. When taken for the first time it may impact differently. To some people it does not cause any effect in them but to some people it will cause intense effect that sometimes makes them stop after taking it once.

Some of the effects of Salvia

The most effective component in Salvia is salvinorin A, binds on the on the kappa opioid receptors in the brain, causing an altered perception of reality. The kappa opioid receptor is thought to have a role in pain control and certain psychiatric disorders. Hence it may possibly have an effect on pain. Some of the effects that come after using salvia include visual distortions, hallucinations, intense dissociation and disconnectedness from reality, physical or visual impairment, disorientation and dizziness. Synesthesia is possible, where physical sensations become intertwined and it is possible to “hear” colors or “smell” sounds!

Salvia is not regulated in most countries and so used without fear of intimidation from authorities but is a handful of states it has been outlawed. However there are discussions whether to regulate it or not.

Kratom Mitragyna

Kratom MitragynaKratom refers to the plant Mitragyna speciosa Korth .Is a plant that is mainly grown in Thailand. The Mitragyna genus, part of the family Rubiaceae, is found in tropical and sub-tropical regions of Asia and Africa. This plant is used for medicinal purposes in Thailand but is also used for its fine timber products. When used for medicinal purposes, the dominant effects seem to be similar to opiate drugs, and include analgesia and cough suppression. These opiate-like effects appear to be mediated mostly by delta and mu opioid receptors. In lower dosages, mitragynine exhibits a yohimbine-like binding to alpha-adrenergic receptors, as well as some binding to the delta opioid receptors. As doses increase, binding to delta receptors increases, and in yet higher doses, crossover to mu receptors occurs.

Possible Side effects

Using this  mitragynine  may result in a reduction in smooth muscle tone, local anesthesia, and central nervous system depression. It also causes dry mouth, increased urination, loss of appetite, and constipation coupled with small, blackish stools. However it does not cause vomiting nor nausea as common with opiates. When used heavily it may cause prolonged sleep.
It also causes anorexia and weight loss, insomnia, and a darkening of the skin, particularly on the cheeks. It also reduces sexual desire when used for a long time and is addictive when used in high doses. Addicts show such withdrawal symptoms as hostility, aggression, wet nose, inability to work, flow of tears, muscle and bone aches, and jerky limb movement. With all these side effects it’s therefore safe to avoid using Kratom Mitragyna.

Finally, Dr. Dalal Akoury (MD) is an experienced doctor who has been in the frontline fighting drug addiction. He runs a website that equips readers of better ways to overcome not only drug addiction but also serious health problems that have caused nightmares to the world population. Get in touch with her today and learn more.

Salvia divinorum and Kratom Mitragyna

 

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25-Nbome Series Are Deadly Hallucinogens

September 28, 2014

25-Nbome Series Are Deadly Hallucinogens

N-Bombs are members of the NBOMe ‘family’ of drugs. These drugs are very powerful hallucinogens, similar to LSD. However the way a person feels may be different from what another feels after using LSD. LSD is said to be much safer than 25-NBOMe Series. These drugs when taken changes the way a person see objects and reality. A person will see things that are not even in existent. It is however very funny that these drugs are majorly abused by people simply because the make you hallucinate. When a person uses this drug he is taken on a trip. This trip involves moments when a person feels like he is supernatural, he sees things that are not normally seen, he feels like he has broken all the boundaries of his mind and begins to understand how certain things work the way they do. However the trip can be good or bad, bad trips may take too long and cause a person to behave abnormally which may force him to be taken to hospital. When in good trips a person sees things that make him feel on top of his world, he becomes very contemplative. The colors become strong and everything seems bright. A feeling of happiness and euphoria is common and a person may laugh a lot.

25-NBOMe

The alterations in the senses of a user differ greatly. At times the distortions may pleasant, but sometimes very frightening (these are called ‘bad trips’). It may also become hard for a person to tell whether something is in motion or not. Something may seem to be in high speed while in real sense they are not even moving. Color, sound and objects can get distorted and you can experience double vision. N-Bomb‘s are also related to the 2C ‘family’ of compounds.

In most countries the use of the N-Bombs is illegal and anybody who is found in possession of these drugs can be jailed for quite a long time. The drugs are classified as Class A drugs. This therefore means that their use is banned. The decision to ban the use of these drugs came up when it was known that unlike the LSD that was thought of as a friendly hallucinogen the N-Bombs had severe effects on the users and even caused death. This means that in many countries today, if the police arrest you in possession of N-Bombs, they’ll always take some action. This could include a formal caution, arrest and prosecution.

Sold As Blotters and Tabs

N-Bombs were often sold as tiny squares of paper. These tiny squares are commonly called “tabs” or “blotters”. Blotters can come in various sizes, shapes, colors and designs. They were also sold in spray, powder and liquid form. It is possible that they will continue to be available in these forms now that they are illegal. The sellers of these drugs are often determined to find ways that they can use to peddle these drugs without being caught by the authorities. Do not be surprised when you hear that they are now sold branded as ‘phone screen cleaner’ or any other funny name. They are looking for better ways to beat the authorities and continue to reap large in this business.

25i_nbomeIt is reported that N-Bombs don’t work if swallowed, so they are usually placed under the tongue or held in the cheeks, where they are absorbed by the lining of the mouth. They can also be sniffed if in their powder form or absorbed via the nose or mouth if a spray form is used. The longer it is kept in the mouth the better for those using it.  Just like other hallucinogens there are a myriad ways through which it can be taken but there are cases that have been reported that snorting the drug is not so safe given that so many people who have been found killed by this drug had snorted it.

N-Bombs are very strong, with only a small amount needed to have an effect. The average dose of the N-Bomb 25I-NBOMe is between 0.00005 and 0.0001gram. Because of this it can be easy to overdose if you are using the powder or liquid forms of N-Bombs. The strength it has also makes it much cheaper as you will only need a smaller size of blotters compared to the size you would need to buy when using LSD.

When a person takes this drug the first feeling comes in at 15 minutes, with a sensation things have definitely changed. This vague feeling will lead to a heightening awareness and pupil dilation. Patterns are most visible. The stitching of your clothes, the veins on a leaf, the design of a ceiling tile. After 45 minute, it will have really set in. Edges will start gaining a fringe. At first it will be as if heat is distorting your vision, then the fringes gain color. There will be peaks and falls in between the first ten hours during a time that what you will see will be very difficult to tell to another person. The climax of these hallucinations will be marked by fractal patterns and pupil dilation. The use of these drugs has caused many deaths mostly because they are so strong that even a slight overdose leads to death. Needless to mention the doses are not easy to control.

Finally, Dr. Dalal Akoury (MD) is an experienced doctor who has been in the frontline fighting drug addiction. He runs a website that equips readers of better ways to overcome not only drug addiction but also serious health problems that have caused nightmares to the world population. Get in touch with her today and learn more.

25-Nbome Series Are Deadly Hallucinogens

 

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