Endogenous Opioids

October 4, 2014

Endogenous Opioids and Opioid Receptors

The term opioids are not new to many, it has been heard as the media is always abreast with all information about these opioid drugs which to the public are known mostly for the wrong reasons. People have got misinformed about these drugs so much that when you tell a layman that these drugs are used in hospital then to him you will something much worse than an alien. However to the medical fraternity these opioids are essentials that are hard to survive without. That said and left, back to the topic; Endogenous Opioids is a new term to many and if your prediction is as right as mine then you are hearing it for the first time. What does it really mean? The endogenous opioids are opiate-like substance, such as an endorphin, produced by the body. If you thought that you can live without these endogenous opioids then you need to wake up from your momentary slumber. Every day of our lives we face pain of all sorts even the most insignificant pains needs the actions of these opioids to give you peace.

Today, the endogenous opioid system is one of the most studied innate pain-relieving systems. The endogenous opioid system consists of widely scattered neurons that produce three opioids: beta-endorphin, the met- and leu-enkephalins, and the dynorphins. These opioids act as neurotransmitters and neuromodulators at three major classes of receptors, termed mu, delta, and kappa, and produce analgesia. The endogenous opioids works in the same manner as the narcotic opioids in that they bind to the same receptors and they also have both good and negative effects. There might be all sorts of information out there that you can lay your hands that may speak well of the opioids but the bitter truth is we all depend on despite the negative light they have been portrayed in.We are all naturally dependent on opioids for our emotional health. Both narcotics and internally generated endogenous opioids exert their action on the body by interacting with specific membrane receptor-proteins on our nerve cells.

There are three large pro-compounds that are produced by the body and these are: proenkephalin, prodynorphin, and pro-opiomelanocortin. However, endorphins can further decompose to small fragments, oligomers, which are still active. Oligomers pass the blood-brain barrier more readily. Enzymatic degradation of small-chain endorphins is accomplished by dipeptidyl carboxypeptidase, enkephalinases, angiotensinases, and other enzymes. This limits their lifetime in the unbound state.

Presynaptically opioid receptors inhibit transmission of excitatory pathways. These pathways include acetylcholine, the catecholamines, serotonin, and substance P. Substance P is a neuropeptide active in neurons that mediate our sense of pain. Endogenous opioids are also involved in glucose regulation. Opioid receptors are functionally designated as mu, delta, kappa among others. These categories can be further sub-classified by function or structure. Decoding the human genome has allowed the genetic switching-mechanisms that control the expression of each opioid receptor to be determined at the transcriptional and post-transcriptional level.

Opioid-driven inhibition of neuronal excitability is mediated by the activation of a variety of potassium channels in the plasma membrane. The disparate subjective and behavioral effects evoked by activation of the different categories of opioid receptor are typically not the outcome of different cellular responses, but reflect the different anatomical distributions of each receptor. Unlike kappa opioid receptors, however, both mu and delta opioid receptors internalize on exposure to agonists. Activation of any type of opioid receptor inhibits adenylate cyclase, resulting in a fall in intracellular cAMP and diminished action potential firing. This causes a reduced flow of nociceptive information to the brain. Conversely, opioid addicts undergoing withdrawal suffer elevated cAMP levels and enhanced protein kinase A activity, resulting in increased neurotransmitter release.

Role of Mu receptors in addiction

The Mu opioid receptors are the gateway to addiction. This is because they mediate positive reinforcement following direct or indirect activation. In an experiment where mice without mu receptors were used, it was found that the morphine’s analgesic and addictive properties are abolished in these mice. This shows that mu receptors mediate both the therapeutic and the adverse activities of opioids. The mice that were lacking mu receptors were found to lack of morphine-induced analgesia, reward, and dependence. The mice had increased sensitivity to pain. This shows that the mu receptors play a critical role in addiction. These mu receptors function as switches upon direct or indirect reinforcement of opioid abuse. Mu-opioid receptors are a key molecular switch triggering brain reward systems and potentially initiating addictive behaviors. The lack of mu-receptors abolishes the analgesic effect of morphine, as well as place-preference activity and physical dependence. This receptor therefore mediates therapeutic analgesia and adverse activities of morphine.

Opioid withdrawal symptom

endogenous opioids When a person has been using the opioids for some time, he will become physically adapted to the drugs so much that when he stops abruptly he will experience the symptoms of withdrawal. Withdrawal is not only faced by opioid user only but also other sick people who are on other drugs as well. However to limit the withdrawal symptoms, there are some factors that come in handy. One of these factors is the pace and how you exit from using these drugs. Your doctor will be of help in helping you by developing safe exit strategies that will limit the withdrawal symptoms.

Finally, 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.

Endogenous Opioids and Opioid Receptors

Types of Opioids and Their Uses

October 4, 2014

Type of Opioids, Their Uses and Side Effects

Opioids are drugs that many people cannot do without. They are essential in hospitals as they are the most effective drugs that can be used to aid the pain patients. Diseases such as cancer are synonymous to pain and in some situations going through the treatments will be very painful and therefore there is need for a drug that will work in different ways to curb the pain that may be disabling to the patient. Chronic pain in itself presents a torture to the patient and without pain relievers, such pain may cripple a patient. The opioids are not news to many years; people know them some as dangerous drugs that should never have been created in the first place. While to many they has become very valuable essentials that they cannot survive without- the pain patients (and even addicts). However, people are not always informed about the given types of opioids. The opioids are mostly classified according to their source. There are opioids that are naturally extracted from the poppy plant and used without designing or any other further processing. These will fall under natural opioids. Opioids may be extracted from the poppy plant but then is further processed. This group is referred to use semi-synthetic opioids while there are some that are some opioids that are processed in the labs. The opioids falling in this group are known as synthetic opioids.

The naturally sourced opioids

The natural opioids are those that are naturally available from the poppy plant. After extraction they are not further processed in a manner that will deplete their contents. Some of these natural opioids are used as pain relievers in hospitals.

Here are examples of the opioids;

Morphine

Morphine is naturally extracted from poppy plant. It is the most dominant opiate in the poppy plant. It was the first active ingredient that was extracted from the poppy plant. Apart from morphine there are also other alkanoids of different types that are found in the opium. The major source of morphine is a chemical extraction from opium.

Despite its use in hospitals for pain relief in patients with intense pain, morphine has a high potential of addiction, tolerance and psychological dependence which develops very rapidly. However psychological dependence takes a little bit longer to develop and may take several months. With morphine, tolerance to respiratory depression and euphoria develops more rapidly than tolerance to analgesia.

Thebaine

Thebaine is naturally available in small quantities in opium. It is also known as Paramorphine. It is white, crystalline, slightly water-soluble and poisonous alkaloid. The Thebaine-Constituent of Raw-Opium is normally between 0.2% and 1.5%. However higher amounts have been reported. It is not used for therapeutic or recreational purposes, but is converted industrially into a variety of compounds such as oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, buprenorphine and etorphine.

In the past thabaine was believed to have no properties that were like those of morphine. However there are many studies that have found that thebaine has a considerable potential for dependence both psychological and physical when used in large doses for a long period of time.

Codeine

Naturally extracted from the poppy plant, codeine is used in hospitals as a narcotic pain-reliever and cough suppressant. It functions similar to morphine and hydrocodone. Moreover, when taken a small amount of codeine is converted to morphine in the body. However the mechanism of action of codeine is not known but just like morphine, codeine binds to opioid receptors in the brain. These receptors are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. Despite its ability to suppress coughs and enable pain tolerance, it has the following side effects, noisy breathing, sighing, slow breathing with long pauses between breaths, drowsiness and blue colored lips.

Semi-synthetic opioids

This is a group of drugs that are naturally extracted from the poppy plant but are further processed before they are used. An example is heroine.

Heroine

Comes from the opium poppy but is further processed. When pure it is a white powder that has a bad taste. Some heroin is dark brown, and black tar heroin is either sticky or hard and looks like roofing tar. It has pain relieving properties. Unlike most pain relieving narcotics that are accepted in most states when prescribed by doctors, heroin is illegal in most countries basically because it is highly addictive and has quite grave side effects. Some of the withdrawal symptoms include; sleeplessness, bad chills and sweats, muscle pain, stomach cramps, nausea, vomiting, and diarrhea.

Synthetic opioids

These are opioids that are made in laboratories. They include;

Methadone

Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs and is only available from certified pharmacies. This drug helps reduce the severity of withdrawal symptoms that are suffered by heroin addicts when they stop using heroin. Some of its side effects include; rapid heart rhythm, severe dizziness and chest pain among others.

Oxycodone

This is an FDA approved drug for use in pain relief as well as suppressing coughs. This drug is a strong pain reliever and works better for both opioids moderate and severe pain. It increases tolerance to pain hence eliminating discomfort. It also causes sedation. May cause very severe side effects when mixed with alcohol. Cases of death have been reported.

Fentanyl

Fentanyl is an opioid medication that is used for anesthesia to help prevent pain after surgery or any other medical procedure that may result in moderate or severe pain. It is injected in the muscle or in the vain through IV. It is mostly used before surgery. Side effects include severe dizziness, drowsiness and impaired reactions.

Finally, 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.

Type of Opioids, Their Uses and Side Effects

Benzodiazepine Withdrawal

October 3, 2014

Benzodiazepine Withdrawal and How to Help the Patient

Benzodiazepine The use of any other drug of abuse comes with some of the most undesired side effects. Before we go deep into this topic we should have at least a basic understanding of these terms.

Withdrawal- This term may have different meanings but to many it is associated with getting money from your bank account. That is right but here it means something completely different. Withdrawal in relation to drugs is a term that refers to the feelings of discomfort, distress, and uncontrolled desire for a substance that takes place when a person stops using the substance. For there to be withdrawal, a person must have used a certain substance for quite a good time that his entire body had become adapted to the substance. When a person has used a certain substance for a long time his body may become dependent on the substance to accomplish some critical functions of the body. When a body is metabolically adapted to the use of a certain drug, when a person stops using that drug he will suffer some defects. He will have physical symptoms of withdrawal and these may differ in severity. Some may be mild and flu like while some symptoms of withdrawal might be so severe and life threatening.

What is Benzodiazepine?

Benzodiazepine’s parent compound of several psychoactive drugs (e.g. nitrazepam, temazepam and diazepam) used as anxiolytics,sedatives and hypnotics; they do not specifically contraindicate local anaesthetics, but as they can cause drowsiness, ataxia, dysarthria andimpaired consciousness, their concomitant use could mask early signs of toxic effects of local anesthetics.

This drug was used in clinics mostly as a tranquilizer. However this drug has potential to be abused. These medicines should be used in a hospital setting or better yet with directions from a physician. However other people are using these drugs for their sedative and intoxicating purposes. Benzodiazepine are addictive drugs and when a person uses them for so long he may reach dependence, it is attempts to stop using these drugs after dependence that results in withdrawal. Just like with any other drug of abuse physical symptoms of withdrawal will appear when you stop using Benzodiazepine after using it for quite along time. There are myriads of symptoms that occur while you stop using these drugs but for this article we will handle just a few.

Some of the Withdrawal symptoms when one stops using Benzodiazepine

Seizure

Seizures are caused by abnormal electrical activity in the brain. However a people who have epilepsy are often considered having a seizure disorder this will require medication. Other factors that may cause seizures are low blood sugar level which is common in diabetic patients. Patients suffering from meningitis often suffer seizures as well. However using some drugs may lead to some dependence of brain cells on the drugs so much that when a person stops using the drugs then it may beckon abnormal electrical activity in the brain thereby causing seizures.

The outward effect of seizures can vary from uncontrolled jerking movement (tonic-clonic seizure) to as subtle as a momentary loss of awareness (absence seizure) in this state the patient may lay flat without even moving an inch.

Rebound Anxiety

When a person suffers anxiety disorders and walks into the hospital, the most likely drug that he will be prescribed will be the benzodiazepine. These drugs are known to work well in addressing anxiety disorders however these drugs have a share of the darker world too. They have other side effects that are quite serious. One of these serious side effects includes the rebound effect. When these drugs were used to cure anxiety disorders and then stopped the patient will become even more anxious which may in itself lead to even more problems. The disadvantage of using these drugs for anxiety is that you will become dependent on them so much as to cause rebound anxiety.

Insomnia

Typically insomnia is the lack of sleep. Insomnia is a symptom of a disease and not a disease in itself. Insomnia is often defined as inability to either initiate or maintain sleep or both. For anybody to have a sound sleep there are hormones that work. These hormones are subject to drug activities and this explains why Benzodiazepine may cause insomnia.

Intravenous Amino Acid Therapy for Benzodiazepine Withdrawal

What happens during addiction is that Neurotransmitters are damaged. There is need to restore the neurotransmitters if the normal functions of the body are to be reached. One fact however is that these neurotransmitters are made from amino acids and these amino acids control nearly every aspect of the neurotransmitters. Dependence or addiction on benzodiazepine destroys these neurotransmitters hence to help person overcome cravings for more of benzodiazepine among other withdrawal symptoms there is need to restore the neurotransmitters. Amino acid can be given intravenously to the patient, this is effective as IV delivery bypasses the digestive system hence effective in restoring the neurotransmitters. IV delivery of the amino acids helps even patients whose digestive systems have been affected by addiction to drugs, alcohol and other substances.

NAD and Intravenous Amino Acid Therapy for Benzodiazepine Withdrawal

Benzodiazepine Nicotinamide adenine dinucleotide (NAD) is a coenzyme derivative of vitamin B3 – otherwise known as niacin. This coenzyme is found in all living cells. It is a key metabolism agent as well as many other basic cellular processes. Addicts are often low in energy and because NAD is essential in energy production its supplementation can be of benefit to the addicts. When used in mega doses it helps in making detoxification more rapid. It is given in IV form to reduce the cravings for addictive substances in addicts without exploring replacement therapies. This method of treatment has been used for quite a good time and has been very successful especially on those addicted to prescription drugs like opiates, benzodiazepines and even on cocaine, alcohol and other drugs.

Drug Addiction is a vice that should be fought by all means that is why we at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts and offering them a place to call home. It does not matter what kind of addiction you are wrestling with right now, just call on Dr. Dalal Akoury (MD) today and begin your journey to victory against addiction.

Benzodiazepine Withdrawal and How to Help the Patient

Gabapentin and Alcohol Dependence

October 3, 2014

Gabapentin Is Useful In Fighting Alcohol Dependence

Gabapentin also known to many as Neurontin is an anticonvulsant and analgesic drug. This drug was originally developed to treat epilepsy however it also works well in relieving is neuropathic pain and is now used for pain relief in most hospitals worldwide. It is recommended as a first line agent for the treatment of neuropathic pain arising from diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. This drug may also be prescribed for other off-label uses such as treatment of restless leg syndrome, anxiety disorders, insomnia, and bipolar disorder. There are, however, concerns regarding the quality of the trials conducted and evidence for some such uses, especially in the case of its use as a mood stabilizer in bipolar disorder. More research needs to be conducted to ascertain the use of this drug as a mood stabilizer in bipolar disorder.

Gabapentin Versus Chlordiazepoxide for outpatient alcohol

Benzodiazepines are used to treat alcohol withdrawal (AW) but they are known to cause cognitive impairment, sedation, and ataxia, and interact with alcohol. Nonbenzodiazepine anticonvulsants are promising and possibly safer alternatives for the treatment of Alcohol Withdrawal.

There several studies that have been conducted on this area especially comparing gabapentin and Chlordiazepoxide. In one of these studies the objective was to find out which of these two medications was safe and effective rather the objective was to compare the safety and effectiveness of these two medications. In this study the patients were divided into two groups. The first group was given gabapentin while the other group was given chlordiazepoxide. The subjects were then monitored after 7 days alcohol abstinence, withdrawal severity scores, adverse events including ataxia, sedation, cognitive function and alcohol craving. The results of this study however were never published. To others it may seem useless speaking about a study whose findings was not even published but the very existent of the research speaks volumes. For a fact it shows that chlordiazepoxide that had been used in the past in dealing with patients of alcohol withdrawal had some inefficiencies or had some serious side effects that needed to be corrected therefore a better medication was indeed needed to replace it. However, this is the authors own opinion lets proceed to other research studies that had been done on this subject.

There is also another study whose objective was to compare follow-up measures of Epworth Sleepiness Scale (ESS), Penn Alcohol Craving Scale (PACS), ataxia rating, and Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar) symptoms between alcohol-dependent individuals randomized to treatment with gabapentin or chlordiazepoxide. In this study it was found that in ambulatory veterans with symptoms of alcohol withdrawal, gabapentin treatment resulted in significantly greater reduction in sedation (ESS) and a trend to reduced alcohol craving (PACS) by the end of treatment compared to chlordiazepoxide treatment. Although limited by the small sample size, the suggestion of reduction in sleepiness and less craving warrants replication of the study with a larger sample.

Gabapentin with Naltrexone for the treatment of Alcohol Dependence

In the fight to overcome alcohol dependence various strategies are used. In some cases a single drug maybe used successfully in fighting alcohol while in other cases two or more drugs may be combined for the same course to help fighting alcohol dependence more effectively. Gabapentin can be used singly to fight alcohol dependence but it can also be combined with naltrexone for more effective action against alcohol dependence.

There are some research studies that have been done on this subject and findings published. In a July 11, 2011 Raymond F. Anton, MD, professor of psychiatry at the Medical University of South Carolina, and colleagues reported their findings in the July issue of the American Journal of Psychiatry.

The report indicated that the addition of gabapentin to naltrexone improved drinking outcomes compared with naltrexone alone in heavy drinkers during the first 6 weeks after they stopped drinking, but when the gabapentin was stopped the effects became the same in both groups, so this shows that gabapentin was indeed responsible for the positive effects.

“From work in mice and rats we know that the underlying biology of alcohol dependence, particularly alcohol withdrawal, is mediated by two neurotransmitters — GABA [gamma-aminobutyric acid] and glutamate. Alcohol use causes these neurotransmitters to be abnormal and, particularly during alcohol withdrawal, to cause significant symptoms,” Dr. Anton told Medscape Medical News.

“We knew that the drug gabapentin works through these systems to normalize the balance of the glutamate and GABA systems in the opposite direction to what alcohol does, and we had done previous studies with gabapentin in mice and in humans showing that it reduced the symptoms of alcohol withdrawal. That led to our hypothesis that using gabapentin, particularly during the first 6 weeks of attempts at abstinence, might improve the efficacy of naltrexone,” he explained.

gabapentine This study used randomly selected 150 alcohol dependent individuals who were put on a 16-week course of naltrexone, 50 mg/d alone; naltrexone, 50 mg/d, plus gabapentin up to 1200 mg/d for the first 6 weeks; or to double placebo. They also received medical management. Most of these participants were in their mid-forties. They were dependent on alcohol and drank 12-13 alcoholic drinks per day before the study entry. By week 6, about 50% of the individuals randomly assigned to placebo or naltrexone alone had a heavy drinking day, compared with about 35% of individuals who got naltrexone plus gabapentin. But by week 16 of the study, there were no differences between the groups. This show that gabapentin works better when combined with naltrexone than when naltrexone is used alone.

Dependence on alcohol and drugs is vice that has 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 as well as other diseases.

Gabapentin Is Useful In Fighting Alcohol Dependence

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 Mitragyna Kratom 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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