Tag Archives: Opioid dependence

Opioid-Abuse

Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders

March 11, 2016

OpioidsMore often than not, pain and abuse of substance exist together and their co-existence makes treatment of one without the other difficult. In most cases, if the pain is to be addressed, then the substance abuse has to be dealt with first. Opioids are compounds that look like opium in their addictive properties or psychological effects. They are sometimes used as pain relief whenever patients are in severe pains and other pain reliefs seem to be inefficient. Opioids are narcotics and as such are to be used moderately to prevent addiction. This is why when there are cases with patients who are already used to substance abuse, using Opioids tends to just aggravate the problem of substance use. These challenges in using opioids to treat pain in persons with substance use disorders are what this article seeks to talk about.

Pain and Substance use

16 to 24 percent of Americans have been reported to have problems with alcohol abuse. 8% out of the total American population, from 12 years and older, do have a problem with illicit use of substance within a given month. Substance use disorders have been seen to be more significant in medical populations. For instance, 19 to 26% of hospitalized patients have substance use disorders, 40 to 60% are people that have sustained a major trauma, 5 to 67% are those who have been or are being treated for depression. From the above, it can be seen that the treatment of chronic pain poses challenges as the patient may just pick up an appetite which may be hard to shake off, long after their stay in the hospital.

Clinical and Ethical Challenges

Persons who have had a history with substance use are less likely to have an effective pain treatment. It is not as if the pain treatment is not effective but because such people are used to substances which have considerably altered or increased their tolerance and adaptability for such substances, even the most potent pain relief in their right doses will appear ineffective. This is where opioids come in.

Mild to moderate pains can easily be taken care of with physical modalities such as ice, rest and splints but when pains are severe, opioids appear to be one effective way of managing them. Clinicians are however concerned that opioids may be misused by patients. Opioids use in patients with substance use disorders does not only raise complex clinical issues, it also raises ethical issues. This is where the challenge lies. Principles of justice and beneficence demands that all persons have equal access to an effective pain treatment. However tension sets in when such persons are used to substance as the principle of non-maleficence asks that a medical practitioner ‘do no harm’ first when there are concerns about misuse which may cause harmful consequences.

Multidimensional Nature of Pain

Pain is multidimensional in nature. This is another challenge posed to treatment of pain. Pain is subjective, rather than objective, making it hard to actually verify if it exists. Since they are transferred by sensory and emotional experience, one can actually have pains without any physical signs that corroborate this. Therefore, since pain cannot be verified to be existent or not, it is advised that all clinicians attend to all cases of pain seriously. Some patients have the knowledge of this and may often feign pain in order to obtain opioids for non-pain related cases. Also, a patient with addiction who also has pains may not be able to properly coordinate or tell where the pain ends and a craving for opioids begins because actually, it may feel the same way. For instance, pain complaints come with distress calls, and when craving starts as well, the patient may show signs of serious distress. The chronic pain disorders’ spectrum as against addictive disorders is the same for everyone making it hard for actually append treatments accordingly. In patients with no past history of substance abuse, administering opioids is a whole lot easier than when it has to be administered to patients who history of substance abuse because it is very hard to tell when they are actually in need of opioids for pains.

In cases where clinicians are not sure, they have been taught to ask questions such as asking the patient how intense the pain is and asking them to describe their pains on the scale of 0 to 10. Sometimes, this may be useful in knowing the intensity of pain and at other times, some other methods needs to be worked up. In cases where pain seems to be persistent, not only the pain is assessed, the impact it will have on the individual receiving pain treatments will also have to be accessed. Such impacts as how it affects sleep, mood, stress level, work functions and recreational activities.

The challenges in using opioids in treating pains in persons with substance use disorders is high and complex and in most cases, clinician tend to evaluate the results. If the patient seems to get better by the use of Opioids, they should generally not be too concerned about the addiction. What can be done is to supervise the use on a short-term basis.

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Necessities of identifying courses of narcotic abuse

September 17, 2015

Necessities of identifying courses of narcotic abuse: Diagnosis of Narcotic Abuse

Necessities of identifying courses of narcotic abuse

Necessities of identifying courses of narcotic abuse will help you get out in the thickest of nicotine addiction

When addressing the necessities of identifying courses of narcotic abuse, it is very important that we appreciated that the whole process of diagnosing narcotic abuse and dependence is very complicated. This is so because users are not ignorant of the fact that their drug use activity is prohibited, illegitimate and illegal. Speaking to the experts at AWAREmed Health and Wellness Resource Center under the able leadership of doctor Dalal Akoury (MD) and founder of the facility, it is evident that physiologically, the user’s brain requires the drug as a substitute for endorphins, this often makes it very difficult for users to stop regardless of whether or not they recognize the problem. It is therefore possible that drug dependency in many situations may be discovered by friends or family members and even this will still have some challenges associated with stigma thereby causing the families to deny or avoid the problem. But addiction being what it is, in most cases with or without anyone speaking about it, somewhere along the way something in the life of the user will reveal his or her dependence. Difficulty at work; criminal activity (e.g., theft, forgery); prescription records gathered by insurance companies and doctors; withdrawal; or the discovery of an illness, like HIV infection, may uncover the problem.

Besides all these the physical signs of drug dependence, like injection marks on the skin, deterioration of nasal tissue from snorting and constricted or dilated pupils may be present. Therefore the process of ascertaining the truth may involve screening for the presence of narcotics in the body by carrying out laboratory tests, like urinalysis or hair analysis. However doctor Akoury registers that testing alone cannot determine the length of time that drugs have been used. In that case differential diagnosis may be necessary in cases where signs indicate nonnarcotic drug use or the presence of a medical condition. Like for instance benzodiazapine and barbiturate use can produce symptoms similar to narcotic intoxication and withdrawal. Hypoglycemia (low blood-sugar, fatigue), electrolyte imbalance, head or brain injury, and stroke can produce delirium and cause slurred speech, inability to concentrate, and impaired memory, which are also signs of intoxication.

Necessities of identifying courses of narcotic abuse: Narcotic Abuse Course

According to the experts at AWAREmed Health and Wellness Resource Center, the exact age for drug use is not always very clear owing to the fact that the effects of narcotics can be felt even before birth, however socially the average age range of onset for drug use is 18 to 25. The most painful fact about narcotic use is that those who are using narcotic drugs be it within this rage or otherwise, usually progress the usage to drug dependency says doctor Dalal Akoury. She is also making emphasis that narcotic addiction may develop after medical treatment as well. Like for instance some users often become dependent on the euphoric effects of narcotics following surgery or long-term treatment for pain. It is likely possible that those risk factors for drug abuse are present in such individuals even before treatment.

Necessities of identifying courses of narcotic abuse: Complications of narcotic abuse

The necessities of identifying courses of abuse cannot be ignored at this point of time. We are living in a world that is saturated with serious infectious diseases like AIDS, hepatitis, and tuberculosis which may also develop during the course of drug dependency. And as a matter of facts in some (if not most) large, urban areas, it is estimated that up to 60 percent of those dependent on heroin are infected with the HIV. And besides that tracks, visible puncture scars, are caused by repeated injection especially with heroin and cocaine users. Experts are raising the red flag that scarring of the veins may lead to swellings this is because many users switch from the veins in the forearm to those in the feet, inside the thigh, or in the neck while others stop using veins and inject directly into the first layer of skin a practice that is commonly known as “skin-popping.” When this practice is done consistently over a period of time, it will eventually lead to the development of cellulitus which is an infection into connective tissue, and abscess, where cell death causes pus to collect beneath the skin. Round, healed scars are common signs of skin-popping.

Doctor Akoury reiterates that being addicted to drugs is not only health hazardous but also brings on board other complications that can really bring your life and that of your loved ones to a standstill. Take for example criminal activity that are associated with drug dependency like theft and forgery (of doctors’ signatures), as well as the transportation, sale, and production of illegal substances. All these can land users into serious problems with the law enforcer’s agencies thereby leading to the pillar or bread winner of the family being imprisoned. The trauma, stigma and discrimination that come with it may be unbearable to the family and more so the children in school. In spite of all these doctor Akoury says that all is not lost because the situation can be remedied by seeking for treatment in good time. She says that it is always very important that when you have noticed that you are struggling with any form of drug, immediate treatment must be sought. This way the effectiveness of your treatment will be less complicated since most of your body organs shall have not been affected by the scourge of addiction. Therefore for quick solution to your addiction problems to all kind of narcotics, schedule for an appointment with the experts at AWAREmed Health and Wellness Resource Center for a thorough evaluation to be done with a view of starting you on the right king of treatment program the will deliver back your health to you for comfort and full enjoyment thereafter.

Necessities of identifying courses of narcotic abuse: Narcotic Abuse Prognosis

Finally it is important to note that the estimated death rate in those dependent on narcotics includes death by overdose as well as by murder associated with drug-related crime. From the various studies, it has been established that the death rate increases by 2 percent for every year of use and the translation of that is that those who have been using narcotics say for the past 10 years stand a 20 percent chance of drug-related death. In 2013, drug overdose deaths surpassed car crashes and the leading cause for injury death in the United States. This raises great concern on the urgency with which lasting solution must be sought. Don’t therefore weight until it is too late, take action now.

Necessities of identifying courses of narcotic abuse: Diagnosis of Narcotic Abuse

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The benefits of Detoxification to various drugs

June 18, 2015

The benefits of Detoxification to various drugs: The process it takes to detox

The benefits of Detoxification to various drugs

The benefits of Detoxification to various drugs is the starting point of a meaningful treatment of drug addiction

With the advent of drug addiction in our societies, efforts are being made every day to deliver lasting solutions to this problem of drug addiction. One of the treatment processes of drug addiction is detoxification which is seen to be the first step. Of course this comes after the patient has come to the acknowledgement of the problem thereby giving the authority to commence any meaningful recovery treatment process. Somebody ones ask me that “what are the benefits of detoxification to various drugs if the victim is in denial?” surely this is worthy and we want to build on it to establish the real benefits that will come as a result of detoxification process. We are privileged to have Dr. Akoury, a veteran expert in addiction, MD and also the founder of AWAREmed Health and Wellness Resource Center which is one of the leading pioneers in natural and holistic addiction treatment in US to take us through the discussion of unlocking the truths about the benefits of detoxification to various drugs. This expert has been of help to many in her over two decades of practice and she will be the same to you. All you need to do on your part is to schedule for an appointment with her now for the commencement of your journey to drug addiction recovery.

And now to the discussion doctor Akoury says that medical detoxification is a process that applicable in the systematic and safe withdrawals of people from addictive drugs. The process of detoxification is not a home-made thing but it is a medical process which is usually done under the care of a physician. It is important to note that drinking alcohol or using drugs can cause physical dependence over time and stopping them can result in withdrawal symptoms in people with this dependence. The detoxification process is therefore designed to eliminate the immediate bodily effects of stopping drug use and to remove toxins left in the body as a result of the chemicals found in drugs being abused or alcohol.

The benefits of Detoxification to various drugs: The plat form of doing detoxification

It is important to note that this treatment process of detoxification is done in close supervision by the physicians and it can be done on both an outpatient basis at mental health centers, addiction clinics or private clinics or inpatient at a hospital or residential treatment center.

  • Inpatient detoxification allows the patient to be closely monitored, prevents use of the substance of abuse, and can speed up the process of detoxification.
  • Outpatient detoxification has the advantage of being less disruptive to the patient’s life and less expensive.

The choice of setting depends on many factors such as the drug of abuse, amount and length of history of abuse, psychosocial issues, patient’s age, and co-existing medical and/or psychiatric conditions among others. While treatment centers often have their own detoxification facilities, others make arrangements for their patients to use detoxification programs at nearby sites, including hospitals and clinics. There are several substance of abuse but for the purpose of our understanding of the importance of detoxification doctor Dalal Akoury is going to shade some light on the following:

The benefits of Detoxification to various drugs: Alcohol Detoxification

We have already mentioned that medical detoxification is a process that is used to systematically and safely withdraw people from addicting drugs, usually under the care of a physician. And that drinking alcohol or using drugs can cause physical dependence over time and stopping them can result in withdrawal symptoms in people with this dependence. We also mentioned that the detoxification process is designed to treat the immediate bodily effects of stopping drug use and to remove toxins left in the body as a result of the chemicals found in drugs or in alcohol.

The intensity of the problem is that many patients struggling with drug addiction are experiencing mild to moderate symptoms during withdrawal from alcohol and can undergo detoxification without medications if they receive supportive care and monitoring. However experts at AWAREmed Health and Wellness Resource Center conquers that inpatient medical detoxification services are the most appropriate for alcoholics who are at risk for serious complications of withdrawal or those with co-existing medical conditions. In consultation with your doctor, it is advisable that these patients and those with previous alcohol withdrawal seizures, delirium tremens, or moderate to severe withdrawal symptoms should receive benzodiazepines to reduce the risk of adverse events. Remember that other than benzodiazepines, other medications have also been used in the detoxification process including clonidine, which can help reduce symptoms such as tremor, mild depression, elevated blood pressure, anxiety and tension, and carbamazepine, an anticonvulsant medication used to prevent seizures or delirium.

Even though time spent with the doctor is the only difference between inpatient and outpatient detoxification, studies has established recently that, outpatient detoxification has also shown to be as effective as inpatient treatment and less costly for people with less severe alcoholism. This requires daily follow-up and monitoring. It is therefore worth noting that outpatient detoxification is commonly performed by using a tranquilizer such as chlordiazepoxide 50 mg, oxazepam 15 to 30 mg, diazepam 10 mg, or lorazepam 2 mg every 6 hours for the first 24 hours. However additional medication can be provided as is medically necessary and doses can be decreased as symptoms resolve. Supportive care for patients undergoing detoxification includes providing treatment for nutritional and electrolyte deficiencies, monitoring withdrawal severity and abstinence, and providing referrals to alcoholism recovery programs and self-help meetings. All these are services that on scheduling for an appointment with doctor Dalal Akoury will all be at your disposal.

Finally we have only discussed alcohol detoxification in this article, nevertheless we are going to continue with the discussion with the remaining two in our next article and I know you don’t want to miss that too. In the meantime it is also important to note that doctor Akoury is also running projects including trainings through organized conferences for professionals in the addiction discipline. Currently AWAREmed Health and Wellness Resource Center, one of the leading pioneers in natural and holistic addiction treatment, will be conducting the first Educational, Functional and Integrative Addiction conference for doctors, counselors, nurses and addiction therapists. The conference will be August 23-25 in Myrtle Beach, South Carolina. This new frontier in Addiction Medicine will be conducted by the most influential group of leading visionaries specializing in the latest advances in natural and integrative addiction medicine, under the theme “The Future of Integrative Addiction”. This is an opportunity you don’t want to miss, for more information you can log in to www.integrativeaddiction2015.com or email sharon@integrativeaddiction2015.com. We will be glad to have you in the conference and it will be great to learn from the best of the best who are specializing in the latest advances in natural and integrative addiction medicine.

The benefits of Detoxification to various drugs: The process it takes to detox

 

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Naloxone and Sex Addiction

May 23, 2015

The Role of Naloxone in Sex Addiction

NaloxoneSex addiction is not yet recognized by the American Psychiatric Association as a distinct diagnosis and they coat it in names like hypersexual disorder but are just that, it doesn’t reduce the severity that those addicted to sex suffer. Sex addiction is one of the most common addictions today that many teens as well as adults alike are enslaved to. Sex addiction has been on the rise thanks to the digital age that has availed pornographic materials at the click of the button. Just like with other forms of addiction exposure to erotic movies, books and pornographic clips play a role in escalating the rates of addiction generally and increasing an individual’s chances of getting into the bottomless abyss of sex addiction.

However, there is a misconception that sex addiction is just about sex, Robert Weiss the director of Sexual Recovery Institute in Los Angeles is quick to rubbish this, he says that sex addiction isn’t just about sex but rather the obsession about sex. Sex addiction is characterized by compulsive sexual thoughts and actions. If a person has a sex addiction he will no longer have the power to control the sexual desires that will crawl his mind all the time. When a person is addicted to sex he loses his will not only in controlling his/her desire for sex but he will also lose focus on other aspects of life as his thoughts become caged in a sexual abyss.

Just like any form of addiction sex addiction has its share of darkness, when one is addicted to sex, he will suffer the consequences in all his spheres of life; socially, physically and emotionally. As have been evident those who are addicted to sex may never maintain any steady relationship and even they may become withdrawn and find it hard to easily mingle in social circles. Like in heroin addiction, the brain chemistry will be adversely altered; the neurotransmitters like dopamine and serotonin become dependent on the acts of sex as they will become the only avenue through which the levels of dopamine can be boosted. When this doesn’t happen they will exhibit down feelings and depression and anxiety will find their way in.

However, sex addicts should be treated with care and shown love as most of them never played a part in the events that culminated into sex addiction. Statistics have shown that most of those who are addicted to sex got there because of acts of sexual abuse they were subjected to earlier in their lives. Sex abuse is a leading cause of sex addiction. Nevertheless the cause of sex addiction doesn’t matter what matters is the menace is real and is underrated by the American Psychiatric Association. The addicts need help just like other people addicted to drugs and other behavioral addictions.

Some of the signs and symptoms of sex addiction include;

Like I stated earlier, sex addiction impacts your life in all spheres; socially, physically and emotional. But since I can’t tell all about sex addiction in a single post, I will not delve much into these categories of the signs and symptoms.

Sex with multiple partners– when a person has an obsession for sex he may not draw the redline to demarcate who he involves with sexually and who he doesn’t and so he may engage in sexual activities with even strangers and this may put him / her at risk of venereal diseases.

They may often suffer mental emotional torture as the feelings of guilt loneliness and fear may creep in their thoughts most of the times they are lonely. Feelings of emptiness may even catapult their urge to meet new sexual partners.

Treating sex addiction with naloxone

NaloxoneToday there is little literature on the effectiveness of naloxone in treatment of sex addicts. There have been few research studies that have been done on the same and even the very studies that have been done were done on a much smaller scope to communicate any reliable information. With this said, naloxone isn’t a new drug as it has been used in the past for treatment of heroin overdose and addiction to opioids. This drug has been a favorite for many addicts and doctors as it is non-addictive unlike other opiates like methadone. It has been particularly been found to be effective in treatment of addiction-induced respiratory depression. It is also useful in ultra-rapid detoxifications and helps restore balance in the brain chemistry. Naloxone is an antagonist and works by blocking receptors in the brain hence breaking the chain in reward mechanism.

Today the WHO still maintains that naloxone is an essential drug owing to its effectiveness in treatment of heroin addiction. Its use in health institutions all over the world is approved by the FDA. There is much to be done in order to show the effects of this drug on sex addiction treatment. There has been growing body of interest in its use in the area as it has been found to be free from abuse by those using as it is not addictive.

Sex addiction isn’t about sex, it is the obsession about sex and lots must be done to free anybody caged in this. We at AWAREmed Health and Wellness Resource Center are committed to giving help to those addicted to sex. Could you be a victim of this menace, feel free to call on Dr. Dalal Akoury (MD) for help.

The Role of Naloxone in Sex Addiction

 

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The Relationship Between Addiction and Adrenal Fatigue

April 21, 2015

Addiction Causes Adrenal Fatigue

Addiction is a serious problem, addiction is the genesis of many health issues and it is even complicated to know that it is one of the wars that few people win. In the past addiction to drugs and other substances have been linked to myriads of diseases such as cancer, diabetes and other neurodegenerative disorders. This explains why addicts are not always on the good side of health, when a person is addicted to drugs and alcohol he will begin to feel sick, generally an addict is never in good health and that is why most of them may have certain strange behaviors such as irritability and even slurred speech. The reason for this is that when a person takes drugs that are rewarding in nature he will be compelled to increase the doses day by day so as to get the euphoric feeling they seek in drugs. Even the drugs that are used in pain management like the opiates have specified dosages beyond the patient will not only get addicted to the drug but will suffer other diseases that come with overdose of such drugs. Drugs of abuse majorly affect the neurotransmitter and this will be extended to the central nervous system (CNS) which is composed of the brain and the spinal cord. The brain is the engine that drives all the activities in the body of every human being but these drugs will interfere with chemical balances in the brain making it unable to perform normally. In some instance even the neurotransmitters that work to transmit signals so as to provoke certain necessary responses may get debilitated hence everything will be messed up. As expected when the neurotransmitters are affected and the entire nervous system is adversely altered then the proper coordination within the nervous system is tampered with and this is what causes a series of health complications.

Adrenal Fatigue

Recently researchers have shown that substance addiction may be linked to adrenal fatigue. Adrenal Fatigue refers to a stress-related condition that is suffered when the adrenal glands, hypothalamus and pituitary gland are functioning below their optimal level. Adrenal gland is the source of various neurotransmitters that are very vital in our nervous systems. These neurotransmitters include; cortisol, DHEA and epinephrine. These neurotransmitters are used to regulate your heart rate, immune system, energy storage and improve the general health and stability. When the adrenal glands have malfunctioned and fail to release these neurotransmitters in good amount then it will not be easy for any individual to have good health.  It is suspected that prolonged stress on the adrenal glands is what causes adrenal fatigue.

Some drugs of pleasure not only affect the dopamine but also the release of other neurotransmitters like adrenaline which is the fight or flight neurotransmitter. Even an addiction to caffeine does this. Ralph T. Golan, ND, in his book, Herbal Defense explains how using caffeine for prolonged periods can exhaust your adrenals:  “Caffeine forces your glands to secrete when they don’t have much left to give, and they have to keep digging deeper and deeper, making you more and more tired over time. And over the years, it takes more and more coffee to get the same result. Some people reach the point of drinking half a dozen or more cups of coffee to get the same result and it’s barely keeping them awake. That’s severe adrenal depletion.”

Role of adaptogens in addiction

Adaptogens are herbs that help in enhancing your immunity and ability to deal with stress, anxiety trauma, and even fatigue. Some adaptogens have been used as anti-aging herbs and have been found to have a capacity to rejuvenate the body and aid longevity. They also work to correct defects that the body is subjected to as a result of long term use of drugs of abuse.

Siberian Ginseng also known as Eleutherococcus senticosus root. This adaptogen is known for its ability to combat lack of appetite, correct insomnia, and improve memory. Siberian ginseng also increases mental alertness that is known to be lacking in those who have been addicted to substance use for quite a long time. This adaptogens also helps in healing nervous disorders and enhances energy. This adaptogens increases the body’s ability to adapt to metabolic stress and helps in recovery from substance abuse.

American Ginseng also known Panax quinquefolius root. American Ginseng is known to be a superior tonic herb with an immense ability to strengthen metabolism and the entire endocrine system. Like other species of Ginseng, the American ginseng also has adaptogenic properties, and is quite useful for the recovering addict. American Ginseng combines well with Siberian Ginseng and can be used together to heal an addict.

Adrenal Fatigue

Astragalus, also known as Astragalus membranaceous root. This adaptogens helps in promoting overall body function by strengthening digestion among other core benefits.  This herb can be used to help in restoring energy and balance the immune system in recovering addicts. It is good for some of the withdrawal symptoms of addiction like stress, colds and even chronic fatigue syndrome. It is also safe and be taken on a daily basis without it having negative side effects.

Tulsi, also known as Holy Basil. In the past this herb was used for treating such illnesses as stomach upsets and bronchitis. This herb has been found to be effective also in reducing stress that most addicts battle with. It has been found to reduce mental confusion that is common with most addicts using cannabis.

Here at AWAREmed Health and Wellness Resource Center we are committed to availing the best integrative approaches to treatment of diseases. We advocate for dietary as well as natural healing to diseases wherever possible. Visit as at Myrtle Beach, South Carolina where Dr. Dalal Akoury (MD) will be of help.

Addiction Causes Adrenal Fatigue

 

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