Tag Archives: Substance abuse

Suicide and Drug Addiction

October 10, 2014

Suicide Rate in Drug Addiction and How to Naturally Prevent

Drug addiction has been known for its destructive effects on the addicts. Most of the side effects are known by many especially depression and other withdrawal symptoms that an addict faces whenever he tries to stop using the drugs. However there is also another serious problem that has now been linked to drug and substance addiction- suicide. Suicide among drug addicts has become a serious problem that have to be curbed as many addicts are finding it the easiest way to end their suffering and depression as they struggle to set themselves free from addiction. Most of the people who commit suicide do it under the influence drugs. The use of opiates like oxycodone and heroin are leading cause of suicides.

Cocaine Use Increased Odd of Suicide Attempt 

Suicide Student Overwhelmed Asking For Helphas been a problem that the society has been fighting with. It has very many causes, however as revealed by a study that was led by Richard Ries MD of Harborview Medical Center University of Washington Seattle, Wa, the major cause of suicide attempts are the use of drugs and substance. This study reveals that of all the major causes of suicide attempts, cocaine use leads by increasing suicide attempts 62 times more likely. This is followed by major depression which increases the odd of suicide attempts 41 times more likely. Alcohol use follows by increasing odd of suicide attempts 8 times more likely. This supports the notion that drug and substance addiction increases chances of a person committing suicide.

In this same study it was found that among other factors divorce and separation increased odd of suicide attempts 11 times more likely. A person may argue that now that divorce and separation also increases the likelihood of a person committing suicide then there is no way to link drug addiction to increased suicide cases. However if deviate from your view you will realize that drug and substance addiction has a bigger role in even divorce and separation. Most of the cases where married parties have to separate or divorce are often linked to drug abuse. A person gets drunk and becomes abusive needless to mention he may not be able to stand with his responsibilities causing the family to break. Socially, the use of drugs and getting addicted to them will even determine the people you relate with and what jobs you will even do. So drug and substance addiction will affect a marriage in many and may be the driving factor that leads to separation linked to increased suicide cases.

However it not reasonable to ignore other factors that may lead to divorce and separation such as infidelity, having abusive partners (some people get abusive even without using drugs), financial problems and other mere misunderstandings. In these cases it calls for counseling in order to rectify the problems before it results in divorce. As it turns saving a divorce may count in reducing the rate of suicide. Marriage counselors may help in restoring peace in a marriage.

What Predicts Suicide Attempts in Alcoholics?

Teen alcohol addiction (drunk teens with vodka bottle)Several studies have linked drug use to increase in suicide attempts. The addicts need to be helped through various ways to help them stay away from suicide thoughts. The doctors have found various ways through which they can predict whether a person addicted to alcohol may attempt suicide or not. These insights may help the doctors to find ways to counsel the addicts to be free from suicide thoughts. One of these pointers is the family history of attempted suicides. When a person has a family member who had committed suicide they are said to develop suicide thoughts. When these suicide thoughts become dominant in their minds they begin to view it as the best solution to end their addiction problems. By studying their family suicide attempt history they can be helped to adopt better ways of solving problems. Another pointer is adverse childhood experience. There are childhood experiences that keep haunting an individual. These thoughts may even be the cause why a person becomes alcoholic. Experiences such as rape, neglect or sodomy may leave a person feeling unworthy and such attitude may cause suicide. The doctors may find ways of helping such an addict to avoid suicide.

Today, suicide has become a major catastrophe. In America alone it is reported that suicide is among top 3 or 4 causes of death in the US from teens to 50. To reduce this rate, there are a lot that needs to be done. Fortunately several studies have shown the major causes of suicide and so an action plan can be developed to minimize the causes of suicidal deaths in both teens and adults not only in America but also in other continents.

Suicide Screen, Assessment Risk and Referral

Suicide is one of the major causes of deaths in teens. For this reasons there is need to screen the alcoholics and even teens for suicide risks. Unfortunately screening for suicide risks has not been utilized in the past majorly because many institutions lack these mental health resources. Risk assessment will be done after the screening to show probability of suicidal death occurring and after this probability is known then various measures can be taken to help the person before he becomes a victim of suicide. In most institutions there may not be abled professionals to handle a subject given the suicide risk factor may be high. In this case referrals become necessary where the person may be taken to more equipped centers with abled professionals who can help prevent such deaths.

Drugs and substance abuse contribute greatly to suicidal deaths and that is why here at AWAREmed we approach addiction integratively so that we not only deal with withdrawal symptoms but also assess other risk factors. Dr. Dalal Akoury (MD) has helped many addicts to retrace their steps and overcome addiction. You can call on her for more help.

Suicide Rate in Drug Addiction and How to Naturally Prevent

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Effects of Benzodiazepine

October 4, 2014

Sedative and Euphoric Effects of Benzodiazepine

BenzodiazepineBenzodiazepines are drugs that have been used in hospitals to curb pain, as anti-anxiety and for sedation. However these drugs are can be abused as they are rewarding in higher doses. For this reason many people have used these drugs for all the wrong reasons. What happens when you take these drugs depends on the dosage. When used as prescribed the work as anti-anxiety and for sedation but when abused they result in even more grave side effects.

Benzodiazepines are glycoproteins with an affinity for benzodiazepine receptors which act as specific binding sites for gamma aminobutyric acid shortly known as GABA. The GABA is the major inhibitory neurotransmitter in the CNS. Many scientists have proposed various action mechanisms but despite all these proposed action mechanisms, the exact sites and mechanisms of actions of these drugs is still a mystery unraveled.

The mechanism of action of these drugs is often based on this belief that these drugs affect CNS by interacting with a macromolecular protein complex in the neuronal membrane which includes GABAa receptors, high-affinity benzodiazepine receptors and chloride channels. The scientists are still working to find more about the mechanisms of action of benzodiazepines in the CNS but until now we can dwell more on their effects in the body and how to safely use them.

Occupation of the benzodiazepine receptor increases the affinity of the GABAa receptor for GABA. GABA potentiates the direct opening of the chloride ion channel, allowing an increased influx of chloride into the neuron. The inward shift of chloride ions hyperpolarizes and stabilizes the membrane, resulting in a net inhibitory effect on neuronal firing. Benzodiazepines alone have little effect on chloride ion channel permeability and depend upon the presence of GABA in the synapse for their actions.

Some of benzodiazepines are very similar in their chemical structures but their potency differs greatly and so is the rate of absorption and other pharmacological parameters. The potency of a benzodiazepine is correlated with its affinity for its binding site, the benzodiazepine receptor. In therapeutic use, the benzodiazepines, while differing in potency, have similar pharmacologic profiles.

It is believed that there are different types of benzodiazepine receptors in different areas of the CNS which produce the various pharmacological actions of the drugs. As the dose of benzodiazepine is increased, anxiolytic effects are first produced, followed by anticonvulsant effects, a reduction in muscle tonus, and finally sedation and hypnosis.

Clinically, benzodiazepines are used in the management of anxiety disorders, insomnia, seizure disorders, skeletal muscle spasticity, alcohol withdrawal, panic disorder and as premedicants prior to surgical or diagnostic procedures. Benzodiazepines have also been used in the management of nausea and vomiting associated with emetogenic cancer chemotherapy.

When taken benzodiazepines get widely spread in the body and accumulate preferentially in lipid rich areas such as the CNS and adipose tissue. The more lipophilic agents have the fastest rates of absorption and onset of clinical effects. Benzodiazepines and their metabolites are highly bound to plasma proteins. Steady state plasma concentrations of benzodiazepines and their metabolites are reached after about 5 elimination half-lives, typically, a few days to 2 weeks after initiation of therapy. The higher the concentrations of benzodiazepines   in the plasma the higher their sedative and euphoric effects. For sedative purposes the concentrations of benzodiazepine in the plasma are much lower than the concentrations of benzodiazepine in plasma that would evoke euphoric effects. This shows that that a person may have euphoric feelings after using higher doses of benzodiazepine than the doses needed for sedative purposes. However, the higher the doses of benzodiazepines the danger it beckons for higher doses may result in intoxication or even delirium which is characterized by ataxia, amnesia, stupor, impaired consciousness, nystagmus.

Mortality hazards of the use of Benzodiazepine

The benzodiazepines are clinically useful but that does not mean that they are free from any side effects. The use of benzodiazepines within the prescribed doses foe sedation and sleeping disorders may give relief and a reason to celebrate but as I have written earlier, these drugs are prone to abuse and as commonly abuse of any drug will always give rise to undesired effects. Though it has not been perceived to be as dangerous as other drugs of abuse such as opioids and ‘bath salts’ that can cause death instantly due to overdose, the side effects of benzodiazepine can lead to death in one way or another. These side effects include; dependency, withdrawal, rebound symptoms, daytime sedation, confusion, cognitive deficits, ataxia, dysarthria, diplopia, and vertigo. The use of benzodiazepines have been linked to motor vehicle accidents especially in the elderly. Benzodiazepines are often used in patients undergoing dialysis for their sedation effects. However a study done in japan where these drugs were used widely in dialysis patients showed that benzodiazepine use may be associated with an increased mortality risk.

Benzodiazepine increased rise of falls in Elderly

BenzodiazepineBenzodiazepine has also been found to increase falls in the elderly leading major fractures. The long term use of these drugs is also associated with nocturnal falls and still the elderly still fall victims. Rise in falls is one of the problems that can be linked to the effects of the drug on the elderly.

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.

Sedative and Euphoric Effects of Benzodiazepine

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Benzodiazepine Withdrawal

October 3, 2014

Benzodiazepine Withdrawal and How to Help the Patient

BenzodiazepineThe 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

BenzodiazepineNicotinamide 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

 

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Buprenorphine and opioids

October 2, 2014

Buprenorphine as Opioid Receptor Antagonist

buprenorphineBuprenorphine is a semi-synthetic opioid derived from thebaine. It is a pain killer and has gained a great deal of notoriety for its ability to interrupt severe opiate addiction, including heroin and methadone addictions. It got approved in 2002 by the FDA for use as an opiate addiction treatment. Dependence on pain drugs is common but very dangerous and that is why buprenorphine is of importance in fighting opioid independence.

Today, buprenorphine is being used in office based treatment of opioid dependent patients. Buprenorphine is a partial mu-opioid receptor agonist. Several clinical studies indicate buprenorphine is effective in managing opioid addiction and dependence. In all of the clinical tests Buprenorphine was found to be more effective than placebo for managing opioid addiction. However, it may not be superior to methadone incase high doses are needed. It is comparable to lower doses of methadone, however. When using buprenorphine, there are critical phases that must be followed. These phases include; include induction, stabilization, and maintenance. Experts advise that Buprenorphine therapy should be initiated at the onset of withdrawal symptoms and adjusted to address withdrawal symptoms and cravings. Advantages of buprenorphine include low abuse potential and high availability for office use. Disadvantages include high cost and possible lack of effectiveness in patients who require high methadone doses. Most family physicians are required to complete eight hours of training before they can prescribe buprenorphine for opioid addiction. Let’s get all the detailed facts here.

It is estimated that 898,000 adults in the United States are opioid dependent. Treating opioid dependence as a chronic disorder improves outcomes and opioid maintenance is the most effective way to decrease illicit use in patients who are addicted to opioids. Without opioid maintenance, it will be easy for any user of opiates for pain to be an addict of the same therefore various strategies must be put in place to exercise opioid maintenance for the safety of the patients. Over the past years Methadone has been the treatment of choice in the United States; however, methadone maintenance programs typically have stringent entrance criteria, long waiting lists, and primarily are located in urban areas. It has been verified that only 14 percent of patients who are addicted to opioids are treated in traditional methadone clinics. Research from the 1970s demonstrated that the analgesic buprenorphine (Subutex), a partial mu-opioid receptor agonist, may effectively treat patients with heroin addiction.

In the Drug Addiction Treatment Act of 2000 physicians are authorized to provide office-based treatment for opioid addiction. Through this act physicians are allowed to prescribe Schedule III, IV, or V “narcotic” medications that are approved by the U.S. Food and Drug Administration (FDA) for patients with narcotic-use disorders. In 2002, buprenorphine and combination buprenorphine/naloxone (Suboxone) was approved by the FDA to manage opioid dependence .It is therefore a legally usable drug that is available in health centers and clinics.

How to use

As stated earlier the Management of opioid addiction with buprenorphine can be divided into three phases: induction, stabilization, and maintenance. The induction phase includes the initial transition from illicit opioid use to buprenorphine and typically lasts three to seven days. Patient education is important during this phase and should emphasize the risk of precipitating withdrawal if buprenorphine is initiated too soon after opioid use. Generally, buprenorphine should be initiated 12 to 24 hours after short-acting opioid use and 24 to 48 hours after long-acting opioid use. It is preferable for most patients to use combination of buprenorphine/naloxone tablets.  It is however advised that pregnant women who are to use buprenorphine and some patients using long-acting opioids such as methadone should use the buprenorphine-only formulation. For those who are on long- acting opioid use, the methadone dose should be less than 30 mg and the patient should switch to the combination tablet after several days.

When the patient has shown opioid withdrawal symptoms, the initial doses should be administered under physician observation (4/1 mg buprenorphine/naloxone or 2 mg buprenorphine if the patient is dependent on a long-acting opioid). It is important for the physician to monitor the patient for precipitated withdrawal and excessive side effects like sedation). If the patient continues to exhibit signs of opioid withdrawal after two hours, another 4/1 mg dose of buprenorphine/naloxone should be administered. Patients who are dependent on long-acting opioids should receive 2 mg buprenorphine every one to two hours. The maximum recommended first-day dosage of buprenorphine is 8 to 12 mg. If the patient continues to show signs of withdrawal, the physician may administer adjunctive nonopioid and symptomatic treatments to help the situation.

Difference between methadone and morphine

There are some differences between methadone and morphine. Some of the differences lie in their costs and uses. Here are some of the differences.

Methadone is much cheaper as compared to morphine. For this reason many physicians favor methadone. Methadone also lasts longer than morphine- it lasts ten times longer than morphine. Methadone also lasts longer than morphine in the body. It takes 24 hours while morphine takes only 2-3 hours only in the body. However methadone should not be used for slight pain despite its availability and cheaper cost.

Another difference is that methadone is excreted through urine while morphine is excreted through the liver and bile ducts before its exit in the urine.

 

BuprenorphineThese drugs are also used in different situations. Methadone is mostly used after unsuccessful use of morphine or when the patient has a history of drug abuse. If tis patient is morphine it may lead to relapse hence methadone is considered safer than morphine. Morphine is addictive while methadone is not addictive.

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.

 

Buprenorphine as Opioid Receptor Antagonist

 

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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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