Opiophilia Replaced By Opiophobia

October 1, 2014

Opiophilia Replaced By Opiophobia the Pendulum Is Again In Motion

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

What is Opiophilia?

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

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

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

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

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

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

Exit strategy from opioid therapy

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

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

Opiophilia Replaced By Opiophobia the Pendulum Is Again In Motion

Naltrexone and Alcoholism

September 30, 2014

Naltrexone promising for alcoholism and SUD

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

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

What is Naltrexone?

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

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

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

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

The role of naloxone rescue in Heroin users

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

How does it work?

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

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

Naltrexone promising for alcoholism and SUD

Sexual Dysfunction & Substance Abuse

September 29, 2014

Sexual Dysfunction & Substance Abuse – Real time Solution with the Experts

If you want satisfaction in sex the a void elements that may cause Sexual Dysfunction like Substance Abuse. You ore yourself the satisfaction, so do the wright thing.

Sexual dysfunction is a problem that affects many men and women in their lifetime. The condition covers a range of sexual problems including:

Erectile dysfunction
Premature or delayed ejaculation in men
Pain associated with intercourse
Low libido and
Poor response to sexual contact

Drugs and alcohol are known to affect a person’s sexual behavior, ability to function and sensations. Drugs and alcohol are often taken as a way to hide psychological or emotional problems or to ignore physical difficulties that are contributing to sexual dysfunction. However we have four main categories of sexual dysfunction disorders which include:

Sexual desire
Sexual arousal
Orgasm
Sexual pain disorders

Each one has distinct symptoms, yet all are negatively contributed to by drugs and alcohol. Some drugs have been found to make sexual problems worse, others are milder. Regardless, sexual problems can cause major relationship and psychological problems if unresolved.

Sexual Desire Disorders

Sexual desire disorders are more commonly referred to as a loss or decrease in libido. This condition may be caused by the influence of substances, fatigue, depression or anxiety. Some medications such as anti-depressants and anti-anxiety medications are known to cause a loss of libido. Alcohol and other substances can also negatively impact on a persons’ libido. Fatigue associated with an alcohol or drug binge may also affect a person’s desire to have sex.

Chronic, long term marijuana use is known to contribute to a loss of libido, especially in women. This lack of sex drive is a symptom of bigger motivational issues that many people suffer when using this drug. For the most part, a persons’ sex drive will return to normal with discontinuation of using marijuana.

Sexual Arousal Disorder

Alcohol is one of the most common substances to affect a persons’ ability to be aroused or maintain arousal. A sexual arousal disorder typically refers to problems associated with getting and maintaining an erection, or for women, to be able to maintain arousal during intercourse. Cocaine and other stimulants can also cause a person to have difficulty in becoming aroused or maintaining a level of arousal.

Orgasm Disorder

Men and women often find they have trouble reaching orgasm when under the influence of alcohol and other substances. Women are especially sensitive to the effect that drugs can have on their ability to orgasm and men can have premature or delayed ejaculation as a result of being high or drunk. Most orgasm disorders, or anorgasmia, are the result of undiagnosed or untreated psychological issues that a person is suffering. Chronic fatigue and insomnia can also affect a persons’ ability to achieve a normal level of orgasm. Opiate addiction is known to cause anorgasmia.

Anorgasmia can cause significant personal and relationship problems. Frustration arising from an inability to orgasm despite stimulation and arousal can cause irreversible relationship breakdowns, especially in the case of men. For women the disorder is more common and can lead to unhappiness, depression and feelings of inadequacy. Therefore having known the consequences of these sexual disorders, it will only be wise that you seek for treatment in good time. The home of sexual disorders solution can only be at AWAREmed Health and Wellness Resource Center under Doctor Akoury’s care. This is health institution was primarily established by doctor Dalal Akoury to meet and restore hope for those who are losing it due to problems like sexual dysfunctions. It may not matter how long you’ve been having this problem, what is important is that you reach out for help by calling doctor Akoury today.

Sexual Pain Disorder

Sexual pain disorders are primarily a female condition. It is a condition which causes a woman to feel immense pain and discomfort when having sex. It is regrettable that this is happening at this point of time, even with the available help offered by very many professionals across the globe. Ladies is pleasurable and should not cause you any pain, it is true that there are two main types of this disorder, dyspareunia or painful intercourse and vaginismus which is an involuntary spasm of the vaginal muscles. Take that bold step and call doctor Akoury today for help, you must not be frustrated by this condition, doctor Akoury will turn your frustrations and pain into lasting fulfillment in your sex life professionally and in confidence.

Alcohol-induced Sexual Dysfunction

Even though it is believed that moderate drinking may increase the likelihood of sexual contact, I want to disassociate this discussion with that theory. Alcohol is very addictive and difficult to control ones consumption abilities. Quite often alcohol consumption is abused and the consequences of this are not friendly at all. Abuse of alcohol will cause partial impotence in men which can be very embarrassing to both sex partners. As for women tis can cause problems with attainment of orgasm, and problems of maintaining arousal and sexual desires. That notwithstanding, alcohol has a way of triggering conflicts and revisiting certain past problems especially when one is suffering from depression and anxiety.

It is important noting that long term, chronic alcohol abuse can affect the sexual impulses in a person, which can cause impotence and additional sexual problems which in many cases may not reversible or treatable.

Treatment for Sexual Dysfunction

Finally this is very critical for you and any other person you may know who is suffering from sexual dysfunctions of any kind. Your starting point will be calling doctor Akoury today for help remember sexual dysfunction can easily be treated through a number of different methods doctor Akoury will advise upon making personal evaluation and assessment to your condition, I recommend that before you think of libido boosting medications like Viagra, seek for professional opinion from doctor Akoury and follow on the medication as advised professionally. The good news about doctor Akoury is that besides being a sexual dysfunction expert she is also an addiction expert who has been in practice for over two decades thereby making her the best option for all your conditions. Remember that abusing drugs and alcohol causes many problems for an individual including sexual issues and the only solution is to stop using the drug before the issues become permanent, something you will be able to do conveniently well under the care of doctor Dalal Akoury.

Sexual Dysfunction & Substance Abuse – Real time Solution with the Experts

Dextromethorphan (DXM) As a Drug of Abuse

September 25, 2014

Dextromethorphan (DXM) As a Drug of Abuse

Dextromethorphan (DXM) As a known fact, most of the drugs that are now commonly abused began as clinical drugs. There are clinical drugs that might have recreational properties in that when a person takes more than recommended dosage he may experience some of the effects of the drug. These may include hallucination and euphoria. For this reason these drugs can be misused in large scale if measures are not taken to strictly regulate their use. Dextromethorphan is one of the drugs that have been used in clinical setup but are known to be rich in recreational properties.

Dextromethorphan (DXM) was used as a cough depressant in the past. Most of the over the counter cough medicines has it as an ingredient. It works in these drugs as an antitussive (cough suppressant) and expectorant in other words it works as an agent that promotes the removal of mucus from the respiratory tract. It also has other medical uses. These may include the temporary relief of sinus congestion, runny nose, cough, sneezing, itching of the nose and throat, and watery eyes caused by hay fever, allergies, cold, or flu (influenza). In fact most of the over the counter cough medication has DXM as the most active component. When the recommended dose is taken, DXM has few adverse side effects, and has a long history of safety and effectiveness. However when taken in huge doses beyond the description it has some serious side effects. It causes hazy images and poor vision plus it also causes hallucinations. This drug, owing to its hallucinatory effects has been highly abused.

Over the past few years, cases related to use of DXM for non-medical purposes has risen and still very many people are using this drug for all the wrong reasons. Experts opine that the rise in abuse of this drug is attributed to the ease of purchasing nonprescription cough drugs from drug stores and in the internet. The drug is also legal and so even those who use it for wrong purpose are not afraid of the authorities even if they are found to be in possession of DXM. This gives it a more reason to be used as opposed to other hallucinogens that are considered illegal in most states. The FDA approves the use of DXM for medicinal purposes basing on the fact that when it is used within the prescribed doses then it can not cause any health hazard. However, it can be a damaging substance. Recreational users intentionally exceed suggested doses to experience a sense of heightened perceptual awareness, altered time perception, and/or visual hallucinations. Also, users often abuse the drug in combination with other drugs. The interaction between DXM and other substances e.g., alcohol, acetaminophen, MDMA/ecstasy, and other OTC cough medicines. When DXM is used with other drugs for recreational purposes, it produces a synergistic effect that can be very dangerous. Ingredients of cough medicines other than DXM, like acetaminophen, are extremely hazardous when consumed in high doses and can cause liver damage, heart attack, stroke, and death. For these reasons it is very important to restrict oneself to the prescribed dosage to avoid all the other undesirable effects.

DXM as Sigma receptors agonists

This drug works in a number ways in suppressing coughs. Firstly it has pharmacodynamic similarities to the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine. It is used as a cough depressant as it has been found to be effective yet very safe when used within the required doses. However this drug does not bind on the N-methyl-D-aspartate (NMDA) receptors only but also binds to sigma-1 (σ1) receptors, which are believed to be protein targets for a potential new class of antidepressant medications.

Due to its hallucinatory effects it has become abused in that instead being used for medicinal purposes people now use it as a recreational drug. When taken a person will experience visual hallucinations and radically altered states of consciousness, often experienced as pleasurable and illuminating. This intense feeling of happiness and euphoria is what make many people to abuse DXM. It takes a person to a mental trip where every boundary of the mind seems overcome. However in case of overdose with the good feelings of happiness and euphoria a person may get feelings of anxiety and revulsion after using DXM. However there are other side effects associated with it.

Dextromethorphan (DXM)

Dextromethorphan side effects

Every drug has a side effect when abused. However the drugs will induce different reactions in people. As for DXM, it is very safe when used within the prescribed doses. However when a person uses this drugs in higher doses he will have to go through certain problems that are induced by the drug. There is however an innocent unintentional overdose under which a person may suffer such symptoms as; difficulty breathing, swelling of your face, lips, tongue, or throat. When this happens, you should stop using dextromethorphan and call your doctor at once if you have any of these serious side effects: severe dizziness, anxiety, restless feeling, or nervousness, confusion, hallucinations and slow, shallow breathing.

Apart from the unintentional overdose that may be termed accidental a person may overdose to get the feelings of euphoria and hallucinations from this drug. However this may result in serious health problems both short-term and long-term.

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.

Dextromethorphan (DXM) As a Drug of Abuse

Phenethylamine Analogues and Addiction

September 24, 2014

Phenethylamine Analogues Are Potentially Addictive

Phenethylamine Amphetamine was used to treat children with attention deficit disorder until its addictive potential was recognized. The fact that it could be abused led the physicians to do lots of research in order to come up with its substitute in medical field that did not have much adverse effects. However to the youths amphetamine has become a substance of abuse that many are familiar with. Here are details of the experiments, the substitutes or other the amphetamine analogues and how they work.

In an experiment Methylphenidate was found to inhibit competitively the striatal dopamine transporter (DAT) and bind at sites on the DAT in common with both cocaine (a non-substrate site ligand) and amphetamine (a substrate site ligand). Some methylphenidate analogues modified on the aromatic ring or at the nitrogen were tested to determine whether the profile of inhibition could be altered. None was found to stimulate the release of dopamine in the time frame of 60 seconds of the experiments conducted, and each of the analogues tested was found to noncompetitively inhibit the transport of dopamine. It was found that halogenating the aromatic ring with chlorine (threo-3, 4-dichloromethylphenidate hydrochloride; compound;

1) Increased the affinity of Methylphenidate to inhibit the transport of dopamine. A derivative of Methylphenidate with simultaneous, single methyl group substitutions on the phenyl ring and at the nitrogen (threo-N-methyl-4-methylphenidate hydrochloride; compound

2) Bound at a site in common with Methylphenidate. A benzyl group positioned at the nitrogen (three-N-benzylmethylphenidate hydrochloride; compound

3) Imparted properties to the inhibitor in which binding at substrate and non-substrate sites could be distinguished. This analogue bound at a mutually interacting site with that of methylphenidate and had a Kint value of 4.29 mM. Furthermore, the N-substituted analogues (compounds 2 and 3), although clearly inhibitors of dopamine transport, were found to attenuate dramatically the inhibition of dopamine transport by amphetamine, suggesting that the development of an antagonist for substrate analogue drugs of abuse may be possible.

Phenethylamine Methylphenidate is currently the most commonly prescribed drug to treat children with attention deficit disorder and is also used to treat narcolepsy. Originally, amphetamine was used to treat children with attention deficit disorder until its addictive potential was recognized. It was estimated in 1992 that 3% of school age children were being treated with Methylphenidate for some extended interval. These numbers have continued to increase. Methylphenidate is not thought to stimulate dopamine synthesis or induce release of dopamine from nerve terminals. The action of Methylphenidate is to block the inward transport of dopamine into the presynaptic terminal, resulting in a prolonged dopamine stimulus.

Although Methylphenidate, a psychomotor stimulant agent, has been shown to have abuse potential, it is still the drug of choice for the treatment of children with attention deficit disorder. Methylphenidate has been shown to bind at the dopamine transporter (DAT) and its binding is saturable and specific for the DAT but it is not clear where Methylphenidate binds on the transporter relative to dopamine and other inhibitors of transport.

Methylphenidate is thought to have behavioral, pharmacological, and binding properties similar to those of amphetamine. Therefore, Methylphenidate has been classified as a non-transported inhibitor of DAT as well as a substrate analogue for DAT when present at high concentrations these discrepancies have led to the current study, which focuses on comparing the inhibition properties and binding sites of Methylphenidate with those of some Methylphenidate structural analogues, amphetamine, and cocaine. The results of previous work by this laboratory in a kinetic model of the actively transporting DAT have shown that amphetamine and m-tyramine bind to the same site on the DAT and at a site competitive with dopamine .Thus, it was shown that amphetamine and m-tyramine are substrate analogues for the DAT. It was shown that amphetamine binds at a site that is separate but interacting with the inhibitory site of cocaine on the DAT.

Different Methylphenidate derivatives have been synthesized in an attempt to develop compounds that will block cocaine binding to the DAT but do not interfere with substrate binding or transport. The test used for their assessment has been to compare the IC50 for inhibition of the transport of dopamine with the IC50 of the test analogue for the displacement of [3H] WIN 35,428 binding.

In this current study, amphetamine, cocaine, and selected structural analogues of Methylphenidate were used to decipher whether Methylphenidate resembles amphetamine or cocaine in its effects on the function of DAT. The Methylphenidate derivatives studied in this work were chosen for their particular characteristics. Compound 1, a dichloro-substituted derivative, is one of the more potent Methylphenidate derivatives with respect to inhibition of [3H] WIN 35,428 binding. It differs from most other Methylphenidate derivatives that have been synthesized in that it is equipotent as an inhibitor of [3H]WIN 35,428 binding and [3H]DA uptake and it also has an equilibrium Hill coefficient (nH) determined against [3H]WIN 35,428 binding of dopamine. Most of the other Methylphenidate analogues are at least threefold less potent as inhibitors of [3H] DA uptake and have nH values of unity. Compounds 2 and 3 were included because they are some of the most effective analogues in discriminating between [3H] WIN 35,428 binding and [3H] DA uptake, with a five- to sevenfold separation in potency to inhibit binding versus transport.

Phenethylamine Analogues Are Potentially Addictive

Tag Archives: Substance abuse