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We welcome you to Methadone And Lots More.  - - I am going to discuss other medications that can interact with opiates.  If you take opiates then you should certainly be made aware of the consequences when different medications are taken together.

I am very much interested in providing material you are interested in.  - Please take the time to write and let me know what you want to hear more about.  - - If you have any articles you have read that you feel benefited then please take the time to send it to me and I will publish it and give you credit and we can all take
part in sharing information because "Knowledge is Power."

ChangeYourLife@MedicalAssistedTreatment.org


What are sedative hypnotics?

Sedative-hypnotics are drugs which depress or slow down the body's functions.   Often these drugs are referred to as tranquilizers and sleeping pills or sometimes just  as sedatives. Their effects range from calming down anxious people to promoting sleep. Both tranquilizers and sleeping pills can have either effect, depending on how much is taken. If taken at high doses or when they are abused, many of these drugs can even cause unconsciousness and death.

Sedatives-Hypnotics  
Two Major Categories 
 1. Barbiturates 
 2. Benzodiazepines
  
- - Which are the ones
on your left?
 - Do you
recognize any of them?

What are some of the sedative-hypnotics?

Barbiturates and benzodiazepines are the two major categories of sedative-hypnotics. The drugs in each of these groups are similar in chemical structure. Some well-known barbiturates are secobarbital (Seconal) and pentobarbital ( Nembutal ). Diazepam ( Valium ), chlordiazepoxide ( Librium ),  and clorazepate ( Tranxene ) are examples of benzodiazepines.

A few sedative-hypontics do not fit in either category. They include methaqualone ( Quaalude ), ethchlorvynol ( Placidyl ),  chloral hydrate ( Noctec ), and mebropamate ( Miltown ).

All these drugs can be dangerous when they are not 
taken  according to a physician's instructions.
         

Can sedative-hypnotics cause dependence?

Yes, They can cause both physical and psychological dependence.  -- Regular use over a period of time may result in tolerance, - - which means people have to take larger and larger doses to get the same effects. - - - When regular users stop using large doses of these drugs, - - they may develop physical withdrawal symptoms, ranging from restlessness, insomnia, anxiety to convulsions and death.  - - When users become psychologically dependent, - - they feel as if they need the drug to function.  - - -   Finding and using the drug becomes the main focus in life.

Is it true that combining sedative-hypnotics with alcohol is especially dangerous?

Yes. - - Taken together, alcohol and sedative-hypnotics can kill.  - - - -  -The use of barbiturates and other sedative-hypnotics with other drugs that slow down the body  body, such as alcohol, multiplies their effects and greatly increases the risk of death. Overdose deaths can occur when barbiturates and alcohol are used together, either deliberately or accidentally.

Can sedative-hypnotics affect an unborn fetus?

Yes.   Babies born to mothers who abuse sedatives during their pregnancy may be physically dependent on the drugs and  show withdrawals symptoms shortly after they are born.Their symptoms may include breathing difficulties,feeding problems disturbed sleep, sweating, irritability, and fever.  

 Many sedative-hypnotics pass through the placenta easily and have caused birth defects and behavioral problems in babies born to women who have abused these drugs during their pregnancy.

       What Are Barbiturates?           
  Amobarbital,Pentobarbital,Secobarbital

Barbiturates are often called "barbs" and " downers."  Barbiturates that are most
commonly abused today are:  1.  amobarbital (Amytal)
                                              2.  pentobarbital (Nembutal)
                                              3.  secobarbital (Seconal)

These drugs are sold in capsules and tablets or sometimes in a liquid form and are available in suppositories.

What are the effects of barbiturates when they are abused?

The effects of barbiturates are, in many ways, similar to the effects of alcohol.  Small amounts produce calmness and relax muscles. Somewhat  larger  doses  can cause slurred speech, staggering gait, poor judgement, and slow, uncertain reflexes.  These effects make it dangerous to drive a car or operate machinery. Large doses can cause unconsciousness and death.

How dangerous are barbiturates?

Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths.  These include suicides and accidental drug poisoningsAccidental deaths sometimes occur when a user takes one dose, becomes confused and unintentionally takes additional or larger dose.    With barbiturates there is less difference between the amount that produces sleep and the amount that kills. Futhermore, barbiturate withdrawal can be more serious than heroin withdrawal!!! 

What is methaqualone?
 
  
  Quaalude®

 Which causes the worst
 withdrawal ?
 Opiates
 Barbiturates
 Alcohol


Can you die from
 withdrawals?

Methaqualone ( "Sopors, Ludes" ) was originally prescribed to reduce anxiety during the day and as a sleeping aid. The dangers from abusing methaqualone include:  injury or death from car accidents caused by faulty judgement and drowsiness, and convulsions, coma, and death from overdose.




What are some of the immediate effects of smoking marijuana?

Some immediate physical effects of marijuana include a faster heartbeat and pulse rate, bloodshot eyes, and a dry mouth and throat.  No scientific evidence indicates that marijuana improves hearing, eyesight, and skin sensitivity. - Some of marijuana's mental effects reduce short term memory, and reduce ability to do things which require concentration, swift reactions.and coordination, such as driving a car or operating machinery.

Are there any other adverse reactions to marijuana?

A common bad reaction to marijuana is the "acute panic anxiety reaction."  - People describe this reaction as an extreme fear of " losing control," which causes panic. The symptoms usually disappears in a few hours.

How does marijuana affect the heart? 

Marijuana use increases the heart rate
as much as 50%, depending on the
amount of THC in the cigarette.It can
cause chest pain in those who have a
poor blood supply to the heart
-and it
produces these effects more rapidly
than tobacco smoke does.

What about long-term affect?

Long-term regular users of marijuana may become psyhocologically dependent.  - They may have a hard time limiting their use, they may need more of the drug to get the same effect, they may develop problems with their jobs and personal relationships. - The drug can become the most important aspect of their lives.

 What is the major concern about Marijuana's
  effect on young people? 
 
 The effects of marijuana can interfere with
 learning by impairing thinking, reading
 comprehension, verbal and mathematical
 skills
 .
  
Research shows that students do not remember what they  have learned when they are high.    
 

One major concern about marijuana is its possible effects on young people as they grow up.. Research shows that the earlier people start using drugs, the more likely they are to go on to experiment with other drugs. In addition, when young people start using marijuana regularly, they lose interest and are not motivated to do their schoolwork. 

What are the other names used for Marijuana?

Marijuana ( grass, pot, weed, joint ) is the common name for a crude drug made from the plant Cannabis sativa. The main mind-altering ( psychoactive ) indgredient in maijuana is THC ( delta-9-tetrahydrocannabinol ). but more than 400 other chemicals also are in the plant. A marijuana "joint" ( cigarette ) is made from the dried particles of the plant.  -The amount of THC in the maijuana determines how strong it's effect will be.

The type of plant, the weather, the soil, the time of harvest, and other factors determines the strengh of marijuana.The potency of the marijuana now available has increased more than 275 percent over the past decade.  This more potent marijuana increases physical and mental effects and the possibility of health problems for the user.

Hashish, or hash, is made by taking the resin from the leaves and flowers of the marijuana plant and pressing it into cakes or slabs. Hash is usually stronger than crude marijuana and may contain five to ten times as much THC. - Hash oil may contain up to 50 percent THC.  - - Pure THC is almost never available, except for research. Substance sold as THC on the street often turn out to be something else, such as PCP.

What is Marijuana "Burnout"?

"Burnout"  is a term first used by marijuana smokers, themselves, to describe the effect of prolonged useYoung people who smoke marijuana heavily over long periods of time can become dull, slow moving, and inattentive.

These "burned-out"users are sometimes so unaware of their surroundings that they do not respond when friends speak to them, -  and they do not realize they have a problem.

How long does Marijuana stay in the body?

When marijuana is smoked, THC, the active ingredient, is absorbed by most tissues and organs in the body, however, it is primarily found in fat tissues. The body, in it's attempt to rid itself of the foreign chemical,  chemically transforms the THC into metabolites. Test involving radioactively labeled THC have traced these metabolites in animals for up to one month.

 How does Marijuana effect the lungs? 

Scientists believe that marijuana can be especially harmful to the lungs because users often inhale the unfiltered smoke deeply and hold it in their lungs as long as possible. Therefore,  the smoke is in contact with lung tissues for long periods of time,  - - which irritates the lungs and damages the way they work. Marijuana smoke contains some of the same ingredients in tobacco smoke that can cause emphysema and cancer. - - In addition, many marijuana users also smoke cigarettes; the combined effects of smoking these two substances create an increased health risk.

Reference: Wichita/Sedgwick County Regional Prevention Center At the D/AAPC 

Updated:   15 November 2006 




 - - -  -The term narcotic is used to describe the family of drugs that are used as an analgesic ( pain-relieving ) compound and is occasionally  used to induce sleep.  Sometimes referred to as opiates ( because they are derived from the opium poppy plant or made synthetically to have the same actions as morphine,******** a major ingredient in opium ), - - - - -this family of drugs may actually be broken into three classifications:

1.  Natural occuring compounds, such as opium, morphine, and codeine;

2.  Semisynthetic compounds, such as heroin and hydromorphone ( derived by modifying the chemicals produced in opium);

3. Synthetic compounds made entirely in the laboratory, such as Demerol, Metha-done and Darvon.

Narcotics have a wide range of medical use, including pain relief, treatment of diarrhea, and cough relief. These compounds are also highly addicting. Heavy use of such drugs, or even occasional use over a period time will produce tolerance, psychological need and physical dependence,  **** as by the appearance of with-drawal symptons upon cessation of use.

Narcotic drugs also depress central nervous system functions.   ***They produce euphoria in the user, provide a sense of well-being, and produce drowsiness that may lead to sleep. Unlike other CNS depressants, there is usually no loss of motor coordination or loss of consciousness with their use, unless the dose is large or the person is ill or fatigued.

The exact effect of most narcotics depends on the indivdual. *** If the person is in pain and taking narcotics, they tend to feel less anxious and find relief from pain. If the person is taking the drugs for reasons other than pain-killing, the same dose would produce mental distress, such as fear and nervousness, s well as nausea and possibly vomiting.

NATURAL OCCURRING COMPOUNDS

Opium is the main source of the natural occurring narcotic drugs. It is produced from poppy, Papauver somniferum. This poppy is cultivated in many countries of the world, including Turkey, India, China, Thailand, Laos and Mexico. Opium is derived from the unripe poppy pod, prior to the development of seeds.  ***(The method of extraction is centuries old - knife is used to slit the pod; a milky fluid oozes from the seedpod and allowed to bleed overnight; the next day, the dried product is scraped off the leaves, producing a brownish gum known as crude or raw opium.

The dried opium is generally smoked and the vapors inhaled. Occasionally the crude product is ingested orally. The compound was widely used throughout the world until the beginning of the twentieth century.  - - The drug is not as popular today, due to the strength of action and bulk of the compound,  - - which makes dealing the drug difficult.  It is legally imported for the production of other legal derivatives, and is illegally imported for the manufacture of heroin.

Morphine is the main alkaloid ingredient of opium, having a purity of from 4 to 21%. It was isolated from opium in 1803. It is used in medicine as a sedative and a pain killer, being one of the most effective pain killers known ( ten times the pain-killing properties of opium ). Large doses have been used to provide anesthesia in heart surgeries because unlike anesthetic drugs,morphine has no depressant effect on the cardiovascular system.   - - Morphine is also used to control post-operative pain.

  - - - Morphine is available in tablets and injectable form. A white crystal form is illegally available on the street.  - It is usually administered IV or IM for the greatest effect. When it is used non-medically, - - the drug produces - -  a euphoric high, - - a sense of well-being and drowsiness. - - Tolerance and/or   physical dependence  may develop rapidly, depending on the dose and frequency of use.

SYNTHETIC COMPOUNDS

Meperidine
Trade Name: Demerol®

It was the very first synthetic narcotic ever produced.   - - - Discovered in the early 1930's, it has similar properties of morphine, though less potent, and unlike many of the narcotic drugs it retains much of it's potency even when administered orally. Tolerance of the drugs effects develops gradually,  - -  -  - therefore it can be used effectively for several weeks at the same dose. - - In spite of this, both physical and psycholgical dependence can develop with long-term use.   - Because of it's use in medical settings, meperidine is the most commonly reported drug of abuse among physicians and nursing professionals who are dependent on narcotic agents.

 Methadone
 Trade Name: Dolophine®
 
Methadone is used to withdraw heroin addicts.  It is given in a cherry liquid and /or Methadose
40mg tablets dissolved in water.

Dolophine comes in 5 and 10mg tablets. The tablets are prescribed for moderate
to severe pain written by Pain Specialists. (The tablets are what they are finding in most of the deaths occurring with frequency lately.)

It is a synthetic narcotic, similar in potency to morphine. It was first synthesized by a german chemist in 1943 as a substitute for morphine,  - which was unavailable in Germany during World War 11.  It has been widely used in the treatment of heroin addiction,  - - and also useful in managing the withdrawal effects of narcotic drugs. The compound has a longer effect,  - - - lasting from 24 to 36 hours, and is highly effective when administered orally. - -  Thus, the drug can be given once a day in detoxification or maintenance programs.  Additionally, the drug appears to block the effects of other narcotic drugs,  - - - - making methadone a valuable tool in the treatment of heroin and other narcotic addictions.  - - - As with other narcotics, the drug produces physical and psychological dependence,  - - - - though such effects develop more slowly and with seemingly less severity.

 Propoxyphene
 Trade Name: Darvon 65mg® 
  

It was first marketed in 1959 for the relief of mild to moderate pain. It is only one-fifth to one-tenth as potent as codeine, *** making it only slightly more potent than two asprin. In spite of this,it continues to be one of the most prescribed analgesics, with more than 30 million prescriptons written each year.It is favored by physicians because it is less dependence producing than other narcotics.The greatest concern with the drug is the synergistic effect when combined with alcohol-it ranks second to barbiturates in prescription overdose deaths.

Pentazocine ( Trade Name: Talwin®) 30Meq Injectable

Talwin NX 50mg® (Pentazocine with Naloxone)
The formulation was changed due to the abuse of the 
medication. Naloxone was added to prevent people
 from injecting it.

  **It was synthesized in 1961 and introduced as an effective analgesic without the dependency problems associated with other narcotics. In reality, while it does have analgesic properties greater than Demerol, - - it is also a weak narcotic antagonist  that  is, it can precipitate mild withdrawal symptons when administered to narcotic dependent users.  -  Talwin® has become a popular drug of abuse because of the euphoria it produces as well as pleasant sensations of floating. - -  Many abusers compare the drug to the effects of marijuana.  - Additionally, when mixed with an over-the-counter antihistamine, pyribenzamine, and injected intravenously, - - the drug produces heroin-like effects.  This combination is known as T's and Blues.

Oxycontin® comes in four different time-released strengths.
 It's active ingredient is timed-released Oxycodone HCI. --It
comes in 10mg,20mg,40mg and 60mg. (I60mg is no longer
made.) People began to crush
Oxycontin® comes in four different time-released strengths. People began to abuse it 
by crushing it up and injecting to release the full dose.  
 

OxyContin®  (is the brand name for a semisynthetic opioid analgesic prescribed for chronic moderate to serve pain). It's active ingredient is oxycodone, which is also found in drugs like Percodan and Tylox. It is more potent than hydrocodone and has a greater potential for abuse. Oxycodone is also found in at least 45 other drugs on the market, including Percocet. OxyContin contains between 10 and 160 milligrams of oxycodone in a timed - released tablet.   Painkillers such as Tylox® contain five milligrams of oxycodone and often require repeated doses to bring about pain relief because they lack the timed - released formulation.

Percocet®, Tylox®,Percodan® all contain the same active
ingredient as Oxycontin® but it is not timed-released.  You
can see it comes in 2.5mg,5.0mg,7.5mg and 10mg.  It has
acetaminophen, (Tylenol)  mixed with it or if it's Percodan, it has aspirin mixed with it. Oxycontin® has neither mixed in with it.  - - There is a difference in the two, yet they both contain the same active ingredient, oxycodone. Actually,
80mg Oxycontin =  taking 8 (10mg) Percocet.  

Since hitting the U.S. market in 1996, Oxycontin has become one of the most popular- and most abused-medical painkillers. More than 7.2 million prescriptons were dispensed annually since 2001, according to the company.  It is a time-released narcotic which provides continous relief for up to 12 hours.  Like other opioids, it works primarily through interaction with the mu opoid receptors, especially in the brain and spinal cord.  It produces a euphoric effect.

Reference:  Barry R.McCaffrey            Updated: 15 November 2006



This is a story about Methadone, does it work, or don't it?

The Heroin addiction had become a daily habit, leaving Scott with violent shakes, twitching legs and excruciating stomach pain. - - To quit, he needed Methadone Maintenance Treatment, a common approach to helping Heroin addicts fight their malaise.

At his worse, 23 year old Scott was shooting 10 bags of heroin a day. He had to make  a daily two-hour round trip drive to Pennsylvania to seek treatment.

Many others also traveled out of state for daily dosages of methadone. They had little choice until last year, when the first clinic was opened in Charleston, Since then, three more have started in Parkersburg, Clarksburg and Martinsburg. A fifth clinic is scheduled to open soon in Beaver, Raleigh County.

National Specialty Clinics, a private company that owns the four existing methadone facilities in the state, has plans for other areas as well. Williamson, Huntington and Lewisburg have approved certificates of need and are in the process of government inspection.

''In West Virginia, we found that there is an overwhelming need for methadone treatment, "regional manager Reeve Sams said. "About 70 percent or more seems to be an OxyContin problem, but if they didn't have that it would be substituted with another opiate. If there was more heroin around and it was cheap, people would be doing more of that."

An Important Remedy

Methadone, a Drug used to treat Opiate Addiction for the last 35 years, usually is an option after conventional drug treatment fails. In order to be eligible for treatment, an opiate addict must have evidence of dependence and usually a habit of at least a year.

According to the National Institute of Health, about 115,000 of the estimated 600,000 opiate-dependent people in the Untied States receive Methadone Treatment. In West Virginia, hundreds of addicts are treated with methadone at the four clinics.

"Some people say it's trading one drug for another and they are dead set against that, "said Merritt Moore, who coordinates Adult Treatment services for the state Department of Health and Human Resources. "There are people who are Diabetic and need Insulin. I don't think anyone would call them an addict. It is a medical condition.

"Anyone addicted to opiates for a considerable amount of time needs assistance. Sometimes people don't give credit because these people are on methadone."

West Virginia's opiate problem lies mostly with OxyContin abuse. --  OxyContin is a synthetic opioid with properties similar to opium-derived painkillers such as morphine and codeine. In 2000, there were an estimated 4,500 drug arrests in the state. The number of arrests from OxyContin alone is not specified.

"A lot of people who failed in a Transititional Treatment Environment may have kept using if methadone wasn't available. "Moore said. "It's another part of the continuum to get into recovery. it is real important to stress recovery in all areas, not just Methadone  Mainte-nance Treatment Facilities alone."

Steve Mason, Director of Alcoholism and Substance Abuse for the Department of Health and Human Resources, says opposition to methadone is due to a lack of knowledge about how Methadone Maintenance Treatment works.

" There is always debate when something is new, "Mason said. "A lot of it is misunder-standing about how methadone works. Hopefully, over time when people learn more about it, it will be more accepted."

Moore said the reason there is not an overwhelming resistance in the state is because people understand West Virginia's opiate problem.

"There may be a little opposition, but I think people understand the need is so great, "he said. " Even if people aren't advocates, they seem to recognize the need."

                            A Downward Spiral

Joey knows both sides of treatment.

At one time it was the best thing he used. Just as quickly, though, it became the worst. Joey's Oxycontin habit took his job and his hope. Along the way, he lost his life as well.

"  I lost my job and I had no place to go, really, " he said. " My life hasn't been good and it's not fun to talk about. You don't know what I had to do for years to make it. I had to survive."

Joey remembers days so strung out he wanted to die. He remembers finding $150 daily to support his habit. He remembers when normal life ended and hell began.

" Drugs are bad news. They are bad, bad news, "he said.

Joey knew his OxyContin abuse had to change or it would kill him. Soon after, he started methadone treatment. The switch was a hard one, but with the help of his counselor at the Charleston Treatment Center, days have become bearable again. Joey now works and helps his family.

"The methadone started to work, and then I felt like I could make it, "he said. "My counselor is the only one who understands what I went through. There are lots of people at the clinic and if it weren't there, you would have hundreds of people out stealing and selling whatever they need to keep from getting sick. Methadone has saved my life, but it's to bad I even needed it."

Not a "Quick Fix"

Methadone's success is dependent on a variety of factors. An outside support system, adequate dosage and continuation of treatment help to ensure the drug's positive response. A high motivation for change also has proved to help addicts beat opiate addiction.

What methadone isn't, however, is a "quick fix."

"The withdrawal from Methadone is sometimes longer and you have to be under a Doctor's Supervision." Moore said.  "You don't want to get off methadone too abruptly. When someone comes into the facility, there is an explanation of the risks. This is not a short-term treatment; however it does not have to be lifelong."

In average cases, a person receives MethadoneTreatment for a year or two.  Cost are about $13.00 a day for dosages, counseling and referral services.

Before 2001, Moore said there did not appear to be a need for methadone treatment in West Virgina. The onset of the OxyContin problem and heroin's popularity changed that.

All of the methadone clinics in West Virgina are privately owned, but are strictly regulated by Federal and State laws. Private companies, such as National Specialty Clinics come into a selected area to assess whether or not there is a need for clinic. Different goverment factions, including the U.S. Drug Enforcement Administration, must approve the clinics before they are permitted to open.

 .......... According to the American Methadone Treatment Association, Methadone Treatment is the most monitored and regulated treatment in the United States.

"It's not impossible to stop using any drug, "Moore said. "I think many people can recover in a Conventional Drug- Free environment. However, there are a certain number of people who do not respond to that kind of treatment.   ..... Methadone Treatments have been an avenue of recovery for those people."

Deception

Joey said methadone saved his life; Scott said it almost killed him.

Scott believed he had his habit under control-four days on dope, three days clean. He didn't want heroin to become a problem, but the drug can be  "deceiving."

"The time in between got longer and longer, and the days I wasn't using were fewer, "It starts out as an occasional thing and slowly takes you over. You don't even know what is happening."

As a last resort, Scott began methadone treatment in Washington,Pennslyvania. He started out on a low dosage of methadone, but continued to use heroin. Instead of using the drug for treatment, it became a substitute. His friends and family thought he was beating his addiction, but Scott knew better. The methadone would stay in his system just long enough so the slightest withdrawal from heroin was tolerable.

Scott thought he had a good system- then he got caught. he ended up in Preston County Memorial Hospital for 11 days on the detoxification floor. Scott now had an added battle of beating both.

"I was scared out of my mind because I have been told that you just can't stop taking Methadone,"he said. "The withdrawal is supposed to be ten times worse plus I had about eight bags of Heroin a day to come off ofThe reason I wanted to get on Methadone in the first place was because I didn't think I could deal with getting off heroin alone.

"Coming off methadone is the most intense hell I have ever been through. Heroin stays in the blood stream, but methadone stays in your bones. I really thought I might want to die.

Now clean for several months, Scott said maybe with a higher methadone dose and separated himself from heroin, the treatment would have worked.

"People should know that it is a drug like anything else, "he said. "It is really up to the individual. It's hard to say if methadone is a good or bad thing. It depends on the situation. It is something people should really think about if they have a serious problem and are looking for an alternative. It's a good way to get the illegal element out of the picture."

Charleston Daily Mail         By: Kelly Carr


(Fentanyl Transdermal System)  75µg/h  (Duragesic)

FENTANYL ALERT

Samhsa Alerts Field To Dangerous Drug Combo

The Substance Abuse and Mental Health Services Administration (Samhsa) has issued an action alert to substance abuse treatment and prevention professionals about a new combination of street drugs with a potentially lethal effect in east coast and midwest cities in the past few months.

In just one week in May, an estimated thirty-three individuals in Detroit are re-ported to have died after using this fatal drug mix.  The same drug combination may have been responsible for over one-hundred deaths in Philadelphia/Cam- den, Chicago, St. Louis, and Detroit since last September.

The alert was issued by Samhsa's Center for Substance Abuse Treatment Director H. Westley Clark,M.D., J.D.,M.P.H.,to Substance Abuse Professional Organizations Treatment Providers, State Substance Abuse Authorities, Recovery Community-Related Organizations and Individuals. It highlights the growing concern about the potentially fatal effects of this street-drug combination and encloses a Brief Fact Sheet about preventing as well as detecting and treating overdoses.

Fentanyl is not for the opioid-naive
It should not be mixed with alcohol, 
benzodiazepines nor barbiturates.

"Individuals involved in the public health need to be aware of this new dangerous drug combination, "Dr.  Clark said. " They need to be prepared to alert patients, clients and others to help save lives. After all, fentanyl is 50-100 times more powerful than morphine. When mixed with cocaine or heroin, the results can be lethal. "

The alert encourages recipients not only to advise their networks of patients and colleagues, but also to join local health authorities to bring information about the drugs to first responders, emergency room personnel, street substance abuse work -ers, drug treatment facilities, local health care providers, the recovery community, and the public at large.

When used illegally, particularly in combination with a drug such as heroin or cocaine, or when used in excessive amounts, fentanyl can result in irregular heart beat, the inability to breathe, and death.  In some cases, heroin or cocaine users are aware they are purchasing this dangerous combination of drugs;   in other cases, the buyer is not aware they he or she is purchasing this potentially lethal drug combination.

 The alert advises local vigilance for the possible introduction of this potent drug mixture into circulation on the street and strongly   emphasizes the importance of education, particularly on the street.


UCLA researcher has developed a low-cost test for a genetic marker for addiction, the New York Daily News reported Feburary 11, 2006.  Ernest Noble, professor of Psychiatry and Director of the UCLA Alcohol Research Center, developed the test for the A1 allele, which researchers have identified as signaling elevated risk of addiction.

The gene is found in people who have lower levels of the neurotransmitter dopamine;  most  addictive  drugs  work  by increasing dopamine production.

Users swab the inside of their mouth and send a sample to a lab for analysis. "With the test, we can get parents to concentrate and educate children on the problems of drugs and alcoholism when they're younger and more amenable to prevention," said Noble . "It's like any other disease, and if you identify it early, like diabetes, you've got a better chance of defeating it."

The test, now under development, will cost about $35;  Noble's research was funded by the Christopher D. Smithers Foundation. "The test is going to be very meaningful for education and prevention of alcoholism and drug addiction," said Foundation President Adele Smithers-Fornaci.  "Once you've had this terrible disease strike your family you don't want to see it repeated,  and this test is a terrific diagnostic tool."

Dated:  February 13, 2006                Reference:  New York Daily News


METHADONE HYDROCHLORIDE:

A Brief Historical Overview

Invented by German scientists around the time of WW11 as an analgesic alternative to morphine.

Clinical trails began in America in the late 1940's . Found to be a poor painkiller. By the 1950's. hardly being used at all.

Early research showed methadone effective at treating Opiate withdrawal syndrome when substituted for morphine.

Until the 1960's, methadone used only to withdraw addicts from heroin, usually in 7-10 days. aka Detoxification.

1960's, Drs. Marie Nyswander and Vincent Dole ( Rockefeller University ) began administering constant daily doses of methadone after building up to a stabilization dose. They coupled this with counseling and rehabilitative services.  Tx called Methadone Maintenance Treatment.

Nyswander and Dole discovered and reported on the three therapeutic benefits of methadone, it's safety and it's efficacy as a treatment for opiate addiction.

Late 1960's and 1970's, heroin epidemic. Heroin related mortality was the leading cause of death for 15-35 year olds in NYC. President Nixion and others looking for a quick fix turned to methadone. Methadone programs expanded rapidly.

1968-  fewer than 400 patients in methadone treatment.

1973-  73,000 patients in MMT

Methadone was oversold due to rapid expansion of programs. Patients were underdosed and Methadone Maintenance Guidelines were not always followed by providers. Heroin abuse and drug related crime continued.

Methadone acquired reputation as part of the drug problem, rather than part of the solu-tion.

WHERE ARE WE TODAY?

Reference:  East Indiana Treatment Center Lawrenceburg,Indiana 47001

Written and Compiled ByDeborah Shrira RPH,CMA       Updated:  15 Nov 2006

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