Addiction to narcotics

Methadone, a synthetic narcotic, may be used for the relief of pain, but it also is used in the detoxification and maintenance treatment of those addicted to narcotics. Detoxification involves withdrawing the patient from the narcotic while preventing withdrawal symptoms. 

Administration of a narcotic agonist-antagonist may result in symptoms of narcotic witiidrawal in those addicted to narcotics. Other adverse reactions associated widi die administration of a narcotic agonist-antagonist... 

A. symptoms of narcotic withdrawal may occur in those addicted to narcotics... 

Ibrahim RB, Wilson JG, Thorsby ME, et al Effect of buprenorphine on CYP3Aactivity in rat and human liver microsomes. Life Sci 66 1293—1298, 2000 Iguchi MY, Handelsman L, Bickel WK, et al Benzodiazepine and sedative use/abuse by methadone maintenance clients. Drug Alcohol Depend 32 257—266, 1993 Isbell H Manifestations and treatment of addiction to narcotic drugs and barbiturates. Med Clin North Am 34 423 38, 1950... 

Narcotic habit Addiction to narcotics such as opiates or cocaine. 

Beginning in 1985, a series of patents was issued for the use of ibogaine as a rapid means of interrupting addiction to narcotics (morphine and heroin) (3), cocaine and amphetamine (4), alcohol (5), nicotine (6) and polydrug dependency syndrome (35). These patents claim that an oral or rectal dose of ibogaine (4-25 mg/kg) interrupts the dependence syndrome, allowing patients to maintain a drug-free lifestyle for at least 6 months. 

The membrane separating fetal blood from maternal blood in the intervillous space, the placental barrier, resembles other membranes, in that hpid-soluble substances diffuse readily but water-soluble substances either do not or diffuse poorly. Thus, for instance, morphine-induced respiratory depression and miosis may occur in both the mother and her newborn infant. The children of narcotic-addicted mothers will be bom with an addiction to narcotics. 

Many patients and healthcare providers are concerned that a patient will become addicted to narcotic analgesics or develop a tolerance for these dmgs. Both can occur. However, proper pain management can alleviate these potential problems. 

Educating the Patient and Famiiy The nurse instructs patients under treatment for narcotic addiction to wear or carry identification indicating that they are receiving naltrexone If the patient is taking naltrexone and requires hospitalization, it is important that all medical personnel be aware of therapy with this drug. Narcotics administered to these patients have no effect and therefore do not relieve pain. Fhtients receiving naltrexone may pose a problem if they experience acute pain. The primary health care provider must decide what methods must be used to control pain in these patients. 

Deaths, cardiac and resp have been reported during initiation and conversion of pain pts to methadone Tx from Tx w/ other opioids Uses Severe pain detox w/ maint of narcotic addiction Action Narcotic analgesic Dose Adults. 2.5-10 mg IM q3-8h or 5-15 mg PO q8h titrate as needed Feds. 0.7 mg/kg/24 h PO or IM -s- q8h T slowly to avoid resp depression X in renal impair Caution [B/D (prolonged use/high doses at term), + (w/ doses =/> 20 mg/24 h)], severe liver Dz Disp Tabs, inj SE Resp depression, sedation, constipation, urinary retention, T QT interval, arrhythmias Interactions T Effects W/ cimetidine, CNS depressants, protease inhibitors EtOH T effects OF anticoagulants, antihistamines, barbiturates, glutethimide, methocarbamol ... 

Meanwhile, opium had been joined by other narcotics. Back in 1805 a German pharmacist s assistant had discovered how to isolate its main ingredient, morphine. A preparation of morphine is about 10 times as potent as raw opium. In 1832, another morphine derivative called codeine was isolated. By the 1850s, a more effective way to administer these powerful narcotics was developed—the hypodermic needle. During the American Civil War, battlefield surgeons had one effective way to relieve the pain of a shattered limb or punctured lung—an injection of morphine. Soldiers who survived their wounds after this treatment often became addicted to the drug. Morphine addiction was thus sometimes referred to as the soldier s disease. ... 

The defendant was charged with violating a California law that made it a misdemeanor punishable by imprisonment for any person to be addicted to the use of narcotics. The defendant had been arrested because a police officer had observed discolorations and scabs on the arms that in his experience resulted from the use of dirty hypodermic needles. The defendant had de-... 

The problem here, the Court found, is that the state court did not construe the law as requiring proof of actual use of narcotics on the part of the defendant. The jury had been instructed that it could convict if it simply found that the status of addict applied to tire defendant—that he had the chronic condition of being addicted to the use of narcotics. This meant that... 

The inappropriate or illegal use and abuse of narcotics such as heroin is a major problem in many countries. Hence, various strategies have been employed to treat people who are addicted to heroin and other opioids. Methadone is the primary pharmacological intervention used to treat opioid addiction. Methadone is a strong opioid agonist, similar in potency and efficacy to morphine. While giving an opioid to treat an opi-... 

Addiction to cannabis is usually casual, because psychopathic individuals tend to drop it for a more potent narcotic. It generally takes the form of an occasional hedonistic indulgence, whose chief danger lies in the introduction to more serious addictions. No relation to criminal offenses, sexual or other, has been established. Physical consequences are no more significant than with... 

Naloxone (Narcan) and naltrexone hydrochloride (Trexan) reverse the respiratory depressant action of narcotics related to morphine, meperidine, and methadone. They differ from other narcotic analgesics in several respects. Naloxone does not cause respiratory depression, pupillary constriction, sedation, or analgesia. However, it does antagonize the actions of pentazocine. Naloxone neither antagonizes the respiratory depressant effects of barbiturates and other hypnotics nor aggravates their depressant effects on respiration. Similar to nalorphine, naloxone precipitates an abstinence syndrome when administered to patients addicted to opiate-like drugs. 

The primary long-term concern of those who use hydromorphone is the risk of addiction. The National Institute on Drug Abuse has determined that persons who become addicted to hydromorphone and other narcotic analgesics are at increased risk of convulsion, overdose, and death. 

Addiction to hydromorphone and other prescription painkillers is one of the major reasons behind admittance to drug rehabilitation clinics. Treatment for opiate addiction has been occurring in the United States since the early part of the twentieth century. In these early days of treatment, doctors in private practice prescribed narcotics to those addicted to opiate drugs. Later, governments outlawed this practice and began operating clinics where morphine could be obtained by addicts. Eventually, these clinics were also closed. At that point in time, addicts began to be treated in public health hospitals or placed in jail. 

OPIOPHOBIA The fear of patients becoming addicted to their narcotic pain medication. 

Addiction to prescription painkillers is a major reason people are admitted to drug rehabilitation centers. In the early part of the twentieth century, however, treatment for addiction to opiates was actually self-administered. Private doctors would prescribe narcotics for opiate addicts, but that practice was soon outlawed, and local governments and communities established formal morphine clinics. By the 1920s, these clinics too were closed and opiate addicts were jailed or treated, usually unsuccessfully, in public health hospitals. 

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