Heroin deaths

The nurse should teach the patient taking naltrexone the impact of therapy. While taking the drug, any use of heroin or other opiate by the patient results in no effect. In fact, large doses of heroin or other opiates can overcome the drug s effect and result in coma or death. 

O Connor PG, Carroll KM, Shi JM, et al Three methods of opioid detoxification in a primary care setting a randomized trial. Ann Intern Med 127 526-530, 1997 Oppenheimer E, Tobutt C, Taylor C, et al Death and survival in a cohort of heroin addicts from London clinics a 22-year follow-up study Addiction 89 1299—1308, 1994... 

Potenza MN, Gold SJ, Roby-Shcmkowitz A, et al Effects of regulators of G protein-signaling proteins on the functional response of the mu-opioid receptor in a mel-anophore-based assay. J Pharmacol Exp Ther 291 482 91, 1999 Quaglio G, Talamini G, Lechi A, et al Study of 2708 heroin-related deaths in northeastern Italy 1985—98 to establish the main causes of death. Addiction 96 1127— 1137, 2001... 

More than 66 percent of PCP-related deaths reported to DAWN in 1983 involved at least one other drug. Table 5 shows a statistically significant relationship for alcohol combined with PCP and heroin combined with PCP (alcohol Xz=12.41, df=l, p <. 001 heroin X2 =29.13, df=l, p <. 001). 

The number of deaths associated with alcohol combined with PCP, and for heroin combined with PCP has been increasing. Nationally, the number of alcohol PCP-related deaths was 21, 50, and 59, respectively, for the three years 1981, 1982, and 1983, according to the DAWN annual reports. The number of heroin PCP-related deaths increased from 11 in 1981, to 24 in 1982, and 58 in 1983. 

The higher than expected frequency of alcohol PCP -, and heroin PCP-rel ated deaths may be the result of an interaction of the combined substances. Balster (this volume) anticipated an interaction of the combined substances when he reported "PCP very markedly enhances the effects of classical depressant drugs, including barbiturates and ethanol."... 

The higher than expected frequencies of alcohol PCP - and heroin PCP-related deaths also would have occurred if the combinations were preferred by the users. The motivation may involve the injection of heroin to moderate the adverse effects of PCP, or the use of PCP to ease the pain of heroin withdrawal. Another explanation assumes a stimulant effect of PCP. The use of stimulants, especially cocaine, with heroin is increasingly popular among heroin users (Kozel et al. 1982). 

The number of alcohol PCP - and heroin PCP-related deaths was higher than expected. Users may prefer taking these drugs in combination, or there may be an interaction in the effect of the combinations. Many of the PCP-related deaths are the consequence of some external event rather than a direct consequence of the drug itself. 

Oliver P, Keen J and Mathers N (2002). Deaths from drugs of abuse in Sheffield 1997-1999 What are the implications for GPs prescribing to heroin addicts Family Practice, 19(1), 93-94. 

The answer is c. (Hardman, pp 528-537.) Morphine is a pure agonist opioid drug with agonist activity toward all the opioid subtype receptor sites. In high doses, deaths associated with morphine are related to the depression of the respiratory center in the medulla. Morphine has a high addiction potential related to the activity of heroin or dihydromorphine. Codeine has a significantly lower addiction potential. 

Other effects caused by methamphetamine include headaches, decreased appetite, dry mouth, dilated pupils, trembling, chest pains, increased respiration and shortness of breath, hyperthermia (elevated body temperature), insomnia, and nausea and vomiting. In more severe cases (i.e., overdoses) it can produce seizures and convulsions, stroke, heart attacks, and death. The risk of encountering these more serious side effects are greatly increased when methamphetamine is used in combination with other drugs like cocaine, marijuana, alcohol, and heroin. 

In 1979-1980, some illegal fentanyl analogues appeared that were being sold as substitutes for heroin on the street. Suddenly, a series of more than a dozen mysterious deaths occurred in southern California. Upon autopsy, the victims strongly looked as if they had overdosed on heroin however, no traces of heroin could be found in their bodies. Later, forensic chemists identified a fentanyl analogue (alpha-methyl-fentanyl) that was present in all of the victims. As it turns out, alpha-methyl-fentanyl was being sold on the streets under the name China White (Figure 7.2), because it resembled (and contained) pure synthetic heroin that was produced in Southeast Asia. 

Respiratory g and 5 ligands participate in the regulation of respiration (Su et al. 1998). Respiratory suppression is a regular feature of morphine, which suppresses all phases of respiration. Respiratory arrest is the most frequent cause of death from morphine or heroin overdose. In... 

With an ethos of drugs, sex, and rock n roll, the music industry has seen heroin claim many lives over the years. Heroin, specifically, has been the cause of many needless deaths of musicians both young and old, and of all types of music. Below are just of few of the lives taken by heroin. 

Aimost two-thirds of all drug deaths In Philadelphia and neighboring metro areas were accidental, A large number of deaths stemmed from opiates like heroin. 

Top five drug misuse deaths, 2003 Opiates, including heroin... 

Public attention is also drawn to the death of celebrities resulting from drug overdose. For example, Janis Joplin, the blues singer, overdosed on heroin, actor River Phoenix and comedian... 

Further situations in which methadone can seem an unsatisfactory substitution agent are towards the other end of the treatment spectrum. In uncomplicated maintenance treatment or for detoxification, the criticisms which are levelled at methadone relate not so much to the subjective effects, but to the aspects of addictiveness, abuse potential and toxicity. The issue of whether methadone is too addictive to be really suitable for detoxification is considered in detail in Chapter 3, and the controversial subject of methadone risks and deaths in Chapter 1. It is in the relatively milder cases of heroin dependence that buprenorphine treatment as an alternative to methadone has risen to great prominence in several countries, although, importantly, the condition definitely does not have to be mild for this medication to be used. Undoubtedly the introduction of buprenorphine is one of... 

For more than 25 years, TCAs were one of the leading causes of drug-related deaths, exceeded only by alcohol-drug combinations and heroin (427). The risk of fatality resulting from a TCA overdose has severely limited their use now that newer, safer antidepressants are available. Nevertheless, overdoses of these medications still occur. There is still no simple antidote for a TCA overdose. A TCA overdose produces a characteristic clinical picture consisting of the following ... 

Stanton, M.D. (1977) The addict as Saviour heroin, death and the family , Family Process, 16 191-7. 

Drug abusers have never bothered about hepatitis, overdoses, choking to death on their own vomit, thrombosis, gangrene or heroin cut with strychnine—so why should they worry about AIDS The fact that more and more drug abusers are being identified as HIV-positive is unlikely to influence them. 

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