Heroin addicts

Most heroin addicts have lymphadenopathy (Carbone et al. 1998 Tirelli et al. 1986). Vein sclerosis and contaminant-related lymphatic obstruction may cause extremity edema. Ulceration and other dermatologic changes are often present in those who skin pop. ... 

At the doses used, there is blockage of the effects of as much as 25 mg of injected heroin. Toxicity in heroin addicts is low, but some reported subtle adverse effects of naltrexone such as decreased energy (Hollister et al. 1981). Nonaddicted obese subjects have been known to develop markedly elevated transaminase levels at doses of 300 mg/day (Mitchell et al. 1987). The inference has been drawn that high doses are potentially hepatotoxic (Pfohl et al. 1986), and the drug is contraindicated in liver failure or acute hepatitis. 

Dole VP, Nyswander MN A medical treatment for diacetylmorphine (heroin) addiction. JAMA 193 646-630, 1963... 

Dole VP, Nyswander MN Heroin addiction a metabolic disease. Arch Intern Med 120 19-24, 1967... 

Mello NK, Mendelson JH Buprenorphine suppresses heroin use by heroin addicts. Science 207 657-659, 1980... 

Nurco DN, Kinlock TW, Hanlon TE, et al Nonnarcotic drug use over an addiction career a study of heroin addicts in Baltimore and New Ytrk City. Compr Psychiatry 29 450-459, 1988... 

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... 

Sanchez-Carbonell X, Sens L Ten-year survival analysis of a cohort of heroin addicts in Catalonia the EMETYST project. Addiction 95 941—948, 2000 Schindler SD, Eder H, Ortner R, et al Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy. Addiction 98 103-... 

Stimson GV, Oppenheimer E Heroin Addiction Treatment and Control in Britain. London, Tavistock, 1982... 

Tmeblood B, Judson BA, Goldstein A Acceptability of methadyl acetate (DAAM) as compared with methadone in a treatment program for heroin addicts. Drug Alcohol Depend 3 125-132, 1978... 

Wikler A Opioid Dependence Mechanisms and Treatment. New York, Plenum, 1980 Williams JT, Christie MJ, Manzoni O Cellular and synaptic adaptations mediating opioid dependence. Physiol Rev 81 299—343, 2001 Woody GE, O Brien CR, Rickels K Depression and anxiety in heroin addicts a placebo-controlled study of doxepin in combination with methadone. Am J Psychiatry 132 447--i50, 1975... 

The clinical characteristics of newborns exposed prenatally to PCP are similar to behavior patterns of infants born addicted to heroin and/or methadone. In 1973, Wilson et al. described the early development of infants of heroin-addicted mothers. The neuro-behavioral symptoms of the newborn included tremors, irritability,... 

The observations of fine motor problems in infants born to heroin addicts has also been described by Wilson et al., in 1973. She notes the discrepancy between the gross motor skills of the infants and fine motor abilities during the first year. Furthermore, in 1979, Wilson et al, described the development of preschool children between 3 and 6 years of age, born to heroin-addicted mothers. They performed poorer on measures of visual, tactile, and auditory perception, were more active, and had... 

Wilson, G.S. Desmond, M.M. and Verniaud, W.M. Early development of infants of heroin-addicted mothers. J. His Child 126 457-462,... 

Wilson, G.S. McCreary, R. Kean, J. and Baxter, J.C. The development of preschool children of heroin-addicted mothers A controlled study. Pediatrics 63 135-141, 1979. 

Pollack M., Rosenbaum J. Fluoxetine treatment of cocaine abuse in heroin addicts. J. Clin. Psychiatry. 52 31, 1991. 

Finally, intravenous drug administration and the sharing of needles and syringes is common among opiate addicts this creates a serious risk of cross-infection. Many studies have shown a high incidence of HIV and hepatitis B and C among heroin addicts. This risk is somewhat reduced in medically controlled narcotic prescription... 

Goldstein A (1991). Heroin addiction Neurology, pharmacology, and policy. Journal of Psychoactive Drugs, 23, 123-133. 

Andersen SN and Skullerud K (1999). Hypoxic/ischaemic brain damage, especially pallidal lesions, in heroin addicts. Forensic Science International, 102, 51-59. 

Keen J, Oliver P, Rowse G and Mathers N (2000). Keeping families of heroin addicts together Results of a thirteen months intake for community detoxification and rehabilitation at a Family Centre for drug users. Family Practice, 17, 484 -89. 

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. 

A former heroin addict is maintained on methadone, but succumbs to temptation and buys an opioid on the street He takes it and rapidly goes into withdrawal. Which opioid did he take ... 

A 36-year-old male heroin addict is seen in the ED because he cannot be aroused from sleep On examination, he has shallow breathing and pinpoint pupils. Naloxone is administered, and the patient wakes up. Which of the opiate receptor subtypes that binds naloxone is responsible for reversing the respiratory depression and miosis ... 

Methadone has oral efficacy, extended duration of action, and ability to suppress withdrawal symptoms in heroin addicts. With repeated doses, the analgesic duration of action of methadone is prolonged, but excessive sedation may also result. Although effective for acute pain, it is usually used for chronic cancer pain. 

Kreek, M.J., Immune function in heroin addicts and former heroin addicts in treatment Pre- and post-AIDS epidemic, NICA Res. Mono., 96, 192, 1990. 

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