Subjective effects heroin

The combination of pentazocine with the antihistamine tripelennamine results in a combination known to drug abusers as T s and blues. This combination produces heroinlike subjective effects, and heroin addicts use it in the absence of heroin. In addition, the use of pentazocine in combination with alcohol or barbiturates greatly enhances its sedative and respiratory depressant effects. 

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... 

The most useful modality for dealing with the societal aspects of opiate abuse (as well as some of the medical and personal aspects) has been methadone maintenance. In consideration of the pharmacology of opiate dependence 4,17,45,58,87,88,131,140,172,185 Dole and Nyswander 51 proposed that maintenance of opiate addicts on relatively large doses of oral methadone would inhibit drug seeking behavior, "block" the subjective effects of parenteral heroin injection because of the tolerance induced, break the needle habit because of lack of reinforcement by this route, and make the addict more available for psychiatric treatment and rehabilitation, breaking the cycle of crime and punishment. Methadone maintenance has been... 

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. 

Seecof R, Tennant FS Subjective perceptions to the intravenous rush of heroin and cocaine in opioid addicts. Am J Drug Alcohol Abuse 12 79—87, 1987 Sees KL, Delucci KL, Masson C, et al Methadone maintenance vs. 180-day psycho-socially enriched detoxification for treatment of opioid dependence a randomized controlled trial. JAMA 283 1303-1310, 2000 Sells SB Treatment effectiveness, in Handbook on Drug Abuse. Edited by Dupont RE, Goldstein A, O Donnell J. Washington, DC, U.S. Government Printing Office, 1979, pp 105-118... 

Psvchopharmaceutieals are medications that can affect the behavior and subjective state of man and are used therapeutically on account of these psychotropic effects. Apart from psychopharmaceuticals, there are man) other substances with psychotropic action, such as alcohol, nicotine, cocaine and heroin, which are characterized as social or addictive products and have no generally recognized therapeutic applications in Western medicine. Analgesics and members of other drug classes also have direct or indirect actions on subjective state and behavior but are not considered to be psychopharmaceuticals because they are not used primarily for their psychotropic effects. 

In Table 1.3 I have included the areas of physical and psychological health, which often do not feature in reviews. Methadone has significant adverse effects, as discussed below, and by no means do all patients report subjective improvements in health on the drug, as opposed to when taking street heroin or other opiates. However, if methadone treatment is adhered to, there is normalization of various circadian rhythms and endocrine effects... 

Heroin and methadone produced a rapid and dramatic reduction in both respiratory rate and cortical hemoglobin oxygenation, while saline had no effects. The authors suggested that opioid-induced acute deoxygenation of cortical hemoglobin was probably associated with respiratory depression. In one in three subjects, oxygen saturation after intravenous heroin fell rapidly, a finding that has not previously been described in humans. 

Marsh et al. and Marsh and Evans utilized the DPC morphine-specific RIA to study the effectiveness of wash procedures and self-reporting of drug use. The assay was found to be highly specific, accurate, and precise. Evaluation of hair from drug-free controls produced results <0.3 ng/mg. In the study, the results of segmental hair tests for morphine for a period of 15 months were used to challenge a subject s declaration of heroin abstinence. In similar studies. Marsh and Evans evaluated the effectiveness of the DPC methadone RIA. The assay was also found to be highly specific, accurate, and precise. 

A low-efficacy opioid can reduce the effectiveness of a high-efficacy opioid by successfully competing with the latter for receptors. Partial agonist (agonist/antagonist) opioids, e.g. pentazocine, will also antagonise the action of other opioids, e.g. heroin, and may even induce the withdrawal syndrome in dependent subjects. 

This chapter addresses the toxic effects of the mixtures of two recreational toxins, ethanol and tobacco. These are the most abused chemicals in the world and both are used recreationally worldwide. There are many other recreational drugs in use. These include marijuana, cocaine, heroin, and methamphetamines for example. These other recreational drugs are not addressed here, except where they are components of xenobiotic mixtures that produce unanticipated toxic effects. At this time there is a substantial volume of information that describes unanticipated toxic effects of ethanol and tobacco when used in conjunction with other toxicants. That information is the subject of this chapter. 

The medical addict usually confines himseK to morphine, but criminal addicts more frequently employ heroin and cocaine when available (Simon, 76). The danger of heroin lies in the ease ivith which addiction occurs, the intense euphoria which often supplants subjective depression, and the absence of unpleasant effects such as vomiting and constipation. The heroin addict is difficult to treat, usually relapses after apparent cure, and often represents a dangerous, asocial, and criminal type of personality. The morphine addict takes morphine in order to feel normal and prevent the appearances of withdrawal symptoms but the heroin addict continues his drug for the euphoric excitation it affords (69). 

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