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Substance Abuse during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Methadone is a synthetic opiate narcotic structurally similar to propoxyphene. Methadone is principally used medically is as opiate maintenance therapy for heroin addiction. It is also used illegally as a substitute for heroin. No studies of methadone abuse are published. Published studies include only pregnant women on regimented-dose maintenance therapy in treatment who took methadone of known pharmacological purity.
The Forensic Toxicological Aspects of Deaths Due to Drowning and Bodies Recovered from Fluid Environments
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
The following are but a few examples of adverse effects of some psychiatric medications. The antidepressant paroxetine (Paxil) can produce symptoms of somnolence, agitation, and muscular weakness.3 This medication is also prescribed for anxiety and obsessive compulsive disorder. One other antidepressant medication, amitriptyline (Elavil, Endep), has been found to impair the skilled performance, such as driving, an effect that is increased with the addition of ethanol.3 Clinical signs of toxicity and overdosage produced by this medication include seizures, coma, and cardiac arrhythmias.5 Specifically, cardiac arrhythmias can lead to drops in blood pressure, fainting, and seizure-like activities, potentially life-threatening situations, when combined with water-related activities. Toxicity related to lithium usage, a medication prescribed for bipolar disorder, includes drowsiness, weakness, unsteadiness, and blurred vision. Methadone, which is prescribed for heroin addiction and chronic pain conditions, can give rise to sedation, weakness, and respiratory depression.5 Overdose and potentially death can occur at therapeutic doses and blood levels, especially in individuals who are naïve to or lack tolerance for this medication.
Mixed Drug Abuse
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Drugs with sedative or antianxiety effects are widely used in the treatment of withdrawal without regard for whether or not there is cross tolerance. Agents with very long half lives are preferred because of the fewer doses needed. Thus diazepam and phenobarbital enjoy wide use (Chapter 27). Clearly the agent should not be continued beyond the first few days in opiate or alcohol withdrawal, but it may be needed for several weeks in phenobarbital or diazepam detoxification. Drugs with an addicting potential should not be utilized in treating addicts after withdrawal. Phenothiazine drugs, although they show cross tolerance, have a remarkably low addiction potential and therefore are the best group of agents if chronic sedation is required. A monkey addiction model dually addicted to cocaine and heroin has shown improvement when treated with buprenorphine, a mixed agonist-antagonist for opioids used for heroin addiction.10
ECG changes in patients with opioid use disorder; P-QT wave dispersion: a retrospective study
Published in Journal of Addictive Diseases, 2020
Bahadir Demir, Filiz Ozsoy, Ahmet Buyuk, Abdurrahman Altindag
Opioids are among the oldest known drugs used as pain relievers. It was found that opioids, which were synthesized as legal drugs to relieve pain, have been found to have a highly addictive effect in the early twenty-first century.1,2 Opioid use disorder is an important public health problem faced by the whole world. In 2015, more than fifty-two thousand people, as opioid use of more than thirty thousand, died because of substance overdose.3 Heroin has been reported as the most frequently misused and addictive among opioids.2 Heroin is an illegal and highly addictive drug. Repeated heroin applications quickly lead to the development of physical addiction. “Physical addiction” is the body’s adaptation to heroin and a physiological desire for the presence of the substance.4 Continuous and uncontrollable heroin intake and heroin seeking behavior together with this desire is defined as “heroin addiction.”5 Heroin use disorder is a chronic neurobiological disease that progresses with relapses and remissions in which genetic, environmental, familial factors, and personality characteristics play a role.6
Overcoming Heroin Addiction without the Use of Pharmaceuticals: A Qualitative Interview Study
Published in Journal of Psychoactive Drugs, 2020
Christina Nehlin, Mimmie Willebrand, Charlotte Wollert Brander, Caisa Öster
The participants reported that using heroin over time was mentally and physically exhausting. Many described being completely worn out. Participants described an accumulation of discontent with their life in heroin addiction, often expressed as “I couldn’t take it anymore”. Many participants felt they were leading a life far from their true self, which led to desperation and self-contempt. The drugs often made them feel numb inside; recurrently participants stressed that heroin left them low or empty of emotions. I was psychologically destroyed, sort of. I had nothing in here [points to the chest], I was completely dead. I love music, but I hadn’t listened to music in years. Sex was completely uninteresting and nothing could excite anything in me. And I never felt good, no matter how much drugs I took. (#4, male)
Exploring trends and challenges from mandated treatment to voluntary treatment outcomes in addiction treatment in Malaysia: moving toward a person-centered service provision
Published in Journal of Substance Use, 2020
Ghani et al. (2015) explained the lack of evidence-based treatment, difficulty accessing treatment and proper care in the Community Drug Detention Centers (CDDC) in Malaysia as a motivation for the government to review the policies and improve access to admission, along with reducing detention and forced rehabilitation methods. Cure and Care Centers (C&C) were introduced to replace the mandated approach with the CDDC. Wegman et al. (2017) found evidence that people on methadone treatment in CDDCs had higher relapse rates to opioids upon release from the centers as compared to those on methadone treatment in the C&Cs. Methadone treatment is employed as a form of Opioid Substitution Therapy (OST) mainly introduced to manage heroin addiction and related problems in Malaysia. The Ministry of Health (2008) reported that there was close to 10% HIV prevalence in the CDDCs as compared to the 6% among incarcerated prisoners (Khan et al., 2018; UNGASS, 2010; Zahari et al., 2010). This finding was 24 times the 0.41% reported HIV cases in the community (Malaysia Ministry of Health, 2012). On the other hand, the relapse rates of people to their drug of choice 1 year after their release from the CDDCs was reported at 70%-90% (Open Society Institute, 2010; Reid, Kamarulzaman, & Sran, 2007; UNODC, 2010; World Health Organization, 2009).