Deaths Among Heroin Users in and out of Methadone Treatment

Desmond, David P.; Maddux, James F.

doi:10.1300/j126v01n04_05

Cited by 8 publications

(5 citation statements)

References 42 publications

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“…11 Use of opiates has changed significantly in recent decades. 12 Until the 1990s, heroin available in the United States was rather weak, with each bag containing approximately 4% heroin and the rest consisting of inert fillers. 13 Beginning in the 1990s, large quantities of heroin entered the United States with an average purity about 10 times that of the past; that is, about 45% pure.…”

Section: History Of Opiate Addiction In the United Statesmentioning

confidence: 99%

A 50-Year-Old Woman Addicted to Heroin

O’Brien

2008

JAMA

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Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone.Dr Ship: Ms W is a 50-year-old woman being treated with methadone maintenance. She lives in Boston and has Medicare.Ms W began using heroin at age 14 years. She used intravenous heroin but has subsequently sniffed it as well. Friends of hers used the drug and she decided to try it. Initially she did not like it, but she returned to it for reasons she cannot understand and became addicted. She supported her habit with stealing, armed robbery, and prostitution. She has been in detoxification "more than 20 times" and had repeated difficulties remaining free from heroin use. She finds that at times of stress it is very difficult to refrain from using heroin, and she relapses.Ms W currently receives maintenance methadone, 108 mg/d. She gets her methadone once a week and sees a counselor as well. She has tried to reduce her methadone dose several times unsuccessfully. Each time, she found herself returning to heroin use. She is tired of taking methadone and would like to try buprenorphine. She hopes that this would prevent her from getting the desperate feeling she has occasionally for heroin and allow her eventually to be drug free.Ms W has 2 living children and 5 grandchildren. She lost 1 teenaged daughter to a gunshot wound. Ms W completed 10th grade and acquired her GED (General Education

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Section: History Of Opiate Addiction In the United Statesmentioning

confidence: 99%

A 50-Year-Old Woman Addicted to Heroin

O’Brien

2008

JAMA

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“…Vielleicht hat sich diese Zahl mit den neuen HIV-Behandlungen etwas gesenkt, dafür wird nach heutigem Stand des Wissens die Zahl der Hepatitis-C-Toten drastisch zunehmen [5]. Im Vergleich dazu liegt die berichtete Todesrate unter Substitutionsbehandlungen meistens bei rund 1 % pro Jahr [6].…”

Section: Mortalität -Das Verdrängte Problemunclassified

“…Die Verwendung der heute gebräuchlichen Substitutionsmittel, wie Methadon, Buprenorphin, Heroin oder anderen Opiaten, erfüllt die Basisforderung der Zielpyramide, indem sich die Mortalitätsrate massiv senken lässt [3,6] und sich Sekundär-risiken, wie Neuansteckungen mit Hepatits B und C und HIV reduzieren [21,22]. …”

Section: Substitutionsgestützte Behandlungunclassified

Jenseits des Abstinenzparadigmas - Ziele in der Suchttherapie

2005

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EinleitungDie folgenden Ausführungen beziehen sich auf das Feld der illegalen Drogen mit der "harten" Droge Heroin als Leitsubstanz. Die Überlegungen schließen aber auch Kokain mit ein und Analogieschlüsse zu weiteren illegalen und legalen Drogen lassen sich ziehen.Auch nach über 150-jähriger Auseinandersetzung der Medizin mit der Suchtthematik -später der Psychologie, der Sozialarbeit, Schlüsselwörter Substitution · Abstinenz · Drogenkonsum · Opiatabhängigkeit · Therapieziele AbstractAccording to medical criteria, addiction to "hard" drugs must be understood as a chronic and often terminal disease. Therapeutic approaches should not be primarily measured by the concept of a cure, which is often equated with abstinence. Reality requires realistic goals. The main goal is to enable the addicts to survive. Achieving the higher goal of improving quality of life requires realistic steps which keep this in mind and are developed together with the addict. The modification of and self-control in drug use is usually a helpful part of this process. In addition to the term substitution-assisted treatment, the term abstinence-assisted treatment will be introduced. This concept could help lift drug therapy out of the dead end of the abstinence paradigm. Both methods should be offered in an inpatient as well as an outpatient setting.

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“…These sensations are close to the painful feelings, but at the same time they differ from them, resembling senestopathies [6]. Accompanied by specific autonomic disorders, such as chill, sweating, rhinorrhea, dry mouth, and nausea, these sensations cause disproportionately potent emotional response with prevailing depressivehypochondriac and dysphoric symptoms [7,8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations of the Opiate Withdrawal Syndrome

Shigakova¹

2015

Int J Biomed

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Currently, substance abuse is one of the most serious problems facing our society. The aim of this study was to investigate the clinical manifestations of the opiate withdrawal syndrome (OWS). The study included 112 patients (57 women and 55 men) aged from 18 to 64 years with opium addiction according to the DSM-IV. To study the clinical manifestation of OWS, the special 25-score scale with four sections to assess severity of sleep disorders, pain syndrome, autonomic disorders, and affective symptoms was used. Given the diversity of the OWS symptoms, attention was focused on three clinical variants, affective, algic and mixed. The OWS affective variant was registered more frequently in women, while the mixed type of OWS was more typical of men.

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Deaths Among Heroin Users in and out of Methadone Treatment

Cited by 8 publications

References 42 publications

A 50-Year-Old Woman Addicted to Heroin

A 50-Year-Old Woman Addicted to Heroin

Jenseits des Abstinenzparadigmas - Ziele in der Suchttherapie

Clinical Manifestations of the Opiate Withdrawal Syndrome

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