Wellness Posts by JeffreyStuckert

How is Suboxone Treatment Different than Drug Abuse?

2011-07-25T13:20:05Z

Wellness.com - How is Suboxone Treatment Different than Drug Abuse? by JeffreyStuckert

How is Suboxone Treatment Different than Drug Abuse?

Physicians who treat opioid addiction also have the option of utilizing 'medication-assisted treatment', and the most common medications used in the treatment of opioid dependence today are methadone, naltrexone, and buprenorphine (Suboxone).

Most people cannot just walk away from opioid addiction. They need help to change their thinking, behavior, and environment. Unfortunately, "quitting cold turkey" has a poor success rate - fewer than 25% of patients are able to remain abstinent for a full year. This is where medication-assisted treatment options like methadone, naltrexone, and Suboxone benefit patients in staying sober while reducing the side effects of withdrawal and curbing cravings which can lead to relapse.

-Methadone-

Methadone is an opioid and has been the standard form of medication-assisted treatment for opioid addiction and dependence for more than 30 years. Methadone for the treatment of opioid dependence is only available from federally-regulated clinics which are few in number and unappealing for most patients. In addition, studies show that participation in a methadone program improves both physical and mental health, and decreases mortality (deaths) from opioid addiction. Like Suboxone, when taken properly, medication-assisted treatment with methadone suppresses opioid withdrawal, blocks the effects of other problem opioids and reduces cravings.

-Naltrexone-

Naltrexone is an opioid blocker that is also useful in the treatment of opioid addiction. Naltrexone blocks the euphoric and pain-relieving effects of heroin and most other opioids. This type of medication-assisted treatment does not have addictive properties, does not produce physical dependence, and tolerance does not develop. Unlike methadone or Suboxone, it has several disadvantages. It does not suppress withdrawal or cravings. Therefore, many patients are not motivated enough to take it on a regular basis. It cannot be started until a patient is off of all opioids for at least two weeks, though many patients are unable to maintain abstinence during that waiting period. Also, once patients have started on naltrexone the risk of overdose death is increased if relapse does occur.

-Buprenorphine / Subutex / Suboxone-

In 2002, the FDA approved the use of the unique opioid buprenorphine (Subutex, Suboxone) for the treatment of opioid addiction in the U.S. Buprenorphine has numerous advantages over methadone and naltrexone. As a medication-assisted treatment, it suppresses withdrawal symptoms and cravings for opioids, does not cause euphoria in the opioid-dependent patient, and it blocks the effects of the other (problem) opioids for at least 24 hours. Success rates, as measured by retention in treatment and one-year sobriety, have been reported as high as 40-60% in some studies. Treatment does not require participation in a highly-regulated federal program such as a methadone clinic. Since buprenorphine does not cause euphoria in patients with opioid addiction, its abuse potential is substantially lower than methadone.

-What is Medication-Assisted Treatment?-

Medication-assisted treatment for opioid dependence can include the use of buprenorphine (Suboxone) to complement the education, counseling and other support measures that focus on the behavioral aspects of opioid addiction. This medication can allow one to regain a normal state of mind - free of withdrawal, cravings and the drug-induced highs and lows of addiction. Medication-assisted treatment for opioid addiction and dependence is much like using medication to treat other chronic illnesses such as heart disease, asthma or diabetes. Taking medication for opioid addiction is NOT the same as substituting one addictive drug for another.

-What is Suboxone and How Does it Work?-

There are two medications combined in ea

Opioid Dependence and Withdrawal

2011-06-29T13:31:30Z

Wellness.com - Opioid Dependence and Withdrawal by JeffreyStuckert

Opioid Dependence and Withdrawal

A person is said to have physical opioid dependence if they have high 'tolerance' of opioids, meaning they need more of the opioid to get the desired effect. Opioid withdrawal symptoms occur when the substance is stopped. Most patients who seek treatment for opioid addiction also have some degree of physical dependence. However, physical opioid dependence alone is not sufficient to make a diagnosis of addiction. A person can be physically dependent - like a cancer patient might be when prescribed opioids for severe pain - and not be addicted. The term 'addiction' refers to certain behaviors.

-What are the Symptoms of Opioid Withdrawal?-

Opioid withdrawal can occur in both the addicted patient and the patient who has opioid dependence but is not experiencing total opioid addiction. When an opioid is stopped or the dose is suddenly reduced, both types of patients experience withdrawal symptoms - sweating, chills, muscle and joint pain, nausea, vomiting, diarrhea, restlessness and insomnia. 'Goosebumps', which commonly occur during opioid withdrawal, give rise to the term 'cold turkey'. Fear of these unpleasant and painful opioid withdrawal symptoms makes it difficult for the addict to stop using and begin the recovery process.

-Who is Prone to Develop Opioid Dependence?-

Although the specific causes vary from person to person, scientists believe that our heredity (our DNA) is the major factor in an individual's susceptibility to the development of the disease of addiction. We also know that psychological factors (feeling stressed, anxious or depressed) and our social environment also play important roles in the development of opioid addiction. The unpleasant effects of opioid withdrawal lead many users to continue abusing prescription or illegal opioids, leading to prolonged dependence.

Opioid abuse has risen dramatically in the United States over the past ten years. The National Institute of Drug Abuse (NIDA) reports that more than 5.2 million Americans misused a prescription painkiller in 2008 for non-medical reasons. Approximately 1 million people in the U.S. are addicted to heroin today. About 1 out of 8 people (13% of the population) who are exposed to a mood-altering substance that can cause an intense euphoric effect (like alcohol, opioids and other drugs of abuse) are prone to develop the behaviors of addiction with repeated use.

-What Happens to the Brain in Addiction?-

Opioid addiction is a disease of the brain. Repeated use of an opioid leading to opioid dependence causes long-term changes in both the structure (the architecture of the brain) and the way the brain functions (the biochemistry of the brain).

The most important structural or architectural change takes place in the circuitry of the brain - particularly in the wiring of the reward pathway. Our brains are wired to ensure that we will repeat life-sustaining activities - such as drinking water and eating food - by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain records that experience making us likely to do it again. Memories that have an intense emotional component (like pleasure) may be permanently 'hard-wired'.

In the person with opioid dependence who is prone to opioid addiction, the excessive stimulation of the reward pathway by an opioid 'tricks' the brain into believing that an opioid is as necessary for survival as food and water. The effect of such a powerful reward motivates people to repeat that behavior again and again, even when it is clearly harmful to do so. This is why drug abuse is something the person prone to opioid addiction can learn to do very, very well.

Chemical changes also take place in the brain as it tries to adapt to the excessive stimulation of the reward pathway. During opioid dependence and opioid addiction, the brain tries t

What is Opioid Addiction?

2011-05-26T12:53:43Z

Wellness.com - What is Opioid Addiction? by JeffreyStuckert

To first understand opioid addiction, you must first understand what opioids are. The term opioid refers to any drug or chemical that attaches (like a key fits into a lock) to sites in the brain called opioid receptors. The human body makes its own opioids (called endorphins) but the opioids we are concerned with when we talk about opioid addiction are those that are manufactured in a laboratory or made by plants. For instance, morphine and codeine are found in the extract (the opium) of seeds from the poppy plant, and this opium is processed into heroin. Most prescription painkillers like oxycodone, hydrocodone, and hydromorphone are synthesized in the laboratory. When a person becomes dependent upon these drugs, they need opioid addiction treatment.

-What are Common Types of Opioids?-

Opioids may be prescribed legally by doctors (for pain, cough suppression or opioid dependence) or they may be taken illegally for their mood-altering effects - euphoria, sedation, "to feel better", or for some, opioids are taken "just to feel normal". Not everyone who takes an opioid is at risk for dependence requiring opioid addiction treatment, but these drugs are commonly abused.

Examples of prescribed medications that sometimes lead to opioid addiction, but that can also help patients battle other types of substance abuse include:

- Codeine - the opioid in Tylenol #3, Fiorinal or Fiorecet #3, and in some cough syrups.
-Hydrocodone - the opioid in Vicodin, Lortab, and Lorcet.
-Oxycodone - the opioid in Percodan, Percocet and OxyContin.
-Hydromorphone - the opioid in Dilaudid.
-Oxymorphone - the opioid in Opana.
-Meperidine - the opioid in Demerol.
-Morphine - the opioid in MS Contin, Kadian and MSIR.
-Fentanyl - the opioid in Duragesic.
-Tramadol - the opioid in Ultram.
-Methadone - the opioid in Dolophine.
-Buprenorphine - the opioid in Suboxone.-

Although not entirely accurate, the terms opiate and narcotic are generally used interchangeably with the term opioid.

The great majority of illicitly used prescription opioids are not obtained from drug dealers. Family and friends are now the greatest source of illicit prescription opioids, and the majority of these opioids are obtained from one physician - not from "doctor shopping". More than 90% of the world's opium and heroin supply comes from Afghanistan and Southeast Asia. 'Black tar' heroin comes primarily from Mexico. Opioids are the most powerful known pain relievers, sometimes leading to opioid addiction requiring treatment. The use and abuse of opioids dates back to antiquity. The pain relieving and euphoric effects of opioids were known to Sumerians (4000 B.C.) and Egyptians (2000 B.C.).

-What Happens When an Opioid is Taken?-

When an opioid is taken into the body by any route (by mouth, nasally, smoking or injecting) it enters the blood stream and travels to the brain. When it attaches to an opioid receptor in the brain, our perception of pain is reduced (if we have pain) and we feel sedated. Most people also feel at least a mild pleasurable sensation, or a sense of well-being when opioid receptors are stimulated. Some report feeling more energized or motivated after taking opioids. A few experience unpleasant side effects such as nausea, vomiting or irritability. Unfortunately, those who are prone to develop an opioid addiction seem to experience an intense euphoric or pleasurable feeling when they take an opioid - leading to prolonged dependence requiring opioid addiction treatment.

An opioid seems to do something for their mood that it does not do for most people. Their experience with an opioid is quite different than it is for the person who is not prone to develop an opioid addiction. Drugs of abuse (like opioids, cocaine and alcohol) are addictive for the susceptible person because repeated use of those substances - in an effort to