Binge Drinking: According to a rent study conducted by Kathryn Graham, et al of the University of Western Ontario psychology department "Depression is most strongly related to a pattern of binge drinking,"
Binge Drinking is defined in the study as consuming at least 5 alcoholic beverages at one sitting.
Whether Binge Drinking resulted in the development depression or whether depression contributed to a persons binge drinking was unclear in this study.
Inpatient Treatment is most often residential in that they require that the client live within the facility during treatment. Inpatient treatment centers and programs are a higher level of care than outpatient programs and provide more intensive services and treatment than lower levels of the care continuum.Alcoholism and Drug Addiction Intervention A drug and alcoholism intervention is an attempt by family members and friends to help a chemically dependent person get help for his or her addiction.Substance Abuse
Substance abuse has a range of definitions related to disaproval over use or overuse of mood altering substances. These fall into four main categories: Substance abuse may lead to addiction or substance dependence. Medicaly, dependence requires the development of tolerance leading to withdrawal symptoms.
Heroin addiction is one of the most difficult addictions to overcome. The heroin abuser’s nervous system becomes accustomed to accommodating chronic exposure to the drug, which is an opioid. Therefore, during heroindetoxification excruciating withdrawal symptoms are ubiquitous. Withdrawal symptoms begin within 12 hours of not using and peak after two to four days. The symptoms include: nausea, anxiety, diarrhea, abdominal pain, insomnia, chills, sweating, sniffing, sneezing, weakness and irritability. Even though there have been improvements in medically supervised heroindetoxification, patient discomfort and high dropout rates exist today. This has led to the growth of ultra-rapid, anesthesia-assisted opioid withdrawal procedures, which have been publicized as a fast, painless way to withdraw from opioid. Studies have also shown however, that the procedure can lead to risk of death, psychosis, increased stress, delirium, attempted suicide, abnormal heart rhythm and acute renal failure. And, the anesthesia method comes at a high price between $5,000 and $15,000.1
Francis Moraes wrote in The Little Book of Heroin, that there are three important brain chemicals or neurotransmitters that relate to heroin. First, dopamine helps to control human appetites for both food and sex. If a person has large quantities of dopamine they are considered out-going and exuberant. Persons who suffer with Parkinson’s disease and depression are said to have too little dopamine. On the other hand, people suffering from schizophrenia have too much. Heroin causes a release of dopamine. Second, norepinephrin controls the sympathetic nervous system: nerves of the body that cannot be voluntarily controlled. This neurotransmitter stabilizes blood pressure so that it does not get too low. The brain’s release of norepinephrin stimulates the fight or flight response. But heroin suppresses the middle part of the brain called the locus coeruleus and therefore provides the user with feelings of safety and contentment. Third, endorphines, which are morphine-like chemicals, used by the body to modulate mood, promote pleasure, and manage reactions to stress.2 These three chemicals are exaggerated or heightened by heroin use.
There are several forms of heroindetoxification including opioid agonist drugs, such as methadone, levo-alpha-acetylmethadol (LAAM), or Buprenorphine; Clonidine, which blocks some withdrawal symptoms; ultra-rapid opioid detox under anesthesia; and an experimental method using the drug lofexidine. Opioid agonist drugs act like heroin but do not provide the same high and are administered in gradually decreasing doses. Since these medications act like heroin there are no withdrawal symptoms.3 Clonidine can be administered by a transdermal patch, which gives the drug constantly over a seven- day period. Patients using the patch should also take Clonidine orally for the first two days since the transdermal medications takes two days to reach a steady effectiveness. Clonidine causes hypotension and sedation and therefore blood pressure monitoring is essential. Ultra-rapid detox is done under general anesthesia with intubations for six to eight hours. During this time a combination of drugs, usually naltrexone and Clonidine are administered.3 Lofexidine, a non-addictive drug brought to the market in 1992, is a centrally acting alpha-2 adrenergic agonist targeted for relief of opiate withdrawal symptoms.
Withdrawal symptoms continue to be the greatest obstacle in heroindetoxification treatment. Studies concur that there is no proof that one detoxification treatment is better than another. Relapses continue to occur in numerous cases around the world therefore making heroindetoxification a monster of an addiction. Statistics show that the average heroin addict will stop and start detox 10 to 25 times in their lifetime relapsing to heroin use every time.4
Heroin detoxification involves admitting there is a problem, seeking medical help, staying focused on the goal and rehabilitation and treatment through a continuing program. All facts conclude that there is no easy cure nor guarantee that relapse will not occur. The determination of the patient and support through family, friends, physicians or other sources must accompany the detoxification process. Long-term treatments that are drug-free or use medications as part of the treatment are useful in detoxification. Solutions 4 Recovery sights, “the best-documented drug-free treatments are the therapeutic community residential programs lasting at least 3 to 6 months.”5
Many times, although not physically dependent on heroin, psychological cravings will overcome the former user throwing him or her into relapse. Overseas studies have proven that detoxification does not work alone in the treatment process.
This article was last modified on 1/11/2007.
References
1. Columbia University Medical Center and New York State Psychiatric Institute. Researchers illustrate severe risk in popular procedure, identify safer procedure. Study finds rapid heroindetoxification procedure under anesthesia does not work and can result in death. Journal of American Medical Association (JAMA) 24 August 2005.
2. Moraes, Francis. The Little Book of Heroin Berkeley, CA: RONIN Publishers, 2000.
3. Rabinowitz, Jonathan, Hagit Cohen and Moshe Kotler. Outcomes of ultrarapid opiatedetoxification combined with naltrexone maintenance and counseling. Psychiatr Serv 49:831-833, June 1998.
4. http://www.abc.net.au/health/regions/features/heroin/links
Health Matters, ABC, 2006.
5. http://www.solutions4recovery.com/heroin_addiction.htm
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