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. 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.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.
Addiction Addiction implies that a drug dependency has developed to such an extent that it has serious detrimental effects on the user (referred to as an addict). They may be chronically intoxicated, have great difficulty stopping the drug use, and be determined to obtain the drug by almost any means. The term addiction is inextricably linked to society's reaction to the user, and so medical experts try to avoid using it, preferring dependence instead.
There have been substantial advances when it comes to understanding the biochemical and genetic basis for substance abuse and addiction over the past ten years. In spite of this knowledge very little information is disseminated in regards to alternative forms of detox treatment. One form of alternative treatment is rapid detox and is a viable alternative for certain patients.1 Rapid detoxification and rapid opiate detox can be beneficial if you are suffering from an addiction to heroin, prescription painkillers, Oxycontin, Methadone, Suboxone, Vicodin, Darvocet, Percocet, Hydrocodone or any other opioid. 2
Traditional treatment entails a detoxification period that is often debilitating and has horrendous withdrawal symptoms that are both painful and often dangerous for the patient. Not only is there intense physical pain there is often psychological cravings for months beyond treatment. 3 Statistics show that with regular detox methods within a year 85 to 90 percent of all patients have suffered a relapse and are using again. 4
The most visible and widely talked about rapid detox method is the Waismann Method. 5 The Waismann Method also known as Neuro-Regulation is performed in a hospital intensive care unit. It involves cleansing the opiate receptors in the patient’s brain of the narcotics while the patient is under anesthesia. During the procedure, the patient will experience no conscious withdrawal, and will be able to return home within days. Over 65 percent of the patients who are treated with the Waismann Method remain drug free after one year.
In April 2000, the American Society of Addiction Medicine (ASAM) released a public policy statement on rapid and ultra rapid opioid detoxification.6 Based on their policy and further studies, ASAM updated April 2005, to include their policy recommendations which are listed below and should be considered when considering detox.
Policy Recommendations
1. Opioid detoxification alone is not a treatment of opioid addiction. ASAM does not support the initiation of acute opioid detoxificationinterventions unless they are part of an integrated continuum of services that promote ongoing recovery from addiction.
2. Ultra-Rapid Opioid Detoxification (UROD) is a procedure with uncertain risks and benefits, and its use in clinical settings is not supportable until a clearly positive risk-benefit relationship can be demonstrated. Further research on UROD should be conducted.
3. Although there is medical literature describing various techniques of Rapid Opioid Detoxification (ROD), further research into the physiology and consequences of ROD should be supported so that patients may be directed to the most effective treatment methods and practices.
4. Prior to participation in any particular modality of opioid detoxification, a patient should be provided with sufficient information by which to provide informed consent, including information about the risks of termination of a treatment plan of prescribed agonist medications such as methadone or Buprenorphine, as well as the need to comply with medical monitoring of their clinical status for a defined period of time following the procedure to ensure a safe outcome. Patients should also be informed of the risks, benefits and costs of alternative methods of treatment available.
In rebuttal to ASAM’s policy Clifford Bernstein, M.D., medical director of AAMOD, the leading practitioners of the Waismann Method treatment for opiate dependency, stated that the study offered misleading results and failed to recognize those who have had success with rapid detox.7 He states that anesthesia-based detox is a humane and effective medical treatment that allows patients to avoid most of the unnecessary withdrawal symptoms. Furthermore, he points out that the study misleads the reader into believing that anesthesia-based detox is not a successful method for opiate treatment by stating that 80% of participants dropped out of follow-up treatment. This statistic does not say anything about the success of the detox treatment or whether or not patients were able to stay off of the drugs. Since the opiates have been blocked from their brains and they no longer feel cravings following the anesthesia-based detox, many of these patients do not need an aftercare program. He stated that the study did not accurately represent the procedure, the merits of the doctors performing it nor the benefits of this treatment. He states that the procedure is safe, however one should use the same precautions as any other procedure under anesthesia as well as verify the qualifications of the doctor performing and to be sure to do it at an hospital with appropriate emergency resources if they are necessary.
Rapid detox is a relatively painless way for people suffering from addiction to opiates. While rapid detoxification can be effective, it is should be undertaken only after discussing the pro’s and con’s as well as follow- up treatment.
This article was last modified on 12/15/2006.
References
1. McCabe S. Rapid detox: understanding new treatment approaches for the addicted
patient. Perspect Psychiatr Care. 2000 Oct-Dec;36(4):113-20.
2. American Medical Association Complete Medical Encyclopedia. American Medical Association, Article Quoted: Detoxification therapy. Bruno, Leonard C., Random House, Reference; 1st edition (14 October 2003).
3. Ott J. Obviation of opiod withdrawl syndrome by concomitant administration of naltexone in microgram doses: two psychonautic bioassays. J Psychoactive Drugs. 2006 Mar; 38(1):101-105.
4. http://www.opiates.com/waismann-method.html The Waismann Method.
5. http://www.rapiddetox.net/blog/ Waismann method of detoxification under anesthesia launches message board to help consumers navigate through the challenging waters of opiate dependence and rapid detox. 21 November 2006.
6. http://www.asam.org/ AMERICAN SOCIETY OF ADDICTION MEDICINE, INC. Public policy statement on rapid and ultra rapid opioid detoxification ( Formerly Public Policy Statement on Opioid Antagonist Agent Detoxification under Sedation or Anesthesia (OADUSA ))
7. Business Wire, Waismann Method: doctor refutes reports of danger in anesthesia-based detoxification for opiate dependency; opiate dependency specialist says study is misleading. 25 August 2005.
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