Medical Detoxification: In order to withdraw from certain addictive substances safely, it may be preferable and in some cases necessary to undergo medically supervised detoxification in a hospital or residential treatment center that has a detoxification unit. This would be advisable for patients that have been using an addictive substance heavily for a longer period of time and are more likely to have more severe withdrawal symptoms, or those with other significant health problems. Inpatient detoxification allows the patient to be closely monitored throughout the process and given appropriate medication to prevent severe withdrawal symptoms. It commonly involves the gradual administration of decreasing doses (tapering) of an agent that is related to the original drug of abuse that is now substituted to prevent withdrawal.

Rapid Detoxification: In this procedure drug withdrawal occurs while patients are asleep under general anesthesia. The patient is given intravenous injections of medications called opiate blockers which stop the action of narcotics and opiate drugs as well as injections of other medications that reduce the symptoms of withdrawal such as muscle relaxants or anti-nausea medications. This process results in rapid withdrawal from the physical effects of addiction. Through the use of opiate blockers such as naltrexone, naloxone, and nalmephine, physical detoxification is achieved within 4 to 8 hours. Rapid detox takes place in an intensive care unit of a hospital. Patients are usually discharged within 48 hours following recovery from anesthesia and assessment of their physical status.

Rapid detoxification helps reduce the distress of opiate withdrawal for people who are chemically dependent on narcotics such as heroin, Vicodin, Percocet, Demerol, Dilaudid, Darvocet, OxyContin, opium, morphine, codeine, oxycodone, hydrocodone, prescription painkillers, and all narcotic type drugs. It shortens the detoxification period and spares patients the pain and physical discomforts of withdrawal. It may be of great benefit to patients who suffer from severe withdrawal symptoms and who have failed repeatedly to complete conventional withdrawal programs . However, there are significant costs as well as risks associated with the use of general anesthesia. It is imperative that the procedure be performed by medical professionals who are highly trained in these procedures in a medical setting that is fully equipped to deal with any complications that may arise.

Stepped Rapid Detoxification: This alternative to rapid detoxification provides small doses of Narcan (Naloxone) subcutaneously and naltrexone orally every hour or so, together with reduced withdrawal management medications , mostly orally, as necessary. This approach using the slower oral and subcutaneous routes rid the body of the opiate more slowly than intravenous Rapid Detoxification . In addition the pacing can be controlled and responsive to any withdrawal symptoms that develop in the patient by having them quickly suck on Buprenorphine tablets under the tongue. There is less need for withdrawal management medications. The patient is alert and directly communicating with medical staff until the situation has been resolved. It is possible to be detoxified and stabilized on Naltrexone Maintenance Therapy with 2 to 4 small manageable bites. If someone tries to use any kind of opiate while they are on Naltrexone, they feel no effect because all of the receptors are completely blocked.

Ultra Rapid Detoxification: This procedure involves putting patients under general anesthesia and giving them a drug called Naltrexone which blocks all of their endorphin receptors. This accelerates the withdrawal process, pushing them into 100% detoxification within a 5-30 minute period. Although this is an extremely painful process it is tolerable under anesthesia. As with rapid detoxification, it is very costly and has significant medical risk.

Outpatient Detoxification
Outpatient medical detoxification is usually safe and effective for people who are more likely to have mild to moderate withdrawal symptoms. For instance, primary care-based opiate detoxification can be accomplished with a variety of medications such as buprenorphine-naloxone (BUP/NX) or clonidine alone or combined with naltrexone. Buprenex, newly approved by the FDA, can now be administered on an outpatient basis by physicians who receive a required eight-hour training. Using Buprenex, the detoxification can take between 7-14 days.

The mental health problems that most commonly co-occur with substance abuse are depression, anxiety disorders, and bipolar disorder.

Common signs and symptoms of depression

• Feelings of helplessness and hopelessness
• Loss of interest in daily activities
• Inability to experience pleasure
• Appetite or weight changes
• Sleep changes
• Loss of energy
• Strong feelings of worthlessness or guilt
• Concentration problems

Common signs and symptoms of mania

• Feelings of euphoria or extreme irritability
• Unrealistic, grandiose beliefs
• Decreased need for sleep
• Increased energy
• Rapid speech and racing thoughts
• Impaired judgment and impulsivity
• Hyperactivity
• Anger or rage

Common signs and symptoms of anxiety

• Excessive tension and worry
• Feeling restless or jumpy
• Irritability or feeling “on edge”
• Racing heart or shortness of breath
• Nausea, trembling, or dizziness
• Muscle tension, headaches
• Trouble concentrating
• Insomnia

Treatment for co-occurring substance abuse and mental health problems

The best treatment for co-occurring disorders is an integrated approach, where both the substance abuse problem and the mental disorder are treated simultaneously.

How do I find the right program for co-occurring disorders?

As with a substance abuse program, you want to make sure that the program is appropriately licensed and accredited, that the treatment methods are backed by research, and that there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.

There are a variety of approaches that treatment programs may take, but there are some basics of effective treatment that you should look for:

• Treatment addresses both the substance abuse problem and your mental health problem.
• You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
• Treatment includes basic education about your disorder and related problems.
• You are taught healthy coping skills and strategies to minimize substance abuse, cope with upset, and strengthen your relationships.

Eventually, we are taking enormous amounts of one or more medications. The “high” just isn’t the same anymore so we might use some other substance to give the medication a “kick.” Some of us turn to alcohol to combine with the medication. Others turn to illegal drugs such as heroin and cocaine. Others begin to steal prescription pads from physicians and forge prescriptions. Whatever the methods, the unmanageability reaches critical stages.

Remember all of those negative feelings we thought the drugs were relieving? Well, now that we are in our addiction, they have returned with a vengeance. Our world now revolves around our medications just the way it did with our chronic pain. We become very lonely. Our medication comes first and we once again alienate ourselves from our loved ones. Shame and guilt set in and our self-esteem lowers even more. Anger, resentments, fear, frustration, depression and anxiety once again dominate our minds. We now need the medications just to feel normal and if we try to stop the medications, we become ill. We have come full circle, and are now prisoners to both our medications and chronic pain.

If you are reading this pamphlet, chances are good you have met the diagnostic criteria for chemical dependency. You only need to relate to three of the following:

For help with drug addiction treatment contact Sunrise Detox.

Benzodiazepines are the most common class of anti-anxiety drugs. They include:

Benzodiazepines are fast acting—typically bringing relief within thirty minutes to an hour. Because they work quickly, benzodiazepines are very effective when taken during a panic attack or another overwhelming anxiety episode. But despite their potent anti-anxiety effects, they have their drawbacks.

Side effects of anti-anxiety drugs

Anti-anxiety drugs like benzodiazepines work by reducing brain activity. Understandably, this leads to side effects beyond anxiety relief.

The higher the dose, the more pronounced these side effects typically are. But some people feel sleepy, foggy, and uncoordinated even on low doses of benzodiazepines, which can cause problems with work, school, or everyday activities such as driving. Some even feel a medication hangover the next day.

Because benzodiazepines are metabolized slowly, the medication can build up in the body when used over longer periods of time. The result is oversedation. People who are oversedated may look like they’re drunk.

Benzodiazepines are also associated with depression. Long-term benzodiazepine users are often depressed, and higher doses are believed to increase the risk of both depressive symptoms and suicidal thoughts and feelings. Furthermore, benzodiazepines can cause emotional blunting or numbness. The medication relieves the anxiety, but it also blocks feelings of pleasure or pain.

Paradoxical effects of anti-anxiety drugs

Despite their sedating properties, some people who take anti-anxiety medication experience paradoxical excitement. The most common paradoxical reactions are increased anxiety, irritability, and agitation. However, more severe effects can also occur, including:

• Mania
• Hostility and rage
• Aggressive or impulsive behavior
• Hallucinations

While rare, these adverse effects are dangerous. Paradoxical reactions to these anxiety medications are most common in children, the elderly, and people with developmental disabilities.  Many times users of benzodiazepines find that they need to enter an inpatient detox center in order to come off of them.

Drugs offered online include generic versions of opiates like OxyContin, methadone and Vicodin, which are legitimately prescribed as painkillers; benzodiazepines like Xanax and Valium, which are prescribed for anxiety; and stimulants like Ritalin.

Federal and state efforts to crack down on Internet sales appear to have reduced the number of sites offering such drugs, from 581 last year, said Joseph A. Califano Jr., director of the National Center on Addiction and Substance Abuse at Columbia University.

“Nevertheless, anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse,” Mr. Califano said. The center is issuing the study, the latest of five annual surveys, on Wednesday.

The Drug Enforcement Administration found that 85 percent of all Internet prescription sales involved controlled drugs, compared with just 11 percent of those filled through regular pharmacies, suggesting that online sales often are destined for misuse.

“Abuse of prescription drugs has exploded among college students, and we think that one way they get these drugs is over the Internet,” Mr. Califano said. The use of prescription opioids and anxiety drugs, especially in combination, accounts for a growing share of deadly overdoses nationwide.

“The Internet made it easy for the drug dealers to sneak into your living room,” said Francine Haight of La Mesa, Calif, whose son Ryan died in 2001 at the age of 18 from an overdose of hydrocodone, generic Vicodin, which he had secretly ordered online with a debit card. An A-student and varsity tennis player, he had claimed in an online questionnaire to be a 25-year-old with back pain, got his prescription and was mailed the drug. Ms. Haight, a registered nurse, has since fought against online sales.

Federal law bars dispensing dangerous medications without a prescription from a doctor who has a bona fide relationship with the patient. But officials have had a hard time catching up to rogue Internet pharmacies that sometimes ship the drugs from foreign countries in disguised packages.

For the last several years, the Drug Enforcement Administration and others have worked to halt the illegal trade and prosecute involved doctors and suppliers, with limited success.

“One of the main problems is that the sites can literally open up for a week, close and open up under a different name,” said Michael Sanders, a spokesman for the Drug Enforcement Administration.

In a more recent practice, the new study found, some sites sell written prescriptions that can then be used at local pharmacies.

Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. Of these, 206 were advertising sites, directing consumers to a seller. Of the 159 sites that directly sold controlled drugs, 135, or 85 percent, did not require a prescription or provided them on the basis of online questionnaires.

In an effort to make their surveys consistent, in each of the last five years the researchers have spent the same amount of time searching, 210 hours, for the same list of drugs. The number of sites rose to 581 in 2007, then fell to 365 this year. The study will be available online on Wednesday at www.casacolumbia.org.

In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act, which would require certification of online pharmacies and that doctors see patients before prescribing controlled drugs. The bill is now in committee in the House.

At least eight states have passed laws barring electronic prescribing or sales without a legitimate prescription. Minnesota passed a law in 2007 requiring doctor-patient consultations but found that “the Web sites went around us, doing 30-second consultations on the phone,” said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug poisoning in 2006, aged 24, after obtaining large quantities of hydrocodone and Xanax from 17 online pharmacies. The law was strengthened this year to require face-to-face consultations.

“Anyone can have these drugs at their door within 48 hours,” usually using a credit or debit card to pay for an online prescription and then a money order to pay for express delivery, C.O.D., Mr. Pearson said.

Federal drug authorities have begun working with credit card companies and banks to try to prevent such transactions, while major Internet search engines have used a verification program called Pharmacy Checker to confirm that advertisers are legitimate. But the system appears to be full of holes, critics say.

Mr. Califano sent letters this week to senior officials of Google, Yahoo and MSN asserting that they were “profiting from advertisements for illegal sales of controlled prescription drugs online,” and calling for stronger action.

Diana Adair, a spokeswoman for Google, said the company took the problem seriously and in addition to using Pharmacy Checker, had consulted with federal agencies on ways to stem the trade. Kelley Benender, a spokeswoman for Yahoo, said the company was “working to identify the illegal sites and will take appropriate action.”

A spokesman from MSN said the company had no comment.

By ERIK ECKHOLM from The New York Times

“When people hear the word ‘cancer,’ there’s kind of an assumption that it’s a death sentence,” says Dr. Marvin Seppala, chief medical officer for the Hazelden Foundation. “That’s not the case, since so many cancers are treatable nowadays. Yet there’s still a chance that people in the midst of addiction treatment might say to themselves: ‘Why bother to get clean and sober? I’m not going to go through with it because I’ve got cancer.’ ”

Studies suggest that rates of substance abuse in people with cancer are lower than in the general population. However, these figures are difficult to interpret. They could simply mean that people in cancer treatment routinely hide their problems with alcohol and other drugs.

Secrecy is just one problem. “If you’re in the midst of an active addiction, you’ll also be undermining any kind of healing process related to cancer,” Seppala says. “And there’s always the question of whether some of the addictive drugs will interfere with medications used to treat cancer.”

In addition, a record of substance abuse can strain the human relationships that underlie cancer treatment. If doctors and nurses suspect that their cancer patients are lying about drug use, they may doubt anything that these patients say about their health.

People with cancer might sense this mistrust, doubt the goodwill of their health care team, and decide not to follow through with their cancer treatments. When this happens, prescriptions go unfilled, medical appointments are missed, and people with cancer can get sicker or die earlier.

A report on substance abuse issues from the National Cancer Institute underscores these problems. It also suggests ways to help people face cancer and abstain from alcohol and illicit drugs at the same time:

Gather facts without judgment. When taking a health history, doctors and nurses sometimes avoid questions about alcohol and other drug use. They may feel awkward about raising the issue, or simply assume that they’ll never get honest answers. This assumption undermines cancer treatment. When health professionals ask about drug use with a non-judgmental attitude, people with cancer are more likely to speak candidly.

Involve a multidisciplinary health care team. Treatment for people with cancer and addiction should involve specialists in mental health and addiction medicine. Many people with a history of substance abuse–including those with cancer–also struggle with anxiety, depression, or personality disorders.

Treat pain with an accurate understanding of addiction. People can become physically dependent on opioid drugs such as codeine and oxycodone (OxyContin) that are used to treat cancer pain. This means that withdrawal symptoms will occur if the drugs are suddenly stopped. In this context, however, physical dependence and addiction are not the same. Addiction refers to the compulsive use of drugs for reasons other than pain control. Careful treatment planning can relieve withdrawal without triggering such use.

Current treatments also offer many options for treating cancer pain without drugs. Examples are acupuncture, acupressure, biofeedback, chiropractic treatment, osteopathic medicine, massage therapy, and meditation.

Set realistic treatment goals. There’s a saying among members of Alcoholics Anonymous: “Getting clean and sober is simple–just change everything about your life and do it now.” This slogan reminds us that recovery from addiction requires a transformation in thinking and behavior, which calls for decades of sustained effort. The risk of relapse is high, especially with the added stress of a cancer diagnosis.

Cancer specialists need to be realistic about this fact. Treatment planning for people in recovery should set up a structure for preventing relapse–and dealing with it openly if it does occur.

For more on this topic, visit the National Cancer Institute Web site at http://www.cancer.gov/ and click on “Cancer Topics” and “Coping with Cancer.”

Source: Hazelden

Most drug addictions start with casual or social use of a drug. For some people, this is as far as it goes. For other people, using the drug becomes a habit and use becomes more and more frequent. As time passes, you may need larger doses of the drug to get high. Soon you may need the drug just to feel good. As your drug use increases, you may find that it becomes increasingly difficult to go without the drug. Stopping may cause intense cravings and make you feel physically ill (withdrawal symptoms).

Drug addiction symptoms or behaviors include:

• Feeling that you have to use the drug regularly — this can be daily or even several times a day
• Failing in your attempts to stop using the drug
• Making certain that you maintain a supply of the drug
• Spending money on the drug even though you can’t afford it
• Doing things to obtain the drug that you normally wouldn’t do, such as stealing
• Feeling that you need the drug to deal with your problems
• Driving or doing other risky activities when you’re under the influence of the drug
• Focusing more and more time and energy on getting and using the drug

Narcotic painkillers
Opioids are narcotic, painkilling drugs produced naturally from opium or made synthetically. This class of drugs includes heroin, morphine, codeine, methadone and oxycodone (OxyContin).

Signs of narcotic use and dependence can include:

• Reduced sense of pain
• Sedation
• Depression
• Confusion
• Constipation
• Slowed breathing
• Needle marks (if injecting drugs)

Recognizing drug abuse in teenagers
Possible indications that your teenager is using drugs include:

• Problems at school. Frequently missing classes or missing school, a sudden disinterest in school or school activities, and a drop in grades may be indicators of drug use.
• Physical health issues. Lack of energy and motivation may indicate your child is using certain drugs.
• Neglected appearance. Adolescents are generally concerned about how they look. A lack of interest in clothing, grooming or looks may be a warning sign of drug use.
• Changes in behavior. Teenagers enjoy privacy, but exaggerated efforts to bar family members from entering their rooms or knowing where they go with their friends might indicate drug use. Also, drastic changes in behavior and in relationships with family and friends may be linked to drug use.
• Spending money. Sudden requests for money without a reasonable explanation for its use may be a sign of drug use. You may also discover money stolen from previously safe places at home. Items may disappear from your home because they’re being sold to support a drug habit.

Source: The Mayo Clinic

People in business circles can find themselves with an Oxycontin addiction and not pinpoint it as such, much like those in other circles.  However, people in business circles can go to the doctor and get a prescription and be hooked quite easily.  They can go to each other’s doctors as referrals, and before one knows it, several are hooked and sharing and passing it around.

The soccer mom, the bank executive, the pastor’s wife, the attorney, all and more are subject to an Oxycontin addiction that can ultimately take over, and thanks to others in their social and business circles using it, Oxycontin can get passed around like one would borrow a mower or a hammer.

Oxycontin addiction is not unheard of in business circles, it is simply not spoken of as an addiction.  Someone can walk up to someone else and say, “I feel a little sore, I left my prescription at home” and presto, the second person pulls out his or her own pills and shares.  The double standard of thinking someone who is addicted to drugs is just on the streets, homeless, on the rougher side of town helps these people to deny their own addictions for a longer period of time.  There is help, though, and it is up to the very people who make decisions that affect their employees and extended families to realize they have a problem and deal with it effectively.

A leave of absence or vacation is a good way to get help discreetly, for an Oxycontin addiction, or for any addiction.  Private treatment programs are available for those in business circles. It is time for those who have the brains to successfully pull ahead in business to realize they can pull ahead successfully in this area as well and beat an Oxycontin addiction.

Finding support in aftercare will also make the business person aware of just how rampant an addiction can be in his or her own circle or environment.  Taking the steps to break free of the addiction is just as sure a sign of success as any bank account or stock report.  Make the ultimate decision today and you will understand the truth behind that statement.

Source: Narconon

WASHINGTON — Many doctors may lose their ability to prescribe 24 popular narcotics as part of a new effort to reduce the deaths and injuries that result from these medicines’ inappropriate use, federal drug officials announced Monday.