Heroin is an extremely addictive both physically and psychologically drug of opiate group. Its usage has serious effects on body such as devastation of bone tissue and tooth, (opiates wash-out calcium mineral), hepatocholecystitis (heroine is transformed into morphine in liver), severe hepatic failure, collapsed veins, illness of the heart and soul lining and valves, abscesses and pneumonia. It also can lead to hepatitis and HIV credited to use of dirty syringes, tuberculosis and fetal results. It changes person's understanding of reality and may cause a damaging, violent and unlawful behavior which have a devastating effect on world. When opiate drugs are used they become morphine which has a similar composition to endorphins which are usually used for reduced amount of pain. They activate the mind and are in charge of lifting a person's mood, helping that person feel stimulated for every day purposes by preventing receptors in synapses between neurons. When a drug is used the receptors are clogged with morphine instead, nonetheless it takes additional time to decompose and an organism stops produce endorphins. As a result an addict dies within six months to one time after starting to use the opiate. When a medicine is not being taken, an addict seems a phantom pain which is very difficult to tolerate, this is an abstinence syndrome. At this time his or her organism goes through detoxication which include diarrhea, muscles pain (cramp), frustration, vomiting, fever and insomnia. Heroin is a comparatively cheap drug and for that reason can be easily obtained by teenagers and its use often causes fatality from both physical effect and actions during altered consciousness.
Treatment of heroin dependency is a difficult, lengthy and complicated process, consisting of three main components: removal of physiological dependency, removal of subconscious addiction and social rehabilitation. Nowadays there is no clear position on medical treatment of heroin habit and scientists want to find a solution.
At present Opiate substitute therapy (ORT) is one of possible alternatives for physiological removal. Essentially, the technique is to provide a chemical abuser with a medication with the similar biochemical effects on the body but having the minimum possible narcotic effect. A dose of replacement medication is little by little and gradually lowered. The therapy might take 5 - 8 years. At the expense of the metabolic status of physiological of non-drug users is achieved. The most common drug used as a replacement is methadone and a therapy is known as methadone maintenance treatment (MMT). Methadone can be an agonist (substance or drug that can interact with receptors and initiate a physiological or pharmacological characteristics of the response of the receptor, triggering a string of intracellular biochemical procedures in the body) used orally and speedily utilized to plasma within 30 mins of being ingested. It is also stored in body cells and steadily released when needed. It generates tolerance so an individual cannot feel a narcotic effect. A dose (25-150 mg to avoid tolerance) of methadone reduces withdrawal symptoms and at the same time and craving for a medication stabilizing metabolic rate. The effect continues for from 24 to 36 time. The purpose of methadone maintenance treatment is socialization of lovers, the abolition of the intravenous drug use, conducted purely under the supervision of specialists.
The graph clearly shows that theoretically methadone detoxication works well and fast. It shows best effect when used in long-term.
Studies show that methadone maintenance treatment drastically reduces illegitimate opiate use, criminal behavior, risky intimate routines, and the transmitting of HIV. Methadone is not dangerous for any major organs even when taken for many years. . However the epidermis becomes waxy or yellowish color because the methadone completely deprives your body of calcium mineral (osteoporosis). A person feels pain in the bone fragments, they become brittle and respite easily
In addition, every person has unique dose needs. People metabolize methadone in a different way, and therefore doses shouldn't be capped by maximum recommendations. To avoild overdose the doctor should evaluate cessation of drug desires and the reduced amount of withdrawal symptoms to determine the ideal methadone dose. In 2005, more than 4, 000 people fatally overdosed on methadone or methadone and other drugs jointly. Many of these people were using high doses of methadone within an unsupervised effort to take care of pain, or were illicitly using methadone for recreational purposes.
When methadone is used in sophisticated with social treatment it gives great results. Psychotherapy largely determines the balance of the effect of drug remedy, duration and quality of remissions. Psychotherapy will never be effective in the absence of an addict wants to eliminate drug habit.
One of the implications to the problem is that patients are determined strictly to go into the program. In Sweden, for example, there are stringent criteria for methadone treatment: a minimum of four years of opiate addiction proved by medical files, a sign of a brief history of unsuccessful passing of many other kinds of therapy, occurrence of medical signs for methadone maintenance therapy, must be more than 20 and not have any other addictions aside from opiate. It's very difficult to triumph over the craving and follow every one of the rules without any support. Because of this an intense communal rehabilitation is an essential on quite a distance to getting better. However some countries where heroin dependency is common do not poses such interpersonal program. If a full complex is used 10-20% of individuals overcome the dependency, however 10-15% return to uncontrolled substance abuse.
If the replacement unit therapy is employed commonly as really the only solution for treatment of most opiate dependencies, it could reduce efficiency of prophylactic actions and would be observed as a fairly easy way to escape duties and implications after utilizing a drug by beginner medication abusers. This as a result would increase consumption of drugs overall.
In many countries methadone is forbidden due to its narcotic impact when used not for medical purposes. If Federal government Drug Control service makes a mistake, it will increase illegal methadone traffic. For instance while methadone maintenance therapy in Lithuania amount of drug addicts increased 8 times. Furthermore, when methadone treatment became very popular in Belorussia in 2004, consequently 3. 5times more of methadone was withdrawn by the police from against the law traffic and 2 times less of heroin. Lately, The Independent raised a question of medicine addiction in Russia. It really is forbidden to use replacement therapy especially methadone to treat addicts, the federal government is from this however the researchers are sure in the necessity to run this program. Researches state that the pace of HIV spread would decrease dramatically (around 55% if the MMT is used).
The treatment has advantages and disasvantages.
MMT is relatively cheap ($13 each day) but able to the same time. (Office of Country wide Drug Control Insurance policy, 1998a). MMT reduces the spread of HIV/Supports infections, hepatitis B and C, tuberculosis, and sexually sent diseases (COMPA, 1997). Heroin users are recognized to share needles and take part in at-risk sex and prostitution, which can be significant factors in the pass on of many diseases. Research shows that MMT significantly decreases the pace of HIV infections for those patients participating in MMT programs (Firshein, 1998).
The patient remains bodily dependent on the opioid, but is freed from the uncontrolled, compulsive, and disruptive action observed in heroin addicts.
Withdrawal from methadone is a lot slower than that from heroin. Because of this, you'll be able to maintain an addict on methadone without harsh side effects. There's a huge risk if a person continues on methadone for longer than 2 weeks; there can be an 80 percent chance that he or she will stay using their methadone maintenance treatment for six months or longer. A lot of patients need a treatment over an interval of years.
There are some different solutions which should be described:
Buprenorphine maintenance treatment. It has its advantages :
Low likelihood of overdose.
Relatively easier withdrawal
Less side results.
Some patients may be studied every other day within an appropriate dose.
The optimal dosage blocks the action of other opiates (however, not for such an extended period, such as methadone) because which it becomes impossible to supplementation of against the law drugs
However there are some drawbacks to consider:
"Withdrawal syndrome" is not necessarily eliminated, not all drug addicts, may appear when the "move" from heroin and other opium derivatives.
Enhances the medial side ramifications of tranquilizers, antipsychotics, which may lead to overdose if their joint request.
High cost of medication.
2. Apomorphine treatment