Methadone: A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of MORPHINE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)Opioid-Related Disorders: Disorders related or resulting from abuse or mis-use of opioids.Drug Overdose: Accidental or deliberate use of a medication or street drug in excess of normal dosage.Buprenorphine: A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Alcoholism: A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. (Morse & Flavin for the Joint Commission of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism: in JAMA 1992;268:1012-4)Opiate Substitution Treatment: Medical treatment for opioid dependence using a substitute opiate such as METHADONE or BUPRENORPHINE.Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Alcohol Drinking: Behaviors associated with the ingesting of alcoholic beverages, including social drinking.Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.Heroin Dependence: Strong dependence, both physiological and emotional, upon heroin.Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.Receptors, Opioid, mu: A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.Substance Withdrawal Syndrome: Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.Receptors, Opioid: Cell membrane proteins that bind opioids and trigger intracellular changes which influence the behavior of cells. The endogenous ligands for opioid receptors in mammals include three families of peptides, the enkephalins, endorphins, and dynorphins. The receptor classes include mu, delta, and kappa receptors. Sigma receptors bind several psychoactive substances, including certain opioids, but their endogenous ligands are not known.Methadyl Acetate: A narcotic analgesic with a long onset and duration of action.Alcohol Deterrents: Substances interfering with the metabolism of ethyl alcohol, causing unpleasant side effects thought to discourage the drinking of alcoholic beverages. Alcohol deterrents are used in the treatment of alcoholism.Heroin: A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)Receptors, Opioid, delta: A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.Receptors, Opioid, kappa: A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.Opiate Alkaloids: Alkaloids found in OPIUM from PAPAVER that induce analgesic and narcotic effects by action upon OPIOID RECEPTORS.Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Cocaine-Related Disorders: Disorders related or resulting from use of cocaine.Alcohols: Alkyl compounds containing a hydroxyl group. They are classified according to relation of the carbon atom: primary alcohols, R-CH2OH; secondary alcohols, R2-CHOH; tertiary alcohols, R3-COH. (From Grant & Hackh's Chemical Dictionary, 5th ed)Substance-Related Disorders: Disorders related to substance abuse.Morphine Dependence: Strong dependence, both physiological and emotional, upon morphine.Neonatal Abstinence Syndrome: Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances.Prescription Drug Misuse: Improper use of drugs or medications outside the intended purpose, scope, or guidelines for use. This is in contrast to MEDICATION ADHERENCE, and distinguished from DRUG ABUSE, which is a deliberate or willful action.Substance Abuse Detection: Detection of drugs that have been abused, overused, or misused, including legal and illegal drugs. Urine screening is the usual method of detection.Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the ENKEPHALINS, the DYNORPHINS, and the ENDORPHINS. Each of these families derives from different precursors, proenkephalin, prodynorphin, and PRO-OPIOMELANOCORTIN, respectively. There are also at least three classes of OPIOID RECEPTORS, but the peptide families do not map to the receptors in a simple way.Temperance: Habitual moderation in the indulgence of a natural appetite, especially but not exclusively the consumption of alcohol.Prescription Drugs: Drugs that cannot be sold legally without a prescription.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Behavior, Addictive: The observable, measurable, and often pathological activity of an organism that portrays its inability to overcome a habit resulting in an insatiable craving for a substance or for performing certain acts. The addictive behavior includes the emotional and physical overdependence on the object of habit in increasing amount or frequency.Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in ALCOHOLIC BEVERAGES.Alcohol-Related Disorders: Disorders related to or resulting from abuse or mis-use of alcohol.Substance Abuse Treatment Centers: Health facilities providing therapy and/or rehabilitation for substance-dependent individuals. Methadone distribution centers are included.Diprenorphine: A narcotic antagonist similar in action to NALOXONE. It is used to remobilize animals after ETORPHINE neuroleptanalgesia and is considered a specific antagonist to etorphine.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Diagnostic and Statistical Manual of Mental Disorders: Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)Sheltered Workshops: Protective places of employment for disabled persons which provide training and employment on a temporary or permanent basis.Alcohol Dehydrogenase: A zinc-containing enzyme which oxidizes primary and secondary alcohols or hemiacetals in the presence of NAD. In alcoholic fermentation, it catalyzes the final step of reducing an aldehyde to an alcohol in the presence of NADH and hydrogen.Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Diagnosis, Dual (Psychiatry): The co-existence of a substance abuse disorder with a psychiatric disorder. The diagnostic principle is based on the fact that it has been found often that chemically dependent patients also have psychiatric problems of various degrees of severity.Alcohol Withdrawal Delirium: An acute organic mental disorder induced by cessation or reduction in chronic alcohol consumption. Clinical characteristics include CONFUSION; DELUSIONS; vivid HALLUCINATIONS; TREMOR; agitation; insomnia; and signs of autonomic hyperactivity (e.g., elevated blood pressure and heart rate, dilated pupils, and diaphoresis). This condition may occasionally be fatal. It was formerly called delirium tremens. (From Adams et al., Principles of Neurology, 6th ed, p1175)Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Alcohol-Induced Disorders, Nervous System: Acute and chronic neurologic disorders associated with the various neurologic effects of ETHANOL. Primary sites of injury include the brain and peripheral nerves.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Analgesics, Non-Narcotic: A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.Substance Abuse, Intravenous: Abuse, overuse, or misuse of a substance by its injection into a vein.Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.Tobacco Use Disorder: Tobacco used to the detriment of a person's health or social functioning. Tobacco dependence is included.Urine Specimen Collection: Methods or procedures used to obtain samples of URINE.Street Drugs: Drugs obtained and often manufactured illegally for the subjective effects they are said to produce. They are often distributed in urban areas, but are also available in suburban and rural areas, and tend to be grossly impure and may cause unexpected toxicity.Enkephalin, Ala(2)-MePhe(4)-Gly(5)-: An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.Taurine: A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids.Alcoholic Intoxication: An acute brain syndrome which results from the excessive ingestion of ETHANOL or ALCOHOLIC BEVERAGES.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Central Nervous System Depressants: A very loosely defined group of drugs that tend to reduce the activity of the central nervous system. The major groups included here are ethyl alcohol, anesthetics, hypnotics and sedatives, narcotics, and tranquilizing agents (antipsychotics and antianxiety agents).United StatesOxycodone: A semisynthetic derivative of CODEINE.Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Disulfiram: A carbamate derivative used as an alcohol deterrent. It is a relatively nontoxic substance when administered alone, but markedly alters the intermediary metabolism of alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenase.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Counseling: The giving of advice and assistance to individuals with educational or personal problems.Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake.Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the PRO-OPIOMELANOCORTIN precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; OPIOID PEPTIDES is used for the broader group.PyrrolidinesSuicide, Attempted: The unsuccessful attempt to kill oneself.Psychiatric Status Rating Scales: Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders.Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (RECEPTORS, OPIOID, KAPPA) and have been shown to play a role as central nervous system transmitters.Dextropropoxyphene: A narcotic analgesic structurally related to METHADONE. Only the dextro-isomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect.Poisoning: A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Enkephalin, D-Penicillamine (2,5)-: A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.Alcoholic Beverages: Drinkable liquids containing ETHANOL.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Medication Adherence: Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency.Charcoal: An amorphous form of carbon prepared from the incomplete combustion of animal or vegetable matter, e.g., wood. The activated form of charcoal is used in the treatment of poisoning. (Grant & Hackh's Chemical Dictionary, 5th ed)Marijuana Abuse: The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Codeine: An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.Motivation: Those factors which cause an organism to behave or act in either a goal-seeking or satisfying manner. They may be influenced by physiological drives or by external stimuli.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Genetic Predisposition to Disease: A latent susceptibility to disease at the genetic level, which may be activated under certain conditions.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Enkephalin, Leucine: One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Antidotes: Agents counteracting or neutralizing the action of POISONS.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.HIV Infections: Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).Interview, Psychological: A directed conversation aimed at eliciting information for psychiatric diagnosis, evaluation, treatment planning, etc. The interview may be conducted by a social worker or psychologist.Age of Onset: The age, developmental stage, or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual.Impulsive Behavior: An act performed without delay, reflection, voluntary direction or obvious control in response to a stimulus.Alcoholics: Persons who have a history of physical or psychological dependence on ETHANOL.Polymorphism, Single Nucleotide: A single nucleotide variation in a genetic sequence that occurs at appreciable frequency in the population.Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Kinetics: The rate dynamics in chemical or physical systems.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.beta-Endorphin: A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.Alcoholics Anonymous: An organization of self-proclaimed alcoholics who meet frequently to reinforce their practice of abstinence.Fetal Alcohol Spectrum Disorders: An umbrella term used to describe a pattern of disabilities and abnormalities that result from fetal exposure to ETHANOL during pregnancy. It encompasses a phenotypic range that can vary greatly between individuals, but reliably includes one or more of the following: characteristic facial dysmorphism, FETAL GROWTH RETARDATION, central nervous system abnormalities, cognitive and/or behavioral dysfunction, BIRTH DEFECTS. The level of maternal alcohol consumption does not necessarily correlate directly with disease severity.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Alcohol Oxidoreductases: A subclass of enzymes which includes all dehydrogenases acting on primary and secondary alcohols as well as hemiacetals. They are further classified according to the acceptor which can be NAD+ or NADP+ (subclass 1.1.1), cytochrome (1.1.2), oxygen (1.1.3), quinone (1.1.5), or another acceptor (1.1.99).Enkephalin, Methionine: One of the endogenous pentapeptides with morphine-like activity. It differs from LEU-ENKEPHALIN by the amino acid METHIONINE in position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.Benzyl Alcohols: Alcohols derived from the aryl radical (C6H5CH2-) and defined by C6H5CHOH. The concept includes derivatives with any substituents on the benzene ring.Chronic Pain: Aching sensation that persists for more than a few months. It may or may not be associated with trauma or disease, and may persist after the initial injury has healed. Its localization, character, and timing are more vague than with acute pain.Alcohol-Induced Disorders: Disorders stemming from the misuse and abuse of alcohol.Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment.Combined Modality Therapy: The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature.Brain: The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.Enkephalin, Leucine-2-Alanine: A delta-selective opioid (ANALGESICS, OPIOID). It can cause transient depression of mean arterial blood pressure and heart rate.Genotype: The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Anxiety Disorders: Persistent and disabling ANXIETY.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community.Morphine Derivatives: Analogs or derivatives of morphine.Benzeneacetamides: Compounds based on benzeneacetamide, that are similar in structure to ACETANILIDES.Child of Impaired Parents: Child with one or more parents afflicted by a physical or mental disorder.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Oxymorphone: An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)Antisocial Personality Disorder: A personality disorder whose essential feature is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be at least age 18 and must have a history of some symptoms of CONDUCT DISORDER before age 15. (From DSM-IV, 1994)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Recurrence: The return of a sign, symptom, or disease after a remission.Self Administration: Administration of a drug or chemical by the individual under the direction of a physician. It includes administration clinically or experimentally, by human or animal.Harm Reduction: The application of methods designed to reduce the risk of harm associated with certain behaviors without reduction in frequency of those behaviors. The risk-associated behaviors include ongoing and active addictive behaviors.Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating.Hydrocodone: Narcotic analgesic related to CODEINE, but more potent and more addicting by weight. It is used also as cough suppressant.Stereoisomerism: The phenomenon whereby compounds whose molecules have the same number and kind of atoms and the same atomic arrangement, but differ in their spatial relationships. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed)Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Energy Drinks: Beverages consumed as stimulants and tonics. They usually contain a combination of CAFFEINE with other substances such as herbal supplements; VITAMINS; AMINO ACIDS; and sugar or sugar derivatives.Drug Users: People who take drugs for a non-therapeutic or non-medical effect. The drugs may be legal or illegal, but their use often results in adverse medical, legal, or social consequences for the users.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Drug and Narcotic Control: Control of drug and narcotic use by international agreement, or by institutional systems for handling prescribed drugs. This includes regulations concerned with the manufacturing, dispensing, approval (DRUG APPROVAL), and marketing of drugs.Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few - MORPHINE; CODEINE; and PAPAVERINE - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Event-Related Potentials, P300: A late-appearing component of the event-related potential. P300 stands for a positive deflection in the event-related voltage potential at 300 millisecond poststimulus. Its amplitude increases with unpredictable, unlikely, or highly significant stimuli and thereby constitutes an index of mental activity. (From Campbell, Psychiatric Dictionary, 6th ed)Suicide: The act of killing oneself.Alcohol Withdrawal Seizures: A condition where seizures occur in association with ethanol abuse (ALCOHOLISM) without other identifiable causes. Seizures usually occur within the first 6-48 hours after the cessation of alcohol intake, but may occur during periods of alcohol intoxication. Single generalized tonic-clonic motor seizures are the most common subtype, however, STATUS EPILEPTICUS may occur. (Adams et al., Principles of Neurology, 6th ed, p1174)Diseases in Twins: Disorders affecting TWINS, one or both, at any age.Benzodiazepines: A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring.Benzyl Alcohol: A colorless liquid with a sharp burning taste and slight odor. It is used as a local anesthetic and to reduce pain associated with LIDOCAINE injection. Also, it is used in the manufacture of other benzyl compounds, as a pharmaceutic aid, and in perfumery and flavoring.Drug-Induced Liver Injury: A spectrum of clinical liver diseases ranging from mild biochemical abnormalities to ACUTE LIVER FAILURE, caused by drugs, drug metabolites, and chemicals from the environment.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Fatty Alcohols: Usually high-molecular-weight, straight-chain primary alcohols, but can also range from as few as 4 carbons, derived from natural fats and oils, including lauryl, stearyl, oleyl, and linoleyl alcohols. They are used in pharmaceuticals, cosmetics, detergents, plastics, and lube oils and in textile manufacture. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed)Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression.Administration, Oral: The giving of drugs, chemicals, or other substances by mouth.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Aldehyde Dehydrogenase: An enzyme that oxidizes an aldehyde in the presence of NAD+ and water to an acid and NADH. This enzyme was formerly classified as EC 1.1.1.70.Receptors, Dopamine D2: A subfamily of G-PROTEIN-COUPLED RECEPTORS that bind the neurotransmitter DOPAMINE and modulate its effects. D2-class receptor genes contain INTRONS, and the receptors inhibit ADENYLYL CYCLASES.Sex Characteristics: Those characteristics that distinguish one SEX from the other. The primary sex characteristics are the OVARIES and TESTES and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction.Behavior, Animal: The observable response an animal makes to any situation.Hydrogen-Ion Concentration: The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH = log 1/2[1/(H+)], where (H+) is the hydrogen ion concentration in gram equivalents per liter of solution. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration.Morphinans: Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.Family: A social group consisting of parents or parent substitutes and children.Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.European Continental Ancestry Group: Individuals whose ancestral origins are in the continent of Europe.New York CityEndophenotypes: Measurable biological (physiological, biochemical, and anatomical features), behavioral (psychometric pattern) or cognitive markers that are found more often in individuals with a disease than in the general population. Because many endophenotypes are present before the disease onset and in individuals with heritable risk for disease such as unaffected family members, they can be used to help diagnose and search for causative genes.National Institute on Alcohol Abuse and Alcoholism (U.S.): Component of the NATIONAL INSTITUTES OF HEALTH. It conducts research focused on improving the treatment and prevention of alcoholism and alcohol-related problems to reduce the health, social, and economic consequences of this disease. NIAAA, NIMH, and NIDA were created as coequal institutes within the Alcohol, Drug Abuse and Mental Health Administration in 1974. It was established within the NATIONAL INSTITUTES OF HEALTH in 1992.Polyvinyl Alcohol: A polymer prepared from polyvinyl acetates by replacement of the acetate groups with hydroxyl groups. It is used as a pharmaceutic aid and ophthalmic lubricant as well as in the manufacture of surface coatings artificial sponges, cosmetics, and other products.Gas Chromatography-Mass Spectrometry: A microanalytical technique combining mass spectrometry and gas chromatography for the qualitative as well as quantitative determinations of compounds.Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone.Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her.Crime: A violation of the criminal law, i.e., a breach of the conduct code specifically sanctioned by the state, which through its administrative agencies prosecutes offenders and imposes and administers punishments. The concept includes unacceptable actions whether prosecuted or going unpunished.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Sodium Oxybate: The sodium salt of 4-hydroxybutyric acid. It is used for both induction and maintenance of ANESTHESIA.Rats, Wistar: A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.Reward: An object or a situation that can serve to reinforce a response, to satisfy a motive, or to afford pleasure.Temperature: The property of objects that determines the direction of heat flow when they are placed in direct thermal contact. The temperature is the energy of microscopic motions (vibrational and translational) of the particles of atoms.Conduct Disorder: A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviors include aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules. The onset is before age 18. (From DSM-IV, 1994)Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.gamma-Glutamyltransferase: An enzyme, sometimes called GGT, with a key role in the synthesis and degradation of GLUTATHIONE; (GSH, a tripeptide that protects cells from many toxins). It catalyzes the transfer of the gamma-glutamyl moiety to an acceptor amino acid.Meperidine: A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.Prescription Drug Diversion: The transfer of prescription drugs from legal to illegal distribution and marketing networks.Personality: Behavior-response patterns that characterize the individual.Haplotypes: The genetic constitution of individuals with respect to one member of a pair of allelic genes, or sets of genes that are closely linked and tend to be inherited together such as those of the MAJOR HISTOCOMPATIBILITY COMPLEX.Dangerous Behavior: Actions which have a high risk of being harmful or injurious to oneself or others.Nondirective Therapy: A procedure in which the therapist refrains from directing the client, but instead reflects back to the client what the latter has said, sometimes restating the client's remark.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.Prisoners
Risk factors for opioid overdose include opioid dependence, injecting opioids, using high doses of opioids, and use together ... injecting opioids, using high doses of opioids, mental disorders, and use together with alcohol or benzodiazepines. The risk is ... Examples of opioids include morphine, heroin, fentanyl, tramadol, and methadone. Symptoms include insufficient breathing, small ... Dependence on prescription opioids can occur from their use to treat chronic pain. Opioid overdoses associated with a ...
These drugs are used mainly as antidotes to reverse opioid overdose and in the treatment of alcohol dependence and opioid ... A course of low-dose naltrexone is thus often used as the final step in the treatment of opioid addiction after the patient has ... This effectively blocks the receptor, preventing the body from responding to opioids and endorphins. Some opioid antagonists ... been weaned off the substitute agonist such as methadone or buprenorphine, in order to restore homeostasis and minimize the ...
... including alcohol, as well as with sedatives in general, possess a significant risk to the user in the form of overdose. ... which allows the use of a smaller dose of the opioid to have a given effect,[citation needed] is useful in general and ... particularly sedatives and/or alcohol). It may reach clinical significance before physiological tolerance and dependence have ... The potentiation effect is also useful in other pain situations and is also especially useful with opioids of the open-chain ...
Benzodiazepine overdoses can be much more dangerous if a coingestion of other CNS depressants such as opiates or alcohol has ... opioids, e.g. morphine, oxycodone or methadone). Concurrent use of these medicines (as well as other benzodiazepines) can ... Important factors which affect the severity of a benzodiazepine overdose include the dose ingested, the age of the patient, and ... Perry HE, Shannon MW (June 1996). "Diagnosis and management of opioid- and benzodiazepine-induced comatose overdose in children ...
Adverse effects of opioids Common and short term Itch Nausea Vomiting Constipation Drowsiness dry mouth Other Opioid dependence ... high-dose oxycodone, or methadone as well as dextromoramide in specific instances such as 1970s Australia, to top that ... "Development of pharmaceutical heroin preparations for medical co-prescription to opioid dependent patients". Drug Alcohol ... A large overdose can cause asphyxia and death by respiratory depression if the person does not receive medical attention ...
People on high-dose buprenorphine therapy may be unaffected by even large doses of opioids such as oxycodone, morphine, or ... Both buprenorphine and methadone are medications used for detoxification, short- and long-term opioid replacement therapy. ... "Press Announcements - FDA approves first buprenorphine implant for treatment of opioid dependence". FDA. Retrieved 12 December ... alcohol, or have underlying lung disease. The usual reversal agents for opioids, such as naloxone, may be only partially ...
However, combinations of high doses of benzodiazepines with alcohol, barbiturates, opioids or tricyclic antidepressants are ... In most cases of fatal overdose it is likely that lack of opioid tolerance combined with the depressant effects of ... "Detection of alprazolam in three cases of methadone/benzodiazepine overdose". Journal of forensic sciences. 42 (1): 155-6. ISSN ... National Treatment Agency for Substance Misuse (2007). "Drug misuse and dependence - UK guidelines on clinical management" (PDF ...
The use of alcohol or benzodiazepines along with the usual dose of heroin is often the cause of overdose deaths in opiate ... To remain true to the term 'depressant' - opioids cannot be classified as such. For opioid agonists and opium derivatives, ... Morphine Heroin Codeine Hydrocodone Oxycodone Methadone Alpha and beta blockers (Carvedilol, Propranolol, atenolol, etc.) ... physical dependence, and, upon cessation of use after long-term use, a withdrawal syndrome. Due to adverse effects associated ...
Given that many anxiety sufferers are more prone to alcohol and opioid addiction, the potential danger in prescribing opioids ... Like barbiturates, therapeutic doses produce sedation and significant overdoses may be fatal. In the US, meprobamate has ... It is much safer than methadone and lots of other opioids and has a very long half-life leading to less compulsive use among ... Tolerance and dependence may also occur, but may be clinically acceptable. Cognitive and behavioral adverse effects are ...
... but without the opioid dependence issues). Many opiate derivatives and synthetic opioids were tested for addiction and abuse ... Subjects were given controlled oral doses of alcohol throughout the day from 6 am until midnight, and a booster dose around 3 ... as treatment for opiate overdoses, the ability of methadone to alleviate opiate withdrawal symptoms, rapid tolerance but lack ... 1955) demonstrated that alcohol causes physical dependence; that is, cessation of alcohol consumption in a chronic user can ...
... the majority of these overdoses involve other drugs including alcohol. Recognised risk factors for tramadol overdose include ... Long-term use of high doses of tramadol will cause physical dependence and withdrawal syndrome. These include both symptoms ... "Syntheses and opioid receptor binding properties of carboxamido-substituted opioids". Bioorg. Med. Chem. Lett. 19 (1): 203-8. ... Pharmacologically, tramadol is similar to tapentadol and methadone in that it not only binds to the MOR, but also inhibits the ...
A typical dose creates driving impairment equivalent to a blood-alcohol level of 0.10 which is higher than the 0.08 limit of ... It has been shown to be a potentiator of analgesia induced by morphine, but not by endogenous opioids, in rats. The drug has ... "Diphenhydramine overdose:". MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Archived from the original on ... Rapid urine drug screens using immunoassays based on the principle of competitive binding may show false-positive methadone ...
... by drug and alcohol workers. Illicit users of benzodiazepines have been found to take higher methadone doses, as well as ... The main problems highlighted in this survey were concerns of dependence, the potential for overdose of benzodiazepines in ... abuse include drug-related deaths due to overdose especially in combination with other depressant drugs such as opioids. Other ... Sedative-hypnotics such as alcohol, benzodiazepines, and the barbiturates are known for the severe physical dependence that ...
A range of synthetic opioids such as methadone (1937), pethidine (1939), fentanyl (late 1950s), and derivatives thereof have ... Most heroin deaths result not from overdose per se, but combination with other depressant drugs such as alcohol or ... Because the lethal dose of heroin was viewed as a hundred times greater than its effective dose, heroin was advertised as a ... Both analgesia and drug addiction are functions of the mu opioid receptor, the class of opioid receptor first identified as ...
Naloxone is a drug used to counter an overdose from the effect of opioids; for example, a heroin or morphine overdose. Simply ... found that serving chronic street alcoholics controlled doses of alcohol also reduced their overall alcohol consumption. ... "Treatment of opioid dependence". World Health Organization. WHO. 2014. Retrieved 17 March 2014. "Drug use prevention, treatment ... However, critics have alleged that the control group gets unsustainably low doses of methadone, making them prone to fail and ...
Methadone and buprenorphine are sometimes used to treat opiate addiction. These drugs are used as substitutes for other opioids ... Of these, the highest numbers are from alcohol use disorders at 137,500, opioid use disorders at 122,100 deaths, amphetamine ... It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably ... ΔFosB Addictive personality Alcohol abuse Combined drug intoxication Controlled Substances Act Drug addiction Drug overdose ...
As with other opioid medications, tolerance and dependence usually develop with repeated doses. There is some clinical evidence ... "Methadone overdose". MedlinePlus. 3 October 2017. Leavitt, Stewart B. (September 2003). "Methadone Dosing & Safety in the ... Compared to other opioids, methadone has a lower cross-tolerance when switching to it from other opioids. This means that ... "Methadone Withdrawal Symptoms". Michael's House Drug & Alcohol Treatment Centers. Archived from the original on 8 March 2013. ...
... are widely used to treat addiction and dependence on other opioids such as heroin, morphine or oxycodone. Methadone and ... Certain opioid medications such as methadone and more recently buprenorphine (In America, "Subutex" and "Suboxone") ... According to the National Institute on Drug Abuse (NIDA), patients stabilized on adequate, sustained doses of methadone or ... ISBN 978-1-57230-659-2. "Addiction & Alcohol Rehab, Alcohol Detox, Drug Rehabilitation in Peterborough, UK". Addiction Rehab ...
Shearer J (2008). "The principles of agonist pharmacotherapy for psychostimulant dependence". Drug Alcohol Rev. 27 (3): 301-8. ... and its minor formation means it does not contribute to the pharmacological profile at therapeutic doses and even in overdose ... for the treatment of cocaine addiction in the same way that methadone is used as a replacement drug for physical dependence ... In individuals with terminal cancer, methylphenidate can be used to counteract opioid-induced somnolence, to increase the ...
... gene of the cytochrome P450 family also mediates breakdown of opioids and thus may play a role in dependence and overdose. The ... the dose will then be gradually reduced until the individual is either free of the need for methadone or is at a level which ... including opioid dependence, cocaine dependence, alcohol dependence, methamphetamine dependence/psychosis, response to ... Opioid dependence can manifest as physical dependence, psychological dependence, or both. Opioids include substances such as ...
Increased chance of overdose - Because IV injection delivers a dose of drug straight into the bloodstream, it is harder to ... This applies particularly to prescription opioids, since some opioid addicts already inject heroin. Injecting preparations ... Although many people use an alcohol swab for this purpose, it is discouraged by health services as the alcohol interferes with ... During most of the 1850s, the previously-held belief that opiate dependence and addiction (often called "the opium appetite", ...
... has been used to treat opioid dependence for more than 45 years (invented in 1937). Therapeutic dosing is ... and also due to the high risk of diverted medication causing an overdose in an individual that is not used to such a large dose ... CS1 maint: Multiple names: authors list (link) http--www.rcgp.org.uk-PDF-drug_meth%20guidance.pdf California Alcohol and Drug ... as treatment for someone who is addicted to opioids such as heroin, where detoxification has been unsuccessful and/or ...
Methadone. Opioid. 1.86. 2.08. 1.87. 1.94 Alcohol. CNS depressant. 1.40. 1.93. 2.21. 1.85 ... Dependence liability is the average rating of the scores for intensity of pleasure, psychological dependence, and physical ... a b c d Overdose Death Rates. By National Institute on Drug Abuse (NIDA). ... opioids and some substituted amphetamines like methamphetamine and MDMA. The exact cause of substance abuse is not clear, with ...
Use with alcohol is not recommended.[2] Hydrocodone works by binding to the mu-opioid receptor.[1] How acetaminophen works is ... of the oral dose is excreted renally.[8] At high doses, the supply of glutathione cannot meet its demand, thus results in the ... Overdose[edit]. Hydrocodone: Respiratory depression, extreme somnolence progressing towards coma, muscle limpness, cold and ... Hydrocodone may demonstrate an enhanced respiratory depressant effect when combined with other sedatives such as other opioids ...
... alone or together with methadone or in other drug dependent patients and of dosulepin with alcohol or in methadone patients ... as the doses required for clinical treatment and potentially lethal overdose (see therapeutic index) are far wider in ... March 2008). "Delta-opioid receptors are critical for tricyclic antidepressant treatment of neuropathic allodynia". Biological ... Singh GP, Kaur P, Bhatia S (June 2004). "Dothiepin dependence syndrome". Indian J Med Sci. 58 (6): 253-4. PMID 15226578. Cohen ...
... (phenethylphenylacetoxypiperidine) is an opioid analgesic that is an analog of pethidine (meperidine). It is related to the drug MPPP, with an N-phenethyl group in place of the N-methyl substitution and an acetate ester rather than propionate. PEPAP is approximately 6-7 times more potent than morphine in laboratory rats.[1] PEPAP presumably has similar effects to other opioids, producing analgesia, sedation and euphoria. Side effects can include itching, nausea and potentially serious respiratory depression which can be life-threatening. PEPAP has been found to be a potent CYP2D6 inhibitor, which makes it likely to cause adverse interactions with some other drugs, although the inhibitory potency of PEPAP is less than that of MPPP.[2] Both cocaine and methadone are also CYP2D6 inhibitors and could, in theory, potentiate the effect. It is unlikely that the tetrahydropyridine byproducts that may be formed during the synthesis of PEPAP are neurotoxic in the ...
Supreme court interpretations of the 1914 Harrison Narcotics Tax Act had criminalized opioid dependency as well as the use of any opioid "for the sole purpose of maintenance." The criminalization and stigmatization of dependent individuals also influenced medical practice. Physicians and pharmacists, who risked being investigated by the Treasury Department officials that monitored their prescriptions, were wary of placing many patients on maintenance. Medical schools provided almost no instruction on addiction.[3]. In 1964, at Rockefeller Institute (now known as Rockefeller University), Dole and Nyswander initially treated six addicts during the first year, but the results of this work "were sufficiently impressive to justify the trial of maintenance treatment of heroin addicts admitted to open medical wards of general hospitals in the city."[2] By 1967 over 300 patients were receiving daily doses of methadone, a potent synthetic ...
... , also known as diamorphine among other names, is an opioid most commonly used as a recreational drug for its euphoric effects. Medically it is used in several countries to relieve pain or in opioid replacement therapy. Heroin is typically injected, usually into a vein; however, it can also be smoked, snorted or inhaled. Onset of effects is usually rapid and lasts for a few hours. Common side effects include respiratory depression (decreased breathing), dry mouth, euphoria, and addiction. Other side effects can include abscesses, infected heart valves, blood borne infections, constipation, and pneumonia. After a history of long-term use, withdrawal symptoms can begin within hours of last use. When given by injection into a vein, heroin has two to three times the effect as a similar dose of morphine. It typically comes as a white or brown powder. Treatment of heroin addiction often includes behavioral therapy and medications. Medications can include buprenorphine, ...
... , or diamorphine assisted treatment, refers to the prescribing of synthetic, injectable heroin to opiate addicts who do not benefit from or cannot tolerate treatment with one of the established drugs used in opiate replacement therapy like methadone or buprenorphine (brand name Suboxone). For this group of patients, heroin assisted treatment has proven superior in improving their social and health situation. It has also been shown to save money, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency. It has also drastically reduced overdose deaths in the countries utilizing it, as patients take their dose in a controlled, professionally supervised setting, and Narcan (naloxone) is on hand in the case of an accidental overdose. Opiate related overdoses in the U.S. kill around 20,000 people per year. Heroin assisted treatment is fully a part of the national health system in Switzerland, ...
... is a CYP2D6 enzyme inducer. When taken with codeine, (known on the streets as "hits", "cibas and codeine ", "Dors and 4s") it enables the body to convert higher amounts of the codeine to morphine. The general sedative effect of the glutethimide also adds to the effect of the combination.[4] It produces an intense, long lasting euphoria similar to IV heroin use. Quite a few deaths have occurred from abuse of this combination.[5] The effect was also used clinically, including some research in the 1970s in various countries of using it under carefully monitored circumstances as a form of oral opioid agonist substitution therapy, e.g. as a Substitutionmittel that may be a useful alternative to methadone.[6][7] The demand for this combination in Philadelphia, Pittsburgh, Newark, NYC, Boston, Baltimore, and surrounding areas of other states and perhaps elsewhere, has led to small-scale clandestine synthesis of glutethimide since 1984,[8]:203 a process that is, like ...
... (Santenol) is a drug which is a stimulant and also an analgesic with effects comparable to codeine. Lefetamine-related 1,2-diphenylethylamines were invented in the 1940s and showed weak analgesic activity. It was investigated in Japan in 1950s. The l-isomer showed weak analgesic action comparable to codeine and antitussive action far weaker than codeine. The d-isomer showed no such activity but caused seizures in rats. It was abused in Japan during the 1950s. In a small study in 1989 it showed some effect against opioid withdrawal symptoms without causing withdrawal symptoms itself. It was concluded that it may be an opioid partial agonist. It has been abused in Europe, in 1989 a small study of 15 abusers and some volunteers found, that it had some partial similarity to opioids, that it produced withdrawal symptoms and had dependence and abuse potential to a certain degree. In a small study in 1994, it was compared to ...
... (INN) is a synthetic opioid analgesic related to methadone that was never marketed.[1] In a clinical trial of postpartum patients it was reported to produce analgesia comparable to that of morphine but with less nausea, dizziness, and drowsiness.[2][3] Other side effects included salivation, ataxia, and respiratory depression that was reversible by naloxone.[2][3] Similarly to many of its analogues, noracymethadol is a Schedule I controlled substance in the United States with an ACSCN of 9633 and 2013 annual manufacturing quota of 12 grammes. [4] and is also controlled internationally under the United Nations Single Convention on Narcotic Drugs of 1961.[5] The salts known are the gluconate (free base conversion ratio 0.633) and hydrochloride (0.903).. Noracymethadol is an acetyl ester of methadol and it can be said with some precision that it is either the heroin or 6-monoacetylmorphine analogue of methadol, and being a methadol it exhibits optical isomerism. The other ...
Drug films are films that depict either drug distribution or drug use, whether as a major theme or in a few memorable scenes. Drug cinema ranges from the ultra-realistic to the utterly surreal; some films are unabashedly pro- or anti-drug, while others are less judgmental. The drugs most commonly shown in films are cocaine, heroin, LSD, cannabis (see stoner film) and methamphetamine. There is extensive overlap with crime films, which are more likely to treat drugs as plot devices to keep the action moving. The following is a partial list of drug films and the substances involved. ...
... (N,N-Dimethyl-1-methyl-3,3-di-2-thienylallylamine, DMTB, trade names Ohton, Aminobutene, Dimethibutin, Kobaton, Takaton, Dimethibutin) is an opioid analgesic drug, most often used in veterinary medicine in Japan and to a lesser extent in other countries in the region and around the world. It is the most prominent and widely used of the thiambutenes, a series of open-chain opioids structurally related to methadone which are also called the thienyl derivative opioids which also includes diethylthiambutene and ethylmethylthiambutene, as well as the non-opioid cough suppressant tipepidine. Dimethylthiambutene was developed in the United Kingdom in the late 1940s and introduced to the market by Burroughs-Wellcome in 1951. Dimethylthiambutene is now under international control under the UN Single Convention on Narcotic Drugs 1961, the laws governing habit-forming substances in virtually all countries and Schedule I of the US ...
... is a 2005 autobiographical comedy film by American independent director and screenwriter Caveh Zahedi. Presented in semi-documentary style, the film chronicles Zahedi's own sex addiction and its impact on his life, relationships, and film making. His addiction was manifested by visiting prostitutes, and being open about this with his successive partners. The film premiered at the International Film Festival Rotterdam and was subsequently picked up for distribution by IFC Films. It aired on The Movie Channel and Showtime in 2007, and subsequently has been shown on the Sundance Channel in the United States. Though not formal sequels, but in chronological order; his 2001 film In the Bathtub of the World documents his life from where I Am a Sex Addict ends and his 2015 Web series 'The Show About The Show continues 15 year later from where the latter ends. Quotations related to I am a Sex Addict at Wikiquote Official website I Am a Sex Addict on ...
... is an experimental combination drug formulation of buprenorphine, a μ-opioid receptor (MOR) weak partial agonist and κ-opioid receptor (KOR) antagonist, and naltrexone, a MOR and KOR silent antagonist, which is under investigation for the potential treatment of psychiatric disorders. The combination of the two drugs is thought to result in a selective blockade of the KOR and hence fewer MOR activation-related concerns such as euphoria and opioid dependence. It has been found to produce antidepressant-like effects in mice (similarly to the case of buprenorphine alone or in combination with samidorphan) and (at a buprenorphine dosage of 16 mg/day but not 4 mg/day) has recently been found to be effective in the treatment of cocaine dependence in a large (n = 302) human clinical trial. Buprenorphine/samidorphan Buprenorphine/naloxone McCann, DJ (2008). "Potential of Buprenorphine/Naltrexone ...
... , or diamorphine assisted treatment, refers to the prescribing of synthetic, injectable heroin to opiate addicts who do not benefit from or cannot tolerate treatment with one of the established drugs used in opiate replacement therapy like methadone or buprenorphine (brand name Suboxone). For this group of patients, heroin assisted treatment has proven superior in improving their social and health situation. It has also been shown to save money, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency. It has also drastically reduced overdose deaths in the countries utilizing it, as patients take their dose in a controlled, professionally supervised setting, and Narcan (naloxone) is on hand in the case of an accidental overdose. Opiate related overdoses in the U.S. kill around 20,000 people per year. Heroin assisted treatment is fully a part of the national health system in Switzerland, ...
... (Santenol) is a drug which is a stimulant and also an analgesic with effects comparable to codeine. Lefetamine-related 1,2-diphenylethylamines were invented in the 1940s and showed weak analgesic activity. It was investigated in Japan in 1950s. The l-isomer showed weak analgesic action comparable to codeine and antitussive action far weaker than codeine. The d-isomer showed no such activity but caused seizures in rats. It was abused in Japan during the 1950s. In a small study in 1989 it showed some effect against opioid withdrawal symptoms without causing withdrawal symptoms itself. It was concluded that it may be an opioid partial agonist. It has been abused in Europe, in 1989 a small study of 15 abusers and some volunteers found, that it had some partial similarity to opioids, that it produced withdrawal symptoms and had dependence and abuse potential to a certain degree. In a small study in 1994, it was compared to ...
DOSED is a documentary that follows an opioid addict on the road to recovery using psychedelics and illuminates the true roots ... The overdose deaths involving legal prescription opioids have quadrupled since 1999 and so have the sales for these drugs. In ... "over fifty percent of all suicides are associated with alcohol and drug dependence." ... "Shed been on countless prescription medications, doctor-prescribed opioid replacement therapy programs like methadone," Tyler ...
Risk factors for opioid overdose include opioid dependence, injecting opioids, using high doses of opioids, and use together ... injecting opioids, using high doses of opioids, mental disorders, and use together with alcohol or benzodiazepines. The risk is ... Examples of opioids include morphine, heroin, fentanyl, tramadol, and methadone. Symptoms include insufficient breathing, small ... Dependence on prescription opioids can occur from their use to treat chronic pain. Opioid overdoses associated with a ...
... high doses or in combination with certain psychotropic medications and/or alcohol inevitably leads to dependence and overdose ... What is Opioid Use Disorder?. The DSM-5 defines opioid use disorder as a problematic pattern of opioid use leading to ... Examples of prescription opioids include: morphine, codeine, methadone, oxycodone, hydrocodone, fentanyl, hydromorphone, and ... What Are Opioids?. Opioids are illicit drugs, such as heroin, as well as some prescription medications used to treat pain. ...
... if the patient uses previously tolerated doses of opioids. Cases of opioid overdose with fatal outcomes have been reported in ... Patients treated for alcohol dependence with naltrexone hydrochloride should also be assessed for underlying opioid dependence ... Patients currently dependent on opioids, including those currently maintained on opiate agonists [e.g., methadone) or partial ... Vulnerability to Opioid Overdose. After opioid detoxification, patients are likely to have reduced tolerance to opioids. As the ...
Methadone official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, ... USP toanother opioid. Doing so will result in an overestimation of the dose of the new opioid and may result in fatal overdose. ... Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may ... Patients in Methadone maintenance treatment for opioid dependence who experience physical trauma, postoperative pain or other ...
The actual liability of abuse and dependence of legitimately prescribed prescription opioids will be conveyed. ... the mechanism of opioid action and the neurobiology of opioid addiction; the epidemiology, diagnosis and risk factors of opioid ... Additionally, the demographics, characteristics, comorbidity and treatment of prescription opioid abuse and dependence (i.e., ... Historically, heroin dependence has been difficult to treat successfully, with poor outcome being attributed to patient ...
"Prescription opioid abuse among enrollees into methadone maintenance treatment." Drug and Alcohol Dependence, 2007; Inciardi, ... With 116 Americans dying from opioid-related drug overdoses each and every day, theres no time to wait.7 ... And given that one in five patients become addicted to opioids even with just a ten-day drug therapy,6 prescribers need to know ... whether patients in need of pain relief are adhering to the right medications at the right dose or taking medications that may ...
Examples of full opiate agonists include heroin, oxycodone, methadone, hydrocodone, morphine, opium and a number of other drugs ... Methadone. Methadone is the most widely known and most common of the opiate agonists used to treat opioid dependence. It ... Naloxone binds to opioid receptors, which rapidly reverse and block the effects of other opioids. In case of an overdose, that ... The oxycodone in high doses, or when combined with other drugs or alcohol, can cause respiratory distress and even death. It is ...
... to another opioid. Doing so will result in an overestimation of the dose of the new opioid and may result in fatal overdose. ... see Drug Abuse and Dependence (9)]. As long-acting opioids such as methadone have pharmacological effects over an extended ... Using products containing alcohol during treatment with methadone hydrochloride tablets may cause you to overdose and die. ... If you take methadone hydrochloride tablets for opioid addiction and miss a dose, take your next dose the following day as ...
... opioid dependence was found to range from 3% to 26%. There was a consistent dose dependent association with risk of overdose ... and the question has to do with extended release long-acting opioids. And one of my colleagues when he prescribes methadone ... and increased risks at higher dosages or when opioids are taken with other drugs or alcohol. Clinicians should also discuss ... Again we found consistently that opioid-related overdose risk is dose-dependent with greater risk at higher dosages. And there ...
... prisons are experimenting with a high-priced monthly injection that could help addicted inmates stay off opioids after they are ... won Food and Drug Administration approval for alcohol dependence in 2006 and in 2010 to prevent relapse in post-detox opioid ... When given take-home doses of methadone for the weekend, he would sell them for heroin. ... A year after treatment stopped, there had been no overdoses in the Vivitrol group and seven overdoses, including three deaths, ...
These drugs are used mainly as antidotes to reverse opioid overdose and in the treatment of alcohol dependence and opioid ... A course of low-dose naltrexone is thus often used as the final step in the treatment of opioid addiction after the patient has ... This effectively blocks the receptor, preventing the body from responding to opioids and endorphins. Some opioid antagonists ... been weaned off the substitute agonist such as methadone or buprenorphine, in order to restore homeostasis and minimize the ...
Methadone Hydrochloride Tablets) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews ... Both tolerance and physical dependence can develop during chronic opioid therapy.. Tolerance is the need for increasing doses ... Abuse of Methadose poses a risk of overdose and death. This risk is increased with concurrent abuse of methadone with alcohol ... Conversion from Other Opioids. Published conversion ratios for other opioids to methadone may overestimate the dose of ...
Patients have an increased risk of methadone overdose in the first two weeks of treatment.18 Titration to an effective dose of ... prevention of opioid dependence by careful opioid prescribing is far more preferable than having to treat dependence. ... Discourage use of alcohol and cannabis during the opioid withdrawal.. Be flexible on the rate of taper. * The rate of taper can ... Gradual dose reduction (tapering). Patients who have been receiving higher doses of opioids or long-term opioid treatment are ...
Medications for Opioid Dependence[edit]. Methadone, a synthetic opioid mu-receptor agonist, is a long-acting analgesic that has ... Naltrexone is an opioid receptor antagonist. Alcohol can increase the release of endogenous opioids in the brain which may ... Patients on naltrexone must not be given opiates for pain management: overdose and death can result from the high opiate doses ... Pharmacotherapeutic treatments are now available for the treatment of opioid dependence, alcohol dependence and nicotine ...
Just last week, we learned that 91% of patients who survive opioid overdose are prescribed more opioids! The CDC calls it an ... the maintenance dose for opioid dependence is 4 to 24 mg/day.5 Analgesic effects are obtained at 0.1- 8 mg (according to Heit, ... stabilize on higher opioid dosages than those without psychiatric diagnoses.. Methadone and especially low-dose buprenorphine ... Finally, there could be no substance or alcohol abuse or benzodiazepine dependence within the past 2 years.. Regarding patient ...
... if the patient uses previously tolerated doses of opioids. After discontinuing treatment, cases of opioid overdose with fatal ... Patients treated for alcohol dependence with naltrexone should also be assessed for underlying opioid dependence and for any ... Opioids dependent patients which include the patients who are on opiate agonists for example methadone or partial agonists ( ... Apart from treating the opioid dependence, naltrexone is also used for treating the alcohol dependence. This is the medication ...
Both tolerance and physical dependence can develop during chronic opioid therapy. Tolerance is the need for increasing doses of ... other opioids, alcohol.. ... Pinpoint pupils are a sign of opioid overdose but are not ... methadone, morphine, oxycodone, oxymorphone, and tapentadol. Sufentanil Citrate Injection can be abused and is subject to ... The total dose of all opioid agonists administered should be considered by the practitioner before ordering opioid analgesics ...
... patients willing to start methadone can only do so in a methadone clinic (a medical centre for drug and alcohol dependence ( ... terms of the proportion of patients not using street opioids compared with the proportion observed in those starting methadone ... an opioid maintenance treatment (OMT), in primary care for drug users has led to an impressive reduction in HIV prevalence ... CSAPA) or a hospital setting) and are referred to primary care physicians after dose stabilization. This study aims to assess ...
Drug and Alcohol Findings Effectiveness Bank analysis titled: ... opioid overdose have been reported in patients who used opioids ... medical use For treatment of alcohol dependence and in the USA also for treating dependence on opioid drugs. in the USA and ... at or near the end of the one-month dosing interval or after missing a dose, or who tried to overcome the opioid blockade. If ... those who have not had treatment success with methadone or buprenorphine;. • those highly motivated for abstinence;. • these ...
... versus dosing at community (offsite) pharmacies, Drug and Alcohol Dependence (2018), https://doi.org/10.1016/j.drugalcdep. ... Categories: Addiction, News Updates, Opioid Abuse/Addiction, Opioids, Overdose. Tags: Addiction, opioids, Overdose ... Opioid Abuse/Addiction. Tags: Addiction, Buprenorphine, Medication-Assisted Treatment, Methadone Treatment, opioids ... Categories: Addiction, News Updates, Opioid Abuse/Addiction. Tags: Addiction, opioids. How Racial Bias Has Shaped the Opioid ...
... blocks opioid molecules from attaching to opioid receptors. See risks & benefits. ... Risk of opioid overdose. You can accidentally overdose in two ways. * VIVITROL blocks the effects of opioids, such as heroin or ... treat alcohol dependence. You should stop drinking before starting VIVITROL.. *prevent relapse to opioid dependence, after ... or diarrhea medicines that contain opioids; or opioid-dependence treatments, including buprenorphine or methadone, for at least ...
... or diarrhea medicines that contain opioids; or opioid-dependence treatments, including buprenorphine or methadone, for at least ... Risk of opioid overdose. You can accidentally overdose in two ways. * VIVITROL blocks the effects of opioids, such as heroin or ... treat alcohol dependence. You should stop drinking before starting VIVITROL.. *prevent relapse to opioid dependence, after ... After you receive a dose of VIVITROL, its blocking effect slowly decreases and completely goes away over time. If you have used ...
Alcohol abstinence vs. moderation People who seek treatment for alcohol dependence sometimes attempt to drink in moderation ... Behavioral therapists regard opioid use disorder as the effect of learned associations and patterns of reward and punishment. ... Dozens of opiates and related drugs (sometimes called opioids) have been extracted from the seeds of the opium poppy or ... Opiates suppress pain, reduce anxiety, and at sufficiently high doses produce euphoria. Most can be taken by mouth, smoked, or ...
Overdoses cause convulsions, cardiac arrest, and death. Psychological dependence develops. Permanent damage to lungs, brain, ... Tolerance, psychological and physical dependence develop. Continued high doses cause heart problems, high blood pressure, ... Opioid derivatives/narcotics (heroin, morphine, codeine, hydrocodone [Lortab or Vicodin combinations], oxycodone [Oxycotin], ... Additional risks of use include malnutrition, hepatitis, and AIDS (with the injectable opioids). ...
  • The oxycodone in high doses, or when combined with other drugs or alcohol, can cause respiratory distress and even death. (opiates.com)
  • In patients administered high doses of Sufentanil Citrate Injection, it is essential that qualified personnel and adequate facilities are available for the management of postoperative respiratory depression. (drugs.com)
  • Although opioids may be physiologically addicting in high doses, they are widely used. (encyclopedia.com)
  • There were 3,074 prescribers of opioid pharmacotherapy drugs, an increase of 3% from 2016. (aihw.gov.au)
  • 1 Treatment for opioid use disorder with bupenorphine therapy increased by 52% from 2012 to 2016. (apsf.org)
  • in 2016 overdose deaths associated with opioids surpassed death from motor vehicle crashes. (apsf.org)
  • the percentage of opioid prescriptions for a greater than 30-day supply increased from 17.6% to 27.3% from 2006 to 2016. (apsf.org)
  • The nomenclature around the illicit use of drugs remains confusing, but the recent International Statistical Classification of Diseases and Related Health Problems ( ICD-10 , released by the World Health Organization in 2016) uses "dependence syndrome" as the preferred term. (lww.com)
  • She was the lead author of a study, published in the August 2016 Journal of Hospital Medicine , revealing that many hospitalists struggle with how to offer patients adequate pain relief without contributing to future opioid dependence. (acphospitalist.org)
  • An investigation of a nonfatal opioid overdose outbreak that occurred in Huntington, West Virginia, on August 15, 2016, identified 20 cases during a 53-hour period (14 overdoses occurred within 5 hours) and provided evidence that a novel, high-potency synthetic opioid was introduced into a community of persons who use illicit opioids. (cdc.gov)
  • On August 15, 2016, the Mayor's Office of Drug Control Policy in Huntington, West Virginia, notified the Cabell-Huntington Health Department (CHHD) of multiple calls regarding opioid overdose received by the emergency medical system (EMS) during 3 p.m.-8 p.m. that day. (cdc.gov)
  • On August 18, 2016, CHHD requested assistance from BPH to investigate the opioid overdose outbreak in Cabell County and conducted a retrospective public health investigation to characterize the outbreak and improve public health response. (cdc.gov)
  • To identify cases, investigators collected Cabell County EMS records and records from the two Cabell County EDs covering a 53-hour period from 3 p.m. on August 14, 2016, to 8 p.m. on August 16, 2016, (24 hours before and 24 hours after the 5-hour period of increased drug overdose EMS calls on August 15). (cdc.gov)
  • Withdrawal from opioids, such as heroin and prescription Vicodin and OxyContin, and stimulants, such as cocaine and methamphetamine, rarely pose immediate health dangers but can be quite unpleasant and difficult for individuals in early recovery to endure. (withdrawal.net)
  • Although not the only opioid that is misused, the well-documented global experience with oxycodone demonstrates the problems that occur when large volumes of strong opioids are available in the community. (bpac.org.nz)
  • Between 2005 and 2011, there was a strong and significant correlation between prescription oxycodone dispensing levels and opioid-related mortality in Ontario. (bpac.org.nz)
  • Dr. Gudin went on to say, "Oxycodone immediate release opioid tablets are widely abused and the development of RoxyBond will offer clinicians a new approach for treating patients in pain while also fighting against the potential for abuse. (salesandmarketingnetwork.com)
  • At certain doses, oxycodone may elicit an intensely rewarding, positive experience for the user. (drugabuse.com)
  • Oxycodone is a powerful opioid painkiller. (drugabuse.com)
  • Her expertise lies in the area of prescription drug overdose prevention, motor vehicle injury prevention, evaluation, implementation science and evidence-based practice guidelines. (cdc.gov)
  • She previously led CDC's Prescription Drug Overdose Team and served as Advisor to New York City's Health Commissioner. (cdc.gov)
  • More than 60 percent of drug overdose deaths involve some type of opioid, according to the Centers for Disease Control and Prevention. (uhc.com)
  • These rules and regulations establish minimum requirements for pain management and opioid prescribing by a practitioner, and require registration of every person who manufactures, distributes, prescribes, administers or dispenses any controlled substance within Rhode Island. (ri.gov)
  • Some of the milder side effects may be avoided by adjusting the time when doses are taken, such as after a meal or at bedtime if a person is experiencing nausea or sleepiness. (psychologytoday.com)
  • and Blurred vision Dizziness Loss of motor control Tingling Insomnia Fatigue Nausea Burning sensations Vivid dreams Bouts of crying Diarrhea Anxiety Stopping Prozac alcohol suddenly, or and cold turkey, may. (grayowldesigns.com)
  • At a much higher dose, they may cause nausea, vomiting and indigestion, followed by euphoria. (asbmb.org)
  • Neonatal opioid withdrawal syndrome (NOWS) is an expected and treatable outcome of use of Methadone hydrochloride tablets during pregnancy. (drugs.com)
  • Prolonged use of methadone hydrochloride tablets during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. (nih.gov)
  • If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available [see Warnings and Precautions (5.4) ]. (nih.gov)
  • Prolonged use of methadone hydrochloride during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life- threatening if not recognized and treated. (nih.gov)