Summer House

Cocaine and methamphetamine are two drugs that are often linked together because they produce similar effects and because they belong to the same class of drugs called psychostimulants. In addition, they both have the potential for causing dependence and abuse which further strengthens the bond associate between them. Though there are many similarities, a fair number of differences do also exist, which will be discussed here.
 

Where Do They Come From?
 

Methamphetamine is man made, while cocaine is derived from the coca plant.
 

Is There A Difference in the Way They Are Used?
 

Both can be smoked, injected intravenously or snorted. The difference being that methamphetamine can be taken in pill form. In addition, cocaine can be used medically as an anesthetic and as an appetite stimulant while methamphetamine has no proven medical use.

Where and By Whom Are the Drugs Used?
 

Out of the two drugs, Methamphetamine has a much more defined area of use as well as stereotype of user. Statistics show that use of methamphetamine is highest in western areas of California, Honolulu, Hawaii, and western areas of the continental United States. Urban areas of California, Oregon, Arizona, Colorado and Washington, show increased use of methamphetamines. In recent years however, use of methamphetamine has increased in rural and urban areas of the South and Midwest.
 

Cocaine use varies so there is no geographic pattern that clearly delineates where the drugs are used. Cocaine use however, is usually significantly higher in large cities and metropolitan areas as opposed to non-metropolitan areas.
 

A possible reason for the difference between cocaine and methamphetamine addiction by area is that in rural areas, cocaine is not as easily accessible. Methamphetamine however, can be made in a garage or basement with household products, making it quite easy for individuals to make their own high.
 

Do They Produce The Same Effects?
 

* Perhaps the reason why cocaine and methamphetamines are confused is because both produce a very well received rush almost immediately. This is followed by feelings of extreme happiness or euphoria which is referred to as a rush.
 

* Methamphetamine’s high can last from eight to twenty four hours and fifty percent of the drug is removed from the body in twelve hours. Cocaine’s high on the other hand, lasts from twenty to thirty minutes and fifty percent of the drug is removed from the body in one hour.
 

* Both cocaine and methamphetamine, when injected intravenously or smoked, can cause an almost immediate rush which is followed by a high.
 

* When ingested nasally, which is referred to as snorting, neither methamphetamine nor cocaine cause a rush or a high. A similar effect is produced when methamphetamine is ingested orally.

Are the Physiological Effects Similar?
 

* Both methamphetamine and cocaine can cause immediate effects of irritability, anxiety, increased heart rate, blood pressure, body temperature and possible death. Methamphetamine’s and cocaine’s short-term effects also can include increased activity, respiration, and wakefulness, and decreased appetite.
 

* Chronic use of cocaine or methamphetamine can cause dependence and possibly stroke.
 

* In either case, cocaine or methamphetamine can lead to psychotic behavior. These behaviors are characterized by hallucinations, paranoia, violence, and mood disturbance.
 

* Some data suggests that violence is more common among methamphetamine users than among cocaine users. Drug craving, paranoia, and depression can occur in addicted individuals who try to stop using either methamphetamine or cocaine.
Is there a difference in neurotoxicity?
 

* Neurotoxicity refers to the toxic damage these drugs can incur on the brain, specifically on neuron transmission. Neurons are responsible for the processing and transferring of information. Methamphetamine can be neurotoxic in animal species ranging from mice to monkeys. Methamphetamine specifically damages neurons that produce serotonin and dopamine. Since the usual doses taken by humans are comparable to the doses causing neurotoxicity in animals, it is reasonable to believe that this also causes the same effect in humans.
 

* On the other hand, cocaine does not cause neurotoxic damage to dopamine and serotonin neurons.
 

Transmission of HIV/AIDS
 

Whether discussing methamphetamine or cocaine, a risk for HIV/AIDS still exists and must be considered when engaging in any type of sexual behavior.

Acupuncture is an Eastern medicine technique that has been utilized for centuries. It has been used for various physiological issues in Asian culture but only more recently has entered the United States. Since it’s induction into popular culture, use of acupuncture has been broadening to treatment for many different health problems. Some of which include: back and neck pain, sports injuries, knee injuries, fibromyalgia, headaches, digestive and gynecological problems, among other things. One of the uses that surprises most people, is acupuncture as a method to treat symptoms of substance abuse withdrawal.

A Treatment Found by Mistake

It was 1970 and a neurosurgeon by the name of H.L. Wen, the only one in all of South China, was getting ready to use electro-acupuncture as a method of surgical analgesia. The patient who happened to be withdrawing from opium, reported a relief in symptoms of withdrawal. Wen immediately canceled the surgery and went looking for patients who were also experiencing symptoms of withdrawal. Wen utilized the same acupuncture treatment and found that these patients also experienced a reduction in symptoms. It was at this moment that acupuncture as treatment for substance abuse withdrawal came into fruition.

How Can Acupuncture Reduce Withdrawal Symptoms?

• Physical withdrawal symptoms are reduced.
• Relieves: depression, anxiety, and insomnia brought on by withdrawal.
• Specific withdrawal symptoms include:
o cravings
o body aches
o headache
o nausea
o sweating
o muscle cramping

What exactly is Qi?

Qi, pronounced chee, is achieved by inserting needles into routes underneath the skin which are called ‘meridias’. The only translation for the word Qi, which is not exact, is ‘vital energy’. If Qi is working properly it protects the body and makes the transition from one body state to another smooth. Chinese medicine works under the assumption that sickness occurs when energy cannot flow through the meridas freely. The needles utilized in acupuncture work by unblocking the meridias and allowing Qi to flow freely.

How Does Acupuncture Treatment Work?

There are points in the ears that pertain to specific organs in relation to detoxification treatment. To be more specific, this includes: the liver, kidneys, lungs, and the nervous system. Needles are placed in each ear, which relate to each organ mentioned prior. The entire treatment takes approximately forty five minutes. This is a good time for the patient to relax, meditate and take this time to think about changes that need to occur in one’s life. One of the reasons that acupuncture helps to relieve symptoms, is because endorphins, a natural body chemical, are released. Endorphins can be called the ‘happy hormones’. Endorphins tend to reduce cravings, ease symptoms of withdrawal and also tend to increase feelings of relaxation.

How Do They Know Where to Stick Those Needles?

The Chinese have been utilizing the proper acupuncture points for years; however, it wasn’t until 1955 that Paul Nogier, a French doctor completed research on these positions. Dr. Nogier, when testing for electrical activity on the surface of the skin, found that all the traditional acupuncture points on the body had a parallel point on the human ear. From that point on, needle stimulation of the ear, otherwise known as auricular acupuncture has been used. This type of stimulation has particular benefit in substance abuse treatment as it allows for several treatments to take place simultaneously thus eliminating the need for privacy.

What Does the Treatment Feel Like?

When needles are placed in the individual’s ears, they may begin to feel warm or start to tingle. Some people do not feel anything and others may even fall asleep. Regardless of which response the person has, they are all natural and normal. Acupuncture is a treatment which will not reap immediate results. It is only after treatments taking place over time, that a true benefit will be felt. The important thing to remember is that it takes time for the treatments to show results.

What is the Detoxification Process?

The purpose of detoxification is to remove toxins from the blood stream that have been building up due to substance use. Your body is able to filter out the toxins that have been stored up. This improves the circulation of blood throughout the body. It is possible to feel out of sorts during this period. One may have aches and pains and may not be sleeping well. Some people have even reported dreaming about substance use. If any of these symptoms occur, it is advisable to let the acupuncturist know in order to alter the pressure points utilized or add additional points in.

Is Acupuncture Treatment a Sufficient Form of Substance Abuse Treatment?

No. Acupuncture is a wonderful complementary treatment to add on to traditional for substance abuse management. In order for substance abuse to be effectively dealt with, a whole team of professionals need to be incorporated. If an individual is interested in natural treatments such as acupuncture, it is advisable to locate a program that specializes in Holistic addiction treatments.

Introduction
 

Cocaine is a intensely powerful addictive stimulant that acts directly on the brain. Cocaine was first extracted from the leaf of the Erythroxylon coca bush, which is endemic in South America, West Indies and Indonesia. Cocaine is one of the most commonly abused drugs and the majority of the individuals who use cocaine are also users of other drugs. The drug can generate a feeling of euphoria, hyperactivity and mental alertness. It can be rapidly highly addictive leading to relentless mental and physical problems.

The neuro-stimulating properties of the coca leaves are thought to have played some role in the development of the Inca People. Soon, the Spanish invaders quickly discovered the euphoric effects of the coca plant and introduced the plant to the Europeans, who also developed a great liking for the plant and its stimulating effects.
 

History
 

The plant was used for medicinal purposes as early as the 15th Century in Europe. In the 18th Century, concentrated forms of cocaine became available and it was soon discovered that the plant extract had some medical benefits. The drug was then widely used as a topical local anesthetic and because of its mental stimulating properties, was also used to treat depression. The use of cocaine in tonics and elixirs became widespread and it was also added to coca cola.
 

However, soon it was soon observed that drug was addictive and had profound effect on the psyche of the individual. Because of cocaine’s potent side effects, in the early part of the 20th Century, the Pure Food and Drug Act was introduced, which required that all cocaine be labeled in all medical products. However, this did not limit the use of cocaine and addiction to cocaine reached endemic proportions. In 1914, the Harrison Narcotics Act was introduced and banned the nonprescription use of cocaine products and labeled cocaine as a narcotic.
 

The Harrison Narcotics Act did nothing to diminish the use of cocaine and over the next 50 years, cocaine became the number one illicit drug used in North America. In the 70s and 80s, a new cheaper formulation of cocaine became available on the market and it has today become the favorite drug among teenagers and socially deprived individuals. By the mid-1980s, the emergency rooms were again becoming full with individuals with cocaine-related problems. Physicians again re-affirmed the abuse potential of cocaine.
 

Today, cocaine is classified as a Schedule II drug — it has towering potential for abuse and can only be administered by a doctor for legitimate medical uses. Today, the medical use of cocaine is limited to topical anesthesia of the upper respiratory tract and eye because the vasoconstrictive properties of cocaine are desirable during these procedures. However, it is not available in majority of the hospitals in North America, because safer and better agents are available.
 

Addiction Potential
 

Cocaine is an addictive psycho-stimulant with euphoric effects. The addictive properties of cocaine are thought to be due to brain dopamine D2-receptor stimulation. Dopamine is released as part of the brain’s reward system and is implicated in the high that is typical of cocaine consumption. Patient dependence depends on a number of different factors, including genetics, social and environmental factors, preexisting medical and mental conditions.

There are two fundamental forms of cocaine: powdered and "freebase." The powdered form easily dissolves in water whereas freebase is a mixture that has not been neutralized by an acid. The freebase form is usually smoked or snorted.
Warning signs of cocaine use include a change in behavior, acting isolated, careless about personal appearance, loss of interest in school, family, friends and frequently needing money. Physical exam may reveal red eyes, runny nose, frequent sniffing, change in eating and sleeping patterns and a change in friends

Cocaine induces an artificial “high” that gives its user a feeling of limitless ability and energy. When users come down, they are usually depressed, nervous, and crave for more. Todate, it has been impossible to predict who will become addicted and when the fatality will occur.
 

Frequency of Use
 

In the US, as of 2005, according to the Office of National Drug Control Policy, more than 3 million people in the United States are considered long-term cocaine users. Cocaine abuse is also widespread universally and has become a major public health issue in North America. Data suggest that the prevalence of cocaine use in the world is approximately 13 million people, or 0.23% of the global population. Cocaine use is also increasing in a number of Latin American countries, including the countries that are the main producers of cocaine.
 

All races and both genders are known to use cocaine. Individuals between the ages of 18-30 are the most frequent users. Men not only are more heavy users but also account for more overdose and toxicity from cocaine.
 

Routes of Intake
 

Cocaine may be inhaled (snorting), injected or smoked. Irrespective of the method of intake, cocaine is still a potentially deadly agent. Most individuals report that the psychotic features and habituation are more rapid and pronounced after smoking cocaine, compared to other methods. The “high” generated with smoking is instant but of a shorter duration, but the addiction potential is the same by all routes. Like all illicit drugs, injection of drugs carries with it the potential for transmission of HIV/AIDs. This becomes of more concern when the needles and other injection paraphernalia are shared.
 

A common route of transportation of cocaine is by swallowing cocaine packed in condoms. Body stuffers usually hide packages of cocaine in the rectum, vagina or mouth. These individuals usually get away until the packages rupture and cocaine intoxication becomes obvious.
 

Street cocaine is often accidentally/intentionally contaminated during the preparation process in order to dilute the cocaine used and increase profits. Commonly used cocaine adulterants may include local anesthetics, phenytoin, sugars, amphetamines, phencyclidine, phenylpropanolamine, quinine, talc, and others.
 

Mortality/Morbidity
 

Data from the Drug Abuse Warning Network (DAWN) indicate that there are about 4-5000 cocaine related deaths annually in the US. Cocaine-related deaths are rare and not always due to high dose intoxication. The lethal dose of cocaine remains unknown. Fatalities are multifactorial, and, often the cause remains unknown. Occasionally, massive exposure of cocaine occurs in body packers and results in rapid death.
 

However, the majority of cocaine users are prone to serious long term medical complications. These complications may include seizures, abnormal heart rhythms, heart attacks, stroke, blindness, liver and kidney failure, lung fibrosis and heart failure.
 

Symptoms
 

Cocaine has numerous physiological and psychological side effects. The adverse effects of cocaine’s appear almost immediately after a single dose, and fade away within a few minutes or hours. Cocaine can cause intense vasospasm of blood vessels, dilate pupils, increase the heart rate and blood pressure and can also generate a febrile response.
 

The psychological effects include euphoria, decreased fatigue, extreme hyperactivity and mental lucidity. The sense of sight, sound and touch are over amplified. During the cocaine euphoria, the need for food, sleep and personal hygiene are significantly absent. The majority of individuals report that cocaine aids them completing simple chores swiftly, whereas others experience mental confusion and are unable to carry out any tasks

The quicker the cocaine is absorbed, the more intense is the “high”, however, the duration of action is short lived. The euphoria from snorting may last 15-30 minutes, while that from smoking may last 5-10 minutes. Increased utilization can diminish the period of stimulation due to development of tolerance. High doses of cocaine and/or extended use can generate an aggressive paranoid behavior, tremors, vertigo, muscle twitches, extreme restlessness and auditory hallucinations.
 

When addicted individuals discontinue using cocaine, they frequently become depressed. This may lead to additional cocaine use to lessen the depression. Extensive cocaine snorting is known to cause ulceration of the nasal mucous membrane and even perforate the nasal septum. Cocaine-related deaths are often a consequence of cardiac arrest or seizures followed by respiratory arrest.
 

When both cocaine and alcohol are consumed, the adverse risks are increased by several folds. Combination of cocaine and alcohol in the liver is known to generate a substance called cocaethylene, which is known to potentiate cocaine’s euphoric effects and also increasing the danger of sudden death.
 

Treatment of Acute Intoxication
 

Patients with cocaine poisoning may exhibit severe CNS and cardiovascular dysfunction, leading to a loss of airway protective reflexes, cardiovascular collapse, and mortality. The goals of pharmacotherapy are to neutralize toxicity, reduce morbidity, and prevent complications.
 

The immediate control of mental agitation is critical in preventing the mortality associated with cocaine overdose. Benzodiazepines are the mainstay of therapy and may be used generously until sedation is accomplished. Avoid physical restraints in patients with psychomotor agitation because they may interfere with heat dissipation. Seizures should be aggressively treated because they may worsen hyperthermia, rhabdomyolysis, hypoxia, and acidosis. In some cases, ventilatory support and neuromuscular blockade may be required

Body packers and body stuffers may require critical care monitoring. The body packers pack their gastrointestinal tract with bags of cocaine. However, occasionally the cocaine-containing package ruptures or the packages may cause gastrointestinal obstruction.
 

All symptomatic body packers and body stuffers require intensive therapy. Charcoal may have to be introduced in the stomach to bind the cocaine and prevent absorption and surgery may be required to remove the packages.
 

Asymptomatic patients may be treated with laxatives and bowel irrigation to remove the cocaine bags. Surgical removal may also be indicated in patients with bowel obstruction.
 

Some individuals may suffer a Cocaine washout syndrome (cocaine crash syndrome) which is characterized by sudden and severe exhaustion with mental slowness, depression, suicidal ideation, anxiety and increased appetite, lasting as long as 18 hours after the last consumption. Cocaine washout syndrome is usually self-limited, and only requires supportive therapy.

Once the acute phase is stabilized, patients may require further therapy to treat the complications of cocaine. It is highly recommended that these individuals enter into a rehabilitation therapy program.
 

Treatment approaches to Addiction
 

Treatment of cocaine addicts is a multi million dollar business. Treatment programs are available throughout North America. The treatment is complex and involves changing the mind as well as altering the psychological, social, familial and environmental factors
 

Pharmacological Approaches
 

There are no approved medications currently available to specifically treat cocaine addiction. Few emerging compounds currently being investigated to assess their safety and efficacy in treating cocaine addiction include disulfiram, terguride, topiramate and modafanil. Additionally, baclofen, a GABA-B agonist, has shown promise in a few individuals who use excessive cocaine. The use of anti depressant drugs has been recommended during the early phase of cocaine abstinence, because of the moderate depression that occurs.
 

Behavioral Interventions
 

Many types of behavior therapies have been used to treat cocaine addiction, and involve both residential and outpatient approaches. Behavioral therapies are frequently the only available effective treatment for cocaine addiction. However, amalgamation of both medical and behavior treatments are more effective in the treatment of cocaine addiction.
 

Behavior therapy which has been shown to be beneficial includes vocational rehabilitation, career counseling, contingency administration and cognitive-behavioral treatment. Therapeutic communities (TCs), or residential programs with intended lengths of stay of 6 to 12 months, present another option to those in need of treatment for cocaine addiction. TCs concentrate on remobilization of the individual to society, and can incorporate on-site vocational rehabilitation and other helpful services.

Enrollment in deterrence programs, such as Narcotics Anonymous, may be of benefit for some patients.

The body’s reaction to the removal of a substance it has become dependent on is called withdrawal. Withdrawal causes craving for more of the substance being removed. The period of time when the body is trying to overcome its addiction is called detoxifica-tion (detox). Detox is the first step in overcoming a substance addiction such as drugs or alcohol. Detox is a pertinent step for the patient is to be successfully rehabilitated.
 

Opiate drugs such as heroin and methadone, and prescription medications including Hydrocodone, Oxycontin, Xanax, Vicodin and Lortab, require medical detox supervision. There are however, other illegal drugs such as marijuana, crystal methamphetamine, and cocaine that do not require medical detox. Since there is psychological dependence associated with these drugs, it would be wise to complete a period of stabilization. The process of drug detox requires the patient to be closely monitored by keeping vital signs, giving support and administering medications if needed. There are numerous withdrawal symptoms or side effects when a patient stops or dramatically reduces drugs after heavy or prolonged use. Those side effects include: sweating, shaking, headaches, drug cravings, nausea, vomiting, abdominal cramps, diarrhea, sleeplessness, confusion, agitation, depression, anxiety, and other behavioral changes.
There are two commonly used drugs to enable the patient to feel relief from these symptoms. First, Klonepin, which reduces physical symptoms, and Buprenophex, which is an anticonvulsant. These drugs must also be monitored as cessation produces withdrawal symptoms. Generally, the time period for drug detox is three to seven days under medically monitored supervision.
 

Alcohol detox, like drug detox, is usually accomplished in an inpatient medical facility. Duncan Raistrick identifies the key to a successful, planned detoxification is preparation. Raistrick goes further to detail that the first job of therapy is to bring the patient to a point of readiness to change their drinking behavior. Second, patients need to be given accurate information about what to expect during detoxification.
 

There are two withdrawal categories: minor, meaning early withdrawal and major, meaning late. The severity of withdrawal depends greatly on the duration of alcohol used. Alcohol Withdrawal Syndrome (AWS) falls into three main categories: central nervous system (CNS) excitation, excessive function of the autonomic nervous system (ANS), and cognitive dysfunction.5 Richard Saitz, M.D., M.P.H., states, since alcohol enhances gamma-aminobutyric acid’s (GABA) inhibitory effects on signal-receiving neurons, neuronal activity is lowered. This lowering leads to an increase in excitatory glutamate receptors. Tolerance occurs as GABA receptors become less responsive to neurotransmitters, which in turn requires more alcohol to produce the same inhibitory effect. During detox, the GABA is ineffective and unable to suppress the excitatory glutamate receptors. Detox is intended to relieve physical symptoms such as: shaking or tremors, headaches, vomiting, sweating, restlessness, loss of appetite, sleeplessness, Delirium Tremens (DT’s), hyperactivity, and convulsions. Alcohol detox medications are similar to drug detox medications: Buprenophex, certain benzodiazepines and anticonvulsant medications. Alcohol detox completion can take from three to fourteen days.
 

Norman S. Miller notes that medical management of alcohol and drug withdrawal during detoxification often is not sufficient to produce sustained abstinence from recurrent use. Therefore, further addiction treatments are needed to prevent relapse to alcohol and drug use following treatment of withdrawal.
 

In conclusion, drug and alcohol detoxification can effectively prepare the addicted abuser for rehabilitation and treatment.
 

Some physicians believe the withdrawal phase is related closely to the drug addiction - the worse the withdrawal, the more likely the continued use of the chemical to prevent withdrawal. Several factors are key to successful detoxification.
 

1. Acknowledge that there is a problem and decide to do something about it.
2. Get rid of all the drugs and paraphernalia.
3. Drop friends and associates that are tied to our drug problem.
4. Seek and accept spousal support, or support from friends, or relatives.
5. Prepare for symptoms with the support of a professional.
6. If tranquilizer drugs are needed for a few days or longer, they must be handled sensitively, as one addiction can easily replace another.

Xanax is a Central Nervous System (CNA) depressant known as benzodiazepine, which is commonly prescribed by physicians to treat panic attacks, nervousness, and tension. Xanax, also known as alprazolam, is considered to be a Schedule IV controlled substance under the Controlled Substance Act (CSA). Xanax has been used as a tranquilizer since the 1960s. With strong opposition to the use of benzodiazepines in the 1970s, there was a 25 percent drop in the number of prescriptions written and today, with approximately 3 million Americans (1.6% of the adult population) having used benzodiazepine on a daily basis for at least 12 months, they are the most controversial of all psychotropic medicines.

According to the United States Department of Justice Drug Enforcement Agency (DEA) and under the CSA, all controlled substances are rated on a five-schedule system. Schedule V, the lowest, for the potential for abuse and dependency and I, the highest. Xanax is a Schedule IV. All Schedule IV controlled substances have the following attributes: a low potential for abuse, a currently accepted medical use in treatment in the United States, and if abused, may lead to limited physical dependence or psychological dependence. Other examples of drugs included in schedule IV are Darvon®, Talwin®, Equanil®, Valium®, and Xanax®.

Although there are many benefits to taking Xanax and other Schedule IV drugs, many patients are becoming addicted and therefore require an intervention and drug treatment program to overcome their addictions. The patient’s body can also build up a tolerance to the drug and require larger doses if taken for long periods of time. With these increases in Xanax use come physical and psychological dependencies. Xanax is not drug to quit cold turkey. The Journal of Postgraduate Medicine stated that up to 25 percent of patients who stop taking their medication experienced withdrawal symptoms such as: nausea, vomiting, dizziness, headache, anxiety, irritability, insomnia, chills, lethargy, fatigue, moodiness, crying, dystonia, paresthesia, tremor, vivid dreams, and myalgias.

The National Institute on Drug Abuse found during a two-year treatment outcome study that 15 percent of heroin users also used benzodiazepines daily for more than one year, and 73 percent used benzodiazepines more often than weekly. Studies also indicate that from 5 percent to as many as 90 percent of methadone users are also regular users of benzodiazepines.

With this information in mind, the Xanax abuse treatment involves careful monitoring and counseling in an in-patient or outpatient treatment facility. The American Psychiatric Association’s (APA) report on benzodiazepines revealed that 11 to 15 percent of the adult population has taken a benzodiazepine one or more times during the preceding year, but only 1 to 2 percent have taken benzodiazepines daily for 12 months or longer. However, in psychiatric treatment settings and in substance-abuse populations, the prevalence of benzodiazepine use, abuse and dependence is substantially higher than that in the general population. Treatment encompasses a patient’s thought process, behavior, and helps them to cope with everyday life. Patients suffering from Xanax addiction should be tapered off gradually. There are basic outpatient plans available for discontinuation of the drug including: gradual discontinuance over a six to 12 week schedule, monitoring and helping the patient to feel in control of their dosage, and supplying a helpline when the patient needs reassurance. Other plans include inpatient treatment centers and 12-step programs such as Narcotics Anonymous, and drug treatment exchanges such as, Clonidine, propranolol, or carbamazepine. Although these substitutes can be dangerous, an inpatient setting where dosages can be physician monitored until the patient can reach a zero dose of the benzodiazepine is recommended.

In conclusion, Xanax and other benzodiazepines can be addictive drugs that are hard to discontinue however, they are also drugs of great benefit to patients who suffer from anxiety, depression, fear of open spaces (agoraphobia), premenstrual syndrome, and panic attacks. The patient and the physician should work together to regulate long-term usage, monitoring side effects, and any signs of abuse.

Sun Sentinel — South Florida is tops in all the wrong things again, this time in prescription drug overdose deaths, with Palm Beach County leading the state in fatal methadone overdoses last year, and Broward ranking second in deaths involving the anti-anxiety drug Xanax and third in oxycodone fatalities.

No one knows why South Florida owns this tragic distinction, but one thing is clear: It proves why crackdowns on doctor shopping and unscrupulously run "pill mills" are so essential. And why they deserve an even higher ranking on the law enforcement priority list.

Drug addiction is not a victimless problem. Even if it’s not your loved one who’s hopelessly hooked, your safety may be affected because addicts often turn to crimes like burglary or robbery to feed their habit.

So combating addiction, and reducing the incidence of overdoses, is a societal, not just a personal, responsibility.