WorldWideAddiction.com — Substance Addiction has been recognized "officially" as a disease for many years now, but there is still a great deal of ignorance on the subject -even amongst the medical profession.

Addicts/alcoholics (people tend to separate the two, but from here on in I will use the term "addict" to cover the broad range of substance abusers) are seen as weak people with no will-power.

Want to know what will-power is?

It is waking up in the morning, so nauseous that you race to the bathroom and don’t know which end to use first! After that initial wake-up purge, you then make your way shivering and shaking into the kitchen and drink an open, flat, warm beer that has a cigarette butt floating in it. Or because you are shaking so much, you drink that warm white wine that has been sitting out all night, through a straw since you can’t hold a glass! You do this, choking back the bile that is rising in your throat, because you know that the only way to begin functioning again on some sort of level is to try and build up the alcohol in your system before you take a seizure.

Do you think drinking methylated spirits at 5am in the morning is an easy thing to do?

I have known many addicts whose veins in their arms and legs are so damaged, that they inject themselves in their eyeballs. Because going without their "hit" is a far worse option.

Addicts have plenty of will-power…….

…it’s just focused in the wrong direction. Recovery teaches them us to refocus energy.

Back to the disease concept. Addiction is classified as a disease because it meets the criteria of all other terminal diseases:

- It has pattern of symptoms which are similar across all types of substance abuse

- It is a chronic condition. It doesn’t go away.

- It is progressive. Addiction only gets worse with continued use, and ends with death.

- The person is subject to relapse. In Australia, 66% of addicts who are lucky to live long enough to make it to detox will eventually die as a direct result of the disease.

- It is treatable. Here’s the good news, while substance addiction is a terminal illness, its progression can be arrested at almost any stage. But if you are seeking treatment, it is of the utmost importance that you gain medical advice. Sudden withdrawal, even from "socially acceptable" drugs such as alcohol, can cause death through seizures and coma.

It is crucial that you consult with a medical practitioner that understands addiction and withdrawal. Some well meaning, but uneducated doctors will prescribe large amounts of unsuitable medications that can lead to cross-addiction. This happened to me at one stage, and made a difficult situation worse. If you are addicted to one drug, the likelihood of becoming addicted to others is extremely high.

Wherever possible, detoxification is best carried out in a detox unit, where there is 24 hour patient care. There are a number of these units around the world, and in some cases (especially in Australia) there is no charge for this care.

When world governments begin to understand that the cost in providing this care free of charge is far outweighed by the benefits to society, we will begin to see an incredible drop in poverty, violence and divorce. The cost in providing this care will also be offset by the decrease in need of other hospitalization. 1 in 3 hospital beds in Australia are taken up by people with conditions that can be directly linked to drug abuse. At best, the world health systems overall are only currently providing band-aid solutions to one of the greatest scourges of mankind.

Are you thinking of getting help for yourself or a loved one?… do it now … for tomorrow may be too late. 

If you had terminal cancer, would you do anything about it? 

Substance addiction is a far worse disease in my opinion -it not only destroys the person, but everyone around them.

To those who helped me all those years ago -doctors, nurses, friends and strangers – even though I may not have been appreciative at the time….. my sincerest thank you. My life means something now.

Addiction is a disease, not just a state of mind.

Its very simple, substance abuse effects body functioning. Drug use can lead to long term physiological effects that can not only be acutely harmful, but can also result in chronic problems. The use of drugs is not the only issue. It is all the harmful behaviors that come along with substance abuse that tend to make matters worse.
 

Substance abuse harms the body in two distinct ways: via the effect of the substance itself and via negative lifestyle changes, such as irregular eating habits and poor dietary intake. For example, infants who were exposed to alcohol while in the womb often have physical defects and mental disabilities. In this case, the growing fetus has deficits both directly caused by the substance crossing the placenta and indirectly due to inadequate nutrition of the mother while she was drinking.
 

Recovery from substance abuse involves many different components, including proper organ functioning, assuring mental well being and proper metabolism. A huge factor in the healing process is proper nutrient supply. Nutrients are essential for not only for energy, but also to keep the immune system strong which helps to fight off infection and keep one strong.
 

Though it is clear that substance use in general is not healthy, like anything else, different substances have different effects on the body. In this article we will discuss a few of the more popular drug categories and how they each can affect body functioning.

Opiates

Which Drugs Are Opiates?
 

This category includes: codeine, morphine, and heroin. All of these affect the gastrointestinal system. One of the main symptoms associated with opiate use is constipation. When one withdraws from opiates classic symptoms of withdrawal include: diarrhea, vomiting, and nausea. The danger here lies primarily in a depletion of valuable nutrients and electrolytes. This includes imbalance in the amount of potassium, sodium, chloride, and calcium. Electrolytes are important for a variety of things, including proper cardiac, or heart, functioning.
 

To combat the severity of these symptoms, one should eat meals that are balanced (i.e. proper amounts of vegetables, grains, fats, and proteins). A high fiber diet with things such as whole grains, beans, peas and vegetables is advisable due to constipation associated with opiate use.
 

Alcohol
 

Out of all the drugs utilized in the US, alcohol is the major cause of nutritional deficiencies. The most prominent deficiencies include the following:
 

* Pyridoxine or Vitamin B-6
* Thiamine
* Folic Acid
 

An individual lacking in these nutrients may develop anemia which is a low blood count, for women a deficiency in folic acid can cause poor pregnancies, and B vitamin deficiency can also cause neurological problems. Lack of thiamine (B1) in particular, can lead to Korsakoff’s syndrome. It is important to understand that it is not necessarily the alcohol that cause the disorder, but the effect of alcohol of the absorption of nutrients that is damaging.
 

Alcohol damages the liver and pancreas in particular. These two organs are necessary for detoxification and processing (liver) and the pancreas effects blood sugar and absorption of fat. If these two organs are not working properly, one can have an imbalance of fluids, calories and electrolytes.
 

Permanent damage can take place in the form of cirrhosis which is liver damage, diabetes, seizures and malnutrition. Liver damage can also result in decreased clotting factors, which means an individual has the chance of bleeding unnecessarily. Women also have an increased risk for osteoporosis and may require calcium supplementation.
 

Stimulants

What is a stimulant?
 

This includes cocaine, methamphetamine and cocaine. Use of these drugs can lead to a decrease in appetite and weight loss which will eventually lead to malnutrition. As the name implies, stimulants stimulate the body thereby causing many users to stay awake for unhealthy periods of time. This can range from one night of missed sleep, to being awake for days at a time. This may result in dehydration and subsequent electrolyte imbalance. One should return to a normal, balance diet which may be difficult given the abuse the body has suffered especially if there has been severe weight loss.
 

The Marijuana Munchies
 

Marijuana can increase appetite, which, in chronic users can lead to being overweight. For these individuals it is probably best to cut back on sugar, fat and overall caloric intake.
 

Nutrition and psychological aspects of substance abuse
When people feel better, they are less likely to relapse. Since balanced nutrition helps improve mood and health, it is important to encourage an improved diet in people recovering from alcohol and other drug problems. Individuals recovering from substance abuse have just given up a huge part of their life and for this reason, it is better for these individuals to focus on not using again as opposed to putting all their energy into a drastic diet change.

How to Incorporate a Healthy Diet into Recovery
 

Perhaps the most important thing for prior substance abusers to remember is routine. For instance, regular meals throughout the day are recommended. An increase in proteins, complex carbohydrates and dietary fiber are highly recommended. Due to the irregularity of diet that tends to accompany substance abuse, most individuals will needs to supplement diet with vitamins and minerals. As every individual is different, it is recommended that recovering addicts meet with a dietician. A trained professional can then develop a plan that is specific to the person’s needs. The vitamins that are most often lacking include zinc, vitamins A and C and most of the B vitamins.
 

Keeping Your Sugar Steady Can Decrease Cravings
 

As many drug addicts do not eat regularly, they may forget what it feels like to really be hungry. Not eating steadily can cause a fluctuation in blood sugar levels which can lead to feelings of unsteadiness throughout the day. For a recovering addict, these feelings may be interpreted as drug cravings which could lead to one using. This is yet another reason to keep a steady and healthy intake of food.
 

The Importance of Water
 

Dehydration is common for substance users and it is very important to emphasize the need for fluids during and in between meals. As appetite can return during recovery, it is important to emphasize fluid intake as well as proper food consumption. For all the reasons discussed prior, it would be detrimental to recovery for an individual to begin eating the high calorie foods with little to no nutritional value due to all the abuse the body has already endured. Drinking water will help the body to absorb nutrients which is something most of these individuals are lacking.

Substance abuse recovery is a difficult road to follow. Good nutrition is something that can help to make that road a little easier to walk down. Encouraging healthy eating and a healthy lifestyle, is something concerned loved one can do to help ensure the people in their lives stay clean.

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.

Addiction to drugs and alcohol encompasses more than a behavioral intervention. The reason for this is drug addiction is a complex disease, however, it is treatable. Like chronic illnesses such as hypertension and asthma, relapse can occur with drug addiction even after extended periods of continued abstinence. For this reason, repeated treatments may be necessary. Treatments should be tailored to the individual in order to be more effective and long lasting, therefore allowing people to live long and productive lives.
 

In a study conducted in 2004, 22.5 million American needed treatment for substance abuse. Out of this large number, only 3.8 million received help (NSDUH2004).Leaving substance abuse and addiction cases untreated, though in the short-term can save money, in the long-term can lead to many extraneous costs to society. Some of these things include: court and criminal costs, emergency room visits, prison costs, child abuse and neglect, foster care, welfare costs, healthcare utilization, reduced productivity and unemployment.
 

For every dollar spent on addiction treatment, there is a four to seven dollar reduction in the cost of crimes related to drugs. In 2002, it was estimated that $181 billion dollars was the cost to society for drug use. Over $500 billion was spent when including tobacco and alcohol costs. This includes lost productivity, healthcare and criminal justice costs. Substance abuse programs that are run successfully and efficiently can help society in more than one way. Not only can they assist the person in need, they can also help reduce the amount of sexually transmitted disease that are spread such as HIV/AIDS and Hepatitis. In addition, crime and costs to society can also be reduced. So, the question comes, how can one develop an effective treatment program?
 

Effective Treatment Guidelines
 

Research has been conducted since the 1970s shows that treatment can help people avoid relapse, change destructive behaviors, and take them out of a life of substance abuse and addiction. Treatment tends to be a long term process and can require several episodes of treatment. This research has helped lay down the structure on which effective treatment programs should be based.
 

• Treatment does not need to be voluntary to be effective.
• For certain types of disorders, medications are an important element of treatment, especially when combined with counseling and other behavioral therapies.
• No single treatment is appropriate for all individuals.
• Treatment needs to be readily available.
• Effective treatment attends to multiple needs of the individual, not just his or her drug addiction.
• Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
• Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
• An individual’s treatment and services plan must be assessed often and modified to meet the person’s changing needs.
• Medical management of withdrawal syndrome is only the first stage of addiction treatment and by itself does little to change long-term drug use.
• Possible drug use during treatment must be monitored continuously.
• Counseling and other behavioral therapies are critical components of virtually all effective treatments for addiction.
• Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, and should provide counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
• As is the case with other chronic, relapsing diseases, recovery from drug addiction can be a long-term process and typically requires multiple episodes of treatment, including "booster" sessions and other forms of continuing care.
 

An All Encompassing Treatment
 

When treating an individual for addiction treatment, it is important for the individual as a whole to be looked at. Usually, treatment begins with detoxification which is followed by treatment and relapse prevention. Initially, in order to ease the individual into treatment, medications may be needed in order to control symptoms of withdrawal. All encompassing care includes mental health services, medical care and of course aftercare. In order to make sure that someone in recovery continues to stay there is to make sure all bases have been covered. Follow up options such as community or family based recovery support systems can be essential to acquiring and maintaining a life that is free of drug use and abuse.
 

Medications

Medications can help in various different fashions. In some cases, coming off of a substance can be life threatening and medication is necessary. Often times, the symptoms of withdrawal can be so severe that medication is necessary. This is not considered treatment; it is however, the first step in the process of recovery. Going through withdrawal treatment is not sufficient. If one does not receive further treatment, it is like not receiving treatment at all.
 

Using chemical substances can help to establish brain functioning that may have gone awry. At present medications are available to help reestablish pathways for addiction related to heroin, morphine (opioid) and nicotine (tobacco). Other medications are currently being developed for treatment of cocaine and methamphetamines (stimulants) and marijuana (cannabis) addictions.
 

Methadone and buprenorphine act as antagonists on brain receptors which means that they block the pathways which opiates like heroin take. This helps to block the drugs effects, suppresses symptoms of withdrawal and can even reduce the incidence of cravings. Ideally, this helps patients to stop drug seeking behaviors and activities that may be criminally related. Thereby, patients should be more focused on treatment having reduced many outside stimuli.
 

Behavioral Treatments
 

This is a very important part of effective therapeutic treatment. Stopping substance abuse habits is only effective if behaviors change, therefore, attitudes have to be changed so that a healthy lifestyle is maintained. Life skills need to be altered, unhealthy patterns need to be changed. In addition, medication effectiveness is usually better, and this can help people stay in treatment longer which will hopefully improve the likelihood of the individual staying clean.
 

Outpatient behavioral treatment can include a wide variety of programs. Most include group or individual counseling. Some of the more popular forms of treatment include the following behavioral treatment programs:
 

• Motivational Incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs.
• Cognitive Behavioral Therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.
• Motivational Interviewing, which capitalizes on the readiness of individuals to change their behavior and enter treatment.
• Multidimensional Family Therapy, which addresses a range of influences on the drug abuse patterns of adolescents and is designed for them and their families.
 

Residential treatment can be very helpful, even more so for individuals with severe problems. Therapeutic communities are structured programs in which patients remain for half a year to twelve months. Those in treatment usually have long histories of drug addiction, have often been involved in criminal activity and may have reduced social functioning. Treatment communities have become so evolved that they may also be structured to accommodate women who are pregnant or have children. The purpose of treatment communities is to help the individual learn how to behave in society without drugs.
 

In conclusion, with the proper mix of effort on the part of the individual, the proper care by practitioners, medications and community, a formula for success on the part of the substance user can be acquired. With that formula put in motion, an addict can become a former one and go on to live a happy and fulfilling life.

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.

Since the 1960s, many addicts have reported that even a single dose of ibogaine, a hallucinogenic alkaloid extracted from the root of an African shrub, helps them kick their habit by reducing their cravings for drugs. And there is hard evidence to back these claims, as well. Ibogaine was first introduced as a potential treatment for opiate addiction by Howard Lotsof, who took the drug in 1962 looking for a psychedelic experience, and awoke 30 hours later with no cravings and no withdrawal symptoms, despite being a heavy heroin user at the time. Lotsof was able to develop and follow an ibogaine maintenance program, which he then followed for three years while remaining opiate free. In 1986, Lotsof opened a company by the name of NDA International to advocate for the use and research of ibogaine and its active constituents as anti-addictive compounds.

Since ibogaine aides in the cessation of addiction, it started to be used to deal with opiates and other substance addictions. Ibogaine has only been introduced to Western scientific medicine but has documented use by the Bwiti tribe in Central Africa for centuries. At lower doses ibogaine has the ability to increase energy and mental alertness and appears to decrease the desire for food and drink. Higher doses (20+ mg/kg) of ibogaine have a larger psychoactive property, and is used ritualistically in initiation rites for its potent hallucinogenic properties.
 

Barbara E. Judd, CSW did a study on ibogaine and stated that the most difficult aspects of treatment are getting the patient to enter treatment.  She notes that the three major obstacles are the fear of detoxification lack of insight, and the inability of patients to control their urges to use drugs. It was in these three areas where she felt the benefits of ibogaine treatment far outweighed those of traditional methods. Judd further states that psychological fear of pain and withdrawal prevents many addicts from even attempting detox. Addicts feared having to deal with the emotions that lead them to use in the first place. Judd adds that when patients learn the benefits of ibogaine they are more willing to try it.
 

Like all forms of detox, ibogaine is not without risks and side effects. At therapeutic doses, ibogaine has an active window of 24 to 48 hours, is often physically and mentally exhausting and produces ataxia for as long as twelve hours. Nausea that may lead to vomiting is not uncommon throughout the experience. These side effects reduce the attractiveness of ibogaine as a recreational drug at therapeutic doses, however, at lower doses ibogaine is known to have stimulant effects. It is still a controversial and experimental drug and there are some cases of fatal cardiac arrhythmias.
 

There are two types of ibogaine treatment. The first type of treatment is oriented toward addiction, most commonly heroin dependence, and typically involves dosages in the range of 15 to 25 mg/ kg .5-8 The second type of treatment, also know as “initiatory," involves a dosage on the order of 8 to 12 mg/kg, or about half of the dose used for addiction and is used for spiritual insight and facilitating psychotherapy.  In addition to reducing craving, ibogaine often promotes a sense of wellbeing that can last from weeks to months. As the studies into the nature of ibogaine progress, scientists have discovered that ibogaine’s anti-additive properties are actually two-fold. First, when the substance is consumed, the body produces a chemical called noribogaine. Noribogaine blocks the brain’s receptors that control cravings. Noribogaine also increases dopamine and serotonin levels, which elevate feelings of wellbeing.

So while ibogaine is not a substitute for drugs, and is not addictive, ibogaine is a chemical dependence disruption and a chance for patients to get a head start on recovery. Ibogaine enables the patient to focus on the underlying causes of addiction without going through the intense withdrawal symptoms that accompany most types of detoxification. And, even if there are some remaining symptoms after ibogaine detox they are more tolerable than other detox approaches. Studies show that ibogaine has the ability to drastically attenuate drug withdrawal in all patients and, in 90 percent of treated patients during one case study, to interrupt the patient’s craving to continue drug use for periods of time ranging from as short as two days to as long as two and a half years from a single treatment.

Currently opiate dependence treatments like methadone can be dispensed only in a few centers that focus in addiction treatment. There are not enough addiction treatment clinics to assist all patients seeking treatment. Suboxone is the first narcotic drug available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed by a physician. Hopefully, this advance in therapeutics will provide more patients the opportunity to access treatment.

Suboxone (buprenorphine with naloxone) is currently available for the maintenance treatment of opioid addiction. The intention of adding naloxone to the formulation is to deter intravenous misuse and reduce the symptoms of opiate dependence. Suboxone treatment is intended for use in adults and adolescents more than 16 years of age who have agreed to be treated for addiction.
 

Once detoxification of the individual is completed, Suboxone is used during the maintenance phase of treatment. Suboxone has recently become the drug of choice instead of methadone in the treatment of opiate addiction. Suboxone use is less rigidly controlled than methadone because it has a lower potential for abuse and is less dangerous in an overdose. As patients progress on therapy, the physician may write a prescription for a take-home supply of the medication.
 

Suboxone Prescription
 

Only those physicians who have approval from the Drug Enforcement Agency (DEA) are able to start in-office treatment and provide prescriptions for ongoing medication. The Center for Substance Abuse Treatment (CSAT) maintains an active database to help patients locate qualified doctors.
 

Route of Administration
 

Suboxone is available as a tablet which is always administered sublingually. The pill is placed underneath the tongue until it is fully dissolved. Swallowing or sucking on the pill does not offer any therapeutic benefit. When placed underneath the tongue, the pill dissolves and is absorbed in 10 -20 minutes.
 

Suboxone treatment is generally done under medical supervision. During the induction phase, one is taught how to properly take the medications and dose adjustments are done during the phase. One is usually started on the smallest dose until the best therapeutic effect is obtained. Once the ideal dose is obtained, the individual is seen once in a while and prescriptions can generally be available from the same physician.
 

Suboxone is available as 2 and 8 mg tablets. Most anecdotal reports indicate that the response to the 2 mg dose is suboptimal. The majority of individuals report benefit at higher doses of 8-16 mg. The aim of the maintenance treatment is to rid the drug craving and decrease the anxiety. The dose is usually adjusted until the drug craving features are diminished.
 

Since Buprenorphine is a Schedule III drug, the physician is only allowed to prescribe 5 refills in 6 months.
 

Maintenance therapy
 

Although Suboxone can be used for detoxification, its intended use is for maintenance. The ideal candidate for maintenance therapy with Suboxone is an older individual who has previously been on drugs but now has a job and wants a stable lifestyle. The individual previously has failed detoxification and wants to live a simple life without the daily cravings of his previous addiction. The majority of past drug users immediately adjust to Suboxone as the cravings disappear immediately and a smoother life style are accessible.
 

Suboxone Control
 

Because of the great potential for abuse, FDA works closely with the drug manufacturer, Reckitt-Benckiser, and other agencies to develop an in-depth risk-management plan. The FDA receives quarterly reports from the manufacturer and pharmacies and maintains a comprehensive surveillance program. This monitoring allows for early detection of abuse of the drug. The major components of the risk-management program are preventive measures and surveillance. Preventive measures instituted include drug education, tailored distribution, Schedule III control under the Controlled Substances Act (CSA), child resistant packaging and supervised dose induction. The program regularly monitors local pharmacies and web sites. Numerous other agencies also monitor the abuse of Suboxone and these include:
 

-Drug Abuse Warning Network (DAWN). This agency run by the Substance Abuse and Mental Health Services Administration (SAMHSA) gathers data from emergency rooms related to the illicit use of drugs or non-medical use of a legal drug.
 

-Community Epidemiology Working Group (CEWG). This agency monitors the use of buprenorphine.
 

-National Institute of Drug Abuse (NIDA). NIDA frequently sends newsletters to physicians about the addictive drugs and to report it if necessary.
 

Side Effects
 

The most common reported side effect of Suboxone includes:
 

- Cold or flu-like symptoms
- Headaches
- sweating
- insomnia
- Nausea
- Mood swings
- Pain
- restlessness

Like other opioids, Suboxone have been associated with respiratory depression (difficulty breathing) especially when combined with other depressants.
 

Cautions
 

Intravenous use of Suboxone usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone has the potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. There are no adequate and well-controlled studies of Suboxone use in pregnancy. Due caution should be exercised when driving cars or operating machinery.

PARIS (AFP) — The drug buprenorphine is twice as effective as a rival treatment called naltrexone in helping heroin patients stay off the narcotic, a trial published in The Lancet on Friday said.

The two drugs, along with a dummy pill called a placebo, were tested for 22 months among 126 patients in Malaysia who had emerged from a detoxification and counselling programme, it said.

Buprenorphine, which is marketed as Temgesic or Buprenex, was twice as effective as naltrexone (branded as Revia, Depade or Vivitrol) and the placebo in terms of days of abstinence from heroin and a full-fledged relapse to the narcotic.

Indeed, buprenorphine proved to be so superior that the trial was halted early, as it would have been unethical to continue it to its scheduled end.

The study, led by Yale University’s Richard Schottenfeld, gives support for placing buprenorphine alongside methadone, and both of them over naltrexone, as pharmacological treatments for helping addicts stay off heroin.

The three drugs belong to a class called opioid antagonists.

These treatments are increasingly used to help ease heroin dependence but remain prohibited in some countries, amid suspicions that they are liable to be abused or simply substitute one addiction for another.

The study is important because it gives the first assessment of the relative effectiveness of two of the opioid antagonists.

Heroin and other illicit opiates were once a problem mainly confined to developed countries, but in the past few decades have spread to developing economies and nations of the former Soviet bloc.

China, India, Indonesia, Iran, Malaysia, Pakistan and Russia are among the countries where expansion of heroin use has risen fastest, according to a 2004 World Health Organisation (WHO) paper.

"Cheese heroin" is a blend of so-called black tar Mexican heroin and crushed over-the-counter medications that contain the antihistamine diphenhydramine, found in products such as Tylenol PM, police say. The sedative effects of the heroin and the nighttime sleep aids make for a deadly brew.

"A double whammy — you’re getting two downers at once," says Dallas police detective Monty Moncibais. "If you take the body and you start slowing everything down, everything inside your body, eventually you’re going to slow down the heart until it stops and, when it stops, you’re dead." (Audio slide show: A father describes his teen son’s death)

Steve Robertson, a special agent with the Drug Enforcement Administration in Washington, says authorities are closely monitoring the use of "cheese" in Dallas.

Trying to keep the drug from spreading to other cities, the DEA is working with Dallas officials to raise public awareness about the problem. Authorities also are trying to identify the traffickers, Robertson says.

"We are concerned about any drug trend that is new because we want to stop it," he says.

Why should a parent outside Dallas care about what’s happening there?

Robertson says it’s simple: The ease of communication via the Internet and cell phones allows a drug trend to spread rapidly across the country.

"A parent in New York should be very concerned about a drug trend in Dallas, a drug trend in Kansas City, a drug trend anywhere throughout the United States," he says.
Middle schoolers acknowledge ‘cheese’

"Cheese" is not only dangerous. It’s cheap. About $2 for a single hit and as little as $10 per gram. The drug can be snorted with a straw or through a ballpoint pen, authorities say. It causes drowsiness and lethargy, as well as euphoria, excessive thirst and disorientation. That is, if the user survives.

Authorities aren’t exactly sure how the drug got its name "cheese." It’s most likely because the ground-up, tan substance looks like Parmesan cheese. The other theory is it’s shorthand for the Spanish word "chiva," which is street slang for heroin.

By using the name "cheese," drug dealers are marketing the low-grade heroin to a younger crowd — many of them middle schoolers — unaware of its potential dangers, authorities say.

"These are street dealers, dope dealers," Moncibais recently warned students at Sam Tasby Middle School. "They give you a lethal dose. What do they care?"

Moncibais then asked how many students knew a "cheese" user. Just about everyone in the auditorium raised a hand. At one point, when he mentioned that the United States has the highest rate of drug users in the world, the middle schoolers cheered. (Watch middle schoolers raise hands, admit they know drug users Video)

"You know, I know being No. 1 is important, but being the No. 1 dopeheads in the world, I don’t know whether [that] bears applause," Moncibais shot back.

Authorities say the number of arrests involving possession of "cheese" in the Dallas area this school year was 146, up from about 90 the year before. School is out for the summer, and authorities fear that the students, with more time on their hands, could turn to the drug.
‘Cheese’ as common a problem as pot

School officials and police have been holding assemblies, professional lectures, PTA meetings and classroom discussions to get the word out about the drug. A public service announcement made by Dallas students is airing on local TV, and a hotline number has been created for those seeking assistance.

Drug treatment centers in Dallas say teen "cheese" addicts are now as common as those seeking help for a marijuana addiction. "It is the first drug to have even come close in my experience here," says Michelle Hemm, director of Phoenix House in Dallas.

From September 2005 to September 2006, Phoenix House received 69 "cheese" referral calls from parents. Hemm says that in the last eight months alone, that number has nearly doubled to 136. The message from the parents is always, "My kid is using ‘cheese,’ " she says.

Phoenix House refers them to detoxification units first, but Hemm says at least 62 teens have received additional treatment at her facility since last September.

Fernando Cortez Sr. knows all too well how devastating cheese heroin can be. A reformed drug user who has spent time in prison, Cortez had spoken to his children about the pitfalls of drug use. He thought his 15-year-old son was on the right track.

But on March 31, his boy, Fernando "Nando" Cortez Jr., was found dead after using cheese heroin. "I should have had a better talk with him," he says. "All it takes is once. You get high once and you die, and that’s what happened to my son." He knows it’s too late for his son. Now, he is using his son’s story to help others. "All I can do is try to help people now. Help the kids, help the parents."

Opiates suppress pain, reduce anxiety, and at sufficiently high doses produce euphoria. Most can be taken by mouth, smoked, or snorted, although addicts often prefer intravenous injection, which gives the strongest, quickest pleasure. The use of intravenous needles can lead to infectious disease, and an overdose, especially taken intravenously, often causes respiratory arrest and death.

Addicts take more than they intend, repeatedly try to cut down or stop, spend much time obtaining the drug and recovering from its effects, give up other pursuits for the sake of the drug, and continue to use it despite serious physical or psychological harm. Some cannot hold jobs and turn to crime to pay for illegal drugs. Heroin has long been the favorite of street addicts because it is several times more potent than morphine and reaches the brain especially fast, producing a euphoric rush when injected intravenously. But prescription opiate analgesics, especially oxycodone and hydrocodone, have also become a problem.

In anyone who takes opiates regularly for a long time, nerve receptors are likely to adapt and begin to resist the drug, causing the need for higher doses. The other side of this tolerance is a physical withdrawal reaction that occurs when the drug leaves the body and receptors must readapt to its absence. This physical dependence is not equivalent to addiction. Many patients who take an opiate for pain are physically dependent but not addicted: The drug is not harming them, and they do not crave it or go out of their way to obtain it.

Detoxification

For some addicts, the beginning of treatment is detoxification — controlled and medically supervised withdrawal from the drug. (By itself, this is not a solution, because most addicts will eventually resume taking the drug unless they get further help.) The withdrawal symptoms — agitation; anxiety; tremors; muscle aches; hot and cold flashes; sometimes nausea, vomiting, and diarrhea — are not life-threatening, but are extremely uncomfortable. The intensity of the reaction depends on the dose and speed of withdrawal. Short-acting opiates, like heroin, tend to produce more intense but briefer symptoms.

No single approach to detoxification is guaranteed to be best for all addicts. Many heroin addicts are switched to the synthetic opiate methadone, a longer-acting drug that can be taken orally or injected. Then the dose is gradually reduced over a period of about a week. The anti-hypertensive (blood pressure lowering) drug clonidine is sometimes added to shorten the withdrawal time and relieve physical symptoms.

Methadone Maintenance

Since the 1970s, professionals who care for opiate addicts have reluctantly recognized that many of them will not or cannot stop taking the drug. The solution is maintenance — dispensing opiates under medical supervision. More than 100,000 American addicts are now using methadone as a maintenance treatment. Although it is still politically controversial, this practice has better scientific support than any other treatment for any kind of drug or alcohol addiction.

Because there is a risk of diversion to the illicit market, addicts must come to specialized clinics for methadone, which they take daily in liquid form. A single dose lasts 24–36 hours, and there are few side effects. Some methadone clinics also provide other medical and social services.

Addicts who switch from illicit opiates to methadone avoid the highs and lows and the medical risks of intravenous injection and the criminal behavior that supports it. Studies show that they are less depressed, more likely to hold a job and maintain a family life, less likely to commit crimes, and less likely to contract HIV or hepatitis. Methadone can be continued indefinitely, or the dose can be gradually reduced in preparation for withdrawal. It has been estimated that about 25% of patients eventually become abstinent, 25% continue to take the drug, and 50% go on and off methadone repeatedly.

Buprenorphine

A promising approach to maintenance is the partial opioid agonist buprenorphine. This drug is taken three times a week as a tablet held under the tongue. It occupies opiate nerve receptors and produces a mild opiate-like effect. At higher doses, it continues to produce the same weak effect while displacing more potent drugs. In a person who is physically dependent on opiates, buprenorphine causes a withdrawal reaction. There is some risk of abuse if the tablet is dissolved and injected, so buprenorphine has been made available in combination with the short-acting opiate antagonist naloxone, which has little effect when absorbed under the tongue but neutralizes the effect of injected opiates.

The main advantage of this combination, sold under the name Suboxone, is that patients do not have to come to clinics to take it, because there is no illicit market and no danger of diversion. Since 2002, individual physicians with proper training and certification have been allowed to prescribe buprenorphine in their offices for patients to take home.