18:35 Drug treatment of heroin addiction | |
| Drug treatment for heroin zavisimostiChislo people dependent on heroin is increasing worldwide. This causes more deaths and various diseases. Treatment of heroin addiction, usually begins with the detoxification and then assigned to maintenance treatment. Some patients experience withdrawal symptoms.
While non-drug therapy has certain advantages, however, drug therapy
has a much greater appeal and the evidence base in order to expand the
use of pharmacotherapy for drug dependence. Some countries are still widely used substitution maintenance therapy with methadone.
Other drugs are used, for example, in Australia it is buprenorphine and
naltrexone, but use of these drugs is required clinical trials. Heroin is the most commonly injected drugs from drug trafficking in Australia. Injection of heroin has been applied in Australia in the late 1960s.
Using several different methods, the researchers estimated that in
Australia by 1997, there were about 70,000 heroin-dependent people.
In the past few years, the number of heroin users in Australia
increased at a faster pace than in the previous quarter of a century. Registered deaths from heroin overdose have increased in Australia mnokratno from 56 in 1964 to 600 in 1997. In 1998, there were already 737 such deaths. And if raspostranen HIV has remained stable, the very significant increase in the number of hepatitis C-infected heroin addiction is bad enough study of chronic, relapsing disease. The mortality rate, estimated to be approximately 1-2% per year, about 15 times more than the population of the same age and sex, not inject drugs. Heroin addicts get a certain effect in the treatment. But, unfortunately, the resistance effect of the treatment is not very high. Pharmacological treatment is more like addicts than non-drug treatments, since their effectiveness is not so obvious. Psychosocial interventions are important in pharmacological treatments, but the best nature and extent of the psychosocial components remains controversial. Some patients with heroin addiction are not suitable for pharmacological treatment or do not wish to see him off. Therefore, for the treatment of heroin addiction requires a wide range of treatment options, including the use of non-pharmacological treatments. The benefits of treatment Treatment can improve the social and economic aspects, as well as the health of the patient. Furthermore, heroin drops sharply. The longer patients are on treatment, the lower the level of heroin use. Reducing heroin leads to a reduction in mortality, reduce infections and the number of crimes. Although not all patients after treatment completely stop drug use, reduction of overdose deaths makes treatment extremely important. The benefits of treatment Health: • Reduction in mortality (all-cause mortality, but especially because of a drug overdose) • Reduce the incidence of (mostly infections - HIV, hepatitis B, hepatitis C, and bacterial infections as a proximal, such as abscesses around the injection site and distal, such as subacute bacterial endocarditis, and reduction in overdose) • Improving mental health • Improve relationships with family • Reduce Crime • Employment growth • Improvement of living conditions (ie, less than the homeless) • Improving education and training • Reduce consumption of drugs (all types) • Reducing the consumption of heroin (including a complete cessation) Economic: • Official incomes and the availability of social insurance • Reduction of Debt • The benefits of treatment outweigh the costs for the individual and for society Detoxification The purpose detoksikatsiiobespechit safe and comfortable way out of substance dependence. Detoxification should not be considered as a single treatment, but often it is useful as a prelude to other forms of treatment. In addition, some patients who have undergone detoxification can be achieved stable abstinence, without further treatment protocol. In Australia, most often provide patients detoxify heroin addicts on an outpatient basis. Outpatient detoxification has been steadily increasing, although not all patients are suitable for this approach in the treatment. Clonidine (alpha-2 agonist-adrenergic receptors) helps to improve some of the most troubling symptoms of heroin withdrawal. Clonidine is usually used in combination with some other oral preparations to provide relief of symptoms. These drugs include acetaminophen to reduce pain in the bones, diphenoxylate or loperamide, to reduce diarrhea and hyoscine for controlling abdominal cramping. Benzodiazepines, such as nitrazepam, can be used for short-term treatment of insomnia. A small percentage of patients receiving clonidine may develop hypotension. Some patients who abruptly stop taking clonidine, rebound hypertension develops. Lofexidine, which has many properties of clonidine, but perhaps fewer side cardiovascular effects, often appointed instead of clonidine in Australia. Relapse after detoxification is very common. Doctors, patients and families of patients should be prepared for the possibility of recurrence, and do not despair if this happens. Relapse can testify to the need for re-detoxification and changes in approaches to treatment. Methadone substitution therapy Methadone, opioid agonists, which are well absorbed when taken orally has been introduced for the treatment of heroin addiction in 1964 and settled such use, as a replacement of illegal expensive heroin with a short action on the legal, affordable and has a longer half-life (only required once a day ). Patients visited the clinic or pharmacy every day (or several days per week) to give methadone and thus, drug dependence is controlled. Detoxification for patients who started taking methadone required. Psychosocial effects are also an important part of treatment. Methadone maintenance therapy is one of the most thoroughly researched methods of treatment in medicine. Part of the scientific literature provides convincing evidence that methadone treatment reduces heroin use and death from a drug overdose, HIV infection and criminal offenses. Methadone treatment is usually safe, but if there is an uncontrolled reception, it can lead to fatal consequences. Methadone can also be cost-effective, and most of the demand for treatment exceeds the availability of methadone programs. But methadone is exposed to merciless criticism from many experts (doctors - drug treatment). Most opponents of methadone methadone program justify the harm that is actually happening just replacing one drug with another. In addition, after the withdrawal of methadone dependence is much stronger than heroin. While on the other hand, no one raises questions nicotine replacement therapy smokers using gum or patches containing nicotine. Defenders of methadone programs say that up to 85% of patients remain on methadone for 12 months. Patients continued treatment at a higher dose and for a longer period of time can achieve the best results. For most patients, optimal results are obtained at a dose of 60-100 mg per day. Many patients in need of treatment for at least two years. Some patients with heroin addicts do not fall within the program, as required mandatory registration. The best results were achieved methadone program in elderly patients. Such positive feedback about the methadone program mainly come from Western countries. But how patient then stopped taking methadone (withdrawal symptoms after discontinuation of methadone several times harder than heroin withdrawal), the reliability of the information about the adherents of the methadone program can not imagine. Naltrexone Naltrexone is a long-acting opioid receptor antagonist that is well absorbed when taken orally (per os). But be aware that the possibility of a severe reaction when administered if the patient has recently received heroin or other IRS. The manufacturer recommends this drug, naltrexone was applied to only a few days (up to 7 days) after the last use of heroin. If a patient is already taking naltrexone heroin or other opiates, all the effects of opioids are blocked. The results of the application of naltrexone as maintenance therapy is very low if the patient takes it as an outpatient. The best results are achieved if the appointment of naltrexone is controlled through an integrated program of treatment, or if patients are "motivated" (professionaly- white-collar workers, persons on parole, probation or in prison). Some worrisome data about the increased risk of death from overdose during maintenance treatment with naltrexone. The reason is that taking naltrexone reduces the sensitivity of opioid receptors. If naltrexone is taken periodically, and then use occurs in intervals of heroin, the risk of death from overdose may be longer. Rapid detoxification using general anesthesia or deep sedation has recently become connected to naltrexone. Sometimes this combination is called ultrafast detoxification. But while this method is not passed clinical trials and the results so far are only experimental. Buprenorphine This partial agonist opioid receptor taken sublingually, because it has a high rate of metabolism when taken orally. This drug is widely used in France and in some other countries. The results of using generally as a rule, comparable to the methadone programs, but each drug has its advantages (and some disadvantages). Buprenorphine can be taken in a day. The risk of overdose when taking buprenorphine is minimal, but the addicts at high doses of heroin may experience withdrawal symptoms. Although buprenorphine is higher than methadone, however, it is more preferable for detoxification, since much less causes euphoria. Leva-alpha acetylmethadol (LAAM) LAAM (also known as levometidol acetate) is a derivative of methadone. It has a longer half-life than methadone, but has similar side effects. Day dosing reduces the cost of treatment, and also reduces the burden on patients. The metabolites are active drugs and other medications can disrupt the production of metabolites. LAAM used in Australia and other countries. The legal prescription of heroin Prescription of heroin was available to control heroin addiction in the UK since 1926. However, while the efficiency of heroin has not been studied. But as evidenced by anecdotal evidence, the effectiveness of eating small doses of heroin was similar to methadone program .In 1990 in Switzerland conducted a study using heroin to treat heroin addiction and the results were encouraging. The main argument in favor of the appointment of heroin was his appointment in patients with severe heroin addiction. Intravenous administration of methadone Intravenous administration of methadone is used in the UK for decades, although the effectiveness of the not obvious. Drug therapy is attractive enough for patients and to a certain extent hinders a huge number of drug addicts with heroin addiction. Clinical studies show that agonists for the treatment of safe, effective and economically viable. The range of pharmacotherapeutic options to control heroin addiction in Australia is currently being expanded. Demand for all types of treatment (especially pharmacological treatments) for heroin addiction is much greater than the supply. Treatment of heroin or methadone addiction, withdrawal withdrawal, detox, Detoxification, Ultra Rapid Opioid Detoxification UROD (AMLO), Naltrexone implants. For the people of Europe the price of treatment - 600 euro: detox from heroin to 3 days (full, painless cure of the drug), accommodation, food + meeting, transfer to hotel (shuttle). TSIPO "MOSMEDSERVIS" - Russia - Moscow
Tel: + 7 495 782 78 12 or Email: mosmedservice@yandex.ru | |
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