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Treating opiate addiction, Part II: Alternatives to maintenance
The is the second part of "Treating opiate addiction". Click here to read Part I: Detoxification and maintenance.
A different kind of drug treatment for opioid use disorder is the long-acting opiate antagonist naltrexone, usually taken once per day after detoxification. It neutralizes or reverses the effects of opiates, and triggers a withdrawal reaction in anyone who is physically dependent on opiates. A person who takes naltrexone faithfully will never relapse, but most people simply stop using it, or refuse to take it in the first place. A newer slow-release naltrexone injection is now available. However, it is too soon to know if it will have a better success rate than the oral form.
Treating opiate addiction, Part I: Detoxification and maintenance
Dozens of opiates and related drugs (sometimes called opioids) have been extracted from the seeds of the opium poppy or synthesized in laboratories. The poppy seed contains morphine and codeine, among other drugs. Synthetic derivatives include hydrocodone (Vicodin), oxycodone (Percodan, OxyContin), hydromorphone (Dilaudid), and heroin (diacetylmorphine). Some synthetic opiates or opioids with a different chemical structure but similar effects on the body and brain are propoxyphene (Darvon), meperidine (Demerol), and methadone. Physicians use many of these drugs to treat pain.
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.
Low-tar cigarettes are not a safer choice
Studies show smoking high-tar unfiltered cigarettes, as opposed to medium-tar filtered cigarettes, greatly increases your risk of lung cancer. So, cigarettes labeled as low-tar or ultra light are an even safer choice, right? Wrong. A study comparing the lung cancer risks of different types of cigarettes found this seemingly logical assumption is false.
The study six years and involved over 900,000 Americans over the age of 30. The researchers compared the risk of death from lung cancer among men and women who were smokers, former smokers, or had never smoked. When analyzed according to the tar rating of cigarette smoked, the results of the study showed the risk of lung cancer death was greatest for smokers of high-tar unfiltered cigarettes. The risk of lung cancer death was no different among smokers of medium-, low-, and very low-tar cigarettes.
Using Addictive Substances
A report recently issued by the National Cancer Institute proves what many people have suspected all along: "light" cigarettes are more a marketing ploy, than an attempt to make smoking safer.
Light and ultralight cigarettes produce lower amounts of tar and nicotine than regular cigarettes when smoked by testing machines. However, this is not the case when a person uses them. This is due to the smoker's desire to get as much of the harmful chemicals as possible, and from the design of the cigarette. Because smokers are addicted to nicotine, not the act of smoking, they usually inhale harder on light cigarettes or simply smoke more of them to get their fix. And the way the cigarettes are designed- with ventilation holes placed where smokers' fingers or lips easily block them - means smokers are often inhaling harder than necessary, regardless of whether or not they are craving more nicotine.
In the 1960s and '70s, studies on light cigarettes showed promising results. Smokers using the reduced strength cigarettes had lower risk of lung cancer risk than those using the full-strength tobacco products. The increasing use of light products was expected to further decrease smoking-related diseases. Unfortunately, this has not come to pass. Lung cancer rates rose until the early 90s. And it was a decrease in smoking in generalnot tobacco lightthat has caused the decline seen since then.
December 2001 Update
Quitting smoking greatly reduces your risk of death from congestive heart failure within two years.
Despite a lack of evidence, physicians have long advised patients with congestive heart failure to quit smoking to improve their chances of survival. Now, a recent study provides the necessary proof.
Researchers in Canada investigated the rates of death, hospitalization for heart failure, and heart attack in smokers, ex-smokers of less than 2 years, ex-smokers of more than 2 years, and non-smokers. All the participants in the study had congestive heart failure in the form of left ventricular dysfunction failure of the left ventricle of the heart to properly pump oxygen-rich blood to the body.
The study found current smoking was associated with a substantial increase in the risk of death, rate of hospitalization, and heart attack. Patients who had quit smoking or never smoked had a 30% lower risk of dying during the time of the study (41 months). Moreover, ex-smokers had the same mortality rate as non-smokers.
These results suggest people who quit smoking lower their risk of recurrent congestive heart failure within two years. The research also showed the benefit from quitting smoking was just as great as the benefit from taking drugs for heart failure.
September 2001 Update
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