The is the second part of "Treating opiate addiction". Click here to read Part I: Detoxification and maintenance.

Naltrexone

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.

Post-traumatic stress disorder

In the aftermath of a life-threatening trauma, most people recover with the support of family and friends. But some develop post-traumatic stress disorder (PTSD), an anxiety disorder that may last a lifetime if appropriate help is not available. Many unwelcome and unanticipated life events, such as a spouse's betrayal or the loss of a job, can cause distressing emotional reactions, but most such events don't lead to Post Traumatic Stress Disorder (PTSD). Under the current official definition, PTSD is diagnosed only if you have been exposed to actual or threatened death or serious injury and responded with fear, helplessness, or horror.

However, the definition of PTSD is broadening, as mental health professionals gain more experience with the disorder. Individual traits and circumstances help determine how an event is perceived and how emotionally overwhelming it is. In making a diagnosis of PTSD, a mental health professional considers both the type of trauma and the individual's reaction. The point in a person's life when a trauma occurs may also predict her likelihood of developing the disorder.

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.

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.

Marijuana use may be harmful to mental health

Think smoking marijuana is harmless? Think again. Chronic users of the drug often find themselves lacking motivation. Some even seem depressed or have other signs of mental illness. But does chronic marijuana use lead to psychiatric problems? Or do people suffering from mental illness use marijuana to self-medicate? While this drug was becoming increasingly popular with young people in the 1990s, researchers were busy trying to figure out if marijuana was a cause or an effect of psychiatric problems. And their work seems to have paid off. Research now indicates that marijuana use increases the risk of depression, as well as schizophrenia. But at the same time, depressed people do not use marijuana more often than their non-depressed counterparts.

In an Australian study, researchers interviewed 1,600 14- and 15-year-olds, then again seven years later. Participants filled out a questionnaire, reporting on their use of marijuana and symptoms of depression or anxiety. A surprising 60% of the participants had used marijuana by the time they were 20. The researchers found that the young women who had used marijuana weekly as teenagers were twice as likely to have depression as a young adult than women who did not use the drug. Daily use as a teenager was associated with four times the risk of depression for young women.

Research we’re watching

The Framingham Heart Study—which has charted the lifestyles and health status of the residents of Framingham, Mass., since 1948—has been tracking the development of dementia among participants since 1975. In a recent analysis, published in the Feb. 11, 2016, issue of The New England Journal of Medicine, researchers calculated the dementia rate among 5,205 people ages 60 or older. The participants had physical exams, including tests for dementia, every five years. The researchers determined that the five-year rate of dementia was 3.6% between 1982 and 1986, 2.8% between 1991 and 1996, 2.2% between 1998 and 2003, and 2.0% between 2009 and 2013. Moreover, the average age when dementia was diagnosed went from 80 to 85 over those three decades.

The declining dementia rate was registered only in high school graduates, but they made up most of the Framingham participants. The rate of cardiovascular disease—including stroke, atrial fibrillation, and heart failure—also fell during the three decades. In that sense, the results give further support to findings that education (which may build up cognitive reserves) protects against dementia, and cardiovascular disease (which restricts blood flow to the brain) may promote it. They provide encouragement that pursuing a healthy, engaged lifestyle may pay off.

Loneliness and social isolation have been linked to higher risk of having a heart attack, needing a procedure to clear blocked heart arteries, or experiencing a stroke. 

Put some oomph into your intentions with simple strategies to keep you on track.

The new year brings new resolve. But if this is the year you’re finally going to start exercising and keep exercising, you’ll need strategies to back up your good intentions. “Research indicates that people have limited reserves of willpower that are taxed by many different aspects of life, such as eating a healthy diet or doing household chores. If you exhaust your will-power in one area, you’ll have less to expend in the others,” says Rachel Wilson, a physical therapist with Harvard-affiliated Brigham and Women’s Hospital.

If you are returning to exercise after a long break, or if you’ve never exercised, get your doctor’s okay first. Then use some of the following strategies to stay on the path to a healthier lifestyle.

A positive view of life and aging may help you live longer.

Giving life two thumbs up may help you stay healthier.
Image: marejuliasz/iStock

Do you look forward to the next week? Do you feel younger than your age? Do you have a sense of purpose? If so, you may already have done something to reduce your risk of degenerative diseases and may even be adding years to your life.