- What are Opiates?
- Prescription Painkillers Facts
- Heroin Facts
- Treatment for Opiate Addiction
- Contact Fifth Avenue Psychiatry
What are Opiates?
Oxycodone and other opioids are extremely addictive psychotropic drugs whose use is now considered epidemic in the United States. The street form, heroin, is an opiate derived from the seed of the poppy plant. Other kinds of opiates or opioids such as oxycodone, morphine, hydrocodone, fentanyl, and codeine, are common prescription narcotics. These are synthetically created in a lab, and prescribed to people as part of a post-surgery protocol or pain management regimen due to injury or other health ailment.
In our practice, Suboxone and Sublocade are used as a form of medication-assisted treatment (MAT) for those who need to taper off a drug dependency through the use of a less-harmful substance. Suboxone and Sublocade are forms of Buprenorphine used for the outpatient treatment of opiate dependence. Suboxone and Sublocade are long acting partial agonists of the opiate receptor, and have been shown to be helpful for people wanting to taper off of Oxycontin or Heroin. Although stigmatized by some, and are still a dependence on a long acting opioid, Suboxone and Sublocade are both very effective in outpatient private practice in addiction treatment. Suboxone can be used for safe outpatient detox from opiods, and both Sublocade and Suboxone are used for long term maintenance of opiate dependency.
Opiates create a chemical dependency or addiction by stimulating the opiate neurotransmitters in the brain (the mu receptors) which produce feelings of euphoria. These drugs can be injected, or in pure enough forms, ingested, sniffed/snorted or smoked. Because black-market drug producers of heroin have refined purification methods allowing for non-injection delivery, the needle barrier to heroin use has been diminished in the 1990s, leading to an increase in first-time users. Oxycontin, though marketed as safe and non addictive and minimally abusable by pharmaceutical companies (notoriously Purdue Pharma), is highly addictive and is easily converted into an even more addictive short acting drug by crushing and snorting the pills.
In 2017, on a global scale, 71 million people had a substance use disorder, and 55 percent of them were classified as having an opioid addiction to heroin or a prescription pain medication. Abuse of prescription painkillers like Vicodin, Dilaudid, Codeine, Oxycontin, etc. led to the opioid epidemic.There are many factors contributing to the opioid epidemic, from false science publications from pharmaceutical companies, to culture changes provoked by these companies among doctors who prescribed painkillers generously based on the false science that people will not become addicted to painkillers if they are dispensed for pain. A cascade of businesses thrived for pain clinics, to pharmacies to Big Pharma. There has been much more supply of prescription painkillers and risk of opiod addiction was underestimated. These drugs are so addictive that now, even with new government guidelines changing the way physicians can prescribe the drugs, many patients are left to manage their opioid medication dependence on their own, opting to switch their drug of choice to the more accessible drug – heroin.
Prescription Painkillers Facts
Many people currently struggling with prescription medication dependency were simply following a doctor’s orders for use. Unfortunately, even good intentions can take a wrong turn. Tolerance to the drug can develop rapidly and in the case of opioid medications, it can happen in just five days.
Drug tolerance will cause users to need stronger doses and/or more frequency of use. Taking more of the drugs does increase its efficacy but also increases its addictive properties. Thus, chronic use of these painkillers can cause physical dependence. When physical dependence has developed, withdrawal symptoms may occur when the person stops taking the medication. This is the essence of the cycle of addiction.
Abusing prescription painkillers can lead to an abnormal mental state, which generally involves excessive sleepiness or unconsciousness. In some cases, drug abuse can lead to overdose symptoms including respiratory depression, seizure and coma.
Heroin is a highly addictive drug that is snorted, smoked or injected. If an injection is a preferred route, use usually occurs several times per day. The euphoria brought about by this kind of drug use lasts between 45 seconds to several minutes, followed by a state of sedation and tranquility.
There are serious adverse effects associated with heroin. Harmful repercussions from injection include HIV, hepatitis B and C, and bacterial or fungal infections. It can also cause decreased kidney function and chronic constipation. Large amounts of heroin intake can cause fatal respiratory depression, and many have died from fatal overdoses because of it.
The purity of heroin is rarely known, particularly because it is bought on the street and its production isn’t regulated. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. In addition, heroin, like other illegal drugs, is often made with the inclusion of other drugs, mostly unknown to the user.
Treatment for Opiate Addiction
There are a wide variety of outpatient treatments for opiate dependence, including medication-assisted treatment with Vivitrol, a non-opioid. Outpatient detox from opioids with medications such as clonidine and other prescriptions can help gently taper off drug dependency. After outpatient detox is complete after 5-8 days, a Vivitrol shot is administered preventing any further opiod abiuse for approximately 26-28 days. At Fifth Avenue Psychiatry, we offer Vivitrol as part of outpatient detox, along with mental health counseling, conducted in a private office setting. Confidentiality and discretion are emphasized throughout the recovery process.
Like the treatment of all other addictions, recovery and “protracted withdrawal” is supported through regular office visits that help manage the recommended treatment plan, while ongoing assessments help measure the milestones reached towards achieving emotional balance. Dr. Glazer and his licensed practitioners work with each patient to design an evidence-based, personalized and effective therapy program that’s right for executives, professionals, and other high profile individuals.
If you or someone you love is suffering from drug addiction, we offer a range of treatment options. Don’t hesitate to call for more information or a consultation.
Contact Fifth Avenue Psychiatry
3 East 85th Street
New York NY 10028
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