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  • Heroin addiction

    Saw something on BBC news where a woman was saying methadone is more addictive than heroin and that it's easier to get off heroin rather than methadone. Could someone explain that ??
    I thought the point of methadone was to wean addicts off heroin, not to change their addiction to another opioid. Is there an alternative to methadone which has a lower potential for abuse/addiction ?
    http://i620.photobucket.com/albums/t...snroses2-1.jpg

    ”We are real. We are not glam sh*t or anything else. We are Guns N’ Roses.”

  • #2
    Re: Heroin addiction

    This extract from: Methadone - Factsheet - Drug Facts might be helpful...

    methadone patients do not experience the extreme highs and lows that result from the waxing and waning of heroin in blood levels. Ultimately, the patient remains physically dependent on the opioid, but is freed from the uncontrolled, compulsive, and disruptive behavior seen in heroin addicts.

    Withdrawal from methadone is much slower than that from heroin. As a result, it is possible to maintain an addict on methadone without harsh side effects. Many MMT patients require continuous treatment, sometimes over a period of years.

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    • #3
      Re: Heroin addiction

      The discussion on BBC Breakfast was promoting the programm on Channel 4 tonight at 9pm, called 'Mum, Heroin & Me' ,which does looks quite interesting!

      The mother was calling for diamorphine to be prescribed instead of methadone, which was when she made the remark mentioned above.

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      • #4
        Re: Heroin addiction

        But is there a particular reason as to why methadone is more addictive than heroin ? (so the lady said). Is there some sort of scale which rates drugs on their potential for addiction ?
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        ”We are real. We are not glam sh*t or anything else. We are Guns N’ Roses.”

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        • #5
          Re: Heroin addiction

          As said before the 'high' you get from methadone is nowhere near that you get from heroin, so users will crave heroin more.

          Physical withdrawal symptoms will last much longer with methadone so that may be why it is perceived as more addictive??

          Never heard of an 'addiction scale' as such, but i stand to be corrected!!

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          • #6
            Re: Heroin addiction

            I think its something to do with desensitisation of seratonergic pathways rather than anything to do with potency at the opioid receptor

            Just found this really intersting article
            http://www.drugabuse.gov/PDF/perspec...s-Neurobio.pdf
            MUR

            Major Underestimation of Resources

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            • #7
              Re: Heroin addiction

              So is there any particular alternative for methadone ? Why is methadone preferred considering the many downsides to its use in treating addiction ?
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              ”We are real. We are not glam sh*t or anything else. We are Guns N’ Roses.”

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              • #8
                Re: Heroin addiction

                Because it's generally considered much safer.

                Much of the danger of opioid abuse (misuse?!) is due to the risks associated with injecting: (blood borne infections/abcesses/gangrene/veins 'shutting down'); or the risks of overdose from an uncut (ie purer) batch. Plus can be a risky lifestyle generally (though that is a generalisation as I've known many addicts who get jobs/manage to hold them down/live a normal life -whatever that is! -they just come in to the pharmacy regularly for medication for a chronic condition like most of our other patients...).

                One way of looking at it anyway, not that I have rose tinted glasses on. It's great when a pt does manage to gradually taper dose down to nought, but not that common. Many addicts seem to use the methadone as a 'breakthrough' remedy for their continuing heroin habit (much like the Oramorph for the MST user!).
                BUT it's bloody hard to conquer addictions for some people; weak? maybe, but maybe has more to do to their genetic propensity for addiction? (Just throwing that out there).

                While heroin has a short half life, and leaves the body in, I think 5 days or so depending on blood conc. (please correct me, this is from memory so may be wrong), it takes much much longer to break the psychological addiction. Methadone gives people the chance/time to sort through issues/whatever lead to addiction in first place while dose is gradually titrated down (in theory at least, though lack of detox/rehab/ongoing counselling in UK means methadone often ends up being sole therapy which is not a solution IMHO...)

                Do we have anyone working with DAT services on the forum btw?
                The funkee pharmacist!

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                • #9
                  Re: Heroin addiction

                  Originally posted by Nikolai View Post
                  So is there any particular alternative for methadone ? Why is methadone preferred considering the many downsides to its use in treating addiction ?
                  it is preferred because the NHS budget is limited! Methadone is a way cheaper than suboxone. suboxone is a better alternative as it does not cause dental decay/easier to take, contains subutex+ naloxone(opoidantagonists) which means if addicts inject any drug, they would not get the euphoric effect of the drug due to blocking opioid receptors by naloxone.
                  [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
                  [/COLOR]

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                  • #10
                    Re: Heroin addiction

                    Originally posted by Raoul View Post
                    it is preferred because the NHS budget is limited! Methadone is a way cheaper than suboxone. suboxone is a better alternative as it does not cause dental decay/easier to take, contains subutex+ naloxone(opoidantagonists) which means if addicts inject any drug, they would not get the euphoric effect of the drug due to blocking opioid receptors by naloxone.
                    You're probably right Raoul lol ; most things boil down to money after all it's not a limitless pot...
                    money so tightly controlled in my hosp that at one time we had to supply our own biros and only had one computer (no printer) for almost 100 staff within pharm dept for non-dispensing use!
                    The funkee pharmacist!

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                    • #11
                      Re: Heroin addiction

                      Originally posted by Nikolai View Post
                      So is there any particular alternative for methadone ? Why is methadone preferred considering the many downsides to its use in treating addiction ?
                      The measurement of success of a DAT is the number of people it treats.

                      The idea isn't necessarily to make patients drug free, or non opioid dependant - but to enable them to take back control of their lives.
                      If we think of addiction as a chronic condition rather than an acute curable condition - then long term methadone maintenance makes sense.

                      If it is or not is under debate at the moment.

                      See some of the newsletters here

                      SMMGP - Welcome

                      as well as the NTA treatment guidelines.

                      Methadone isn't the only treatment used.

                      Alternatives - add ons.

                      Heroin - but political opposition - and phased out many years ago - possibly due to a misinterpretation of a study showing a high dose of methadone to be superior to a low dose of heroin.

                      (Heroin is is now being tried again in a few pilot studies)

                      Subutex - useful, but a pain to supervise - generic version due out very soon

                      Suboxone - little evidence of it being any better than subutex - but subutex patent about to expire.

                      Naltroxone implants - not licensed. Tend to be the preserve of private clinics.

                      CBT - often used - though we don't see it on a script

                      Motivational therapy - again not seen on scripts

                      Lofexidine - used to lessen withdrawal symptoms when stopping

                      Zopiclone to aid sleep

                      Anti-depressants.

                      Lavender oil, hot baths, thistle milk - the list could be endless.

                      Jeff

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                      • #12
                        Re: Heroin addiction

                        I worked in a store with lots of methadone patients while on pre-reg a few years back, and one of the regulars was having much more difficulty getting off the zopiclone that was part of the initial 'rattle pack' than the heroin...
                        Still lesser of two evils etc etc!
                        The funkee pharmacist!

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                        • #13
                          Re: Heroin addiction

                          the last 2 drug centres i went to couldnt wait to pump methodone into me,its cheap and easy.drug centres are over worked and are looking for a easy way and quick fix,it aint gonna work.methodone is NOT the answer.its ten times worse to get of than smack,it having such a long half life.put it this way,i went back onto heroin to get of meth and i know a lot of people who have done the same. getting of heroin takes time that unfortunatley most local drug centres do not have

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                          • #14
                            Re: Heroin addiction

                            many of us agree that methadone is not the answer to everything. As someone referred to in a much earlier thread (i think? or did i read it on a blog? Damn my memory! ) there was a clinic in the wirral which successfully used diamorphine for addicts.

                            After a few years addicts would lose interest in using - much of the activities in getting hold of money for heroin (eg crime) were no longer needed as they were getting the diamorphine safely and legally - letting them run a normal life again - they could then go on dose reduction and detox regimens.
                            I believe pressure in the 80's from the usa (the 'war' on drugs) made clinics like the wirral one 'unfashionable' for the powers that be and they were pressurised into switching to methadone instead.

                            would some drug treatment centres now offer dexedrine to help detoxing from meth? Not that i even have the first clue about detoxing from it but as they are both amphetamines (admittedly dexedrine has a much shorter half life) would it help as substitution therapy?
                            “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

                            Terry Pratchett

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                            • #15
                              Re: Heroin addiction

                              Originally posted by [email protected] View Post
                              the last 2 drug centres i went to couldnt wait to pump methodone into me,its cheap and easy.drug centres are over worked and are looking for a easy way and quick fix,it aint gonna work.methodone is NOT the answer.its ten times worse to get of than smack,it having such a long half life.put it this way,i went back onto heroin to get of meth and i know a lot of people who have done the same. getting of heroin takes time that unfortunatley most local drug centres do not have
                              Krishug,
                              Don't they have a shared care system in Scotland - where you can be treated by a GP and key worker with more time?

                              Jeff

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