Copyright AllCEUs 2011-2020  Unlimited CEUs $99/year
<ul><li>To provide information about opiates </li></ul><ul><li>To assist students in understanding consequences of opiate ...
<ul><li>Opiates are better known as painkillers or narcotics. </li></ul><ul><li>Not all pain relievers are opiate based, b...
<ul><li>Narcotics: Strong prescription painkillers such as Demerol, Stadol, or Codeine  </li></ul><ul><li>Heroin: a narcot...
<ul><li>Heroin </li></ul><ul><ul><li>Heroin  WebCast   or  This link </li></ul></ul><ul><ul><li>Heroin  Info at a Glance <...
<ul><li>General effects: pain relief, euphoria, drowsiness/nausea, constipation, confusion, sedation, respiratory depressi...
<ul><li>What types of medications should you be careful taking or things should you be careful doing when taking opiates a...
<ul><li>So many times we try to “work through the pain.”  Do you think it is safe to workout while taking pain medication ...
<ul><ul><li>intense cravings for the drug  </li></ul></ul><ul><ul><li>irritability  </li></ul></ul><ul><ul><li>nausea or v...
<ul><li>Alcohol </li></ul><ul><li>Depressants (GHB, inhalants, benzodiazepines) </li></ul><ul><li>OTC </li></ul><ul><ul><l...
<ul><li>First Conviction: </li></ul><ul><ul><li>  Up to one year imprisonment and fined at least $1,000 (but not more than...
<ul><li>Common pregnancy complications include miscarriage, placental abruption, poor fetal growth, premature delivery, lo...
<ul><li>There are three major misconceptions about  Methadone  : </li></ul><ul><li>” Methadone is more addictive than hero...
<ul><li>Methadone does not produce the “rush” opiates do and blocks the opiate cravings </li></ul><ul><li>Methadone is oft...
<ul><li>Overview  Online Reading </li></ul><ul><li>Responsible Use </li></ul><ul><ul><li>Use opiates as prescribed </li></...
<ul><li>Identify 5 concepts or pieces of information you gained from this video and why you believe they will be useful. <...
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Alcohol and drugs week 8

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  • Methadone Article Methadone is a rigorously well-tested medication that is safe and efficacious for the treatment of narcotic withdrawal and dependence. For more than 30 years this synthetic narcotic has been used to treat opioid addiction. Heroin releases an excess of dopamine in the body and causes users to need an opiate continuously occupying the opioid receptor in the brain. Methadone occupies this receptor and is the stabilizing factor that permits addicts on methadone to change their behavior and to discontinue heroin use. Taken orally once a day, methadone suppresses narcotic withdrawal for between 24 and 36 hours. Because methadone is effective in eliminating withdrawal symptoms, it is used in detoxifying opiate addicts. It is, however, only effective in cases of addiction to heroin, morphine, and other opioid drugs, and it is not an effective treatment for other drugs of abuse. Methadone reduces the cravings associated with heroin use and blocks the high from heroin, but it does not provide the euphoric rush. Consequently, 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. Methadone maintenance treatment provides the heroin addict with individualized health care and medically prescribed methadone to relieve withdrawal symptoms, reduces the opiate craving, and brings about a biochemical balance in the body. Important elements in heroin treatment include comprehensive social and rehabilitation services. Naltrexone Article Answers to Frequently Asked Questions About Naltrexone Treatment for Alcoholism * 1. What is naltrexone? Naltrexone is a medication that blocks the effects of drugs known as opioids (a class that includes morphine, heroin or codeine). It competes with these drugs for opioid receptors in the brain. It was originally used to treat dependence on opioid drugs but has recently been approved by the FDA as treatment for alcoholism. In clinical trials evaluating the effectiveness of naltrexone, patients who received naltrexone were twice as successful in remaining abstinent and in avoiding relapse as patients who received placebo-an inactive pill. 2. Why does naltrexone help for alcoholism? While the precise mechanism of action for naltrexone&apos;s effect is unknown, reports from successfully treated patients suggest three kinds of effects. First, naltrexone can reduce craving, which is the urge or desire to drink. Second, naltrexone helps patients remain abstinent. Third, naltrexone can interfere with the tendency to want to drink more if a recovering patient slips and has a drink. 3. Does this mean that naltrexone will &amp;quot;sober me up&amp;quot; if I drink? No, naltrexone does not reduce the effects of alcohol that impair coordination and judgement. 4. If I take naltrexone, does it mean that I don&apos;t need other treatment for alcoholism? No, naltrexone is only one component of a program of treatment for alcoholism including counseling, help with associated psychological and social problems and participation in self-help groups. In both studies where naltrexone was shown to be effective, it was combined with treatment from professional psychotherapists. 5. How long does naltrexone take to work? Naltrexone&apos;s effects on blocking opioids occurs shortly after taking the first dose. Findings to date suggest that the effects of naltrexone in helping patients remain abstinent and avoid relapse to alcohol use also occur early. 6. Are there some people who should not take naltrexone? Naltrexone should not be used with pregnant women, individuals with severe liver or kidney damage or with patients who cannot achieve abstinence for at least 5 days prior to initiating medications. Also, people who are dependent on opioid drugs, like heroin or morphine must stop their drug use at least 7 days prior to starting naltrexone. 7. What does it feel like to be on naltrexone? Aside from side effects, which are usually short-lived and mild, patients usually report that they are largely unaware of being on medications. Naltrexone usually has no psychological effects and patients don&apos;t feel either &amp;quot;high&amp;quot; or &amp;quot;down&amp;quot; while they are on naltrexone. It is not addicting. While it does seem to reduce alcohol craving, it does not interfere with the experience of other types of pleasure. 8. What are the side effects of naltrexone? In the largest study, the most common side effect of naltrexone affected only a small minority of people and included the following: nausea (10%), headache (7%), dizziness (4%), fatigue (4%), insomnia (3%), anxiety (2%), and sleepiness (2%). These side effects were usually mild and of short duration. As treatment for alcoholism, naltrexone side effects, predominantly nausea, have been se vere enough to discontinue the medication in 5-10% of the patients starting it. For most other patients side effects are mild or of brief duration. One serious possibility is that naltrexone can have toxic effects on the liver. Blood tests of liver function are performed prior to the onset of treatment and periodically during treatment to determine whether naltrexone should be started and whether it should be discontinued if the relatively rare side effect of liver toxicity is taking place. 9. Do I need to get blood tests while I&apos;m on naltrexone? How often? To ensure that naltrexone treatment is safe, blood tests should be obtained prior to initial treatment. Following that, retesting generally occurs at monthly intervals for the first three months, with less frequent testing after that point. More frequent testing may be requested depending on the health of your liver prior to beginning treatment. Blood tests are needed to make sure that liver function is adequate prior to taking naltrexone and to evaluate whether naltrexone is having adverse effects on the liver. 10. Can I take other medications with naltrexone? The major active effect of naltrexone is on opioid drugs, which is one class of drugs used primarily to treat pain but is also found in some prescription cough preparations. Naltrexone will block the effect of normal doses of this type of drug. There are many non-narcotic pain relievers that can be used effectively while you are on naltrexone. Otherwise, naltrexone is likely to have little impact on other medications patients commonly use such as antibiotics, non-opioid analgesics (e.g., aspirin, acetaminophen, ibuprofen), and allergy medications. You should inform your physician of whatever medication you are currently taking so that possible interactions can be evaluated. Because naltrexone is broken down by the liver, other medications that can affect liver function may affect the dose of naltrexone. 11. Will I get sick If I drink while on naltrexone? No. Naltrexone may reduce the feeling of intoxication and the desire to drink more, but it will not cause a severe physical response to drinking. 12. Will I get sick If I stop naltrexone suddenly? Naltrexone does not cause physical dependence and it can be stopped at any time without withdrawal symptoms. In addition, available findings regarding cessation do not show a &amp;quot;rebound&amp;quot; effect to resume alcohol use when naltrexone is discontinued. 13. What should I do If I need an operation or pain medication? You should carry a card explaining that you are on naltrexone and that also instructs physicians on pain management. Many pain medications that are not opioids are available for use. If you are going to have elective surgery, naltrexone should be discontinued at least 72 hours beforehand. 14. What Is the relationship of naltrexone to AA? There is no contradiction between participation in AA and taking naltrexone. Naltrexone is not addictive and does not produce any &amp;quot;high&amp;quot; or pleasant effects. It can contribute to achievement of an abstinence goal by reducing the craving or compulsion to drink, particularly during early phases of recovery. It is most likely to be effective when the patient&apos;s goal is to stop drinking altogether. 15. How long should I stay on naltrexone? If naltrexone is tolerated and the patient is successful in reducing or stopping drinking, the recommended initial course of treatment is 3 months. At that time the patient and clinical staff should evaluate the need for further treatment on the basis of degree of improvement, degree of continued concerns about relapse and level of improvement in areas of functioning other than alcohol use.
  • Definitions of Heroin on the Web: Heroin, a highly addictive drug derived from morphine, is obtained from the opium poppy. It is a &amp;quot;downer&amp;quot; that affects the brain&apos;s pleasure systems and interferes with its ability to perceive pain. Heroin can be injected into a vein (mainlining) or a muscle; smoked through a water pipe or standard pipe; mixed in a marijuana joint or regular cigarette; inhaled as smoke through a straw (chasing the dragon) or as powder through the nose. Heroin -- also known as smack, horse, brown sugar, junk, big H, and dope is fast-acting, especially when injected or smoked. Heroin users quickly develop a www.healthatoz.com/healthatoz/Atoz/dc/caz/suba/tnsa/tsglossary.jsp (Also known as smack, brown, horse, gear, H, steps, junk, skag and jack). Heroin is a pain killing drug made from Morphine, which is derived from the Opium Poppy. When it is pure it comes as a white powder, but street heroin is usually brownish-white. It can be snorted, smoked or injected. It is a Class A drug. www.unisex.org.uk/2_4.htm The potent, widely abused opiate that produces addiction. It consists of two morphine molecules linked together chemically. science.education.nih.gov/supplements/nih2/addiction/other/glossary/glossary2.htm Measures of use of heroin in the respondent&apos;s lifetime, the past year, and the past month were developed from responses to the question about recency of use: &amp;quot;How long has it been since you last used heroin?&amp;quot; www.oas.samhsa.gov/NHSDA/2k1NHSDA/vol2/appendixd.htm (her·o·in) (her¢o-in) diacetylmorphine. www.merckmedicus.com/pp/us/hcp/thcp_dorlands_content.jsp One of a group of opiates, or substances derived from opium poppy (Papaver somniferum). Other opiates include the pain relievers morphine and codeine. Base heroin, commonly marketed in Europe, is brown or beige in color and needs to be acidified with ascorbic acid (vitamin C) or another acid before it can be dissolved in water. Base heroin can be converted into salt form by the addition of ethyl alcohol, ether and hydrochloric acid, creating a powder that will readily dissolve in water. “Black tar” heroin is sticky and dark brown or black in color and also dissolves in water. Heroin www.hrw.org/reports/2003/usa0903/1.htm A semisynthetic opiate derivative used in a variety of cough and cold preparations. Its abuse potential is between that of codeine and morphine. ojjdp.ncjrs.org/PUBS/drugid/glossary.html A chemical compound of morphine and acetic acid originally manufactured by European pharmaceutical companies as a pain killer and cough suppressant. During the 1920s the American medical profession decided that heroin&apos;s highly addicting properties made it unsuitable as a prescription drug and withdrew it from the market. www.drugtext.org/library/books/McCoy/book/glossary.htm Heroin is a depressant that affects the brain by slowing down the activity of certain chemicals. This drug belongs to a group called narcotic analgesics or opioids. www.drugstrategy.central.sa.edu.au/20_druginfo/c_glossary/ an illegal opiate drug. It is highly addictive as users find that they have a need for persistent, repeated use of the drug (known as craving) and that their attempts to stop using the drug lead to significant and painful physical withdrawal symptoms. Can either be snorted, smoked or injected intravenously. Street names include &amp;quot;Bomb,&amp;quot; &amp;quot;Skag,&amp;quot; &amp;quot;Junk,&amp;quot; &amp;quot;Mud,&amp;quot; &amp;quot;Smack,&amp;quot; &amp;quot;Horse,&amp;quot; and &amp;quot;Black Tar.&amp;quot; web.naplesnews.com/01/12/naples/d715275a.htm Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the opiates. It is typically sold as a white or brownish powder or as the black sticky substance known on the streets as &amp;quot;black tar heroin.&amp;quot; soberwebdesign.com/care/dictionary.html a narcotic that is considered a hard drug; a highly addictive morphine derivative; intravenous injection provides the fastest and most intense rush wordnet.princeton.edu/perl/webwn Heroin or diamorphine (INN) (colloquially referred to as junk, babania, horse, golden brown, smack, black tar, big H, lady H, dope, skag, juice, diesel, etc.) is an alkaloid opioid. Heroin is the 3,6-diacetyl derivative of morphine (hence diacetylmorphine) and is synthesised from it by acetylation. The white crystalline form is commonly the hydrochloride salt, diamorphine hydrochloride. It is highly addictive. en.wikipedia.org/wiki/Heroin
  • March of Dimes Report on Illicit Drugs and Pregnancy What are the risks with use of heroin during pregnancy? When a pregnant woman uses heroin, she and her baby may face many serious complications. Common pregnancy complications associated with heroin use include miscarriage, placental abruption, poor fetal growth, premature rupture of the membranes (the woman’s water breaks too soon), premature delivery and stillbirth. As many as half of all babies of heroin users are born with low birthweight. These babies, most of whom are premature, often suffer from serious prematurity-related health problems during the newborn period, including breathing problems and brain bleeds, sometimes leading to lifelong disabilities. Most babies of heroin users suffer from withdrawal symptoms after birth, including fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying and, occasionally, seizures. Babies exposed to heroin before birth also face a ten-fold increased risk of sudden infant death syndrome (SIDS). While heroin can be sniffed, snorted or smoked, most users inject the drug into a muscle or vein. Pregnant women who share needles are at risk of contracting HIV (the virus that causes AIDS) and passing it on to their babies. A pregnant woman who uses heroin should not attempt to suddenly stop taking the drug. This can put her baby at increased risk of miscarriage or premature birth. She should consult a doctor or drug treatment center about treatment with a drug called methadone. Although infants born to mothers taking methadone also may show some signs of dependence on the drug, they can be safely treated in the nursery and generally do far better than babies born to women who continue to use heroin. What is the long-term outlook for babies exposed to heroin before birth? The outlook for these children depends on a number of factors, including whether they suffered serious prematurity-related complications. Some studies suggest that children exposed to heroin before birth are at increased risk of low IQ (in the mentally retarded range) and of serious behavioral problems. However, socioeconomic factors also may play an important role in a child’s outlook. One study found that heroin-exposed children who were adopted soon after birth were no more likely to have developmental delays than unexposed children, though exposed children who were raised by their biological parents were at increased risk.
  • Alcohol and drugs week 8

    1. 1. Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    2. 2. <ul><li>To provide information about opiates </li></ul><ul><li>To assist students in understanding consequences of opiate use </li></ul><ul><li>To assist students in understanding drug interactions </li></ul><ul><li>To educate students about the symptoms of toxicity, overdose and withdrawal </li></ul><ul><li>To motivate students to make informed choices about opiate use </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    3. 3. <ul><li>Opiates are better known as painkillers or narcotics. </li></ul><ul><li>Not all pain relievers are opiate based, but many prescription ones are. </li></ul><ul><li>They relieve pain and induce a state of sedation and apathy </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    4. 4. <ul><li>Narcotics: Strong prescription painkillers such as Demerol, Stadol, or Codeine </li></ul><ul><li>Heroin: a narcotic painkiller </li></ul><ul><li>Methadone </li></ul><ul><li>Naltrexone </li></ul><ul><li>Buprenorphine </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    5. 5. <ul><li>Heroin </li></ul><ul><ul><li>Heroin WebCast or This link </li></ul></ul><ul><ul><li>Heroin Info at a Glance </li></ul></ul><ul><ul><li>Other Opiates or This link </li></ul></ul><ul><ul><li>Other Pain Medications at a Glance </li></ul></ul><ul><ul><li>Hydrocodone (Vicodin, Lortab) </li></ul></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    6. 6. <ul><li>General effects: pain relief, euphoria, drowsiness/nausea, constipation, confusion, sedation, respiratory depression and arrest, tolerance, addiction, unconsciousness, coma, death Also, for codeine—assists in cough suppression, less analgesia, sedation, and respiratory depression than morphine Also, for heroin—staggering gait </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    7. 7. <ul><li>What types of medications should you be careful taking or things should you be careful doing when taking opiates as prescribed? </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    8. 8. <ul><li>So many times we try to “work through the pain.” Do you think it is safe to workout while taking pain medication for an injury or after surgery? What if you are not working out the injured part? </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    9. 9. <ul><ul><li>intense cravings for the drug </li></ul></ul><ul><ul><li>irritability </li></ul></ul><ul><ul><li>nausea or vomiting </li></ul></ul><ul><ul><li>muscle aches </li></ul></ul><ul><ul><li>runny nose or eyes </li></ul></ul><ul><ul><li>dilated pupils </li></ul></ul><ul><ul><li>sweating </li></ul></ul><ul><ul><li>diarrhea </li></ul></ul><ul><ul><li>yawning </li></ul></ul><ul><ul><li>fevers </li></ul></ul><ul><ul><li>chills </li></ul></ul><ul><ul><li>inability to sleep </li></ul></ul><ul><ul><li>depression </li></ul></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    10. 10. <ul><li>Alcohol </li></ul><ul><li>Depressants (GHB, inhalants, benzodiazepines) </li></ul><ul><li>OTC </li></ul><ul><ul><li>Antihistamines </li></ul></ul><ul><ul><li>Decongestants </li></ul></ul><ul><li>Stimulants </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    11. 11. <ul><li>First Conviction: </li></ul><ul><ul><li>  Up to one year imprisonment and fined at least $1,000 (but not more than $100,000) or both. </li></ul></ul><ul><li>After One Prior Drug Conviction: </li></ul><ul><ul><li>At least 15 days in prison (but not to exceed two years) and fined at least $2,500 (but not more than $250,000) or both. </li></ul></ul><ul><li>After Two or More Prior Drug Convictions: </li></ul><ul><ul><li>At least 90 days in prison (but not to exceed three years) and fined at least $5,000 (but not more than $250,000) or both. </li></ul></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    12. 12. <ul><li>Common pregnancy complications include miscarriage, placental abruption, poor fetal growth, premature delivery, low birth weight and stillbirth. </li></ul><ul><li>In sufficient quantity, opiates can depress the heart rate of the baby sufficiently to kill the fetus </li></ul><ul><li>Most babies of heroin users suffer from withdrawal symptoms after birth, including fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying and, occasionally, seizures. </li></ul><ul><li>Babies exposed to heroin before birth also face a ten-fold increased risk of sudden infant death syndrome (SIDS). </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    13. 13. <ul><li>There are three major misconceptions about Methadone : </li></ul><ul><li>” Methadone is more addictive than heroin”. Although withdrawal from methadone does last significantly longer than that from heroin, methadone is not more addictive </li></ul><ul><li>” Methadone depresses the immune system”. Methadone is the only narcotic that does not depress the immune system. </li></ul><ul><li>” Methadone rots the teeth”. Many heroin addicts do not take care of their teeth, but when stabilized on methadone , individuals become aware of their dental problems </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    14. 14. <ul><li>Methadone does not produce the “rush” opiates do and blocks the opiate cravings </li></ul><ul><li>Methadone is often a drug people take for a lifetime </li></ul><ul><li>Methadone is useful in pain management </li></ul><ul><li>Methadone is physically addictive </li></ul><ul><li>Therefore, should people be encouraged to use methadone for pain management or to stop using other opiates? </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    15. 15. <ul><li>Overview Online Reading </li></ul><ul><li>Responsible Use </li></ul><ul><ul><li>Use opiates as prescribed </li></ul></ul><ul><ul><li>Do not mix with alcohol or other depressants </li></ul></ul><ul><ul><li>Do not drive while using opiates </li></ul></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
    16. 16. <ul><li>Identify 5 concepts or pieces of information you gained from this video and why you believe they will be useful. </li></ul>Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year

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