Semisynthetic Opiate Addiction: Buprenorphine

Harm Reduction paper Randy Jones Substance Abuse Counselling January 18, 2012 This paper will discuss the principles and position of harm reduction. It will also examine the public perception of the user, which has created an ineffective philosophy. Most importantly, my paper seeks to recognize the harm of harm reduction. This discussion will highlight the lack of hope it creates in the user. Harm reduction needs to be addressed so that a long-term solution for the user can be implemented, not just a quick fix Band-Aid solution. If caregivers, counselors and the general public do not hold more of an abstinence position on recovery they will eventually do users a disservice. I will touch on needle exchange, safe injection sites, wet

This paper is intended to educate those who almost nothing about heroin and those who use it. Many people have been associated with friends or families who have used some kind of drug. There are many people who have not had any contact with heroin users or if they have, don’t understand much about it. Using various sources about heroin to explain where it came from, how it is used, who uses it and how a person starts on the path towards heroin, preventing addiction, and global issues surrounding this drug. Although the topic of heroin is inexhaustible, it is my hope to spark reader’s curiosity. Knowledge of this drug might just help the reader join in on discussions about heroin.

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

Southwestern Assemblies of God University School of Distance Education Methadone Treatment Programs are Effective in Stopping Heroin Use A Paper Presented to Professor Loyd Uglow, Ph.D In Partial Fulfillment of The Requirements for the Course THE 5113 Research Literature and Technology Sharon Pete November 28, 2012 THESIS STATEMENT: To investigate Methadone maintenance is found to be more effective in treating heroin addiction than 180 day detoxification. The objective is how methadone maintenance, a widely used but controversial method of weaning heroin addicts off the drug—with counseling has psychosocially enriched 180 day methadone assisted detoxification.

Methadone Maintenance Treatment Post World War II New York City was faced with a major heroin epidemic with over 151,000 names listed in the Narcotics Register (Herman). As a medical response, methadone was developed to treat heroin addiction (Herman). Today methadone maintenance treatment has grown to become a popular therapy for

• Support of NP’s ability to prescribe medication-assisted therapies (MATs), such as buprenorphine for those in drug withdrawal

There are three predominate forms of Medication Assisted Treatment (MAT) that have proven effective in combating opioid use disorder. Methadone, buprenorphine, and naltrexone have all shown to be effective in the treatment of substance use. When prescribed and monitored properly, MAT has been shown to reduce illicit drug use and reduce the rate of accidental overdose. However, while as many as 2.5 million people are suffering from substance use disorder, less than 40% have access to MAT

Methadone is one of the most common medications used to treat opioid addiction. It decreases the symptoms of opioid withdrawal and inhibits the euphoric effects caused by abusing heroin and prescription opioids such as oxycodone. When used as prescribed and under the supervision of a trained physician, methadone is an effective complement to treatment. SAMHSA also recommends patients remain on methadone treatment for at least 12 months. Many people require multiple years of treatment. When discontinuing methadone treatment, patients should slowly taper off of it under doctor supervision. Buprenorphine decreases the potential for opioid abuse, reduces withdrawal symptoms and cravings and decreases the risks of overdose. Because buprenorphine

Buprenorphine is morphine-like but is 25 to 50 times more potent [15,16]. It is noteworthy that buprenorphine has very low oral bioavailability because it undergoes extensive first-pass metabolism. However, its bioavailability is substantial enough that sublingual (SL) administration makes this a feasible treatment for opioid dependence. The mean time to peak plasma concentration following SL administration varies and can range from 40 minutes to 3.5 hours. Buprenorphine is highly protein bound (96%) and has a large volume of distribution. It is metabolized extensively to norbuprenorphine by N-dealkylation, primarily through cytochrome P450 (CYP) 3A4. The half-life of buprenorphine is long, and there is considerable variation in reported values of terminal elimination, with mean values ranging from 3 to 44 hours. Most of a dose of buprenorphine is eliminated in the feces, with approximately 10–30% excreted in urine.

Background: Physical dependence to a substance is a state of adaptation that is manifested by specific signs and symptoms of certain drugs that can be produced as a result of abrupt cessation, rapid dose reduction, decreasing blood level of the drug, or administering an antagonist. Dependence is a normal physiologic consequence of extended opioid use, and by itself, is not the same as addiction.¹ To treat this state of reliance, opioid agonists, such as methadone and buprenorphine-based regimens, have been the mainstays of therapy. While they are both long-acting and bind to opioid receptors in the central nervous system, they differ in their mechanism of action and how they are perceived by the general population. This consult’s objective is to evaluate current literature that is available regarding the differences in outcomes and efficacy between methadone and buprenorphine-based treatment in opioid-dependent patients.

The opioid war can be resolved through the combination of counseling and extended addiction services for individual treatment plans. The program at Center for Behavioral Health Elizabethtown provides counseling and intensive therapy both during the addiction process and for up to a year for all patients after leaving the program (Zsigray 4). The treatment of the addict, and the mental illness and emotional disorders attached to addiction, can fix the epidemic. Patients who treat the addiction by use of corrective therapy are more likely to stay clean than patients who do not (Zsigray 3). Therapy and counseling are a vital part of the recovery process.

Opiate Dependency vs. Opiate Addiction Today the recent growth of prescription opioid painkillers has made opiate use far more domesticated and widespread than ever before.  Even though heroin use has declined, the use of prescription opiates has increased. The use of prescription opiates for people who are dependent on the drugs for pain reduction has lead to an increase in abuse. When a family member or friend begins taking the drugs, not because they need them, but because they want to feeling, it becomes an addiction. Even though an addict is dependent on opiates, a person who is opiate-dependent is different because of the psychological, physical, and financial effects.

Stabilization Phase (finding the correct dose) The physician adjusts the dosage of buprenorphine if withdrawal symptoms or cravings are bothersome or if there are medication-related side effects. Patients visit their physician frequently until progress is on firm ground, usually once weekly. Stabilization lasts about two to four weeks. Maintenance Phase (when intensive

Marleen Apodaca 11/9/16 PSY 123 Dr. Yancey Fighting the War on Heroin Drug addiction is one of the many problems that is prevalent world-wide. An even bigger uphill battle that comes with drug addiction is the ethics behind rehabilitation and treatment. Heroin is one of the most

Thus far, throughout the semester, I have gained so much awareness and understanding for those whom are struggling with substance misuse. Addiction has played a major role in my immediate family life. Over the years, I have realized that addiction does not discriminate on a basis of race, gender,