Drug treatments for heroin dependence

1. Drug treatments for heroin dependence

2. Heroin dependence Heroin is a highly addictive drug; the reason for this is because it acts upon the reward pathway in the brain When it has entered the body, Heroin goes through the walls of the alveoli in the lungs, and is absorbed into the bloodstream The heroin travels to the brain, where it mimics endorphin (a natural opiate) Normally, endorphin is released which releases dopamine to facilitate the reward pathway in the brain Heroin mimics endorphin and floods the endorphin receptors, increasing the amount of dopamine rapidly; this causes a feeling of well being and neutral emotion http://www.youtube.com/watch?v=fySL2OkO33s

4. Drug treatment for heroin dependence • Medications which have been approved for the treatment of heroin addiction work through the same opioid receptors in the brain that heroin works on, but are safer • Pharmacological treatments (to tackle physical dependence)are combined with psychological therapy (to tackle psychological dependence)in order to provide a comprehensive programme of treatment for heroin dependent individuals

5. Drug treatment for heroin dependence ... • Because heroin actually changes the brain’s chemistry, this needs to be re-balanced before psychological therapy can be effective; the dependent individual has to go through a process of detoxification • The aim of treatment is firstly to stabilise the drug use, minimise harm and then work towards abstinence

6. Drug treatment for heroin dependence ... • These are categorised into three types: • Agonist – these activate opioid receptors • Partial agonist – these also activate opioid receptors but produce a lesser response • Antagonists – these block the receptor and therefore the rewarding effects of opioid • Drugs used to treat heroin dependence are: methadone, buprenorphine and naltrexone

7. Methadone ... (Dolophine or Methadose) ... is a synthetic opiate which works at the synapse as a substitute for heroin; it is an opioid agonist which is taken orally and is therefore slow-acting It works by dampening the ‘high’ that heroin users experience, while at the same time preventing withdrawal symptoms Methadone is dispensed to patients on a daily basis through approved outpatient treatment programmes; it is taken under supervision at first, until the patient can be trusted to take it at home. This is the oldest of the pharmacological treatments for heroin addiction

8. Detoxification ... • This is when the individual gets a medical check every 3 months to monitor their progress and to ensure they haven't taken any Heroin • The methadone levels are slowly reduced, until the individual feels they are ready to complete their treatment by coming off the medication completely • http://www.youtube.com/watch?v=jfaFGKFOlYo

9. Buprenorphine ... (Subutex/suboxone) • ... is a partial opioid agonist, which works by relieving the craving for heroin without the ‘high’ or dangerous side effects of opioids • Suboxone also contains a substance called naloxone – this medication is taken orally or sublingually. It is designed to prevent attempts by users to get high by injecting the drug (if Suboxone is injected, it produces withdrawal symptoms the user does not experience if they take the medication orally as prescribed) • Subutex is given during the first few days of treatment, while Suboxone is used during the maintenance phase of treatment

10. Naltrexone ...(Depade/Revia) • ...is an opioid antagonist which acts by blocking opioid receptors in the brain and nervous system; this means that users will no longer experience the euphoria-like effects of opiates, and this will help them to stay drug-free • Users are prescribed naltrexone if they have been through an opiate detoxification regime, as it decreases the desire to take opiates • Naltrexone does not help someone stop doing drugs, it is used to help people who have already stopped to maintain abstinence

11. Evaluation – strengths/limitations of drug treatments ... Strengths Limitations Many addicts continue to rely on Methadone, and so never try to detox Methadone withdrawal takes longer than Heroin and lasts a month Some Methadone ends up in the illegal drugs market, once it has been taken for home-administration, which completely defeats the object of the treatment • Enables addicts to break links with dealers decreasing pressure to take Heroin • It is difficult to overdose, so safer to use than other opiates • There is no danger of infection when administered, as it is taken orally

15. Nicotine Addiction Nicotine is a substance in Tobacco which is highly addictive. It stimulates acetylchloline(Ach) synapses in the brain. Ach is associated with learning and thinking, which explains the alertness and ability to react which smokers report. When these synapses are activated, the dopamine reward pathway is also activated. This triggers the production of endorphins, which cause the feeling of well-being and calmness. Nicotine enters the blood system within 7-20 seconds of entering the body, which explains why its effects are felt so instantaneously. Another effect of nicotine is that it triggers the production of glucose and adrenalin. With glucose raising the blood sugar level and adrenalin causing increased alertness.

16. Effects of smoking on your body The Doctors Explain How Smoking Affects Your Body.... http://www.youtube.com/watch?v=SwYEFu-GKP4&feature=related

17. Nicotine addiction treatment “How you can benefit from quitting smoking program” by a doctor himself.... http://www.youtube.com/watch?v=ErTyRkziXFg&feature=related Treating nicotine addiction with hypnotherapy A hypnotic state is known the be very relaxed and is induced by a qualified therapist. Ideas are slowly put into the unconscious mind, which continues to influence behaviour once full consciousness is restored. THEY ARE NOT PUT TO SLEEP, but rather made to focus on the hypnotist and exclude any irrelevant information. It is referred to as an altered state of consciousness rather than a lack of consciousness. The main objective is to implant the idea that the person does not want to smoke and to relate the thought of smoking to unpleasant thought. The sessions usually last between one and two hours.

18. What are the pro’s and cons? Advantages disadvantages There is a great deal of variability on how easy it is to hypnotise somebody, for example it is harder to do if the person is not relaxed. It will only work if the client has BELIEF that it will work for them. A meta-anaylsis by Green and Lynn (2000)- 59 studies, and none were found to be more effective than any other therapy. • If it works, it is very cost effective compared with other intervention programmes as just one treatment is needed. • Spiegal et al (1993) found it was better than unsupported attempts to quit. • There are no side effects of a hypnotherapy session.

19. A drugs campaign that has effected me. • This advert has effected me hugely. As being a new driver and also with my birthday approaching, it reinforced to me the importance of not drinking and driving. The people who are stupid enough to do this, don't just effect themselves but will effect everyone around them. http://www.youtube.com/watch?v=ymiF-okrdMg