Alcohol and Drug Addiction, Abuse and Treatment

For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking? The following information explains both alcoholism and alcohol abuse, the symptoms of each, when and where to seek help, treatment choices, and additional helpful resources.

What Is Alcoholism?

Alcoholism, also known as “alcohol dependence,” is a disease that includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
  
• Loss of control: The inability to limit one’s drinking on any given occasion.
  
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
  
• Tolerance: The need to drink greater amounts of alcohol in order to “get high.”

People who are not alcoholic sometimes do not understand why an alcoholic can’t just “use a little willpower” to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful “craving,” or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.

Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With treatment and support, many individuals are able to stop drinking and rebuild their lives.

Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to do with genetics. Scientists have found that having an alcoholic family member makes it more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the whole story. In fact, scientists now believe that certain factors in a person’s environment influence whether a person with a genetic risk for alcoholism ever develops the disease. A person’s risk for developing alcoholism can increase based on the person’s environment, including where and how he or she lives; family, friends, and culture; peer pressure; and even how easy it is to get alcohol.

What Is Alcohol Abuse?

Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence. Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

• Failure to fulfill major work, school, or home responsibilities;
  
• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
  
• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
  
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

Although alcohol abuse is basically different from alcoholism, many effects of alcohol abuse are also experienced by alcoholics.

What Are the Signs of a Problem?

How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:

• Have you ever felt you should cut down on your drinking?
  
• Have people annoyed you by criticizing your drinking?
  
• Have you ever felt bad or guilty about your drinking?
  
• Have you ever had a drink first thing in the morning (as an “eye opener”) to steady your nerves or get rid of a hangover?

One “yes” answer suggests a possible alcohol problem. If you answered “yes” to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your answers to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action.

Even if you answered “no” to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek professional help. The effects of alcohol abuse can be extremely serious—even fatal—both to you and to others.

Alcoholism Treatment

The type of treatment you receive depends on the severity of your alcoholism and the resources that are available in your community. Treatment may include detoxification (the process of safely getting alcohol out of your system); taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReVia™), to help prevent a return (or relapse) to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach alcoholics to identify situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. These treatments are often provided on an outpatient basis.

Because the support of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment process. Programs may also link individuals with vital community resources, such as legal assistance, job training, childcare, and parenting classes.

Alcohol is often mentioned in one breath with drugs, especially when the subject is abuse or addiction. More often, alcohol is referred to as a separate substance and in fact, its abuse is often discussed separately from that of drugs. But can alcohol be considered a drug?

Drug defined

If a textbook definition is used, a drug may be defined as a substance that has an effect on living cells and their function and is also used for medical purposes for the diagnosis, prevention and cure of disorders and diseases. As such, alcohol may not be considered as a drug since it is not used directly to effect a cure. However, it is also a substance that can have similar effects to drugs to disinfect, act as an analgesic, a tranquilizer or rarely, a stimulant.

The link between alcohol and drugs

Alcohol is said to possibly be a contributor to health as some are some drugs, but alcohol, like some drugs can be addictive. When used in moderate amounts, alcohol has been said to improve cardiovascular health. However, health experts discourage non-drinkers to start drinking alcohol for the sole reason of benefiting the heart. They recommend that other methods such as exercising and eating a good diet, should be considered as the first line of defense.

As an addictive substance, alcohol can be as bad as drugs. Alcohol abuse and addiction, often referred in general terms as alcoholism, is a common problem in many communities, able to cut across economic and social barriers. It also produces a physical dependence and when it does, it becomes a chronic disease. The use of too much alcohol, like drugs, can also increase tolerance and produce withdrawal symptoms.

Like drugs, alcoholism can lead to family, health and social problems. It's not uncommon for alcoholics to destroy family and social relationships, lose their jobs or turn to illegal activities in order to support their habit. It also causes health problems that are potentially life threatening, such as liver cirrhosis and cancer.

The danger of alcohol

Alcohol affects different people in different ways, and for some that may be trouble. Some individuals, for example, are more prone to suffer from the effects of alcohol compared to others who drink the same amount. However, the danger of using alcohol cannot be emphasized enough. The devastating effect of alcoholism on families and society is well documented and recognized.

Alcohol use is also often discouraged in pregnant women, older people, individuals who have heart diseases and hypertension and those who are taking certain medications. Alcohol, like drugs, not only produces physical dependence, it also promotes neurochemical conditioning, where an individual develops a tolerance to the substance, encouraging him to use alcohol in increasing amounts. Alcohol can also change an individual's perception in its true benefits, allowing a person to think that alcohol is needed in order for them to function socially and emotionally.

Getting help for alcohol addiction or abuse

Once the problem with alcohol addiction or abuse is acknowledged and accepted, the road to recovery may begin. There are plenty of local and national treatment centers and resources that may be tapped for help, either as a source of information or as a means for rehabilitation.

There are several approaches to the treatment of alcoholism, depending on how it is viewed. However, most treatments tend to focus on encouraging people to stop alcohol intake. It is often supplemented by social networking and group supports, along with life training, to effectively help alcoholics from using alcohol again.

Since alcohol, like drugs, often involves a combination of factors that lead to misuse and addiction, these factors are often considered first before a course of treatment is prescribed. It is often more effective in helping in alcohol treatment

An addictive drug is one that causes uncontrollable and compulsive drug craving, seeking and the use of the drug, even if one is aware of negative effects and social implications. A person starts getting physically dependent on such drugs or alcohol, requiring it to pursue even day-to-day activities.

In absence of availability of the alcohol or drugs, a person feels lost and irritated. The lack starts affecting the normal behavior and such a person just cannot function till he/she is able to take a shot of that particular drug. A person might also turn to crime to lay hands on the banned substance. The figures revealed via extensive research on the cases brought to the various drug and alcohol rehabs or treatment centers give a clear indication how deep the abuse has seeped into society.

An addiction usually starts from a single try, after which, the repeated use ultimately results in being addicted to the substance. An addict requires lot of strength and courage to accept that he/she is addicted. This is usually the first step towards de-addiction. However, addicts require lot of help and support, as well as love and acceptance to kick off the habit.

Treatment centers:

Approaching the drug and alcohol rehabs or treatment centers is the best way to get rid of addiction. There are various Rehabilitation Centers across the globe, which help addicts to give up the craving. An addict might choose the drug and alcohol rehabs or treatment centers either by self-will or forcefully, by the way of family or peer pressure or a court ruling.

The drug and alcohol rehabs or treatment centers help to bring about a change from the negative behavior and addiction, to a normal healthy lifestyle. Going through the procedures within the drug and alcohol rehabs or treatment centers involves a very emotional decision for the addict, as well as the family members and friends. Withdrawals:

A rehab program will require great determination and constraint from the addict to come out of the addiction and stay drug or alcohol free. In many cases, after successfully coming out of addiction, a person succumbs again, after initial restraint ranging from few weeks to a couple of months. This is usually because addictive drugs remain as stresses in the fats of the body and they are released in small quantities into the blood stream if a person goes through stress or anxiety.

In the face of these “small kicks”, the body craves for more drugs or alcohol leading a person back into addiction. Every person that walks into a rehab center is a different individual, with different physical and psychological factors leading the condition and different reasons to use drugs or alcohol. Different people will have different addictions and hence, they cannot be treated in a same manner. It is the responsibility of the drug and alcohol rehabs or treatment centers to provide all possible support and motivation to an addict as well as provide all help and treatment, to lead a normal and healthy life.

Alcohol rehabilitation begins with you and the choices you make about how you want to live your life. Since denial that you have an alcohol problem is such a powerful factor in substance abuse and dependence, you place yourself upon the road of recovery the moment you admit that you have a drinking problem. Once you've decided that alcohol needs to be eliminated from your life for the sake of your health, your family and your job, your alcohol rehabilitation has begun.

What now? First, keep in mind that if someone tells you that, “my way is the only way to recover from alcohol addiction,” be very suspicious. In alcohol rehabilitation, there is no right way, and no wrong way to recover; there is only your way. An anonymous alcoholic and drug counselor once said, “I don’t care if you want to go out and bark at the moon if it keeps you sober.” Alcohol rehabilitation is a very personal thing; it is not at all helpful for addiction therapists and support groups to have a “cookie cutter” approach to recovery. Such a practice would involve a disregard for your personal characteristics, your values and beliefs, and what sort of help you need. Instead, alcohol rehabilitation must be personalized to your needs.

When you make the choice for abstinence, here are some things for you to consider about the type of alcohol rehabilitation that would work best for you:

a) Are you comfortable in a group setting where you and other addicts can help and support each other with the aid of a professional addiction counselor who is also in recovery?

b) How do you handle trust issues? Are you willing to speak openly and truthfully about things you have done or said when you were drinking/using?

c) How severe is your addiction to alcohol? Do you have uncomfortable withdrawal symptoms when you aren’t drinking/using? As part of your alcohol rehabilitation, do you need medical detoxification services?

d) Does your family and/or peer group use alcohol and other drugs to excess? To recover, do you need to get away from others who are still drinking/using?

e) Will your family and friends support your decision to stop drinking/using?

f) Are you experiencing serious legal consequences for your drinking/using?

g) Are spiritual and religious beliefs and values important to you?

h) Deep in your heart, do you believe that alcohol rehabilitation can help you get sober and stay sober?

It’s rare to find an alcoholic who is not also addicted to at least one other drug of abuse. It is common to find an alcoholic who also has mental health issues like depression. This is yet another way that alcohol rehabilitation can help you; by addressing all your needs, your chances of recovery increase dramatically.

With the right sort of alcohol rehabilitation that works for you, you can begin today to make smart choices about how to recover from this dark period in your life.

Drug Addiction

Drug addiction is a state of being that is characterised by the compulsive intake and intoxication of a drug. It is the compulsion to consume the drug, regardless of the negative consequences. It can be either a physical or psychological addiction or even a combination of both of these.

It is more appropriate to say that it is a behavioural problem where the use of a mind altering substance dominates the person's motivation and where it appears that normal controls no longer work. Addiction is actually a complicated brain disorder but it can be treated.

This is one of the most common illnesses in the Western world with an estimated nine million Americans needing treatment for an addiction. This makes the condition more prevalent than heart disease. There are also thousands of drug-related deaths every year and around a quarter of AIDS cases are from injecting drugs.

Not every drug affects every user in the same way. It is believed that some people are more predisposed to addiction than others. This may be psychological or genetic in nature. Also, some drugs require more exposure than others before addiction sets in.

Often, substance abuse is confused with addiction. However, substance abuse which is any use of a harmful substance can occur with or without addiction. These drugs affect the neurological impulses affecting motivation and reward. They also inhibit further learning, therefore meaning that further use ceases to make learning important to the user.

It has long been known that Glutamate, Dopamine, and Serotonin, chemicals in the brain, are associated with drug addiction and the compulsive behaviours related to cocaine and amphetamine use.

There are two components to drug addiction and these are physical dependency and psychological dependency. With physical dependency, the person has used the drug so often that it is now habit and he or she must continue to use the drug in order to feel that they are able to function normally. To stop using the drug would bring on severe and highly unpleasant withdrawal symptoms.

Psychological dependency, on the other hand, happens when the drug has been used regularly to obtain pleasure or alleviate pain and the person has become emotionally dependent on the effect. As with physical dependency, to stop the drug makes the person feel incapable of normal functioning and produces intense cravings. It is common for addicts to have both physical and psychological dependency.

There are treatments available to help the addict. These can include cognitive therapy, psychotherapy, counselling, medications and combinations of any of these. The success of treatment is just as effective as it is for other chronic disorders such as asthma and high blood pressure and the treatment is cost effective.

It has also been noted that there is a marked reduction in drug related crime among those under treatment. Additionally, those on Methadone treatment are less likely to contract AIDS than those not in treatment.

Recovery from addiction varies depending on the drugs involved and the amount used, how long the person has been addicted, and social networks. It is just as important that the significant people in the person's life, such as family and close friends, receive treatment. The traumatic nature of supporting a drug addict, either physically or emotionally, is brutal on those who love him or her.

Drug addiction, like any other chronic disorder, needs treatment and understanding. This is a condition that destroys lives as well as families and costs millions to combat. However, if this epidemic can be curbed, then it is worth every dollar spent.

Ecstasy Addiction and Treatment

Ecstasy: Too Often a Fatal Trip

Ecstasy--an illegal drug often referred to as this decade’s version of LSD—is, according to some of its users "the hottest drug going now." It’s also one of the deadliest. While Ecstasy is most often associated with large open-to-the-public teen dance parties--or "raves"--federal officials say the drug also known as MDMA (and most commonly called "X" on the street) is so readily available that teens can easily buy it on the street or even on their school’s campus.

A recent survey of teens conducted by the National Center on Addiction and Substance Abuse found that one in four questioned said they had a friend or class mate whom they knew had used Ecstasy, and 17% said they knew more than one user.

Some of the slang terms for Ecstasy include:

• B-bombs
  
• Disco biscuit
  
• Essence
  
• Go
  
• Hug Drug
  
• Love drug
  
• Scooby snacks
• Sweeties
  
• Wheels
  
• "X"
  

Adding to the already existing dangerous potential of Ecstasy is the fact that, increasingly, other drugs altogether are being passed off as Ecstasy and that Ecstasy pills are sold heavily laced with other dangerous drugs such as PCP.

"When somebody tells me they’ve taken Ecstasy these days, I have no idea what they’ve taken," says Dr. Grob, director of child and adolescent psychiatry at the Harbor-UCLA Medical Center in Torrance, California. Grob, who conducted the first Food and Drug Administration-approved study of MDMA’s effects in the mid-90’s, says the growing furor surrounding the illegal use and abuse of the drug has overshadowed its potential as a legitimate, professionally monitored psychiatric treatment for such ailments as posttraumatic stress disorder.

Some of the Facts About Ecstasy

• When most people refer to Ecstasy they are usually referring to 3,4- methylenedioxymethamphetamine, or MDMA. Patented in Germany before World War I, MDMA was not tested on humans until the 70’s. Chemically, it’s structurally similar to both amphetamine and mescaline, a hallucinogen.
  
• In 1985, the Drug Enforcement Administration ordered that MDMA be classified as an illegal drug. However, that did little to stop its spread on the black market. By the mid-90’s, Ecstasy had become a popular "club drug" in Europe, the U.S., and other parts of the world.
  
• A dangerous trend has become pervasive and often proves fatal: In attempts to prolong the effects of the drug and enhance the "I love everyone" feelings, "stacking"--using multiple doses in one night--or combining Ecstasy with alcohol or other drugs is becoming increasingly widespread.
  
• Medical experts are also alarmed by commonly used impure forms of Ecstasy (laced with other drugs), as well as look-alike pills. Other critical concerns include the drug’s capacity to accelerate dehydration and overheating, which, especially at crowded dance clubs, has been the cause of death in some cases.
  
• If you or someone you care about is using Ecstasy, consider getting immediate and confidentialhelp from your doctor or local therapist. As tempting as this drug might be, there are lots of other healthier ways to feel euphorically "high on life"--ways that don’t risk killing you.

Methamphetamine Addiction and Treatment

Methamphetamine Facts

Methamphetamine is a powerfully addictive stimulant that dramatically affects the central nervous system. The drug is made easily in clandestine laboratories with relatively inexpensive over-the-counter ingredients. These factors combine to make meth a drug with high potential for widespread abuse.

What is Methamphetamine?

Methamphetamine is commonly known as "speed," "meth," and "chalk." In its smoked form, it is often referred to as "ice," "crystal," "crank," and "glass." It is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. The drug was developed early in this century from its parent drug, amphetamine, and was used originally in nasal decongestants and bronchial inhalers.

Methamphetamine's chemical structure is similar to that of amphetamine, but it has more pronounced effects on the central nervous system. Like amphetamine, it causes increased activity, decreased appetite, and a general sense of well-being. The effects of methamphetamine can last 6 to 8 hours. After the initial "rush," there is typically a state of high agitation that in some individuals can lead to violent behavior.

How Is Methamphetamine Used?

Methamphetamine comes in many forms and can be smoked, snorted, orally ingested, or injected. The drug alters moods in different ways, depending on how it is taken.

Immediately after smoking the drug or injecting it intravenously, the user experiences an intense rush or "flash" that lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria - a high but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes.

As with similar stimulants, methamphetamine most often is used in a "binge and crash" pattern. Because tolerance for methamphetamine occurs within minutes - meaning that the pleasurable effects disappear even before the drug concentration in the blood falls significantly - users try to maintain the high by binging on the drug.

In the 1980's, "ice," a smokable form of methamphetamine, came into use. Ice is a large, usually clear crystal of high purity that is smoked in a glass pipe like crack cocaine. The smoke is odorless, leaves a residue that can be resmoked, and produces effects that may continue for 12 hours or more.

What Are the Effects of Methamphetamine Use?

Short-Term Effects

• Increased attention and decreased fatigue
• Increased activity
• Decreased appetite
• Euphoria and rush
• Increased respiration
• Hyperthermia

Long-Term Effects

• Dependence and Addiction Psychosis
• Paranoia
• Hallucinations
• Mood Disturbances
• Repetitive Motor Activity
• Stroke
• Weight Loss

Methamphetamine can cause a variety of cardiovascular problems. These include rapid heart rate, irregular heartbeat, increased blood pressure, and irreversible, stroke-producing damage to small blood vessels in the brain. Hyperthermia (elevated body temperature) and convulsions occur with methamphetamine overdoses, and if not treated immediately, can result in death.

Chronic methamphetamine abuse can result in inflammation of the heart lining, and among users who inject the drug, damaged blood vessels and skin abscesses. Methamphetamine abusers also can have episodes of violent behavior, paranoia, anxiety, confusion, and insomnia. Heavy users also show progressive social and occupational deterioration. Psychotic symptoms can sometimes persist for months or years after use has ceased.

Acute lead poisoning is another potential risk for methamphetamine abusers. A common method of illegal methamphetamine production uses lead acetate as a reagent. Production errors therefore may result in methamphetamine contaminated with lead. There have been documented cases of acute lead poisoning in intravenous methamphetamine abusers.

Fetal exposure to methamphetamine also is a significant problem in the United States. At present, research indicates that methamphetamine abuse during pregnancy may result in prenatal complications, increased rates of premature delivery, and altered neonatal behavioral patterns, such as abnormal reflexes and extreme irritability. Methamphetamine abuse during pregnancy may be linked also to congenital deformities.

How Is Methamphetamine Different From Other Stimulants, Such as Cocaine?

Methamphetamine is classified as a psychostimulant, as are other drugs of abuse such as amphetamine and cocaine. We know that methamphetamine is structurally similar to amphetamine and the neurotransmitter dopamine, but it is quite different from cocaine. Although these stimulants have similar behavioral and physiological effects, there are some major differences in the basic mechanisms of how they work at the level of the nerve cell. However, the bottom line is that methamphetamine, like cocaine, results in an accumulation of the neurotransmitter dopamine, and this excessive dopamine concentration appears to produce the stimulation and feelings of euphoria experienced by the user.

In contrast to cocaine, which is quickly removed and almost completely metabolized in the body, methamphetamine has a much longer duration of action and a larger percentage of the drug remains unchanged in the body. This results in methamphetamine being present in the brain longer, which ultimately leads to prolonged stimulant effects.

Prescription Drugs Addiction and Treatment

Prescription drugs are rapidly becoming primary drugs of abuse in the United States and throughout the world. There are many commonly held misconceptions of the abuse potential for powerful substances such as Oxycontin ®, because such substances can be obtained legally, and have legitimate use in the medical profession.

Although many prescription drugs can be abused or misused, there are three classes of prescription drugs that are most commonly abused:

• Opioids, which are most often prescribed to treat pain
  
• CNS depressants, which are used to treat anxiety and sleep disorders
  
• Stimulants, which are prescribed to treat the narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity
  

Preventing and detecting prescription drug abuse

Although most patients use medications as directed, abuse of and addiction to prescription drugs are public health problems for many Americans. However, addiction rarely occurs among those who use pain relievers, CNS depressants, or stimulants as prescribed; the risk for addiction exists when these medications are used in ways other than as prescribed. Health care providers such as primary care physicians, nurse practitioners, and pharmacists as well as patients can all play a role in preventing and detecting prescription drug abuse.

Health Care Providers

About 70 percent of Americans - approximately 191 million people - visit a health care provider, such as a primary care physician, at least once every 2 years. Thus, health care providers are in a unique position not only to prescribe needed medications appropriately, but also to identify prescription drug abuse when it exists and help the patient recognize the problem, set goals for recovery, and seek appropriate treatment when necessary. Screening for any type of substance abuse can be incorporated into routine history taking with questions about what prescriptions and over-the-counter medicines the patient is taking and why. Screening also can be performed if a patient presents with specific symptoms associated with problem use of a substance.

Over time, providers should note any rapid increases in the amount of a medication needed - which may indicate the development of tolerance - or frequent requests for refills before the quantity prescribed should have been used. They should also be alert to the fact that those addicted to prescription medications may engage in "doctor shopping," moving from provider to provider in an effort to get multiple prescriptions for the drug they abuse.

Preventing or stopping prescription drug abuse is an important part of patient care. However, health care providers should not avoid prescribing or administering strong CNS depressants and painkillers, if they are needed. (See box on pain and opiophobia.)

Pharmacists

Pharmacists can play a key role in preventing prescription drug misuse and abuse by providing clear information and advice about how to take a medication appropriately, about the effects the medication may have, and about any possible drug interactions. Pharmacists can help prevent prescription fraud or diversion by looking for false or altered prescription forms. Many pharmacies have developed "hotlines" to alert other pharmacies in the region when a fraud is detected.

Patients

There are several ways that patients can prevent prescription drug abuse. When visiting the doctor, provide a complete medical history and a description of the reason for the visit to ensure that the doctor understands the complaint and can prescribe appropriate medication. If a doctor prescribes a pain medication, stimulant, or CNS depressant, follow the directions for use carefully and learn about the effects that the drug could have, especially during the first few days during which the body is adapting to the medication. Also be aware of potential interactions with other drugs by reading all information provided by the pharmacist. Do not increase or decrease doses or abruptly stop taking a prescription without consulting a health care provider first. For example, if you are taking a pain reliever for chronic pain and the medication no longer seems to be effectively controlling the pain, speak with your physician; do not increase the dose on your own. Finally, never use another person's prescription.

Treating prescription drug addiction

Years of research have shown us that addiction to any drug, illicit or prescribed, is a brain disease that can, like other chronic diseases, be effectively treated. But no single type of treatment is appropriate for all individuals addicted to prescription drugs. Treatment must take into account the type of drug used and the needs of the individual. To be successful, treatment may need to incorporate several components, such as counseling in conjunction with a prescribed medication, and multiple courses of treatment may be needed for the patient to make a full recovery.

The two main categories of drug addiction treatment are behavioral and pharmacological. Behavioral treatments teach people how to function without drugs, how to handle cravings, how to avoid drugs and situations that could lead to drug use, how to prevent relapse, and how to handle relapse should it occur. When delivered effectively, behavioral treatments - such as individual counseling, group or family counseling, contingency management, and cognitive-behavioral therapies - also can help patients improve their personal relationships and ability to function at work and in the community.

Some addictions, such as opioid addiction, can also be treated with medications. These pharmacological treatments counter the effects of the drug on the brain and behavior. Medications also can be used to relieve the symptoms of withdrawal, to treat an overdose, or to help overcome drug cravings. Although a behavioral or pharmacological approach alone may be effective for treating drug addiction , research shows that a combination of both, when available, is most effective.

Xanax Addiction and Treatment

Xanax is a benzodiazepine which causes relaxation. It is categorized as a CNS depressant. CNS depressants slow normal brain function. In higher doses, some CNS depressants can become general anesthetics. Tranquilizers and sedatives are examples of CNS depressants. CNS depressants can be divided into two groups, based on their chemistry and pharmacology:
Benzodiazepines, such as alprazolam (xanax), which can be prescribed to treat anxiety, acute stress reactions, and panic attacks.

Despite their many beneficial effects, benzodiazepines have the potential for abuse and should be used only as prescribed. During the first few days of taking a Xanax, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug, these feelings begin to disappear. If one uses these drugs long term, the body will develop tolerance for the drugs, and larger doses will be needed to achieve the same initial effects. In addition, continued use can lead to addiction and—when use is reduced or stopped—withdrawal. Because all CNS depressants work by slowing the brain's activity, when an individual stops taking them, the brain's activity can rebound and race out of control, possibly leading to seizures and other harmful consequences. Although withdrawal from Xanax can be problematic, it is rarely life threatening, whereas withdrawal from prolonged use of other CNS depressants can have life-threatening complications. Therefore, someone who is thinking about discontinuing Xanax therapy or who is suffering withdrawal from a CNS depressant should speak with a physician or seek medical treatment.

In addition to medical supervision, counseling in an in-patient or out-patient setting can help people who are overcoming Xanax addiction. For example, cognitive-behavioral therapy has been used successfully to help individuals in treatment for abuse of Xanax. This type of therapy focuses on modifying a patient’s thinking, expectations, and behaviors while simultaneously increasing their skills for coping with various life stressors. Often the abuse of CNS depressants occurs in conjunction with the abuse of another substance or drug, such as alcohol or cocaine. In these cases of poly drug abuse, the treatment approach should address the multiple addictions.

Patients addicted to Xanax should not attempt to stop taking them on their own, as withdrawal from these drugs can be problematic, and in the case of Xanax addiction, potentially life-threatening. Although no extensive body of research regarding the treatment of Xanax addiction exists, patients addicted to Xanax should undergo medically supervised detoxification because the dose must be gradually tapered off. Inpatient or outpatient counseling can help the individual during this process. Cognitive-behavioral therapy also has been used successfully to help individuals adapt to the removal from benzodiazepines.
Often the abuse of Xanax occurs in conjunction with the abuse of another substance or drug, such as alcohol or cocaine. In these cases of polydrug abuse, the treatment approach must address the multiple addictions.

Oxycontin Addiction, Abuse and Treatment

General Principles

OxyContin is an opioid agonist first introduced in 1995. It is a Schedule 11 controlled drug used in the treatment of severe pain disorders. OxyContin is a long acting formulation of oxycodone, the medication's active ingredient. Today, various formulations of oxycontin are available.

The drug is a powerful pain killer and widely used in clinical medicine. However, because of its mood altering effects, Oxycontin, like morphine, can be abused and unlawful possession may be subject to criminal prosecution. Over the past decade, OxyContin has become a popular drug and its mood altering effects has led to a significant increase in illicit usage.
Introduction

Besides pain, oxycontin can decrease anxiety, cause euphoria, mental relaxation, respiratory depression, constipation, meiosis (papillary constriction) and suppression of cough. Like all opioid analgesics, with increasing doses there is increasing pain relief. With oxycontin, like morphine, there is no definite maximum dose; the upper limit of pain control is controlled by side effects- the most dangerous of which is respiratory depression. The precise mechanism of oxycontin is unknown. However, it may interact with opioid receptors located in the brain and spinal cord.

Therapeutic uses

OxyContin can be used to treat moderate to severe pain associated with trauma, injuries, muscle pain, dislocations, fractures, neuralgia, arthritis, lower back pain, and pain associated with cancer. Because of the potency of oxycontin and potentially serious side effects, the drug has to be monitored. Treatment should be continuously assessed and adjusted based upon the patient's own reports of pain and side effects and the physician’s clinical judgment.

Since the drug is a controlled substance, a prescription is required to obtain it. Today, it is the most frequently prescribed opioid pain killer in North America.

Dose

OxyContin tablets are available as a controlled-release oral formulation of oxycodone hydrochloride and indicated for the management of moderate to severe pain when a continuous, daily analgesia is needed for a long period of time. The drug is always administered orally. The controlled-release product has a long duration of action (8-12 hours). It is recommended that OxyContin not be used for sporadic pain relief.

OxyContin tablets should be swallowed whole. It is recommended that the tablets not be broken, chewed or crushed, otherwise a rapid release of the drug can occur and lead to severe side effects.

The drug should always be started at the lowest dose in patients who have never been on opioids before, or in those patients who are receiving concurrent treatment with muscle relaxants, sedatives, or other CNS depressants. Concomitant analgesia can be provided with non steroidal anti inflammatory drugs to minimize side effects. Patients should not receive any other type of opioid drugs while on Oxycontin

Oxycontin Abuse and Withdrawal

Since the introduction of OxyContin in 1995, there has been a dramatic increase in abuse of this narcotic. Unlike hydrocodone and its derivatives, whose potential for abuse is limited by the presence of aspirin/paracetamol, OxyContin contains only oxycodone. The drug is easily abused by simply crushing the tablets and either ingestion, injection, inhalation or placed rectally. The drug can have serious side effects when injected as it has a prolonged extended action.

Oxycontin is frequently made more available by "doctor shopping," where individuals, who do not have a legitimate illness, repeatedly visit many doctors to acquire large amounts of controlled substances. Other methods of obtaining oxycontin include pharmacy diversion, robbery, fake/stolen prescription, the internet and improper prescribing practices by physicians.

Recent reports indicate that non medical use of Oxycontin is relatively high among teenagers. The increased misuse of the drug has led to a numerous emergency admissions and even deaths. Many States have introduced legislation to decrease the illegal use of Oxycontin. Numerous States have also introduced prescription monitoring and banned the sale of the drug over the internet. Despite all the increased efforts by the FDA, DEA, and state/local authorities, the illicit use of Oxycontin is at an all time high. Over the last decade the increased illicit use of oxycontin has led to the manufacture of “fake” oxycontin pills all over north America.

Sudden stoppage of oxycontin can result in serious withdrawal symptoms. The withdrawal syndrome may be characterized by restlessness, lacrimation, restlessness, anxiety, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, include irritability, vague pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

Both physicians and pharmacies now maintain careful record-keeping of prescribing information, including quantity, frequency, and renewal requests. Adequate evaluation of the patient, proper prescribing practices, frequent assessment of pain, proper dispensing and storage are recommended steps that may help limit the abuse of OxyContin.

Side effects

Respiratory depression is a major severe complication of oxycontin. Respiratory depression is a cause of concern in elderly or debilitated patients, and usually follows after the use of large initial doses in non tolerant patients, or when other opioids are given concurrently. In the community, the majority of OxyContin-related deaths have occurred in individuals who were ingesting large quantities of oxycontin in combination with either alcholol or benzodiazepines.

Oxycontin should be used with extreme caution in patients with significant lung disorders such as chronic obstructive pulmonary disease, heart failure or pre-existing respiratory depression. In such patients, even usual therapeutic dose of oxycontin may suppress the respiratory drive to the point of arrest.

OxyContin may cause severe hypotension. There is an added risk to individuals whose ability to maintain blood pressure has been compromised by a depleted blood volume, or after concurrent administration with drugs such as phenothiazines or other agents which compromise vasomotor tone. Oxycontin, should be administered with caution to patients in circulatory shock, since vasodilatation produced by the drug may further reduce cardiac output and blood pressure.

Like other opioid narcotics, oxycontin can be fatal at high doses or when combined with other brain depressants such as alcohol.
Precautions

Oxycontin, like all opioid analgesics, has a narrow therapeutic index in certain patient populations, especially in those taking other CNS depressant drugs. Its use should be reserved for cases where the benefits of opioid analgesia outweigh the known risks of respiratory depression, altered mental state, and postural hypotension. The administration of oxycontin may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycontin may aggravate convulsions in patients with seizure disorders.

Contraindications

OxyContin is not indicated for use for intermittent or mild pain after surgery. It is not to be used in cases where the pain is not expected to last a prolonged period of time.

DRUG INTERACTIONS

Use with CNS Depressants
OxyContin, like all opioid analgesics, should be used with caution in patients who are concurrently taking other CNS drugs like sedatives, anti depressants, tranquilizers or alcohol. Combination of oxycontin with these drugs can lead to respiratory depression, hypotension, and profound sedation or coma and even death. It is recommended that the smallest dose of oxycontin be used if required in these patients.

Pregnancy
The drug should not be taken by pregnant females and nursing mothers. Neonates whose mothers have been taking oxycontin chronically may exhibit respiratory depression and/or withdrawal symptoms, either at birth and/or in the nursery. Breast feeding should not be undertaken while a patient is receiving OxyContin because of the possibility of sedation and/or respiratory depression in the infant.


Pediatric and Elderly Patients
The safety and effectiveness of OxyContin has not been established in pediatric patients below the age of 18. As with all opioids, the starting dose should be reduced to 1/3 to 1/2 of the usual dosage in debilitated, non-tolerant patients. Respiratory depression is the chief hazard in elderly or debilitated patients.

Summary
It is highly recommended that patients receiving OxyContin tablets or their caregivers should be informed about the following:

1. Oxycontin is a strong pain killer and similar to morphine.
2. Oxycontin should be ingested whole and not broken, chewed, or crushed- which can result in a risk of fatal overdose.
3. if pain persists despite oxycontin, patients should see their physicians to optimize therapy.
4. the dose of oxycontin should not be changed unless recommended by the physician.
5. Concerns about abuse and addiction should not deter proper pain management. The development of addiction to opioid analgesics in properly managed patients with pain is rare.