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Shopping list for detox

Oct 17, 2008 - 2 comments

Substance Abuse in any form substantially depletes your body of nutrients. In order to be effective during WDs most people state they needed to increase doseage levels beyond the recommend dose level; some substantially. Levels are for intensity of Detox WDs; post-detox WDs would be less. Use your own judgment about your needs and what you feel is best for you and what you are comfortable with and customize your own detox list to your preferences/needs. These things may help lessen WDs; others have reported good success.

What Symptoms To Expect
Vicodin has a half-life of 4-8 hours; therefore, WDs will begin for most between 8-16 hours after last dose taken. Most people express that detox feels like a case of the flu. You will likely experience achy joints, weakness, restless legs syndrome if you were a havy user over 100 mg a day (this is less likley to occur in those who exercise daily or who are active), headaches, lack of clarity in thought, irritability-does not play well with others, severe “coffee jitters” to the extent that it is difficult to sit still and with heavy use, some experience involuntary muscle twitches, general feeling of “the all overs”, nausea but most do not report vomiting, and most report diarrhea. WDs will increasingly worsen up to about days 3-4 and then begin to turn the corner and stabilize.

It is best to plan your detox needs and shop in advance of starting. When you externally provide the body with chemicals that alter the brain, the body reads the signal and reacts by stopping its own natural production levels. So, when you cold turkey stop the external source, it jolts your body and whiplashes your system into wakeup mode. All those little workers have been snoozing for however long you have been administering the external supply source. Now the alarm bells are ringing all throughout your system, and they are running around like keystone cops screaming “oh s**t!!!!” They will get back on the job for you again, but it takes a while for them to get synchronized and functioning efficiently again.

1-2 weeks Ahead of Planned Detox
If possible, plan your detox 1-2 weeks ahead and commence with the Multi-Vitamin, Multi-Mineral, B-Complex 100mg, Zinc (pain-take only after eating food), & St. John's Wort (depression; but do NOT take if you are taking SSRIs) to build a solid base level BEFORE you start the detox. Many who have not built a solid base in advance have reported a more difficult time during detox. It took them a minimum of 1 week to achieve maximum relief level when days 1-4 are likely to be your worst WD days during detox. You may not feel depression now, but detox WDs usually results in the onset of depression until your body acclimates and can regulate itself. Building a nutriment base BEFORE detox will help lessen WDs and lessen the level of additional supplements you will need to help you cope. Waiting til you are actually in WDs to start taking supplements will mean that the supplements will be less effective and you will likely need substantially increased levels. Start a n exercise routine that you can live with to release stoved up endorphins that are dying to work again...MOVE!

About Work
You should plan to take time off work to detox, usually a long weeeknd for light use and a week for heavier use/using 100 mg as a medium. Options on work are plan to take off or call in sick with the flu, or the hybrid plan is time detox where you take last pill late the night before, go to work jittery and leave work early “with flu”---since you went home sick w/flu no one will be terribly surprised when you aren’t able to make it in most, if not all, of the following week.

During days 1-2 (and possibly day 3)  Exercise of some sort each and every day for 20-30 minutes minimum
Most detoxers say it is best if you can try to sleep as much as you can during the first couple of days at least. Nyquil, Benadryl (not w/Benzodiazepine Detox!), Valerian Root, Melatonin, Sominex, 5HTP (do not exceed 300mg daily) are types of things that may help you to sleep. Select other things from the OTC Options list as needed use other things from the list. Phenergan and Elavil are 2 prescription drugs that help and both are not habit forming. Take a good calcium/magnesium supp at night to help with sleep as well.  Theanine helps with anxiety and REAL green tea as well

Days 3-5
You will likely start to stabilize. When you feel that you are starting to level off begin the L-Tyrosine and phenylalnine.  Both of these can cause anxiety if you are anxiety prone, but as a rule they help energy tremendously for most.

-HOT baths several times a day to help with aches; add Epsom Salts or vingear

-Heating Pad & warm blankets to keep muscles warm and relaxed. Cold temperatures in your house for sleep.

-Hot Rice Socks for muscle warmers. Fill cotton socks w/rice, stretch and leave room on ends to loop and self tie sock end. Heat rice socks in microwave for approximately 2 min. Heat check & apply to achey areas.

-Keep nourished; drink lots of water: Add 1 tablespoon of Apple Cider Vinegar for body PH rebalancing & pain; and if you can, add 1 tablespoon Honey for energy. Dehydation feels alot worse than withdrawals.  Do not dehydrate and is very easy to do considering the runs and decreased intake due to nausea.

-Relaxation Exercise to help lessen muscle cramping ,pain, & restless legs syndrome, EASY exercise regimine to activate your own natural endorphins & dopamine to help w/pain, While in bed work your muscles-tighten the muscles in your entire body all at once as hard as you can---hold it for several seconds(hold breath)---slowly release muscles and breath. Do entire body 5 times and then repeat doing one area at time--both legs then both arms-then low back/abdomen area; repeat cycle/one leg-one arm, etc. compression therapy with tight stockings or ace wraps help RLS as well..Exercise helps RLS more than anything.

SHOPPING LIST OPTIONS TO HAVE ON HAND DURING DETOX
Print out list to shop and to use as a tool to track what you take & its effectiveness.

Soup & Frozen Meals- enough for a few days

Liquid Nutritionally Balanced Meals; e.g., Slim Fast or Ensure

Gatorade (replaces electrolytes)

Benadryl, melatonin, valerian root with a good strong odor, choose what works for you for sleep. Nyquil works for many. Check the tylenol dose.Tylenol PM works but by this point most have had enough tylenol for a life time.

Robitussin DXM-helps WDs; taper ease aide...mucinex with dextramorphan (DXM) helps as well
;
Imodium (4-6 hours after onset; first few hours let body purge toxin concentrates) [detoxers have posted that 4-6 tablets x3 daily substantially helped them not only control diahhreah, but also lessened WDs] Liquid type works faster and better..available at Walmart.

Aspercreme or Biofreeze for Joint Pain

EmergenC from Walmart or wherever to help your immune systema as it is common to pick every bug in the air after detox.  You need your C!

Orange Juice w/Calcium-2 (will help joint pain & helps stabilize central nervous system)

Bananas-2 bunches (potassium source; eat 2-3 daily; will help joint pain &helps stabilize central nervous system)

Green Tea-great antioxidant to help cleanse your system of toxins. Get te real stuff from the oriental market.

Peppermint Tea & Peppermint Candy-Nausea. Walmart also has an anti-nausea medication that is less than 3 dollsrs.  very sweet.

Hershey’s Dark Chocolate Bars-has antioxidant & central nervous system coping properties.  Eat for cravings

Zinc 50 or 60 mg (3xdaily ONLY W/FOOD; will substantially help joint pain) or a multi -vitamin with this equivalent

*L-Tyrosine-Health Food Store-will help joint pain & nerves) One hour before eating start w/2000 mgs; scale up/down based on how you feel up to 4,000 mgs. Take w/B-6 to help w/absorption. It will give you a surge of physical & mental energy that helps counteract malaise feeling. If you experience "coffee jitters" reduce to comfortable level.

*5HTP 100mg 3xdaily-no more than 300 mg daily ...some may take this only at night at 100-200 mg for sleep
D-Phenylalanine (Health Food Store-helps joint pain) Compliments effectiveness of L-Tryosine and 5HTP

B-6 (needed for aborption & effectiveness of L-Tyrosine/D-Phenylalaline)

B-Complex w-B12 Sublingual Liquid Drops (Walmart-Spring Valley Line-key ingredient here is the B-12 which helps central nervous system & energy level. B-12 can only be absorbed by the body through natural dietary sources, injections, or liquid sublingual-under tongue

Calcium and magnesium (helps joint pain & nerves) best at night for sleep

*St. John's Wort will help w/onset of depression which will also affect level of joint pain) also helps fibromyalgia if taken in a combo with 100 mg of 5htp and 800 mg of magnesium 3 x a day

Multi-Vitamin Formula (Costco/Sams/Walmart) -helps joint pain, nerves, and depression)

Multi-Mineral Formula (Costco/Sams/Walmart) -helps joint pain, nerves, and depression)

Hyland's Leg Cramps-Walmart-Homepathic Supplement has Quinine in it which helps w/leg syndrome; sublingual under tongue. RX levels of Quinine available from doctor.

Fish Oil-OMEGA 3-Helps w/legs syndrome &pain /helps inflammation

Kava Kava comes in handy for anxiety and can be found in some shoppes and also online

Always check with your doctor before taking any herbal supplements if you are on antidepressants

Mindless Comedy Movies-mental distraction aids; make sure you get 1 week rentals unless you have someone who can return them for you. Books to read that take you away from the present..a thriller can be a good choice as it gets your adrenalin going and takes your mind away as well

However, NO antihistimines if you are detoxing from Benzodiazepines Some online medical reports suggest that antihistimines (Benadryl, TylenolPM, sleep aids) may increase risk of Benzo withdrawal seizure.

None of these things will totally eliminate WDs; but, may help lessen them.

FIND AN AA OR NA GROUP NEAR YOU!
(818) 773-9999

Wishing you all the luck in the world!  This is your recovery and your goal...make the best of it!

Pain Relief, Tension and releasing Endorphins Without Narcotics

Oct 14, 2008 - 0 comments

Exercise, exercise, exercise! It seems counterintuitive to exercise with pain or fatigue, but I promise it works. A walk (especially if it’s a beautiful day outside) or even a jog, some stretching, or anything that warms up the muscles and uses them will generally loosen them up enough to allow relief. In addition, the endorphins produced by the body during exercise will often clear pain from you body and mind.. Also, if you’re exercising, you’re probably getting away from any major source of the tension, whatever it is. That always helps.
Yoga, my personal passion, is unbeatable for stress relief (in my opinion, of course). It is a combination of exercise and relaxation therapy that soothes the mind, body and spirit. You’re warming and loosening the muscles in a way that almost no other exercise can match, while focusing your mind on breathing and being very present.
An interesting and more unusual tip is to have a selection of photos you find very soothing and relaxing. If you enjoy the beach, a set of pictures of a sunny, sandy paradise might work, or if (like me) you’re a deep-forest kind of gal, some photos of a green, leafy glade could do the trick. Spend a few moments just looking at the photos and visualizing yourself in that place. With practice you will find that just looking at the photos can produce an instant calming effect. It’s all about burning new neural pathways and making your brain associate the pictures with the relaxation. Practice this when you have time on your hands – looking at the photos in conjunction with deep breathing, dim lights, and some soothing music. Then when you are very tense, you’ve got the response already ingrained.

There are of course things you want to avoid (if you can!) when suffering from tension and/or pain. Some are obvious – loud noise, uncomfortable situations, and the company of anyone who makes you more tense. Some are not so obvious: caffeine, for instance, while it may seem to help fatigue, can actually increase tension and raise blood pressure. Brightly lit areas or very vivid warm colors like red or orange will exacerbate your attention. So, you know, avoid Target and Home Depot. J Blues and greens are very soothing and lower light levels will also help lower blood pressure and heart rate, and alleviate tension and/or pain. (Which should mean Wal-Mart is a good place to go when you have tension, but believe me, that is not the case. So. Not. The. Case.)


My personal method of dealing with tension and pain? First I stretch my arms and shoulders. Then I close my office door, turn off the lights, and close my eyes. I take about ten minutes to just focus on my breathing, even if I don’t do a full meditation, and let the thoughts that have been bothering me exit my head the same way they entered, just focusing on my breathing. Then I do a short self-massage. When I feel I’ve relaxed as much as I can, I get up and go get a glass of water, which I drink pretty much nonstop. And then I repeat to myself, “je ne regrette rien” – in French, loosely translated, “I regret nothing”. This is to remind myself that at the end of my life, I will have no regrets, because I will have lived every moment for the joy and beauty it has and wasted no time or energy on the things that don’t really matter. Because of its personal meaning for me, this is a sort of mantra that helps me release the tension and focus on the positives. (And no, this doesn’t actually interfere with my productivity, because I lose a lot more than this 15 minutes worth of efficiency when I am in pain.)

Old stand bys like massage...some great massage units out there like the shiatzu by hoedics, but human touch can sometimes mean more than the actual massage, heat for tightness and ice for pain and swelling, the jacuzzi...ahhhhhhhhh..even hot baths with candles and music.  Sometimes if there is a stressor in your life that can be eliminated as not all stressors can be, it can be worthwhile to cut it loose.

In the end, your stress and tension are unique to you, and your best method of dealing with them will be, too. I hope that some of the above information might be helpful to you in finding a method that works for you, at least some of the time.



If you do have to take something – and let’s face it, sometimes, you just do – my personal preference for this type of pain is either ibuprofen or naproxen sodium. Or it was, before I decided to be allergic to them. They seem to work better for muscle tension than acetaminophen. At all costs, avoid Excedrin and Goody powders, because it does contain caffeine and while it might help the pain at first, it’s not going to help get rid of the tension.


Of course, before you take ANY medication, check to be sure that you are not allergic to any of the ingredients, that you don’t have a medical condition that makes it inadvisable, and that there are no side effects you can’t live with. It’s always a good idea to talk to your doctor.

Addiction is a Disease and Understanding the Disease is Important to Recovery

Oct 11, 2008 - 2 comments

Addiction Is a Brain Disease

An interview with Dr. Alan Leshner, director of the National Institute of Drug Abuse.

One of America's foremost experts on drug abuse discusses some of the latest knowledge about use, addiction, and treatment. Addictive drugs change the brain in fundamental ways, he says, producing compulsive, uncontrollable drug seeking and use. Leshner was interviewed by Contributing Editor Jerry Stilkind.



Question: Are there particular personality types or socioeconomic conditions that predominate among those who try a drug in the first place?

Leshner: There are different ways to approach this question. One, is to recognize that there are 72 risk factors for drug abuse and addiction that have been identified. They're not equally important. They operate either at the level of the individual, the level of the family or the level of the community. These are, by the way, the same risk factors for everything else bad that can happen -- poverty, racism, weak parenting, peer-group pressure, and getting involved with the wrong bunch of kids, for example. What these risk factors do is increase the probability that people with certain characteristics will, in fact, take drugs.

But you cannot generalize because the majority of people who have a lot of risk factors never do use drugs. In spite of the importance of these risk factors, they are not determinants.

So, what determines whether, say, Harry will use drugs, and whether Harry will become addicted to drugs? They're not the same question. Whether or not Harry will use drugs has to do with his personal situation -- is he under stress, are his peers using drugs, are drugs readily available, what kind of pressure is there to use drugs, and does Harry have a life situation that, in effect, he wants to medicate? That is, does Harry feel that if he changed his mood he would feel better, he would have a happier life? People, at first, take drugs to modify their mood, their perception, or their emotional state. They don't use drugs to counteract racism or poverty. They use drugs to make them feel good. And we, by the way, know a tremendous amount about how drugs make you feel good, why they make you feel good, the brain mechanisms that are involved.

Now, there are individual differences, not only in whether or not someone will take drugs, but in how they will respond to drugs once they take them. A Harvard University study published a few weeks ago demonstrated that there is a genetic component to how much you like marijuana. That's very interesting because the prediction, of course, is that the more you like it the more you would be prone to take it again, and the greater the probability you would become addicted. And so there's a genetic component to your initial response to it -- whether you like it or not -- and also to your vulnerability to becoming addicted once you have begun taking it. We know far more about this for alcohol than we do about other drugs.

Q: Do you mean that the genetic make-up of one person may be such that he gets more of a kick from taking cocaine than another individual? Is that what you mean by vulnerability?

Leshner: There's no question that there are individual differences in the experience of drug-taking -- not everybody becomes addicted equally easily. There's a myth that I was taught when I was a kid, and that was if you take heroin once, you're instantly addicted for the rest of your life. It's not true. Some people get addicted very quickly, and other people become addicted much less quickly. Why is that? Well, it's probably determined by your genes, and by other unknown factors like your environment, social context, and who you are.

Q: Is this true for people around the world -- in the United States, Western Europe, India, Colombia?

Leshner: The fundamental phenomenon of getting addicted is a biological event and, therefore, it's the same everywhere, and the underlying principles that describe the vulnerability, or the propensity to become addicted, are universal.

Q: What is addiction? How is it created in the body?

Leshner: There has long been a discussion about the difference between physical addiction, or physical dependence, and psychological dependence, behavioral forms of addiction. That is a useless and unimportant distinction. First of all, not all drugs that are highly addicting lead to dramatic physical withdrawal symptoms when you stop taking them. Those that do -- alcohol and heroin, for example -- produce a physical dependence, which means that when you stop taking them you have withdrawal symptoms -- gastrointestinal problems, shaking, cramps, difficulty breathing in some people and difficulty with temperature control.

Drugs that don't have those withdrawal symptoms include some of the most addicting substances ever known -- crack cocaine and methamphetamine are the two most dramatic examples. These are phenomenally addicting substances, and when you stop taking them you get depressed, you get sad, you crave the drug, but you don't have dramatic -- what we call "florid" -- withdrawal symptoms.

Second, when you do have those dramatic withdrawal symptoms with alcohol and heroin, we have medicines that pretty well control those symptoms. So, the important issue is not of detoxifying people. What is important is what we call clinical addiction, or the clinical manifestation of addiction, and that is compulsive, uncontrollable drug seeking and use. That's what matters. People have trouble understanding that uncontrollable, compulsive drug seeking -- and the words "compulsive" and "uncontrollable" are very important -- is the result of drugs changing your brain in fundamental ways.

Q: How do drugs change the brain? What is it that makes you feel good and wants you to have more?

Leshner: Let's, again, separate initial drug use from addiction. Although addiction is the result of voluntary drug use, addiction is no longer voluntary behavior, it's uncontrollable behavior. So, drug use and addiction are not a part of a single continuum. One comes from the other, but you really move into a qualitatively different state. Now, we know more about drugs and the brain than we know about anything else and the brain. We have identified the receptors in the brain for every major drug of abuse. We know the natural compounds that normally bind to those receptors in the brain. We know the mechanisms, by and large, by which every major drug of abuse produces its euphoric effects.

Q: Including tobacco, alcohol, marijuana?

Leshner: Tobacco, alcohol, marijuana, cocaine, heroin, barbiturates, inhalants -- every abusable substance. We know a phenomenal amount. What we also know is that each of these drugs has its own receptor system -- its own mechanism of action. But in addition to having idiosyncratic mechanisms of action, each also has common mechanisms of action. That common mechanism of action is to cause the release of dopamine, a substance in the base of the brain, in what is actually a circuit called the mesolimbic reward pathway. That circuit has a neurochemical neurotransmitter, which is dopamine.

We believe that the positive experience of drugs comes through the mesolimbic-dopamine pathway. We know that because if you block activation of that dopamine pathway, animals who had been giving themselves drugs no longer give themselves drugs. In addition to that, about a week ago, Nature Magazine (a British science and medicine journal) published a study showing that the greater the activation of the dopamine system following the administration of cocaine the greater the experience of the high. So we know that this is a critical element, and we know that every addicting substance modifies dopamine levels in that part of the brain. That is to say, alcohol, nicotine, amphetamines, heroin, cocaine, marijuana -- all produce dopamine changes in the nucleus accumbens, in the mesolimbic pathway in the base of the brain.

We also know that in the connection between the ventral tegmentum and the nucleus accumbens -- in the mesolimbic circuit -- that at least cocaine, heroin, and alcohol produce quite similar changes at the biochemical level. That is, not only in terms of how much dopamine is produced but also in the similar effects these substances have long after you stop using the drug. So the point here is that we are close to understanding the common essence of addiction in the brain and we care about this because it tells us how to develop medications for drug addiction. That is the goal -- how to treat drug addiction.

Q: But over time, doesn't the brain of an addict release less and less dopamine? So how does he continue to feel good? How does he get his high if dopamine levels are reduced, rather than increased?

Leshner: Here is another indication of the difference between drug use and addiction. Initially, taking drugs increases dopamine levels, but over time, it actually has the reverse effect. That is, dopamine levels go down. And one of the reasons that we believe that most addicts have trouble experiencing pleasure is that dopamine is important to the experience of pleasure, and when the levels are low you don't feel so good. But once addicted, an individual actually does not take the drug to produce the high.

It is the case in heroin addiction that, initially, they take the drug for the high, but ultimately they take the drug to avoid being sick. The same is true, to some degree, in crack cocaine addiction. That is, we find that people coming off crack cocaine get depressed very badly, and so they are, in effect, medicating themselves, giving themselves crack cocaine to avoid the low. What they're trying to do is pump their dopamine levels up, which doesn't happen, but they keep trying to do it.

Q: Perhaps we should assure people that a certain level of dopamine is normally produced in the brain by pleasurable foods, or activities, and is necessary for human life. Is that correct?

Leshner: Dopamine is a very important substance in many different ways. It is, for example, involved in motor function. In order to maintain motor function, you must have a minimal amount of dopamine. Parkinson's disease is a deficit in dopamine levels, which results in motor problems. Both schizophrenia and depression have dopamine components to them, mostly schizophrenia. In fact, anti-psychotic drugs work on dopamine levels. And so, what you need to be doing is balancing your dopamine, not raising it or lowering it. You're trying to maintain dopamine at a normal level. And again, we think that people who are addicted have trouble experiencing pleasure because their dopamine systems are altered.

Q: If the working of the brain changes during addiction, is this alteration permanent, or can other drugs administered by physicians, or behavioral changes in various programs, bring the brain back to an unaddicted, unaffected state?

Leshner: Drugs of abuse have at least two categories of effects. One is what I will call "brain damage." That is, they literally destroy cells or functions in the brain. For example, if you use inhalants, you literally destroy brain tissue. If you use large doses of methamphetamine, we believe you literally destroy both dopamine and serotonin neurons. In most cases, however, we believe changes in the brain associated with addiction are reversible in one way or another, or they can be compensated for. We know that the brain of an addicted individual is substantially different from the brain of a non-addicted individual, and we have many markers of those differences -- changes in dopamine levels, changes in various structures and in various functions at the biochemical level. We know some of those changes, like the ability to produce dopamine, recover over time. What we don't know is if they recover to fully normal.

Secondly, we know that some medications can compensate, or can reverse some effects. If the change is reversible, your goal is to reverse. If it's not reversible, but you still need to get that person back to normal functioning, you need a mechanism to compensate for the change.

Q: That moves us into the question of prevention and treatment programs. First, what kinds of prevention programs are known to work?

Leshner: One problem in the prevention of drug abuse is that people think in terms of programs, rather than in terms of principles. But the truth is, like anything else that you study scientifically, stock programs that you apply anywhere around the world in exactly the same way do not work. Rather what you want are guiding principles. And we have now supported over 10 years of research into prevention, and have actually been able to derive a series of principles of what works in prevention, and have just issued the first ever science-based guide to drug-abuse prevention. And some of those principles are fairly obvious once you state them, but if you don't say them you don't do them. For example, prevention programs need to be culturally appropriate. Well, people say that all the time, and then they look at a prevention program and they say, "Oh good, I'm going to just take that one and put it in my country." Then they're shocked when it doesn't work. Well, you need to have the cultural context to whatever you do.

Another obvious principle is that programs need to be age appropriate. Everyone knows that youngsters early in adolescence are a different species from those late in adolescence. So, you need to deal with them differently. The messages have to be different. The advertisement industry has done a very good job with that.

In addition, people frequently like "one-shot" prevention programs. Go in, do something, and then the problem's solved. Well, they never work. You need to have sustained efforts with what we call "boosters." You make your first intervention, then you go back and give another intervention, and then another, and finally you successfully inoculate the individual. There are a whole series of principles outlined in a pamphlet we recently published -- "Preventing Drug Use Among Children and Adolescents: A Research Based Guide" -- and a checklist against which you could rate programs.

Q: Is this booklet on your web site?

Leshner: Yes. You can find this prevention booklet by going to -- www.nida.nih.gov -- and looking under publications. You can download the whole thing.

Q: Which have been found more effective in treating addicts -- behavioral or medical programs? Or do they need to complement each other?

Leshner: I believe that addiction is a brain disease, but a special kind of brain disease -- a brain disease that has behavioral and social aspects. Therefore, the best treatments are going to deal with the biological, the behavioral, and the social-context aspects. Now that's difficult for people to understand, I think, but it's a very important principle. We have studies that show that although behavioral treatment can be very effective, and biological treatment can be very effective, combining the two makes them more effective. In addition to that, remember that people who are addicted typically have been addicted for many, many years, and, therefore, they have to almost relearn how to live in society. And that's a part of treatment.

Q: Such a comprehensive approach sounds pretty expensive. Is it more expensive than a prevention program?

Leshner: The question boils down to whether you're going to try to compare treating an individual once addicted, which involves doing a cost-benefit analysis of what that individual's habit is costing society, versus a massive prevention program that might cost only three cents per person but which only affects the one or two people who would have used the drug in the first place. So, it's not a comparison that you can actually make. However, I can tell you that even the most expensive treatments -- inpatient, therapeutic communities that cost, depending on the particular kind of program, between $13,000 and $20,000 a year per person, are a lot less than imprisoning people. Incarceration costs $40,000 a year per person. So the cost-benefit ratio always is in favor of the treatment approach.

Q: How many drug addicts are there in the United States and around the world?

Leshner: We believe that there are about 3.6 million individuals in the United States who are addicted to heroin, crack cocaine, amphetamine,marijuana -- the illegal drugs. So, at least that many are in need of treatment. Then heavy users add to that number. It's impossible to know exactly the total number who are in need of treatment, but it's probably between four and six million people. I don't know what the comparable figures are internationally.

__________

Jerry Stilkind writes on drugs, environment and other subjects for the United States Information Agency.


Global Issues
USIA Electronic Journal, Vol. 2, No. 3, June 1997




Advantages/Disadvantages of Suboxone/Subutex in comparison to Methadone

Sep 30, 2008 - 1 comments

Methadone:   Buprenorphine (Suboxone, Subutex):

Advantages:

Allows addict to avoid withdrawal symptoms (at least temporarily)
Allows addicts to obtain medication in a safe, clinical environment as opposed to the streets
Eliminates health risks, such as those associated with IV administration
Dose can be controlled, and gradually reduced
Methadone is usually relatively cheap
Disadvantages:

Methadone is highly addictive
Some claim this is simply trading one addiction for another
Often, social and psychological issues are not addressed
Some people may remain on methadone indefinitely
Withdrawal from methadone lasts longer than withdrawal from heroin or oxycodone
Withdrawal from methadone can be just as intense
Many people have to visit a clinic everyday to get their medicine because of restrictions
  
Advantages:

Allows addict to avoid withdrawal symptoms (at least temporarily)
Allows addicts to obtain medicine in a safe, clinical environment as opposed to the streets
Eliminates health risks, such as those associated with IV administration
Dosage is controlled, and can be easily reduced
Usually only monthly visits are required
High binding affinity to opioid receptors causes a blockade rendering other opioids ineffective
Naloxone (only present in Suboxone) is used to deter people from injecting the drug, and is said to precipitate withdrawal if used in this manner.
There is very little, if any, euphoria associated with this drug
Withdrawal is not as intense
Disadvantages:

Buprenorphine is highly addictive
Some claim this is simply trading addictions
Often, social and psychological issues are not addressed
Withdrawal can last two weeks, though it is not as intense as withdrawal from a full opioid agonist
Buprenorphine therapy is very expensive




III. Miracle Cures for Addiction Do Not Exist

The facts listed above are intended to help guide anyone who is seeking some sort of opioid replacement treatment, whether maintenance or detoxification. It's extremely easy to look at all the facts, and scare yourself out of attempting to quit; however, this is exactly what our addicted mind wants us to do. We will convince ourselves somehow, someway, that we need to stay on drugs, that we are "better off" on opioids. Whether taking Suboxone or methadone, the body is still dependent on opioids, but it can make all the difference in the world -- if you really, really want it. Neither drug will work wonders by itself. Recovery is a process that requires constant tuning and retuning, reflection, effort, persistence, and knowledge. Coupled with a good drug counselor, support group meetings (whether Narcotics/Alcoholics Anonymous or SMART Recovery), and a positive attitude, methadone or buprenorphine can help pave the road to a drug-free life.



IV. "Don't meth it up, get subport!"

"Don't meth it up, get subport!"

I have heard horror stories from people coming off both these drugs; however, I have never heard a horror story about Suboxone that compares with coming off of heroin or methadone cold turkey. I will admit that I do possess a bias when it comes to which drug I believe is the better candidate for addiction treatment. I used Suboxone to help break old habits, and it definitely prevented a relapse or two! I won't sit here, and list the advantages and disadvantages because they are already listed above, but I will say one thing: don't ever get on methadone! If possible, don't use either drug. Long-acting opioids are very tough to withdrawal from, and if you can stick it out for a week without using any opioids, you will be much better off.

I've heard of a lot of people who start Suboxone, and end up being on it for six months or even two years. That's way too long! An eight week program (or less) should be more than sufficient to reduce withdrawal symptoms to a bearable level. During those eight weeks, the patient should be involved in an intensive outpatient program. An intensive outpatient program usually includes going to support groups three times a week, seeing a psychiatrist (as needed), and talking with a drug counselor. If the root problems, those which (a) led to drug use, were (b) exacerbated drug use, (c) hidden by drug use, and/or (d) caused by drug use, are not acknowledged, and fixed, the patient will find themselves in a neverending cycle of misery and despair.



V. "We all got belly buttons, but yours looks funny!"

Methadone will help some people, and buprenorphine will help others. Every human being has a unique body chemistry, and some may tolerate one drug better than another. Before making any decision, talk to people, and find out what worked for them. I recommend talking to people who are clean, for they obviously did something right. Do research. Read the "Prescribing Information" for each drug. Talk to people in support forums online. Read stories... you get the picture. Before deciding on anything, educate yourself, and remember, without any extra effort/support these drugs will do nothing