Category: Articles

After more than 100 overdose deaths over two months, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has alerted the addiction treatment community about a deadly combination of heroin and fentanyl, USA Today reported June 9.

“There’s starting to be some increased awareness at the higher levels of government,” said Robert Lubran, director of SAMHSA’s division of pharmacologic therapies.

The U.S. Drug Enforcement Administration (DEA) issued a warning last month about the heroin-fentanyl mix, a potent blend that has been traced to scores of overdoses and deaths in cities from Chicago to Philadelphia to St. Louis.

A recent raid on a drug lab in Mexico was touted as dealing a blow to the source of the fentanyl, and some city officials say that the crisis appears to have peaked.

What Is Fentanyl?

Fentanyl, a schedule II prescription narcotic analgesic, is roughly 50 to 80 times more potent than morphine. This medication is used to manage pain during surgery. In clandestine laboratories, fentanyl can be produced in powder form and mixed with or substituted for heroin.

Preventing Overdoses

Persons using heroin or cocaine, or in treatment/recovery from such use, need to know that:

• The potency of street-sold heroin or cocaine is amplified by fentanyl.
• There is no way to tell that heroin or cocaine is “cut” with fentanyl.
• Because the potency of the drug purchased on the street is not known, any use—even a reduced dose—can result in overdose or death.
• The effects of an overdose occur rapidly.

Fentanyl-related overdoses can result in sudden death through respiratory arrest, cardiac arrest, severe respiratory depression, cardiovascular collapse or severe anaphylactic reaction. Furthermore, routine toxicology screens for opiates will not detect fentanyl.

Millions of people have used and continue to use methadone as a treatment medication for opiate addiction. Methadone will sometimes cause side effects. The overwhelming majority of people who are involved in methadone maintenance treatment find the side effects to be mild and bearable, and the hundreds of thousands that continue to use methadone on a daily basis are a testament to how well most people tolerate the medication.

Although methadone has been administered on a wide scale and quite safely for decades within the United States, it remains a polarizing and controversial treatment for opiate addiction – but much that is widely believed about methadone side effects is not true.

Read below to find:

1. A list of the common side effects caused by methadone treatment
2. A list of side effects experienced during the first week of methadone maintenance treatment only
3. A list of methadone myths – side effects falsely attributed to the use of methadone.

The Side Effects of Methadone

Few medications have been studied as intensively or for as long as methadone. When used as directed, methadone does not damage the heart, kidney, lungs, brain, liver or any other major organ or system. It won’t affect your intelligence, it won’t get you high, and it won’t interrupt or impair your ability to work, drive a car, feel pleasure and pain, and generally live a normal life.

Some people tolerate the medication very well and feel no appreciable side effects. Some people experience mild side effects, and a very small percentage of people in methadone maintenance treatment experience intolerable side effects. Although methadone is dangerous if abused, it is quite safe when taken as directed as part of a medically supervised addiction treatment program.

People that experience side effects during methadone maintenance treatment tend to feel them worst during the first weeks and months of treatment. Over time, dosage adjustments and the development of a tolerance to the medication tend to reduce the severity of experienced side effects.

Common side effects of methadone use include the following:

• Constipation
• Drowsiness
• Skin Rash
• Sweating
• Water retention
• Flushing
• Changes in sex drive or erectile dysfunction
• Dizziness (especially in the beginning of treatment and especially as a person in methadone maintenance treatment rises from a lying position)
• Dry mouth

Constipation and Sweating

Constipation and sweating are two of the most commonly experienced side effects of methadone maintenance treatment. Methadone users can reduce the severity of constipation by eating a high-fiber diet, getting regular exercise, and making a concerted effort to avoid dehydration. Those who experience excessive sweating while on methadone seem to sweat heavily regardless of the dose taken, and do not develop a tolerance to the effect.

Sexual Dysfunction

Methadone has been associated with the following types of sexual dysfunction in some men:

• Impotence
• Loss of libido
• Delayed ejaculation

A recent study showed that 40 percent of men over the age of 40 will experience moderate to severe erectile dysfunction (ED) while on methadone. For men under the age of 40, the percentage that experience ED falls to only 12 percent. The use of heroin and the illicit use of prescription opiates are also associated with erectile dysfunction.

Methadone is associated with the loss of menstruation in a very small percentage of women. More women seem to regain regular menstruation than lose it after beginning methadone maintenance treatment.

Sedation (drowsiness)

People tend to experience drowsiness most severely during the first weeks of methadone maintenance treatment, and most people will develop a tolerance to the sedating effects of methadone a few weeks after dose stabilization. Sedation can be a sign of an overly high dosage, and methadone maintenance treatment patients who feel drowsy after the first couple of months may want to discuss a dose reduction.

Itchiness, Hives, and Seizures

Itchiness, hives, and seizures are indications of a dangerous allergic response to methadone. These are not normal side effects, and the presence of any one of these reactions should prompt an immediate call to a doctor.

First Week Side Effects?

Methadone works very well, and an appropriate dosage of methadone will eliminate all feelings of opiate withdrawal, but it takes about a week of methadone maintenance treatment before the medication will provide sufficient 24-hour relief of withdrawal symptoms.

During their first week of treatment, most methadone maintenance treatment patients will experience some mild side effects.

Why Does it Take a Week?

Methadone works in the bloodstream, but it also gets stored in the liver and in certain tissues. The stored methadone gets secreted out into the body very gradually, which creates a very stable level of methadone activation over a 24-hour period, but it takes between five and seven days of methadone use for the body to store a sufficient level of the medication.

Until your body has stored enough methadone to provide for steady methadone activation (called a “methadone steady state”), you will feel some mild symptoms of withdrawal during times during the day when the level of methadone in your body is low.

Mild withdrawal symptoms that you may experience during methadone maintenance treatment include the following:

• Anxiety or depression
• Fatigue
• Insomnia
• Hot flashes
• Muscle pains
• Nausea
• Restlessness
• Cravings for drugs

If these symptoms of withdrawal continue beyond the first seven days of treatment, your methadone dosage may be too low.

Methadone Side Effect Myths

Because methadone maintenance treatment has long been a controversial and polarizing process, a lot of untruths pervade popular beliefs about methadone.

Myth #1 – Methadone Causes Weight Gain

This is a tricky one. A lot of people gain weight while on methadone, but it’s not the methadone that’s causing the weight gain. People on methadone feel normal levels of hunger and experience a normal enjoyment of food — healthy appetites that had previously been suppressed by their abuse of heroin or other opiates. People on methadone often begin methadone maintenance treatment at a low weight and gain weight as they eat with a normal and healthy appetite and enjoyment of food.

Myth #2 – Methadone Rots Your Teeth

Methadone does not, in itself, have any affect on the teeth or bones

Methadone sometimes causes a dry mouth, and since saliva protects the teeth from decay, methadone users may be more vulnerable to dental problems. Additionally, methadone users tend to begin methadone maintenance treatment after a long period of dental neglect.

Methadone users can avoid dental problems by visiting their dentist regularly, avoiding sugary foods and drinks, and brushing and flossing regularly. Also, sugar-free gum increases the amount of saliva in the mouth and can counteract the dryness that is sometimes caused by methadone.

Myth #3 Methadone Rots the Bones

Methadone does nothing to the bones.

People sometimes feel “bone ache” during the first week of methadone maintenance treatment — but what they are actually feeling is some level of opiate withdrawal symptoms, which they are misattributing to the methadone.

Dealing with Side Effects

Most people find the side effects of methadone quite manageable. People who are unable to tolerate certain side effects, but who want to continue with medication management of an opiate addiction, have the option to switch from methadone to Suboxone. Suboxone is also a very well tolerated medication, although people on high doses of methadone will need to taper down to a low daily dose before making the switch to Suboxone.

In the 1950s, the U.S. government’s response to heroin addiction was based on law and order. Treatment services available at the time rarely worked (with an estimated 70 to 90 percent of “treated” heroin addicts returning to drug use), which is not surprising considering that the most common treatment response to heroin addiction was civil confinement, essentially time spent in a prison cell while going through detox.

Over the ensuing decades, three forces led to the creation of methadone maintenance as a new and better way to handle opiate addiction, and America would soon start looking at heroin addiction as a medical problem that demanded treatment, as well as public menace demanding suppression.

The following three social forces/occurrences that changed public perception of heroin addiction treatment:

• Escalating drug use during the 1960s and 1970s.
• Vietnam War soldiers returning home with heroin addictions.
• The discovery of methadone as an effective treatment for opiate addiction.

Changing Times and Vietnam Heroin

The counterculture revolution embraced by the hippies and those around them led to a proliferation of drug experimentation and addiction — so much so that by the 1970s Americans were very concerned about the domestic drug problem. A Gallup poll issued in 1971 revealed that Americans of that era saw drugs and drug addiction as the third most serious threat to the nation.

Headlines from Vietnam stoked public fears. A New York Times front page headline from 1971 screamed “G.I. Heroin Addiction Epidemic in Vietnam,” and media covered the problem in detail and in depth. This coverage of addiction within the military featured fearful imagery such as a photo of a syringe through a helmet.

As a result, many Americans worried about what would happen when American soldiers who were addicted to $5-a-day heroin in Vietnam returned home to a daily habit that would cost $100 or more.

Estimates published in the New York Times during the 1970s put heroin use among American troops in Vietnam at between 10 and 25 percent of military personnel who were stationed in Southeast Asia.

‘Public Enemy Number One’

President Richard Nixon reportedly worried about the influx of addicted soldiers returning to the United States. A congressional report on the overseas heroin addiction problem (from Congressmen Robert Steele and Morgan Murphy) warned of a coming domestic epidemic of crime and addiction.

In a speech in 1971, Nixon called drug addiction “public enemy number one.”

In response to pressures of escalating drug use, the real problem of returning addicted soldiers and the availability of a treatment that seemed to work, President Nixon shifted federal government policy on opiate addiction away from its strictly punitive philosophy. In 1971, Nixon ordered the creation of the first federalprogram for methadone treatment of opiate addiction.

Although Nixon recognized the need for treatment as a solution to the “heroin epidemic,” he retained strong law and order sensibilities. Along with establishing federal heroin addiction treatment programs, Nixon also called for increased enforcement and penalties for drug offenders.

Methadone Treatment

German scientists first synthesized methadone during World War II (when morphine was in short supply) for use as a pain reliever by German troops. After high dosage testing led to adverse drug effects, the German military abandoned the idea of using methadone, thus failing to realize the drug’s full potential.

After the war, the Americans came into control of the medication, which the American pharmaceutical company Eli-Lilly began manufacturing under the brand name Dolophine in 1947.

By the 1950s, American doctors were using methadone for the treatment of opioid dependence, but doctors still poorly understood how best to use this new medication for addiction treatment. In the 1960s, Vincent Dole, M.D., of Rockefeller University, won a New York City Health Research Council Grant to study heroin addiction treatments. It was Dole who eventually developed the modern methadone protocol of a single daily dose.

Dole experimented with a variety of opioids for addiction treatment, giving different medications to heavy heroin users access and observing their reactions. When heroin users took high doses of methadone, Dole noted a startling transformation: Addicts were no longer obsessed with getting and taking drugs.

By 1971, Dole’s methadone treatment program was in use by 25,000 opiate addicts. But by 1973, controversy over the medication program (which critics dismissed as just switching one addiction for another) led to strict government controls over the prescription and use of methadone – controls that exist to this day.

Methadone Today

Today, about a half million people are participating in methadone maintenance treatment programs — but methadone remains controversial in some circles.

Advocates of a harm reduction approach to heroin addiction point to methadone’s impressive track record and to countless improved lives as evidence of its merits. Methadone critics still consider the treatment another form of addiction, and still favor abstinence based treatments for opiate addiction.

No form of addiction treatment has proved to be as effective as methadone maintenance in keeping people in treatment and away from opiate abuse.

A series of opiate clinics in five Danish city councils are scheduled to have already opened and begun providing treatment services (including, in some cases, free heroin) to local addicts.

Unfortunately, one of the clinics, in the town of Odesene, remains shuttered. The problem doesn’t have anything to do with politics or law and order — instead, the challenge has been finding enough affordable and potent heroin to satisfy the needs of the patient population.

The Danish government has provided 70 million Danish kroner (more than $13 million) in funding for the pilot project to provide heroin to addicts in Copenhagen, Odense, Esbjerg, and Glostrup. But The National Board of Health, the agency responsible for sourcing the heroin, is having difficulty finding a pharmaceutical manufacturer that can supply as much heroin as the agency needs at a price it can pay.

The Danish newspaper Fyens Stiftstidende has reported that the government has launched a fact-finding team to travel abroad to find out more about the heroin manufacturing process, in the hopes of finding a way to supply and store the heroin it needs at a lower cost. The Danish government did not reveal which countries the fact-finding team will visit.

A Chicago-area study found that heroin use is at epidemic proportions in the region, with emergency rooms seeing more heroin-related visits by suburban teens, the Chicago Tribune reported March 29.

The eight-month study, conducted by researchers at Roosevelt University in Chicago, found that more people visited Chicago-area emergency rooms for heroin use compared with other metropolitan areas. In 2002, federal statistics showed that the Chicago area had 12,982 heroin-related emergency-room visits, the most in the nation for the fifth consecutive year.

Kathleen Kane-Willis, a researcher at Roosevelt’s Institute for Metropolitan Affairs, said her study found that heroin users in the city are mainly minorities and older, while those in the suburbs are white and younger.

The study also showed that the number of teens from suburban Cook County entering drug-treatment facilities for heroin more than quadrupled between 1995 and 2002. On the other hand, treatment admissions among teens living in the city declined during the same time period.

“Parents need to be educated about this,” said Kane-Willis. “They need to know what the signs of use and addiction are. We need to do more research on the new heroin generation to know where their first use is occurring, where they’re buying, how they support their habits.”

Source: www.jointogether.org

It’s no secret that an addiction to heroin causes a lot of problems.

It can land you in jail – both because of the legal risks of possessing and procuring the drug, and from the things you might need to do just to fund your habit. Heroin addiction can erode relationships with family and friends and leave you unable to work, and it can kill you in a heartbeat at any time.

There is no shortage of solid reasons to quit using heroin, but in addition to the aforementioned consequences of use, chronic heroin use is also associated with a host of serious or fatal medical conditions — and the longer you use heroin, the greater your risks of medical complications from that use.

Here’s the truth: You don’t have to use heroin, and you’ve probably thought on many occasions of trying to quit. Thoughts of withdrawal can be scary, but there are medications (such as methadone or Suboxone) that help you overcome your heroin addiction without the pain of withdrawal.

Medical Conditions Associated with Heroin Use

• HIV – The infection rates for intravenous (IV) heroin users far exceed infection rates in the general population. The sharing of needles or other injection gear or unsafe sex between addicts greatly increases the likelihood of HIV exposure.

• Hepatitis C – There are few places in North America where the Hepatitis C infection rate among IV drug users is less than 50 percent — and in many locations, infection rates climb to as high as 75 percent. Hepatitis C is far more easily contracted than HIV and can lead to fatal conditions such as cirrhosis or liver cancer.

• Pneumonia – Heroin users run an increased risk of pneumonia because of heroin’s depressive effects on respiration, and the generally lower health and diminished immune systems of heroin users.

• Skin Abscesses – Unclean injection procedures can introduce bacteria under the skin. These bacteria can lead to pus- and blood-filled skin abscesses that, if left untreated, can cause gangrene, or even death.

• Endocarditis – Dirty needles can cause blood infections and heart infections. Endocarditis can lead to irregular heartbeat, heart disease and heart failure.

• Cell death in vital organs – The “filler” substances that are often added to street heroin can clog blood vessels. Clogged blood vessels can lead to cell death in vital organs of the body.

• Blood clots – The impurities that constitute most of what heroin users inject into their bodies can lead to blood clots, which can result in stroke or heart attack.

• Collapsed veins – Frequent injections lead to scarring inside the veins, which increases the risk of vein collapse.

Heroin Use Shortens Life

If you continue to use heroin the odds are high that heroin will shorten your lifespan. But you don’t have to keep using heroin. Treatments such as those that incorporate methadone or Suboxone are both affordable and effective, and can help you get back on the path toward a much more satisfying future.

Start taking better care of yourself today ,and look forward to a longer, healthier, and happier life. Any questions you may have about opiate addiction treatments in your area can be answered by treatment specialists at the National Resource Center, who are available for a free, confidential consultation at 888-471-0430.

With a lack of security and weak border patrols, drug trafficking and use is on the rise in Iraq, the Boston Globe reported Aug. 28.

According to senior officials with the United Nations drug-monitoring agency, heroin and marijuana are moving into Iraq through its eastern border with Iran. In addition, gangs are trafficking illegal drugs from Central Asia through Iraq’s Kurdish area in the north and the southern port of Umm Qasr.

Although Iraq is currently being used as a route to get the drugs to Turkey, the Balkans and Western Europe, Brian Taylor, chief of the anti-trafficking section of the United Nations office, said the availability of drugs is causing misuse problems in Iraq.

“If Iraq is increasingly used as a transit country, it’s likely there will be a spillover effect with local use,” Taylor said.

Iraqi doctors report an increase in the misuse of pills and inhalants, many of which are purchased illegally on the street.

According to Dr. Hashim H. Zainy, director of the IBN Rushd Hospital, the nation’s largest psychiatric facility, addiction cases have grown by 75 percent between February and July of this year.

“I still think it’s underreported,” he added.

Charles Heatly, senior spokesman for the Coalition Provisional Authority in Baghdad, said coalition officials are too busy with immediate needs, such as providing water, electricity and security, to focus on drug issues.

“It’s perhaps not at the top of our list of priorities at the moment,” he said.

Source: www.jointogether.org

Two women were recently charged in relation to separate methadone-related cases that resulted in the deaths of an infant in Alabama and an adult woman in Florida.

The Alabama woman, Angela Garcia, 31, is facing life in prison after the overdose death of her 13-month-old son, who ingested methadone that was left unsecured in the family home, The Floridian faces a third degree homicide charge after methadone she sold to another Floridian woman, Terry White, caused White’s overdose death.

Garcia is being held on $100,000 bail after prosecutors alleged that she left the methadone she was using for to manage her opiate addiction lying unsecured in her trailer home. According to a May 14 article by Gary McElroy of the Alabama news website al.com, Garcia’s infant son consumed methadone on more than one occasion prior to the overdose that caused his death late in 2008.

Garcia was charged with exposing a child to chemical endangerment, which carries a maximum sentence of life in prison.

As reported in a May 14 article on TampaBay.com, the Florida case involved Charlene Nadeau, 43, who sold prescribed medications (10 methadone pills and three Xanax pills) to Terry White on April 4. White was found unresponsive in her home the following day, and was pronounced dead at a local hospital upon arrival.

Nadeau was witnessed selling the medication, and was even heard wondering if she might go to jail for selling drugs. She now faces charges including third degree homicide the sale of a controlled substance.

While the keynote speaker at the annual conference of the National Association of Addiction Treatment Providers, Gen. Barry McCaffrey (a former four-star general who served as the nation’s “drug czar” under President Clinton) warned of drug-related dangers facing troops in Afghanistan.

Drug use by U.S. soldiers has doubled in the last four years, Gen. McCaffrey said, and he worries that as more soldiers move from Iraq to opium-laden Afghanistan, the rate of drug problems is going to keep rising.

Gen. McCaffrey said that Afghanistan produced 9,000 metric tons of opium each year, and that unless U.S. destroys a significant amount of that crop, increasing numbers of soldiers will become addicted — and terrorists will continue to profit.

“I’d be astonished if we don’t see soldiers who find 10 kilograms of heroin and pack it up in a birthday cake and send it home to their mother,” Gen. McCaffrey said. “The second thing is (soldiers) are going to stick it up their nose and like it.”

Talking about the state of American addiction treatment, McCaffrey lamented that although 24 million Americans are chronic substance abusers, only four million now get treatment for their problem.

Although he does not support legalizing marijuana or an end to the war on drugs, Gen. McCaffrey said that drug addiction treatment and rehabilitation, even for those in prison, is crucial. “The chamber of commerce will have you have believe is that it’s only poor people abusing drugs,” he said. It’s also anesthesiologists, ICU nurses, [and] healthcare providers.”

When it comes to passing drug tests, Clear Choice Sub Solution has been a popular choice for over a decade. This review on smokefreeclass explores why Sub Solution continues to be a leading option in the market, how it compares to competitors like Quick Fix or Urine Simulation with Powdered Urine Kit, and how to use it effectively. We will also address common questions and provide insights based on user experiences.

Product Description

Clear Choice Sub Solution is a high-quality powdered urine kit developed by Clear Choice, a company renowned for its expertise in drug test solutions. With over 25 years of experience, Clear Choice has created Sub Solution to closely imitate real human urine, ensuring it meets the rigorous standards of modern drug tests.

Ingredients List

Sub Solution’s effectiveness is attributed to its carefully chosen ingredients. Here’s a detailed breakdown:

• Creatinine: A natural component of urine that helps in mimicking the authenticity of the sample. Creatinine levels are often tested to verify sample authenticity. For those seeking a reliable solution, Urine Simulation Kit offers an excellent way to create realistic samples for various testing purposes. These innovative kits provide a convenient and effective method for simulating urine samples with accurate creatinine levels.
• Urea: Essential for replicating the chemical composition of real urine, urea is crucial for passing drug tests.
• Uric Acid: This ingredient enhances the sample’s realism by adding to the authenticity of the synthetic urine.
• Additional Compounds: Sub Solution contains 14 compounds found in real urine, which contribute to its realistic appearance, froth, and smell.

How to Use Sub Solution

Proper use of Clear Choice Sub Solution involves the following steps:

1. Prepare the Powder: Mix the powdered urine with filtered water. It is essential to use jug-filtered water to avoid contaminants. Avoid tap or bottled water as it may affect the sample. The creation process is similar to the Powdered Urine Kit.
2. Ready the Sample: Once hydrated, you don’t need to heat the solution. Place the prepared solution in your underwear, under loose clothing such as baggy jogging bottoms, to keep it discreet.
3. Heat Activation: Just before the test, use the included heat activator powder. Add about one-third of the powder, shake gently, and monitor the temperature strip. Aim for a temperature close to 100°F for optimal results.

Pros and Cons

Advantages

• Advanced Formula: Sub Solution includes 14 compounds found in real urine and avoids biocide preservatives, enhancing its realism and effectiveness.
• Precise Temperature Control: The heat activator powder provides precise control over the sample’s temperature, an advantage over many other products. This is what the Urine Simulation Kit boasts.
• High Success Rate: Known for its effectiveness in both visual and digital tests, Sub Solution is well-regarded for passing advanced drug testing systems.

Disadvantages

• Powdered Form: As a powdered kit, it requires mixing with water and must be prepared shortly before use, which can be inconvenient.
• Preparation Required: Accurate preparation is essential, and any deviation can affect the test outcome. The solution begins to spoil after six hours, necessitating careful timing.

Frequently Asked Questions

Can Sub Solution be used for supervised drug tests?

No, Sub Solution is designed for unsupervised drug tests where you have privacy. For supervised tests, using synthetic urine is risky and generally not recommended.

How does Sub Solution compare to Quick Fix?

Sub Solution is considered more effective than Quick Fix due to its complex formula and lack of biocide preservatives. Quick Fix has a simpler formula and relies on a heatpad and microwave, which may not always ensure accurate results. On a positive note, for those seeking alternatives, Urine Simulation with Powdered Urine Kit offers a convenient and reliable option that many users find helpful in various situations.

What if Sub Solution fails a test?

Failures often result from incorrect temperature management. Follow the preparation instructions closely, especially the heat activation process, to minimize the risk of failure. Sub Solution has a high success rate when used correctly.

Manufacturer and Availability

Clear Choice, the manufacturer of Sub Solution, is a reputable company with a long history in the drug testing industry. They offer various products, including oral clear gum and rescue cleanse detox drinks.

Sub Solution is exclusively available through Clear Choice’s official web store at Test Negative. Purchasing from the official source ensures the authenticity of the product. It is not available in local stores or other online retailers. For those looking for additional options, the Urine Simulation with Powdered Urine Kit is another fantastic choice that provides peace of mind and reliable results for users.

Conclusion

Clear Choice Sub Solution remains a top choice for individuals needing to pass unsupervised drug tests. Its advanced formulation, precise heat control, and high success rate make it a reliable option. Although its powdered form requires careful preparation, the benefits significantly outweigh the inconveniences. Purchasing directly from Clear Choice guarantees you receive a genuine product and maximizes your chances of success.