by Morningside Recovery Blog on February 19, 2009
Since successful outcomes often depend upon retaining the person long enough to gain the full benefits of treatment, strategies for keeping an individual in the program are critical. Whether a patient stays in treatment depends on factors associated with both the individual and the program. Individual factors related to engagement and retention include motivation to change drug-using behavior, degree of support from family and friends, and whether there is pressure to stay in treatment from the criminal justice system, child protection services, employers, or the family. Within the program, successful counselors are able to establish a positive, therapeutic relationship with the patient. The counselor should ensure that a treatment plan is established and followed so that the individual knows what to expect during treatment. Medical, psychiatric, and social services should be available.
Whether a patient stays in treatment depends on factors associated with both the individual and the program.
Since some individual problems (such as serious mental illness, severe cocaine or crack use, and criminal involvement) increase the likelihood of a patient dropping out, intensive treatment with a range of components may be required to retain patients who have these problems. The provider then should ensure a transition to continuing care or “aftercare” following the patient’s completion of formal treatment.
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by admin on January 23, 2009
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 sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity.
What are opioids?
Opioids are commonly prescribed because of their effective analgesic, or pain-relieving, properties. Medications that fall within this class – sometimes referred to as narcotics – include morphine, codeine, and related drugs. Morphine, for example, is often used before or after surgery to alleviate severe pain. Codeine, because it is less efficacious than morphine, is used for milder pain. Other examples of opioids that can be prescribed to alleviate pain include oxycodone (OxyContin), propoxyphene (Darvon), hydrocodone (Vicodin), and hydromorphone (Dilaudid), as well as meperidine (Demerol), which is used less often because of its side effects. In addition to their pain-relieving properties, some of these drugs – for example, codeine and diphenoxylate (Lomotil) – can be used to relieve coughs and diarrhea.
How do opioids affect the brain and body?
Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these drugs attach to certain opioid receptors, they can block the transmission of pain messages to the brain. In addition, opioids can produce drowsiness, cause constipation, and, depending upon the amount of drug taken, depress respiration. Opioid drugs also can cause euphoria by affecting the brain regions that mediate what we perceive as pleasure.
What are the possible consequences of opioid use and abuse?
Chronic use of opioids can result in tolerance for the drugs, which means that users must take higher doses to achieve the same initial effects. Long-term use also can lead to physical dependence and addiction – the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (”cold turkey”), and involuntary leg movements. Finally, taking a large single dose of an opioid could cause severe respiratory depression that can lead to death. Many studies have shown, however, that properly managed medical use of opioid analgesic drugs is safe and rarely causes clinical addiction, defined as compulsive, often uncontrollable use of drugs. Taken exactly as prescribed, opioids can be used to manage pain effectively.
