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Methadone, sold under the brand names Dolophine and Methadose among others, is a synthetic opioid agonist used for chronic pain and also for opioid use disorder. It is used to treat chronic pain, and it is also used to treat addiction to heroin or other opioids. Prescribed for daily use, the medicine relieves cravings and removes withdrawal symptoms. Withdrawal management using methadone can be accomplished in less than a month, or it may be done gradually over a longer period of time, or simply maintained for the rest of the patient's life. While a single dose has a rapid effect, maximum effect can take up to five days of use. After long-term use, in people with normal liver function, effects last 8 to 36 hours. Methadone is usually taken by mouth and rarely by injection into a muscle or vein.
Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
A drug overdose is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically it is used for cases when a risk to health will potentially result. An overdose may result in a toxic state or death.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection, as a skin patch (transdermal), or as an implant. For opioid use disorder, the patient must have moderate opioid withdrawal symptoms before buprenorphine can be administered under direct observation of a health-care provider.
A methadone clinic is a medical facility where medications for opioid use disorder (MOUD) are dispensed-—historically and most commonly methadone, although buprenorphine is also increasingly prescribed. Medically assisted drug therapy treatment is indicated in patients who are opioid-dependent or have a history of opioid dependence. Methadone is a schedule II (USA) opioid analgesic, that is also prescribed for pain management. It is a long-acting opioid that can delay the opioid withdrawal symptoms that patients experience from taking short-acting opioids, like heroin, and allow time for withdrawal management. In the United States, by law, patients must receive methadone under the supervision of a physician, and dispensed through an Opioid Treatment Program (OTP) certified by the Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Administration.
Drug detoxification is variously construed or interpreted as a type of "medical" intervention or technique in regards to a physical dependence mediated by a drug; as well as the process and experience of a withdrawal syndrome or any of the treatments for acute drug overdose (toxidrome). The first definition however, in relation to substance dependence and its treatment is arguably a misnomer and even directly contradictory since withdrawal is neither contingent upon nor alleviated through biological excretion or clearance of the drug. In fact, excretion of a given drug from the body is one of the very processes that leads to withdrawal since the syndrome arises largely due to the cessation itself and the drug being absent from the body; especially the blood plasma, not from ‘leftover toxins’ or traces of the drug still being in the system.
The drug policy of Portugal, informally called the "drug strategy", was put in place in 2000, and came into effect in July 2001. Its purpose was to reduce the number of new HIV/AIDS cases in the country, as it was estimated around half of new cases came from injection drug use.
Heroin-assisted treatment (HAT), or diamorphine-assisted treatment, refers to a type of Medication-Assisted Treatment (MAT) where semi-synthetic heroin is prescribed to opiate addicts who do not benefit from, or cannot tolerate, treatment with one of the established drugs used in opiate replacement therapy such as methadone or buprenorphine. For this group of patients, heroin-assisted treatment has proven superior in improving their social and health situation. Heroin-assisted treatment is fully a part of the national health system in Switzerland, Germany, the Netherlands, Canada, and Denmark. Additional trials are being carried out in the United Kingdom, Norway, and Belgium.
Sheila Macdonald Bird OBE FRSE FMedSci is a Scottish biostatistician whose assessment of misuse of statistics in the British Medical Journal (BMJ) and BMJ series ‘Statistics in Question’ led to statistical guidelines for contributors to medical journals. Bird's doctoral work on non-proportional hazards in breast cancer found application in organ transplantation where beneficial matching was the basis for UK's allocation of cadaveric kidneys for a decade. Bird led the Medical Research Council (MRC) Biostatistical Initiative in support of AIDS/HIV studies in Scotland, as part of which Dr A. Graham Bird and she pioneered Willing Anonymous HIV Surveillance (WASH) studies in prisons. Her work with Cooper on UK dietary bovine spongiform encephalopathy (BSE) exposure revealed that the 1940–69 birth cohort was the most exposed and implied age-dependency in susceptibility to clinical vCJD progression from dietary BSE exposure since most vCJD cases were younger, born in 1970–89. Bird also designed the European Union's robust surveillance for transmissible spongiform encephalopathies in sheep which revolutionised the understanding of scrapie.
Martin T. Schechter is a Canadian epidemiologist recognized for contributions to research about HIV prevention and treatments, addiction research, and Indigenous health research. He is a professor and was the founding director of the School of Population and Public Health in the Faculty of Medicine at the University of British Columbia (UBC). Schechter received his Order of British Columbia in 1994 alongside BC's first Nobel Prize laureate Michael Smith and noted Indigenous artist Bill Reid. In 2022, Schechter was named as a Member of the Order of Canada.
Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone. It is used to treat opioid use disorder, and reduces the mortality of opioid use disorder by 50%. It relieves cravings to use and withdrawal symptoms. Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.
Gerry Stimson is a British public health social scientist, emeritus professor at Imperial College London from 2004, and an honorary professor at the London School of Hygiene and Tropical Medicine from 2017. Stimson has over 220 scientific publications mainly on social and health aspects of illicit drug use, including HIV infection. He has sat on numerous editorial boards including AIDS, Addiction, and European Addiction Research, and with Tim Rhodes he was the co-editor-in-chief of the International Journal of Drug Policy from 2000 to 2016. He is one of the global leaders for research on and later advocacy for harm reduction.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
Aslam Anis is a Bangladeshi-Canadian health economist whose primary areas of research involvement include health services research, measuring patient-reported outcomes, Canadian competition policy in the pharmaceutical industry, and the cost-effectiveness of treatments for HIV/AIDS, rheumatoid arthritis, and other conditions.
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.
Prescription drug addiction is the chronic, repeated use of a prescription drug in ways other than prescribed for, including using someone else’s prescription. A prescription drug is a pharmaceutical drug that may not be dispensed without a legal medical prescription. Drugs in this category are supervised due to their potential for misuse and substance use disorder. The classes of medications most commonly abused are opioids, central nervous system (CNS) depressants and central nervous stimulants. In particular, prescription opioid is most commonly abused in the form of prescription analgesics.
The Modernizing Opioid Treatment Access Act is a proposed United States congressional bill introduced in the 118th United States Congress. Introduced in response to the national opioid epidemic, the legislation would expand access to methadone, an approved medication for treating opioid use disorder (OUD).
Trecia Ann Wouldes is a New Zealand academic, and is a full professor in the Department of Psychological Medicine at the University of Auckland, specialising in the developmental effects of drug exposure in pregnancy.
References
- 1 2 "Professor Janie Sheridan – The University of Auckland". unidirectory.auckland.ac.nz.
- ↑ Roy, Eleanor Ainge (26 October 2018). "One in three New Zealanders drink dangerously through their entire lives – study" – via www.theguardian.com.
- ↑ "New research shows binge drinking isn't something we grow out of". 25 October 2018 – via www.nzherald.co.nz.
- ↑ "Energy drinks : un problème de santé pour les adolescents". Santé sur le net. 17 May 2018.
