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Heroin,also known as diacetylmorphine and diamorphine among other names,is a morphinan opioid substance derived from the dried latex of the Papaver somniferum plant and is mainly used as a recreational drug for its euphoric effects. Medical-grade diamorphine is used as a pure hydrochloride salt. Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents. Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine),which is the result of crude acetylation during clandestine production of street heroin. Heroin is used medically in several countries to relieve pain,such as during childbirth or a heart attack,as well as in opioid replacement therapy.
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.
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.
The war on drugs is a global campaign,led by the United States federal government,of drug prohibition,military aid,and military intervention,with the aim of reducing the illegal drug trade in the United States. The initiative includes a set of drug policies that are intended to discourage the production,distribution,and consumption of psychoactive drugs that the participating governments and the United Nations have made illegal. The term was coined by President Richard Nixon and popularized by the media shortly after a press conference given on June 18,1971 –the day after publication of a special message from President Nixon to the Congress on Drug Abuse Prevention and Control –during which he declared drug abuse "public enemy number one". That message to the Congress included text about devoting more federal resources to the "prevention of new addicts,and the rehabilitation of those who are addicted" but that part did not receive the same public attention as the term "war on drugs". Two years prior to this,Nixon had formally declared a "war on drugs" that would be directed toward eradication,interdiction,and incarceration. In 2015,the Drug Policy Alliance,which advocates for an end to the War on Drugs,estimated that the United States spends $51 billion annually on these initiatives,and in 2021,after 50 years of the drug war,others have estimated that the US has spent a cumulative $1 trillion on it.
Substance dependence,also known as drug dependence,is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction,a distinct concept from substance dependence,is defined as compulsive,out-of-control drug use,despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB,a gene transcription factor,is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions,but not dependence.
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.
Contingency management (CM) is the application of the three-term contingency,which uses stimulus control and consequences to change behavior. CM originally derived from the science of applied behavior analysis (ABA),but it is sometimes implemented from a cognitive-behavior therapy (CBT) framework as well.
Dr. Norman Earl Zinberg was a psychoanalyst and psychiatrist whose research into addiction is seen as a great influence on current clinical models and greatly influenced the work of addiction treatment specialists such as Stanton Peele. He was a clinical professor of psychiatry at the Harvard Medical School and a psychiatrist at Cambridge Hospital. He also taught at Boston University and the Tufts School of Medicine. Zinberg earned his bachelor's and doctoral degrees from the University of Maryland.
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.
An opiate,in classical pharmacology,is a substance derived from opium. In more modern usage,the term opioid is used to designate all substances,both natural and synthetic,that bind to opioid receptors in the brain. Opiates are alkaloid compounds naturally found in the opium poppy plant Papaver somniferum. The psychoactive compounds found in the opium plant include morphine,codeine,and thebaine. Opiates have long been used for a variety of medical conditions with evidence of opiate trade and use for pain relief as early as the eighth century AD. Opiates are considered drugs with moderate to high abuse potential and are listed on various "Substance-Control Schedules" under the Uniform Controlled Substances Act of the United States of America.
Robert L. DuPont is an American psychiatrist,known for his advocacy in the field of substance abuse. He is president of the Institute for Behavior and Health,whose mission is "to reduce the use of illegal drugs". He has written books including Chemical Slavery:Understanding Addiction and Stopping the Drug Epidemic,The Selfish Brain:Learning from Addiction,as well as Drug Testing in Treatment Settings,Drug Testing in Schools,and Drug Testing in Correctional Settings,published by the Hazelden Foundation. DuPont is a fellow of the American Society of Addiction Medicine and a life fellow of the American Psychiatric Association.
Marie Nyswander was an American psychiatrist and psychoanalyst known for developing and popularizing the use of methadone to treat heroin addiction.
This is a history of drug prohibition in the United States.
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.
Harris Isbell was an American pharmacologist and the director of research for the NIMH Addiction Research Center at the Public Health Service Hospital in Lexington,Kentucky from 1945 to 1963. He did extensive research on the physical and psychological effects of various drugs on humans. Early work investigated aspects of physical dependence with opiates and barbiturates,while later work investigated psychedelic drugs,including LSD. The research was extensively reported in academic journals such as the Journal of Pharmacology and Experimental Therapeutics,Psychopharmacologia,and the AMA Archives of Neurology and Psychiatry.
Operation Golden Flow is an unofficial term that was coined during the Nixon era for the mandatory drug testing of all military service members returning from Vietnam,a program that was headed by Dr. Jerome Jaffe,head of the White House drug office.
In the United States,the opioid epidemic is an extensive ongoing overuse of opioid medications,both from 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. The great majority of Americans who use prescription opioids do not believe that they are misusing them.
Discrimination against drug addicts is a form of discrimination against people who suffer from a drug addiction.
Robert G. Newman was an American physician,scientist,health manager and philanthropist.
Hendrée E. Jones is a researcher on women's substance abuse disorders and its impact on children. She is a professor in the Department of Obstetrics and Gynecology at the University of North Carolina School of Medicine,and adjunct professor in the University of North Carolina College of Arts &Sciences Department of Psychology and Neuroscience. Jones is the executive director of the UNC Horizons Program,which is a comprehensive drug treatment program for mothers and their drug-exposed children. She is a consultant for the Substance Abuse and Mental Health Services Administration,the United Nations,and the World Health Organization.
References
- ↑ Jaffe, J. H. (1 January 1999). "Conversation with Jerome H. Jaffe". Addiction. 94 (1): 13–30. doi: 10.1080/09652149934143 . PMID 10665082.
- ↑ James Swartz (2012). Substance Abuse in America: A Documentary and Reference Guide. ABC-CLIO. ISBN 978-0-313-35376-5.
- 1 2 "Interviews - Dr. Jerome Jaffe - Drug Wars - FRONTLINE - PBS". www.pbs.org.
- ↑ "Author: Jerome H. Jaffe". www.dana.org.
