By Dr. Ramaz Mitaishvili
Opioid Drugs
– Opioid drugs include morphine, heroin, methadone, and codeine
1. Physical effects and withdrawal
– Opioids induce euphoria and sedation, are anlgesic, and depress the respiratory system.
– The intravenous method of drug use employed by many addicts (sharing of contiminated needles) contributes to AIDS and hepatitis B infection.
– While overdose may be fatal, death from withdrawal of opioids is rare unless a serious physical illness is present.
– Because of cross-dependence, opioids such as methodone can be substituted for illegal opioids such as heroin to prevent withdrawal.
– regular use of opioid antagonists such as naloxone can be used tomaintain abstinence in opioid abusers.
Heroin
Heroin is a highly addictive drug, and Heroin Addiction is a serious problem in Abkhazia. Recent studies suggest a shift from injecting heroin to snorting or smoking because of increased purity and the misconception that these forms of use will not lead to addiction.
Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the poppy plant. Heroin usually appears as a white or brown powder. Street names for heroin include "smack," "H," "skag," and "junk" , and specific name in Abkhazia “Shirka”. Other names may refer to types of heroin produced in a specific geographical area, such as Abkhazia or Tzhinvai Region (both are breakaway provinces of Georgia).
Heroin Addiction
According to the AISER research there are currently about 5300 heroin addicts needing treatment (total Population of Abkhazia – 150,000-200,000). In the United States, about 50% of all heroin addicts live in New York City. There are three male addicts to every female addict; most are in their early thirties. Compare to Abkhazia, female addicts, count only 15-20 to 1.Heroin has many serious health hazards associated with its use. HIV/AIDS, Hepatitis C, Fatal Overdose, Collapsed Veins and Infectious Diseases just to name a few. when compared to morphine, heroin is more potent, crosses the blood-brain barrier quickly, and has a faster onset of action and more euphoric action.
Aside from the debilitating effects of long-term use the heroin user will most likely suffer from three factors: Tolerance, Addiction and Withdrawal.
Heroin Tolerance, Addiction and Withdrawal
Tolerance
***Tolerance is the need for increased amounts of the drug to gain the same effect.
***Cross-tolerance occurs when tolerance develops to one drug as the result of use of another drug.
What is meant by tolerance is that the more a person uses a drug the more the person has to take to experience the high. Heroin has a high rate of tolerance, which makes the drug that much more addictive and dangerous.
Addiction
Once a physical dependence occurs the user becomes addicted. As more low-priced, high-quality street heroin becomes more available, this can happen within the first few uses of the drug.
Withdrawal
One of the most troubling aspects of heroin addiction is the withdrawal period. Among users this is called “dope sickness”. With long-term users this may be a daily exercise in desperation. Withdrawal may occur as soon as two hours after the last dose and symptoms include drug craving, restlessness, insomnia, cramping, vomiting and diarrhea, cold flashes and kicking movements (hence the term “kicking dope”). These symptoms occur most visibly between 48 and 72 hours after last use and may continue up to a week or more. Among long-term dependent users withdrawal may require hospitalization as it is occasionally fatal although less so than barbiturates and alcohol.
Assessing Heroin Addiction and Determining Levels of Care
When assessing whether or not someone has a drug or alcohol problem treatment professionals are best to help to determine to what degree or if at all a person has a drug or alcohol dependence that deserves professional treatment. It is important that a full assessment be taken by a trained and qualified counselor.
While most people have a very firm belief in what deems use, misuse and abuse, the lines are very clear and are best determined when a full client history can be taken. The sociological background, psychological makeup, educational and work history, family and marriage difficulties and medical issues all have to be taken into account and weighed carefully against specific criteria that determine the prevalence of a chemical dependency problem.
Heroin Detoxification and Rehabilitation
In addition to a strong support group to help the addict successfully quit using, oftentimes, and especially in the case of heroin and opiate drug use it is necessary to include a preliminary medically assisted detoxification to help the individual get off the drugs safely and comfortably. Once the person is successfully detoxified from the drugs, it is typically recommended that a length of time in some form of counseling or treatment is necessary.
Whether the individual undergoes detoxification, residential, outpatient or day treatment, or a combination thereof, an approach that combines treatment of the mind, body, and spirit with education and skills development is the key to the lifelong journey of recovery. By using scientifically-based and tested treatment components, rehabilitation can affect positive outcomes for those seeking treatment for chemical dependence.
Methadone
methadone is a synthetic opioid dispensed by federal health authorities to treat heroin addiction. Although methadone also causes physical dependence and tolerance, it has advantages over heroin for the addict: Methadone is legal, can be taken orally, suppresses heroin withdrawal symptoms, has a longer duration of action, and causes less euphoria, drowsiness, and depression.Individuals taking methadone can mantain work status and avoid the criminal activity that is necessary to maintain a costly heroin habit.
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