Category Archives: Guides

If you are having trouble staying clean, or simply looking for more information to help you stay clean take a look at a few articles on how to stay clean from heroin.

How to Use Narcan to Reverse an Overdose

how to use narcanWhile prolonged opioid addiction is a terrible scourge in our country, one of the worst aspects of the opioid epidemic is how easy it is to overdose on these drugs. With the introduction of Chinese-made fentanyl into the illicit American market, it’s easier to overdose on opioids than ever before. However, the effects of opioid overdose can be reversed with the aid of a drug that was developed to save the lives of people who have fallen into the trap of heavy opioid use.

This drug is commonly known as Narcan, and it serves as a ray of hope for overdose victims and their loved ones. Instead of having to stand idly by or rely on dangerous anti-overdose drugs like adrenochrome, people who are confronted with the terrifying situation of dealing with an overdose can now use a safe and effective drug to save a life.

What Is Narcan?

Narcan is a brand name of naloxone, a drug that was developed to stop the physiological process of an overdose in the human body. If naloxone is administered in time, it reverses or blocks the effects of opioids.

An overdose is dangerous because opioids bind to the nerve cells that control respiration. Naloxone chemically displaces these opioid molecules, allowing the victim of overdose to quickly begin breathing again. The drug is a significant improvement on previous forms of anti-overdose drugs, which mainly sent a jolt designed to shock the body out of failed respiration or cardiac arrest.

Naloxone is administered in a variety of different ways, and it may be possible for you to store this drug in your home or place of work in case of emergency. If this course of action isn’t possible, most hospitals and addiction recovery clinics keep various forms of naloxone on hand at all times.

What to Do in the Event of an Overdose

Before you learn how to use drugs like Narcan, it’s important to understand that there are other actions you should take if you or another person ingests a toxic dose of opioids. While naloxone provides a lifeline for people who have ingested dangerous levels of opioids, administering this drug isn’t the only thing that you should do in this critical situation.

Call for Help

Before you do anything else, it’s important to call 911. That way, emergency services will be alerted to the situation and will start heading toward your location. If you need to leave the person on their own while you make the call, you’ll need to put them in recovery position first. This position is achieved when the person’s arm is crossed under their neck and one leg is placed over the other with the knee bent. When an overdosing person is put in this position, it is assured that they will not choke.

Use Naloxone

After you call 911, you’ll need to administer naloxone if you have it. If you don’t have any naloxone on hand, you’ll need to wait for EMTs to arrive on the scene. Since there are no known effects of naloxone if a person isn’t overdosing, there’s no reason to be cautious when using this substance. If the person isn’t having an overdose, naloxone won’t have any effect.

Help the Person Breathe

In many cases, opioid overdose causes trouble with respiration. If the person is having trouble breathing, you can conduct rescue breathing. Pinch the person’s nostrils closed, and breathe into their mouth once every five seconds until their breathing normalizes.

Provide Comfort

Once you’ve administered naloxone and helped the person start breathing again, there’s not much more you can do until EMTs arrive. Make sure that the person stays in the recovery position, and comfort them as much as possible. If the person is conscious, they may be confused or in a panic. They may also want to use drugs. It’s your job to restrain and pacify them until medical professionals arrive.

Suggest Treatment

After paramedics have arrived and the person’s condition has stabilized, it’s time to address the issues that caused this situation to occur in the first place. Do everything you can to keep the person from using drugs, and suggest that it might be time to detox under the careful supervision of a qualified inpatient addiction treatment center.

How Is Naloxone Applied?

Naloxone comes in a number of different forms, and each is administered differently. These different administration techniques have various benefits and detractors. You should be aware of each administration route before you decide which type of naloxone to have on hand in case of emergencies. Here is some basic information on the different forms that naloxone may take:

Hypodermic injection:

Traditional hypodermic injection remains one of the most popular routes of administration for naloxone. In most cases, naloxone injections are applied to the thigh or arm, and they can be administered through clothing. In some cases, naloxone will come in small packages that you’ll need to pour into a hypodermic syringe, but it’s much more common to encounter injectable naloxone in packages that fit directly into syringes. Single-use syringes with naloxone already inserted are also available.

Before stocking up on injectable naloxone, talk with your pharmacist about the recommended dose. In most cases, naloxone is injected in a dose of 0.4mg/ml. With this amount, a second dose is sometimes needed.

If you plan to administer naloxone with a hypodermic syringe, it’s important to receive professional injection training first. Injecting lifesaving drugs like naloxone isn’t as easy as it may seem. Adequate training will make sure that you don’t harm the overdosing person.

Autoinjection:

If you want to inject naloxone easily and safely, you should definitely learn about the benefits of autoinjection. A pharmaceutical brand called Evzio was approved to make an autoinjector with naloxone in 2014. This marked the first time that an autoinjector had been approved outside of clinical settings. This autoinjector is much easier to use than a traditional hypodermic needle, and it looks like a small box with instructions and an LED indicator on the side. It administers a single, calculated dose of naloxone with a retractable needle, and it doesn’t require any assembly or technical knowledge to be used.

The autoinjector can be used through clothes, and all you need to do to administer a dose of Evzio is hold the end of the box next to the overdosing person and press the button. This handy overdose tool even comes equipped with a recorded voice that gives you instructions from the moment that you begin administration. This voice will let you know when it’s time to remove the autoinjector.

Nasal spray:

Narcan, which is one of the most prominent manufacturers of naloxone, makes a nasal spray that delivers the drug through the nasal membranes. This nasal spray is approved by the FDA, and it provides one of the easiest ways to apply naloxone.

To use this spray, simply insert the nozzle of the Narcan administrator into one of the overdosing person’s nostrils. Then, press down on the applicator with your thumb to administer this lifesaving drug. Each package of Narcan comes with two pre-filled applicators, but you shouldn’t need to use more than one in the case of an overdose. You only need to apply Narcan to one nostril.

Nasal atomizer:

While this administration method isn’t as popular as the others, Luer-lock makes a nasal atomizer device that contains naloxone. This device has a number of different parts, and the nosepiece is usually only available at pharmacies with a prescription. In some cases, however, it is possible to buy the nosepiece from medical supply companies.

This nasal atomizer is relatively complicated, and you probably won’t know how to use it unless you’re a trained medical professional. Since the Narcan nasal spray and the Evzio autoinjector are much easier to use, they are the administration methods that people without medical training should choose.

Who Is Qualified to Administer Naloxone in an Emergency?

Qualification requirements depend on the type of naloxone that is being administered. In general, hypodermic needles and atomizers are too complicated to be used by anyone except for a paramedic. However, autoinjectors and nasal sprays are easy enough for anyone to use without any medical training.

As you decide which type of naloxone that you should keep on hand, keep in mind that the laws in your state may have an impact on your ability to possess naloxone. Some states have made it illegal to possess naloxone unless you are a certified medical professional, and other states may only allow possession of certain forms of naloxone. In your state, it may be possible to purchase the drug at a pharmacy without a prescription, but you should check the Prescription Drug Abuse Policy System website to learn about your state’s laws before you proceed.

Does This Anti-overdose Drug Have Any Side-Effects?

Naloxone does not appear to have any effect on people who are not overdosing on opioids. If you accidentally administer naloxone when you aren’t overdosing, you should have nothing to worry about. In the case of people who are overdosing, the only direct effect of naloxone is the unbinding of opioid molecules from the nervous system.

When naloxone forcibly removes opioids from the system of an overdosing person, they almost immediately enter into the withdrawal process. While opioid withdrawals are uncomfortable at best, they can also be life-threatening. Even if you administer naloxone yourself in a person’s home environment, it’s still important to seek out medical attention immediately to ensure that the person is safely guided through the detoxification process.

How Much Does Narcan Cost?

The cost to buy a dose of naloxone depends on your state of residence and your insurance plan. With the correct insurance, a dose of Narcan nasal spray currently costs about $20 to $40. This cost is extraordinarily low when compared with what can happen without the drug.

Before you purchase Narcan or a similar naloxone product, you should get in touch with your insurance company to see if they cover the cost. If your insurance doesn’t cover the cost of naloxone, you can get in touch with your local pharmacy to learn retail prices for this drug. You should also keep in mind that the manufacturers of Evzio offer a cost-assistance program to help you with your purchase.

Where Do You Get This Drug?

In most states, you can purchase naloxone without a prescription. To learn about the process of purchasing naloxone in your home state, you should call a local pharmacy and speak with a pharmacist or a pharmacy technician. Most pharmacies stock naloxone, and even if they can’t offer this anti-overdose drug without a prescription, they can help you learn about the process you’ll need to follow to be approved for one.

What Are the Next Steps?

After you’ve successfully administered naloxone and the overdosing person is in the recovery process, it can seem like your work is over. However, both you and the overdosing person have some important decisions to make that will determine their health and well-being going forward. An overdose is, by far, the clearest sign that a person needs help. You should make sure that he or she enrolls in an inpatient addiction clinic as quickly as possible.

While hospitals provide services to help in the detoxification process, addiction clinics offer the most comprehensive services available when it comes to getting and staying clean. Whatever you do, it’s important to make sure that the person knows that you are there to help with whatever they may need to overcome their addiction.

The Dangers of Drugged Driving

driving-while-highThe following is written with the assistance of the Florida Department of Transportation, and the National Highway Traffic Safety Administration.

Over the past few decades, politicians, corporations, and community leaders have focused much attention and effort in an attempt to curb drunk driving. Much of this social movement can be traced back 35 years, to the establishment of Mothers Against Drunk Driving (MADD). Since 1980, MADD has become one of the most widely supported and respected non-profit organizations in the U.S.

To understand the impact MADD has had on American society, some milestones are worth considering:

  • 1982
    • Presidential Commission on Drunk Driving formed
    • Bill enacted giving states federal highway funds for anti-drunk driving efforts
    • 100 MADD chapters by year-end
  • 1983
    • An NBC made-for-TV movie about MADD airs
    • 129 new anti-drunk driving laws pass by year-end
  • 1984
  • Federal 21 Minimum Drinking Age Act signed into law on July 17
  • More than 330 MADD chapters in 47 states by year-end
  • 1988
    • All states and D.C. pass federal 21 drinking age law
    • Omnibus Anti-Drug Abuse Act signed—amendments include extending crime victim compensation rights to DUI/DWI victims and increased incentives for states enacting key DUI?DWI laws
  • 1994
    • Alcohol-related deaths drop to a 30-year low
    • Chronicle of Philanthropy survey names MADD America’s most popular charity
  • 2000
    • MADD grows to approximately 600 chapters and 2 million member/supporters
    • National .08 BAC measure (part of the Federal Transportation Appropriations Bill) signed into law Oct. 23
  • 2004
    • First Law Enforcement Leadership Council held
    • MADD testifies before Congress in the U.S. House Education Reform Subcommittee on underage drinking issues
    • All states and D.C. pass .08 BAC as the legal drunk driving limit (MADD).

drugged-driving

The changes MADD has spearheaded rival those of any other social movement in American history. In the U.S., because of MADD, since it was founded in 1980, the number of drunk driving deaths has been cut in half (National Highway Traffic Safety Administration). Perhaps now it is time begin efforts at targeting and isolating the dangers of driving while high—that is, the dangers of driving under the influence of prescription pills, heroin and other illicit drugs.

Studies have shown that, much the same as alcohol, heroin, prescription opiates, and the class of sedatives known as benzodiazepines slow reaction time, decrease motor coordination, and cause dizziness and drowsiness—each of these factors alone increase the likelihood of accidents. At present, no measure of drug impairment (like BAC in drunk driving) has been determined to reflect exactly how much of a drug effects ones driving ability. But, because even small amounts of certain drugs can have a measurable effect, some states have zero tolerance laws for drugged driving: if there is any amount of drug in the blood or urine of a driver in these states, the driver can face charges for driving under the influence (DUI). Some drugged driving detection techniques used by law enforcement include testing drivers identified as impaired who do not have a BAC exceeding the legal limit and employing Drug Recognition Experts (DREs) at roadside checkpoints (Stop Drugged Driving). While the prevalence rates of drugged driving are difficult to determine because of this lack of specific legal limit for BAC, the following data clearly illustrates a need for further, and prompt, research and action:

In 2013, 9.9 million persons, or 3.8 percent of the population aged 12 or older, reported driving under the influence of illicit drugs during the past year. This rate was lower than the rate in 2002 (4.7 percent), but was similar to the rate in 2012 (3.9 percent). Across age groups, the rate of driving under the influence of illicit drugs in 2013 was highest among young adults aged 18 to 25 (10.6 percent); this rate for young adults was lower than the rate in 2012 (11.9 percent). Additionally, the rate of driving under the influence of illicit drugs during the past year among youths aged 12 to 17 decreased from 2.3 percent in 2012 to 1.9 percent in 2013 (SAMHSA 2014).

Just as it is difficult to accurately determine the prevalence of drugged driving, determining the number of accidents caused by drugged driving offers a similar challenge. A few reasons for this challenge include: a) a good roadside test (like the breathalyzer test for alcohol) for drug levels in the body does not yet exist. b) people are not usually tested for drugs if they are above the legal limit for alcohol because there is already enough evidence for a DUI charge. c) many drivers who cause accidents are found to have both drugs and alcohol or more than one drug in their system, making it hard to know what substance had the greater effect (NIH, 2015).

The problem, and dangers, of drugged driving are most apparent within the teen/young adult portion of the population. According to data presented by Teen Driver Source (2015), putting aside the dangers of driving under the influence of drugs, motor vehicle crashes are the number one cause of death among adolescents and the greatest lifetime chance of crashing occurs during the first six months after obtaining a driver’s license. While distractions, following too closely, and an overall underestimation of the dangerousness of a situation are commonly cited factors in teen crashes, add drugs to the equation and it’s a recipe for disaster. For example:

A study of college students with access to a car found that 1 in 6 (about 17 percent) had driven under the influence of a drug other than alcohol at least once in the past year. Of those students, 57 to 67 percent did so at least three times and 27 to 37 percent at least 10 times. Marijuana was the most common drug used, followed by cocaine and prescription opioids (Arria, 2011).

This data is persuasive evidence that the time has come to consider drugged driving a danger worthy of further research and greater societal concern, just as MADD thought it time for action 35 years ago. By developing a “field drug test” for suspected drivers and establishing an accurate blood level content measure to determine impairment, dangerous drivers can be removed from the road and directed to treatment for drug abuse/addiction—a win-win for both society and the offender.

References

Arria, A.M., Caldeira, K.M., Vincent, K.B., Garnier-Dykstra, L.M., O’Grady, K.E. (2011). Substance-related traffic-risk behaviors among college students. Drug and Alcohol Dependence. 118(2-3), 306-312.

MADD (2015). http://www.madd.org/

National Highway Traffic Safety Administration Fars Data (2012). http://www.nhtsa.gov/FARS

NIH: National Institute on Drug Abuse (2015). Drug facts: Drugged driving. http://www.drugabuse.gov/publications/drugfacts/drugged-driving

SAMHSA (2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/N SDUHresults2013.pdf

Stop Drugged Driving (2015). http://www.stopdruggeddriving.org/enforce.html

Teen Driver Source (2015). Basic facts about teen crashes: General statistics. http://www.teendriversource.org/stats/support_teens/detail/57

Methadone

What is Methadone?

methadone-scienceAccording to the U.S. National Library of Medicine, methadone is an opiate analgesic prescribed for the treatment of severe pain. It is primarily prescribed to people who are expecting to be in pain, such as after a medical procedure, or those who are unable to be treated with other types of medication.

Furthermore, a growing number of people are using methadone as a means of beating an opiate addiction.

How is Methadone Made?

Anybody who will rely on methadone, regardless of the reason, will want to learn more about the drug. This includes how it is made. The Centre for Addiction and Mental Health notes the following:

“Methadone is a “synthetic” opioid, which means that it is made from chemicals in a lab. Methadone was developed in Germany during the Second World War and was first used to provide pain relief.”

How does Methadone Work?

Now that you understand the basics of methadone, including why it is prescribed and how it is made, it is time to learn more about the way the drug provides relief to the patient.

Just the same as all medications, you may never fully understand the finer details of methadone, including how it works. However, it is important to have a basic understanding.

On a basic level, methadone treats pain by changing the way the nervous system and brain respond to pain.

How should Methadone be used?

Methadone-40mgNo matter who you are or why you are taking methadone, it is extremely important that you follow the direction of your doctor. This is a powerful drug that should only be taken as prescribed.

Methadone is commonly prescribed in a tablet form, however, it is available in a dispersible tablet and a liquid.

If methadone is prescribed to relieve pain, it may be taken every eight to 12 hours or as directed by your medical team. In the event that you are taking the drug as part of a treatment program, you may follow a different schedule.

Note: it is important to always take methadone as directed, as taking too much of the drug can lead to serious side effects.

While you are taking methadone, regardless of the reason, it is not uncommon for your doctor to alter your dose. For example, your dose may decrease as your treatment continues.

If you believe it is time to stop taking methadone, check with your doctor first. In most cases, you want to slowly decrease your dose. If you stop without warning, you could experience a variety of withdrawal symptoms.

Common Methadone Withdrawal Symptoms

Regardless of your reason for taking methadone, you should follow through with the treatment for the duration. Stopping without warning can lead to a number of withdrawal symptoms, some of which can be both painful and uncomfortable.

Note: it is common for your doctor to decrease your dose over time. This helps fight against serious withdrawal symptoms.

Some of the most common symptoms include: restlessness, teary eyes, sweating, yawning, runny nose, muscle pain, anxiety, irritability, joint pain, backache, weakness, difficulty sleeping, stomach cramps, nausea, vomiting, diarrhea, and decreased appetite.

Long Term Impact of Methadone

Over the years, many myths have circulated in regards to the long term effects of methadone use. In short, some people believe that using this drug for too long can take a toll on their body. More specifically, that it will damage their thyroid gland and liver while also causing memory issues.

There is no concrete evidence that long term use of methadone is unsafe. In fact, it is believed to be 100 percent safe if used at the correct dose.

In many cases, methadone use can actually improve your health. For example, if you have a condition that requires methadone maintenance treatment, the use of the drug can help you better deal with pain and discomfort.

Common Methadone Myths

In addition to the myth that long term methadone use can be harmful, here are several others to be aware of:

  • Methadone will lead to a high. Unlike other drugs that get you high, methadone does not have the same impact on your body. When you first take the drug, it may make you sleepy or lightheaded for a couple days. However, you will quickly develop a tolerance. When taking methadone, you can expect to feel normal most of the time.
  • Methadone can and will make you sick. As noted above, you may feel strange when you first start taking methadone. This is particularly true if your dose is not high enough. If you do begin to feel sick, it will only be mild. At that point, your doctor can adjust your dose and you will begin to feel better soon enough.
  • Methadone will lead to weight gain. This is one of the primary myths that scare people away from using the drug. Here is what you need to know: not everybody packs on a few pounds when they begin to take methadone. That being said, this could happen. The reason for this is that methadone improves your health, which naturally leads to eating more.

Before taking methadone, it is important to understand “fact” and “fiction.” This will ensure that you are comfortable with the approach to your illness, how you feel, and what the future holds.

Methadone Overdose

In a previous section, we examined the long term impact of methadone use. In addition to this, it is important to understand that taking too much of the drug can lead to an overdose. If this happens, a person will experience a variety of side effects. Even more so, death by overdose is a possibility.

In the event that a person takes too much methadone at one time, some or all of the following side effects could set in:

  • Pinpoint pupils
  • Low body temperature
  • Shallow breathing
  • Slow pulse
  • Low blood pressure
  • Dizziness
  • Poor circulation
  • Seizures
  • Clammy skin
  • Coma

As you can see, these overdose symptoms are serious enough to end poorly. For this reason, if you or somebody in your presence is experiencing these symptoms as the result of taking too much methadone, it is important to immediately call an ambulance or visit an emergency room.

Methadone Maintenance

For many people, methadone maintenance treatment has been the difference between a life full of addiction and becoming clean sooner rather than later.

With this type of treatment, methadone is prescribed over the long term to help a person overcome an opioid addiction.

Note: anybody who is taking part in methadone maintenance treatment will also receive care by way of counseling, therapy, and psychological services. Put together, this makes for a comprehensive treatment program that has been proven successful.

Those who have never undergone methadone maintenance treatment have a difficult time understanding the benefits. However, once you learn what it can do for you and your addiction, you may be willing to give it a try.

By taking methadone the body is able to better deal with the symptoms of opioid withdrawal. Once the level of methadone reaches a particular level, the person know longer experiences such intense cravings. Over time, tolerance to methadone develops slowly. As a result, patients are able to use methadone maintenance treatment for an extended period of time.

Studies have shown that methadone maintenance treatment can cause a reduction in:

  • The future use of opioids
  • Criminal activity
  • High risk behavior
  • Mortality

Furthermore, this treatment can improve a person’s quality of life, mental and physical health, social functioning, and ability to complete a treatment program. Furthermore, and most importantly, it gives them a better outlook for the future.

When you get involved with a methadone maintenance treatment program, you will be watched by an experienced medical team, which typically includes physicians as well as on-site counselors, nurses, and a pharmacist. In other words, you are in good hands as you rely on this type of treatment to beat an opioid addiction.

Methadone Alternatives

Buprenorphine-SuboxoneWhile there are many benefits of taking methadone, there are other medications that can be substituted when treating opioid dependence. These include Buprenorphine and LAAM (L-alpha-acetyl-methadol).

According to the Center for Substance Abuse Research at the University of Maryland, Buprenorphine is a semi-synthetic narcotic substance. It also adds the following:

“Unlike the other treatment drugs, Buprenorphine produces far less respiratory depression and is thought to be safer in the event of an overdose. In addition, it does not produce significant levels of physical dependence or discomforting withdrawal symptoms; so discontinued use is easier than methadone.”

LAAM, on the other hand, is used instead of methadone as its impact lasts longer, meaning that patients only need to take the drug three times per week, not every day.

Conclusion

All in all, methadone is used by millions of people the world over. Some people use this drug for all the right reasons, while others become addicted thanks to illicit use.

If used the right way, methadone can help relieve pain. It can also be used to treat people with an opioid addiction. Subsequently, if abused, methadone is addictive and has the ability to cause a variety of side effects.