Answer Addiction

Tag: opioid withdrawal

  • How to Find the Best Nucynta ER Addiction Treatment or Rehab

    How to Find the Best Nucynta ER Addiction Treatment or Rehab

    Looking for information about Nucynta ER? Use this helpful guide.

    1. What is Nucynta ER and What is it Used For?
    2. Alternative Nucynta ER Names
    3. What is Nucynta ER Abuse?
    4. When Nucynta ER Rehab is Necessary
    5. Risks of Avoiding Nucynta ER Rehab
    6. The Risk of Nucynta ER Overdose
    7. Withdrawal and Detox – How Long Does Nucynta ER Stay in Your System?
    8. Medical Treatment in Nucynta ER Rehab
    9. Therapy and Other Treatments in Nucynta ER Rehab
    10. Factors to Consider When Choosing Nucynta ER Rehab
    11. What is the Best Nucynta ER Rehab for You?

    Nucynta ER rehab may become necessary if you abuse and become addicted to this opioid painkiller. It is a strictly controlled substance because, although it can manage serious pain, Nucynta is also susceptible to abuse and habit forming. Any misuse of it can lead to a serious addictive disorder. 

    If you or someone you care about has been misusing Nucynta ER, consider getting professional help and going to rehab. There are several factors to consider when choosing a rehab facility and treatment program. Residential rehab is often recommended, but you should also consider your own personal needs and preferences and where you will feel most comfortable. Most importantly, reach out and seek help before your addiction gets worse or leads to an overdose. 

    What is Nucynta ER and What is it Used For?

    Nucynta ER is a narcotic, opioid painkiller. Nucynta is the brand name, and ER refers to the fact that it is an extended release formulation. It is designed to provide round-the-clock clinical pain management in just one dose, because it releases the medication a little bit at a time. 

    The generic name for the drug is tapentadol. Made by Janssen Pharmaceutical, tapentadol was the first new opioid painkiller to be released in decades when it came on the market in 2009. Tapentadol is similar in chemical structure and action to the company’s previous opioid, tramadol, which was first introduced in 1995. 

    Like other opioids, Nucynta ER works in the brain to disrupt pain signals. It also acts like a central nervous system depressant, slowing down brain activity, heart rate, breathing, and blood pressure and generally inducing calm, sleepiness, and a sense of euphoria. 

    Nucynta ER is approved as a medicine to treat severe pain that needs 24-hour control, pain that has not responded to other medications. Specifically, Nucynta ER is often prescribed to manage diabetic peripheral neuropathy pain. It is not indicated to treat pain on an as-needed basis. 

    Alternative Nucynta ER Names

    Nucynta is the only brand name available for tapentadol, but it comes in Nucynta and Nucynta extended release formulations. Street names for this drug are the same as other opioids. Any illicit name for an opioid of abuse could apply to Nucynta and tapentadol: 

    • Apache
    • Cody 
    • Captain Cody
    • China girl
    • China white
    • Dance fever
    • Demmies
    • Doors and Fours
    • Goodfella
    • Dillies
    • Friend
    • Jackpot
    • Juice
    • Loads
    • Murder 8
    • Oxy 80
    • Ocycat
    • Pain killers 
    • Perks
    • Tango and Cash
    • TNT

    These names are always changing, and those selling and using tapentadol and other opioids illegally may refer to them by a number of other names and phrases. 

    What is Nucynta ER Abuse?

    Nucynta ER abuse is different from Nucynta ER addiction. Of course, abuse of the drug can lead to an addiction, and it often does. Abuse of a drug refers to any kind of misuse: using it without a prescription, using larger doses than recommended, using the drug for longer or more frequently than recommended by a prescribing doctor, or using it for any purpose other than it was intended, such as getting high or relaxing. 

    The Nucynta ER effects that people seek when abusing this drug include euphoria, relaxation and calm, relief from stress, and sleepiness. This is an effective painkiller, but it is also susceptible to abuse for these reasons. The Drug Enforcement Administration places tapentadol in schedule II of the controlled substances because of this susceptibility and because abuse can lead to serious and severe Nucynta ER dependence. 

    When Nucynta ER Rehab is Necessary

    You may not be totally aware when your abuse of Nucynta ER has led to the point that you need professional help. Ask yourself the following questions, which are the criteria used to diagnose opioid use disorders:

    1. Do you consistently use Nucynta ER more often and in larger doses than you meant to?
    2. Have you tried to cut back on drug use but failed, more than once?
    3. Do you experience cravings for Nucynta?
    4. Is more and more of your time spent using, recovering, and seeking out Nucynta ER?
    5. Have your responsibilities been sliding because of time you spend using drugs?
    6. Have you given up activities you used to enjoy because of drug use?
    7. Are your relationships with people you care about suffering because of drug use?
    8. Do you continue to use Nucynta ER even though it is negatively impacting your physical health, mental health, or both?
    9. Have you used Nucynta ER in situations that put you at risk of getting hurt or being harmed?
    10. Do you have a tolerance built up to opioids and need more to get the same effect?
    11. Do you go through withdrawal when not using?

    If you have any of these Nucynta ER addiction symptoms, or are at all concerned that your use of this drug is problematic or out of control, get started now seeking help for Nucynta ER addiction treatment. Just two signs of an opioid use disorder is enough for a diagnosis of a mild opiate addiction. This should be taken seriously, because not seeking help and stopping use of this drug can lead to very serious risks. 

    Risks of Avoiding Nucynta ER Rehab

    There are many risks associated with abusing Nucynta ER and other opioids. The clearest one is the risk of becoming addicted. And, if you are abusing the drug and have already become mildly addicted, you run the risk of developing a more severe addiction by not getting the help you need. 

    Misusing any drug can be harmful to your physical and mental health. By abusing Nucynta ER you increase the risk of experiencing side effects, some of which can pose a serious risk to your overall health. The most common Nucynta ER side effects reported are nausea, dizziness, constipation, headaches, and sleepiness. You may also experience heartburn, stomachaches, anxiety, dry mouth, irritability, strange dreams, and insomnia. 

    More serious side effects you may experience from abusing Nucynta include loss of consciousness, heavy sweating, overheating, rash, sexual dysfunction, irregular menstruation, loss of appetite, weakness, agitation, seizures, and hallucinations. 

    Any kind of drug abuse can also lead to more far-reaching issues and complications. You may lose your job and have financial problems; your relationships may fail; your academic performance may suffer; you may contract a communicable disease; and you could even be the victim of violence or assault or be injured in an accident. 

    The Risk of Nucynta ER Overdose 

    Opioid overdoses have reached epidemic proportions in the U.S. Of all the Nucynta ER addiction side effects, the worst is overdose. Putting off getting Nucynta ER addiction help puts you at serious risk of having a fatal overdose. This drug, like other opioids, can kill you if you take too much, and there is no way to know how much is too much until it happens. 

    Signs of an overdose on Nucynta or another overdose include lack of responsiveness, loss of consciousness, slow or shallow breathing, difficulty breathing, cold and clammy skin, blue-colored lips and fingernails, vomiting, and weak muscles and poor coordination. 

    The risk of overdosing on Nucynta ER increases if you mix it with another opioid, alcohol, or another type of drug that causes central nervous system depression. This may include any benzodiazepine, barbiturates, and all types of sedatives. An opioid overdose can be reversed, but to save a life you must get immediate medical treatment, in an emergency room or from first responders. 

    Withdrawal and Detox – How Long Does Nucynta ER Stay in Your System?

    If you are giving up this drug, Nucynta ER withdrawal effects are likely to kick in between 24 and 30 hours from the last does you took. Shorter-acting opioids begin causing withdrawal much sooner, within 12 hours. But with an extended release formula, you will have the drug in your system longer, delaying withdrawal. 

    It is necessary to go through these uncomfortable symptoms, because it is a part of detoxing, which is letting the drug leave your system. How long this will take depends on individual factors, like the severity of your addiction and your overall health. Nucynta ER withdrawal side effects could last a couple days or persist for a few weeks. 

    As opioid withdrawal begins, you can expect to first experience discomfort with muscle aches, insomnia, excessive yawning, tearing, and sweating, and a runny nose. You will probably also feel anxious, agitated, and irritable. 

    After a day or two the symptoms will transition and may become even more uncomfortable. You may start to feel nauseated and have stomach cramps. Diarrhea and vomiting are common. You’ll also feel chilled and may have a fever, and your cravings for tapentadol will become intense. 

    Withdrawal from opioids like Nucynta is not inherently dangerous. The Nucynta ER withdrawal symptoms you experience will be very uncomfortable, even painful, but they don’t cause long-term harm. The real risk of detox is relapse. You will feel strong urges to use again, and a big danger is that in relapsing you may overdose. 

    For this reason, and to make the process generally more comfortable, supervision is always recommended. A loved one can help keep you safe and prevent relapse, but medical detox includes medications that will help make you feel better and provide some relief from Nucynta ER withdrawal. 

    Medical Treatment in Nucynta ER Rehab

    Opioid use disorder can be managed and treated with medications. The first step in treatment is to go through detox, and if you choose a good program you will benefit from medical care during this difficult process. You may be given fluids, supplements, and approved medications for reducing withdrawal symptoms and cravings. 

    It is important to realize that, although you will feel much better after detox, this relatively short process does not cure your Nucynta ER addiction. It is only the first step that must be followed by long-term treatment in order to have a successful recovery. Ongoing medication and medical treatment after detox is also not enough. But, medications do make up an important part of comprehensive Nucynta ER rehab. The medications that can be used to treat and manage an addiction to any opioid include:

    • Methadone. Methadone has long been used to help heroin addicts. It is an opioid agonist, which means it stimulates the opioid receptors, the same receptors stimulated by opioid drugs of abuse. Methadone is used to reduce withdrawal symptoms and to taper patients from other opioids. It may take a week or more to taper. 
    • Buprenorphine. This is also an opioid agonist, but only a partial one. It is less susceptible to abuse than methadone but can still reduce withdrawal and be used for tapering off opioids. It may also be less dangerous than methadone, which can potentially trigger an overdose. Buprenorphine has less of a depressive effect on breathing. 
    • Naltrexone. Naltrexone, and the opioid overdose antidote naloxone, is an opioid antagonist. Rather than stimulating the receptors, it blocks opioids from stimulating them. This is how naloxone, also known as Narcan, can reverse an overdose. Naltrexone can be given in a 30-day dose to prevent relapses, because with the drug in your system, taking an opioid becomes pointless. There will be no effect. 

    Therapy and Other Treatments in Nucynta ER Rehab

    When choosing Nucynta ER rehab and a treatment program, be sure it offers you a range of therapy types. This is the backbone of treatment and what will help you transition to recovery and be able to resist cravings and minimize relapses in the future. The point of therapy is to help you understand the choices you have made and how to make better, healthier choices in the future. Some of the types of therapy you will be offered in rehab include:

    • Behavioral therapies. Cognitive behavioral therapy, or CBT, is the foundation of behavioral therapies, the most common type used in helping patients overcome drug addictions. Behavioral therapists will help you understand your motives for abusing Nucynta ER and teach you practical strategies for making positive changes, for preventing relapse, and for adopting a healthier lifestyle. 
    • Family and relationship therapy. Your relationships with others likely suffered with your drug abuse but can also contribute to unhealthy behaviors. Working in therapy with family or your partner can be helpful in achieving lasting recovery.
    • Group support and therapy. A good treatment center will include support from other patients. Together you will learn how to make healthier choices and provide each other with positive support and encouragement. 
    • Trauma-focused therapy. Past trauma is a major risk factor for substance abuse and addiction. There may be trauma in your past that you need to explore and process. Doing so will help you make better choices going forward and learn better ways of coping with painful memories than turning to drugs or alcohol. 

    Factors to Consider When Choosing Nucynta ER Rehab

    As you begin your search for rehab and treatment, you will find that you have a lot of choices. There are several factors to consider that will make this decision a little easier. Start with the practicalities and eliminate any treatment programs you cannot afford, that are not covered by your insurance plan, or that are too far away to be feasible. 

    Next, decide whether you want to go to a residential, inpatient rehab or get treatment on an outpatient basis. An addiction advisor can help you make this important decision, but generally, for more severe addictions and in cases in which you are at serious risk of relapse, residential care is recommended. An inpatient rehab facility can provide you with 24-hour care and supervision, a wider variety of therapy options, and supportive services, including aftercare. 

    Finally, look at your narrowed options and choose the one that seems best to you. Some factors to look for in the best Nucynta ER rehab are:

    • The option of a medical detox
    • An intake that includes an evaluation to diagnose any substance use disorder and mental illness 
    • Concurrent treatment for addiction and any mental illnesses for which you receive a diagnosis
    • An individualized treatment plan designed just for your specific needs and that considers your preferences
    • A comprehensive medical treatment program
    • A variety of therapy types
    • A community, group support approach to care
    • Alternative therapies as well as other services as options, such as holistic medicine, alternative medicine, recreation, healthy living, nutrition, exercise, and others
    • Aftercare programs
    • A focus on relapse prevention

    The best treatment programs and rehab facilities for opioid and Nucynta ER addiction will include all of these. While outpatient care might be best for some people, it is impossible to get all these services and factors in an outpatient program. They are naturally more limited, but if living at home is best for you, outpatient treatment can be effective. 

    What is the Best Nucynta ER Rehab for You?

    Making the choice of rehab can feel like an overwhelming chore. Make sure you have a loved one you trust by your side to help narrow down your options and guide your decision. Having this support will take a big weight off your shoulders. In your current state, making the best decision for you may be too difficult. Accept this help in making your choice, as your loved one may know better what you need right now. 

    If your trusted friend or family member can narrow down your options, you can then choose based on which program or location just feels right to you. You should be allowed to visit a facility, talk with staff, and get a better feel for services before making a final decision. As long as everything else is in place, choose a treatment program based on how comfortable you feel with it. 

    Getting any treatment for Nucynta ER abuse and addiction is the most important thing you can do right now. Choose the best rehab and treatment program for your needs and prepare to do the hard work necessary for lasting recovery. If you can commit to it, you will find that treatment is effective and lasting. 

    View the original article at thefix.com

  • Vicodin Addiction: How To Find the Best Rehab

    Vicodin Addiction: How To Find the Best Rehab

    Looking for information about Vicodin? This helpful guide has all the information you need about side effects, warning signs of dependence and treatment for opioid addiction.

    1. What is Vicodin and What is it Used For?
    2. Vicodin and the Brain
    3. The Path to Vicodin Addiction
    4. Abusing Vicodin with a Prescription
    5. Abusing Vicodin without a Prescription for Medical Reasons
    6. Abusing Vicodin for Recreational Purposes
    7. Vicodin Addiction Symptoms
    8. Diagnosing Vicodin Addiction
    9. Vicodin Withdrawal and Detox
    10. Vicodin Addiction Treatment and Rehabilitation
    11. Finding the Right Vicodin Rehab Facility for You

    Vicodin addiction is a natural consequence of Vicodin abuse. If you take more of it than you should, you may develop a dangerous drug dependency.

    Defeating Vicodin addiction is not easy. But the situation is far from hopeless. If you enroll in an addiction treatment program at a high-quality Vicodin rehab center, you’ll have an excellent chance of overcoming your substance use disorder. You can choose sobriety over addiction, and during your time in Vicodin rehab you’ll learn how to do it.

    What is Vicodin and What is it Used For?

    In 2018, Vicodin and other painkillers with a similar formula were the top-selling prescription medication in 10 states. Vicodin is given to medical patients suffering from moderate to severe chronic pain, including those who are recovering from injuries, illness or medical procedures. 

    The active ingredients in Vicodin are hydrocodone, a moderately strong opioid, and acetaminophen, the over-the-counter substance sold as Tylenol. Standard Vicodin tablets contain just five mg of hydrocodone and 300 mg of acetaminophen. But it is the hydrocodone that gives Vicodin its potency. 

    Vicodin was long considered a relatively harmless narcotic drug. Consequently, many physicians prescribed it for only mild pain, or even as a precaution for conditions that might be accompanied by some level of pain. 

    But in fact, Vicodin is just as addictive as any other type of opioid. In addition to its painkilling abilities, hydrocodone causes feelings of pleasure, relaxation and mild euphoria that users find very alluring.

    Now that physicians know the truth, they are being more careful about handing out prescriptions. But Vicodin is still highly effective against chronic pain, which has helped it retain its popularity with both doctors and patients.

    This drug can be used safely. But exceeding recommended doses, or taking it without a prescription, is risky behavior that could leave you addicted and unable to control your Vicodin consumption.

    Vicodin and the Brain

    Vicodin works by linking with opioid receptors in the brain. The human body can manufacture its own opioids, in response to pain, and these receptors are designed to connect with these endogenous products. But opioid receptors do not discriminate and will bind with any opioid molecules they encounter, including those in medications like hydrocodone.

    While they share similar chemical structures, naturally-produced opioids are less powerful than opioid medications. Vicodin will provoke a stronger pain-killing response from opioid receptors, enough to take the edge off of pain that endogenous opioids cannot counteract. Opioids also trigger the release of the neurochemical dopamine, which is what causes the pleasurable sensations associated with Vicodin consumption.

    None of this is especially disturbing, as long as doses of Vicodin are carefully controlled. But if you begin taking more Vicodin than you should, two things will happen. First, your brain’s opioid receptors will adjust to the presence of so much hydrocodone, and they will gradually lose their sensitivity to its effects. This will force you to boost your Vicodin consumption to compensate, causing your Vicodin dependence to blossom.

    The second result of excessive Vicodin use is an escalating desire for the pleasurable effects caused by dopamine. You’ll crave the euphoric feelings this chemical can cause, and once that happens you’ll have another incentive to keep increasing the size and frequency of your Vicodin doses.

    Eventually, it becomes almost impossible to function without heavy quantities of Vicodin. Brain chemistry becomes seriously altered, and you are no longer able to gain any satisfaction from Vicodin unless you’re consuming levels that are neither safe nor sustainable. 

    The Path to Vicodin Addiction

    The fall into Vicodin dependence is a slippery slope. As your addiction deepens, you’ll become trapped by a pattern of behavior that only makes the problem worse. Your descent into the abyss will accelerate, reinforced by decision-making that becomes increasingly compulsive and uncontrollable. Without Vicodin rehabilitation, you may be unable to reverse course and turn your life around. 

    Abusing Vicodin with a Prescription

    Most men and women who receive prescriptions for Vicodin listen to their doctors and limit their doses. But others become so enamored of the drug’s effects that they push beyond the limits. They take more than they’re supposed to, to deal with some residual pain, or simply because they like the way it makes them feel.

    They may convince themselves that this is okay, and not risky as long as they don’t exceed recommended doses by much. But they underestimate hydrocodone’s addictive power. Soon their Vicodin abuse will carry them into the danger zone and into Vicodin dependence.

    Abusing Vicodin without a Prescription for Medical Reasons

    Some people who suffer from severe pain don’t go to the doctor for help. Or they do see a physician but become dissatisfied with the course of treatment, which does not remove all of their pain. In these instances, some men and women will self-medicate with Vicodin, which isn’t hard to do since the drug is so widely available. Their friends or family may have bottles of it sitting around, or they may have some of it themselves, left over from expired prescriptions. They may even know where to find it on the black market.

    No matter how cautious they try to be, they are putting themselves at grave risk for Vicodin addiction with this type of behavior. There simply is no way a person can properly regulate their Vicodin consumption without medical supervision. If they try, the chances are great that they will use too much of it and become Vicodin dependent.

    Abusing Vicodin for Recreational Purposes

    In some instances, people use Vicodin for reasons that have nothing to do with medical need. Instead, they use it because of its mind-altering side effects. They often use it in combination with other drugs or alcohol, in order to increase the intensity of the high or enhance the feelings of relaxation.

    Recreational Vicodin abuse alone is hazardous enough. But when it’s used in combination with other intoxicants, the risks of addiction and drug overdose will skyrocket. Recreational opioid abuse leads many people to heroin, which highlights how dangerous this reckless this behavior really is.

    Vicodin Addiction Symptoms

    Vicodin is expected to produce some side effects, even if taken as prescribed. But ever-escalating consumption will bring new and more intense Vicodin side effects, signaling your slide into addiction. 

    The most common Vicodin addiction symptoms include:

    • Frequent drowsiness
    • Mental confusion or detachment
    • Memory problems
    • Poor coordination
    • Weakness
    • Slow heart rate
    • Nausea and vomiting
    • Unexplained muscle cramps or pains
    • Trouble urinating
    • Fatigue, lethargy
    • Bouts of agitation or anxiety
    • Shallow breathing or respiratory difficulties
    • Depression

    If you experience these symptoms and have been gradually increasing your consumption of Vicodin, there is reason for concern. 

    One of the most disturbing and frightening signs of Vicodin addiction is an overdose. Almost 50,000 people in the United States died from an opioid overdose in 2017, and many of these unfortunate victims were abusing Vicodin in combination with alcohol, benzodiazepines, cocaine and other intoxicants. 

    Vicodin overdose symptoms include overwhelming grogginess, unresponsiveness, a loss of coordination and balance, nausea and vomiting, dilated pupils, lips turning blue, low blood pressure and respiratory distress. 

    If you don’t get help when these symptoms first appear, you could pay the ultimate price. Of course, the best way to save yourself from a Vicodin overdose is to seek help from a Vicodin rehab facility before anything this drastic happens.

    Diagnosing Vicodin Addiction

    Under standards listed in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for diagnosing Vicodin addiction include the following behavioral and emotional symptoms:

    1. Vicodin use is often heavier than planned.
    2. Using and obtaining Vicodin, and recovering from its abuse, has become overly time-consuming.
    3. Cravings for Vicodin are frequently experienced.
    4. Vicodin use is linked to a variety of social and interpersonal difficulties.
    5. Important personal, familial, occupational and educational responsibilities are neglected because of Vicodin abuse.
    6. Vicodin use has led to reckless or physically dangerous behaviors.
    7. Abuse of Vicodin is connected to the development of serious physical and mental health disorders.
    8. Favorite hobbies and other enjoyable activities have been abandoned in favor of Vicodin abuse.
    9. Attempts to reduce Vicodin consumption have been made, but have all proven unsuccessful.
    10. Growing tolerance for Vicodin has led to increased usage.
    11. Withdrawal symptoms are experienced when Vicodin is not taken for a few hours.

    The severity of your Vicodin addiction will depend on how many symptoms you report. 

    Half of all people with Vicodin addiction will have co-occurring mental health disorders or additional substance use disorders. So, medical professionals who evaluate you for Vicodin addiction will screen for these conditions at the same time.

    Vicodin Withdrawal and Detox

    Vicodin withdrawal symptoms will likely be experienced approximately six to eight hours after use of the drug ceases or is significantly reduced. They will peak in intensity within 48-72 hours and endure at levels that cause physical and emotional discomfort for a week or longer. 

    The most frequently experienced Vicodin withdrawal symptoms include:

    • Anxiety and agitation
    • Nausea and vomiting
    • Muscle aches
    • Heavy sweating
    • Insomnia
    • Racing or uncontrollable thoughts
    • Irritability
    • Lack of energy
    • Diarrhea
    • Chills and other fever-like symptoms
    • Powerful cravings 

    Needless to say, experiencing such symptoms for several days could be enough to destroy anyone’s determination to stay clean and sober. But the worst of Vicodin withdrawal symptoms can be avoided, through your participation in a medically-supervised detox program. 

    The main purpose of detox is to help patients reach a sustainable level of physical and emotional stability, to prepare them to receive addiction treatment. The best Vicodin rehab facilities offer detox services onsite, in clinical settings where all of your medical needs can be addressed and monitored on a 24-hour basis. Addiction specialists and mental health professionals will be available to meet with you at all times, and physicians, nurses, physicians and support staff will provide any additional healthcare services you require.

    If your addiction to Vicodin is mild to moderate, you may begin to taper off the drug during detox, at a reasonable pace that prevents the appearance of significant Vicodin withdrawal side effects. Or, alternatively, you may be given a maintenance medication called buprenorphine, which you can take as a replacement for Vicodin. This opioid satisfies Vicodin cravings but without causing euphoria, changing the psychological dynamics of addiction and making your transition to full sobriety easier.

    You will still have to taper your opioid consumption over time, as you pass through detox, treatment and aftercare. But studies show that buprenorphine use decreases the chances of eventual relapse. Since it doesn’t cause euphoria, buprenorphine won’t reinforce your addiction and will therefore be easier to give up completely. 

    Other medications administered in opioid detox include methadone, which traditionally has been taken as a replacement drug for heroin, and clonidine and lofexidine, two non-opioids that can reduce the intensity of Vicodin withdrawal symptoms.

    Detox programs generally last from a week to 10 days, after which you’ll be officially admitted as a patient in your chosen Vicodin rehab facility.

    Vicodin Addiction Treatment and Rehabilitation 

    Once you’ve been admitted, you’ll spend between one and three months in your Vicodin rehab facility. Inpatient or outpatient treatment programs will both be available, and your choice will depend on your personal preferences and medical needs. 

    In either inpatient or outpatient treatment, your recovery plan will be comprehensive and diverse. It will include services for mental health disorders, if they’ve been diagnosed in addition to your drug dependency.

    Your Vicodin addiction treatment plan will include a mixture of:

    • Individual therapy. With your counselor you’ll work through any personal, psychological or emotional issues that made you susceptible to drug dependency.
    • Group therapy. This involves counseling sessions shared with peers who can give you advice, understanding and acceptance.
    • Family therapy. Loved ones can boost your chances of recovery by offering unconditional love and moral support.
    • Life skills and relapse prevention classes. You’ll emerge from these sessions with more self-comprehension and better ideas about how to cope with life’s stresses.
    • Instruction in holistic healing practices. Mind-body therapies like yoga, acupuncture, medication and biofeedback will help you manage stress and anxiety, which can easily sabotage your sobriety.

    The top Vicodin rehab centers rely exclusively on evidence-based treatments with an established record of success. You’ll be in good and caring hands throughout your time in treatment, and as you transition into aftercare services at the end you’ll be well prepared to embrace your new drug-free lifestyle.

    Finding the Right Vicodin Rehab Facility for You

    Before choosing a Vicodin rehab center, you’ll want to visit multiple institutions to make sure you find the one that offers the best combination of healing services. 

    Your needs are unique and your story is your own, and staff and administrators at the rehab you select will understand that and respect it. They will rely on proven treatment methodologies but still customize your treatment plan to ensure it gives you a great chance to find lasting sobriety. 

    You’ll ask many questions during your visits to Vicodin rehab centers, while seeking the input of your loved ones as well. The best addiction treatment professionals will welcome your questions and give you answers that leave you feeling hopeful and encouraged.

    When you find the right Vicodin rehab facility for you, the choice will be obvious. The peace of mind you feel after that initial visit will stay with you as your treatment progresses, and it will be a major asset in your efforts to overcome your Vicodin dependence. Qualified treatment professionals can help you turn your life around once you’re ready to embrace the challenge.

    View the original article at thefix.com

  • How to Find the Best Rehab for Percodan Addiction

    How to Find the Best Rehab for Percodan Addiction

    Use this helpful guide to find out everything you need to know about Percodan, its side effects, and warning signs of addiction.

    1. What is Percodan and What is it Used For?
    2. Other Names for Percodan
    3. Percodan Side Effects
    4. How Addiction to Percodan Develops
    5. Signs and Symptoms of Percodan Dependence and Addiction
    6. Percodan Withdrawal Symptoms
    7. Percodan Overdose
    8. Percodan Addiction Help
    9. Do You Need Inpatient or Outpatient Treatment?
    10. What to Expect from Percodan Addiction Treatment

    Percodan is a type of opioid medication that may be prescribed to relieve moderate to severe pain, usually after an injury or surgery. Besides pain relief, it can give users a relaxed or euphoric feeling leading to a high potential for dependence or misuse.

    Overcoming Percodan dependence usually requires the help of professionals trained in the field of addiction recovery. With the help of one of the best Percodan addiction treatment centers, you or a loved one can overcome addiction to Percodan and learn what to do if you feel compelled to misuse it in the future.

    What is Percodan and What is it Used For?

    Percodan is a brand name of a combination drug that is a mixture of oxycodone and aspirin. Oxycodone is an opioid analgesic. Aspirin is a salicylate drug that can reduce inflammation, fever and pain, and it’s also known as an anti-inflammatory analgesic. Combining these two drugs gives greater pain relief than either drug alone.

    Percodan may be prescribed for pain relief when other types of pain medication have been ineffective or couldn’t be tolerated. Other reasons Percodan may be prescribed include relief of migraines, dental pain, back pain and pain in joints or muscles. Because of its high potential for misuse, it’s important to take Percodan exactly as prescribed. Patients should avoid taking higher doses or taking the drug more often than prescribed. Whenever pain medication isn’t working to control pain, contact your doctor rather than trying to increase the dose of strong medication on your own.

    Other Names for Percodan

    Another brand name for oxycodone-aspirin is Endodan.

    Percodan may be referred to by a variety of different names on the street including:

    • O.C.
    • Oxy
    • Oxycotton
    • Hillbilly heroin
    • Percs

    Percodan Side Effects

    Strong prescription drugs such as opioids often come with unwanted side effects.

    Some side effects that you may experience when you take Percodan include:

    • Blurred vision
    • Confusion
    • Constipation
    • Agitation or restlessness
    • Lack of coordination
    • Fainting
    • Decreased appetite
    • Tremors
    • Tiredness, sleepiness or weakness
    • Dizziness
    • Heartburn
    • Upset stomach

    How Addiction to Percodan Develops

    Since Percodan contains oxycodone, it can be a very addictive substance. It’s classified as a Schedule II controlled substance. These are narcotics that can lead to significant psychological or physical dependence, and they have a high potential for abuse. Like other drugs that contain oxycodone, Percodan works by binding to opioid receptors in the brain, which can relieve very intense pain. This can affect the release of mood-related neurotransmitters in the brain and lead to a relaxed, euphoric high.

    Percodan and other opioids can be misused by taking more pills than prescribed or taking pills that weren’t prescribed to you. Pills can be crushed and snorted, smoked, or diluted with water and injected. Misuse also includes taking medication that belongs to someone else or taking the medication only for its effects.

    Whenever opioids are used for a long time or taken in a way other than prescribed, they can become habit-forming. You may begin to feel that it takes more of the drug than it used to in order to obtain the effect you’re looking for, so you may try to “lose” your prescription in an effort to get the doctor to prescribe another dose. You may find yourself lying to loved ones about how much you’re taking or trying to avoid participating in any activities unless you are under the influence of Percodan or other opioids.

    Signs and Symptoms of Percodan Dependence and Addiction

    Dependence and addiction can develop subtly and without warning. Most people who misuse substances believe they can quit whenever they want to, but the compulsion to keep returning to substance abuse can be very overpowering.

    There are some telltale signs of Percodan dependence and addiction, which include:

    • Requiring larger doses to obtain the desired effect
    • Attempting to forge prescriptions or trying to obtain prescriptions from more than one doctor
    • Stealing from or lying to loved ones to obtain more of the substance
    • Losing interest in other activities that used to bring pleasure
    • Continuing to misuse substances in spite of negative consequences such as job loss, relationship conflict, financial difficulties or legal problems
    • Feeling strong cravings for the drug
    • Experiencing withdrawal symptoms if you try to quit using Percodan

    Percodan Withdrawal Symptoms

    Physical and psychological dependence can trigger withdrawal symptoms if you try to stop taking Percodan suddenly. These symptoms may also happen if you have been using Percodan exactly as prescribed and try to suddenly stop.

    Withdrawal symptoms you may experience include:

    • Abdominal cramps
    • Nausea
    • Diarrhea
    • Sweating
    • Chills
    • Joint or muscle pain
    • Agitation or anxiety

    Withdrawal from opioids is not usually life-threatening, but it’s very uncomfortable. Because of the extreme discomfort you may experience, if you try to discontinue use without help, you may reach for more Percodan just to stop the intensity of the withdrawal symptoms. Continuing to misuse opioids puts you at risk of overdose. If you’ve been misusing other substances at the same time, it’s even more important to get help from addiction professionals to get through withdrawal safely.

    Percodan Overdose

    Addiction is a progressive disease and almost always gets worse if it isn’t treated. The compulsion to use higher doses of Percodan than the doctor prescribed puts you at risk for taking more of this drug than your body can handle.

    Signs of a Percodan overdose include:

    • Inability to stay awake
    • Fainting or lightheadedness
    • Difficulty breathing
    • Low blood pressure
    • Rapid heartbeat
    • Confusion
    • Severe sweating
    • Cold, clammy skin
    • Seizures
    • Ringing or buzzing in the ear

    One of the most dangerous things that may happen during a Percodan overdose is that breathing may slow or stop, leading to oxygen deprivation. If you suspect a loved one has overdosed on Percodan or other substances, call 911 immediately.

    Percodan Addiction Help

    Drug addiction is a treatable disorder, and it’s possible to get help for addiction to Percodan or other mind-altering substances. If you’re an addict, there’s a good chance you won’t be able to overcome the compulsion to use opioids without help.

    Addiction from substance use disorder begins with getting all substances out of your system, but this is only the beginning. Misuse of mind-altering substances can alter the structure and function of the brain. Part of the brain that may be affected is the part that allows you to use some self-control when it comes to using substances.

    When you’re ready to get Percodan addiction help, a good place to start is to talk to your own doctor. You can also reach out to a counselor or an addiction professional.

    Do You Need Inpatient or Outpatient Treatment?

    Treatment for drug addiction can be done on either an inpatient or an outpatient basis. The decision regarding which is better for you will be determined by both you and your doctor or counselor.

    If you’re addicted to multiple substances, withdrawing from them can be dangerous or even life-threatening. A residential facility gives you the opportunity to go through withdrawal under around-the-clock medical supervision. Medical professionals on staff may be able to give you medication to help reduce the severity of your symptoms.

    Even if the only substance you’ve been misusing is Percodan, staying at a residential facility for a period of time gives you a chance to give early recovery your total attention. At a Percodan rehab center, you’ll be able to take advantage of many different kinds of therapy and support groups, which can give you a good foundation for future and ongoing recovery. Another advantage of inpatient treatment is being able to distance yourself for a period of time from people who might encourage you to continue to misuse substances.

    If your addiction is mild and you have multiple responsibilities, you may be able to start your recovery journey at an outpatient treatment program. This allows you to continue to meet your day-to-day responsibilities such as work, school or childcare while attending therapy sessions and support groups. You’ll need to be committed to following the treatment plan laid out by your doctor.

    Talk to your doctor or counselor and members of your family. If you’re considering inpatient treatment, visit more than one facility and ask questions. Bring a loved one with you to help consider your choices and think about what features are most important to you. Talk to addiction professionals about your options and the type of treatment that would work best in your case, and then get help as soon as you can.

    What to Expect from Percodan Addiction Treatment

    For many people, making the decision to ask for help and try to find the best Percodan addiction treatment facility seems pretty scary, so knowing what to expect may help. At a treatment center, the initial phase is detoxification. As all traces of substances leave your system, you’ll be supervised by medical professionals to keep you safe.

    Once there are no more mind-altering chemicals in your system, you’re ready to learn more about the disease of addiction. Your treatment will include education, support groups and different types of therapy.

    It’s extremely important to get in the habit of participating in support groups. They will be the lifeline of your recovery once you get out of rehab. You’ll share what you’ve gone through with other people who have had similar experiences and together you’ll learn new coping skills and better ways of thinking while offering each other support. Relying on others will give you the strength to resist the temptation to turn to substances when you experience cravings or turbulent emotions.

    Using evidence-based therapies, you’ll begin to get in touch with deep-rooted feelings that may have triggered you to begin misusing substances. At the best Percodan addiction treatment centers, your time in treatment will also include learning new ways to cope with anxiety or upsetting feelings. This may include mindfulness, yoga, progressive muscle relaxation, music therapy or art therapy. Addiction almost always affects all members of the family, so your family may be encouraged to get involved in family therapy.

    Substance misuse can be difficult to overcome, but with the help of experts in the field of addiction recovery, you’ll be able to learn to live a life that doesn’t require dependence on Percodan or any other mind-altering chemical. While you won’t be magically cured, Percodan rehab will help you to get on the right track and will help you to know what you need to do to stay sober once you get out.

    View the original article at thefix.com

  • Warning: Detoxing in Jail May Lead to Severe Injury or Death

    Warning: Detoxing in Jail May Lead to Severe Injury or Death

    Given the undeniable and inextricable link between jails and dangerous withdrawal from drugs and alcohol, isn’t it time that more jails had adequate detox infrastructure and medical personnel?

    In January, Frederick Adami was detained in Bucks County Correctional Facility in Doylestown, Pennsylvania. Soon, he began vomiting and defecating profusely and persistently. His cellmate’s pleas for medical assistance were ignored for hours. The next morning, guards found Adami dead in his cell. The cause of death was opioid withdrawal – a condition that, when properly medically supervised, has a near-zero mortality rate.

    In March, an inmate in a Delaware County, Ohio jail died from opioid withdrawal despite being on the facility’s medical addiction protocol. A sheriff’s office spokeswoman felt “pretty confident that there were no red flags … that there was nothing more that we could have done.” In nearby Logan County, a pending lawsuit charges that an inmate died last June after being strapped to a chair while withdrawing from alcohol — a drug whose legality belies the grave risks of nonclinical detoxing, including seizures and the substance-specific delirium tremens.

    Hard Facts and Half-Measures

    The story of withdrawal oversight in our nation’s jails is one of convincing facts met with half-measures. According to an instructive paper published by the Center for Health & Justice titled “Safe Withdrawal in Jail Settings,” 64,000 Americans died from drugs in 2016 (the number climbed to 72,000 in 2017), and 20.1 million people reported substance abuse issues in 2016.

    The paper then cites a truly eye-opening statistic: nearly two-thirds of people serving sentences in jail meet the diagnostic criteria for drug dependence or abuse. Incredibly, that data is from 2007-2009 – before the current opioid crisis and its record addiction and death totals. And since these detained people with addictions to alcohol or drugs are separated from their substances by metal bars, jails are often ground zero for withdrawal symptoms to both begin and worsen.

    Alarmingly, these hard facts are followed by soft recommendations. The paper concludes that “medically supervised withdrawal from alcohol or illicit substances is ideal whenever possible,” and that “partnerships with local medical providers can help jails safely manage withdrawal syndrome.”

    “Ideal whenever possible” is official-ese for “if it’s convenient for you” and especially “if you can afford it.” And “partnerships with local medical providers” is an intentionally vague phrase providing more cover for jails than coverage for the jailed.

    Wardens Are Not Equipped to Treat Withdrawal

    Isn’t it the duty of law enforcement officials to prevent unnecessary injuries and deaths in their own jails? High, drunk, or sober, shouldn’t concern for inmate safety be a priority? What’s more, as withdrawal tends to occur early in the detention process, it undoubtedly affects many detainees who haven’t even seen a judge yet, much less been convicted of a crime.

    Given the undeniable and inextricable link between jails and dangerous withdrawal from drugs and alcohol, isn’t it time that far more jails had adequate detox infrastructure and medical personnel?

    The issue clearly isn’t getting the attention it deserves. New York City — a historically forward-thinking city whose mayor, Bill de Blasio, is among the country’s most progressive — is a prime example, since its jail system has been a focal point of change in recent years.

    New York plans to replace its notoriously decrepit jail at Rikers Island with a number of smaller jails spread throughout the city. Despite improved safety being a key tenet of the long overdue initiative, the word “withdrawal” can be found exactly zero times in its 50-page roadmap plan. 

    Granted, the plan does include a program called HealingNYC, which treats opioid-dependent inmates with methadone, a known treatment for weaning. However, merely distributing meds won’t matter if an inmate shows the types of severe symptoms — including relentless vomiting and defecating — that can lead to long-term health issues or death. Further, methadone won’t do a thing for those withdrawing from alcohol.

    Though no national record is available detailing withdrawal deaths in jails, the scenario is far from far-fetched: according to HealingNYC, 17 percent of the 55,000 people admitted annually to NYC’s jails are in acute opioid withdrawal. Investigative reporting by Mother Jones found 20 lawsuits filed between 2014 and 2016 alleging that an inmate died from opiate withdrawal complications — a figure that, according to an attorney for one of the victims, likely represents a mere fraction of the actual total.

    And neither figure includes people going through alcohol withdrawal, a condition with even more dangerous complications. 

    These situations call for medical personnel, not just medicines. As a larger report on our jail system’s healthcare crisis in The New Yorker noted, “withdrawal can require close monitoring and specialized treatment that jail wardens are not equipped to provide.”

    Healthcare Behind Bars: Profits Over People

    And while many local jail systems have turned to private entities to provide healthcare for inmates, unsurprising reports have surfaced that many of these organizations place profits over people, and tend to operate only as effectively as they are overseen. In Arizona, which employs a private healthcare provider called Corizon, a pending lawsuit accuses the state of care so shoddy that it violates the Constitution’s Eighth Amendment ban on cruel and unusual punishment.

    As a recovering alcoholic, I’ve both heard and witnessed frightening accounts of alcoholics and addicts detoxing without medical assistance. Too many of these stories unfolded in jails following recent arrests; in 2011, my final drinking spree ended with 30 hours in a lower Manhattan jail following a DUI. Fortunately my withdrawal symptoms were minor, but I have no confidence in the ability of that antiquated facility — so dank and dungeon-esque it earned the nickname “The Tombs” — to handle serious withdrawal.

    Nobody is expecting perfection. Compared with larger, more concentrated state and federal prisons, jails are inherently scattered, transitional facilities operated by county or municipal law enforcement departments. With more than 3,000 jails across the country housing some 700,000 detainees, it’s unrealistic to mandate each be fully staffed and equipped to treat all facets of drug and alcohol withdrawal.

    However, we can and should do far better. Amid recent encouraging changes in the way the criminal justice system treats drug-related offenses — reduced sentencing, increased redirection and referrals to rehabs, equipping police officers with the fast-acting opioid overdose-preventing drug naloxone — it only makes sense to improve the way we deal with addiction and alcoholism at a detainee’s first true danger point. Increased funding for proper detox facilities and trained medical personnel at jails should be considered another stepping stone in an ongoing fight to reduce drug- and alcohol-related injuries and deaths.

    View the original article at thefix.com

  • Discontinuing Opioids Too Quickly Can Be Harmful, FDA Warns

    Discontinuing Opioids Too Quickly Can Be Harmful, FDA Warns

    The FDA issued guidance to help address the issue of opioid-dependent patients discontinuing or tapering off too quickly and becoming sick. 

    Since the national crackdown on prescription opioids, many pain patients have been forced to taper their dose of painkillers. Now, the Food and Drug Administration is warning doctors that tapering too quickly can have unintended and dangerous consequences. 

    “The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased,” the agency said in a statement. “These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.”

    The FDA issued guidance to help address the problem. 

    “These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued,” the agency wrote. 

    The agency said that providers should make an individualized plan for patients who need to taper off opioids, and should never stop the pain pills suddenly. The plan should take into consideration the type of opioid and dosage, as well as the patient’s pain and psychological concerns. 

    “Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress,” the FDA wrote. 

    The agency also warned that patients should not discontinue opioids without talking to their providers. They should be candid about any side effects they have as their dose of opioids is being tapered. 

    “Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal,” the agency warned. “Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.”

    Although many public health officials applaud efforts to reduce the amount of opioids prescribed, pain patients say that the regulations have gone too far, and have left vulnerable pain patients unprotected. 

    Speaking with The Fix last fall, Lauren DeLuca, a pain patient and founder of the Chronic Illness Advocacy and Awareness Group, said that not being able to access pain medications can be devastating for patients. She said she regularly hears from pain patients who are not able to access enough medications to alleviate their symptoms. Sometimes, these people begin to consider suicide.

    “It is borderline genocide,” she said. “You are allowing them to go home and essentially suffer until they kill themselves.”

    View the original article at thefix.com

  • Rejected Depression Drug Could Provide Relief For Opioid Withdrawal

    Rejected Depression Drug Could Provide Relief For Opioid Withdrawal

    A rejected depression drug is being reexamined as a potential non-addictive treatment for opioid withdrawal symptoms. 

    A drug that was developed to treat depression but was ultimately shown in clinical trials to be ineffective could have a new purpose: helping people overcome withdrawal symptoms when they stop using opioids. 

    The drug, rapastinel, binds to the same receptors as ketamine, NMDA receptors, and was being explored as a treatment for depression, similar to the newly-approved esketamine. However, in March, clinical trials showed that rapastinel was not effective in alleviating depression symptoms. 

    Yet, researchers found that in rats, rapastinel provided relief from opioid withdrawal symptoms, according to a press release. The findings were presented at the 2019 Experimental Biology Meeting of the American Society for Pharmacology and Experimental Therapeutics, held April 6-9 in Orlando. 

    Researchers Julia Ferrante, an undergraduate at Villanova University, and Cynthia M. Kuhn, a professor of pharmacology and cancer biology at Duke University, say that rapastinel could serve as a non-addictive medication to treat opioid withdrawal symptoms. 

    “We have found that rapastinel has potential as a new treatment for opioid dependence, as it is effective in reducing withdrawal signs and has not been shown to produce any negative side effects,” Ferrante said. “By reducing withdrawal symptoms, the patient feels less discomfort during treatment, and we hypothesize this would lead to a decreased risk of relapse.”

    Currently, buprenorphine and methadone are used to manage symptoms of opioid withdrawal, but since both are opioids they are problematic for people with opioid use disorder. Ketamine has been explored as a possible way to manage withdrawal symptoms, but it also has the possibility for abuse, and can cause hallucinations that are particularly problematic for people with underlying mental health issues. 

    During the research, rats with opioid dependence were given saline, ketamine, or rapastinel. Those given rapastinel showed the fewest withdrawal symptoms. With that data in mind, Ferrante said that in humans rapastinel could potentially be delivered intravenously in an outpatient setting, in order to help people through the painful opioid withdrawal process. 

    “Our research suggests that new alternatives to standard treatments for opioid dependence have potential to be safer and more effective,” Ferrante said. 

    Unfortunately, that goal may be a long way off, since additional research is needed before rapastinel could even begin human trials. 

    “Rapastinel research for opioid dependency is currently only being done in rodents, but if the drug continues to have successful trials, it may enter clinical trials for use in humans,” Ferrante said. 

    View the original article at thefix.com

  • Promising New Treatments for Opioid-Dependent Babies

    Promising New Treatments for Opioid-Dependent Babies

    Compassionate care for the mothers was crucial to positive outcomes for opioid-dependent babies.

    I gave birth to my daughter in late January of 2014. It was the kind of birth you see in the movies—the contractions started hard and grew closer together within moments. By the time I realized I was in labor, I was already in too much pain to walk. I began needing to push while my husband was on the phone calling for an ambulance. The 911 operator had to walk him through the beginning of my daughter’s delivery. Luckily, paramedics showed up to take over while she was still crowning. The lieutenant who delivered her said it was her first completed childbirth. I will never forget holding my newborn daughter in the elevator while we rode down to the ambulance, or how the entire labor and delivery staff burst into applause when we wheeled into the hospital. But the joy and pride of my wild, badass childbirth was quickly replaced by a deep sense of guilt.

    Within hours, my daughter began showing symptoms of opioid withdrawal—symptoms like rigid limbs, sneezing, and a sharp, screeching cry that burrowed into my belly and filled me with self-loathing. The withdrawal was from methadone, which I was prescribed and taking under a doctor’s supervision. Methadone has been the gold standard of care for pregnant people with opioid dependencies since the 1960s. I did the right thing. Still, watching my newborn daughter go through withdrawal was excruciating. Unfortunately, the treatment she and I received at the hospital—after that initial congratulatory applause—did not make the experience easier.

    My daughter’s level of discomfort was rated using the same system used by the majority of U.S. hospitals. It’s called the Finnegan Neonatal Abstinence Scoring Tool (though its inventor, Dr. Loretta Finnegan, notes with a laugh that her name was tacked onto it later without her knowledge). It consists of a comprehensive list of observable newborn withdrawal symptoms. Hospital staff, usually treating nurses, observe the babies every four hours and tally up the number of listed symptoms they observe. Each symptom is a point, and the overall score for that observation period is used to determine how to move forward with treatment. Usually a score above eight means the infant should begin an opiate wean, or have his dose raised if he has already been started on medication.

    The scoring system is the product of meticulous observations recorded by Finnegan in the early 1970s, when babies were dying from opioid withdrawal simply because nobody knew how to define and treat it. But in 2014, when my daughter was subject to it, and when her scores caused her to be sent to the Neonatal Intensive Care Unit (NICU) to be medicated with titrated doses of morphine for over a month by staff who were less than welcoming to me, I resented the Finnegan Score. Other methadone and buprenorphine-dependent mothers whom I have spoken with have related similar discontent with the system. Usually, the complaints center around variability between the way that different nurses score the babies, or at having their babies sent to the NICU. It turns out, the way some of these hospitals use the scoring system is not in keeping with best practice, according to its creator.

    Loretta Finnegan, who is now the Executive Officer of the College on Problems of Drug Dependence, says that inter-rater reliability is key to correct usage of the tool, and recommends that hospitals which use it conduct re-orientations “a minimum of every six months.” She also doesn’t believe that the modern NICU set-up is appropriate for babies who are experiencing NAS without other complications. In fact, she says that “the NICU is the worst place for these babies,” because of the overstimulation caused by the noise and bright lights. Finnegan puts out a training manual, and gives recommendations for the care of infants include swaddling, non-nutritive sucking, decreased stimulation, and plenty of access to mom. When she was doing her clinical work in Philadelphia, she says they “had [their] moms come in every day,” and that “compassionate care for the mothers” was crucial to positive outcomes for the babies. If I had received treatment more in line with Finnegan’s protocols, I probably would have resented the scoring system—and my daughter’s extended hospital stay—a lot less, and I suspect that other mothers would agree.

    But besides providing better training to staff who are using the current standard NAS protocol, there are a couple of promising new tools for NAS that could help decrease hospital stays for infants, and promote better trust between parents and hospital staff. One of these tools, developed by Matthew Grossman, M.D., an assistant professor of pediatrics at Yale School of Medicine, is called “Eat, Sleep, Console.”

    Renee Rushka gave birth to her daughter in July 2018, while taking methadone prescribed for opioid addiction. Her daughter was treated for NAS at Danbury Hospital in Connecticut. She says that they used the Finnegan NAS Scoring System to assess her baby, but they also performed another form of assessment. Although she says she never heard the term “Eat, Sleep, Console,” and she can’t remember the exact measures, she describes a protocol that sounds very much like the system first developed and researched by Grossman in 2014.

    Grossman’s system essentially measures exactly what the name implies—whether the baby is eating at least one ounce of milk, whether the baby can sleep for an hour straight, and whether she can be consoled within 10 minutes of becoming fussy. The protocol suggests maternal contact and non-pharmacological approaches whenever possible. Pharmacological intervention is indicated based on the infant’s level of functioning and comfort, rather than with the goal of reducing all withdrawal symptoms. According to Grossman’s trial conducted at Yale New Haven Children’s Hospital, only 12% of infants required morphine therapy, as opposed to 61% using the Finnegan system (though the study does not tell us whether they used it the way Finnegan herself recommends), and it significantly reduced the length of stay for many of the babies.

    Rushka reports that her experience with the combined Finnegan and ESC-like approach was extremely positive. She brought her baby home, healthy, after five days, having required zero medication intervention. She also notes that she did not feel judged by the staff, and even recalls receiving compliments and affirmations about her recovery—pointing toward the compassionate, inclusive approach that both Finnegan and Grossman deem crucial to the care of opioid-dependent infants. Finnegan expresses concerns that inter-rater reliability might also be an issue should ESC become more wide-spread, in part because of the design simplicity. But she’s definitely in favor of various treatments being designed for NAS. “In most diseases there are many ways to treat them,” she notes, adding, “I just need to see more proof [that ESC works.]”

    Another promising new tool for treating NAS takes a surprising form. It’s a crib called SNOO, whose designer was not initially thinking about NAS at all—his goal was to reduce Sudden Infant Death Syndrome (SIDS). Pediatrician Harvey Karp says that the crib can not only sense when a baby is in distress, but also what level of distress he’s experiencing—and will rock and emit soothing sounds to help calm the baby, similar to a human caregiver, but all while the real caregiver gets some much-needed rest. Karp says that “NAS babies are more skewed to the irritable side,” then, “the more sciencey way of saying it is that they have poor state control…basically you take a child with terrible state control and give them the rhythmic stimulation they need to get down to a calmer state…it’s so important to our neurology that even adults calm down this way; it’s not an accident we fall asleep in planes, trains, and cars. It’s an echo to this ancient, ancient response to the normal womb sensation.”

    Currently, Mark Waltzman, Chief of Pediatrics at South Shore Hospital in Boston, is conducting a study to test the efficacy of the SNOO in reducing distress in babies with NAS. He’s also using Grossman’s Eat, Sleep, Console tool to assess the babies’ level of discomfort. Waltzman’s study is still enrolling, so there’s no data available yet, but he is hopeful that SNOO will offer a relatively simple, non-pharmacological approach to treating the discomfort associated with NAS.

    It has been almost five years since my elder daughter was treated for NAS. Mothers across the country still report complaints similar to the ones I had then—but there are also moms like Rushka who are finding community and support in the hospitals where their babies are being treated. Regardless of the outcome of Waltzman’s SNOO trial, or further testing for Grossman’s Eat, Sleep, Console tool, the fact that this kind of diverse attention is being paid toward NAS—and alongside it a resurgence of the compassion toward the mothers that Finnegan first championed in the 70s—gives me a sense of much-needed hope. Maybe attitudes about addiction are making a positive shift within the medical community. Maybe, in the future, experiences like mine will be obsolete, and all opioid-dependent mothers and infants will have the compassionate care and affirmative respect enjoyed by Rushka and her daughter.

    View the original article at thefix.com

  • County Pays Millions Over Teen’s Heroin Withdrawal Death In Jail

    County Pays Millions Over Teen’s Heroin Withdrawal Death In Jail

    “Anyone who looked at her would have known that she was very sick and that she needed attention,” said the family’s lawyer.

    A Pennsylvania county has agreed to pay nearly $5 million as part of a settlement in the case of a teenager who died in jail after guards ignored her worsening medical condition during four brutal days of heroin withdrawal. 

    Despite the costly payout, it’s not clear whether the Lebanon County Correctional Facility death will lead to any policy change—but attorneys say it sends a message that even small lock-ups need to take care of inmates who are physically dependent on drugs.

    “The days of viewing people addicted to drugs as junkies unworthy of sympathy and care, are long past,” Jonathan Feinberg, a civil rights attorney representing the family, told the Associated Press. “It’s a very short chain of events that leads to death.”

    When 18-year-old Victoria Herr was arrested in March 2015, she had a 10-bag-a-day heroin habit. She’d been picked up when police looking for her boyfriend found drugs in their apartment. It was her first time in jail, and she warned staff about the amount of drugs she’d been doing and told her cellmate she was worried about how bad the withdrawal would be. 

    For four days, the teen was vomiting and had diarrhea. But the jail only gave her Ensure, water and adult diapers. She couldn’t keep down any liquids and became severely dehydrated. The day before she collapsed, Herr begged for lemonade during a phone call home to her mother.

    “Anyone who looked at her would have known that she was very sick and that she needed attention,” Feinberg said. “There was a complete disregard for her needs, which can only be tied back to the fact that she was addicted to drugs.”

    On March 31—four days after her arrest—she collapsed in the jail and was rushed to the hospital. She went into cardiac arrest, according to the Lebanon Daily News, but lingered for days on a ventilator before finally dying on April 5.

    The fatality, her lawyers said, could have been prevented if jailers had simply taken her to the hospital sooner for intravenous fluids. 

    Although opioid withdrawal does not always lead to death, it can be fatal in cases of severe dehydration. That possibility has prompted some jails to begin offering medications—like buprenorphine—to ease withdrawal, and sometimes continue use for long-term treatment.

    Despite the hefty size of the agreed-upon payout in Herr’s case, an attorney for the jailers stressed that no one actually copped to doing anything wrong as any part of the settlement.

    “The case was resolved amicably,” the attorney, Hugh O’Neill, told the Associated Press. He declined to say whether the county had changed any policies since the teen’s death. The county administrator, Jamie Wolgemuth, issued a statement to the local news highlighting the fact that state police and the Lehigh County Coroner did not send the case to prosecutors for “further inquiry.”

    Regardless, lawyers for Herr’s family framed the settlement as a win for correctional accountability.

    “It’s certainly one of the largest settlements in at least the last 10 years involving the death of a prisoner in civil rights litigation,” Feinberg told the Lebanon paper. “When there are breakdowns in the way a prison is run, and when those breakdowns cause harm like the unimaginable harm that was caused to Tori Herr, this suit shows that prisons and staff will be held accountable.”

    View the original article at thefix.com

  • Kratom Draws Support And Controversy As Opioid Addiction Treatment

    Kratom Draws Support And Controversy As Opioid Addiction Treatment

    “It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” said one kratom user. 

    A controversial supplement, kratom, could have benefits when it comes to treating opioid use disorder, according to a new study. However, there is still much controversy around it due to safety concerns.

    Kratom is a psychoactive drug that comes from the leaves of Mitragyna speciosa, which is an Asian plant in the coffee family. 

    Some believe it is effective for treating substance use disorders, but organizations such as the Food and Drug Administration (FDA) and the Drug Enforcement Administration are wary of that. In fact, the DEA even attempted to ban the substance.

    In February, FDA commissioner Scott Gottlieb spoke against kratom, saying “there is no evidence to indicate that kratom is safe or effective for any medical use.”

    Scott Hemby, a professor of pharmaceutical science at High Point University in North Carolina, led a new study recently published in Addiction Biology, which found that kratom may in fact have some benefits.

    Kratom has two main ingredients: mitragynine (MG) and 7‐hydroxymitragynine (7‐HMG). MG accounts for 60% of the compound in the plant while HMG is about 2%. Using rats, Hemby’s study examined how both these ingredients affect the brain. 

    Hemby and other researchers allowed rats to self-administer both components of kratom. They found that the rats quickly began self-administering HMG, but did not have interest in MG.

    “In other words, while one of kratom’s main compounds appeared to be addictive, the other wasn’t at all—in fact, it appeared to have the opposite effect,” Business Insider reported. 

    Because kratom affects some of the same receptors in the brain as opioids, the FDA announced in February that it would be called an “opioid.” But others believe kratom could be beneficial and treat cravings while reducing symptoms of withdrawal and the likelihood of relapse.

    The results of the study suggest that it could be beneficial to breed the plant to have higher concentrations of one compound versus the other. However, the results are preliminary because the study was not done on humans.

    Some people, such as 26-year-old Bryce Avey, began using kratom because they could not get access to other opioid treatments like buprenorphine and naltrexone. “It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” Avey told Business Insider. 

    David Juurlink, professor of medicine at the University of Toronto, told Business Insider that the use of kratom makes sense, as it affects the same brain receptors as opioids. “It makes sense that this product would mitigate the symptoms of opioid withdrawal or allow someone to transition from a higher dose to lower dose, or help get them off of opioids altogether,” he said.

    Business Insider notes that concern about the supplement arises because there is no “quality oversight of kratom,” meaning people don’t know what the pills actually contain.

    “Personally, I would never take this stuff,” Juurlink told Business Insider. “When you go to a pharmacy, you know there’s quality control, you know precisely how much you’re getting, and you know exactly what you’re getting. With this, it’s impossible to know.”

    View the original article at thefix.com