Answer Addiction

Tag: withdrawal symptoms

  • Opioids Improved Her Life, But Withdrawals Were Hell

    Opioids Improved Her Life, But Withdrawals Were Hell

    “I was afraid. I knew these drugs were heroin in another form. But after I started, I instantly regretted having waited so long.”

    By the time Madora Pennington was 13, she was living with extreme pain. Pennington was born with Ehlers-Danlos syndrome, a painful genetic disorder that left her suicidal by the time she was 20.

    Although she knew about the dangers of powerful prescription opioids, she felt she had no other option that could improve her quality of life.

    “Instead of following through with suicide plans, I spoke with my doctor, who prescribed me opiates,” Pennington wrote for The Los Angeles Times. She began taking Vicodin, morphine and a muscle relaxant every night.

    “I was afraid. I knew these drugs were heroin in another form,” she wrote. “But after I started, I instantly regretted having waited so long.”

    Living With Less Pain

    The opioids allowed Pennington to live with much less pain. For the first time, she was able to make progress in physical therapy, because her body had space to heal. Still, she recognized the powerful allure of the drugs. 

    “At night, when I took my tiny pills, I was transported to a realm where there are no problems. It felt so fake, so obviously chemically induced, but deeply soothing, nonetheless,” Pennington wrote. 

    Her doctor had warned her that she may never be able to quit morphine once she started. However, Pennington told herself that she would do anything she could to get off opioids once her pain and symptoms were under control. When she had the chance, she did just that. 

    “Per the medical definition, I was not an addict. I was never drug-seeking, never doctor shopping, never secretly taking more than I said, never taking for emotional relief. I reduced my intake as my Ehlers-Danlos improved,” she wrote.

    Time To Taper

    Her pharmacist warned her to taper her opioids extremely slowly. Still, Pennington felt unprepared for the physical and emotional symptoms she experienced as she worked to reduce her opioid intake.

    “In a life filled with pain, even I never knew such anguish could exist,” she explained. She was experiencing extreme stomach pain, emotional outbursts and jitters. “I stopped titrating and parked my dose where it was, too sick to go lower,” Pennington wrote.

    When Philip Seymour Hoffman left rehab and fatally overdosed in 2014, Pennington says she understood. 

    A doctor suggested that Pennington stay on low-dose opioids forever, but “that made me furious,” she wrote. “I wanted to be free.”

    She decided to start tapering again, as quickly as she could handle. “I stopped trying to get anything done and steeled myself for the unending agony,” she wrote.

    In 2014, Pennington was officially free from opioids. She had reached her goal and felt great physically, but writes that “the empty low was indescribable.”

    Low-Dose Naltrexone Became A Viable Option

    Finally, she was able to connect with a provider who gave her low-dose naltrexone to help ease the residual effects of opioid withdrawal. Now, she shares her experience on her website to highlight both the importance and dangerous power of opioids.

    “As someone born genetically destined to suffer, I don’t quibble over hypotheticals,” Pennington writes. “It’s no one’s fault that chronic pain is so difficult to treat. I wish I’d had better advice for opiate recovery. I wish I could have gotten to my life now sooner, where I enjoy getting up every day and doing what I want. But I made it here because of the relief I got from opiates. Yes, it was worth it.”

    View the original article at thefix.com

  • Jails Struggle With Being The Nation’s Primary Detox, Treatment Centers

    Jails Struggle With Being The Nation’s Primary Detox, Treatment Centers

    One Massachusetts sheriff estimates that 80 to 90% of the prisoners in his jail have a substance use disorder.

    By some estimates up to two-thirds of prisoners in county jails around the country have some sort of substance use disorder, which has made jails the nation’s primary detox and treatment centers, a role they are often ill-equipped for.

    “It was never traditionally the function of jail to be a treatment provider, nor to be the primary provider of detoxification in the country — which is what they have become, so with the opioid epidemic, jails are scrambling to catch up,” Andrew Klein, a research scientist with Advocates for Human Potential, a company that works with jails to facilitate treatment, told NPR.

    Peter Koutoujian, sheriff of Middlesex County, Massachusetts, says that jails have become a catch-all system for people who fall through the cracks. 

    “We have not been able to get our hands around it because, quite honestly, society has not gotten its hand around either preventing [drug-addicted] people from coming into our institutions or supporting them once they get back outside,” he said. “The fact is you shouldn’t have to come to jail to get good [treatment] programming. You should be able to get that in your own community so you don’t have to have your life disrupted by becoming incarcerated.”

    And yet Koutoujian estimates that 80-90 percent of prisoners in his jail have a substance use disorder. 

    Increasingly, jails are stepping up to try to figure out how to help people get treatment while they are locked up. The National Sheriff’s Association recently put out guidelines for delivering medication-assisted treatment in jails. Still, many law enforcement officials are wary of using medication-assisted treatment, the established best practice for treating opioid addiction, because the medications can be diverted or abused in the jail. Only about 12 percent of jails offer MAT, but that is good progress, Klein said. 

    “Although this number is not the majority of jails, five years ago it was zero. And the number is increasing every week,” he said. 

    In order to save lives, jails need to consider not only keeping people sober when they’re inside, but also how to help them stay sober once they’re released, said Carlos Morales the director of correctional health services for California’s San Mateo County. 

    “We know if you are an opiate user you come in here, you detox, and you go out — it’s a 40 percent chance of OD-ing,” he said. “And we have the potential to do something about it.”

    However, Koutoujian said that MAT alone is not the answer. 

    “Medication-assisted treatment is very important but people have to remember if you do the medication without the treatment portion — the counseling and the supports — it will fail. And we will just fall prey to another easy solution that just simply does not work.”

    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

  • Lip Balm Addiction: Reality or Urban Myth?

    Lip Balm Addiction: Reality or Urban Myth?

    A group of experts gave their take on whether or not you can actually be addicted to lip balm.

    As Health.com recently noted, the belief that one can become dependent on lip care products like lip balm has become a topic of intense online discussion.

    Everyone from dermatologists to lip care product manufacturers have been forced to weigh in on the possibility.  

    And while both parties dismiss the possibility of a real “addiction” to lip balm, they also note that frequent use of such products can have both physical and psychological side effects that users should be aware of the next time they feel the need to keep their lips moisturized.

    Blistex, which manufactures an array of personal care products, including dozens of lip balms, outlined the argument against dependency on lip care products in a post on the Frequently Asked Questions page of its website.

    The post quoted Dr. Charles Zugerman, associate professor of clinical dermatology at Northwestern University Medical School, who stated that individuals do not become physically “addicted” to the products or their ingredients.

    Anyone who stops using lip balm or related products can stop using them and experience none of the symptoms associated with withdrawal from addictive substances or conditions.

    However, Zugerman did note that individuals who frequently apply lip balm may become accustomed to the “moist, comfortable” feeling associated with its use, and may experience discomfort when their lips dry out due to environmental exposure.

    That notion is corroborated by Joshua Zeichner, MD, who directs cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York, who told Real Simple  that applying ointments that form a barrier on the skin can “create an artificial barrier to lock in moisture, but when overused, can cause lips to become lazy, because the skin doesn’t have to work to maintain its own hydration level.”

    Additionally, some lip balms have ingredients that can potentially irritate your lips. These include camphor, menthol or salicylic acid. According to Zeichner, these ingredients can inflame lips and cause them to lose hydration. “This, in turn, causes your lips to need more moisture, so you keep applying the product, and it turns into a vicious cycle,” he explained. 

    A third concern comes from licking your lips. Dermatologist Rachel Nazarian, MD, told Health.com that saliva contains enzymes that help to digest food, and when you lick your lips, the enzymes can dry out your lips and make them feel chapped, which again, requires more lip balm. In this case, as Nazarian noted, the core issue is licking your lips, but the impact on your lip moisture may cause increased lip balm use.

    There are a handful of solutions to the issue of dryness: Zeichner suggested to Real Simple that using a product with lanolin will create a barrier on the skin but still allow for lips to naturally hydrate themselves.

    Dermatologist Debra Jaliman also told Health.com that drinking plenty of water during the day will help to keep lips hydrated, but the best approach, according to Zeichner, is to simply use lip balm “when you need it, rather than compulsively throughout the day. Constant reapplication can cause more harm than good.”

    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

  • Can Eating Less Junk Food Cause Withdrawal Symptoms?

    Can Eating Less Junk Food Cause Withdrawal Symptoms?

    A new study examined whether cutting back on junk food could produce symptoms similar to those experienced when quitting tobacco or pot.

    A body of research on the effects of highly processed foods has suggested that cutting down on regular consumption of such items have resulted in physical and psychological symptoms.

    The latest research to support this theory comes from the University of Michigan, where a study has suggested that reducing the amount of highly processed foods in one’s diet may produce symptoms similar to those experienced when quitting tobacco or marijuana.

    The study, which utilized a modified questionnaire used to assess symptoms for other dependency-forming substances, may offer a new means of measuring and understanding the impact of processed foods on individuals.

    In the study—published in the September 2018 edition of the online journal Appetite—a group of 200 adults aged 19 to 68 who’d been on diets that involved cutting down on junk food in the past year were given a questionnaire, called the Highly Processed Food Withdrawal Scale which is modeled after a similar tool used to measure symptoms that occurred after individuals quit smoking or using marijuana.

    Based on the study group’s self-reported information, withdrawal symptoms, including mood swings, cravings, anxiety and headaches, were determined to be most intense between the second and fifth days after making an attempt to reduce junk food intake—which according to study lead author Erica Schulte, echoes a timeframe similar to one experienced by people who undergo drug withdrawal.

    Researchers noted that the study did have several limitations, most notably a lack of information on the intensity of withdrawal symptoms or which methods participants used to change their intake, whether through gradual reduction or complete elimination from their diets.

    The study also did not ask participants to record their withdrawal symptoms in real time, but instead asked them to only recall the scope of the symptoms as a whole. 

    Still, the study did contribute to growing awareness of the possible dependency-forming aspect of highly processed foods, and the results may help individuals who consider reducing such items from their diets to prepare for the possibility of side effects.

    According to Schulte, it may also provide some insight into the barriers that may cause people to stop making such changes, or even leave treatment to address dependency issues altogether.

    View the original article at thefix.com

  • Pennsylvania Supreme Court To Decide If Prenatal Drug Use Is Child Abuse

    Pennsylvania Supreme Court To Decide If Prenatal Drug Use Is Child Abuse

    A lengthy legal battle has been waged by the state against a mother whose newborn was hospitalized for 19 days to treat drug withdrawal.

    The highest court in the Keystone State this week heard arguments on the divisive matter of whether prenatal drug use counts as child abuse. 

    Attorneys for child protective services framed it as a matter of “human rights,” while defense lawyers for an unnamed mother warned that criminalizing such behavior could be a “slippery slope,” according to the Philadelphia Inquirer. 

    The Pennsylvania Supreme Court case revolves around a woman who tested positive for a medley of drugs—including pot, opioids, and benzodiazepines—just after giving birth in a central Pennsylvania hospital. Afterward, her newborn was hospitalized for 19 days to treat drug withdrawal.

    Children and Youth Services took custody of the baby and accused the mother of abuse, setting off a lengthy legal battle still winding through state courts. 

    Early on, a Clinton County court decided that the mother’s drug use didn’t constitute child abuse as a fetus is not a child. But during the appeals process, a Superior Court bounced the case back to the lower court, though two judges raised concerns about the implications of labeling drug use during pregnancy as a form of abuse.

    “Should she travel to countries where the Zika virus is present? Should she obtain cancer treatment even though it could put her child at risk?” wrote Judge Eugene Strassburger, according to the Philadelphia newspaper. 

    Earlier this year, attorneys for the mother—who is identified in court filings only by her initials—asked the state’s high court to take up the case, and this week the justices heard oral arguments from both sides. 

    “Failing to heed a doctor’s advice to take folic acid, if the child is born with a neural tube defect, then the mother could be a child abuser under the county’s reading of the statute,” said attorney David Cohen, arguing that labeling prenatal drug use as child abuse could open the door to a variety of similar arguments against unhealthy behavior. 

    But Justice Christine Donohue called that “slippery slope” argument “too much,” and said she wasn’t sure that she’d “buy” it. Meanwhile, county CYS attorney Amanda Browning told the court that the case was about “human rights, equal protection and child welfare,” pointing to the painful withdrawal process after birth.

    It’s not clear when the high court will issue its decision.

    View the original article at thefix.com

  • More ERs Are Providing Withdrawal Meds As First Step To Recovery

    More ERs Are Providing Withdrawal Meds As First Step To Recovery

    Patients in need are receiving buprenorphine to address their withdrawal symptoms. 

    Kicking an opioid habit comes with a host of physical withdrawal symptoms so severe that people often end up in the emergency room.

    There, they are usually treated for diarrhea or vomiting, but not the underlying issue. Now, however, more emergency rooms around the county are providing buprenorphine to help ease withdrawal and get more people into treatment. 

    “With a single ER visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings,” Dr. Andrew Herring, an emergency medicine specialist at Highland Hospital in Oakland, California, told The New York Times. 

    At Highland, people who come in presenting with withdrawal symptoms are given a dose of buprenorphine, also known as Suboxone, and are told to follow up with Herring, who runs the hospital’s buprenorphine program. 

    “It can be this revelatory moment for people—even in the depth of crisis, in the middle of the night,” Herring said. “It shows them there’s a pathway back to feeling normal.”

    Although the Drug Enforcement Administration (DEA) requires doctors to receive special training and a license to prescribe buprenorphine, doctors in the ER can provide the medication without this training. Still, Herring said, many healthcare providers hesitate to provide the first step toward medication-assisted treatment (MAT). 

    “At first it seemed so alien and far-fetched,” he said. 

    Yet, research into the practice is promising. A 2015 study showed that people who were given buprenorphine in the ER were twice as likely to be in treatment 30 days later than those who were not given medication to help with withdrawal.  

    “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” said Dr. Gail D’Onofrio, lead study author. “They’re beyond thinking they can just be a revolving door.”

    California has plans to expand treatment for withdrawal in emergency rooms, using $78 million in federal funding to establish a hub-and-spoke system where people would get their first dose of medication in the emergency room before being connected with ongoing services.

    Dr. Kelly Pfeifer, director of high-value care at the California Health Care Foundation, said this is the next step in providing quality care for people fighting addiction. 

    “We don’t think twice about someone having a heart attack, getting stabilized in the emergency department, and then getting ongoing care from the cardiologist,” she said. “And the risk of death within a year after an overdose is greater than it is for a heart attack.”

    View the original article at thefix.com