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Oxycontin Formula Change Has Many Abusers Switching to Heroin

Posted by Sun on July 18, 2012

ScienceDaily (July 11, 2012) — A change in the formula of the frequently abused prescription painkiller OxyContin has many abusers switching to a drug that is potentially more dangerous, according to researchers at Washington University School of Medicine in St. Louis.

The formula change makes inhaling or injecting the opioid drug more difficult, so many users are switching to heroin, the scientists report in the July 12 issue of the New England Journal of Medicine.

For nearly three years, the investigators have been collecting information from patients entering treatment for drug abuse. More than 2,500 patients from 150 treatment centers in 39 states have answered survey questions about their drug use with a particular focus on the reformulation of OxyContin.

The widely prescribed pain-killing drug originally was thought to be part of the solution to the abuse of opioid drugs because OxyContin was designed to be released into the system slowly, thus not contributing to an immediate “high.” But drug abusers could evade the slow-release mechanism by crushing the pills and inhaling the powder, or by dissolving the pills in water and injecting the solution, getting an immediate rush as large amounts of oxycodone entered the system all at once.

In addition, because OxyContin was designed to be a slow-release form of the generic oxycodone, the pills contained large amounts of the drug, making it even more attractive to abusers. Standard oxycodone tablets contained smaller amounts of the drug and did not produce as big a rush when inhaled or injected.

Then in 2010, a new formulation of the drug was introduced. The new pills were much more difficult to crush and dissolved more slowly. The idea, according to principal investigator Theodore J. Cicero, PhD, was to make the drug less attractive to illicit users who wanted to experience an immediate high.

“Our data show that OxyContin use by inhalation or intravenous administration has dropped significantly since that abuse-deterrent formulation came onto the market,” says Cicero, a professor of neuropharmacology in psychiatry. “In that sense, the new formulation was very successful.”

The researchers still are analyzing data, but Cicero says they wanted to make their findings public as quickly as possible. The new report appears as a letter to the editor in the journal. Although he found that many users stopped using OxyContin, they didn’t stop using drugs.

“The most unexpected, and probably detrimental, effect of the abuse-deterrent formulation was that it contributed to a huge surge in the use of heroin, which is like OxyContin in that it also is inhaled or injected,” he says. “We’re now seeing reports from across the country of large quantities of heroin appearing in suburbs and rural areas. Unable to use OxyContin easily, which was a very popular drug in suburban and rural areas, drug abusers who prefer snorting or IV drug administration now have shifted either to more potent opioids, if they can find them, or to heroin.”

Since the researchers started gathering data from patients admitted to drug treatment centers, the number of users who selected OxyContin as their primary drug of abuse has decreased from 35.6 percent of respondents before the release of the abuse-deterrent formulation to 12.8 percent now.

When users answered a question about which opioid they used to get high “in the past 30 days at least once,” OxyContin fell from 47.4 percent of respondents to 30 percent. During the same time period, reported use of heroin nearly doubled.

In addition to answering a confidential questionnaire when admitted to a drug treatment program, more than 125 of the study subjects also agreed to longer phone interviews during which they discussed their drug use and the impact of the new OxyContin formulation on their individual choices.

“When we asked if they had stopped using OxyContin, the normal response was ‘yes,'” Cicero says. “And then when we asked about what drug they were using now, most said something like: ‘Because of the decreased availability of OxyContin, I switched to heroin.'”

These findings may explain why so many law enforcement officials around the country are reporting increases in heroin use, Cicero says. He compares attempts to limit illicit drug use to a levee holding back floodwaters. Where the new formulation of OxyContin may have made it harder for abusers to use that particular drug, the “water” of illicit drug use simply has sought out other weak spots in the “levee” of drug policy.

“This trend toward increases in heroin use is important enough that we want to get the word out to physicians, regulatory officials and the public, so they can be aware of what’s happening,” he says. “Heroin is a very dangerous drug, and dealers always ‘cut’ the drug with something, with the result that some users will overdose. As users switch to heroin, overdoses may become more common.”

Funding for this research comes from the Denver Health and Hospital Authority, which provided an unrestricted research grant to fund the Survey of Key Informants’ Patients (SKIP) Program, a component of the RADARS (Researched Abuse, Diversion and Addition-Related Surveillance) System.

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Scientists Create Vaccine Against Heroin High

Posted by Sun on July 21, 2011

ScienceDaily (July 20, 2011) — Researchers at The Scripps Research Institute have developed a highly successful vaccine against a heroin high and have proven its therapeutic potential in animal models.

The new study, published recently online ahead of print by the American Chemical Society’s Journal of Medicinal Chemistry, demonstrates how a novel vaccine produces antibodies (a kind of immune molecule) that stop not only heroin but also other psychoactive compounds metabolized from heroin from reaching the brain to produce euphoric effects.

“In my 25 years of making drug-of-abuse vaccines, I haven’t seen such a strong immune response as I have with what we term a dynamic anti-heroin vaccine,” said the study’s principal investigator, Kim D. Janda, the Ely R. Callaway, Jr. Chair in Chemistry and a member of The Skaggs Institute for Chemical Biology at Scripps Research. “It is just extremely effective. The hope is that such a protective vaccine will be an effective therapeutic option for those trying to break their addiction to heroin.”

“We saw a very robust and specific response from this heroin vaccine,” said George F. Koob, chair of the Scripps Research Committee on the Neurobiology of Addictive Disorders and a co-author of the new study. “I think a humanized version could be of real help to those who need and want it.”

A Worldwide Epidemic

While injection drug abuse is a debilitating worldwide epidemic, heroin abuse and addiction are especially destructive, with costs estimated at $22 billion in the United States due to loss of productivity, criminal activity, medical care, and social welfare, the authors say in their study.

Heroin abuse and addiction are also driving forces in the spread of HIV through needle sharing.

Using an approach termed “immunopharmacotherapy,” Janda and his Scripps Research colleagues previously created vaccines that used immune molecules to blunt the effects of other abused drugs such as cocaine, methamphetamine, and nicotine. Human clinical trials are under way for the cocaine and nicotine vaccines.

Attempts by other researchers over the past four decades to create a clinically viable heroin vaccine, however, have fallen short, in part due to the fact that heroin is an elusive target metabolized into multiple substances each producing psychoactive effects.

An Innovative Approach

To overcome this problem, in the new study the Scripps Research team used a “dynamic” approach, targeting not only heroin itself, but also the chemical it quickly degrades into, 6-acetylmorphine (6AM), and morphine.

“Heroin is lipophilic and is rapidly degraded to 6AM,” said G. Neil Stowe, a research associate in Janda’s laboratory who is first author of the new study. “Both readily cross the blood-brain barrier and gain access to the opioid receptors in the brain.”

The researchers linked a heroin-like hapten (a small molecule that elicits an immune response) to a generic carrier protein called keyhole limpet hemocyanin or KLH, and mixed it with Alum, an adjuvant (vaccine additive), to create a vaccine “cocktail.” This mixture slowly degraded in the body, exposing the immune system to different psychoactive metabolites of heroin such as 6AM and morphine.

“Critically, the vaccine produces antibodies to a constantly changing drug target,” said Stowe. “Such an approach has never before been engaged with drug-of-abuse vaccines.”

To compare the results of a non-dynamic approach, the team also prepared a vaccine simply targeting morphine, a substance related to heroin. Both vaccines were then injected into rats and the effects were examined in Koob’s laboratory.

Promising Results

The results showed that the rats rapidly generated robust polyclonal antibodies in response to the dynamic heroin vaccine.

In addition, the study found that addicted rats were less likely to “self-administer” heroin by pressing on a lever after several booster shots of the vaccine. Only three of the seven rats that received the heroin vaccine self-administered heroin. In contrast, all of the control rats, including those given the morphine vaccine, self-administered the drug.

The effect of the heroin vaccine “was very dramatic; as dramatic as we have ever seen in experiments of this kind,” said Koob. “To have an animal vaccinated and not show a response to heroin is pretty amazing.”

The team also found that the heroin vaccine was highly specific, meaning that it only produced an antibody response to heroin and 6AM, and not to the other opioid-related drugs tested, such as oxycodone as well as drugs used for opioid dependence — methadone, naltrexone, and naloxone. “The importance of this,” said Janda, “is that it indicates these vaccines could be used in combination with other heroin rehabilitation therapies.”

The Scripps Research team has recently begun an exciting collaboration with researchers at the Walter Reed Army Institute of Research to see if it is feasible to develop a dual-purpose vaccine against HIV and for the treatment of heroin addiction in a single shot, Janda said.

Source:http://www.sciencedaily.com

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Heroin Addiction Detox

Posted by Sun on July 19, 2011

For an addict who is not prepared, heroin detox can be a very unpleasant experience. Addicts should receive proper education about the effects of heroin in order to understand what the detox process will entail. When dealing with withdrawal symptoms, knowing what to expect can be beneficial. Studies have indicated that 65 percent of heroin addicts who knew what the withdrawal symptoms would be got through the detox process with fewer problems than those who were unaware of the symptoms.

  • The method in which the drug is used will have an effect on the detox process. Heroin users who inject the drug will have different withdrawal symptoms than addicts who smoke heroin.
  • Injecting heroin will produce severe withdrawal symptoms while ingesting the drug will produce milder symptoms.
  • Physical health plays a large role in detox. The healthier the addict is, the fewer withdrawal symptoms they will experience. There are many heroin addiction health effects that come along with the disease.

Heroin Addiction Detox Methods

There are different methods of detox that are used for heroin addicts. Many of the methods can have medical risks associated with them and be unsafe and ineffective. A large majority of heroin addicts will have few medical problems during detox, but 18 percent of addicts will find their detox is ineffective or included medical complications.

There are three main methods of detox available for heroin addicts. Each person will respond differently to detox. Heroin addicts who find one method is ineffective have the option of using a different detox method.

  • Methadone maintenance. This is the most common type of detox for heroin addicts. Over 75 percent of all heroin addicts will find this method to be effective. This is an outpatient detox in which the addict takes methadone in lieu of the heroin. They must go to a clinic or drug rehab to take the medication and are required to have frequent drug testing. After the first few weeks of treatment, about 60 percent of addicts will be able to take the medication home and avoid having to go to a clinic every day.
  • Suboxone Treatment. This is one of the newest methods of heroin detox. Suboxone is a prescription medication that addicts can get from their physician. There is no need to go to clinics. This method of detox is effective in 90 percent of addicts who have a low-dose heroin addiction.
  • Inpatient Treatment Facilities. About 35 percent of heroin addicts will not respond to medications and will benefit from an inpatient treatment program. Inpatient addicts will not be given a replacement drug that mimics the action of heroin. Instead, they will go through withdrawal symptoms and be given prescriptions to help them with the pains that are associated with withdrawal.

The first two methods are considered medical heroin detox while an inpatient detox is considered a natural form of detox.

The Importance of Heroin Addiction Detox

When an addict is attempting to recover from a heroin addiction, the most important process is detox. This is when the chemical is removed from the body; it allows the addict to overcome their physical addiction to the substance. After the physical addiction is gone, addicts will have to address the mental and emotional conditions. Detox is the first step in addiction recovery. Heroin withdrawals can be severe and this is the main reason addicts relapse. An astounding 45 percent of heroin addicts will not complete the process of detox. The withdrawal symptoms are so severe that it is better to be addicted to the drug than to deal with the pain associated with detox and withdrawal.

Once an addict goes through detox, they can move on to the next steps in their treatment plan. More than 90 percent of addicts will benefit from counseling and therapy, either in a group setting or individually. Aside from overcoming the physical addiction to heroin, it is important for the addict to understand how the addiction was formed. Addiction treatment will also include teaching the addict how to cope with stressful situations so they do not turn to the drug as a coping mechanism. Research has shown that heroin addicts who are inpatient and successfully complete the detox process will have a lower chance of relapse and a higher likelihood of leading a drug-free life following their treatment. There are about 20 percent of addicts who will begin treatment multiple times and only 40 percent of these addicts will overcome their addiction completely and remain free of future addictions. Check here to find out more about heroin addiction facts.

If you have any questionsplease feel free to ask

Source: http://rehab-international.org/heroin-addiction/detox

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Heroin

Posted by Sun on July 15, 2011

Brief Description: Heroin is an addictive drug that is processed from morphine and usually appears as a white or brown powder or as a black, sticky substance. It is injected, snorted, or smoked.

Street Names: Smack, H, ska, junk

Effects: Short-term effects of heroin include a surge of euphoria

and clouded thinking followed by alternately wakeful and drowsy states. Heroin depresses breathing, thus, overdose can be fatal. Users who inject the drug risk infectious diseases such as HIV/AIDS and hepatitis.

If you have any questions, please feel free to ask


Source: http://www.nida.nih.gov

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