Treatment typically involves steps to help you withdraw from using the drug, followed by counseling and attending self-help groups to help you resist using the addictive drug again.
The goal of withdrawal therapy (detoxification) is for you to stop taking the addicting drug as quickly and safely as possible. Detoxification may involve gradually reducing the dose of the drug or temporarily substituting other substances that have less severe side effects. For some people it may be safe to undergo withdrawal therapy on an outpatient basis. Other people may require placement in a hospital or a residential treatment center.
Withdrawal from different categories of drugs produces different side effects and requires different approaches.
CNS depressants can be divided into two groups, based on their chemistry and pharmacology: Barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal), which are used to treat anxiety, tension, and sleep disorders.
Benzodiazepines, such as diazepam (Valium), chlordiazepoxide HCl (Librium), and alprazolam (Xanax), which can be prescribed to treat anxiety, acute stress reactions, and panic attacks. Benzodiazepines that have a more sedating effect, such as triazolam (Halcion) and estazolam (ProSom) can be prescriped for short-term treatment of sleep disorders.
Minor side effects of withdrawal may include restlessness, anxiety, sleep problems and sweating. More serious signs and symptoms also could include hallucinations, whole-body tremors, seizures, dehydration and weakness. The most serious stage of withdrawal may include delirium and is potentially life-threatening. Withdrawal therapy may involve your gradually scaling back the amount of the drug.
Stimulants are a class of drugs that enhance brain activity - they cause an increase in alertness, attention, and energy that is accompanied by increases in blood pressure, heart rate, and respiration.
Historically, stimulants were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. As their potential for abuse and addiction became apparent, the use of stimulants began to wane. Now, stimulants are prescribed for treating only a few health conditions, including narcolepsy, attention-deficit hyperactivity disorder (ADHD), and depression that has not responded to other treatments. Stimulants may also be used for short-term treatment of obesity, and for patients with asthma.
Stimulants such as dextroamphetamine (Dexedrine) and methylphenidate (Ritalin) have chemical structures that are similar to key brain neurotransmitters called monoamines, which include norepinephrine and dopamine. Stimulants increase the levels of these chemicals in the brain and body. This, in turn, increases blood pressure and heart rate, constricts blood vessels, increases blood glucose, and opens up the pathways of the respiratory system. In addition, the increase in dopamine is associated with a sense of euphoria that can accompany the use of these drugs.
Side effects of withdrawal typically include depression, fatigue, anxiety and intense cravings. In some cases, signs and symptoms may include suicide attempts, paranoia and impaired contact with reality (acute psychosis). Treatment during withdrawal is usually limited to emotional support from your family, friends and doctor. Your doctor may recommend medications to treat paranoid psychosis or depression.
Among the drugs that fall within this class - sometimes referred to as narcotics - are morphine, codeine, and related drugs. Morphine is often used before or after surgery to alleviate severe pain. Codeine is used for milder pain. Other examples of opioids that can be prescribed to alleviate pain include oxycodone (OxyContin-an oral, controlled release form of the drug); propoxyphene (Darvon); hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine (Demerol), which is used less often because of its side effects. In addition to their effective pain relieving properties, some of these drugs can be used to relieve severe diarrhea (Lomotil, for example, which is diphenoxylate) or severe coughs (codeine).
Side effects of withdrawal of opioids such as heroin, morphine, oxycodone or codeine can range from relatively minor to severe. On the minor end, they may include runny nose, perspiration, yawning, feeling anxiety and craving the drug. Severe reactions can include sleeplessness, depression, dilated pupils, rapid pulse, rapid breathing, high blood pressure, abdominal cramps, tremors, bone and muscle pain, vomiting, and diarrhea. Doctors may substitute a synthetic opiate, such as methadone, to reduce the craving for heroin and to gently ease people away from heroin. The most recently approved medication to ease withdrawal from opiates is buprenorphine (Suboxone, Subutex). This drug is the first narcotic medications used for the addiction treatment that may be prescribed in a doctor's office rather than a treatment center.
Researchers are continually searching for new ways to help ease the symptoms of withdrawal and to treat addiction more effectively.
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