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- Date: Sun, 17 Apr 1994 21:37:39 -0400
- From: Victor Borras <latin@PANIX.COM>
- Subject: Re: controlled drinkers?
- Sender: "Academic & Scholarly discussion of addiction related topics."
- <ADDICT-L@KENTVM.BITNET>
- Message-id: <01HBAJJB5G7M8WY3Q0@ymir.claremont.edu>
-
- I've been on both ends of withdrawals, heroin and methadone, every patient
- of methadone will always tell you the same, as I do; I can kick heroin
- anytime, but methadonde that is something else. In 15 yrs of heroin
- addiction, I've kicked 3 times, 'cold-turkey'. In 10 years on methadone
- I've never kicked methadone. Once I landed in jail, you have to do 72hrs.
- of jail time before you see the judge, called 'due' process.
- I was literally on the floor screaming my guts out. About 12hrs. before I
- was to see the judge, I demanded to be taken to the hospital, I just
- couldn't take it. I was cuffed, and looking like a 'chair' was glued to
- my back, I limped to the ambulence, since I couldn't lift my leg to climb
- into the back, the police grabbed me on both sides and shoved me in like a
- sack of potatoes, I fell flat on my face.
- The doctor realizing my condition and that it was severe, gave me a shot
- of morphine or methadone,(I had ID# and she called my Doctor). The cops
- were very angry. When they saw that I was ok, walking straight without
- pain or slouching, they cuffed me to a chair, called another unit to
- return me to the court building. The new transport was ok with me, when I
- got to the court building the cops wrote a message on my sheet.
- "This is the addict that cried and was give dope, don't let him go to see
- the judge, RETURN him to precinct jail to start new 72 hrs." I was
- returned to the precinct and 2 days later I was in the same condition!
-
- Never did I go through such hell in all my days, I finally saw the judge,
- I was able to stand and talk because, lucky for me, another inmate had
- some heroin, I gave him my food for the 'dope'!
-
- THE INTENSITY OF METHADONE WITHDRAWAL IS JUST TOO MUCH! I COULD NEVER DO IT,
- BTW ABOUT 5 YEARS AGO ONE INMATE WENT INTO CONVULSION AND UPON FALLING, HE
- HIT THE METAL BARS, HE DIED!
-
- =============================================================================
-
- Eli-
- I objected to the idea that heroin, "did not cause any direct
- health problems," because of two things, those being addiction and
- withdrawl. However; I was under the impression that withdrawl could
- be fatal, which is not usually the case.
-
- If anyone is interested in learning more about this drug, I would
- like to recommend the following book:
-
- Heroin, Myths and Reality
- by: Jara A. Krivanek pub. 1988, Allen & Unwin
-
- Our discussion originally stemmed from the question: How bad is
- heroin withdrawl? Then it led to flames about "health problems",
- tobacco withdrawl, etc... Here is a section from _Heroin, Myths and
- Reality_ that discribes addicts and withdrawl:
-
- "The development of physical dependence depends as much on
- regularity of use as on the ammount actually used. In pratice, the
- vast majority of addicts fo not use heroin consistently on an
- ongoing basis. Less than half of the addicts who have been on the
- streets for more than a year will have used daily for that period
- (Johnson, 1978). They may voluntarily withdraw to reduce their
- tolerance, or the scene may be temporarily too much of a hassle, or
- they may have an important engagement such as a trial, at which an
- appearance of addiction would be undesirable. Or they may simply
- need a rest. During such times, physical dependence may virtually
- disappear, yet they will still think of themselves and describe
- themselves as addicts. In other cases, the users may never use
- enough drug to develop significant physical dependence. Senay
- (1986) estimates that between 25 per cent and 40 per cent of street
- addicts are not physically dependent. Nevertheless, such 'chippers'
- may wish to see themselves as addicts for reasons of their own, and
- will so describe themselves.
-
- The withdrawl syndrome we have been discussing is what is termed
- 'primary' or 'early' abstinance. A substantial portion of the
- physical symptoms of this stage seem to depend on the activity of a
- part of the brainstem called the locus coeruleus. Opiates depress
- this area and it would therefore be expected to become hyperactive
- during withdrawl. The locus coeruleus is an important centre in the
- brain's fear-alarm system, and such hyperactivity would be
- consistent with the marked anxiety and agitation withdrawing addicts
- report. Fortunately for withdrawing addicts, other drugs beside the
- opiates can depress this region and one of them is clonidine.
- Clonidine is generally used as an anti-hypertensive agent, but in
- 1978 Gold and his colleagues reported that it could supress or
- reverse the symptoms of opiate withdrawl. Subsequent work has shown
- that this reversal is by no means complete, but there seems no doubt
- that clonidine can make opiate withdrawl much more comfortable.
-
- Even if clonidine is not used, medical detoxification is usually
- accomplished by giving decreasing doses of a long-acting opiate like
- methadone. Aftr a few weeks of this, the patient is usually
- opiate-free without having suffered any appreciable physical
- discomfort. Since a percentage of the methadone marketed for
- medical use finds its way into the streets, many addicts also detox
- themselves this way without formal medical help. Still others detox
- 'cold turkey'--without any pharmacological help at all. They simply
- tell their friends they have the flu, go to bed, and suffer in
- relative silence.
-
- Medical supervision and assistance is certainly not essential for
- successful withdrawl." --pages 88 and 89
-
- That was immediate withdrawl. The author goes on to say, "the
- duration of early abstinence depends on the drug's rate of
- elimination and in the case of heroin most major symptoms should be
- gone within seven to ten days."
-
- He then describes, "A protracted abstinence syndrome follows
- withdrawl from both heroin and methadone and...
- lasts at least 31 weeks after withdrawl, and perhaps longer. Blood
- pressure, pulse rate, body temperature and pupil diameter seem to be
- the main physiological variables affected. Behaviourally, the
- subject shows an increased propensity to sleep and there are
- negative changes in mood and feeling state."
-
- --Ahren
-