Addiction Treatment Blog

In 1954, Olds and Milner discovered that there appeared to be pleasure spots in the brain. Implanting electrodes in certain areas of the brain, through which a rat can give itself an electric current by pressing on a lever, produced in most brain areas nothing of note. In some areas, however, the rats seemed keen on the effects of self-stimulation and, in some cases, if left to their own devices would self-stimulate to the exclusion of all else – even food and drink.

As mentioned, noradrenaline was discovered in the brain in 1954. In 1959, a second catecolamine, dopamine, was identified, which was shown to be deficient in Parkinson’s disease.

The later mapping of dopamine-containing neurones has shown that they too, like noradrenergic neurones, tend to originate in a discrete area, the ventral tegmentum. Some of these neurones run to strictly motor areas of the brain and constitute the nigrostriatal system, and it is loss of nerve calls in this pathway that leads to Parkinson’s disease. Read more…

It is as natural to die as to be born; and to a little infant, perhaps, the one is as painful as the other.

Sir Francis Bacon, 1561-1626, Essays, ‘Of Death’.

Drug Abuse in Pregnancy

It is particularly difficult to study drug abuse in human pregnancy. There are a number of reasons for this.

• Recruitment. Suitable women may be difficult to identify because they may feel guilty about their drug taking, be afraid to tell healthcare staff about illegal drug use and be frightened of reproaches from relatives should this come to light.
• Confounding. The lifestyle of many women who abuse drugs may already predispose them to an adverse pregnancy outcome, e.g. living conditions, general health, reproductive health, nutritional status and socioeconomic group. Separating environmental and personal confounders is particularly difficult when trying to follow-up drug-exposed infants after birth.
• Multi-drug use. It is almost impossible to study any single drug of abuse in complete isolation because multi-drug use is common. Tobacco and alcohol alone are frequently consumed by those who abuse street drugs, and these are known to have adverse effects upon the foetus.
• Identification. Many drug abusers do not know exactly what they are taking, either in terms of identity (due to adulteration) or in terms of dose (due to impurity and dilution).
• Collecting data. Usually studies rely on maternal recall of the extent and nature of drug use during pregnancy and this may not be reliable.
• Changing use. The pattern of use may change during the pregnancy. Mothers may increase or decrease dose or frequency. Read more…

Illness is in part what the world as done to a victim but in a larger part is what the victim has done with his world, and with himself.

Karl Menninger, quoted in ‘Illness as Metaphor’ by Susan Sontag.

Drug abuse is a cause for many serious illnesses, including HIV (AIDS).

From time to time the healthcare professional will encounter an individual with a medical condition who abuses drugs. Although not condoning the taking of these substances, it is desirable that those in a position to advise are able to provide information on whether the drug is liable to exacerbate the condition. The sections below provide brief details which may be helpful in advising those with some of the more common medical conditions. The information given should be used as a guide only. The data available are sparse in most cases and while it is hoped that the details in this chapter will be useful, every patient’s particular circumstances will differ and one should be cautious about extrapolating limited information to all situations in which it could be applicable.

It is difficult to find data in the advisability of drug abuse in those suffering from concomitant medical conditions. The data given here are based upon details of side effects that have been reported in the medical literature and knowledge of drug handling by the body. This information is incomplete because none of the drugs of abuse have been subject to large-scale clinical trials at the doses abused. This is the main mechanism by which side effect profiles of therapeutic drugs are determined. This being the case, most of the data on adverse effects from street drugs are derived from small-scale studies, case reports, surveys and anecdotal evidence. Causality can also be difficult to ascertain because many users employ a variety of drugs simultaneously. Many drug abusers have a poor quality of life due to bad living conditions and/or inadequate nutrition; this may make them more susceptible to various diseases. Read more…

If opium-eating be a sensual pleasure, and if I am bound to confess that I have indulged in it to an excess not yet recorded of any other man, it is in no less true that I have struggled against this fascination with a fervent zeal, and have at length accomplished what I never yet heard attributed to any other man, have untwisted, almost to its final links, the chain which fettered me.

Thomas de Quincy, ‘Confessions of an English Opium Eater’, 1821

History

Opiates were originally available from the opium poppy (Papaver somniferum), native to Asia Minor. The active constituents can be found in the latex which exudes from incisions in the unripe capsule of the flowering head. The alkaloids which occur in the poppy include morphine, noscapine, codeine, papaverine and thebaine. Strictly speaking, alkaloids derived from the opium poppy which have morphine-like actions are termed opiates, whereas opioids are synthetic derivatives, e.g. methadone. However, in recent times the term opioid has been understood to encompass opiates.

Heads of opium poppies

Morphine is responsible for most of the psychotropic activity and comprises some 9 to 17 per cent if the weight of dried opium but is usually about 10 per cent. Opium itself has been used by man for thousands of years, both as medicine and as an intoxicant. It was cultivated in many places in Neolithic Europe, where it may have been burned to produce an intoxicating smoke. However, in most cultures, opium was usually taken orally. Smoking of opium using an individual pipe probably originated in China in the 17th century and a huge population of dependent individuals began to develop there. Opium was subsequently the cause of two wars between Britain and China in the 19th century when the British continued to sell opium to the Chinese people despite a decree from the Emperor outlawing the use of it. Read more…

Hypodermic injections should be prepared extemporaneously. In most cases they are plain solutions of alkaloidal or other salts in water. All utensils used should be sterilised by thorough washing and drying in an oven at 220 degrees Fahrenheit. The distilled water must also be sterilised by boiling.

Instructions for preparation of injections in ‘Pharmaceutical Formulas’, 1911.

Most intravenous drug users do not start by injecting.

Most intravenous drug users do not start by injecting. Cocaine, amphetamine and heroin are the main drugs which are administered intravenously, and the majority of current users who inject these drugs began by taking them in a non-parenteral form, or started by taking non-parenteral drugs alone. Many chronic drug abusers eventually prefer to inject rather than administer by other routes and there are a number of reasons for this. Intravenous administration provides the quickest access to the circulation, resulting in rapid passage of the drug to the brain. This produces the fastest possible onset of intoxication, and usually a ‘rush‘ or ‘buzz‘ of initial euphoria occurs when a bolus of drug reaches the brain. This effect is particularly sought after. Other methods of administration generally provide a slower onset and a less intense ‘rush‘. Non-parenteral methods often involve a degree of wastage as well: when given orally a proportion of the dose may not be absorbed or may be metabolised by the liver before reaching the brain; smoking or vaporisation usually destroys some of the drug; inhalation wastes the percentage of the drug which passes down the throat to be absorbed more slowly later.

Apart from these considerations, injecting forms part of the ritual drug abuse many individuals. Ritual is not an important component of the injection drug user’s experience – in a similar way, tobacco smokers or coffee drinkers prefer to partake at specific times of the day or to use particular techniques for preparation or administration. Read more…

There are three basic methods for drug administration.

There are three basic methods by which drugs of abuse are taken into the body: by injection, by mouth and via the airways.

Injection

Many drugs are commonly given by intravenous injection including cocaine hydrochloride, heroin, amphetamine and temazepam. The intravenous route affords rapid access to the circulation and thence to the brain, allowing fast onset of intense psychoactive effects. However, bypassing the body’s normal defense mechanisms in the gut carries great risks to health. The subcutaneous route is an alternative which is occasionally used if the intravenous route is not available. Intra-arterial injections are usually only given by mistake when a needle misses a vein. The intramuscular route is only used for anabolic steroids.

Oral Administration

For many drugs the oral route is preferred for convenience – ecstasy, LSD, alcohol and caffeine are all usually taken this way. Read more…

There are many international laws aim to prevent drug abuse.

Legal Status of Drugs

In the UK, drugs of abuse are controlled by two main pieces of legislation.

Misuse of Drug Act (1971)

This Act classifies drugs into three classes according to the maximum penalty which an offender can expect to receive if he or she contravenes the law. The Act renders possession, export, import, manufacture or supply of any of these drugs illegal except in certain specified circumstances.

• Class A drugs: Pure cannabinoids (but not cannabis itself), cocaine, LSD, opioids, phencyclidine, psilocybin. Injectable forms of drugs in class B.
• Class B drugs: Amphetamine, barbiturates, cannabis, cocaine, dihydrocodeine, ecstasy, methamphetamine, methylphenidate.
• Class C drugs: Benzodiazepines, cathine, cathinoe, dextropropoxyphene, diethylpropion, anabolic steroids, human chronic gonadothropin and growth hormones.

Misuse of Drugs Regulations (1985)

These are principally concerned with regulating the legitimate supply and use of abusable substances. Read more…

Kurt Cobain (1967 - 1994) was addicted to heroin.

Founder member, singer and guitarist of the grunge band Nirvana. A talented and creative child, Cobain was diagnosed as ‘hyperactive’ and prescribed the amphetamine derivative Ritalin. Deeply affected by his parents’ divorce at the age of seven, Cobain is alleged to have said that he never felt loved or secure again. After a series of relocations, and staying with various relatives, Cobain eventually settled in Seattle and channelled his energies into music. Troubled by continual insomnia and an unidentifiable stomach complaint, Cobain began self-medicating with drugs. By the late eighties, Nirvana were up and running and had released their first album Bleach and become recognized as the pioneers of the grunge sound that characterized the rest of the nineties, paving the way for other bands such as Pearl Jam. In 1992, Nirvana released their hugely successful album Nevermind and the single ‘Smells like Teen Spirit‘. Mass media attention followed with Cobain’s photograph adorning numerous front covers of newspapers and magazines all over the world, and the album selling several million copies. The band rapidly became the voice of a disgruntled generation with many fans idolizing Cobain. Distinctly uncomfortable and depressed with the demands of such sudden and intrusive fame, Cobain turned increasingly to heroin. Despite marrying and having a child, the continuing rollercoaster success of the band placed Cobain under even greater stress, and in March 1994, he was admitted to hospital in a coma having attempted suicide. A week later, he enrolled in a Lis Angeles psychiatric drug recovery centre. Thirty-six hours after admission, he bolted and ended his life with a single shotgun blast to his head. Heroin and valium were found in his bloodstream.

Sad Facts

• Two of Cobain’s uncles had also taken their own lives.
• One of Cobain’s favourite Nirvana songs was ‘Lithium’.

Founded in 1953 in Los Angeles, Narcotics Anonymous now has a network that stretches from the Western world to Islamic societies, with more than 20,000 metings in ninety countries every week.

Like Alcoholics Anonymous, NA uses the twelve steps as the central precept of its recovery programme. The organization emphasizes the therapeutic value of members working with each other to become free of drug addictions, rather than employing professional therapists with no personal experience of drug or alcohol problems. Those who commit to the rehabilitation process are encouraged to stay off drugs and alcohol as the best means of achieving recovery. Due to the dramatic increase in drug addiction in our societies, Narcotics Anonymous currently offers the most inclusive and cost-free way to tackle the problem.

Fact: Four million of Iran’s seventy million people are addicted to drugs, with opium being one of the most prevalent in the country.

Contact details

Narcotic Anonymous, 202 City Road, London EC1V 2PH
020 7251 4007
Helpline: 020 7730 0009
Fax: 020 7251 4006
Email: ukso@ukna.org
Website: www.ukna.org

For advice, information and counselling on drug addiction.

It’s kind of hard to come to terms with the words we need to use because all of the words already have a meaning to people. For instance, it makes no sense to call gambling a drug because it’s obviously a behaviour. To call taking cocaine a behaviour is confusing because it mixes up the drug with the action of taking it. So we need to come up with a word that means, in essence, stuff that releases dopamine. Science already has a term for that in behavioural psychology. The word is “reinforcer.” Reinforcer doesn’t really do it for me, but if you like that word for what we’re talking about, I can live with it. My problem is that for behavioural scientists it brings up the idea that the person is normal and that no illness exists. The word I like better is “reward.” A reward causes dopamine to be released in the reward center of the brain. It doesn’t tell us if the reward comes from outside or inside, and it doesn’t tell us if the person is ill or well. It’s just a reward.

Now, we can see that if people have normal reward systems and get normal reward from normal life, there is no need for other external reward inputs. However, if someone doesn’t have a normal reward system and needs a specific behaviour or drug to feel normal reward, then we will see their focus concentrate on that useful reward.

It might be helpful to know what sort of things give us a reward signal. For people with addiction these things can become compulsive. These include alcohol and drugs, of course, including nicotine. As well there is food and sex. Interestingly, novel stimuli also work and that would include 30 new images every second like TV or a video game. While I believe addiction is a single disease, people point out to me all the time the differences between addicts such as cocaine addicts and compulsive overeaters: “You don’t see people grinding up hamburger and injecting it,” they say with a smile to tell me how wrong I am. The difference is that different drugs and behaviours effect the reward system through different mechanisms. For instance, cocaine works directly in the MFB to block the reuptake of dopamine (it blocks the vacuum cleaner raising the dopamine level) while food works through several different sensory mechanisms to release dopamine.

The Causeway Retreat addiction treatment experts are ready for help to you and your loved ones 24 hours a day and 7 days a week. Please give us a call on +44 (0)207 100 7260 and talk to one of our doctors or nurses.