The Effects of Law Enforcement Activity on a Population of Opiate Abusers

This study examined the effect of police action against heroin pushers on clients of methadone programs in metropolitan Denver. On November 10, 1979, twenty suspected drug dealers and buyers were arrested and another twenty were under investigation in a vice squad operation in metropolitan Denver. The operation involved an undercover agent who mingled with addicts and bought opiates over an extended period from dealers, who were later arrested within a 48-hour period. Newspaper reports indicated that most of those arrested had been selling heroin in the vicinity of the outpatient clinic operated by Addiction Research and Treatment Services (ARTS) of the University of Colorado School of Medicine. Although linked to the clinic by the press, only two of those arrested were known to clinic personnel. In this study we examined the patterns of opiate use of the clients enrolled in that clinic as reflected by the presence of opiate metabolites in their urine samples collected before and after the drug bust. The clinical course of a sample of clients who abused opiates before, but not after the bust was examined. In addition, urine data from the other two methadone programs in the city were examined. Metropolitan Denver Read more […]

Opioid Use by Adolescents

Screening for alcohol abuse and illicit drug use needs to be a standard procedure in any practice that cares for adolescents and young adults. Recent national surveys indicate that prescription pain relievers have replaced marijuana as the most common entry drugs for adolescents beginning to experiment with drugs. In this chapter, we review appropriate screening tools and management approaches for use in this population. We cover standard treatment options with a focus on the treatment of adolescents dependent on heroin or opioid pharmaceuticals and the promising role of buprenorphine in the treatment of this high-risk population. A case is presented at the end of this chapter, including related questions for additional consideration. Epidemiology Opioid abuse among adolescents is a growing problem in the United States. According to data from the National Institute on Drug Abuse’s Monitoring the Future study, use of “narcotics other than heroin” has doubled among high school students since the year 2000, with marked increases in the use of long-acting oxycodone tablets and hydrocodone-acetaminophen combination tablets. In 2007, the annual prevalence for oxycodone and hydrocodone use reached its highest level Read more […]

Outpatient Treatment and Outcome of Prescription Drug Abuse

Forty-six consecutive patients who voluntarily sought outpatient treatment for abuse of one or more prescription drugs were studied. Barbiturates, amphetamines, and diazepam were the most common drugs abused. Desired treatments by patients included counseling, medical withdrawal, or medical maintenance with the drug of abuse or a chemically related drug. Twenty-two (47.8 percent) patients left treatment and relapsed within one month; another eight (17.4 percent) patients relapsed between one and three months after entering treatment. Only 13 (28.3 percent) reported abstinence 90 days after entering treatment. This experience suggests that a wide range of medical, social, and psychologic resources are required to treat prescription drug abuse, and that long-term drug abstinence is difficult to achieve with all patients. Treatment of prescription drug abuse has dealt primarily with drug complications such as overdose, toxic reactions, and techniques for medical withdrawal. Other reports describe behavior patterns of prescription drug abuse and often refer to it as poly-drug abuse, since many persons frequently abuse more than one drug. Some reports emphasize the clinical complexity of poly-drug abuse and particularly Read more […]

Opioid-Related Disorders

Opioid abuse manifests in various ways in patients in medical settings. Psychiatrists are frequently consulted regarding opioid therapy for patients who are prescribed methadone, are thought or known to be dependent on prescription or illicit narcotics, engage in drug-seeking behavior, exhibit personality problems that interfere with medical care, or have overdosed. Suspicion is heightened by exaggerated pain complaints, by visits to multiple providers for multiple pain complaints requiring a narcotic prescription (e.g., migraine, back pain, dental pain, fibromyalgia, and endometriosis), and by claims to be “allergic” to every analgesic except for particular opioids (e.g., hydro-codone or oxycodone). Opioid-dependent patients often provoke angry reactions from staff, which can result in discharging a patient prematurely or underprescribing pain medications. Chronic pain patients who develop tolerance to opioids and experience opiate withdrawal on cessation of use are often misla-beled addicts (see “Pain”). Tolerance and withdrawal alone are not sufficient for the diagnosis of either substance abuse or dependence. For example, cancer patients with painful bone metastatic lesions may need high doses of narcotics and Read more […]

Oxycodone: In the news

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.

Oxycodone: Law and order

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.

Oxycodone: Legal consequences

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.

Oxycodone: Personal and social consequences

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.

Oxycodone: Treatment and rehabilitation

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.

Oxycodone: Reactions with other drugs or substances

Oxycodone: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Oxycodone effects. Reactions with other drugs.