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Heroin Dependence

Heroin Addiction


Presentation

  • The presented heroin-related visual cues reliably elicited heroin craving in all tested subjects.[ncbi.nlm.nih.gov]
  • CONCLUSION: Although the mechanism remains unclear, the present study shows that chronic heroin use is associated with alteration of morphology as well as rsFC over the right DLPFC.[ncbi.nlm.nih.gov]
  • RESULTS: 139 participants were included in the present analysis. At each follow-up visit, those with non-use of illicit heroin represented 47.5% to 54.0% of the sample.[ncbi.nlm.nih.gov]
  • Paper presented at the National Drug and Alcohol Annual Symposium, 8 September, Sydney Australia.[ndarc.med.unsw.edu.au]
Physician
  • Copyright 2010 Physicians Postgraduate Press, Inc.[ncbi.nlm.nih.gov]
  • In order to prescribe either, physicians must first obtain a waiver from the Drug Enforcement Administration.[pbs.org]
  • The medication was administered at PHC's Crosstown Clinic under the supervision of an interdisciplinary team of physicians, nurses, social workers and counselors.[sciencedaily.com]
  • Thus, physicians should be familiar with the identification and diagnosis of heroin dependence in their patients and be able to initiate treatment of heroin dependence both directly and by referral.[annals.org]
Congestive Heart Failure
  • Lungs Aspiration pneumonia; pulmonary oedema due to direct heroin toxicity, affecting pulmonary capillaries or myocardium; hypoxic endothelial damage; congestive heart failure; central vasomotor effect (increased protein in oedema fluid); talc granulomas[medical-dictionary.thefreedictionary.com]
Prostitute
  • A small proportion of heroin users resort to prostitution to support their habit. In the McIntosh and McKeganey study, all of the women who reported turning to prostitution hated it and only took it up out of desperation.[recoverystories.info]
Nausea
  • Medication may be used to ease the physical effects of withdrawal, which include goosebumps, cramping, body aches, nausea, and intense craving.[medicinenet.com]
  • People who are addicted to heroin are likely to show some or even all of the following signs: Fatigue, followed by patterns of alertness Shallow or laboured breathing Injection wounds Infections on the skin from injections, boils Nausea Vomiting Small[castlecraig.co.uk]
  • Withdrawal symptoms of heroin can include: Intensive cravings Negative mood Stomach pain Nausea and vomiting Muscle aches and whole body pain Body weakness Joint pain Runny nose Nausea and vomiting Extreme sweating Chills Runny nose Increased blood pressure[acadianaaddiction.com]
  • Nausea, body ache, fever and fatigue are common withdrawal symptoms. Anxiety, depression, restlessness and irritability are often part of the picture as well.[hazeldenbettyford.org]
Vomiting
  • People who are addicted to heroin are likely to show some or even all of the following signs: Fatigue, followed by patterns of alertness Shallow or laboured breathing Injection wounds Infections on the skin from injections, boils Nausea Vomiting Small[castlecraig.co.uk]
  • Withdrawal symptoms of heroin can include: Intensive cravings Negative mood Stomach pain Nausea and vomiting Muscle aches and whole body pain Body weakness Joint pain Runny nose Nausea and vomiting Extreme sweating Chills Runny nose Increased blood pressure[acadianaaddiction.com]
  • If you try to quit using, you'll feel jittery, get chills, vomit, have bone and muscle pain , and feel other withdrawal symptoms.[webmd.com]
  • If you try to quit using, you'll feel jittery, get chills, vomit, have bone and muscle pain, and feel other withdrawal symptoms.[webmd.com]
  • At this time, weakness and depression are pronounced and nausea and vomiting are common. Nevertheless, some chronic addicts have shown persistent withdrawal signs for many months or even years.[ncbi.nlm.nih.gov]
Constipation
  • Side effects: Nausea, vomiting, diarrhea, constipation, headache, dizziness. For a more complete list of side effects visit this NIH page.[addictionrecoveryguide.org]
  • Chronic heroin users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease.[aegistreatmentcenters.net]
  • Constipation or diarrhea are common in heroin addicts, as is insomnia and a generally weakened immune system. Heroin use over long periods of time can cause infection of the heart lining or heart valves, regardless of how it’s taken.[altamirarecovery.com]
  • Typical physical symptoms of heroin addiction include: Anxiety Burn marks on the fingers or mouth from smoking Bags and dark circles under the eyes Constipation Chest pain Cuts, bruises, and scabs Cotton mouth Euphoria Depression Fatigue Excessive yawning[casapalmera.com]
  • Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease.[castlecraig.co.uk]
Abdominal Cramps
  • Other symptoms include: Restlessness Insomnia Goosebumps Tremors Irritability Joint and muscle pain Abdominal cramps Profuse sweating Chills Runny nose Nausea Vomiting Diarrhoea Urinary incontinence Shortness of breath Involuntary muscle spasm Reactions[castlecraig.co.uk]
  • Someone who displays the below symptoms after consuming heroin should seek immediate medical attention in order to avoid a grave outcome: Slowed heart rate Abdominal cramping Blue hue around mouth or fingertips Muscle spasms Loss of consciousness Pinpoint[roserehab.com]
  • Anorexia and abdominal cramps. Nausea, vomiting and diarrhoea. Tremor. Insomnia, restlessness, anxiety and irritability. Generalised aches and pains. Tachycardia, hypertension. Goose flesh (goosebumps). Dilated pupils. Increased bowel sounds.[patient.info]
  • They include difficulty sleeping, aggression, irritability, abdominal cramps, tremors, spasms and drug cravings lowered blood pressure, dizziness and shallow breathing, if your dose is too high tooth decay – as with heroin and other opioids, methadone[betterhealth.vic.gov.au]
Loss of Appetite
  • […] of appetite Legs and arms that seem heavy More energy Low sex drive Nausea Muscle spasms or cramps No menstrual cycle Needle marks or “track marks” (which look like little red dots or bruises) Overstimulation Nosebleeds Psychosis Pinpoint pupils Rapid[casapalmera.com]
  • Some effects of heroin addiction include: Irritability Depression Loss of appetite Liver damage Respiratory depression Difficulty swallowing Circulatory problems Nausea and vomiting Intense sweating Sleep apnea Joint pain Chills Body weakness Runny nose[acadianaaddiction.com]
  • Side effects: Drowsiness, weakness, nausea, constipation, headache, loss of appetite. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: Madden LM, et al.[addictionrecoveryguide.org]
Hypotension
  • A small proportion of patients prescribed clonidine may develop hypotension. Some patients who cease clonidine abruptly develop rebound hypertension.[nps.org.au]
Slow Pulse
  • Signs of a heroin overdose include: Shallow breathing Dry mouth Tongue discoloration Very small pupils Slow pulse Bluish lips[addictioncenter.com]
Blurred Vision
  • vision, back pain, fainting, dizziness, and sleepiness.[suboxone.com]
Anhedonia
  • Below are some of the more common withdrawal symptoms associated with heroin: Anhedonia Dysphoria Nausea, vomiting, diarrhea Agitation Anxiety Disrupted sleep patterns Strong cravings for heroin Flu-like symptoms Effects of heroin overdose: When an individual[roserehab.com]
  • Effect of extended-release naltrexone on striatal dopamine transporter availability, depression and anhedonia in heroin-dependent patients. Psychopharmacology. 2015;232(14):2597-2607. 7.[mentalhelp.net]
  • A condition called anhedonia, or lack of pleasure, often develops in recovering heroin addicts. One of the primary goals of treatment is to help the addict find peace, hope and joy in a drug-free life.[dualdiagnosis.org]
Denial
  • Denial that there is a problem at all. Nonchalant acceptance that they are indeed using heroin. The last reaction is possibly the most difficult to work with – because for many, it can signify a refusal to change.[luxury.rehabs.com]
Slurred Speech
  • Physical Loss or increase in appetite, change in eating habits, unexplained weight loss or gain Slowed or staggered walking, bumping into things Smell of alcohol on breath Slow or slurred speech Irregular sleep patterns, having difficulty sleeping, awake[sfad.org.uk]
  • speech Lack of memory, forgetting things or not remembering important events or matters Lack of interest in the future or what comes next Unkempt self-image, lack of hygiene, loss of self discipline.[castlecraig.co.uk]
  • speech Track marks Weight loss Malnutrition Constant runny nose Scabs or bruises due to skin picking Dizziness Headache Dry mouth Loss of self-control Inhibitory behavior Psychological symptoms : Emotional numbing Inability to think clearly Personality[acadianaaddiction.com]
  • speech Other general signs of addiction include hiding things/secrecy, loss of control, increased risk-taking, doing things one normally wouldn’t to obtain the drug, lack of interest in things that used to interest you and distancing yourself from others[addictioncampuses.com]
Confusion
  • , sores, and/or abscesses Irregular heart rate Insomnia Slowed breathing Weight loss Itchiness Lethargy and fatigue Sensation of heaviness in arms and legs Constricted pupils Cognitive Symptoms: Trouble focusing or thinking clearly Impaired judgment Confusion[roserehab.com]
  • National Library of Medicine , signs that someone has overdosed on heroin include: Shallow or stopped breathing Pinpoint pupils Dry mouth Bluish coloring to the fingernails and lips; discolored tongue Weak pulse Stomach spasms or cramping Delirium or confusion[americanaddictioncenters.org]
  • Although, the truth is, that for many people who are struggling and even for those who are just young and confused or dealing with self-exploration, the allure of this kind of freedom, this type of reward, this access to so much pleasure, is very, very[smartrecovery.org]
Stupor
  • A. heroin; is a opiate(derivative)-the other drugs in this catagory-are-morphine,codeine,heroin,dilaudid,percodan,percocet,demerol,darvon.and overdose wil cause stupor progressing to coma with respiratory depression,pupils become pinpoint and non-reactive-pulmonary[medical-dictionary.thefreedictionary.com]
Sexual Dysfunction
  • Heroin addicts often have reproductive problems, sexual dysfunction, and menstrual irregularities.[altamirarecovery.com]
  • This can be minimised with good oral hygiene menstrual changes sweating constipation sexual dysfunction (inability to reach orgasm) drowsiness heart palpitations dizziness nausea and vomiting skin rashes and itching.[betterhealth.vic.gov.au]
  • Sexual dysfunctions. Mood swings – from joy and elation to apathy to depression. Constricted pupils. Negligence of responsibilities at school, work or home. Accidents or injuries from heroin-associated violence.[luxury.rehabs.com]
  • dysfunction for men irregular menstrual cycles for women Injection Drug Use, HIV, and Hepatitis People who inject drugs such as heroin are at high risk of contracting the HIV and hepatitis C (HCV) virus.[drugabuse.gov]

Workup

Torsades De Pointes
  • Prolongation of the QT interval in the ECG of patients with torsade de pointes (TdP) has been reported in methadone users.[ncbi.nlm.nih.gov]

Treatment

  • SETTING: The syringe exchange programme in Malmö, Sweden and an out-patient clinic (research treatment facility) for maintenance treatment, situated outside the hospital area and run by Malmö Addiction Centre.[ncbi.nlm.nih.gov]
  • There has been debate regarding how heroin treatment should be positioned within the range of treatment approaches for this condition.[ncbi.nlm.nih.gov]
  • This challenges the view that comorbidity predicts poor drug treatment outcomes.[ncbi.nlm.nih.gov]
  • Ninety-six self-referred subjects with heroin dependence were randomly assigned to methadone or to stepped treatment initiated with buprenorphine/naloxone and escalated to methadone if needed. All subjects received intensive behavioral treatment.[ncbi.nlm.nih.gov]
  • DESIGN AND METHODS: A convenience sample of 192 treatment entrants were recruited from alcohol and drug treatment services in four Australian jurisdictions.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis The National Drug Treatment Monitoring System reported that, for the year 2014-2015, 47% of patients attending UK drug treatment services achieved abstinence from illicit opiates when reviewed at six months.[patient.info]

Epidemiology

  • ., Extramural MeSH terms Adult Alleles Analgesics, Opioid/metabolism Bulgaria/epidemiology Bulgaria/ethnology Case-Control Studies Exons Female Genotype Heroin Dependence/genetics* Heroin Dependence/physiopathology Humans Male Polymorphism, Genetic Polymorphism[ncbi.nlm.nih.gov]
  • Author information 1 Institute of Psychiatry, Psychology and Neuroscience, MRC SGDP Centre, King's College London, United Kingdom. 2 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom. 3 Department of Actuarial Sciences[ncbi.nlm.nih.gov]
  • Epidemiology [ 5 ] In England, there were 295,224 adults using Drug and Alcohol treatment services in 2014 to 2015. Opiates (such as heroin) were the most common substance (152,964 adults).[patient.info]
  • Epidemiological data indicate that having a substance use disorder increases the risk of being diagnosed with an anxiety disorder by almost 2.5 times.[mentalhelp.net]
Sex distribution
Age distribution

Pathophysiology

  • Abstract Metabotropic glutamate receptor subtype 3 (mGluR3, encoded by GRM3) plays important roles in the pathophysiology of schizophrenia, depression, and drug dependence.[ncbi.nlm.nih.gov]
  • Abstract Much evidence suggests that dysfunction of dopamine transporter-mediated dopamine transmission may be involved in the pathophysiology of substance abuse and dependence.[ncbi.nlm.nih.gov]

Prevention

  • SUMMARY: Long-acting sustained release formulations of naltrexone are well tolerated and more effective for relapse prevention in heroin addicts than the oral ones.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: These results emphasize the need for prompt identification and treatment of these children and highlight the need to pay clinical attention not only to the patient, but also to the co-parent in order to optimize prevention in offspring.[ncbi.nlm.nih.gov]
  • It is crucial to integrate substance treatment with behavioral interventions into harm reduction programs to prevent bloodborne virus transmission among IDUs.[ncbi.nlm.nih.gov]
  • We recommend that clinical psychiatric staff carefully gather information related to the identified risk factors to prevent suicide among heroin users. Copyright 2014 Elsevier Ireland Ltd. All rights reserved.[ncbi.nlm.nih.gov]
  • Our findings set the stage for further bio-behavioral investigations of the mechanisms of relapse prevention in opioid dependence.[ncbi.nlm.nih.gov]

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