Substance Abuse

All You Need To Know About Krokodil

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krokodil desomorphine molecular structure

A few years ago, some news reports said that the zombie drug called krokodil – which has caused a widespread drug addiction epidemic in Russia – may have crossed over to the United States.

Apparently, there have been some isolated reports of users who exhibited the symptoms of exposure to krokodil injections. This has caused alarm because of the known dangers of the abuse of krokodil, a synthetic drug that is said to cause the most harm compared to other illicit substances.

What is Krokodil?

Desomorphine, also known by its street name krokodil, is a derivative of morphine that produces fast-acting opioid effects including sedation and analgesia. It has been said to be eight to ten times more potent than morphine. Desomorphine is a powerful drug that renders dangerous effects, and is highly addictive.

However, synthetic krokodil is mostly impure and may not even contain the desomorphine but it contains codeine. The drug is easily manufactured and may be produced in homes in the same manner that illicit methamphetamine and pseudoephedrine are produced.

Homemade versions of the substance are concocted by “cooking” codeine-based pills that are purchased over the counter with a poisonous mixture that includes solvents (such as gasoline, paint thinner, or lighter fluid), iodine, hydrochloric acid, and red phosphorus scratched from matches. The end product is a yellow or caramel liquid that distinctly smells like iodine, resembling an antiseptic. The smell can be overpowering and it could not be washed off the clothing of Krokodil addicts. The home or the apartment where the drug was manufactured can rarely be reused for residential purposes as it could never be entirely cleansed of the lingering odor of iodine.

Because of the combination of the toxic chemicals from these substances, those who inject the drug into their veins can develop skin ulcerations, scales, discoloration, and gangrene. Their skin resembles the scales of a crocodile. This prominent effect is what lends the substance its nickname as krokodil, which means “crocodile” in Russian. In Ukraine, it is also known as “Himiya.”

krokodil desomorphine molecular structure

History of Krokodil

Desomorphine was first synthesized in 1932 and patented in 1934 in Switzerland where it went by the brand name Permonid. It was used medically for the treatment of severe pain. Due to its side effects, however, medical use of the drug was terminated in 1981.

The clandestine production of Krokodil is most popular in Russia where it has been manufactured for more than a decade. While heroin used to be the drug of choice in the country, users found Krokodil to deliver the same euphoric effects at a much lower cost.

In 2003, when the government authorities carried out crackdown operations on heroin production and trafficking, heroin users began producing Krokodil in their homes. The unavailability of heroin coupled with the cheap cost of Krokodil production prompted the drug’s popularity among addicts who belong to the lower economic strata. It was reported that between 2009 and 2011, the amount of Krokodil seized by Russian authorities increased by 23 times. In 2011 alone, there were about 100,000 people who had injected Krokodil.

In 2012, the Russian government imposed restrictions on the sale of over the counter drugs that contain codeine. While the legislation diminished the number of addiction cases, it failed to effectively eradicate the problem. It continues to be considered as the most dangerous subject of drug addiction in the country.

Cases of Krokodil use have also been reported in other countries including Ukraine, Georgia, Germany, Norway, and Kazakhstan.

Krokodil first entered the United States in 2013 with the first case being that of a 30-year-old addict in Missouri whose skin began to rot after injecting Krokodil. Following this, other cases were reported in Illinois and Oklahoma.

The U.S. Drug Enforcement Administration (DEA) has categorized desomorphine as a Schedule I drug under the Controlled Substances Act (CSA).

Adverse Effects of Krokodil

The illicit production of Krokodil involves the use of considerable amounts of toxic chemicals which are “cooked.” Since no efforts are made to remove toxic by-products that result from the synthesis, injecting the concoction can produce extremely dangerous effects on the skin, blood vessels, bones, and muscles, which can lead to gangrene and amputation of the limbs.

Within a few days from the injection, the skin around the area of the point of entry can get severely infected with abscess or skin ulcerations. It can even lead to tissue damage and necrosis, leaving the bone exposed. Scaly, green patches also develop in other areas of the skin. Thus, Krokodil has earned its nickname as the “flesh-eating” or “zombie” drug.

The other adverse effects include the following:

  • Gangrene
  • Phlebitis
  • Thrombosis
  • Blood vessel damage
  • Muscle damage
  • Meningitis
  • Septicemia
  • Bone infection
  • Rotting gums and tooth loss
  • Liver and kidney damage
  • Brain damage
  • Nervous system damage
  • Speech and motor skills impairment
  • Memory loss and impaired concentration
  • Weight loss
  • Pneumonia
  • Blood-borne diseases such as HIV, AIDS, and Hepatitis C
  • Overall deterioration of health
  • Overdose
  • Death

Krokodil Addiction

Krokodil is highly addictive, and dependence can develop right after the first use. This is intensified by the fact that its half life is short and the euphoric effects last for less than two hours.  As a result, frequent injection is necessary to recreate the “high” as well as to avoid the withdrawal symptoms. The need to consume large amounts of the drug on a more frequent basis can prompt binge patterns where users lock themselves up in the apartment or the home to “cook” Krokodil and use it repeatedly. It has been said that being a Krokodil addict is a full-time job because of the cyclic patterns of cooking and injecting.

In addition, modifications in the ingredients and cooking process place a user at an increased risk of overdose and death. Krokodil use reduces life expectancy by two years. An addict is most likely to die from a fatal overdose or from the complications arising from Krokodil use within two to three years.

To date, no other drug causes the same destruction that Krokodil does. While it affects the brain in a manner similar to most drugs – by targeting the neurotransmitters that associated with pleasure, learning, and memory – the long-term effect of Krokodil addiction leaves a damaging mark. Most Krokodil addicts fail to fully recover their motor skills and their eyes assume a vacant, distant look.

Psychological Effects of Krokodil

In addition to dependence and addiction, chronic users of Krokodil are also likely to develop anxiety and worsening depression as the euphoric effects of the substance wear off. Krokodil addicts may develop some forms of psychosis and exhibit abnormal behavior when they are not under the influence of the drug.

In efforts to avoid the effects of withdrawal, Krokodil addicts commonly resort to illegal means to purchase supplies to cook the drug or to find other sources of Krokodil. They may steal from friends or even family members. They may also resort to other crimes.

As with most chronic drug users, Krokodil addicts will often deny their dependence on the substance and will rarely seek medical help. In most cases, they are brought to emergency rooms and referred to rehabilitative treatment only when their bodies rot away or begin to suffer tremendously from the physical damage caused by the substance.

Withdrawal from Krokodil

The withdrawal symptoms of Krokodil have been described to be similar to that of heroin, but the physical and psychological effects are long-lasting. The discomfort includes:

  • Intense flu-like symptoms
  • Vomiting
  • Diarrhea
  • Tremors
  • Fever
  • Profuse sweating
  • Severe anxiety
  • Intense drug cravings
  • Muscle pain and twitching
  • Chills and goosebumps
  • Depression
  • Relapse into abuse

Going through the withdrawal phase can be very painful. The symptoms and physical discomfort may last for more than a month from the cessation of use.

Krokodil Rehabilitation

A person who displays the signs and symptoms of Krokodil abuse or withdrawal needs immediate medical and psychological attention. Since the life expectancy of chronic users is significantly reduced, a delay in seeking professional help could have fatal consequences.

Several treatment and rehabilitation centers offer intensive detoxification and recovery programs that could help users beat the addiction. These programs include medically managed detoxification, behavioral therapy, counseling sessions, and physical therapy for those whose motor skills have been impaired.

Because Krokodil has one of the highest relapse rates among opiates, enrollment in a long-term inpatient therapy is strongly recommended to help an addict sustain abstinence and regain control over his life.

While the effects of Krokodil abuse can be extensive and may last a lifetime, a timely rehabilitation can, at least, save the addict’s life.

Confronting a family member, colleague, or friend who has a dependence on Krokodil can be very challenging but a slight delay may be fatal. It is crucial that help is sought as soon as possible.

Recovering from Krokodil Addiction

In Russia, one of the documented cases of Krokodil rehabilitation is that of a former addict, Irina Pavlova, who was admitted to the rehabilitation center in a tiny village called Chichevo. Hers, however, is not a typical case because she survived six years of injecting the drug almost every day. This period is double that of an average user who is expected to die within two to three years from the inception of use.

But Pavlova did not escape the addiction unscathed. She suffered brain damage that impaired her motor skills and speech. As with other Krokodil addicts, her eyes also came to assume a vacant gaze.  She has never fully recovered from these effects and she must be assisted each time she attempts to take some steps forward only to jolt and fall back.

Pavlova recalls that she had learned to cook Krokodil and did so in her brother’s apartment where she hung out with other addicts. Sometime in 2008, she went on a binge for two weeks and did nothing but cook Krokodil and inject it into the femoral artery in her groin. Afterwards, she developed gangrene and blood poisoning around the area. She was brought to the hospital to be treated where she was invited to a rehabilitation center. She agreed to seek professional help.

Recovery did not come easy. About a year into rehabilitation, she could no longer bear the drug cravings. She escaped from the center which is about two hours away from Moscow and separated from the nearest town by vast fields and pine forests. She hitchhiked to Moscow and went all the way to Vorkuta to get high again.

During the second course of her rehabilitation, she finally passed the stage of intense and almost unendurable cravings that are characteristic of Krokodil withdrawal. She has also found the commitment to stay away from drugs for fear of returning to what she calls the “horrible swamp” of Krokodil addiction.

Pavlova’s story is only one of the hundreds of thousands who have lived the life of a Krokodil addict. Most of them are not as fortunate. They only spiral in the darkness of drug abuse until the damage sets in and leads to their deaths.

Conclusion

With accounts like these, it is hoped that the public would be forewarned of how destructive Krokodil is so that addiction may be prevented. Those who have begun to use Krokodil should also seek treatment as soon as possible. The sooner medical intervention is accomplished, the higher their chances of survival and recovery.

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Substance Abuse

Study Highlights Pros and Cons of Switching From Tobacco to E-Cigarettes

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cigarettes have become the subject of debate for many interested parties, particularly on its safety and purpose. While some people vouch for e-cigarettes as a healthier alternative to traditional cigarettes, other health experts say that they are laced with dangerous chemicals that keep a smoker addicted. The question remains: are e-cigarettes really safer than traditional tobacco cigarettes?

A study was published in the journal Nicotine & Tobacco Research said that tobacco smokers who switch to electronic cigarettes get the same levels of nicotine, albeit lower levels of toxins. The study suggests that smokers who switch over to e-cigarettes have a lower risk of exposure to cancer-causing chemicals.

Furthermore, the study highlighted the benefits and dangers of switching from tobacco to e-cigarettes. Here are some of the important advantages of switching to e-cigarettes, as raised in the study:

  • Researchers concluded that smoking e-cigarettes decreases the desire to smoke tobacco cigarettes.
  • E-cigarettes also dramatically decrease the consumption of traditional cigarettes without causing withdrawal symptoms. Furthermore, the nicotine concentration in their blood remained low and stable.
  • E-cigarettes produce fewer carcinogens unlike traditional tobacco products that may contain between 4,000 and 7,000 harmful chemicals.
  • Since e-cigarettes use vapor technology, using the product reduces generation of harmful secondhand smoke.
  • It is a cheaper alternative to smoking tobacco. Research studies in the U.K. show that vaping habits can be significantly less expensive than traditional smoking.

Meanwhile, here are some of the disadvantages cited in the study:

  • E-cigarettes may reduce the risk of cancer but it still uses nicotine. Nicotine impacts neurotransmitters in the brain that cause addicting behavior.
  • E-cigarette uses liquid nicotine, a highly dangerous substance even in small doses.

Whatever the preference of a smoker is, risks are always abound. Experts recommend either knowing full well the effects of using these kinds of products, or not starting the smoking habit at all.

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Health & Wellness Substance Abuse

New Painkiller Drug Removes Risk of Overdose

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An elite group of international researchers led by scientists from Stanford University, University of North Carolina and the Friedrich-Alexander University Erlangen-Nürnberg in Germany has developed a new drug that works as a painkiller like morphine but without triggering and eliciting dangerous side effects such as respiratory suppression.

In a research study recently published in Nature, researchers said that they have identified the new opioid drug by using the computational techniques that allowed them to experiment and explore more than four trillion different chemical effects and interactions. The team of researchers also noted that they used the atomic structure of the brain’s receptors to reverse-engineer the novel drug that promises to block pain but does not have the potentially dangerous side effects.

While the drug compound has only been studied and tested on mice, the indication and implication of the drug may be massive. In the research experiment, the mice were exposed to a solution that contains the compound in varying degrees. Results showed that the mice displayed alternating and indifferent attitudes, which suggest that it has low addictive potential.

This novel drug compound is also known to not interfere with breathing, which remains to be the main cause of death in overdosing on painkillers. Moreover, the new drug also appears to bypass the brain’s dopamine-driven addiction to prevent drug-seeking behavior on mice.

More work still needs to be established to make sure that the compound is truly non-addictive. More tests are also needed to confirm it is as safe and effective in humans as it is for rodents. If this is confirmed, this drug could transform the fight against the ongoing epidemic of prescription painkiller addiction.

Drug Testing

Popular Cases of Cheating in Drug Tests

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The number of drug users has soared for the past years. It is no secret how many famous personalities were caught using these drugs and how some of them found several means of cheating their way through drug tests. With the help of online resources, more people have resorted to ways on how they could get themselves out of the hole.

The spotlight is often cast on celebrities and athletes when it comes to drug issues. The world has witnessed how some famous personalities have been exposed for their addiction on certain drugs. In fact, some have been busted for trying to alter their drug tests by doing questionable methods. Here are some of them:

Mike Tyson

He admitted using a fake penis to excrete fake urine to be able to pass his drug test and be able to proceed with a fight.

Alex Rodriguez

Popular Major League baseball player A-Rod took a mid-stream urine sample based on the assumption that drug metabolites are present at the start and end stream of urine excretion only.

Young Buck

This G-unit rapper was caught sneaking a yellow substance into his urine specimen but was eventually identified as being positive for marijuana. He initially claimed that he was not a user of marijuana but was just a “victim” of famous rap artist Snoop Dogg’s marijuana use.

Lance Armstrong

The world renowned cyclist ended his career in 2012 when he got busted for using, trafficking and administering erythropoietin (EPO), testosterone, and blood transfusions. He admitted that he has done these so many times during his career, leading him to winning several races.

While Armstrong was not busted at any time during drug tests, some of his fellow athletes broke their silence. News of his drug test cheating methods has reached the authorities, who conducted a drug test and found the champion cyclist to be positive for EPO.

Other athletes get away from these drug tests because they just use them in “micro-doses” a night before the race. Unfortunately, some have even asked the help of other physicians to help them with the administration of certain drugs. This has caused revocation of the medical licenses of the physicians found guilty in helping these athletes.

Tom Sizemore

The actor was caused cheating on his drug test by using a prosthetic device to falsify his urine sample. He was charged with the possession of methamphetamine.

John Anzrah

The Kenyan Coach was sent home after authorities in the recently concluded Rio Olympics found out that he was trying to pose himself as an athlete and gave sample urine to hide the doping activity of one of his athletes. He was immediately sent back to Kenya after authorities confirmed that his face does not match the photo of the athlete to be tested.

Russian Athletes at Rio Olympics

A group of Russian athletes have been found to be using performance-enhancing drugs to win themselves a gold medal. However, it has been discovered how rampant it was among their athletes. In fact, one female athlete for the track and field category accidentally leaked her adulterated urine sample onto the floor. She was trying to provide a urine sample through a device that was hidden under her clothes.

Apparently, some of these Russian athletes have their unusual way of evading drug tests. Some of them just disappear in the middle of the race or go missing among the crowd in such a way that the drug testing staff won’t be able to get to them.

There was also one incident wherein two athletes were found to be missing their drug tests. When they learned that their cheating ways have been discovered, they filed for retirement.


How People (Attempt To) Cheat on Drug Tests

The desperation of some drug users have led them to consider cheating their way through drug tests. Here are some of the most popular and infamous drug test cheating methods:

Dilution of urine

One common way of cheating a drug test is by taking in large amounts of water at least 4 to 6 hours prior to submission of the sample. In doing so, the individual is forced to urinate and by doing so, whatever chemical may be in his system will somehow be flushed out.

There is only a specific range of drug presence in the urine that can determine if the individual is indeed positive with a drug. Other individuals, however directly put water with the urine to dilute the sample. Unfortunately, this is easily detected by laboratories because now, they add a dye to their toilets and their faucets are turned off.

Sample Substitution

Some individuals would submit urine samples from another individual who is 100 percent free from any drug substance.

Surprisingly, there are concentrated urine products in powdered form, which can be bought online. Adding water to it would produce urine. However, this could be easily detected if the urine sample does not maintain the specific temperature. Too warm or too cold would mean demanding for another urine sample to be taken.

Adding a chemical

There are certain chemicals that can alter the chemical composition of the urine. This, however, is easily detected. Any urine sample that is found to have chemicals that aim to disrupt the testing process is tagged as an “adulterated sample”.

Vinegar overload

Drinking vinegar may alter the ph level of the urine and may “mask” the presence of any drug. However, with testing, vinegar is easily detected.

Tattoo

Performance-enhancing drugs are being injected by athletes through their tattoos. By doing this, only a small amount of the drug is enough to provide the needed strength or endurance that an athlete may need.

Human Growth Hormone (HGH)

This is used to boost performance of energy-inducing drugs.  By using HGH with regular low dose of blood-boosting hormone EPO, the presence of this drug may be difficult to detect, as some users would vouch.

Exemptions from Drug Testing

Some athletes who were found to be positive with some disorders like attention-deficit disorder are prescribed with Adderall or Ritalin. These drugs are highly addictive. Howver, athletes who abuse these drugs make an excuse not to undergo drug testing because they say that their use of the said drugs would affect results.

Gene Doping

This involves altering the normal DNA structure of the human body.  A gene, after it has been isolated, is injected with a “virus” (the deadly components taken out) to produce superhuman strength. This is introduced back into the body and generally improves overall performance of an athlete.

Blood Doping

There are two techniques of blood doping:

Autologous

The blood of an athlete who has injected EPO is extracted, stored in a blood bank, and injected back to the athlete at a later date.

Homologous

This is when the blood coming from another donor has been transfused to the athlete. The purpose is to dilute the concentration to evade detection but the effect of the drug will not alter the athlete’s performance.

Detoxification

Using diuretics have been used to evade detection of any presence of drugs. Frequent urination will flush out traces of drugs from the system, but this strategy isn’t fool-proof.

Using Testosterone-Based Ointments

When an individual takes on drugs, the testosterone levels greatly drops, which can sometimes lead to a “0” reading. However, with the use of this kind of ointment, it retains the normal level of testosterone in the body.

Visine

It has been found out that the presence of benzolkonium chloride in a urine sample can mask the presence of THC metabolite in drug analysis, but this hasn’t been confirmed to be effective.

Drug-Evading Kits

Whizzinator is a kit that has been marketed all over to fraudulently evade detection of presence of drugs during a drug test. This is made up of a syringe, heater pack, dried urine and a penis-shaped appendage to attempt to dispense fake urine into a drug testing cup.

Drug Tests To Prevent Cheating

Urine or blood tests may have been the most common means to detect presence of drugs in an individual. However, there have also been several strategies in trying to evade a positive result. To combat any attempts of drug test cheating, some drug tests have been developed to determine the presence of these substances with little to almost no possibility of being tampered and adulterated.

Because the urine drug test is probably the most adulterated and tampered method of all, some companies and testing firms use other kinds of drug tests. Saliva or oral tests, for instance, are much more difficult to cheat because the drug testing staff will extract the sample themselves. This is done by swabbing a piece of cotton onto a person’s inner cheek.

Conclusion

It really comes as no surprise as to why celebrities and athletes would involve themselves into drug use. After all, fame can be so overwhelming that they wouldn’t want to lose their sparkle or downgrade their performance.

Drug abuse in some celebrities start as early as childhood, when they take drug cocktails to remain awake and alert for shoots. As a result, a lot of child stars who are now in their teens or adult life have gotten themselves hooked on drugs because society dictates that they should remain active with what they do.

Sadly, the same thing also happens to athletes. The thought of bringing home a medal or trophy is something that every athlete would dream about. Unfortunately, they try to make use of these drugs to help them push beyond their limits.

Drug users will always find a way to manipulate the results of drug tests so that they can continue to use them for longer periods of time. However, knowing that drug abuse may also lead to a downfall of society at large, there should be a need to prevent individuals from getting away from it. As technology progresses, more drug tests are now becoming fool-proof to ensure that the prevalence of drug addiction may be completely eradicated from the society in the coming years.

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Substance Abuse

All You Need To Know About Hydromorphone Addiction and Treatment

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Photo by Vaprotan via Wikimedia Commons

There are certain prescription medicines that have been found to be illegally used that lead to dependency and abuse. Most of the drugs being abused are for symptoms to relieve pain. One of the commonly abused drugs is hydromorphone, also known as dihydromorphinone and is commercially known with the brand name Dilaudid.

What is hydromorphone?

Hydromorphone is a narcotic analgesic listed under Schedule II Controlled Opioid Agonist along with morphine, fentanyl and methanyl. This highly potent narcotic analgesic is said to be six to nine times stronger than morphine.

This drug is manufactured in two different kinds: extended release formula, and the instant release formula used in the hospital for surgery. Hydromorphone may come in any of the following dosage forms:

  • Capsule
  • Liquid
  • Tablet
  • Solution

Its chemical name is 4,5α-epoxy-3-hydroxy-17- methylmorphinan-6-one hydrochloride.

Precautions in using hydromorphone

Prior to usage, patient and doctor should be able to assess if this drug is the right choice to treat the immediate complaint. Several factors need to be considered:

Test for allergy

Patients should inform the doctor for any kind of allergy that they may have (food, dye, or specific medication)

Age of the patient

The effect of hydromorphone may be good in treating pain, however prescribing it to children may not be a good choice because its side effects may be too much for children to handle or tolerate.  For the elderly, they may become more sensitive to the effects of hydromorphone than younger patients, and so there should be caution in the dosage of the said drug. Failure to check the correct dosage may lead to complications with the use of other medications for the lungs, liver, heart or kidney.

Breastfeeding

Breastfeeding women are not to be prescribed hydromorphone because it may affect milk production. If there is no alternative medication, there is a need to check on the infant for possible side effects.

Drug Usage

Hydromorphone comes in different forms, and the dosage varies in each form. This drug is prescribed to be used several times in a day. However, if one dose has been missed, patient should immediately take hydromorphone as soon as it is remembered. If, by the time you remember, it is almost time for the next dose, skip the last dose and continue with the second dose. Doubling the dose is not recommended.

Drug Interactions

There are certain medicines that need to be combined to give optimal effect in curing a condition. But on certain instances, there may be a need to use different drugs. With these, decreasing the dose may be needed to avoid dangerous drug interactions.

The doctor may lessen the dose of one or both of the medicines.The following medicines are just a few that can be prescribed along with hydromorphone but should still be taken with utmost care:

  • Anileridine
  • Baclofen
  • Brofaromine
  • Buspirone
  • Butalbita
  • Carisoprodol
  • Chlordiazepoxide
  • Codeine
  • Desflurane
  • Diazepam
  • Estazolam
  • Fentanyl
  • Flurazepam
  • Halazepam
  • Haloperidol
  • Iproniazid
  • Ketomine
  • Lorezapam
  • Loxapine
  • Meperidine
  • Metaxalone
  • Midazolam
  • Morphine
  • Nitrous Oxiede
  • Opium
  • Oxazepam
  • Oxycodone
  • Pentobarbital
  • Quazepam
  • Rasagiline
  • Secobarbital
  • Sodium Oxybate
  • Temazapam
  • Thiopental
  • Triazolam
  • Zolpidem

It should be noted that certain food or medicine may cause interaction. The use of alcohol and tobacco can also be a factor, because they may interact with the drug.

Extreme care should also be taken by people who are diagnosed with the following medical conditions:

  • Alcohol abuse
  • CNS depression
  • Hypothyroidism
  • Brain tumor
  • Chronic obstructive pulmonary disease (COPD)

Some individuals may not be satisfied using hydromorphone alone to have an intense “high” that they wanted. They would sometimes incorporate it with alcohol or benzodiazepines. The combination can increase the euphoric effect, but this poses greater risk like severe respiratory depression and even death.

Hydromorphone effects

Hydromorphone works on the central nervous system to block pain receptors.  This medication is prescribed for those who need round-the-clock pain relief and could not be treated with any other kind of drug.  It is taken every 3-6 hours (liquid form) or 4-6 hours (tablet form). It is advisable to take hydromorphone at the same time every day.

The following are signs and symptoms that a person may be using hydromorphone:

  • Sleepiness
  • Dilated pupils
  • Nausea
  • Constipation
  • Abdominal pain
  • Slow breathing
  • Difficulty in urinating
  • Inability to concentrate
  • Decreased libido
  • Cold skin
  • Mood swings

Prolonged use of hydromorphone can be habit-forming, which may cause mental dependence. It should not be feared, however, if certain individuals are prescribed to use the said drug for a longer time because doctors prescribe them according to the amount that is only needed. Dependency on the drug only occurs if the individual wants to be on the euphoric state all the time. That is why this drug can only be dispensed with a medical prescription to be used according to what it is intended to cure.

Individuals who use this drug usually develop a tolerance quickly. They feel the need to quickly take another dose before the earlier dose wears off.  When this happens, dependency steps in. The following are signs and symptoms of abuse in using hydromorphone:

  • Panic
  • Anxiety
  • Psychotic disorder
  • Body cramping
  • Cold sweats
  • Diarrhea
  • Restlessness
  • Drug craving
  • Agitation
  • Depression
  • Irritability
  • Seizures
  • Difficulty in urinating
  • Stroke
  • Heart attack
  • Coma
  • Paranoia
  • Hallucinations

Causes of hydromorphone addiction

Drugs taken without any prescription, most especially narcotic analgesics may lead to more serious health risks.

It is to be understood that individuals who become drug dependents are caused by several factors. Most often than not, individuals who resort to drug addiction are trying to avoid certain issues in their lives, that instead of facing these problems, their means of escape is to take these drugs.

The following are risk factors that increase the probability of succumbing to hydromorphone addiction and abuse:

  • Individuals born to parents having the same drug dependency
  • Imbalance on certain chemical components
  • Influence from environment
  • Starting with illegal substance use at an early age
  • Under treatment for medical illness

Effects of hydromorphone addiction

When an individual has become addicted to hydromorphone – or to any drug for that matter – there is always a tendency of wanting to have more. The normal sensation for people engaged in drug abuse is experiencing the euphoric feeling.

Such behavioral changes may be evident in people who engage in hydromorphone addiction:

  • Stealing
  • Social isolation
  • Forged prescription
  • Reckless behavior
  • Hiding hydromorphone in different parts of the house
  • Lying on the amount of hydromorphone used
  • Choosing to wear long sleeved shirts and pants to hide needle marks

There have been studies about the relation of drug addiction to mental illness. An individual with mental condition is more likely to have a drug addiction.  Some disorders found with the use of hydromorphone are:

  • Schizophrenia
  • Alcoholism
  • Anxiety disorders
  • Bipolar disorders

Mental illness can be exacerbated with unusual doses of hydromorphone. It is highly recommended that individuals who may be suffering from mental conditions must be given these medications by a family member instead of the individual themselves.

Hydromorphone withdrawal

An individual may want to stop taking the drug because of the realization of the drug’s effects with prolonged and continued use. However, just like any individual who wants to discontinue the use of a drug after using it for a long time, withdrawal symptoms are likely to happen.

It may be difficult to abruptly stop because the body needs to adjust gradually. The only difference with regards to the withdrawal symptoms is that with hydromorphone, it can be a shorter process than other opiates.

Some withdrawal symptoms from hydromorphone addiction are:

  • Diarrhea
  • Restlessness
  • Shaking
  • Sleep disturbances
  • Drug craving
  • Dysphoria
  • Nausea
  • Muscle and bone pain
  • Suicidal thoughts
  • Sleeping disorder
  • No appetite
  • Flu-like symptoms
  • Seizures

Treatment options

Treating individuals with hydromorphone addiction may be much easier to handle compared to other kinds of drug addiction because its withdrawal symptoms are much bearable. The medicines used to treat such addiction may be in the form of other opiate derivatives. The only difference is that the dose is prescribed accordingly and that it is given to the individual under the care of a clinic.

Fortunately, rehabilitation centers are available to help individuals get over drug addiction. Confinement of certain number of months to a year may be necessary for completely getting treated from hydromorphone addiction. Some rehabilitation centers provide assistance to individuals that need medical intervention. Each facility may offer a program that can lead an individual to full recovery but this may be expensive.

Detoxification may be the first step in treating addiction. It would take 3-7 days to flush out the drug from the individual’s system.  This way, withdrawal symptoms can be controlled.  Stopping the intake of the drug abruptly is not recommended. In addition, relying solely on detoxification to fully recover from addiction may not be effective for every case.

There may also be a need for psychological treatment in the process to completely heal the patient. Some patients have turned into drug abuse because of some personal problems that they can’t face alone. Unless these issues are addressed properly, complete healing from hydromorphone addiction may not be achieved. Such counseling can be done inside a facility because the patient can be well taken care of without any distractions. This treatment includes peer counseling and individual therapy.

Discussions in a support group wherein fellow patients with the same condition are able to help themselves heal all together by way of sharing how they went through the ordeal.

Long term treatment on a patient decreases the chances of a relapse.Other forms of therapy include hypnotherapy, life skills development, and health and nutrition counseling. All of these can help an individual to fully recover. However, there should also be a support system in their individual homes after they have been discharged from the facility.

Patients who had been into hydromorphone addiction may need a lifetime of recovery.  An aftercare program will be helpful in aiding a patient to stay away from the addiction and be able to fully recover and may be able to live a normal life.

Conclusion

Not everyone may be able to handle their problems the same way. While others may seek expert advice or choose to involve themselves with other activities to help them with their own struggles, some resort to drugs because of fear of facing such challenges alone and feel defeated. Medicines were meant to help people to be cured from different sicknesses. However, potent drugs can have a tendency for abuse.

Be aware if a family member or a loved one starts to avoid people and completely isolates himself from the rest of the world. Any change in behavior should be a cause of alarm. Never let a loved one waste his life due to drug addiction.

Health & Wellness

Diabetes Rate In Teens Higher Than Estimated, Study Says

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A recent study revealed that more American teenagers have diabetes or prediabetes. Surprisingly, the new data showed that the figures are actually higher than those that were previously estimated.

According to the new survey, almost 1 percent of more than 2,600 teens had diabetes. Of these, one in three cases were undiagnosed. The researchers also found that nearly 20 percent of the group studied were affected with prediabetes – a condition where the blood sugar levels are higher than normal and yet are not high enough to be medically considered as diabetes.

The results of the study are significant because teenage or childhood diabetes is associated with the early development of several risk factors and complications that arise from the blood sugar disorder. These medical complications include heart disease, kidney disease, blindness, and amputation of extremities.

Those with prediabetes are at a risk of developing type 2 diabetes unless lifestyle changes are introduced immediately. The condition is potentially reversible as long as the patient strictly adheres to the recommended diet plans and observes regular physical activities.

The new findings are disturbing because it indicates that diabetes is beginning to affect a much younger population on a larger scale. Parents are urged to be more fastidious in the preparation and monitoring of their children’s meals. The key is to observe a low-sugar, low-fat diet and to make sure that their kids maintain an active lifestyle by performing at least 30 minutes of moderate physical activities 5 times a week. Also, children should be subjected to blood glucose screening methods and regular check-ups regardless of whether or not there is a family history of the illness.

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Substance Abuse

How Fentanyl Is Used Aside From Its Prescribed Purpose

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Fentanyl, one of the strongest opiods and narcotic analgesics in the market today, is indicated for the management of chronic pain mostly prescribed for cancer patients or in treating patients after a major surgery. It is commonly known under the brand names Durogesic, Duragesic, Sublimaze, Abstral, Haldid and Lazanda, among others.

This substance is said to be 50 times more potent than heroin and 100 times more potent than morphine. It is usually used in combination with Demerol or morphine. Any misuse or abuse of this drug can lead to addiction that may eventually lead to death.

It was in the 1970’s when Fentanyl has begun circulating for non-therapeutic purposes.  Its biological effect was said to be similar as that of heroin, which is why sometimes street heroin is mixed with fentanyl or sold as fentanyl itself because of its euphoric effect.

There are several known fentanyl analogue, such as the following:

  • 3-Methylthiofentanyl
  • β-Hydroxyfentanyl
  • α-Methylthiofentanyl
  • Thiofentanyl
  • Butyrfentanyl

The prescription or administration of fentanyl should only be done by a health care professional who has full knowledge in using such potent opiod to manage chronic pain.

Different Forms of Fentanyl

Fentanyl Transdermal Patches

Known through the brand name Duragesic, this form of fentanyl is absorbed through the skin into the bloodstream. Its effect can last up to 72 hours, which is very favorable in managing chronic pain. This is only prescribed to patients who are opiod-tolerant or those patients who are have been taking at least 60 mg of morphine in a day.

Intravenous fentanyl

Under the brand name Sublimaze, this is most commonly used as anesthesia accompanied with another substance like propolol for epidural or spinal administration. In combination with sedatives like benzodiazepine, it is used for medical procedures like surgery and endoscopy.

Used patches should be discarded properly because the gel of these patches can be swallowed or injected, which may cause some serious side effects on the person.

Fentanyl lozenge

This form, popular as Actiq, may pose danger when children accidentally ingest them. This should not be prescribed along with other narcotic medicines because it may lead to difficulty in breathing, which could be fatal. Although fentanyl is an analgesic, it is not recommended for short- term pain such as migraine or dental pain. Fentanyl lozenges should be taken with a 4-hour interval.

Intranasal Fentanyl

This form should be used with utmost care. It is not advised to convert or substitute it with other products that may contain fentanyl. The prescribed dosage may be different on each patient.

Adverse Effects

Like most prescribed drugs, there are certain side effects that the patient may feel after administration or ingestion of fentanyl. These are:

  • Nausea
  • Dizziness
  • Drowsiness
  • Insomnia
  • Vertigo
  • Constipation
  • Fatigue
  • Headache
  • Palpitations
  • Diarrhea
  • Dry mouth
  • Abdominal pain
  • Itching
  • Weakness
  • Muscle spasms
  • Depression
  • Hallucinations
  • Slow heart rate
  • Cold, clammy skin
  • Dyspnea
  • Hypoventilation

Dangers of fentanyl abuse

Drinking alcohol is prohibited while taking Fentanyl because it increases the risk of feeling sleepy or dizzy. The drug is not advisable over a long period of time because of it being highly addictive. However, there are individuals who have illicitly used this medicine.

Its efficacy in treating pain has been proven to be very high. However, there had been reports of abuse in the usage of the said drug. Fentanyl is highly addictive. Meanwhile, the slight difference between the prescribed medical dosage and dead dose can be very slim.

Fentanyl is sometimes sold combined with low-quality heroin to increase the heroin value. The combination of these substances can be more than a hundred times more potent than street heroin. Drug users take Fentanyl orally, injected, snorted or smoked. This causes severe respiratory depression, wherein there is inadequate ventilation to perform gas exchange. This is a very common side effect among those who use recreational drugs.

Since Fentanyl can only be purchased through prescription, the black market has found its way to sell and distribute fentanyl transdermal patches from which the gel inside the patches can be injected or ingested. This poses danger to children when these patches are not properly disposed.  According to some reports, children who have been exposed to these transdermal patches have died due to ingestion.

Actiq Fentanyl lollipop, sold as Oral Transmucosal Fentanyl Citrate (OTFC) and listed as a Schedule II Controlled Substance under the Federal Controlled Substances Act, is a sugar-coated fentanyl on a stick. This is absorbed through the buccal mucosa (inner cheek), where it is slowly dissolved in the mouth. Actiq lollipop contains 2 grams of sugar in raspberry flavor and is available in 6 different strengths. The strongest is 1600 mcg, which could be the equivalent of absorbing 160 mg of morphine.

Other than the common psychological effects of taking fentanyl is the increase of dental caries on long-time users of this drug. This may be due to the sugar that goes with the fentanyl lozenges since it does not dissolve quickly and sugar sticks into their teeth for a long time.

Individuals using Fentanyl can also quickly create tolerance to this substance. The usage of an individual may increase week after week until it comes to a point of endangering his own life.

There is an increase in the number of overdose cases with fentanyl-laced heroin. According to the Drug Enforcement Administration (DEA), “drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety”.  Chicago, Philadelphia and Detroit have been reported to have multiple cases of deaths due to fentanyl overdose. They have traced the source of the lab to be in Mexico.

Conclusion

Fentanyl users have common reasons why they resort to substance abuse when they are asked. They want to either get away from their problems, or have the sense of belongingness and have fun. What comes with this addiction is losing integrity and credibility. With that, drug addiction in general has been linked to so many crimes that even family members are not spared.

Unless we take a step in helping these individuals, more people will succumb to drug abuse, which can lead to the total destruction of the community.

Substance Abuse

New Dangerous Drugs On The Rise

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The United Nations Office on Drugs and Crime (UNODC) recently revealed that new psychoactive substances are emerging in the market in terms of both quantity and diversity. However, the paucity of data on the harmfulness and prevalence of these substances offer a challenge in facilitating risk assessment at the international level.

Here are the seven new dangerous drugs that are gaining traction and notoriety:

Acetylfentanyl

Disguised as oxycodone, aceteylfentanyl is a potent painkiller that has five times more potency than heroin. Its symptoms include lethargy, disorientation, shallow breathing, slow heart rate, and low blood pressure.

MT-45

This drug is a piperazine derivative with potent analgesic activity similar to morphine.

Phenazepam

This substance is a benzodiazepine that has anxiolytic, euphoric, anti-convulsant, amnestic, muscle relaxant, and hypnotic effects.

Para-Methylaminorex

As a synthetic stimulant, this designer drug is related to 4-methyaminorex and pemoline. It is a new and potentially potent kind of synthetic drug.

Methoxetamine

This is a recreational drug, structural analog of ketamine with that can cause hallucinations.

Alpha-Pyrrolidinovalerophenone

This drug is a psychomotor stimulant that comes with cardiotoxicity, violent behavior, and show of psychotic behavior.

Para-Methoxymethylamphethamine (PPMA)

Used as a substitute for ecstasy, this stimulant and psychedelic recreational drug has a hallucinogenic effect and can lead to a fatal rise in temperature.

Government agencies and law enforcement groups must work hand in hand to make sure that these new dangerous drugs are controlled to keep them from getting into the hands of individuals. The drug menace has already claimed so many lives and the arrival of these new substances may once again put so many lives at risk.

Substance Abuse

What Is Purple Drank And Why Is It Dangerously Trending?

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Purple drank is a drug concoction made of codeine cough syrup mixed with carbonated drinks and hard candy. It is commonly known as “syrup”, “lean”, “Texas Tea”, “dirty Sprite” and the more popular term “sizzurp”.

Purple drank emerged as the drug of choice by celebrities and professional themes. The substance has figured in several music festivals, which have catapulted this dangerous mix into media frenzy.

This cold medication contains promethazine and codeine, which is combined to make a purple drink that induces euphoria and dissociation from the body. This recreational drug is a popular choice of drug in the Southern United State.

This illegal recreational drink is usually taken way beyond the medically approved dose. The amount of cough syrup may exceed up to 25 times than the usual recommended dosage. This addictive brew is known as a dissociative drug similar to ketamine and can be a health hazard when abused. Its active ingredient is codeine, known to be an opiate medication that can be extremely addicting.

Meanwhile, purple drank can also contain anti-histamine medication like promethazine that produces a mildly sedative effect. If mixed together and taken in large quantities, sedation and altered state of mind are some of its known effects.

As reported in The Daily Mail, Actavis announced last 2014 that they will cease production of the prescription cough syrup that has become a popular choice in mixing up Sizzurp. Actavis is a pharmaceutical company known to be the biggest distributor of cough syrup with promethazine and codeine in the mixture. Upon realizing this, Actavis decided to stop all production and sales of the said cough syrup.

Purple drank looks enticing and innocent, but it's a highly addictive substance.

Purple drank looks enticing and innocent, but it’s a highly addictive substance. [Source]

Purple Drank Abuse

Today reported that doctors are warning the public of the dangers of this substance. A statement made by Lenox Hill Hospital in New York declared that purple drank can be a very dangerous drug because it can lead to seizures and may even lead the patient to stop breathing.

The primary and active ingredients of the Texas Tea brew are promethazine and codeine, which can only be available upon prescription. The Sizzurp mixture is popular in the hip hop industry and has been the topic of countless songs that encourage others to use this recreational drink.

There are different signs that show up when a person has abused purple drank. The prevailing signs of Sizzurp abuse include slurred speech, lethargy, drowsiness, sedation, altered state of mind and impaired motor skills. The high that users get from taking this mixture is referred to as “swooning euphoria”, because it usually stimulates fainting, periods of blackout, and the tendency to lean on objects for support because it impairs and affects motor skills.

If purple drank is taken in high dosages, some of the unpleasant signs that users experience include vomiting, hives, chest pain, hallucinations, seizures and tremors.

One notable person who suffered from purple drank overdose is Lil Wayne. On October 2012, Lil Wayne was reported to suffer from seizures and tremors while flying his private jet. A few days after his hospitalization, his manager released a report that the seizure was brought about by fatigue and dehydration despite the fact that the award-winning musician is vocal about his addiction.

Purple drank users are often described to be going through sudden changes in behavior and experiencing mood swings and withdrawal symptoms.

purple drank advertisement

Scope of Purple Drank Abuse

Addiction Center concluded that there are roughly 33 million people who use codeine every year. Meanwhile, about 4.7 million are considered to be addicted to the dangerous mixture as reported in the 2008 National Survey on Drug Use and Health. Between 2004 and 2008, about 152% of emergency visits involved pain killers, codeine and promethazine.

Purple drank is a breathing depressant and can be a deadly choice especially when mixed with alcohol and other illicit drugs like Ecstacy.

There are locations that tend to have higher population of purple drank users than other places. A report by Narconon.org concluded that Texas, Florida and Philadelphia are noted as locations with the highest level of Sizzurp abuse. The reason why this type of recreational drug is addictive is because the active ingredient codeine is an entry-level drug that induces and promulgates addiction.

Effects of Sizzurp Addiction

Purple drank – also known as Sizzurp and Texas Tea – is gradually becoming a popular choice in getting high. Some of the effects caused by purple drank abuse includes constricted pupil, raspy voice, uncontrolled eye movement, loss of coordination and drowsiness.

The physiological effect of purple drank on the user includes a dissociative feeling from the body. It may also produce motor-skill impairment and lethargy. The effects of purple drank usually last within three to six hours but frequent users can usually last longer. There are also instances wherein purple drank users get codeine overdose, resulting in opiate overdose and death.

Health hazards arise when the mixture of cough syrup and antihistamine is taken in high dosages. Promethazine is a depressant that directly affects the central nervous system, while codeine is a respiratory depressant. If taken in large amounts, it may cause the user to stop breathing because the entire central nervous and respiratory systems shuts down. The risk of this happening is usually when purple drank is taken alongside alcohol and Ecstacy.

When taking purple drank, codeine enters the brain to stimulate the receptors, which makes the users feel euphoric. If abused and frequently used, the brain gets used to the stimulant, leading users to feel the need to take higher doses of codeine.

Sizzup Withdrawal Symptoms

Since purple drank is highly addictive, users who abruptly stop the use of the drug may experience withdrawal symptoms that can last for a week or more depending on the frequent use.

Some of the symptoms experienced during withdrawal include insomnia, lower threshold for pain, depression, muscle ache, headache and nausea. Withdrawal symptoms usually last for a few days to a week, while depression may take months before it can be overcome.

Treatment of Purple Drank Addiction

The biggest challenge in the growing addiction of purple drank is that it can be easily mixed, with codeine or cough syrup being easily accessible in the black market. Fortunately, there are different options for the successful and efficient detox for codeine and promethazine. These three detoxification options include Cold Turkey, Tapering Off and Substitution.

Cold Turkey is a highly preferred detoxification process for purple drank abuse, but it can be extremely hard to fulfill. Over the course of several months of abstinence to sizzurp, recovering addicts may experience long-term withdrawal symptoms such as insomnia, cravings and anxiety.

These detoxification processes can be an effective method to wean off and get off the addiction. However, self-detox can be highly dangerous especially if done without the supervision of the medical personnel. Self-detox may lead to heart failure, convulsions, anxiety, delirium tremens and hallucinations. The extent of the severity of the symptoms varies on the history of abuse and the user’s physical condition. It is still best to seek professional help to treat purple drank addiction, because constant monitoring of medical staff and proper intake of medication is the key to combat the addiction.

The most common medical treatment for codeine and purple drank addiction is clonidine. This medicine can greatly reduce the impact of withdrawal symptoms brought about by purple drank addiction. The medication works directly on the body’s nervous system.

There are also some other treatment options such as the use of buprenorphine. The substance works to prevent codeine from accessing its opioid receptors, through the activation of the opioid blocker ingredient naltrexone.

Another form of treatment option in combating purple drank addiction is non-medication based treatment. This form of treatment is a support option for sizzurp users and usually includes psychotheraphy as its form or baseline of treatment.

One of the commonly used psychotherapy treatments is behavioral therapy. Behavioral approach as a treatment for addiction works because it helps engage users in drug abuse treatment. It also works as an encouragement for them to abstain from using this drug.

Another effective form of therapy that works in codeine abuse is contingency management interventions or motivational incentives. This type of intensive-based intervention therapy is highly effective in increasing the retention of treatment and promoting the abstinence from drugs.

Another helpful therapy that can promulgate the user to undergo treatment for addiction is group counseling and family counseling. An effectual intervention can only work if users feel supported by their loved ones. This form of therapy is highly effective because drug users need to undergo a set of tedious treatment and therapy sessions to combat addiction, and any form of support can mean a great deal for them.

purple drank cough medicine

Conclusion

Purple drank has become a popular form of addiction as it seems to be widely accepted by the hiphop industry. Some celebrities have been very vocal in advocating this as their form of addiction. Some people have even used social media to promote and even share instructions on how to create this dangerous mixture. Some musicians have also introduced the concept of purple drank use in their songs.

Addiction to this visually alluring purple drink can be considered as a disease that is slowly eating the society. It is hard to get off from addiction and even harder to overcome withdrawal symptoms. However, it can still be treated.

The treatment of this form of addiction can only be effective if recovering addicts are open in making the change within. The support of families and friends is also highly important in ensuring that they are getting all the help they need. Lastly, users should be able to access a treatment center that can cater to their personal needs to alleviate and get well from this toxic addiction.

Alcohol Testing

Is EtG Test For Alcohol Effective and Accurate?

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Road accidents are most commonly caused by drunk driving, which does not only affect drivers but also the people they are with as well as innocent bystanders. Fortunately, a lot of highly reliable testing procedures are now available to immediately determine the presence of alcohol, and one of the best techniques in this field is EtG urine test.

EtG, also known as ethylglucoronide, is a substance that attaches itself to drugs and toxins present in the body, for excretion through urine. With this test, even small amounts of alcohol can be easily detected.

EtG test is considered to produce accurate results because the presence of EtG in the urine will remain for more than 48 hours – and even longer in some cases, depending on the amount of alcohol consumed. This is in contrast to traditional alcohol testing using blood or saliva, wherein the presence of alcohol could no longer be determined after several hours from the last drink.

This kind of test could not detect the number of drinks that a person has consumed, but detecting a large amount of alcohol in urine indicates more consumption. All in all, it still depends on how quickly a person has excreted alcohol by urinating.

To be certain of the alcohol presence in the urine, two sets of urine samples are taken: 100ng/mL and 500 ng/mL. The “margin of safety” is set with a collection of urine sample at 100ng/mL, which means that even with this small amount of sample, alcohol can be detected. The second sample is done to confirm the level of alcohol present.

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