Know all about Addiction

            

                                                                ADDICTION

Addiction is a word very frequently used in general as well in medical terminology but its impact and pain hardly discribable.Most people see it as a crime and hardly like a addicted person.Now we must see it through the different prism as addicted person feel very hopeless and easily get depressed so we must treat him differently without any preassumption.Here in the topic below I try to put some light on this subject with the help of friends, internet books ,news and many living experiences.

People with an addiction lost control over what they are doing, taking or using. This addiction may be harmful if untreated for a long time. Addiction can be defined in simple terms as a physical and pyscological dependence on certain substence as alchohal,tobacco,heroin,cocaines and other stimulating drugs.But some psycologist include behavioural addiction, as gambling,pornography,sex,internet,tv etc. to addiction.
 

In the past addiction used to refer just to psychoactive substances that cross the blood-brain barrier, temporarily altering the chemical balance of the brain; this would include alcohol, tobacco and some drugs. A considerable number of psychologists, other health care professionals and lay people now insist that psychological dependency, as may be the case with gambling, sex, internet, work, exercise, etc. should also be counted as addictions, because they can also lead to feelings of guilt, shame, hopelessness, despair, failure, rejection, anxiety and or humiliation.

Addiction, often referred to as dependency often leads to tolerance - the addicted person needs larger and more regular amounts of whatever they are addicted to in order to receive the same effect. Often, the initial reward is no longer felt, and the addiction continues because withdrawal is so unpleasant.

       

 Substance dependence

The exact cause of drug abuse and dependence is not known. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors.

Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have de
pression, attention deficit disorder, post-traumatic stress disorder, or another mental health problem.

Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life.

People who are more likely to abuse or become dependent on drugs include those who:

• Have depression, bipolar disorder, anxiety disorders, and schizophrenia
• Have easy access to drugs
• Have low self-esteem, or problems with relationships
• Live a stressful lifestyle, economic or emotional
• Live in a culture where there is a high social acceptance of drug use

 Signs And Symptoms Of Addiction

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, sleepiness may be a symptom while dilated pupils may be a sign. when a person is addicted to a substance, such as a drug, alcohol or nicotine, they are not able to control the use of that substance.

The signs and symptoms of substance dependence vary according to the individual, the substance they are addicted to, their family history (genetics), and personal circumstances.

• The person takes the substance and cannot stop - in many cases, such as nicotine, alcohol or drug dependence, at least one serious attempt was made to give up, but unsuccessfully.
• Withdrawal symptoms - when body levels of that substance go below a certain level the patient has physical and mood-related symptoms. There are cravings, bouts of moodiness, bad temper, poor focus, a feeling of being depressed and empty, frustration, anger, bitterness and resentment. There may suddenly be increased appetite. Insomnia is a common symptom of withdrawal. In some cases the individual may have constipation or diarrhea. With some substances, withdrawal can trigger violence, trembling, seizures, hallucinations, and sweats.
• Addiction continues despite health problem awareness - the individual continues taking the substance regularly, even though they have developed illnesses linked to it. For example, a smoker may continue smoking even after a lung or heart condition develops.
• Maintaining a good supply - people who are addicted to a substance will always make sure they have a good supply of it, even if they do not have much money. Sacrifices may be made in the house budget to make sure the substance is as plentiful as possible.
• Dealing with problems - an addicted person commonly feels they need their drug to deal with their problems.
• Obsession - an addicted person may spend more and more time and energy focusing on ways of getting hold of their substance, and in some cases how to use it.
• Denial - a significant number of people who are addicted to a substance are in denial. They are not aware (or refuse to acknowledge) that they have a problem.
• Excess consumption - in some addictions, such as alcohol, some drugs and even nicotine, the individual consumes it to excess. The consequence can be blackouts (cannot remember chunks of time) or physical symptoms, such as a sore throat and bad persistent cough (heavy smokers).
• Having stashes - the addicted individual may have small stocks of their substance hidden away in different parts of the house or car; often in unlikely places.
• Financial difficulties - if the substance is expensive the addicted individual may sacrifice a lot to make sure its supply is secured.
• Relationship problems - these are more common in drug/alcohol addiction.

                                                 

How drugs interact with the brain

People use alcohol and other drugs because they stimulate the brain in ways that “feel good.” This immediate rewarding experience makes people want to repeat it. All substances with addictive potential stimulate the release of dopamine, a chemical in the brain that is associated with reward and pleasure. Eating, drinking and having sex are all activities that release dopamine. Substance use, however, brings a flood of dopamine, which alters the chemistry of the brain. The brain, in turn, tries to keep things in balance by developing tolerance, which means that more and more of the drug is needed to bring feelings of pleasure. The brain also adapts by decreasing the amount of dopamine available. That’s one reason why people who are addicted report feeling “flat” and depressed without drugs (NIDA, n.d.; Glantz & Pickens, 1992).

Commonly abused substances

• Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. These include heroin, opium, codeine meperidine (Demerol), hydromorphone (Dilaudid), and oxycodone (Oxycontin).
• Central nervous system (CNS) stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance).
• Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety-reducing effect, which can lead to dependence.
• Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence.
• Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish.

                                                                                         

1.Alcohol addiction

It is the most frequent addiction in all types of drug addiction.Almost all countries allowed selling and drinking alcohol legally.Even some goverments promots alcohol consumption. 

Alcohol addiction is simply defined as a compulsive need for an intoxicating liquid that is obtained from fermented grain or fruit. These liquids include beer, wine, whiskey,brandy,gin,arrack,toddy etc

The market is stocked with different types of alcoholic beverages, differing in terms of alcohol content. There are some alcohol beverage types that are low in alcohol content like beer. Beer has an alcohol content of about 3-8% and wine consists of approximately 7-18% alcohol concentration. Many a times, it happens that by adding on distilled products, the alcohol content of certain alcoholic beverages is increased.

Distinctive alcoholic beverages differ in terms of their aging process like beer that undergoes a process of short fermentation, lasts for about a week or so. On the contrary, wine, which involves a longer process of fermentation, has a long aging period, lasting many months or even years.

Beer is usually made from barley, whereas whisky is a blend of distinctive kinds of grains. Wine can be made with different fruits like plums and cherry, but usually the wine that can be found in the market is made from grapes. In the list of distilled alcoholic beverages, vodka and gin are the most common ones.

Alcohol content of different alcoholic beverages

Beverage	Source	Alcohol content (percentage)
Brandy	Fruit juices	40 - 50
Whisky	Cereal grains	40 - 55
Rum	Molasses/sugarcane	40 - 55
Wines (Port, Sherry)	Grapes & other fruits	10 - 22
Beer	Cereals	4 - 8

Alcoholism and alcohol abuse

Alcoholism (alcohol dependence) and alcohol abuse are two different forms of problem drinking.

• Alcoholism is when you have signs of physical addiction to alcohol and continues to drink, despite problems with physical health, mental health, and social, family, or job responsibilities. 
• Alcohol abuse is when your drinking leads to problems, but not physical addiction

Alcohol abuse has been a rising problem over the past three decades. With the continued exposure to alcohol, how does the human body respond or adapt? The body's increased tolerance to alcohol involves the following changes:

• Increase in level of liver's enzymes that are used to break down alcohol
• Increase in activity of brain and nervous-system neurons

These bodily adaptations change a person's behavior. The levels of alcohol dehydrogenase and aldehyde dehydrogenase in the liver increase in response to long-term alcohol exposure. This means that the body becomes more efficient at eliminating the high levels of alcohol in the blood. However, it also means that the person must drink more alcohol to experience the same effects as before, which leads to more drinking and contributes to addiction.
The normal chemical and electrical functions of nerve cells increase to compensate for the inhibitory effects of alcohol exposure. This increased nerve activity helps people to function normally with higher BAC; however, it also makes them irritable when they are not drinking. Furthermore, the increased nerve activity may make them crave alcohol. Most certainly, the increased nerve activity contributes to hallucinations and convulsions (e.g. delirium tremens) when alcohol is withdrawn, and makes it difficult to overcome alcohol abuse and dependence.

Expulsion from the body-

Once absorbed by the bloodstream, the alcohol leaves the body in three ways:

• The kidney eliminates 5 percent of alcohol in the urine.
• The lungs exhale 5 percent of alcohol, which can be detected by breathalyzer devices.
• The liver chemically breaks down the remaining alcohol into acetic acid.

As a rule of thumb, an average person can eliminate 0.5 oz (15 ml) of alcohol per hour. So, it would take approximately one hour to eliminate the alcohol from a 12 oz (355 ml) can of beer.
The BAC increases when the body absorbs alcohol faster than it can eliminate it. So, because the body can only eliminate about one dose of alcohol per hour, drinking several drinks in an hour will increase your BAC much more than having one drink over a period of an hour or more.

Symptoms

People who have alcoholism or alcohol abuse often:

• Continue to drink, even when health, work, or family are being harmed
• Drink alone
• Become violent when drinking
• Become hostile when asked about drinking
• Are not able to control drinking -- being unable to stop or reduce alcohol intake
• Make excuses to drink
• Miss work or school, or have a decrease in performance because of drinking
• Stop taking part in activities because of alcohol
• Need to use alcohol on most days to get through the day
• Neglect to eat or eat poorly
• Do not care about or ignore how they dress or whether they are clean
• Try to hide alcohol use
• Shake in the morning or after periods when they have not a drink

Symptoms of alcohol dependence include:

• Memory lapses after heavy drinking
• Needing more and more alcohol to feel "drunk"
• Alcohol withdrawal symptoms when you haven't had a drink for a while
• Alcohol-related illnesses such as alcoholic liver disease

Complications

Alcoholism and alcohol abuse can increase your risk of many health problems,including

• Bleeding in the digestive tract
• Brain cell damage
• Brain disorder called Wernicke-Korsakoff syndrome
• Cancer of the esophagus, liver, colon, and other areas
• Changes in the menstrual cycle (period)
• Delirium tremens (DT's)
• Dementia and memory loss
• Depression and suicide
• Erectile dysfunction
• Heart damage
• High blood pressure
• Inflammation of the pancreas (pancreatitis)
• Liver disease, including cirrhosis
• Nerve damage
• Poor nutrition
• Sleeping problems (insomnia)

Alcohol use also increases your risk for sexually transmitted infections (STIs) and violence.

Drinking alcohol while you are pregnant can lead to severe birth defects in the baby.

Signs and tests

The health care provider will perform a physical exam and ask questions about your medical and family history to screen for alcohol abuse or dependence:

• Do you ever drive when you have been drinking?
• Do you have to drink more than before to get drunk or feel the desired effect?
• Have you felt that you should cut down on your drinking?
• Have you ever had any blackouts after drinking?
• Have you ever missed work or lost a job because of drinking?
• Is someone in your family worried about your drinking?

Tests that may be done include:

• Blood alcohol level (this can tell whether someone has recently been drinking alcohol, but it does not necessarily confirm alcoholism)
• Complete blood count (CBC)
• Liver function tests
• Magnesium blood test

Treatment

Completely stopping the use of alcohol is the ideal goal of treatment. This is called abstinence. A strong social network and family support are important in achieving this.

Completely stopping and avoiding alcohol is difficult for many people with alcoholism. There will be times when it is difficult. You should aim to avoid drinking for as long as possible.
Some people who abuse alcohol may be able to simply reduce the amount they drink. This is called drinking in moderation. If this method does not work, you should try to quit drinking completely.

DECIDING TO QUIT

Many people with alcohol problems do not recognize when their drinking gets out of hand.
The ideal approach to treatment is to help the person realize how much their alcohol use is harming their life and those around them.
Studies find that more people with alcohol problems opt for treatment when their family members or employers are honest with them about their concerns, and try to help them see that drinking is preventing them from reaching their goals.
Withdrawal from alcohol is best done in a controlled, supervised setting. Complications from withdrawal can be life threatening.
Your health care provider should order blood and urine tests to check for health problems that are common in people who abuse alcohol.

LONG-TERM SUPPORT

Alcohol recovery or support programs can help you stop drinking completely. These programs usually offer:

• Counseling and therapy to discuss alcoholism and its effects and how to control your thoughts and behaviors
• Mental health support
• Medical care

You may be treated in a special recovery center (inpatient), or you may attend a program while you live at home (outpatient).
Medications are sometimes prescribed to prevent you from drinking again.

• Acamprosate is a drug that has been shown to lower relapse rates in those who are alcohol dependent.
• Disulfiram (Antabuse) produces very unpleasant side effects if you drink even a small amount of alcohol within 2 weeks after taking the drug.
• Naltrexone (Vivitrol) decreases alcohol cravings. It is available in an injectable form.

You cannot take these medications if you are pregnant or have certain medical conditions. The medications are often used with long-term treatment with counseling or support groups.
Depression or other mood or anxiety disorders may be noticed after you stop drinking. These should be promptly treated.
It is important that the patient has a living situation that supports their need to avoid alcohol. Some programs offer housing options for people with alcoholism or alcohol abuse.

2.Nicotine Addiction

A Nicotine addiction means a person has formed an uncontrollable dependence on Nicotine producing products like cigrattee
Nicotine is the tobacco plant's natural protection from being eaten by a inscet, nicotine is a  toxin super toxin, drop for drop it is more lethal thanstrychnine or diamondback rattlesnake venom and three times deadlier than arsenic Yet amazingly, by chance, this natural insecticide's chemical signature is so similar to the neurotransmitter acetylcholine that once inside the brain it fits a host of chemical locks permitting it direct and indirect control over the flow of more than 200 neuro-chemicals, most importantly dopamine.

Causes of  Addiction

Nicotine is the drug in tobacco that causes addiction. It is absorbed and enters the bloodstream, through the lungs when smoke is inhaled, and through the lining of the mouth (buccal mucosa) when tobacco is chewed or used as oral snuff or for non-inhaled pipe and cigar smoking. It is also absorbed through the nose from nasal snuff, which was popular in the 18th century.

Nicotine is a psychoactive drug with stimulant effects on the electrical activity of the brain. It also has calming effects, especially at times of stress, as well as effects on hormonal and other systems throughout the body. Although its subjective effects are less dramatic and obvious than those of some other addictive drugs, smoking doses of nicotine causes activation of "pleasure centers" in the brain (for example, the mesolimbic dopamine system), which may explain the pleasure, and addictiveness of smoking.

Smokers develop tolerance to nicotine and can take higher doses without feeling sick than when they first started smoking. Many of the unpleasant effects of cigarette withdrawal are due to lack of nicotine and are reversed or alleviated by nicotine replacement (for example, nicotine chewing gum or the nicotine patch).

Smoking is a physical addiction that produces a "chain reaction" in the body:

• Nicotine acts on receptors normally used by one of the main neurotransmitters in the brain and nervous system (acetylcholine). Neurotransmitters are the "chemical messengers" released by nerve cells to communicate with other cells by altering their electrical activity.


• The body responds to nicotine at these receptors as if it was the natural transmitter (acetylcholine) and the activity and physiological functions of many brain systems are altered.


• With repeated nicotine dosage the body adapts to what it regards as extra acetylcholine in an attempt to restore normal function. One way it does this is to grow more acetylcholine receptors.

Thus nicotine induces structural as well as functional changes in the brain of smokers. When nicotine is suddenly withdrawn, physiological functions in the brain and other parts of the body are disturbed. This is known as withdrawal syndrome. It takes time for the body to readjust to functioning normally without nicotine.

Effects of Nicotine uses-

Nicotine use can have many different effects on body functions, both positive and negative. Nicotine acts as both a stimulant and depressant on your body. The use of nicotine:

• Decreases the appetite (for this reason, the fear of weight gain affects some people's willingness to stop smoking).
• Boosts mood and may even relieve minor depression. Many people will feel a sense of well-being.
• Raises the blood level of blood sugar (glucose) and increases insulin production.
• Increases bowel activity, saliva, and phlegm.
• Increases heart rate by around 10 to 20 beats per minute.
• Increases blood pressure by 5 to 10 mmHg (because it tightens the blood vessels).
• May cause sweating, nausea, and diarrhea.
• Stimulates memory and alertness. People who use tobacco often depend on it to help them accomplish certain tasks and perform well.

Nicotine Withdrawal Symptoms

Over time as you continue to smoke, your body learns to depend on nicotine. As a result when you stop smoking you get 'nicotine cravings' one of many different nicotine withdrawal symptoms. Cravings and withdrawal symptoms when you quit smoking are a common experience. It is the way your body reacts when it stops getting nicotine and all the other chemicals in tobacco smoke.

• Cravings. Each one lasts 3 -5 minutes, and may be strong. Over time however, cravings will happen less often. More about cravings below.
• Headaches (occasional), indigestion, nausea, diarrhoea and sore throats rarely last more than four days.
• Try usual over the counter remedies for these symptoms.
• Insomnia and an increased tendency to dream.
• Coughing most commonly caused by the cilia that line your lungs cleaning out the tar and mucus.
• Irritability, depression or anxiety are closely connected to the physical action of nicotine leaving your body and will lessen over one to three weeks.
• Increased appetite and possible weight gain.
• Tiredness and lack of concentration.
• Try and relax more during the first few weeks any tiredness will pass.
• Take a break from what your doing and take a short walk if possible to help concentration. 

A milder form of nicotine withdrawal that involves some or all of these symptoms can occur when a smoker switches from regular to low-nicotine cigarettes or significantly cuts down on the number of cigarettes smoked.

Symptoms of nicotine withdrawal can mimic, disguise, or worsen the symptoms of other psychiatric problems.

Complications of nicotine dependence

• Lung diseases - the majority of lung cancers, cases of chronic bronchitis and emphysema are caused by smoking. Smoking is responsible for 90% of male lung cancer deaths and 80% of female lung cancer deaths in the USA. 90% of deaths in the USA from COPD (chronic obstructive lung disease) are caused by smoking.
• Asthma - people with asthma usually find that smoking makes it worse.
• Cardiovascular problems - people who smoke regularly have a significantly higher risk of dying of heart attack, angina, peripheral vascular disease, and stroke. Even people who smoke just five cigarettes a day have an increased risk of cardiovascular diseases. Somebody who smokes 15 cigarettes per day runs twice the risk of having a heart attack, compared to a lifetime non-smoker. Smokers with cardiovascular disease usually have worse symptoms than non-smokers with cardiovascular disease.
• Cancer - not only does smoking increase the risk of developing lung cancer. Smokers are at higher risk of developing various other types of cancers, including cancer of the bladder, cervix, stomach, lip, throat, esophagus and larynx.
• Skin - smokers' skin tends to age faster than non-smokers'.
• Infertility - female regular smokers have a higher risk of infertility.
• Male impotence - male regular smokers have a significantly higher risk of developing erectile dysfunction (inability to get or sustain an erection).
• Pregnancy and the baby - smoking while pregnant significantly raises the risk of miscarriage. Babies of mothers who smoked regularly during pregnancy tend to weigh less than other babies. Incidence of sudden infant death syndrome (SIDS) is higher among babies whose mothers smoke.
• Respiratory infections - smokers tend to get more respiratory infections than non-smokers, such as flu, colds and bronchitis. Smokers are more prone to pneumonia, a potentially fatal infection in which the lungs become inflamed.
• Insulin resistance - smoking raises insulin resistance, increasing the risk of developing diabetes type 2. People with diabetes who smoke are more likely to suffer from complications compared to people with diabetes who don't smoke.
• Buerger's disease (thromboangiitis obliterans) - smoking can cause Buerger's disease; a disease of the arteries and veins in the arms and legs. The blood vessels swell and become blocked with thrombi (blood clots), eventually damaging or destroying skin tissues. Sometimes this may lead to infection and gangrene.
• Premature death - on average, a ma who has smoked throughout his life lives ten years less than a lifetime non-smoker. In the vast majority of cases the deaths were due to smoking-related diseases, including:
  
  • Lung cancer
  • COPD (chronic obstructive pulmonary disease) - including chronic bronchitis and emphysema
  • Heart disease
  • Stroke

Treatment

There are several strategies for treating nicotine withdrawal.

Nicotine supplements can help. All of them work well, if used properly.

Nicotine supplements come in several forms:

NRT (nicotine replacement therapy) - smoking is a way of getting nicotine into the nicotine addict. Nicotine is highly addictive. People become addicted to smoking, not because it is nice, but because of the nicotine in cigarettes. NRT releases nicotine into the bloodstream at lower doses than one would obtain from tobacco smoke. For many people, this steady supply can help alleviate the cravings that occur when giving up smoking.

Examples of NRT include:

• Nicotine patch - the patch is placed on the skin, where it remains, usually for a whole day. The nicotine enters the bloodstream through the skin. It is replaced each day.
  
  A typical nicotine patch course lasts from 8 to 12 weeks - in many cases it may be longer. Experts say the patient should try not to be impatient. If the patch has worked, there is no hurry to stop using it.
  
  Patients who have not managed to stop smoking completely after two weeks on the patch should see their doctor, who may suggest a different dosage, or adding another medication.

Nicotine gum - this is a chewing gum which contains nicotine. The nicotine enters the bloodstream through the mucosal lining of the mouth. Heavy smokers should probably use the 4mg dose gums, while others should use the 2mg gums.

The gum should be chewed a few times until a mild peppery taste is felt, at which point it should be placed between the cheek and the gumline for about 20 minutes. While the gum is in place and releasing nicotine, avoid fizzy drinks and coffee.

Nicotine lozenge - this hard candy-like tablet dissolves in the mouth and delivers a small dose of nicotine into the bloodstream through the mucosal lining of the mouth. There are 2mg and 4mg doses. The user should place it either under the tongue or between the gumline and cheek, and leave it there until it dissolves.

 

Nicotine inhaler - a cartridge containing nicotine is placed in a cigarette-holder like device. The user sucks on it, inhaling nicotine vapor. The nicotine is absorbed into the bloodstream through the mucosal lining of the mouth and throat. Initially, some users may experience coughing or throat irritation. Patients who miss having something to suck and hold may find this type of NRT especially effective. In many countries the nicotine inhaler is a prescription-only product.

Nicotine nasal spray - the user sprays a solution which contains nicotine directly into each nostril. The nicotine enters the bloodstream through the nasal membranes. Some prefer this method because the nicotine reaches the brain more quickly than with a gum, patch or lozenges (but still more slowly than with a cigarette).

Nonhabit forming prescription medications may help you quit smoking and keep you from starting again. Smoking cessation medications

Such medicines include:

• Varenicline(Chantix/Champix) - this drug interferes with the brain nicotine receptors, resulting in less pleasure from smoking and eventually fewer withdrawal symptoms. Varenicline should not be taken by patients under the age of 18 years, pregnant or breastfeeding women, individuals with advanced kidney disease, and people with epilepsy.
• Clonidine (Catapres) - this medication is usually recommended if other therapies have not worked. It is primarily used for treating hypertension (high blood pressure). However, the side effects, such as sedation and drowsiness put many doctors and
• Antidepressants - bupropion (Wellbutrin, Zyban) raise levels of dopamine and norepinephrine, as does nicotine. Some doctors may recommend a combination of bupropion and nicotine patch. This medication also reduces the risks of weight gain; a common consequence of giving up smoking. Patients with a history of seizures or serious head trauma, those under 18 years of age, pregnant or breastfeeding women, patients with anorexia or bulimia, individuals with a central nervous system tumor, and people with severe cirrhosis of the liver should not take bupropionpatients off.
• Nicotine vaccine - this is still under development. The vaccine triggers the immune system to develop antibodies to nicotine, which bind to it as it enters the bloodstream, preventing the nicotine from ever reaching the brain. If this vaccine works, it will eliminate the brain rush that smokers experience, thereby doing away with the pleasure people derive from smoking. If nicotine does not enter the brain, there is no point in smoking for most addicted smokers.
• Behavioral counseling, support groups and smoking cessation programs - most studies indicate that patients who receive a combination of medication and behavioral counseling tend to have better success rates. While medications may help with the immediate physical problems, behavioral therapy helps people remain smoke free over the long term. In the UK most GPs (general practitioners, primary care physicians) will refer patients to the NHS Stop Smoking support service. Examples of counseling and other non-medical support include:
  • Telephone counseling - several countries worldwide have local or national telephone counseling services for patients who are trying to quit. People in the United Kingdom should call the NHS Stop Smoking helpline on 0800 022 4 332 for more information. Those in the USA may call the National Cancer Institute's 800-QUIT-NOW (800-784-8669) and the American Cancer Society's Quitline at 800-ACS-2345 (800-227-2345).
  • Counseling with a tobacco treatment specialist - the patient can learn new techniques for quitting. Depending on which part of the world you live, these services may be available in hospitals, some health care plans, and health care providers.
  • Internet - there are some web sites which offer support and encouragement for people who are trying to give up smoking. An example of a reputable web site is Nicotine Anonymous.

Untreated depression can prevent you from quitting tobacco. A screening test for depression may help ensure proper treatment and increase the odds that you will stay off tobacco products.
People who are trying to quit smoking often become discouraged when they don't succeed at first. Research shows that the more times you try, the more likely you are to succeed -- so don't give up! If you aren't successful the first time you try to quit, look at what worked or didn't work, think of new ways to quit smoking, and try again. Many attempts are often necessary to finally "beat the habit

                                                                  

3.Opiate addiction

Opioid Addiction comes from Opioids, a class of drugs derived from the opium poppy. They are primarily used as analgesics (pain relief). Along with the pain relief, most opiates give a feeling of euphoria and a degree of sedation. These side effects are what make them popular as drugs of abuse.
Opioid dependency is a medical diagnosis characterized by an individual's inability to stop using opioids even when he want to stop its consumption.Along with drugs derived directly from the opium poppy, the term opioid has come to refer to other, synthetic pain medications that act on the same receptors in the body and cause many of the same effects. While not strictly accurate, synthetic and semi-synthetic drugs will sometimes be referred to as opiates. They are more properly called narcotics, from the root narko, meaning sleep, numbness, or stupor.

Common Opiate Use

Opioids are divided into classes based on whether they are straight extracts from the opium poppy, extracts that have been chemically modified, or completely synthetic and unrelated to opium. The effects differ slightly, as does the abuse potential.

Opium Alkaloids:

• Codeine (Tylenol 3®, Tylenol 4®, Fiorinal #3®, Fioricet#3)
• Morphine (MS Contin®, Roxinal®, Avinza®)

Semi-synthetic

• Hydrocodone (Vicodin®, Vicodin ES®, Vicoprofen®, Lortab®, Lorcet®, Norco®)
• Hydromorphone (Dilaudid®)
• Oxycodone (Percocet®, Roxicet®, Endocet®, Percodan®, Oxycontin®)
• Oxymorphone (Opana®, Opane ER®)

Synthetic

• Propoxyphene (Darvocet®, Darvon®)
• Methadone (Dolophine®, Methadose®)
• Meperidine (Demerol®)
• Fentanyl (Alfenta®, Sufenta®, Ultiva®, Actiq®)
• Loperamide (Imodium)

                                                               

                                                                    
Symptoms of addiction

Opioid symptoms of dependence depends on usage level and duration. The first phase is developing tolerance, which means a higher dose must be taken to obtain the same effect. Along with tolerance, a person is said to be dependent on opiates when not taking them results in adverse effects (not related to the original condition) and opioid symptoms.
Addiction includes the above opioid symptoms as well as cravings for the drug. Addiction adds a psychological and social element to the mere physical facts of tolerance and dependence. Because of this, addiction is a more serious erosion of normal life – the drug becomes not just an escape, but a main driver of daily routine.
Opioid addicted peoples show  one of the below mentioned characters

• A strong desire or sense of compulsion to take the drug;
• Difficulties in controlling drug-taking behaviour in terms of its onset, termination, or levels of use;
• A physiological withdrawal state when drug use is stopped or reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
• Evidence of tolerance, such that increased doses of the drug are required in order to achieve effects originally produced by lower doses;
• Progressive neglect of alternative pleasures or interests because of drug use, increased amount of time necessary to obtain or take the drug or to recover from its effects;
• Persisting with drug use despite clear evidence of overtly harmful consequences, such as harm to the liver, depressive mood states or impairment of cognitive functioning.

Symptoms of withdrawal

Symptoms of withdrawl from opiates include, but are not limited to

Physical Symptoms

• Extreme Pain
• Tremors
• Cramps
• Chills
• Perspiration
• Priapism
• Tachycardia
• Itch
• Restless legs syndrome
• Flu-like symptoms
• Rhinitis
• Yawning
• Sneezing
• Vomiting
• Diarrhea
• Weakness

Psychological Symptoms 

• Dysphoria
• Malaise
• Cravings
• Anxiety/Panic Attacks
• Paranoia
• Insomnia
• Dizziness
• Nausea
• Depression

Other rare symptoms but more serious are cardiac arrhythmias, strokes, seizures, dehydration and sucide attempts. Depending on the quantity, type, frequency, and duration of opioid use, the physical withdrawal symptoms last for as little as forty-eight to seventy-two hours (for short-acting opioids such as hydromorphone [Dilaudid] and oxycodone after short duration lower-dose use), and as long as thirty to sixty days for long-acting opioids such as buprenorphine and methadone, respectively, after extended high-dose use. When long acting opioids like methadone (Methadose, Physeptone) or buprenorphine (Suboxone [buprenorphine in a 4:1 ratio to naloxone] and Subutex [single-agent buprenorphine]) are used for an extended period, physical withdrawal symptoms can last up to six weeks. This initial withdrawal is characterized by the body regaining physical homeostasis.

Treatment

 Medical treatment for opioid addiction takes two general tracks.

The first is replacement therapy. Methadone is a synthetic opioid that can be taken orally by those addicted to more serious forms of opiates, like injectable heroin. Although this creates an addiction to methadone addicts are better able to manage their lives and the replacement allows them to function more normally than heroin would.

The second type of medical therapy for opioid addiction is to administer a drug that blocks the effects of narcotics. One such is naltrexone. A related drug, naloxone, acts like an antidote to opioids and is used to save lives in those who have overdosed. Giving it to addicts means they will not achieve the desired effects of their drug.

One difficulty with naltrexone is getting patients to stay on it. It does little to stop cravings and an addict can once again abuse when it wears off. There are time-release forms that extend coverage, but many addicts decide to go off naltrexone because their cravings become so intense.

Naloxone has recently been available in combination with a mild replacement drug, buprenorphine. This combination of naloxone and buprenorphine is marketed as Suboxone.

Suboxone can be prescribed by a physician on an out-patient basis to those who are dependent on opioids. It is administered orally (sublingual) in a five-stage process of Intake, Induction, Stabilization, Maintenance, and Medically Supervised Withdrawal. The advantage is that the combination seems to lessen cravings and the series can be administered without someone being confined to a treatment facility.

Some drug treatment programs have widely advertised treatments for opiate withdrawal called detox under anesthesia or rapid opiate detox. Such programs involve placing you under anesthesia and injecting large doses of opiate-blocking drugs, with hopes that this will speed up the return to normal opioid system function.

There is no evidence that these programs actually reduce the time spent in withdrawal. In some cases, they may reduce the intensity of symptoms. However, there have been several deaths associated with the procedures, particularly when it is done outside a hospital.

Because opiate withdrawal produces vomiting, and vomiting during anesthesia significantly increases death risk, many specialists think the risks of this procedure significantly outweigh the potential (and unproven) benefits.

4.Cocaine Addiction 

Cocaine (benzoylmethylecgonine) (INN) is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant.When modified chemically for smoking, it is referred to as crack cocaine. Cocaine base is water soluble, while the crack form is not.The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine.Cocaine has been called the champagne of drugs, gold dust, Cadillac of drugs, status stimulant, yuppie drug, and others. Street names for cocaine also reflect its appearance or method of use (such as flake, snow, toot, blow, nose candy, her, she, lady flake, liquid lady [a mixture of cocaine and alcohol], speedball [cocaine and heroin], crack, rock). It can also express its method of preparation, such as freebase. It is more popularly known simply as coke. It is a stimulan of the central nervous system, an appetite suppressant, and a topical anesthetic. Its possession, cultivation, and distribution are illegal for non-medicinal and non-government sanctioned purposes in virtually all parts of the world. Although its free commercialization is illegal and has been severely penalized in virtually all countries, its use worldwide remains widespread in many social, cultural, and personal settings.

                                                   

Causes of  Dependency

Although there is no one single cause of cocaine addition, addictive disease is generally believed to be the result of a combination of genetic background and environmental risk factors. Those from high-risk family environments are particularly susceptible to the development of addictive disease, and they need to be aware of this information during their preadolescent period. However, the presence of an addict in the family does not mean that a person can be certain to become an addict.

Research indicates that repeated exposure to cocaine causes a change in genes that leads to altered levels of a specific brain protein. This protein regulates the action of a normally occurring brain chemical called dopamine. It is a chemical messenger in the brain associated with the cocaine's pleasurable "rush," the mechanism of addiction. Certainly, more research is needed to unlock the mysteries of addiction, but this information adds one more link in explaining how the brain adapts in the addiction processCocaine addiction follows a path that begins with tolerance, then dependence, and finally full blown addiction. Tolerance is the process where the same amount of drug doesn’t quite give the same pleasure or euphoria that it used to. This leads to increasing the dosage to reach a better high.

Effects of Cocaine

The effects of cocaine can be divided into what goes on in the central nervous system, in the brain, and in the rest of the body. The effects of the drug vary greatly, depending on the route of administration, amount, purity, and effects of the added ingredients. The effect also varies with the user's emotional state while taking the drug. This is based on the user's attitude toward the drug, the physical setting in which the drug is being used, his or her physical condition, and whether or not the person is a regular user.

• Central nervous system and psychiatric effects: Users who have pleasurable experiences report varying degrees of euphoria; increased energy, excitement, and sociability; less hunger and fatigue; a marked feeling of increased physical and mental strength; and decreased sensation of pain. Some will feel a great sense of power and competence that may be associated with the delusion or false sense of grandeur, known as cocainomania. There can be talkativeness, good humor, and laughing. Dilated pupils, nausea, vomiting, headache, or vertigo (the sensation of your surroundings or yourself moving or spinning). With or even without increased amounts of coke, these can progress to excitement, flightiness, emotional instability, restlessness, irritability, apprehension, inability to sit still, cold sweats, tremors, twitching of small muscles (especially of the eyes and other face muscles, fingers, feet), and muscle jerks. The effects of cocaine on the teeth may include teeth grinding. The cocaine user may also experience hallucinations (cocaine bugs, snow lights, voices and sounds, smells) and cocaine psychosis. Cocaine psychosis resembles paranoid schizophrenia and can bring on paranoia, mania, and psychosis.Major effects that usually cause a cocaine abuser to go to an emergency department are severe headache, seizures, loss of consciousness that can be caused by not breathing or bleeding in the brain, stroke, hyperthermia (increased body temperature), coma, and loss of vital support functions (such as low blood pressure, slow heart rate, slow respirations, and death).
• Brain effects: The effects of cocaine on the brain include alteration of responsiveness of the brain to various chemicals. These chemicals or neurotransmitters, such as norepinephrine, dopamine, serotonin, acetylcholine, and gamma-aminobutyric acid, are responsible for most of the complications of cocaine. Infants of cocaine-smoking parents have been brought to an emergency department because of seizures induced by secondhand cocaine smoking.
• Ear, nose, and throat effects: Because the majority of users sniff or snort cocaine through their nose, there are a variety of nasal and sinus diseases. Many users complain of nasal irritation, nasal crusting, recurrent nosebleeds, nasal stuffiness, facial pain caused by sinusitis, and hoarseness.The mucous membrane of both sides of the septum (the cartilage that separates the nostrils) can be damaged by decreased blood supply, along with drying, crusting, and nose picking. This results in a perforation or hole in the septum with more crusting, foul secretions, nosebleeds, and whistling with nasal breathing, the so-called coke nose.
• Lung effects: The direct effects of smoking cocaine are responsible for most lung and breathing complications. The large surface area of the lungs and its great blood supply cause rapid and profound brain stimulation known as the head rush. Smoking the freebase, crack, or paste is done using a glass pipe, water pipes, or cigarettes, which are heated by butane lighters or matches. The residue from the tars, matches, cocaine contaminants, and additives, such as marijuana, often cause chronic bronchitis, chronic coughing, and coughing up black, nonbloody phlegm. These conditions can cause shortness of breath and chest pain. Utilizing the technique of deep inhalation and breath holding to maximize the amount of cocaine inhaled and absorbed can cause the lung to collapse. These cocaine users will complain of sharp chest pain, often worse with deep breathing, neck pain, difficult or painful swallowing, and air under the skin in the neck that feels like Rice Krispies under the skin when touched (subcutaneous emphysema). Though unusual, the user's lungs can fill with fluid (pulmonary edema), causing extreme shortness of breath, sometimes respiratory failure, and death.
• Cardiovascular (heart, blood vessels) effects: The major effect of cocaine is to stimulate the sympathetic nervous system. This system is responsible for the "fight or flight response" and is controlled primarily by adrenaline or epinephrine. The effects include increased heart rate, blood vessel narrowing, and high blood pressure. Angina or the chest pain that is felt with decreased blood supply to the heart and heart attack have accounted for more reports in medical journals than any other complication of cocaine intoxication.
• Pregnancy effects: Cocaine use during pregnancy can increase the complications of pregnancy and affect the fetus directly. These abusers may also use other drugs, alcohol, and nicotine, which adversely affect the pregnancy as well. They have an increased rate of miscarriages and placenta abruption, in which the placenta separates from the wall of the uterus and results in stillbirth. There is increasing information that cocaine may cause birth defects with increased rates of malformation, low birth weights, and behavioral abnormalities.
• Infections: The infectious complications related to IV use of cocaine are not unique to cocaine. All IV drug users are at risk for infections such as cellulitis (soft tissue infection at the injection site), abscesses at the injection sites, tetanus or lockjaw, lung or brain abscesses, or infection of the heart valves. These are due to nonsterile techniques of IV injections. Contagious viruses such as hepatitis B, hepatitis C, and HIV (AIDS virus) are transmitted by sharing IV needles. The abuser may complain of pain, swelling, and redness at the injection site or fever. Abusers may also complain of jaundice or turning yellow, abdominal pain, nausea, vomiting, loss of appetite, or the multitude of complaints that accompany hepatitis and AIDS.
• Body packers or stuffers: People smuggle the processed cocaine across international borders. They often swallow drug-filled packets or stuff them into body openings such as the vagina or rectum. The "body packer" or "mule" can carry 50-200 tightly wrapped condoms or latex bags filled with high-grade cocaine hydrochloride. If the containers break or leak, the cocaine can be absorbed by the person's body. Most mules have no symptoms and may be apprehended by an astute official who notices some suspicious behavior. Some will become acutely ill when the packets leak or rupture, resulting in massive intoxication, seizures, and death. A similar problem may occur with "body stuffers." These are cocaine users or traffickers who swallow bags of cocaine when arrested so there is no evidence.

Dependence begins to occur when the brain has become used to getting the drug. Without using cocaine, users become moody and depressed. Fatigue is a common symptom and many users will resort to sleeping medications to recover from bouts of heavy use. Physical dependence means the neurological pathways in the brain have changed in response to repeated dosing and ordinary levels of these reward/pleasure neurotransmitters are not enough to give the normal uplifting mood.

Weight loss and loss of appetite

This can result from a lack of interest in food, which no longer gives pleasure. Other affects of cocaine, such as losing one’s sense of smell and difficulty swallowing may increase this effect.

Nasal deterioration

This leads to a constantly runny nose (cocaine drip) and possible gastrointestinal effects from cocaine laden fluids that leak down into the esophagus. Gangrene of the esophagus has been reported because of vasoconstriction caused by cocaine use.

Rapid heartbeat and high blood pressure

This will happen with each dose and over time can lead to serious cardiac consequences and the possibility of stroke.

Mental disorders

These include paranoia, anxiety, depression, and hallucinations.

Sociological Effects

Perhaps more important are the sociological effects – job loss because of increased absenteeism (both from binging and then recovery), marital and relationship problems, and financial distress. Significant others will notice the personality changes that come with increased paranoia and irritability. Along with these, arrest and criminal charges for possession or distribution may finally expose the addiction for what it is.

Cocaine has a half-life of only one hour. Half the dose has been metabolized in an hour, 3/4ths in two hours and 7/8ths in three hours. Because of this, the initial effects of cocaine disappear rather quickly. Withdrawal can begin in as soon as 6 hours from the last dose.

The physical symptoms of withdrawal from cocaine are much less severe than for other drugs, such as heroin or alcohol. They are uncomfortable, and may be dangerous, but are not considered life threatening in most patients.

Other risks

Because the relapse rate is so high, addicts are at risk when they withdraw and then relapse. The risk is overdose when someone who has been clean for weeks or months goes back to the drug and overestimates the amount they can handle. The slide back into use isn’t as slow or as carefully done as the initial addiction process. An addict returning to the drug will quickly regain their previous use pattern.

Another risk comes from the depression during withdrawal. In some cases, it may be serious enough that suicidal thoughts emerge. Addicts who first started cocaine use to combat depression (self medicate) are even more at risk. Not only does the original depression come back, but it is magnified by the depression associated with withdrawal.

Finally, there is a little understood phenomenon where users who have undergone physical withdrawal return to the drug and have a severe reaction. In these cases, even a small dose of cocaine will act as if it were an overdose – putting them at risk of heart attack or stroke.

Not every smoker is affected to the same degree. Some will experience severe nicotine withdrawal symptoms but generally the symptoms will come and go over a period of a few days and most are gone within three weeks.

Treatment

Tests are necessary to evaluate the symptoms of someone with cocaine-induced conditions. In addition to a physical exam and medical history, tests may include blood and urine analysis, chest Xray, CT scans, MRI scans, and spinal tap.

• Cocaine-induced headache diagnoses can include such conditions as tension headache, stroke (bleed in head), sinusitis, meningitis, or brain abscess.
• Cocaine-induced seizures might indicate more serious problems such as bleeding in the brain, meningitis, very high blood pressure with organ injury, or low blood pressure, respiratory failure, and heart problems. Infants may experience seizures caused by parents' smoking cocaine in their presence. It is important to note that this is a form of child abuse and should immediately be reported to local child welfare services.
• Psychiatric problems caused by cocaine abuse may include cocainomania, anxiety, hallucinations, paranoia, psychoses, violence, major depression, suicidal or homicidal tendencies, or attempted suicide or homicide.
• Nasal and throat complications of cocaine abuse can include diagnoses of nasal itching, post-nasal drip, nosebleed, sinusitis, laryngitis, and perforated nasal septum.
• Pulmonary diagnoses may include pneumonia, bronchitis, COPD (chronic obstructive pulmonary disease or emphysema), asthma or reactive airway disease, or a collapsed lung.
• Cardiovascular diagnoses include heart problems such as chest pain, heart attack, abnormal heart rhythms, and various heart conditions that can lead to sudden death.
• Pregnancy diagnoses may include vaginal bleeding, threatened abortion, incomplete abortion, or spontaneous abortion, or miscarriage. Ultrasound may be used to establish the diagnosis in these cases.
• Infectious diagnoses may include cellulitis, shooter's abscess, lung abscess, brain abscess, septic shock, hepatitis, and any of the opportunistic infections associated with AIDS if you are HIV infected.
• Body packers and stuffers may have various diagnoses depending on whether the packets leak or remain intact. If they leak, the diagnoses may be massive cocaine intoxication with seizures, high temperatures, hypertension, muscle breakdown, kidney failure, and death. If the abuser has no symptoms with normal vital signs and refuses medical care, invasive procedures may not be done until proper legal documentation has been provided

The withdrawal from cocaine may not be as unstable as withdrawal from alcohol. However, the withdrawal from any chronic substance abuse is very serious. There is a risk of suicide or overdose.

Symptoms usually disappear over time. People who have cocaine withdrawal will often use alcohol, sedatives, hypnotics, or antianxiety medications such as diazepam (Valium) to treat their symptoms. Use of these drugs is not recommended because it simply shifts addiction from one substance to another.

At least half of all people addicted to cocaine also have a mental disorder (particularly depression and attention-deficit disorder). These conditions should be suspected and treated. When diagnosed and treated, relapse rates are dramatically reduced. All prescription drug use should be monitored carefully in patients who abuse substances.

     
                                                            

5.Heroin Addiction

Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the Asian poppy plant. Heroin usually appears as a white or brown powder. Street names for heroin include "smack," "H," "skag," and "junk." Other names may refer to types of heroin produced in a specific geographical area, such as "Mexican black tar."The pleasurable sensation from heroin is called a rush, and the intensity of the rush depends on how much drug was taken and how rapidly the drug entered the brain. When a person injects heroin directly into a vein, the rush occurs within seconds, whereas it takes at least 10 minutes when the drug is sniffed or smoked. Along with the rush, the person using heroin usually has a warm flushing of the skin, small pupils, watery eyes, runny nose, dry mouth, and a heavy feeling in the arms and legs. Heroin may also cause nausea, vomiting, and severe itching. Soon after the rush, the person feels drowsy and very relaxed. Breathing and heart rate slow, thinking becomes cloudy, and the person may fall into a trancelike state that can last 4 to 6 hours.

How is Heroin Used

Heroin is usually injected, sniffed/snorted, or smoked. Typically, a heroin abuser may inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds), while intramuscular injection produces a relatively slow onset of euphoria (5 to 8 minutes). When heroin is sniffed or smoked, peak effects are usually felt within 10 to 15 minutes. Although smoking and sniffing heroin do not produce a "rush" as quickly or as intensely as intravenous injection

Injection continues to be the predominant method of heroin use among addicted users seeking treatment; however, researchers have observed a shift in heroin use patterns, from injection to sniffing and smoking. In fact, sniffing/snorting heroin is now the most widely reported means of taking heroin among users admitted for drug treatment in Newark, Chicago, and New York.

Signs of Heroin Dependence


Heroin addicts have similar experiences when they have become dependent on the drug, including:

• Cravings in between uses
• Spending time thinking about the last time they got high and what the next high will be like
• Focusing on where and when they can get the next dose
• Sudden financial difficulties and erratic behavior
• Track marks around injection points

Causes of Dependency

Heroin is a very effective pain killer that works by depressing the body's central nervous system. Using it affects the way nerves in the spinal cord communicate pain sensations to the brain. Shortly after the drug is snorted or injected, it creates an intense feeling of pleasure. Heroin works on the pleasure centers in the brain by affecting the level of dopamine that it produces.

Consequences of Heroin Use

Short-Term Effects

• Rush
• Depressed respiration
• Clouded mental functioning
• Nausea and vomiting
• Suppression of pain
• Spontaneous abortion

Long-Term Effect

• Addiction Infectious diseases, for example, HIV/AIDS and hepatitis B and C
• Collapsed veins
• Bacterial infections
• Abscesses
• Infection of heart lining and valves
• Arthritis and other rheumatologic problems

Medical consequences of chronic heroin abuse include scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses (boils) and other soft-tissue infections, and liver or kidney disease. Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health condition of the abuser as well as from heroin's depressing effects on respiration. Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems.

Of course, sharing of injection equipment or fluids can lead to some of the most severe consequences of heroin abuse-infections with hepatitis B and C, HIV, and a host of other blood-borne viruses, which drug abusers can then pass on to their sexual partners and children.

Heroin abuse can cause serious complications during pregnancy, including miscarriage and premature delivery. Children born to addicted mothers are at greater risk of SIDS (sudden infant death syndrome), as well. Pregnant women should not be detoxified from opiates because of the increased risk of spontaneous abortion or premature delivery; rather, treatment with methadone is strongly advised. Although infants born to mothers taking prescribed methadone may show signs of physical dependence, they can be treated easily and safely in the nursery. Research has demonstrated also that the effects of in utero exposure to methadone are relatively benign.

Tretments for Heroin addiction-

Treatment tends to be more effective when heroin abuse is identified early. The treatments that follow vary depending on the individual, but methadone, a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms, has a proven record of success for people addicted to heroin. Other pharmaceutical approaches, like LAAM (levo-alpha-acetyl-methadol) and buprenorphine, and many behavioral therapies also are used for treating heroin addiction.

Detoxification-The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state. Not in itself a treatment for addiction, detoxification is a useful step only when it leads into long-term treatment that is either drug-free (residential or outpatient) or uses medications as part of the treatment. The best documented drug-free treatments are the therapeutic community residential programs lasting at least 3 to 6 months. 

Methadone Treatment-Methadone treatment has been used effectively and safely to treat opioid addiction for more than 30 years. Properly prescribed methadone is not intoxicating or sedating, and its effects do not interfere with ordinary activities such as driving a car. The medication is taken orally and it suppresses narcotic withdrawal for 24 to 36 hours. Patients are able to perceive pain and have emotional reactions. Most important, methadone relieves the craving associated with heroin addiction; craving is a major reason for relapse. Among methadone patients, it has been found that normal street doses of heroin are ineffective at producing euphoria, thus making the use of heroin more easily extinguishable.

LAAM  Treatment- LAAM, like methadone, is a synthetic opiate that can be used to treat heroin addiction. LAAM can block the effects of heroin for up to 72 hours with minimal side effects when taken orally. In 1993 the Food and Drug Administration approved the use of LAAM for treating patients addicted to heroin. Its long duration of action permits dosing just three times per week, thereby eliminating the need for daily dosing and take-home doses for weekends. LAAM will be increasingly available in clinics that already dispense methadone. Naloxone and naltrexone are medications that also block the effects of morphine, heroin, and other opiates. As antagonists, they are especially useful as antidotes. Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending on the dose. Naltrexone blocks the pleasurable effects of heroin and is useful in treating some highly motivated individuals. Naltrexone has also been found to be successful in preventing relapse by former opiate addicts released from prison on probation.

Behavioral Therapies-Although behavioral and pharmacologic treatments can be extremely useful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach. There are many effective behavioral treatments available for heroin addiction. These can include residential and outpatient approaches. An important task is to match the best treatment approach to meet the particular needs of the patient. Moreover, several new behavioral therapies, such as contingency management therapy and cognitive-behavioral interventions, show particular promise as treatments for heroin addiction. Contingency management therapy uses a voucher-based system, where patients earn ÒpointsÓ based on negative drug tests, which they can exchange for items that encourage healthy living. Cognitive-behavioral interventions are designed to help modify the patient's thinking, expectancies, and behaviors and to increase skills in coping with various life stressors. Both behavioral and pharmacological treatments help to restore a degree of normalcy to brain function and behavior, with increased employment rates and lower risk of HIV and other diseases and criminal behaviour.


Buprenorphine Treatment- Another medication to treat heroin addiction.Buprenorphine is a particularly attractive treatment because, compared to other medications, such as methadone, it causes weaker opiate effects and is less likely to cause overdose problems. Buprenorphine also produces a lower level of physical dependence, so patients who discontinue the medication generally have fewer withdrawal symptoms than do those who stop taking methadone. Because of these advantages, buprenorphine may be appropriate for use in a wider variety of treatment settings than the currently available medications. Several other medications with potential for treating heroin overdose or addiction are currently under investigation by NIDA.

Methadone's effects last for about 24 hours - four to six times as long as those of heroin - so people in treatment need to take it only once a day. Also, methadone is medically safe even when used continuously for 10 years or more. Combined with behavioral therapies or counseling and other supportive services, methadone enables patients to stop using heroin (and other opiates) and return to more stable and productive lives.

Methadone dosages must be carefully monitored in patients who are receiving antiviral therapy for HIV infection, to avoid potential medication interactions.

                                                                                                                                                                                                                                                              

6.Marijuana Addiction

Marijuana or Marihuana, also known as Cannabis, is a drug that produces psychoactive effects when an individual consumes it. The drug is made up of dried leaves, stems, and flowers of the female plants. They can be rolled over and then used for smoking through pipes, bongs, paper wrapped joints, and tobacco leaf wrapped blunts.The primary active ingredient in marijuana is THC (delta 9 tetrahydrocannabinol).

This psychoactive drug is also known as pot and ganja in the Asian countries. The effect of smoking marijuana is almost immediate. The inhaler experiences a distorted perception of time and space, alterations in his moods, and hallucinations. The drug is also known to increase the heart rate, lower the blood pressure, and impair memory and concentration. The smoker gets into a state of euphoria along with mental relaxation. Anxiety and insomnia are commonly observed in such people.Marijuana addiction is simply an uncontrollable urge to possess and use the drug. Those with marijuana addiction are not able to stop using the drug even if they wish.

 

Signs of Marijuana Dependence

Changes in a person's behavior that may indicate marijuana use include:

• Withdrawal, fatigue, and depression.
• Carelessness with grooming.
• Hostility and relationship problems.
• Changes in academic performance and increased absenteeism or truancy. Regular use of marijuana affects short-term memory, learning, and attention span.
• Loss of interest in favorite activities, including sports.
• Changes in eating or sleeping habits.

When a teen is using marijuana, the parent may find evidence of the drug and drug paraphernalia, including pipes and rolling papers, in the teen's bedroom. There may be a noticeable sweet odor on the teen's clothing. The teen may burn incense or use room deodorizers to get rid of the marijuana smell. The teen may also use eyedrops to get rid of bloodshot eyes.

Signs that use of marijuana has moved from the recreational stage to a more serious problem are similar to those of other addictions.

• Spending a large portion of time thinking about marijuana
• Focusing on getting more and finding the money to get it
• Need to use a larger amount to get the same effect

Causes of Dependency

An individual who is addicted to marijuana becomes dependent on the drug because it affects the pleasure centers in the brain. Repeated use makes it more difficult for the person to remember events, learn new ideas or skills, and adapt to changes appropriately. This impairment can lead to depression, and the marijuana addict may continue to use the drug as a way to deal with the feelings of emptiness and hopelessness that accompany this disorder. The side effects of marijuana use may also lead to anxiety when the person tries to quit.

Effects of Use

Marijuana is usually smoked but can also be eaten to feel its effects. Rolled up like a cigarette called a joint, in a pipe or from a water pipe called a bong, all effectively deliver smoke straight to the lungs. The active ingredient of marijuana is THC (delta-9-tetrahydrocannabinol) which gets into the bloodstream through the lungs and into the brain. The brains reward system is triggered giving the user a euphoric pleasurable feeling but at the same time hampering thought, concentration and perception of time.

The effects are felt right away and can last up to 4 hours. THC affects the same part of the brain that controls memory and focus. Some people can become paranoid on pot and become very anxious. More marijuana information about side effects include the following:

Bloodshot eyes
Faster heartbeat
Sensations become more intense
Hunger may be felt
Dry mouth
Fear
Loss of control
Loss of memory
Loss of coordination
Reaction time slowed
Addiction

Marijuana information reveals that chronic use of pot can lead to respiratory problems, chest pains and a phlegm filled cough. Cancer of the lungs is also linked to marijuana information because the unfiltered pot smoke has more carcinogens than even cigarettes.

Marijuana addicts claim that using the drug gives them these effects, which last for two or three hours after the drug is ingested:

• Ease in social situations
• Euphoria
• Feeling of relaxation
• Sexual arousal

Complications and Long Term Effects of Marijuana Abuse

Using marijuana produces a sense of fuzziness in the brain, which has led to a number of accidents involving motor vehicles and in the workplace. Marijuana abuse during pregnancy leads to low-birth weight babies, and puts the child at increased risk for a form of blood cancer.

Marijuana doesn't contain nicotine, but it does have more tar than tobacco products do. Repeated use increases the addict's risk for:

• Bronchitis
• COPD (Chronic Obstructive Pulmonary Disease)
• Emphysema
• Lung cancer
• Respiratory tract infections

 Treatment for Marijuana Addiction

Marijuana addiction is something that will be hard to overcome. This is because both your body and mind have become dependent on this drug. Even if you try to quit, your body and mind will still crave for this drug. Quitting is not hard, but the withdrawal symptoms are what make many people opt to remain in marijuana use. If you have been using marijuana without knowledge that you are getting addicted then it is high time you make a resolution and quit. Marijuana is one drug that can be very addictive; however, with dedication you can be out of its chains.

Drug rehab centers offering programs for substance abuse are able to provide help and support to marijuana addicts. They can assist the addict through marijuana withdrawal symptoms, which include:

• Agitation
• Insomnia
• Irritability
• Nausea
• Sweating
• Tremors
• Weight loss

After the withdrawal phase of marijuana addiction treatment is completed, individual and group therapy can be used to help the person successfully quit marijuana. Clients are taught to recognize the triggers that make them want to use the drug as part of marijuana addiction treatments. Once the triggers have been identified, the addict can learn effective strategies to deal with them. Screening for other addictions and psychiatric disorders should be part of the services offered, since marijuana is often used with other substances, such as alcohol, or as part of self-medicating for mental illness.  

Importance of Meditation and Yoga

Meditation and Yoga is very useful in getting rid of drug addiction,we will discuess some simple yogic techniques in detail.

Meditation

Do meditation regularly for a healthy life and it is very impressive in drug addication cases.Find out a quite and comfortable place.Sit in cross legged or lotus position and take few long breathes.Eyes closed and free your body,think as you are weightless.Now start focuessing on your mind.Monitor your thoughts,remember you have to just monitor not interfer on these thoughts.At begining it would be very difficult to focuess on thoughts but keep it doing regularly.Thoughts will start decreasing slowely and at one time your mind will be at complete calm no thoughts present in your mind, increase this time as much as possible for you.Soon you will realise you are in complete control of your thinking patteren and you are less dependable on druges.

Prayanaam

They are the breathing techniques for complete relaxation of body and remove toxins from the body.They will definitely help to drug addicted patients.Some popular prayanama are following-

Bhastrika pranayama - Bhastrika pranayama is all about inhaling and exhaling completely so that your body gets maximum amount of oxygen. Follow the steps given below and learn to do Bhastrika pranayama.

• Be seated in comfortable posture. Padmasana (crossed leg) and Vajrasana are the ideal yoga postures to practice pranayama. Place your hands on your knees. Feel relaxed. Focus on your breathing pattern and be relaxed.
• Breathe in by inhaling forcefully through both the nostrils. Make sure that your lungs are full with air. Once you inhale fully, exhale with great force making hissing sound. 
• In Bhastrika pranayama one needs to apply force while breathing in and breathing out. You can determine how much speed to apply while inhaling and exhaling keeping in mind your heath and endurance power.
• When you breathe in while performing Bhastrika pranayama, your abdominal should not blow up. Instead your chest area should blow up. Repeat the procedure for 5 to 10 times. 
• You have successfully completed Bhastrika pranayama. One should perform Bhastrika pranayama for 5 minutes everyday. Those who have high blood pressure or heart disease should not practice Bhastrika pranayama.

Kapalbhati pranayama

Kapalbhati pranayama purifies entire respiratory system. Devoting some time to the practice of Kapalbhati pranayama in the morning will be highly beneficial.

• Be seated in a comfortable posture. Padmasana (crossed leg) and Vajrasana are the ideal yoga postures to practice pranayama. Place your hands on your knees. Feel relaxed. Focus on your breathing pattern. 
•  Now exhale with a great force, your abdominal muscles should get contracted when you exhale.Focus completely on exhalations,let the air come in without any effort. 
• The exhalations should be forceful. Make sure that while exhaling, you are throwing the air out from the lungs with full force.   
• You have successfully completed one round of Kapalbhati pranayama. A learner can do 3 rounds of Kapalbhati pranayama by doing 15 exhalations in each round. Take small breaks between each round. You can increase the number of exhalations and rounds of pranayama as per your convenience. 

Anulom Vilom pranayama-

Anulom Vilom pranayama is another breathing techniques it helps in toxin reduction and improve immunity power.

• Sit in any comfortable balanced meditative pose as the Sukhasana or the Vajrasana. Those who are unable to sit down can sit on a chair and do the breathing exercises. However sitting down in a proper yogic posture is most beneficial.
• Left hand is to be kept on the left knee and the right hand on the bridge of the nose and the 4th and the middle fingers on the left side of the nose.

• Folding your index and middle fingers. Do not twist your nose; only press it on the bony region to the control breathing.

• Now begin to first exhale through left nostril, and then inhale through the same, by closing the right nostril,then exhale Then exhale through the right nostril and lastly exhale through the left nostril.

Alternative medicine for drug addiction-

Herbal Medicine for Alcoholism & Drug Addiction

Herbs can ease some alcohol or drug withdrawal symptoms (from anxiety to insomnia) and help detoxify the body. They also may be used to reduce the addicted person's craving for alcohol and other drugs.Especially helpful are herbs that influence the nervous system, gently encouraging a relaxed and sedated state. These include catnip, chamomile, peppermint, and skullcap, which can be used together as a tea.
For detoxification, several herbs contribute to cleansing the blood, including burdock root and echinacea (purple coneflower). Others such as milk thistle, which contains silymarin, support the liver - the main toxin-filtering organ -- and may help prevent drug-induced damage to this organ.
Kudzu root, often prescribed as a bitter tea, has long been used by traditional Chinese doctors to reduce the appetite for alcohol. Recent animal research suggests that alcohol-free kudzu root extract can cut the consumption of alcohol in half.

Acupuncture-

The ancient Chinese science of acupuncture has earned widespread regard in America as an effective treatment for alcohol and drug addiction. Success rates can be as high as 50 percent of patients treated.

Acupuncture looks at addiction as an imbalance in the flow of the body's vital life energy, or qi, particularly on the kidney, liver, or nervous system meridians (channels). Using tiny needles inserted in particular acupuncture points on the body, this therapy works to correct the qi imbalances. Not only does this ease or eliminate withdrawal symptoms, but the patient's mind is then prepared to tackle some of the factors that led to the addiction.

Auriculotherapy, a form of acupuncture that treats the entire body through points on the ears, is particularly recommended for addiction treatment. Treatment usually consists of several months of acupuncture sessions coupled with counseling and lifestyle modifications.

Other Alcoholism & Drug Addiction Therapies

• Biofeedback Training for Alcoholism & Drug Addiction -- The training, together with relaxation techniques, can help bring relaxation and reduce withdrawal symptoms and cravings.

• Chiropractic Therapy for Alcoholism & Drug Addiction -- Adjustments and manipulations can correct any disturbances that may be contributing to physical withdrawal symptoms.

• Homeopathy for Alcoholism & Drug Addiction -- There are several common remedies for different addictions and different types of addicts.

• Hypnotherapy for Alcoholism & Drug Addiction -- Hypnotic trances can give the subconscious mind suggestions of new ways to behave -- important in maintaining abstinence.