Narcotic, cocaine, and PCP overdoses require immediate medical care. Overdoses of heroin, morphine, and other narcotics can suppress breathing, lower heart rate, and temperature, and cause unresponsiveness. An allergic-like reaction, most likely due to contaminants, also can occur. Cocaine overdose results in increased blood pressure and heart rate, seizures, irregular heart rhythms, and difficulty breathing. A PCP overdose can trigger seizures, coma, and breathing problems. Emergency cocaine and PCP treatment includes drugs to lower the blood pressure, heart rate or temperature, or stop seizure activity.
Depending on the drug and the patient's history, withdrawal may require acute care. Medical personnel often observe withdrawal symptoms when patients are hospitalized for a different condition.
Sedative-hypnotic withdrawal can pose serious problems that can be deadly, but are manageable if recognized in time. Symptoms of withdrawal include nervousness, restlessness, insomnia, weakness, muscle tension, tremors, and sometimes seizures, confusion, dehydration, and delirium. Patients addicted to sedative-hypnotic agents (benzodiazepines, barbiturates, and other drugs) may receive medications to manage withdrawal symptoms. Doctors typically substitute less-intoxicating, longer-acting drugs, and then gradually decrease the dose.
While unpleasant, opiate and codeine withdrawal rarely produces severe physical symptoms; however, drug-seeking behaviors and cravings make it a difficult time for patients and care providers. Opiate withdrawal can include hyperactivity, agitation, rapid breathing and heart rate, runny nose, tearing, sweating, hot and cold flashes, muscle twitching, abdominal cramping, nausea, and diarrhea.
Outpatient detoxification, with patients gradually withdrawing from the drug, has become more prevalent. Patients with a history of seizures, previous serious withdrawal symptoms, or a medical or mental condition that could complicate treatment become candidates for inpatient care.
Narcotics and Cocaine Anonymous, international fellowships of recovering drug addicts, have helped many drug abusers kick the habit and stay clean. The 12-step programs were adapted from and resemble the Alcoholics Anonymous program. Recovering drug abusers help each other stay off drugs. Participants admit their addiction, share their stories, make amends, and serve as sponsors to new members.
Be aware of and avoid activities that increase your cravings.
Designate a friend as someone whom you can contact during the more difficult stages of recovery.
Your doctor is the best source of information on the drug treatment choices available to you.
Substance abuse treatment involves detoxifying and rehabilitating the patient, achieving abstinence, and preventing relapses. The primary focus of treatment is abstinence from all addictive substances. Relapse prevention includes treatment for underlying mental and physical conditions, and limiting exposure to situations and friends who may trigger a desire to use the substance again. Psychological and behavioral counseling provide a framework for treating drug-dependent patients. Sessions teach patients how to manage stress, understand their personality type, and change thought patterns. Doctors and nurses inform patients about health risks associated with substance use. Treatment includes regular participation in self-help groups. Developing friendships with people who do not use drugs, and working and resuming family relations aid in long-term success.
Therapeutic community concept programs, where addicts live in a communal setting while rebuilding their lives, have helped many patients. Such halfway houses aid recovering addicts as they establish new friendships and habits, accept responsibility for themselves, and return to work.
Pregnant women who take legal and illegal drugs put their unborn babies at risk. During pregnancy, a fetus is exposed to the same drugs the mother uses. Newborns can experience symptoms of withdrawl that can prove fatal, especially when the mother has not told the medical team of her drug use. Infants born addicted to narcotics may develop a high-pitched cry, jitters, tremors, or seizures. Babies born to cocaine addicts may lack coordination, have abnormal sleep patterns, and enter normal developmental stages, such as crawling and speaking, later than expected. Mothers who smoke marijuana often deliver smaller-than-normal-babies.
Early intervention improves a drug user's prognosis.
While many strive for abstinence, drug abusers frequently relapse. The molecular changes some drugs make in the body may establish a lifelong proclivity for returning to drug abuse. Successful abstinence often depends on the length and intensity of treatment. Supportive family and friends help make a difference in a long-term victory over drugs. People who have jobs, are better educated, and remain in treatment for at least two months have the best general prognosis. Abusing multiple drugs decreases a person's chances of achieving abstinence. When drug abusers also suffer from a mental illness, the prognosis declines for both conditions.
Opiate users typically do not live as long as nonusers. Death from suicide, homicide, HIV, hepatitis, or accidents claims the lives of at least 25% of opiate abusers within 10 to 20 years of starting active drug use.
Monthly visits to the doctor to reinforce abstinence may prove effective in nondependent patients.
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