Prescriptions Drugs FAQ

Posted on by Melany Heger

What Are The Most Prescribed Drugs In The UK?

The leading painkiller prescribed in the UK is higher-dose codeine (Co-codamol) with about 15 Million prescriptions given in 2017. [1]

The leading psychopharmaceutical drugs prescribed are Citalopram Hydrobromide (14+ Million in 2017) and Amitriptyline Hydrochloride (13+ Million in 2017). [1].

Both Citalopram and Amitriptyline are used to treat depression.

 

Citalopram is a Selective Serotonin Reuptake Inhibitor (SSRI), while Amitriptyline is a tricyclic antidepressant.

Both Citalopram and Amitriptyline are used to treat depression.

Meanwhile, Atorvastatin, a drug for high cholesterol tops the list of most prescribed medicine with 37+ Million prescriptions.

Because Aspirin and Paracetamol are available over-the-counter, the figures for these drugs are excluded from this list.

 

Morphine and morphine-like painkillers are called opioid painkillers.

These painkillers are most often prescribed for the following conditions [2]:

  • Orthopedic pain – conditions involving hips, knees, feet, ankles, shoulders, hand and spine
  • Dental conditions
  • Back pain
  • Headaches
  • Cancer pain

 

Opioid painkillers have a high potential for abuse and dependence [3].

The most commonly abused opioid painkillers are [4]:

  • >> Tramadol
  • >> Hydrocodone
  • >> Oxycodone

 

The number of incidents of prescription drug addiction in the UK is not as high as the number of incidents reported in US.

Authorities credit stricter rules and implementation for this lower incident rate. [5]

However, at the current level, prescription drug addiction has already caused a number of deaths due to overdose.

A number of complications can also be attributed to prescription drug misuse. These are: [6]

  • >> Constipation
  • >> Feeling sleepy
  • >> Dizziness
  • >> Nausea/ vomiting
  • >> Difficulty breathing
  • >> Hyperalgesia (increased sensitivity to pain)
  • >> Immune function problems
  • >> Hormonal problems
  • >> Muscle rigidity
  • >> Jerky muscle contractions
  • >> Physical and psychological addiction
  • >> Risk of overdose when used together with alcohol and/or anti-depressants

 

In addition, the long-term treatment of conditions using opioids is not definitively proven effective.

Experts warn that using opioids to relieve pain affects multiple organ systems, which influence numerous body functions [6].

 

Meanwhile, antidepressants are the most commonly prescribed type of psychopharmaceutical drug [7].

In 2018, it was found out that: [8]

  • Individuals aged 65 older are given more prescriptions than their younger counterparts
  • More women than men are prescribed antidepressants

 

 

Aside from depression, anti-depressants are used to treat migraine and diabetic neuropathy. [8]

The most widely known antidepressant is a type of drug called Selective Serotonin Reuptake Inhibitors (SSRIs).

SSRIs are sold under the names:

  • >> Citalopram
  • >> Dapoxetine
  • >> Escitalopram
  • >> Fluoxetine
  • >> Fluvoxamine
  • >> Paroxetine
  • >> Sertraline
  • >> Vortioxetine

 

What Are The Most Common Prescription Drugs?

Co-codamol is the most common prescription drug for pain (15+ Million prescribed in 2019) [1].

Meanwhile, three drugs for depression top the list of prescribed psychopharmaceutical drugs. These are: [1]

  • >> Citalopram Hydrobromide (14+ Million)
  • >> Amitriptyline Hydrochloride (13+ Million)
  • >> Sertraline Hydrochloride (nearly 13 Million)

 

The NHS lists the most popular painkillers as Co-codamol,

 

Morphine, and Morphine-like drugs. These drugs include:

  • >> Oxycodone
  • >> Hydrocodone
  • >> Fentanyl
  • >> Buprenorphine
  • >> Codeine

 

Some health care professionals pinpoint the widespread use of opioids to [3]:

  • >> The waiting lists in clinics being too long
  • >> Prisons prescribing the use of opioids for pain
  • >> Psychiatry consultants preferring the use of these drugs
  • >> Popular appeal of opioids in media and social media
  • >> Limitations on the prescriptions of stronger painkillers

 

Psychological dependence on prescription drugs can be assumed if an individual is described as [2]:

  • >> Needing more of the prescribed medicine to feel its effects
  • >> Taking more prescription medicine than originally intended
  • >> Daily activity is planned around the use of the medicine
  • >> Previously enjoyed activities are cut short in relation to the use of the medicine
  • >> Secretive behaviour surrounding the procurement of prescribed medicine
  • >> Moodiness and irritability when unable to obtain the medicine

 

Physical symptoms of prescription drug abuse vary depending on the drug type.

However, the pattern for psychological dependence is similar, no matter what type of drug is abused [9].

 

Recently, Public Health England addressed the misuse of Alprazolam (Xanax), a type of benzodiazepine drug [10]

Health risks posed by being dependent on benzodiazepines like Alprazolam include [11]:

  • >> Drowsiness, sleepiness, or dizziness
  • >> Unusual patterns of sleep
  • >> A form of amnesia where the person can have difficulty creating new memories
  • >> Next-day drowsiness
  • >> Problems thinking and reasoning clearly
  • >> Allergic reactions including extreme reactions that need immediate attention
  • >> Danger risk when driving and operating machinery

 

 

In addition, there is a great chance of becoming physically and psychologically dependent on benzodiazepines if use is not professionally supervised.

Other than Alprazolam, other benzodiazepine type drugs include:

  • >> Diazepam (Valium)
  • >> Chlordiazepoxide
  • >> Lorazepam
  • >> Lorprazolam
  • >> Nitrazepam
  • >> Temazepan
  • >> Flunitrazepam
  • >> Oxazepam
  • >> Phenazepam

 

Addiction to prescription drugs such as benzodiazepines and SSRIs can be treated safely in a rehab clinic such as Abbeycare Scotland.

 

What Happens To Your Brain When You Use Prescription Drugs?

Prescription opioid pain medicines stimulate the pleasure area of the brain. [12]

Long-term use of opioid painkillers can cause brain damage that affects a person’s ability to reason logically.

Addiction to opioid painkillers changes parts of the brain that make drug cravings irresistible, causing the person to use drugs even if it already harmful.

 

Opioid drugs quiet the part of the brain that is associated with stress. This area is called locus coeruleus.

However, when opioids are overused, the brain compensates by making the neurons of the locus coeruleus over-active.

When the neurons are over-charged, the person experiences withdrawal symptoms.

 

Prescription anti-depressants called SSRIs (including Citalopram and Sertraline) affect the brain by regulating the neurotransmitter called serotonin.

An optimum amount of serotonin in the brain makes a person feel calm.

But when the level of serotonin is too high, a person can feel anxious and confused [13]

 

Prescription anti-anxiety drugs like Valium and Alprazolam slows down the body’s functions by increasing the effect of GABA (gamma amino butyric acid) in the brain. [10]

Prescription stimulant drugs like Concerta XL, Ritalin and Medikinet XL affect the brain by boosting the levels of two key neurotransmitters, dopamine and norepinephrine.

 

What Are The Dangers Of Prescription Drugs?

Overdose can happen if a person misuses prescription drugs.

Other potential harms include physical and psychological addiction, as well as side-effects associated with the specific prescription drug.

 

In the UK, the most misused prescription drugs include anti-depressants, anti-anxiety drugs, strong painkillers, and stimulants. [13]

The harms associated with misusing/abusing anti-depressants are: [14]

  • >> Nausea, vomiting
  • >> Weight gain or appetite increase
  • >> Impotence, erectile dysfunction, decreased orgasm
  • >> Fatigue, tiredness, drowsiness
  • >> Dizziness and headaches
  • >> Insomnia, problems falling and staying asleep
  • >> Dry mouth
  • >> Constipation
  • >> Irritability and anxiety

 

The harms associated with misusing/abusing anti-anxiety drugs are:

  • >> Feeling drowsy/ sleepy
  • >> Feeling tired all the time
  • >> Poor balance or physical coordination
  • >> Trouble finishing and concentrating on tasks
  • >> Slurred speech
  • >> Memory problems
  • >> Insomnia or sleep disturbance

 

The harms associated with misusing/abusing strong painkillers are: [15]

  • >> Sleepiness/ drowsiness
  • >> Not thinking clearly (blurry thoughts)
  • >> Shallow breathing
  • >> Nausea/vomiting
  • >> Difficulty passing urine
  • >> Constipation
  • >> High blood pressure
  • >> Feeling of euphoria becomes the focus of using medication instead of pain relief
  • >> Unsafe use of needles (if drug is used intravenously)
  • >> Increased sensitivity to pain (hyperalgesia)
  • >> Tolerance to the drug means needing more of the drug to feel less pain

 

 

The harms associated with misusing/abusing stimulants are: [16]

  • >> Pain in the stomach area
  • >> Pain in the chest area
  • >> Heart beats too fast or too slow
  • >> Appetite loss
  • >> Anxiety and restlessness
  • >> Nervousness
  • >> Difficulty falling asleep
  • >> Excessive sweating
  • >> Hair loss
  • >> Dizziness
  • >> Can cause thoughts about suicide
  • >> Can trigger psychotic breakdown (lost touch with reality)
  • >> Slows growth down (for children and adolescents)

 

A way to safely detox from prescription drug withdrawal is by entering a detox programme in a rehab clinic.

What Causes Prescription Drug Abuse?

Individuals can abuse prescription drugs because of the belief that the drugs will make them feel good.

The motivation to use drugs, in general, is driven by the perceived benefits drugs have to a person’s happiness.

Young people are at high risk of prescription drug abuse if they have access to these drugs.

 

According to the National Institute on Drug Abuse (US), young adults (18-25 years old) count as the largest group that tends to misuse prescription drugs [kid].

Young adults who use prescription drugs say they use these medicines to:

  • >> relieve pain
  • >> deal with problems
  • >> decrease anxiety
  • >> feel better
  • >> lose weight
  • >> sleep
  • >> have a good time with friends
  • >> increase alertness
  • >> experiment
  • >> counter effects of other drugs
  • >> concentrate
  • >> relax
  • >> get high

 

 

The three types of prescription drugs most commonly abused in the UK are: [13]

Opioid pain killers including morphine and morphine-like medications

  • >> Anti-depressants
  • >> Anti-anxiety drugs (Benzodiazepines)
  • >> Stimulants used to treat Attention Deficit Hyperactivity Disorder (ADHD)

 

 

As of the moment, there are no government statistics on the exact number of individuals with prescription drug misuse problems. [8]

However, health experts warn that the more a person uses these drugs in an unsupervised manner, the higher his/her chances are of becoming addicted or dependent.

 

In addition, a rough approximate of 1/2 million individuals are using opioids for more than three years now.

Information from the Department for Health reveals a 60% increase of opioid prescriptions in recent years.

 

Since opioids are highly addictive [3], the long-term use of these drugs exposes individuals to the risk of painkiller prescription addiction.

Ways in which a person can accidentally become addicted to opioid painkillers:

  • >> Using the painkiller in a primary care circumstance
  • >> Taking a higher dose
  • >> Taking more of the drug
  • >> Refilling or topping up dosage inappropriately

 

A private clinic with experts handling this type of addiction would be Abbeycare Gloucester.

 

References

  1.   Mattews, S. (2018). A nation of pill poppers: Record 1.1 BILLION prescriptions written in 2017 as figures reveal the 20 most popular drugs but critics slam the NHS for spending millions on paracetamol. Daily Mail Online. Available at: https://www.dailymail.co.uk/health/article-5505639/NHS-figures-reveal-20-drugs-dished-most.html
  2.   Janakiram, C. et al. (2019). Opioid Prescriptions for Acute and Chronic Pain Management Among Medicaid Beneficiaries. American Journal Of Preventive Medicine, 57(3), 365-373. DOI: 10.1016/j.amepre.2019.04.022. Available at: https://www.ajpmonline.org/article/S0749-3797(19)30216-8/pdf
  3.   Owens, B. (2015, June 11). Tackling prescription drug abuse. The Pharmaceutical Journal. https://www.pharmaceutical-journal.com/news-and-analysis/features/tackling-prescription-drug-abuse/20068685.article?firstPass=false
  4.   NHS. (2019). Which painkiller? Healthy body. Available at: https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/
  5.   Britton, R. (2019, September 10). The UK is dangerously close to having a full-blown opioid crisis. Independent. Available at: https://www.independent.co.uk/voices/opioid-crisis-addiction-drugs-prescription-addaction-tramadol-depression-a9099071.html
  6.   Benyamin, R. et al. (2008). Opioid complications and side effects. Pain Physician, 11(2). Available at: https://www.ncbi.nlm.nih.gov/pubmed/18443635
  7.   NHS. (2017). Health Survey for England 2016 Prescribed medicines. Available at: http://healthsurvey.hscic.gov.uk/media/63790/HSE2016-pres-med.pdf
  8.   Walker, A. (2019, November 2). Report reveals severe lack of services for UK opioid painkiller addicts. The Guardian. Available at: https://www.theguardian.com/society/2019/nov/02/report-reveals-severe-lack-of-services-for-uk-opioid-painkiller-addicts
  9.   Drug Free Kids Canada. (2018). help your teens before they help themselves. Available at:https://www.drugfreekidscanada.org/prevention/drug-info/prescription-drugs/
  10.   Public Health England. (2018). Alprazolam (Xanax): What are the facts? Available at: https://publichealthmatters.blog.gov.uk/2018/07/30/alprazolam-xanax-what-are-the-facts/
  11.   Anderson, L. (2019). Benzodiazepines: Overview and Use. Available at: https://www.drugs.com/article/benzodiazepines.html
  12.   Haydon, I. (2018, July 26). How opioids reshape your brain, and what scientists are learning about addiction. Available at: https://www.inquirer.com/philly/health/addiction/what-science-knows-about-how-opioids-reshape-your-brain-20180724.html
  13.   National Institute of Drug Abuse. (2016). Misuse of Prescription Drugs. Available at: https://www.drugabuse.gov/publications/misuse-prescription-drugs/overview
  14.   Roberts, J. (2014). The Most Dangerous & Heavily Promoted Prescription Drugs & Their Potential Natural Alternatives. Collective Evolution. Available at: https://www.collective-evolution.com/2014/10/14/the-most-dangerous-heavily-promoted-prescription-drugs-possible-natural-alternatives/
  15.   Savage, S., Kirsh, K., Passik, S. (2008). Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders. Addict Sci Clin Pract 4(2), 4–25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797112/
  16.   NHS. (2018). Treatment Attention deficit hyperactivity disorder. Available at: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/treatment/
  17.  National Institute on Drug Abuse. (2012). Prescription Drug Abuse: Young People at Risk. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/infographics/prescription-drug-abuse-young-people-risk

Hippy Crack FAQ

Posted on by Melany Heger

Why Is Nitrous Oxide Called Hippy Crack?

“Hippy” typifies the laid-back trait of persons who use it; “crack” describes the speed in which the drug takes effect, taking after “crack cocaine”[1].

“Crack” also originates from the whip-it cracker, a device used to discharge the drug into balloons or other containers.

Hippy crack is called many names including [2]:

  • >> Whippets/ Whip-its/ whippits/
  • >> Laughing gas
  • >> N20
  • >> Noz
  • >> Nangs
  • >> Sweet Air

 

In the UK, using Nitrous Oxide for recreational purposes is illegal under the Psychoactive Substances Act [3].

However, the easy availability of the drug coupled with loose enforcement of the law means its use is widespread.

Hippy Crack/Nitrous Oxide paraphernalia have been found in areas surrounding a music festival, parties, and other events youth frequent [2].

 

So far, up to thirty deaths have been connected with the unlawful use of Nitrous Oxide [3].

But because the negative effects of the drug are under-reported, many users seem to dodge serious consequences.

There is no formal categorisation of addiction to Hippy Crack/Nitrous Oxide.

However, mental health workers and health care professionals address problems regarding Nitrous Oxide use with the same guidelines as those used to treat other addictions [4].

 

A person addicted to using Nitrous Oxide, like other dissociative drugs, can have the following symptoms [5]:

  • >> A need to use it in a higher dose to obtain the same desired effect
  • >> Cravings for Hippy Crack
  • >> Headaches and/or flu-like symptoms when the “usual dose” is missed
  • >> Mood swings and irritability
  • >> Excessive sweating

 

Nitrous Oxide/Hippy Crack is considered a dissociative drug, which causes individuals to have [6]:

  • >> Hallucinations – seeing or feeling things that are not actually existing
  • >> Sensorial disturbances – sense of smell, taste, and feel are not normal
  • >> Panic attacks
  • >> Feeling disconnected from the body or self
  • >> The person feels as if s/he is floating
  • >> Feeling numb
  • >> Having a sense of euphoria (some describe it as bliss)
  • >> Perceiving things in real life are not real
  • >> Detachment from self
  • >> The theme of being connected to a “Higher Power” is common

 

 

Withdrawal symptoms from Nitrous Oxide can also be similar to withdrawal symptoms from other dissociative drugs.

However, withdrawal symptoms from Nitrous Oxide are still being studied so that a comprehensive understanding can be developed. [6]

Detox and withdrawal from Hippy Crack can be done safely in a rehab clinic like Abbeycare Gloucester.

 

Is Laughing Gas Dangerous?

Yes, laughing gas is dangerous because its use can cause a person to be deprived of oxygen, which leads to unconsciousness and in the worst case, death [7].

Laughing Gas, known as Nitrous Oxide or Hippy Crack harms the body by:  [7]

Creating a risk for asphyxiation (being deprived of oxygen)

  • >> Loss of oxygen in the brain can cause death or permanent brain damage

Loss of consciousness (passing out)

  • >> Increases the crime risk of harm for the person

Nitrous Oxide–induced Vitamin B12 deficiency causing:

  • >> Numbness and weakness in arms and legs
  • >> Neck pain
  • >> Reduced range of movements (difficulty extending arms and/or legs)
  • >> Shooting pain that starts with the neck and goes down the spine
  • >> Poor coordination of hands and feet
  • >> Handling small objects
  • >> Not standing or walking in a balanced way
  • >> Increasing the risk of acute megaloblastic anemia, which causes:
  • >> Shortness of breath
  • >> Muscles feel weak
  • >> Pale skin
  • >> Loss of appetite
  • >> Diarrhoea/nausea/vomiting
  • >> Swollen tongue

Escaping cold gas can:

  • >> burn the skin
  • >> shock the vagus nerve, causing the heart beat to slow down

 

There is also a risk for psychosis and cognitive impairment (thinking problems) [4].

 

Nitrous Oxide is considered safe when used in a controlled setting by a health care professional.

Officially used, it can help soothe children who get anxious with a dental procedure [8].

 

 

Likewise, in a clinic, Nitrous Oxide can be used as a minor anaesthetic.

The recreational use of Nitrous Oxide, known as Hippy Crack has become an alarming trend recently (2016-2019). [1]

 

Young people are prone to abuse Nitrous Oxide because of its mistaken reputation as a “safe” party drug.

In both recreational use and clinical use, the most negative effect seems to be nausea and/or vomiting.

 

Some individuals also become addicted to using Nitrous Oxide.

Authorities pinpoint its accessibility and low price (compared to other recreational drugs) [9].

Quitting the use of Laughing Gas/Nitrous Oxide can be safely done in a rehab clinic like Abbeycare Scotland, where professional help can ease possible withdrawal symptoms.

 

Is Laughing Gas Harmful?

Yes. The potential harms of Laughing Gas/Nitrous Oxide use include accidental suffocation and muscle debility [2].

There is also a risk for Nitrous Oxide Addiction, which can cause a person physical and psychological distress.

 

Inhaling Laughing Gas/Hippy Crack in an enclosed space increases the risk of oxygen deprivation or suffocation.

Suffocation can happen when a person who uses Laughing Gas has no access to air [2].

 

When Laughing Gas is inhaled [7]:

  • >> It binds to the opiate receptors in the Central Nervous System
  • >> The brain releases its natural opioids, or pain killers
  • >> The person feels relaxed, less anxious
  • >> But during this state the brain needs a boost of oxygen

 

If a person using Laughing Gas does not get oxygen immediately after, the following will likely happen:

  • >> Headaches/Migraines
  • >> Nausea/Vomiting
  • >> Loss of consciousness

 

In a health care facility where Nitrous Oxide is handled by professionals, oxygen is administered through a simple face mask that fits over the person’s nose to prevent loss of consciousness.

 

Loss of consciousness is caused when some parts of the brain stop receiving signals telling the person to stay alert. [10]

In situations when loss of consciousness happens, the person can be exposed to risks such as:

  • >> Crime (committed while the person is unconscious)
  • >> Vomiting – the person’s throat can be blocked, and because he/she is unconsciousness, this becomes a choking hazard
  • >> Hypoxia or oxygen deprivation can cause permanent brain damage [11]

 

 

In the A&E, persons who become unconscious due to oxygen loss are immediately given oxygen.

However, irreparable and permanent damage can happen when immediate access to oxygen is not received [11].

Therefore, inhaling nitrous oxide directly from the canister, and/or placing a plastic bag over the head while inhaling Laughing Gas/Hippy Crack is extremely dangerous.

In serious cases with no immediate help, fatalities can occur [2].

 

Even in clinics, undesirable side effects of Laughing Gas/Nitrous Oxide have been reported. These minor complaints include:

  • >> Nausea/vomiting
  • >> Shivering/ feeling cold
  • >> Sweating
  • >> Dizziness/headaches
  • >> Feeling very tired

 

Is Using Nitrous Oxide Illegal?

In the UK, using Nitrous Oxide/Hippy Crack for recreational purposes is illegal under the Psychoactive Substances Act [3].

Selling Hippy Crack, for psychoactive purposes is illegal. But selling Nitrous Oxide per se is not illegal.

The reason Nitrous Oxide is not a banned or controlled substance is that it has legitimate use in: [3]

  • >> Dental procedures
  • >> A&E and outpatient clinics
  • >> Restaurants (aerosol chargers used to make whipped cream in drinks)

 

 

In addition, possession of Nitrous Oxide/Hippy Crack is not illegal

But possessing it with intent to sell it as a (party) drug is illegal.

It is difficult to prove in court that a person who has possession of Nitrous Oxide intends to sell the substance for psychoactive purposes. [12]

In a recent report by the BBC, journalists easily obtained the substance by phone, online and in actual person at Manchester [3].

 

Hippy Crack’s low price (compared to other illegal drugs) and easy availability has are the reason why a growing number of people have become addicted to Laughing Gas.

In the Global Drug Survey of 2012, as many as 22,000 youths from the UK have reportedly tried the drug in nightclubs, music festivals, and other social gatherings [7].

Most of these individuals have wrongly been led to believe that Hippy Crack is safe and does not cause any undesirable effects.

What Does Hippy Crack Do?

Known formally as Nitrous Oxide, the drug is an anaesthetic and an analgesic [8].

An anaesthetic renders a person unable to feel pain, while an analgesic lessens pain sensations.

When inhaled, Nitrous Oxide causes a person to feel less pain or to totally feel no pain at all.

 

However, this effect is accurately reached when Nitrous Oxide is mixed with a ratio of oxygen.

In recreational use, the effects of Nitrous Oxide/Hippy Crack can vary.

Sometimes the desired effect is achieved and sometimes negative effects happen.

Negative effects of Nitrous Oxide/Hippy Crack

  • >> Vomiting and nausea – if not mixed with enough oxygen or when the dose is too high
  • >> Not recommended for use when the person is already using opioid painkillers
  • >> Can cause shallow breathing

Healthcare professionals, however, find Nitrous Oxide as an effective drug because:

  • >> It reaches the Central Nervous System (brain and spinal chord) within seconds after being inhaled
  • >> It is a non-invasive procedure
  • >> It has a good safety record of safety
  • >> Few side effects when administered with oxygen
  • >> The person given the drug is not required to be constantly monitored
  • >> Does not usually cause deep sedation
  • >> Can be used in different care environments as long as there is equipment
  • >> Usually applied to manage sudden pain connected to minor procedures

 

Using nasal hood or full face mask, Nitrous Oxide is mixed with a ratio of oxygen.

Within 1-2 minutes, a person can already feel it take effect.

Nitrous Oxide’s anaesthetic or sedative effect is much more known than its analgesic (pain relieving) effect.

That is why it is administered together with other pain killers. (Paracetamol or Ibuprofen for example).

 

Professionals believe that it decreases pain because it lowers a person’s anxiety about the procedure.

With children, Nitrous Oxide is a boon to because it allows for the procedure to be done without much complaint.

For adults, Nitrous Oxide can be applied when undergoing some procedures like: [8]

  • >> Incision and drainage of wounds
  • >> Joint Dislocation/Injections
  • >> Muscle Pain
  • >> Pain involving fractures
  • >> Dental Procedures
  • >> Minor to Moderate Burns
  • >> Repairs of muscle tears
  • >> Foreign Body Removal

 

 

In short, when used by professionals, Nitrous Oxide is generally considered a safe drug.

But when Nitrous Oxide is used as a psychoactive drug, unintentional harm can occur.

Also, some individuals become addicted to Hippy Crack/Nitrous Oxide.

A sensible way of detoxing from Hippy Crack would be in a rehab clinic such as Abbeycare.

 

References

  1.   Lake, E. (2019, March 28). No laughing matter – What s ‘hippy crack’, what are the side effects of laughing gas and are nitrous oxide canisters illegal?. The Sun. Available at: https://www.thesun.co.uk/news/3364682/nitrous-oxide-canisters-side-effects-laughing-gas-hippy-crack-illegal/
  2.   Sidmouth College (n.d.) Fact Sheet – Nitrous Oxide. Available at: https://www.sidmouthcollege.devon.sch.uk/uploads/3/1/6/1/31615835/nitrous_oxide_fact_sheet_-_feb_2016.pdf
  3.   O’Donoghue, L. (2018, December 19). Laughing gas laws not working, says ex-chief crown prosecutor. BBC News. Available at: https://www.bbc.com/news/uk-england-manchester-46591871
  4.   Sheldon, R., Reid, M., Schon F. & Poole, Norman. (2019). Just say N2O – nitrous oxide misuse: essential information for psychiatrists. BJPsy Advances. Available at: https://www.researchgate.net/publication/336192570_Just_say_N2O_-_nitrous_oxide_misuse_essential_information_for_psychiatrists
  5.   National Institute on Drug Abuse. (2019). Hallucinogens. Availbale at: https://www.drugabuse.gov/publications/drugfacts/hallucinogens
  6.   Alcohol and Drug Foundation. (2017). Nitrous oxide. Available at: https://adf.org.au/drug-facts/nitrous-oxide/
  7.   Thompson, A., Leite, M., Lunn, M. & Bennett, D. (2015). Whippits, nitrous oxide and the dangers of legal highs. Practical Nuerology, 15(3), 207–209. Availabe at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453489/
  8.   Lapietra, A. (2018). Nitrous Oxide in the Emergency Department. Pain & Procedural Sedation in Acute Care. Available at: https://painandpsa.org/n2o/
  9.   Rawlinson, K. (2017, August 31). Laughing gas still illegal despite court decisions, UK government says. Available at: https://www.theguardian.com/society/2017/aug/31/laughing-gas-still-illegal-despite-court-decisions-government-says
  10.   Massachusetts Institute of Technology. (2015). Researchers reveal brainwave changes in patients receiving nitrous oxide. Available at: https://medicalxpress.com/news/2015-07-reveal-brainwave-patients-nitrous-oxide.html
  11.   Singh, V., Gupta, P., Khatana, S., & Bhagol, A. (2011). Supplemental oxygen therapy: Important considerations in oral and maxillofacial surgery. Natl J Maxillofac Surg., 2(1), 10–14. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304228/
  12.   Extance, A. (2017, September 4). Nitrous oxide causes UK drug law confusion. Available at: https://www.chemistryworld.com/news/nitrous-oxide-causes-uk-drug-law-confusion/3007935.article

Stop Drinking FAQ

Posted on by Melany Heger

What Happens When You Stop Drinking?

When you stop drinking, most will likely experience withdrawal symptoms, including sweating, tremor, headache, blood pressure fluctuations, and sleeplessness.

Generally speaking, withdrawal symptoms can be unpleasant.

The most severe withdrawal symptoms usually occur in the first few days after drinking has stopped.

 

Here is the typical timeline for alcohol withdrawal symptoms [1]:

Days 0 to 1

  • >> Anxious feelings
  • >> Irritability
  • >> Sleeplessness
  • >> Headaches/Migraines
  • >> Stomach upsets
  • >> Excessive sweating
  • >> Loss of appetite
  • >> Insomnia

 

Days 1 to 2

  • >> Shakes/ Tremors/ Muscle spasms
  • >> Fever
  • >> Stomach upsets
  • >> Nausea/Vomiting
  • >> Continued Insomnia

 

Days 2 to 3

  • >> Shakes/ Tremors/ Muscle spasms
  • >> Delirium Tremens (a form of seizure)
  • >> Blood pressure may rise
  • >> Heart can beat faster than usual
  • >> Excessive sweating
  • >> Continued Insomnia
  • >> Some individuals experience hallucinations

 

Symptoms in days 2 to 3 can last up to 5 days, especially without professional help.

Experts believe, that if symptoms do not get worse 24 to 48 hours after the last drink, there is a better chance of recovery [2].

Alcohol Withdrawal Syndrome (AWS) is the formal name given to the collection of symptoms felt during alcohol withdrawal [1].

 

AWS can range from Mild, Moderate to Severe.

In a rehab clinic, health care workers determine how serious AWS is by conducting an assessment process.

 

The AWS assessment process can include [3]:

Using a scale called CIWA-Ar:

  • >> Using a scale called CIWA-Ar:
  • >> Blood tests
  • >> Alcohol and/or toxicology screen

 

 

The assessment process will help to: [3]

  • >> Monitor a person’s progress during treatment
  • >> Determine instances when it is appropriate to give medication
  • >> Give an indication when treatment can be stopped
  • >> Help health care workers know when the person can be referred to outpatient care

 

 

Severe cases of AWS can result in death, due to Delirium Tremens.

This is especially true if a severe case is not immediately treated [2].

 

Why Alcohol Withdrawal Syndrome (AWS) happens [4]:

  • >> The brain maintains balance by maintaining the levels of inhibitory (“stoppers”) and excitatory (“go-ers”) neurotransmitters.
  • >> One of the major excitatory neurotransmitters (or brain chemical) is glutamate, which acts through the N-methyl-D-aspartate (NMDA) neuroreceptor.

 

  • >> Alcohol stops the action of the NMDA neuroreceptors, when this happens, the brain becomes over-excited.
  • >> Continuous, regular use of alcohol makes this over-excitement a regular action for the brain (this is called hyperexcitability).

 

  • >>Hyperexcitability accounts for AWS symptoms such as anxiety, insomnia and tremors.
  • >> As for the brain’s inhibitory (“stopper”) neurotransmitter, it is called γ-amino-butyric acid (GABA).

 

  • >> GABA acts through (GABA-A) neuroreceptor.
  • >> When the brain acts in a normal way, GABA prevents a person’s brain from becoming overly excited.
  • >> Alcohol enhances the effect of GABA by making the GABA-A neuroreceptors over-eager

 

  • >> The “over-eagerness” is why a person feels relaxed after drinking an alcoholic beverage.
  • >> But when alcohol is consumed too much and too often, the brain gets used to this over-eagerness of the receptors.

 

  • >> The person’s brain becomes used to this high level of GABA-A neuroreceptor activity.
  • >> To maintain this unusual level, the person tends to want more alcohol in order to relax or just feel normal (not agitated)

 

An important concept in both alcohol craving and alcohol withdrawal is the “kindling”

With repeated attempts at alcohol withdrawal, a person may experience “kindling”.

Kindling means, that brain cells experience long-term changes and worsening of alcohol withdrawal symptoms every time an attempt to quit is performed.

When a person seeks professional help for detox, for instance in a clinic like Abbeycare, there is a better chance of preventing relapse [5].

 

What Defines An Alcoholic?

An alcoholic is defined as a person who exhibits problematic drinking behaviour, which affects the individual’s mental and physical health. [6]

The person’s social life, family life, and activities at work also tend to be affected.

For the person to be officially diagnosed as “alcoholic”, the problems (called impairments) should last for at least a week.

 

The term “alcoholic” is sometimes considered derogatory or insulting.

The terms “problematic drinking” and “Alcohol Use Disorder (AUD)” have largely replaced “alcoholic”.

Persons who have AUD are also classified as having a mild, moderate or severe case of AUD, depending on the number of symptoms they exhibit.

Experts say that AUD is best approached undergoing a structured rehab program such as one offered by Abbeycare Gloucester Clinic.

 

In recent years, the term “grey area drinker” has become buzz word [7].

A grey area drinker can be described as a person who does not strictly meet the criteria for Alcohol Use Disorder.

A grey area drinker may not have work, family or job impairments that make the problematic drinking easy to spot.

Grey area drinkers may not hit rock bottom like persons who have a more serious case of AUD.

But they can also benefit from professional care in an alcohol rehab clinic.

 

 

What Is The Best Way To Stop Drinking?

The best way to stop drinking is to reduce intake levels over time, gradually [8].

A cold-turkey approach increases the chance of relapse.

Relapse is linked to a phenomenon called “kindling”.

Kindling is a tendency for withdrawal symptoms to get worse every time there is another attempt to quit alcohol.

Individuals who quit drinking all of a sudden are prone to experience the most negative effects of alcohol withdrawal.

 

In serious cases, some individuals can be hospitalised due to Delirium Tremens or seizures connected with alcohol, withdrawal.

Less serious cases of Alcohol Withdrawal Syndrome can be successfully treated on an out-patient basis.

Overall, finding professional help is also a good idea so that the negative experiences associated with alcohol withdrawal can be minimised.

 

Here are some tips to quit alcohol adapted from the National Institute on Alcohol Abuse and Alcoholism (US): [9]

  • >> Gradually decrease alcohol consumed to the recommended levels
  • >> Identify and avoid alcohol triggers
  • >> Talk through urges to drink with an accountability partner or a professional (counsellor, therapist, etc.)
  • >> Develop the habit to say “no, thanks” convincingly and readily.
  • >> Seek other healthier ways to cope with stress, manage moods, and feel more relaxed around other people.

 

 

Professionals who can help with quitting alcohol include:

  • >> Addiction counsellor
  • >> Local health care workers
  • >> Therapists who use Cognitive Behavioural Therapy and 12 Step facilitation

 

 

A rehab clinic well-equipped to provide professional help will also:

  • >> Be able to handle withdrawal complications
  • >> Have qualified staff to administer treatments
  • >> Check an individual’s progress during alcohol withdrawal
  • >> Look after overall health
  • >> Personalise a treatment plan
  • >> Recommend support so the person can be supported after therapy

How Do You Know If Alcohol Is Affecting Your Health?

Signs that a person’s health is being affected by alcohol, can include memory loss, and early symptoms of liver damage.

In addition, alcohol dependency is another warning sign [4].

Memory loss is seen when: [10]

  • >> A person becomes increasingly forgetful of recent events
  • >> Appointments are forgotten
  • >> Some daily tasks are overlooked
  • >> Things become lost or misplaced more often
  • >> Usual activities take more time than usual because the person got confused about the next step
  • >> Other persons have remarked about the memory loss

 

Loss of memory is associated with problematic alcohol use because alcohol affects the hippocampus, the part f the brain responsible for memories. [11]

 

Early signs of liver damage

Whereas, memory loss is quite obvious, are less easy to spot.

The first stage of liver disease associated with heavy use of alcohol is alcoholic fatty liver disease. [12]

The symptoms of alcoholic fatty liver disease are:

  • >> stomach upsets/ nausea
  • >> abdominal pain
  • >> diarrhoea
  • >> lessened appetite
  • >> feeling weak
  • >> itchy skin

 

If there is blood in the vomit or stools, it is a sign to seek professional help.

 

Indicators of alcohol dependency [2]

  • >> morning drinking (with or without vomiting)
  • >> unable to feel “normal” without drinking
  • >> tremors and muscle spasms
  • >> the person plans the day around drinking
  • >> skipping meals
  • >> cannot sleep without drinking
  • >> being unable to keep a self-imposed drink limit

 

Defining “normal drinking” is useful when a person wants to know if his or her behaviour conforms to what is considered acceptable.

With this line of reasoning, the NHS guidelines can be consulted.

 

The NHS recommends drinking only 14 units of alcohol a week [13].

  • >> One unit of alcohol is equivalent to:
  • >> half a pint of regular beer
  • >> half a glass of red wine
  • >> one single measure of spirits or aperitifs

 

The NHS also suggests refraining from binge drinking.

 

Binge drinking means:

  • >> Male – 8 units of alcohol in a single session
  • >> Female – 6 units of alcohol in a single session

 

This definition is different because male and female bodies process alcohol differently in terms of metabolism, pharmacokinetics, and pharmacodynamics [14].

It is also recommended to evenly spread the 14 units recommended throughout the week.

Whenever possible, alcohol-free days should be practiced

 

Individuals who are concerned about alcohol use can benefit from detoxing safely in a structured program [15].

A rehab clinic such as Abbeycare Scotland can also offer a home detox option for a mild case of alcohol dependency.

Since alcohol dependence can be a sign of a deeper problem, some mental health workers also recommend psychotherapy.

 

Psychotherapeutic approaches most often used with problem drinking include:

  • >> 12 Step Facilitation
  • >> Cognitive Behavioural Therapy
  • >> Dialectical Behaviour therapy

 

An individual who undergoes detox and therapeutic work is likely to have a better grasp of the issues causing alcohol addiction.

This understanding can help sustain a sober living lifestyle.

 

References

  1.   Muncie, H. Jr., Yasinian, Y. & Oge’ L. (2013). Outpatient Management of Alcohol Withdrawal Syndrome. Available at: https://www.aafp.org/afp/2013/1101/p589.html
  2.   Richard K. Newman; Megan A. Stobart Gallagher; Anna E. Gomez. (2019). Alcohol Withdrawal. Available at: https://www.ncbi.nlm.nih.gov/books/NBK441882/
  3.   Gortney, et. al. (2016). Alcohol withdrawal syndrome in medical patients. Cleveland Clinic Journal of Medicine. Available at: https://www.mdedge.com/ccjm/article/105413/critical-care/alcohol-withdrawal-syndrome-medical-patients
  4.   Bayard, M., Mcintyre, J., Hill, K. & Woodside, J. (2004). Alcohol Withdrawal Syndrome. Am Fam Physician. 69(6), 1443-1450. Available at: https://www.aafp.org/afp/2004/0315/p1443.html
  5.   National Institute on Alcohol Abuse and Alcoholism (2017). Understanding Relapse. Available at: https://alcoholtreatment.niaaa.nih.gov/support-through-the-process/understanding-relapse
  6.   Phillips, M. (1990). Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Available at: https://www.ncbi.nlm.nih.gov/books/NBK418/
  7.  Scott, C. (2017, November 16). ‘I belonged to the grey area between normal drinker and alcoholic’. Available at: https://www.yorkshirepost.co.uk/news/latest-news/i-belonged-to-the-grey-area-between-normal-drinker-and-alcoholic-says-leeds-woman-who-is-now-helping-growing-number-of-problem-drinkers-1-8860147
  8.  Chernyak, P. (2019). How to Quit Drinking Alcohol. Available at: https://www.wikihow.com/Quit-Drinking-Alcohol
  9.  National Institute on Alcohol Abuse and Alcoholism. (2015). Self-help strategies for quitting drinking. Available at: https://www.rethinkingdrinking.niaaa.nih.gov/Thinking-about-a-change/support-for-quitting/Self-Help-Strategies-For-Quitting.aspx
  10.  Braun, M. (2018). 3 Warning Signs of a Potential Memory Problem. Available at: https://www.psychologytoday.com/us/blog/high-octane-brain/201807/3-warning-signs-potential-memory-problem
  11.  National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol Alert. Available at: https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm
  12.  Felman, A. (2018). What’s to know about alcoholic liver disease? Medical News Today. Available at: https://www.medicalnewstoday.com/articles/215638.php
  13.  NHS. (2016). New alcohol advice issued. Available at: https://www.nhs.uk/news/food-and-diet/new-alcohol-advice-issued/
  14.  Whitley, H. & Lindsey, W. (2009). Sex-Based Differences in Drug Activity. American Family Physician, 80(11), 1254-1258. Available at: https://www.aafp.org/afp/2009/1201/p1254.html
  15.  National Institute on Alcohol Abuse and Alcoholism. (2019). Available at: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help

 

Molly/MDMA FAQ

Posted on by Melany Heger

Can You Die From Molly Days Later?

Individuals can die from using molly/ecstasy days after using the drug.

The cause of death is usually suicide due to depression. [1]

Accidental death because of molly/ecstasy use is due to:

Hyperthermia (body temperature too high) [2]

  • >> The body’s temperature becomes too high
  • >> The brain, heart, muscles,liver and kidneys are damaged
  • >> The individual becomes dehydrated, which leads him or her to drink more water, making the next symptom worse

 

Hyponatraemia (water intoxication) [3]:

  • >> Feeling overheated, the individual drinks too much water
  • >> Molly/MDMA makes the person not feel like peeing (antidiuretic effect)
  • >> Water intoxication happens (cells swell with too much water)

 

Arrhythmia (abnormal heart rhythm) [4]

  • >> Which can cause a sudden heart attack

Hypertension (high blood pressure) [4]

Cerebrovascular accidents (stroke) [4]

Unusual risk-taking behaviour caused by using the drug [4]

In the UK, there are recent reports of ecstasy use in music venues and festivals.

Sadly, ecstasy use has been connected to several deaths in these events [3].

In the US, ecstasy, often called “molly” is popular in raves.

Rave parties are organised dance parties where electronic dance music is played by DJs.

 

It is said that using ecstasy can heighten the experience of raves, particularly the trance-like feel evoked by the lights and sounds

Some individuals also use ecstasy in music events because the drug reportedly: [4]

  • >> Makes the party-goer more energetic
  • >> Boosts stamina and endurance to dance and stay up late
  • >> Helps a person overcome shyness, so the person socialises more
  • >> Enhances sexual arousal by increasing touch sensations

 

When its illicit use first became popular, it was widely hailed as a “love drug”.

Apparently, using ecstasy could make a person more empathic [5].

Having a greater sense of empathy is usually associated with being more demonstrative, “sweet”, and “cuddly”.

 

Ecstasy’s after-effects 2 to 5 days later is sometimes referred to as “suicide Tuesday” [1].

The feel-good effects of the drug wear off after six hours typically.

During this “crash” or low period, individuals describe their feelings as sad, depressed and blue.

Some refer to this state as being “E-tarded”.

These after-effects can be considered withdrawal symptoms ecstasy addiction.

 

Scientists pinpoint how ecstasy targets parts of the brain affecting memory and concentration.

In fact, brain changes of individuals who use ecstasy for a long time mimic those of individuals who are ageing and/or have age-related dementia [4].

 

The reason why it takes 2 to 5 days before the negative effects show is because of ecstasy’s slow half-life.

The half-life of ecstasy is 8 hours [4].

In contrast, the half-life of paracetamol (Panadol or Calpol) is 4 hours [6].

Half-life means the time it would take for a drug to show half of its effects in the human body.

Ecstasy/MDMA needs 5 half-lives to be totally eliminated by the body.

Consequently, it would take about the body about 40 hours to remove 95% of ecstasy from the system [4].

Abbeycare Clinic has a structured programme to help individuals who want to remove ecstasy from their system safely.

 

How Long Do The After Effects Of Molly Last?

The short-term after-effects of Molly, last 2 to 5 days. For long-term after-effects, these can be prolonged over a month or more.

Molly/ecstasy affects parts of the brain that control [7]:

  • >> Affection
  • >> Sex
  • >> Aggression or anger
  • >> Sleep
  • >> Management of pain

 

Individuals who use ecstasy, use the drug because of its reported feel-good effects.

However, the negative after-effects can be more than what the user bargained for.

 

The negative short-term effects connected with ecstasy use are [4]:

  • >> Excessive sweating
  • >> Muscles become tense
  • >> Teeth grinding
  • >> Restless movements of the legs
  • >> In some cases, epileptic-like seizures
  • >> Increase in body temperature and increased thirst
  • >> Headaches up to 2 days later
  • >> Stomach upsets
  • >> Insomnia
  • >> High blood pressure

 

 

There are also negative short-term psychological effects, which often feel like drug withdrawal symptoms:

  • >> Hyperactivity
  • >> Feeling of having too many thoughts/ thinking too fast
  • >> Difficulty concentrating
  • >> High level of anxiety
  • >> Panic attacks
  • >> Irresponsible reckless behaviour
  • >> Difficulty falling asleep and staying asleep
  • >> Mild hallucinations (seeing/sensing things that do not exist in reality)
  • >> Feeling separated from self (depersonalisation)

 

 

In addition to these, depression is common 2 to 3 days after ecstasy use, as well as increased moodiness [8]

Individuals who use ecstasy for the first few times do not usually mind the negative short-term effects.

But persons who use ecstasy regularly have expressed how the negative feelings outweigh the positive effects [4].

Because of these negative effects, some individuals choose to detox in a rehab clinic such as Abbeycare.

 

For the negative long-term physical effects connected with ecstasy use, these are [4]:

  • >> Liver toxicity – jaundice (yellowing of the skin), liver injury, and hepatitis
  • >> Teeth get worn due to teeth grinding and jaw clenching
  • >> Muscle aches, spasms, pains and tremors
  • >> Heart problems especially if there is already an existing heart condition
  • >> Increased chances of stroke
  • >> High blood pressure
  • >> Slowness of movement, rigidity, and unstable posture (parkinsonism)
  • >> Bilateral abducens paralysis (eye problem, usually resulting in being permanently cross-eyed)
  • >> Serotonin toxicity or serotonin syndrome [9]

 

Documented long-term mental/psychologically-related problems of ecstasy use are: [4]

  • >> Impairment of memory (difficulty remembering what was seen or said)
  • >> Impairment of the decision-making making process
  • >> Difficulties completing logical thinking and problem-solving tasks
  • >> Tendency to be impulsive
  • >> Tendency to lack of self-control
  • >> Increased number of panic attacks months of use has stopped
  • >> Paranoia (feeling someone is “out to get me”)
  • >> Hallucinations
  • >> Depersonalization
  • >> Flashbacks
  • >> Psychotic episodes (a break from reality where the person does something that can be described as weird or out-of-touch with reality)

 

Safely stopping the use of ecstasy can be done through professionally-assisted ecstasy detox and treatment at a drug rehab clinic, such as Abbeycare Scotland or Abbeycare Gloucester.

 

Is MDMA Used For Therapy?

MDMA is used in a clinical trial or testing capacity, in the United States.

The use of MDMA is now in Clinical Trials, Phase 3 [10].

After completing Phase 3, MDMA will be forwarded for approval by the U.S. Food and Drug Administration (FDA).

Foreseeably, the drug can be approved for use with persons being treated with PTSD in an out-patient setting while the person also has psychotherapy.

 

Ecstasy is popular recreational drug that is that has 3,4-methylenedioxymethamphetamine (MDMA) [8].

But it is important to know that MDMA is NOT ecstasy/molly.

The MDMA used in the clinical trials is clinical-grade or pharmaceutical grade.

This kind of standard of purity makes MDMA suitable for use as medicine.

Meanwhile, ecstasy, which is produced illegally and with varying amounts of 3,4-methylenedioxymethamphetamine, is not suitable for the treatment of diseases [8].

 

In a controlled setting such as a laboratory, researchers have been able to prove that MDMA can help PTSD patients by:

  • >> Helping them relax while recalling traumatic events
  • >> Helping the patient feel secure while talking about the trauma
  • >> Helping the individual develop self-empathy while reflecting on the events

 

The rigorous process of drug approval by the FDA is to help assure that the potential benefits of MDMA outweigh its negative side-effects.

MDMA has a potential for abuse by persons who, because of the feel-good effects of the drug, become dependent on it.

Persons who become addicted or dependent on ecstasy/MDMA/molly are usually referred to a rehab clinic for professional help.

 

Is MDMA Good For PTSD?

MDMA can have potential benefits for those suffering with PTSD which is currently being treated with psychotherapy.

But MDMA used together with psychotherapy in an outpatient setting is still being tested in a clinical trial [10].

The U.S. Food and Drug Administration (FDA) has not approved of MDMA use outside the clinical trial.

In the UK, MDMA is a Class A drug. Using it, carrying it and selling it are acts punishable by law [11].

 

The MDMA used in the US clinical trials is also NOT ecstasy.

Clinically-graded MDMA has a specific dosage, and is manufactured in controlled laboratories.

Whereas ecstasy sold illegally is manufactured with different dosages of the active component.

A study has shown that street-grade ecstasy can have 67%–100% MDMA as the active ingredient [8].

Some pills can also contain less than 67%, and in some cases, there was no MDMA contained in the pills.

 

Recently, some ecstasy pills seized by authorities were described as “fast releasing”; while some were dubbed “double dose” types. [11]

The varying dosage in illegally produced MDMA means a person can take a high dose and sometimes a low dose, with little to no precaution.

This uncertainty and instability can lead to accidental overdose, and in worse case scenarios even death.

In raves and music festivals ecstasy is usually combined with alcohol.

Because alcohol has a diuretic effect, it can increase the toxic effects of ecstasy, causing dehydration and overheating.

 

In addition, unwise judgments from alcohol and ecstasy use can sometimes cause accidents to happen [12].

Persons who become dependent on the use of alcohol can detox safely by participating in an alcohol detox programme.

In a clinic such as Abbeycare, persons who have issues with alcohol and ecstasy can securely discuss their options for treatment.

Recovering from ecstasy addiction can be challenging because it means dealing with withdrawal symptoms as well as cravings for the drug.

Provided proper care and professional support, a person can learn specific techniques to overcome these challenges.

 

References

  1.   Kim, J. Fan, B. Lui, X. & Wu, P. (2011). Ecstasy Use and Suicidal Behavior Among Adolescents: Findings from a National Survey. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152632/
  2.   The Conversation. (2019). How does MDMA kill? Available at: https://theconversation.com/how-does-mdma-kill-109506
  3.   Chalk, W. (2017). This is what happens if you take too much MDMA. BBC UK. Avilable at: http://www.bbc.co.uk/newsbeat/article/40403970/this-is-what-happens-if-you-take-too-much-mdma
  4.   Kalat, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ, 16597), 917-928. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81503/
  5.   Smothers, H. (2016). This Is What Sex on Ecstasy Is Like. Cosmopolitan. Available at: https://www.cosmopolitan.com/sex-love/news/a62989/sex-on-mdma/
  6.   Medicines.org. (2010). Paracetamol 500mg. Available at: https://www.medicines.org.uk/emc/product/4199/smpc
  7.   National Institute on Drug Abuse. (2012). The Neurobiology of Ecstasy (MDMA). Available at: https://www.drugabuse.gov/publications/teaching-packets/neurobiology-ecstasy/section-iii/1-short-term-effects-after-ecstasy-gone-body/
  8.   Meyer, J. (2013). 3,4-methylenedioxymethamphetamine (MDMA): current perspectives. Subst Abuse Rehabil. 4, 83–99. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931692/
  9.   Soloway, R. (2015). Ecstasy Summary of Harmful Effects. Available at: https://www.poison.org/articles/2012-apr/ecstasy-a-summary-of-harmful-effects
  10.   Multidisciplinary Association for psychedelic Studies. (2017). A Phase 3 Program of MDMA-Assisted Psychotherapy for the Treatment of Severe Posttraumatic Stress Disorder (PTSD). Available at: https://maps.org/research/mdma/ptsd/phase3
  11.   BBC. (1 May 2019). MDMA: Why it’s ‘impossible’ to know how the drug affects you. Available at: https://www.bbc.com/news/newsbeat-48120198
  12.   SAMSHA. (2013). Ecstasy-Related Emergency Department Visits by Young People Increased between 2005 and 2011; Alcohol Involvement Remains a Concern. Available at: https://www.samhsa.gov/data/sites/default/files/spot127-youth-ecstasy-2013/spot127-youth-ecstasy-2013.pdf

Rehab FAQ

Posted on by Melany Heger

What Does A Rehab Do?

A rehab facility tries to help individuals who have problems with alcohol and/or drug use manage their addiction.

Most rehab clinics aim to ultimately lead clients to live sober lives.

The activities in a rehab clinic aim to:

Educate clients about alcohol and/or substance abuse

Help enlighten clients about the origins of their addictive behaviour

Remove the stigma of seeking help for addiction

Promote new ways to live without alcohol and/or drugs

 

A reputable rehab centre in the UK such as Abbeycare Scotland conforms to Care Quality Commission standards (CQC).

CQC Certification guarantees that : [1]

  • >> The clinic makes sure the clients are safe before they enter rehab.
  • >> National clinical guidance/rules are followed.
  • >> Employees of the clinic are professionally trained and up to par with current standards
  • >> The clinic employs adequate support staff
  • >> The centre has facilities to support treatments offered

 

After attending rehab, most rehab centres link with Mutual Support Groups, so clients so that recovery efforts can be sustained.

Examples of Mutual Support Groups are:

  • >> Alcoholics Anonymous
  • >> Narcotics Anonymous
  • >> Cocaine Anonymous
  • >> Women for Sobriety
  • >> SMART Recovery
  • >> Secular Organization for Sobriety/Save Our Selves
  • >> LifeRing Secular Recovery

 

In order to ensure success in treatment, a rehab clinic should provide : [2]

  • >> Professionally supervised detoxification
  • >> Behavioural counseling (12 Step Programme, Cognitive Behavioural Therapy, and so on)
  • >> Evaluation of other mental health problems
  • >> Follow-up for long-term recovery

 

A person seeking treatment for addiction issues would be better serviced by a rehab clinic that aims for long-term recovery rather than quick fixes.

To promote a sober living lifestyle, behavioural therapies in a rehab clinic should emphasise:

  • >> changing attitudes about alcohol and/or drug use
  • >> learning new ways to cope with stress and triggers
  • >> seeking out help through social support
  • >> improve the ability to cope with the daily demands of life
  • >> establish a sense of emotional stability and calm

 

In addition, clients can benefit from rehab clinics like Abbeycare Gloucester that use a holistic approach treatment.

Holistic care can help clients regain physical, social, nutritional and spiritual balance.

Holistically oriented rehab clinics can incorporate exercise, massage, and aromatherapy into their care repertoire.

Ultimately, a rehab clinic should be able to:

  • >> Influence a client to maximise his/her quality of life
  • >> Address the individual’s multi-faceted needs
  • >> Help individuals adjust to living a lifestyle without substance abuse
  • >> Direct individuals towards wellness and health
  • >> Assist the individual to return to home and community as a renewed person

 

What Does Rehab Consist Of?

Rehab consists of detox, behavioural therapies, and aftercare services.

Expect a rehab clinic to provide:

  • >> Conducive accommodation
  • >> Professionally Supervised Detox
  • >> A regular schedule to follow
  • >> Counseling for emotional support and behavioural change
  • >> Education about health and addiction issues
  • >> Recreation (gym facilities and fitness classes for example)
  • >> Family Participation
  • >> Relapse prevention strategy planning sessions
  • >> Continuing Care or rehab aftercare

 

In the morning, rehab begins with a healthy breakfast, followed by the first group meeting.

Mid-morning, therapy sessions are held (individual or group)

Depending on the clinic, there may be another afternoon therapy session or a group meeting after lunch

Time is usually allotted for breaks in-between sessions.

Some rehab facilities hold sessions in the evening.

 

The type of programme an individual has can depend on a personalised treatment plan.

For individual therapy sessions utilising Cognitive Behavioural Therapy, sessions last 30 to 60 minutes.

Group therapy sessions can last from 1 to 2 hours.

A private rehab clinic differs from public rehab clinics offered by the NHS.

Reasons why clients choose private rehabs are:[3].

  • >> Accessibility – no need to wait for weeks for an admission
  • >> Continuation of care provider – the professional assigned to the client sees through the whole process of treatment
  • >> In-patient care availability is limited in public rehab
  • >> Overall, the quality of services by private rehab clinics is seen as superior

 

However, due to financial constraints, some individuals are limited to using NHS rehab clinics.

Private rehab can be covered by insurance, while public rehab is offered free by the NHS to UK citizens.

 

What Is The Process Of Rehabilitation?

The process of alcohol or drug rehabilitation involves assessment, detox, rehabilitation (proper) and aftercare [4].

Specifically, alcohol or drug rehabilitation these phases are:

Phase One: Assessment

Interviews and checks are done so that the centre will have an idea of how to formulate a personalised treatment plan.

Questionnaires can be given asking the client about the history of alcohol and/or drug use.

Paperwork about insurance and other formal matters can be finalised

 

During this phase, clients will be interviewed about:

  • >> What substances are they currently using
  • >> When was substance use initiated? (How did it begin?)
  • >> Previous history of joining a rehab programme
  • >> His or her goals about rehab
  • >> In addition, the centre may ask about:
  • >> The client’s overall health
  • >> Education and/or work history
  • >> Details about social life
  • >> Quality of relationships with family/friends/supporting individuals

 

The last step of Phase One will usually be a Rehab centre orientation

 

Phase Two: Detoxification

The first two to three days of detox are the most challenging, physically, emotionally and mentally  [5].

But with professional guidance, the hardship can be overcome.

Emotional and physical support is crucial during detox, as individuals who go through relapse alone can be less-equipped to handle the demands of the withdrawal process.

Individuals who are well-supported during detox tend to follow-through with the rehabilitation process, assuring a better chance of life-long recovery. [2]

After one week in detox, a person is better able to handle the regular therapy sessions available in rehab.

Phase Three: Rehabilitation

During this stage, individual and/or group psychotherapy is offered

Clients learn about their motives, feelings, and hopes about addiction.

This part of rehab is where clients do the hard work of learning about themselves in a deeper level, so that they can learn new ways to cope.

Rehab clinics differ in therapy methods chosen.

A private clinic like Abbeycare offers 12 Step facilitation, Cognitive Behavioural Therapy and Holistic therapy.

 

Other basic facilities only outpatient programmes or in-patient programmes with limited capacity.

Usually, therapies are composed of:

  • >> Assessment – determines where the person is in terms of the addiction and recovery process
  • >> Formulation of goals – what the client wishes to achieve after therapy
  • >> Treatment – where homework and behavioural monitoring occur

 

Individual Therapy in particular helps individuals to:

  • >> learn to monitor and control their thinking
  • >> discover their thinking patterns and how these lead to addiction
  • >> maintain a sense of self-control over drug cravings
  • >> learn coping skills to live alcohol or drug-free
  • >> break the cycle of substance abuse
  • >> gain an understanding of how thoughts, behaviours, and emotions relate to each other
  • >> utilise rational planning skills to cope with life’s daily challenges

 

Phase Four: Maintenance or Aftercare

In rehab, this phase involves strategic planning to know how to proceed after the client exits rehab.

Outside rehab, this phase can involve

Peer support groups or Mutual Support Groups (Alcohol Anonymous SMART Recovery, etc.)

Peer providers – such as certified peer specialists, peer support specialist, recovery coaches, sponsors or mentors

The rehab clinic usually connects the client to these after-care groups, as it is of utmost importance that the client is supported after rehab.

Evidence shows that clients who have continuing personalised care have better chances at recovery than persons who do not have after-care support.  [4]

How Long Is Rehab For?

The shortest stay will be for seven days, the typical stay will be 28 days, and some clients can stay up to 90 days in rehab.

Most rehab programmes in the UK last 28 to 30 days.

Some clients, however, choose longer treatment programmes.

The longest length of stay can be up to 12 weeks.

The length of stay in rehab depends on the following factors:

  • >> What substance is used
  • >> For how long has the person been using the substance
  • >> How motivated the person is to change
  • >> The amount of emotional, social, and financial support the client has

 

The NHS recommends individuals who need more than just detox to continue with a drug rehab programme or an alcohol rehab programme.

In a private rehab clinic, clients are not forced to stay for the duration of the rehab process.

However, leaving before the programme concludes is not recommended.

Usually, rehab facilities employ motivational techniques to keep clients to focus on the end-goal: successful sober living.  [5].

Out-patient programmes are better suited to individuals who have a moderate level of alcohol and/or substance abuse.

Recent developments in research have led experts to conclude that addiction is a treatable disorder [6].

 

Like some chronic conditions, relapse does occur in treatment.

But relapse does not mean failure, rather, it is a sign that change has happened, treatment is resuming, or there is a need to modify some treatment approaches.

Rehab clinics the best treatment programs address the needs of the person as a whole.

By treating addiction as a lifestyle disease much like diabetes or asthma, clients can approach their problem in a positive manner.

By removing negative self-judgment and treating addiction as a health problem, clients can move away from self-blame towards self-empowerment.

 

 

References

  1.   Care Quality Commission. (2019). Briefing: Substance misuse services. Available at: https://www.cqc.org.uk/publications/themed-work/briefing-substance-misuse-services
  2.   National Institute on Drug Abuse. (2012). Treatment Approaches for Drug Addiction. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
  3.   The Conversation. (2018). Drug rehab: what works and what to keep in mind when choosing a private treatment provider. Available at: https://theconversation.com/drug-rehab-what-works-and-what-to-keep-in-mind-when-choosing-a-private-treatment-provider-95431
  4.   The Surgeon General’s Report on Alcohol, Drugs, and Health. Available at: https://www.ncbi.nlm.nih.gov/books/NBK424859/
  5.   NHS. (2018). Treatment Alcohol Misuse. Available at: https://www.nhs.uk/conditions/alcohol-misuse/treatment/
  6.   National Institute on Drug Abuse. (2013). Drugs, Brains, and Behavior: The Science of Addiction. Available at: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

Intervention FAQ

Posted on by Melany Heger

How Do You Do An Intervention?

To stage an intervention, set an appropriate time and place, prepare the right mindset and most importantly, get the help of an Intervention Specialist.

First, in order to set the tone, an initial intervention should be done at a conducive place.

It is useful to remember that the end goal of this initial intervention goal is to get the concerned person professional help.

 

Second, in order to motivate a person with alcohol and/or substance use disorder to seek professional intervention, family members and/or loved ones must have the right mind-set.

Alcohol and/or drug addiction is a health condition requiring professional attention.

Highly-regarded evidence has shown that alcohol and/or substance use disorders can be effectively treated with comprehensive continuing care [1].

Like other chronic illnesses such as diabetes and hypertension, alcohol and/or drug addiction should be approached as a disease with a strong behavioural component.

 

The third step in staging an intervention is to invite the presence of an Intervention Specialist.

Having an Intervention Specialist or another helping professional can communicate to the concerned person that:

  • >> Nobody is “out to get them”
  • >> Family members and/or loved ones have the concerned person’s well-being in mind
  • >> Support is available/ there is adequate and professional help

 

Individuals with alcohol and/or substance abuse disorder tend not to be receptive if they feel harshly judged.

An intervention staged solely by family members and/or loved ones can be perceived as threatening.

 

There is a tendency for the concerned person to think:

“They are ganging up on me.”

 

Whilst, the presence of a third-party, with an objective, professional stance can communicate to the person that:

  • >> “We are here to help.”
  • >> “It is a problem we will solve together.”
  • >> “You are not alone in this.”

 

In addition, an Intervention Specialist can help family members and/or loved ones put together:

  • >> Well-thought-out plans about what to do next
  • >> Ideas about a possible alcohol and/or drug treatment program
  • >> A helpful and sympathetic tone to carry out the message

 

Because the initial intervention may be the first time the concerned person is made aware of the problems brought about by addiction, an emotional scene is almost unavoidable.

An Intervention Specialist can mediate between loved ones and the person concerned so that both parties do not feel aggravated or antagonized.

It must be remembered that this initial intervention is just a run-up to the longer process of change that the concerned person and his/her supports will face.

What Happens In An Intervention?

In an intervention, a person with substance abuse problems is approached by his or her significant others and an Intervention Consultant to talk about the difficulties caused by the addictive behaviour.

Significant others pertain to:

  • >> Adult family members – spouse/partners, siblings, parents
  • >> Adult children of the concerned individual
  • >> Community members – neighbors, members of the clergy, etc.
  • >> Friends
  • >> Colleagues at work

 

Working together, the significant others and the Intervention Consultant try to convince the concerned individual to go to a rehab clinic.

The particular steps taken for successful intervention are:

  1. Contacting the Intervention Consultant
  2. Family members and/or loved ones formulate a strategic Intervention Plan with the consultant; they also check in with each other
  3. The significant others write down in advance what they want to say to the concerned person
  4. A specific time and place is prepared for the event.
  5. The concerned person is gently nudged towards attending the intervention in the appointed date
  6. The significant others take turns talking about the impact of the addictive behaviours in their respective lives.
  7. The Intervention Consultant mediates between the significant others and the concerned person
  8. The most positive outcome would be for the concerned person to agree to enter treatment in a rehab clinic or a similar facility as soon as possible.

 

To take advantage of the opportunity as soon as it exists, it can be helpful to ensure that a slot is available for the concerned person to go to if he or she agrees to seek treatment.

In addition the following elements can lead to a successful outcome:

  • Empathic communication
  • A non-judgmental stance
  • A plan that is Specific, Measurable, Achievable, Realistic, Timely (SMART)
  • And a tone that the concerned person is not condemned or judged

 

Even if the concerned person does not take action immediately, an intervention is not considered an utter failure.

Some individuals may take longer than others to seek help.

Often times, bringing up the issues about the concerned person’s addictive behaviour is already a powerful move.

Chances are, the concerned person would respond to the message.

Hopefully, he or she finds the motivation to change.

What Is The Purpose Of An Intervention?

The main purpose of an intervention is to help a person with health problems find ways to cope better with life.

According to health experts [2], the term “intervention” means activities aimed to improve a person’s life by:

  • preventing a disease
  • curing a disease
  • lessening the number of symptoms of a disease
  • reducing the negative impacts of the disease
  • shortening the time the disease is felt
  • restoring functions lost because of disease
  • helping the person recover or adapt to new ways of doing things after an injury

 

Because alcoholism and substance abuse are both considered diseases, they can be treated with interventions.

The formal term for alcoholism as a disease is “Alcohol Use Disorder”.

Meanwhile, persons who have problems with drugs have “substance use disorder”.

For these problems, an alcohol rehab facility such as Abbeycare Gloucester can help by offering interventions such as:

  • >> 12 Step Facilitation
  • >> Cognitive Behavioural Therapy
  • >> Family-therapy
  • >> Dialectic Based Therapy
  • >> Animal-Assisted Therapy

 

In a rehab clinic, an intervention can be classified according to how many people participate in the activity.

Some individuals prefer to participate in Group Therapy.

Some individuals Individual rely on Individual Therapy.

Usually, both group and individual interventions are offered side-by-side.

The logic is they complement each other.

Lessons learned from Individual Therapy can be explored in Group Therapy before being applied outside the rehab facility.

Interventions can also be classified according to the problem targeted. This is why some programs are named:

  • >> Alcohol Abuse Intervention
  • >> Drug Abuse Intervention
  • >> Substance Abuse Intervention (for simultaneous addiction to many substances, called poly-addiction)
  • >> Behavioural Addiction Intervention (for addiction to sex, gambling and pornography)

 

Also, there are preventive interventions geared towards changing behaviours target specific groups of people.

For example, some interventions target:

  • >> Overweight individuals to encourage exercise
  • >> Teenagers to help raise awareness of problems associated with drug use
  • >> Pregnant women to explain the benefits of breastfeeding

 

With these programmes, education is paramount.

However, it is not enough to merely educate the target population.

If individuals are not motivated to change, or if they lack the resources, no new skills will be learnt.

Whatever goal an intervention has, a structured environment provides much-needed support [3].

In a safe place such as a rehab clinic, a hospital, or a community centre, individuals can be adequately supported while learning essential new skills.

Specifically, structured environments help by: [4]

  • >> Reducing anxiety about unpredictable events – a person in rehab is already dealing with a lot of changes
  • >> Maintaining and monitoring group dynamics, so everybody plays fair
  • >> Providing dedicated and professional help when clients ask for it
  • >> Continuous supervision and guidance

 

How Long Does An Intervention Last?

An intervention can last 1.5 hours to 2 hours.

This time frame applies to initial interventions such as those intended to motivate individuals with substance alcohol and/or substance abuse issues to seek professional help.

Taken from guidelines used in time-limited group therapy [5], 1 to 2 hours would be enough time for a group of people to discuss a tough issue such as substance abuse without causing fatigue.

As for interventions that happen inside a rehab clinic or an outpatient program, the duration of an intervention depends on the specific type of intervention.

  • >> For individual therapy sessions –  45 to 50 minutes [6]
  • >> For group therapy sessions –  75-120 minutes [7].

 

Recent research says that 15 to 20 sessions can be good enough for 50% of individuals to say the treatment done was effective.  [8]:

Some psychological conditions can take 12 to 16 weekly sessions for significant changes to occur.

Mostly, therapists and their clients prefer to continue treatment over longer periods of time in order to reap the positive benefits.

Some therapists and clients use up 20 to 30 sessions, lasting a period of six months.

The amount of time spent in therapy or intervention depends on the problem tackled.

With alcohol and/or substance abuse, inpatient treatment in a rehab clinic lasts approximately 28 days.

Therapeutic interventions that happen within the rehab facility are generally conducted twice a day, lasting form one hour to two hours.

In a structured environment typical of a rehab clinic, interventions are expected to:

  • >> Foster independence and feelings of competence
  • >> Encourage self-efficacy
  • >> Help restore planning and decision-making skills
  • >> Decrease challenging and/or aggressive behavior
  • >> Promote engagement in community
  • >> Facilitate friendly social interactions with others
  • >> Provide predictability in day-to-day functions

 

After the duration of the rehab stay, clients are encouraged to keep in touch with therapists and to seek further help if needed.

References

  1.   US Substance Abuse and Mental Health Services Administration. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Available at: https://www.ncbi.nlm.nih.gov/books/NBK424859/
  2.   Smith. P., Morrow, R.H., & Ross D.A. (eds.) (2015). Field Trials of Health Interventions: A Toolbox. 3rd edition. Available at: https://www.ncbi.nlm.nih.gov/books/NBK305514/
  3.   Yen, I. Syme, S. (1999). The Social Environment and Health: A discussion of the Epidemiologic Literature. Available at: https://www.annualreviews.org/doi/pdf/10.1146/annurev.publhealth.20.1.287
  4.   The Conversation. (2019). How rehab helps heavy drug and alcohol users think differently. Available at: https://theconversation.com/how-rehab-helps-heavy-drug-and-alcohol-users-think-differently-118822
  5.   Center for Substance Abuse Treatment. (1999). Brief Interventions and Brief Therapies for Substance Abuse. Available at: https://www.ncbi.nlm.nih.gov/books/NBK64936/
  6.   American Psychological Association. (2019). Understanding psychotherapy and how it works. Available at: https://www.apa.org/helpcenter/understanding-psychotherapy
  7.   Group Therapy. Available at: https://www.psychologistanywhereanytime.com/treatment_and_therapy_psychologist/psychologist_group_therapy.htm
  8.   American Psychological Association. (2019). How Long Will It Take for Treatment to Work? Available at: https://www.apa.org/ptsd-guideline/patients-and-families/length-treatment