Meridia Abuse and Addiction

Meridia (Sibutramine, Reductil and Sibutrex) is an appetite suppressant drug used primarily to treat obesity.  Safety concerns have led to suspension of sales in the United Kingdom and Europe, but it is still manufactured and sold in the United States.

Meridia is classified as a Schedule IV controlled substance in the United States due to is use as an anorectic and its over-prescription resulting in a number of abuse and addiction cases.

Meridia increases the risk of heart attack and stroke in people with a history of cardiovascular disease.  Symptoms of overuse or overdose include seizures, urniation problems, abnormal bruising or bleeding, jaundice, fever, rigors, chest pain, abnormal vision, dyspnea, and edema.

Other common side effects of Meridia include dry mouth, paradoxically increased appetite, nausea, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, and joint and muscle pain.

Infrequent but serious side effects of Meridia include cardiac arrhythmia, severe mental/ or mood changes, restlessness, confusion, depression, and suicidal ideation.

Studies are ongoing into reports of sudden death, heart failure, renal failure, and gastrointestinal problems due to Meridia abuse.

The FDA has issued alerts and recalls for a number of dietary supplements that contain Sibutramine at concentrations twice the amount recommended for weight loss.   Related compounds such as Fen-Phen have been known to cause pulmonary hypertension, a rare but clinically significant problem.

Methylyn Abuse and Addiction

Methylyn (methylphenidate) is a psychostimulant drug approved for treatment of Attention Deficit Hyperactivity Disorder, Postural Orthostatic Tachycardia Syndrome, and narcolepsy.  It may also be prescribed for treatment-resistant cases of lethargy, depression, neural insult, obesity, and Obsessive Compulsive Disorder.

Methylphenidate belongs to the piperidine class of compounds, which increase the levels of dopamine and norepinephrine in the brain.  Methylphenidate is structurally similar to amphetamine, and its pharmacological effects are closely related to those of cocaine.

In the United States, Methylyn (methylphenidate) is classified as a Schedule II controlled substance, the designation used for substances that have a recognized medical value but present a high likelihood for abuse because of their addictive potential.

Methylyn is approved by the FDA for the treatment of Attention Deficit hyperactivity disorder because of its effects of increasing or maintaining alertness, combating fatigue, and improving attention.  The long term effects of methylphenidate on the developing brain are unknown, and it is not approved for children under six years of age.

Methylphenidate has shown some benefits as a replacement therapy for methamphetamine addiction.  Methylphenidate and amphetamine have also been investigated as a chemical replacement for the treatment of cocaine dependence, in the same way that methadone is used as a replacement for heroin.  Methylphenidate is actually more potent than cocaine in its effect on dopamine transporters.

Methylphenidate has a high potential for drug abuse and drug dependence due to its pharmacological similarity to cocaine and amphetamine.

Methylphenidate abuse is higher among college students compared to non-college attending young adults.  College students abuse methylphenidate as a so-called "study drug" to improve concentration or stay awake.  Methylphenidate has been dubbed "kiddie coke" due to its low price and high availability among young people.  It is one of the top ten stolen prescription drugs in the United States.

Increased alcohol consumption due to abuse of stimulants such as Methylyn has additional negative effects on the health, particularly in young adult abusers.

Methylyn long term use, and use in high doses, has been associated with higher levels of psychiatric admissions, drug dependence, paranoia, schizophrenia and psychosis.  Psychotic symptoms from Mehyphenidate can include hearing voices, visual hallucinations, urges to harm oneself, severe anxiety, euphoria, grandiosity, paranoid delusions, confusion, and increased aggression.

Tolerance may occur with long-term use of methylphenidate, including cross tolerance with other stimulants such as amphetamines and cocaine.

Withdrawal symptoms of methylphenidate can include psychosis, depression, irritability and a temporary worsening of the original symptoms for which the drug was prescribed, known as rebound.

Meprobamate Abuse and Addiction

Meprobamate (brand name Miltown, Equanil and Meprospan) is a an anti-anxiety drug that was once the best-selling minor tranquilizer in the United States.  It has largely been replaced by benzodiazepines such as Valium, Librium, and Xanax.

Meprobamate is a Schedule IV drug under the Convention on Psychotropic Substances.

Symptoms of Meprobamate overdose include drowsiness, unresponsiveness, loss of muscle control, severe impairment or cessation of breathing, coma, and shock.

Death has been reported with ingestion of as little as 12 grams of Meprobamate.

Prolonged use of Meprobamate can lead to physical dependence and has a life-threatening abstinence syndrome similar to alcohol and barbiturates.  Sudden abstinence from Meprobamate can lead to severe reactions including insomnia, vomiting, tremor, muscle twitching and overt anxiety in the first 3 to 4 days.

Acute psychotic reactions and hallucinations resembling delirium tremens have been noticed in severe cases of Mebrobamate abuse.

Medically supervised detoxification (detox) followed by psychosocial treatment is highly recommended in cases of long-term Mebprobamate abuse and dependence.

Interventionists

The following is a list of Interventionists we have worked with.

Summit Malibu does not endorse or recommend one interventionist over another, but is providing this list as a starting point in your search for the right Interventionist.

As part of the Intervention process, the client and their Interventionist must be free to choose the correct next step in their recovery regardless of any affiliation, stated or implied.

• Pat Moomey, BRI-I
  • Board Registered Interventionist (BRI-I) with the Association of Intervention Specialist Credentialing Board (AISCB), Certified Addiction Treatment Counselor, and Certified Recovery Coach.
• Dallas Taylor, CAS, BRI-II
  • Board Registered Interventionist (BRI-II) with the Association of Intervention Specialist Credentialing Board (AISCB), Certified Addiction Counselor with the American Academy of Health Care Providers in the Addictive Disorders.

Meperidine Abuse and Addiction

Meperdine (Demerol, Pethedine, Lidol, Pethanol, Alodan and Dispadol) is a fast-acting opioid analgesic drug used for the treatment of moderate to severe pain.  It is most commonly known by its brand name, Demerol.  It is administered in tablets, syrup or by intramuscular or intravenous injection.

Meperidine causes users to experience marked euphoria because it triggers the brain's pleasure centers while it blocks pain.

Meperidine's effects are felt a few minutes after ingestion and last from two to four hours.  Meperidine’s effects are similar to morphine, but with sedation, respiratory depression, and euphoria less intense than morphine.  Nausea and vomiting are common with oral use but less likely when administered by injection.

For much of the 20th century Meperidine was the opioid of choice for many physicians.

Meperidine was considered to be safer and to carry less risk of addictionthan Morphine.  It was also thought to be superior in treating pain due to its antispasmodic effects.  Physicians now consider Meperidine to be no more effective than Morphine in treating pain. In addition, its low potency, short duration, and toxicity has caused it to lose popularity in recent years.

Meperidine toxicity can result in seizures, delirium, and other serious neuropsychological effects.

The side effects of Meperidine are similar to those of other opiods: nausea, vomiting, sedation, dizziness, urinary retention and constipation. Meperidine overdose can cause muscle flaccidity, respiratory depression, cold and clammy skin, hypotension, and coma.

Fatalities have occurred with both oral and intravenous Meperidine overdose.

Serotonin syndrome, a potentially life-threatening build up of excess serotonin in the brain, has occurred in patients taking Meperidine during antidepressant therapy or with selective serotonon reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MOIs).

Despite being structurally distinct from Morphine and related opiates, Meperidine's effects on opiate receptors in the brain are similar to those of morphine.

The major hazard of Demerol is respiratory depression, but other risks include circulatory depression, respiratory arrest, shock, and cardiac arrest.

Physical tolerance and psychological dependence can develop, especially with excessive doses or long-term use.  Stopping usage abruptly after prolonged or high dosage can result in extreme fatigue and mental depression.

Medially supervised detoxification is highly recommended when experiencing Meperidine withdrawal.

Severity of withdrawal symptoms is directly related to the amount of Meperidine taken and the length of time it has been taken.  Dependence can develop after even a few weeks of regular use.  Treatment will ultimately depend on the degree of addiction.

Lomotil Abuse and Addiction

Lomotil is the brand name of diphenoxylate, an anti-diarrheal that is chemically related to the narcotic drug meperidine (aka Demerol).  It works by slowing down the movement of the intestines.  It is often combined with Atropine, which reduces spasms in the bladder, stomach and intestines.

Lomotil and Atropine are generally safe in short-term use and with recommended dosage, but long-term use may present problems of dependence.

Lomotil abuse can cause side effects including dry mouth, headache, constipation, blurred vision, drowsiness and dizziness.  Because of these efects, Lomotil shouldn't be used by motorists or operators of machinery.

Symptoms of Lomatil overdose can take up to 12 hours to appear.

Overdose is common among drug abusers, possibly because of its relatively mild initial effects that may cause them to take additional amounts to feel the desired effects.  Symptoms of Lomatil overdose include convulsions, respiratory depression, dilated eye pupils, rapid side-to-side eye movements, flushed skin, constipation, nausea, vomiting, tachycardia, drowsiness, coma and hallucinations.

Treatment of Lomotil overdose must begin immediately after diagnosis and may include the following: emesis (induced vomiting), gastric lavage, ingestion of activated charcoal, laxative and a counteracting medication such as a narcotic neutralizer.

Recovery from Lomatil overdose usually occurs within 24 to 48 hours, but children and young adults are at risk of a very poor outcome and must be kept for observation.

Librium Abuse and Addiction

Librium (chlordiazepoxide) is a psychoactive benzodiazepine drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring.  Librium was the first benzodiazepine discovered.  It was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963.

Librium is commonly misused and are often taken in combination with other drugs of abuse.

Librium enhances the effect of the neurotransmitter gamma-aminobutyric acid (GABA) which results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant and amnesic effect.  These properties make Librium useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures.

In general, Librium is safe for short term use, although cognitive impairments and paradoxical effects such as aggression or behavioral disinhibition occasionally occur.

Long-term use has adverse psychological and physical effects, decreasing effectiveness, physical dependence, and benzodiazepine withdrawal syndrome.

Librium overdoses can cause dangerous deep unconsciousness.  However, they are much less toxic than barbiturates, and death rarely occurs when a benzodiazepine is the only drug taken.  When combined with other central nervous system depressants such as alcohol and opiates, the potential for toxicity increases.

The long-term adverse effects of Librium include a general deterioration in physical and mental health and tend to increase with time.

Adverse effects can include cognitive impairment such as feelings of turmoil, difficulty in thinking constructively, increased anxiety, and depression.  Behavioral problems also occur, such as loss of sex-drive, agoraphobia and social phobia, loss of interest in leisure pursuits and interests, and an inability to experience or express feelings.  An altered perception of self, environment and relationships may also occur.

The most frequent symptoms of withdrawal from Librium is insomnia, gastric problems, tremors, agitation, fearfulness, and muscle spasms.  Other effects include irritability, sweating, depersonalization, derealization, hypersensitivity to stimuli, depression, suicidal behavior, psychosis, seizures and delirium tremens.

Severe symptoms usually occur as a result of abrupt withdrawal, so medically supervised detoxification is recommended.

Approximately 10% of patients will experience a protracted withdrawal syndrome, which can last for many months or longer.  This phenomenon is known as "benzodiazepine withdrawal syndrome."  Symptoms do gradually lessen over time, eventually disappearing altogether.

Librium is considered to be major drugs of abuse.

Librium is used recreationally and by drug abusers, with abuse mostly limited to individuals who abuse other drugs.  Benzodiazepine abuse ranges from occasional binges on large doses, to chronic and compulsive drug abuse of high doses.  Mortality rates are higher among drug abusers that use Librium, particularly among heavy alcohol users.

Both long-term and short-term use have the potential to cause physical and psychological dependence and severe withdrawal symptoms.

Dependence and tolerance can also develop rapidly, with benzodiazepine withdrawal syndrome occurring after as little as three weeks of continuous use.  Withdrawal symptoms include depression, anxiety, panic attacks, and agoraphobia, among others.

Ketamine Abuse and Addiction

Ketamine is a short-acting "dissociative" anesthetic.  This means that it has the ability to separate perception from sensation, which is useful in surgical situations.  It also has hallucinogenic and painkilling qualities that affect people in a variety of different ways.  Ketamine is occasionally administered to people but is more commonly used by veterinarians for animal surgery.

Ketamine is chemically related to PCP ("Angel Dust") and is known on the street by the slang terms "Street K" and "Special K."

The effect of Ketamine on the respiratory and circulatory systems is different from that of other anesthetics.  When used at anesthetic doses, it will usually stimulate rather than depress the circulatory system.  It is sometimes possible to perform Ketamine anesthesia without protective measures to the airways.  Ketamine is also a potent analgesic and can be used in sub-anesthetic doses to relieve acute pain.

Patients have reported vivid hallucinations while anesthetized, and these unwanted psychological side-effects have reduced the use of Ketamine in human medicine.

Ketamine sold illicitly comes primarily from theft of veterinary clinics. Ketamine is also illegally synthesized and sold as a recreational drug in either powdered or liquid form.  In its powdered form it can be inhaled, injected, or taken orally.  It is also smoked in a cigarette or pipe, usually mixed with marijuana or tobacco.

Heavy Ketamine abusers use injection as their primary method of administration due to the bypassing of the liver and the rapid onset of the effects.

Specialized "puff pumpers" are often sold in "rave clubs."  These are small bottles with a small inhaler screw-on top designed to deliver approx. 40 mg of Ketamine crystals when inhaled.

Disturbing psychological effects are reported by users, including delusional egocentrism and paranoia.

Delusion egocentrism means the interpreting of patterns and coincidences (synchronicities) and concluding that the user is somehow more important or integral to the world than others. This same sense of "being at the center of the world" can also create a sense of paranoia, where the patterns and coincidences take on a threatening or frightening quality.

The main characteristic of Ketamine abuse is a stupor similar to extreme drunkenness while also experiencing hallucination and dissociation.

Dissociation with Ketamine is a state characterized by a sense of detachment from the physical body and the external world.  High doses create a state of dissociation similar to schizophrenia.  Ketamine abusers may become completely unaware of their individual identities or the external world.  Effects subside slowly, and users may not remember their own names, or even know that they are human.  Physical movement is extremely difficult, and a user may not be aware that he or she has a body at all.

This state is commonly known as "being in the K-hole" and can result in dangerous physical symptoms including increased heart rate, slurred speech, paralysis, nausea, numbness, delirium, amnesia, impaired motor function, high blood pressure, and respiratory depression which can be fatal at high doses.

Long-term, chronic use of Ketamine can lead to cognitive impairments including severe memory problems.

Hydromorphone Abuse and Addiction

Hydromorphoneis  a potent analgesic drug of the opioid class.  It is a semi-synthetic derivative of morphine.  It is both medically an opioid analgesic and legally a narcotic.  Hydromorphone inhibits ascending pain pathways in Central Nervous System.  It also increases the pain threshold and alters pain perception.

Like all opioids, Hydromorphone is highly addictive and is listed as a Schedule II drug in the United States.

Hydromorphone is prescribed medically as an alternative to morphine for analgesia, and as a second- or third-line narcotic antitussive (cough suppressant) for severe cases.  It is generally considered the strongest of the antitussive drugs.

Hydromorphone was developed when heroin was removed from clinical use in most of the world and banned outright in many countries.

Hydromorphone is often called "drug store heroin" on the streets.  While Hydromorphone use may sometimes be prescribed for a legitimate ailment, it is more often purchased illegally in its prescription form.  Because of its similarity to street heroin and other powerful opiates, short term abuse can lead to complete dependence in just a few days of continuous use.

Hydromorphone abusers often turn to street drugs such as heroin when their preferred drug is no longer available.

Adverse effects of Hydromorphone are similar to those of other opioid analgesics, such as morphine.  Major hazards include respiratory depression and circulatory depression.  Some more common side effects include light-headedness, dizziness, sedation, constipation, nausea, vomiting, and sweating.

Overdoses are rare in tolerant individuals, but when they do occur they can lead to complete circulatory system collapse.  The effects of overdose are increased if the medication is taken with alcohol or benzodiazepines.

The euphoria produced by Hydromorphone that is associated with relief from pain can lead to addictive reward-seeking behavior.

Withdrawal from Hydromorphone is brief but intense.  The symptoms are similar to morphine and heroin withdrawal, but they are compressed into a spike which will peak in 14 to 21 hours and resolve in 36 to 72 hours.

Withdrawal symptoms from Hydromorphone can occur four to five hours after the last dose and usually last 7 to 10 days.

To avoid severe withdrawal, Hydromorphone abusers should taper down slowly under a knowledgeable physician’s care, or participate in a medically supervised detoxification.  In cases of long term use, an in patient detox in a hospital or medical supervised setting is highly recommended.

As with all opioids, psychological dependence will continue long after physical withdrawal is complete, and psychosocial treatment is recommended.

Kadian Abuse and Addiction

Kadian (MS Contin, Avinza, Actavisis) are brand names of a variety of timed-release compounds of morphine sulfate.  Kadian is an analgesic usually prescribed for chronic pain.  Due to its strength, it is typically prescribed to cancer patients and victims of severe but non-cognitive-damaging trauma.

Kadian is considered particularly dangerous to recreational drug users who are unaware that the time-release mechanism is a wax inside of the pill that, when heated, encases the morphine sulfate and presents an extreme danger to drug users who heat and inject the drug.

As with other opiod narcotics, the most hazardous side effect of Kadian is respiratory depression.  Users who are older or who have lung or breathing problems are particularly vulnerable to respiratory depression. Other side effects include anxiety, constipation, depressed or irritable mood, dizziness, exaggerated sense of well-being, light-headedness, nausea, sedation, sweating and vomiting.

Kadian, like other opiod analgesics, can be highly addictive.

Kadian abusers will develop physical tolerance, and will experience withdrawal when stopping abruptly.  Withdrawal symptoms include dilated pupils, restlessness, runny nose, sweating, abdominal and leg pains, abdominal and muscle cramps, anxiety, diarrhea, hot and cold flashes, inability to fall or stay asleep, increase in body temperature, high blood pressure, tachycardia, kicking movements, loss of appetite, severe backache, twitching and spasm of muscles, vomiting and weakness.

Depending on the amount and length of time Kadian has been abused, the initial  period of physical withdrawal will end within a few weeks.

Most Kadian abusers also experience a secondary phase of withdrawal which might last for 2 to 6 months.  Symptoms of secondary withdrawal include aching muscles, irritability, and insomnia.

Kadian withdrawal can be successfully managed with medically supervised detox.  Kadian detox normally takes about seven days and is usually followed by psychosocial treatment in a residential treatment center to address issues of psychological dependence and social readjustment.

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