Opioids like morphine and codeine cause addiction. However, heroin is the most commonly abused opioid. It is not used for treatment of any medical condition. Heroin is also used in combination with cocaine; the combination is called speedball. This combination gives an increased high feeling to the user.
Withdrawal symptoms of opioids include craving for the drug, anxiety, insomnia, yawning, palpitations and high blood pressure. Treatment of opioid dependence includes the following:
- Opioids like heroin are substituted by methadone, a long acting opioid. Methadone allows the patient to experience some pleasurable effects of opioids; thus the craving for opioids is reduced. At the same time, since it is taken orally, the patient is not exposed to diseases caused by injection drugs such as HIV and hepatitis. Since methadone acts for a long time, it needs to be taken just once a day. Hence it is used to prevent the patient from going back to his addiction.
- The patient is also administered a drug called clonidine. Clonidine helps to reduce symptoms of withdrawal such as nausea, vomiting, muscle cramps, palpitations and high blood pressure.
- Buprenorphine of buprenorphine naloxone combination given under the tongue is also used instead of methadone to prevent addiction relapse. Patients taking these drugs do no experience the same high with heroin as they experienced earlier.
- Naltrexone is another drug used to treat opioid dependence. It blocks the effect of opioids. However, it does not block craving or withdrawal symptoms, hence it is used only for patients who are highly motivated to stop taking the opioid.
- Goodman and Gilman. The Pharmacological Basis of Therapeutics 11th edition.