Heroin/Brown Sugar

Heroin  is a highly addictive drug also  called smack, junk, skag, dope, and chaw.

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It is derived from morphine which is a natural opioid derived from the seed pods of poppy plants.

It is usually a pale brown powder, white powder or sticky tar like called tar heroin.

As per the Times of India, heroin manufacturing in the South east Asian countries is about 40 tonnes  , 17 tonnes of which is consumed by India alone. This is stark evidence enough of the looming problem of heroin in the country.

Brown sugar which is the street form of heroin contains only 20 % heroin in it and is adulterated by talcum powder, milk powder, strychnine and other unknown substances. The adulterants makes it a very dangerous substance to consume.

Modes of intake

Snorting

Smoking

Chasing (most common for brown sugar) wherein the substance is placed on a tin foil, which is heated from beneath it and the fumes thus created are inhaled.

Fixed/injected – to inject brown or heroin it has to be mixed with an acid usually , ascorbic or citric acid. Even then many of the adulterants do not dissolve if it is brown sugar.

Heroin is many times mixed with Crystal meth – this is called “Speedballing”

The Effects

The instant effect is a surge of euphoria created by the substance attaching itself to the opioid receptors in the brain  .It affects the areas controlling, pain , pleasure, heart rate , sleeping and respiration.

Short term effects

Warmth of skin, dry mouth, heaviness of limbs, nausea, inability to function mentally.

Long term effects

Abscesses on body, ulcers, fired thickened walls of blood vessels, infection of the pericardium (lining of the heart) and the blood vessel linings Mental health issues like depression , anxiety etc. , sexual dysfunction in men and menstrual irregularities in women, liver and renal disease.

Diseases like Hepatitis C , HIV that are contracted due to sharing needles and risky sexual behavior of not using condoms during intercourse.

Overdose 

Overdose commonly occurs with heroin and can happen with brown sugar too and is on the rise.

As a person is overdosing the person’s respiratory rate reduces resulting in hypoxia or lack of oxygen to the brain, this can result in seizures, coma and even death or permanent brain damage.

Withdrawals on stopping heroin/brown sugar

Body ache- muscular and joint pains, at times bone pains- excruciating.

Strong cravings which can be uncontrollable

Stomach cramps

Muscular cramps

Restlessness

Uncontrolled shaking of the legs

Lachrymation, Coryza

Lack of appetite

Diarrhea and vomiting

Sleep issues at times excessive sleep

Since a few years in India in  the withdrawals from Brown sugar –  seizures have also been observed caused primarily due to the unknown adulterants that go into its making.

Treatment

Harm reduction

Across the workd harm reduction therapies have been tried for heroin and brown sugar which involves Buprenorphine and or Methadone being given at specified centres as per dose required to tide over the withdrawals.

However, Harm reduction has not been found to be too successful .

Long term successful treatment has been residential rehabilitation care after detox in a hospital. This in an environment that is voluntary, accepting, free, non- regimented,  non- judgmental, compassionate which involves  non -medical care with meditation, counseling and other alternate therapies as therapeutic techniques to go beyond finding the need to use.

The individual discovers self -love and dignity in life and learns to live a balanced fulfilling life.

LSD

LSD or D Lysergic acid di-ethylamide is from a class of drugs called Hallucinogens .

It is a clear odorless chemical made from lysergic acid which is derived from the fungus ergot growing on the rye plant.

Street names- Acid, Blotter, Dots, Yellow sunshine.

Modes of use- tablets, pills, swallowing as liquid, blotters which are the liquid dropped on paper and stuck to the upper palate or tongue from which it absorbs into the system.

Repeated use increases tolerance and consequent increased use which is dangerous , hence is believed to be included in chemicals with a potential for addiction.

History

It was first processed in 1938 by Albert Hoffman who got aware of its psychedelic properties when a few drops of the liquid fell on his skin and he started hallucinating.

In the early 1960s’ LSD was used in scientific research and for treatment of schizophrenia , addiction to alcohol , depression and spiritual enhancement etc.

Then it entered the streets and abused due to which it was made illegal and a Schedule 1 drug- indicating it is possible of high amounts of abuse.

Effects on brain.- called as a “trip”

Desegregation

The brain’s neural network is usually segregated. However, with the LSD the segregation is broken down and a connection with all parts of the brain develops resulting in a kind of ego dissolution.

Seeing with eyes shut- Visual hallucinations

The visual cortex is affected thereby, even with closed eyes the person is capable of seeing things which is the visual hallucinatory component of the drug. There are also profound changes in consciousness.

It can cause synesthesia whereby one can “feel” music and “taste” odors i.e. the sensory organ functions are all mixed up.

LSD is considered to be a fat soluble chemical – hence thought to stay in the fat cells of the body resulting in “flashbacks” wherein there are flashes of the same high or sudden hallucinations which last for some time and then disappear.

LSD induced psychoses is known to happen with multiple or even a single strong hit of the drug– called as Hallucinogen Persisting Perceptual Disorder (HPPD) Psychosis is a break from reality. This includes delusion ( false beliefs which are real to the person believing in them and cannot be altered by any amount of reasoning or confrontation with reality) and hallucinations

Problems also arise when the drug is used in combination with alcohol, weed etc.

Physical effects

Rapid heart rate, Imbalanced gait , loss of appetite, weakness , mild gastritis, vomiting etc.

Treatment

Residential stay for a substantial period as it takes 6-8 weeks for the susbtance to leave the tissues of the body. The stay ahs to be accepting, non threatening caring with love and compassion as its baseline. Mediation , Counseling and other alternate therapies are the need of the hour. Anatta is a luxury facility catering to the same.http://anatta.in

ADDICTION TO COUGH SYRUPS WITH CODEINE DERIVATIVES

The innocuous cough syrup that usually acts immediately when one has a common cold or bad cough in providing relief to us , can also become addictive if taken in unnatural amounts for a long enough period time.

The addictive component is the derivative of codeine or of opioid origin.

This requires a doctor’s prescription to obtain from the pharmacy.

The normal medical dose is 5-10ml a day about two or three times as advised by the physician.

Common brand names- Phensedyl, Corex etc.

If taken in large quantities it gives a drowsy feeling , buzzed out throughout the day which is then enjoyed by the person who is using it.

Quantities taken can be several bottles of 100ml or 50ml orally per day.

Side effects- Perspiration, insomnia, dryness of mouth, weight loss, lack of appetite, overt drowsiness, respiratory depression, pain in stomach, constipation, headache, dizziness, nausea , vomiting, anxiety, pancreatitis, Itchiness of skin, lowered blood pressure.

Long term effects of addiction - Insomnia, anxiety, nightmares, liver damage, physical pain, seizures, motor tremors, coma, death, multiple organ damage

Overdose- can result in - Pin point pupils, heaviness in chest, Unconsciousness, cyanosis (blueness around the lips and nail beds) , difficulty in breathing due to respiratory distress, Chest pain, sluggish pulse rate, vomiting, fatigue that is extreme.

Treatment

This involves stopping the substance to begin with . This can give rise to withdrawal symptoms that can be as follows-

Insomnia, stomach cramps, headaches, muscle pains, diarrhea, lack of appetite, rapid heartbeat, lachrymation, runny nose, yawning, heaviness in head, nausea, vomiting.

The period of Detoxification enables the individual seeking help to get beyond the withdrawals.

Treatment involves residential stay at a rehabilitation center for about 8-12 weeks in an accepting loving compassionate ambience. Treatment is of the addictive traits in the person and the inability to manage and deal with emotions that make the person doing the only thing they know to cope ie of using

Meditative techniques that are psychotherapeutic enable the client to relax, calm own, and bring to the fore suppressed and repressed emotions stored in the cellular memory. Counseling , sharing, writing and various alternate therapies facilitate in helping the client go beyond using to understanding oneself and living life fully without finding the need to use.

“I CAN HANDLE IT”

These are the four fatalistic words spoken by an alcoholic who is absolutely drunk…

And these are the very four words that more often than not take him to the grave.

“ I am sorry I will not do it again ..” after breaking the furniture for the umpteenth time the night before after getting drunk

“ He forced me to have a drink.. it is after all his birthday… I only had two.”

“  How can I not drink/use drugs… I was neglected as a child, my parents were never there when I was growing up… “ how old am I today? 30

“ I promise I will stop drinking from tomorrow itself.. today  I am feeling a little disturbed .. I need it.”

“  If you do not allow me too drink I will jump from the balcony”

“ I love you only, I will not look at another female..”  a guy high on drugs to his wife before calling his girlfriend after a minute.

“ Marijuana is not a drug . It is a herb , it is not addictive, it is legal in many countries in the world.”  A student who is stoned the entire day, grades are dropping and has auditory hallucinations as a consequence of using weed.

“ I will drink only 2 drinks today.. not more” this after having downed 4 drinks before coming home and kept 4 at the bar counter to gulp apart from the two had with the spouse.

“I can quit anytime”  “ I am not an alcoholic because I don’t drink since morning “  “ I don’t drink hard liquor hence I am not a alcoholic.”

“If you did not fight with me so much I would not drink “ “ you never appreciate me hence I took to drinks” “She broke my heart.. what could I do but drink?”

“You need treatment not me”

“ I cannot go to a rehab now, I have my business to look after, my children need me”

Sound familiar ?

How many times have you been caught in these web of apologies promises emotional blackmails et al…..  all  the web of manipulations spread by the person suffering from addiction . .

As a doctor I have seen clients of cirrhosis of the liver with fluid filling in their abdomen and vomiting blood and telling me I will be fine … I am waiting to attend the New Years bash at so n so’s place … it will be rocking! …. n soon drinking again without accepting help and not living to see the new year in . This is where the manipulation of the person addicted kills him …

By being socially manipulative they manage to keep their relationships alive on false promises, persuading partners to take on their responsibilities and take care of them . Plans and family outings  are made around using .. lies and deceptions and excuses made in order to drink/ use.  Many times parents and spouses even comply and get the alcohol and drugs themselves to prevent a fight or thinking if he/she uses at home he/she will remain safe . Thus the family unwittingly ends up enabling the addict .

Many times the addict starts believing his own fabricated stories which makes things worse as the lines between truth and falsehood blur.

The person risks reaching a state of mind in which the lying , making up stories and conniving are not considered wrong and seem to be a natural way of thinking and behaving. The masks become one with the face.

Causes of manipulation –

– Controlling those around

– Thinking that one will not be accepted or loved if one does not control

– Attention seeking

– All these lies and manipulations are to protect, guard, progress one’s usage of alcohol and drugs and throw a smokescreen on the same.

Consequences of manipulative behaviors

–  Loved ones around soon cry wolf as they see through the lies and deception

– The person addicted to alcohol/ drugs soon finds oneself isolated from friends , social dos and family and gets trapped in his/her own self deceptions and lies.

– The disease of addiction progresses as the person addicted keeps putting up blocks and obstacles in seeking or getting help through these manipulations.

Ways to avoid being manipulated for the co dependent

– You are not responsible for the drinking /using of the person addicted to the substance nor are you responsible to get him to stop doing so.

– From your own experiences with the person suffering from addiction identify and recognize when you have been manipulated.

– Realize you have the right to say no without feeling guilty even if made to feel so

-You are not responsible for keeping the addict happy so if you see the person being extremely polite to someone then in a split second being extremely rude and abrupt you are witness to classic manipulation . Keep a safe separation and detachment for your self preservation

–  If something unreasonable is being asked of you question it and probe and ask questions thus showing the mirror to the person addicted to the substance. If the person is a bit aware will realize that their manipulation has been seen through.

– Avoid self blame

Treatment

In treatment in order to get beyond one’s manipulative behavior

– Residential alcohol/drug rehab stay

– A treatment program that involves acceptance, inclusion, counseling, meditative techniques and other alternate therapies to enable the person addicted to identify, admit, accept and work introspectively towards taking responsibility of one’s actions and get beyond them thereby leading a joyful, honest full life not finding the need to use any alcohol/drugs.

Addiction to alcohol/drugs is literally a life or death situation. The manipulations , lies and deceptions are primarily self directed and are cries for help. By the time usage reaches addiction, the alcohol and drugs hijack the individual physically, mentally and spiritually.  Professionals who have the experience in treatment that is voluntary can facilitate the person into receiving help.

Reach out. Help is available.
Rehab India | Alcohol Rehabilitation Centre in India

Mephedrone aka m-cat aka meow- meow

A drug that has taken the Mumbai streets by storm due to lacunae created by poor quality cocaine and is cheaper than it, is Mephedrone also known as M-CAT/ meow-meow/plant food etc.

Mephedrone [4-methyl methcathinone (4-MMC) or 4-methyl ephedrone,] is a synthetic stimulant akin to amphetamines and is a cathinone similar to those found in the psychostimulant plant Khath used in Africa. It is sold across the world as plant food and research chemicals online in order to by pass legal bans and routes.

History 

It was first discovered in 1929 but went into obscurity till it was re synthesized by an underground chemist in Israel in about 2003 .

Mode of use– snorting, rectally, orally in tablets, intravenously.

Even today  the complete and long term effects of the drug on the brain and body have not been researched .  Hence what is known is from short term studies and effects observed in users and shared by them.

Effects

Users have described its effects to be akin to the effects of MDMA and cocaine.

Its effects set in within 15minutes to half an hour of snorting it and lasts for 3-4 hours.

It  creates a sense of euphoria, elation, sleeplessness, a sharpness and mental acuity that makes one feel very productive and able to focus better . It also creates a markedly heightened sexual desire with intercourse lasting for hours. This increases the chance of risky sexual behavior increasing the propensity to sexually transmitted diseases like HIV, Hepatitis B, Hepatitis C etc.

Currently mephedrone is used in many places in the world for what are called as ““chemsex” parties .

Body and brain-

-It creates a complete lack of appetite wherein users do not eat at all while in the phase of using and consequently loose weight and fall ill.

-The pupils  are dilated,

there is an increase in heart rate of the drug user/ person addicted to the drug. Since the effect lasts only for a few hours the frequency of usage and quantity of usage gradually increase thus making abuse of the drug very easy.

-There is no low feeling or depression following the stoppage of use.

-Short term memory is grossly affected.

-Anxiety and paranoia are seen in some.

-Heightened nervous stimulation is seen in some resulting seizures.

-It also creates in some a feeling of affection towards people around.

-Teeth grinding , jaw clenching , cold fingers and toes are some other effects.

Withdrawals

Physical- Body ache, headache, heart palpitations, constipation, increased appetite,  excessive sleepiness, lachrymation, watering of the nose.

Mental- irritability , restlessness

Solution

The solution for someone addicted to the drug is a residential treatment program in a voluntary drug rehabilitation facility wherein the treatment program is voluntary, non medical and incorporating counseling , meditation and other therapies are incorporated . We at Anatta offer such a program wherein the individual is treated with understanding and acceptance and his/her confidentiality and anonymity is maintained.

HOW TO TALK TO YOUR CHILD ABOUT A PARENT’S ADDICTION

Growing up in a family in which a member is addicted to alcohol or drugs , can be chaotic and scary to a child. Witnessing the fights and the tears between the parents and the displaced anger they are inflicted upon many times makes them believe that they are responsible for the drinking or using of their addicted parent.  It is confusing. They can get reactive, aggressive angry. The academic studies are affected. They can become under achievers or over achievers to compensate for the helplessness and anger they feel. Many a time they too begin using addictive substances. They can be more mature for their age.

They are faced with repeated promises of giving up and being lied to and lied about by their addicted loved one. Taking care of ones needs in such situations seems not right to them.
How to speak to your child depends on their age. the primary premise being the child should be told the truth in an age appropriate manner.
The following general guidelines can be followed:
The affection on the child and its impact has to be acknowledged and the child has to be encouraged to express its feelings.
The shame associated is to addressed. Many times the parent blames the chid for their usage causing them to take on responsibility for their using. They need to be explained that the parent under influence is very different and they are also helpless about their use.
It takes time for a child of an addict to process their emotions to identify and express them without fear. An environment where they can do so should be created
Below 10years- Children can identify with feeling  an intense desire to want a toy and want it when they want it and throwing a tantrum when they are unable to get it and many times their mind tells them “no” but they cannot help themselves. It can be explained that their  parent behaves in the same manner when they want to drink alcohol or use drugs. And even when they know they are making the wrong choice they still choose it.
Very young children can be told that their parent /loved one is ill  from an addiction.
Early teens-They find it difficult to listen to long winding explanations. It is better to ask their understanding of the situation at home and answer their questions honestly.
Older teens : today are already seeing substance use and addiction around them in their friends so identifying the same in their parents is not difficult. Hence ,  trying to minimize their loved ones usage is not right. An opening to the conversation can be that “ you had seen your dad trip down the stairs and I had to help him get to bed. “ they will share similar experience and from there it can be explained that the parent  is afflicted by addiction , what it is, and how the effort is to motivate them to go for treatment to a alcohol/drug rehab.
One person of the family preferably a parent or a counselor of the family trained in addiction and co dependency treatment speaks to the child and passes on the facts. This prevents confusion and gossip to the kids.
The National Association for Children of Alcoholics,say ,Annata Drug Alcohol Rehab centre Indiachildren need to know the “Seven Cs of Addiction”:
I didn’t Cause it.
I can’t Cure it.
I can’t Control it.
I can Care for myself
By Communicating my feelings,
Making healthy Choices, and
By Celebrating myself.
Every day a child lives with an addicted parent it is becoming damaged psychologically. Other sources of help need to be also taken- such as Al a Teen the self help group for children of those addicted to substances. Also regular Counseling by an experiential Co dependency counselor or one who has worked in the field for long needs to be done as when they see non judgmental acceptance with love being imparted they feel safe to emote , trust and express and receive help.
We provide this facility in AH to all children of our clients and have seen them blossom with self love and care.

ADDICTION AND NUTRITION

Alcohol and drug abuse /addiction can result in numerous and gross nutritional deficiencies that hamper the physical and mental health of the individual. A healthy diet plays a major role in sustaining and improving the quality of life in recovery.
Alcohol and drug use can affect nutrition in the following ways
(i)  Not eating- drinking and using drugs causes a drop in appetite and at times they forget to eat.
(ii)  Eating insufficient– Drinking /using drugs is given a priority over eating .
(iii)  Overeating- at times there can be an increased appetite due to drug and alcohol use and the person eats unconsciously without an idea of satiety.
(iv)  Damage to organs- Alcohol and drug abuse can result in damage to the liver, pancreas, stomach, intestinal linings which are all involved in the digestion, absorption and retention of nutrients in the body.
(v)  Drop in Immunity- The depletion of nutrients causes a fall in immunity making the person prone to various ailments
(vi)  Gastrointestinal disorders
(vii)  drop in glucose levels resulting in mental and physical imbalances.
Alcohol
Those addicted to alcohol have poor food intake. Either they do not eat at all in order to drink or eat a lot without awareness of satiety.
In both cases there is nutritional depletion as the body is busy processing the alcohol that needs to be metabolized before the food.
Alcohol results in inflammation of the gut and stomach lining  resulting in indigestion, acid reflux, gastritis, malabsorption resulting in diarrhea and consequent dehydration.
Severe deficiencies of Thiamine, B12,B6 and Folic acid develop resulting in conditions like peripheral neuritis , anemia, fatigue, headache, memory problems and Wernicke Korsakoff syndrome due to Thiamine deficiency.
Muscle wasting, immunity reduction happens making the person prone to ailments , and in Indians the most common ailment that afflicts a person when the immunity drops is Tuberculosis.
Chronic alcohol use can cause significant damage to the liver and pancreas which are involved in digestion of proteins, fats, carbohydrates , hormones and sugar balance thus causing an imbalance in them.
Opiates
Withdrawals from drugs like opium, heroin etc results in cramps and severe diarrhea preventing the person from eating resulting in dehydration and electrolyte imbalance. Eating carbohydrates and enough fluids will tide over this.
Stimulants -like amphetamines, MDMA, Crystal meth, cocaine
Stimulants keep the drug user awake for hours on end, hyperactive and kills the appetite whereby people do not eat for days  . This results in malnutrition , electrolyte and hormonal imbalance leading to severe weight loss, muscle loss, alopecia, increased risk of infections , heart ailments, depression, apathy, confusion etc.
In treatment, eating more  can result in an upset digest system as it is just getting used to food. this requires an experienced medical care. meals should be had in small portions.
Marijuana
Marijuana usage results in a ravenous appetite but for mainly junk food excessive consumption of which can result in obesity. Lack of any nourishment in junk food results in malnutrition also. There is a deficiency of omega 3 and omega 6 fatty acids which can result in skin ailments like eczema, rash and other inflammatory processes. Healing of wounds is delayed and susceptibility to infections is increased.
Diet during Treatment and Recovery
-A craving for sweets develops in most people in recovery from addiction to alcohol and drugs , as sweets trigger the same dopamine reward pathway that are triggered by the substances in brain.
-Exercise regularly- various yoga asanas aid in bringing the hormonal balance in the body and regain optimum organ functioning, regain physical and mental balance and core muscle tone. Start working out slowly being in connect with one’s body as the existent muscle wasting and lack of tone if pushed into working out too soon and too hard will result in recurrent injuries.
-Eat more complex carbs – Green vegetables,Whole grains and foods made from them, such as and whole-grain breads,rotis, Starchy vegetables such as potatoes, sweet potatoes, corn, and pumpkin, Beans, lentils, and peas.
(i)  Eat small portions of frequent meals, the appetite will slowly improve.
(ii)  There should be an increase in intake of fiber which will maintain gut health and proteins would help build muscles affected by alcohol and drug abuse.
(iii)  Avoid or reduce Caffeine intake in the form of coffee or carbonated drinks.
(iv)  Have plenty of water
(v)  Taking supplements of vitamins and minerals are essential as they will help initially to replenish immediate deficiencies and then enable the body to function well.
Every treatment /rehab facility should have a good and nutritious diet provision with adequate opportunities to exercise . We at AH provide such  an optimum  blend of nutrition and physical and mental growth in a luxurious ambience.
Alcohol Rehabilitation Centers In Mumbai