Explain the different treatments for heroin abuse. Address why they work. Additionally, address the negatives associated with the different forms of treatment

Question

What will be an ideal response?

Answer 1

Answer: For the heroin abuser seeking treatment for heroin dependence, the two primary difficulties are the short – term effects of heroin withdrawal and the long-term effects of heroin craving. Any successful treatment must combine a short-term and long-term solution.

Traditionally, it has been possible to make the process of withdrawal from heroin, called detoxification less distressing to the abuser by reducing the level of heroin in a gradual fashion under medical supervision rather than withdrawing from heroin "cold turkey" In medical settings, a synthetic opiate such as propoxyphene (brand name: Darvon) or methadone has been administered to replace the heroin initially; then doses of these so-called transitional drugs
are decreased over a period of two weeks or so.
For the heroin abuser seeking out medical treatment for heroin dependence, the most immediate problem is getting the drug out of the abuser's system during detoxification with a minimum of discomfort and distress. In some procedures, the administration of naloxone
has been used to speed up withdrawal and reduce the severity of physiological symptoms.
After detoxification, however, the long-term problem of drug dependence remains. The craving for heroin persists, and the abuser most often has little choice but to return to a drug-oriented environment where the temptations to satisfy the craving still exist.

One strategy has been to have a detoxified heroin abuser participate in a program in which oral administrations of the synthetic opiate methadone are essentially substituted for the injected heroin. This treatment approach, called methadone maintenance, was initiated in New York City through the joint efforts of Vincent Dole, a specialist in metabolic disorders, and Marie Nyswander, a psychiatrist whose interest had focused on narcotic dependence. Their idea was that if a legally and carefully controlled narcotic drug was available to heroin abusers on a regular basis, the craving for heroin would be eliminated, their drug-taking life-style would no longer be needed, and they could turn to more appropriate social behaviors such as steady employment and a more stable family life.

The general philosophy behind their program was that heroin abuse was essentially a chronic metabolic disorder requiring a long-term maintenance drug for the body to "normalize"
the drug abuser.