Illicit Drug Use: Effects of Heroin and Interventions for Management
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This assignment discusses the harmful effects of heroin on the physical and mental health of users, as well as its impact on society. It also explores different interventions for managing heroin addiction, including cognitive-behavioral therapy, contingency management, and self-help groups.
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Running head: ILLICIT DRUG USE
ILLICIT DRUG USE
Name of the student:
Name of the university:
Author note:
ILLICIT DRUG USE
Name of the student:
Name of the university:
Author note:
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1
ILLICIT DRUG USE
Illicit drugs are those that are illegal to make, sell as well as to use. Most of the illicit
drugs are seen to be highly addictive and they pose serious risks on the physical as well as the
mental health of human beings who use them. Researchers have noted that these drugs mainly
begin as an experiment or might also begin because of curiosity (Jones et al. 2013). In the other
cases, it is seen to mainly begin from the instances of using prescription pain medication that are
prescribed for treatment of an illness or for an injury. Over the course of time, it is seen that a
user may become hooked on the mental as well as the physical effects of the drug. Often the user
is seen to use more of the drugs to get on the desired effects. Without help, such individuals
become highly vulnerable to different types of threats such as health issues or safety issues
(Bogenschutz et al. 2014). This assignment would be mainly depicting one of the most harmful
drug called the heroin and how it affect the life of the user in many ways. It will also show how
different interventions need to be taken by the healthcare government so that effective care is
provided to help them withdraw themselves from such addiction.
Problem or problematic drug use can be referred as the drug use that might be dependent
as well as recreational. It must be remembered that it is not the frequency of the drug use, which
is the primary “problem”, but actually the effects that the habit of drying taking might have on
the life of the user. The user might experience social, psychological, financial, physical as ell as
the legal problems as the result of the effects of the drugs. Addiction is the word that is closely
associated with the problematic drug abuse. Addiction can be referred to as the disease that has
the capability of affecting the brain as well as the behavior (Bucehl et al. 2017). When an
individual becomes addicted to the drugs, the person cannot resist the urge of using them no
matter how much harm each of the drugs might cause them. Initially individuals believe that they
may chose to take the drug because of the pleasure or the way it makes them feel. The individual
ILLICIT DRUG USE
Illicit drugs are those that are illegal to make, sell as well as to use. Most of the illicit
drugs are seen to be highly addictive and they pose serious risks on the physical as well as the
mental health of human beings who use them. Researchers have noted that these drugs mainly
begin as an experiment or might also begin because of curiosity (Jones et al. 2013). In the other
cases, it is seen to mainly begin from the instances of using prescription pain medication that are
prescribed for treatment of an illness or for an injury. Over the course of time, it is seen that a
user may become hooked on the mental as well as the physical effects of the drug. Often the user
is seen to use more of the drugs to get on the desired effects. Without help, such individuals
become highly vulnerable to different types of threats such as health issues or safety issues
(Bogenschutz et al. 2014). This assignment would be mainly depicting one of the most harmful
drug called the heroin and how it affect the life of the user in many ways. It will also show how
different interventions need to be taken by the healthcare government so that effective care is
provided to help them withdraw themselves from such addiction.
Problem or problematic drug use can be referred as the drug use that might be dependent
as well as recreational. It must be remembered that it is not the frequency of the drug use, which
is the primary “problem”, but actually the effects that the habit of drying taking might have on
the life of the user. The user might experience social, psychological, financial, physical as ell as
the legal problems as the result of the effects of the drugs. Addiction is the word that is closely
associated with the problematic drug abuse. Addiction can be referred to as the disease that has
the capability of affecting the brain as well as the behavior (Bucehl et al. 2017). When an
individual becomes addicted to the drugs, the person cannot resist the urge of using them no
matter how much harm each of the drugs might cause them. Initially individuals believe that they
may chose to take the drug because of the pleasure or the way it makes them feel. The individual
2
ILLICIT DRUG USE
may think that he has the entire capability to control the amount as well as the frequency of
taking the drugs. However, in course of time, drugs start on altering the control of the brain. The
physical challenges are seen to last over a long period. The individual gradually starts to lose the
self-control and this in turn lead to damaging behaviors (Carlson et al. 2016).
Heroin can be defined as the opioid drug that is prepared from the substance called
morphine. It is also the natural substance that is usually extracted from the seedpod of the
various opium poppy plants. These are mainly grown in the regions like that of the southeast as
well as the southwest Asia, Mexico as well as Columbia (Johnston et al. 2018). It can be either a
white as well as the brown powder or it can also be a black substance which is quite sticky and is
called the black tar heroin as well. People are mainly seen to take in the drug either by injecting,
sniffing, snorting as well as smoking heroin. Many of the people are seen to form a mixture of
heroin with that of crack cocaine and different people mainly call this practice as the process of
speedballing.
Huge number of effects may result when persons gets engaged in problematic use of
drugs especially of that of heroin. It mainly enters the brain in a rapid manner and thereby binds
to opioid receptors on the cells that are located in different regions. These regions are involved in
the feelings of the pain as well as pleasure. These regions are also responsible for the controlling
of the heart rate as well as sleeping and even breathing. People who use heroin are seen to feel a
rush that is actually a surge for the pleasure as well as the euphoria (Roy et al. 2014). There are
many other common effects as well that include drying of the mouth as well as warm, flushing of
the skin. Moreover, the individuals also feel heavy on their arms and legs. They also suffer from
nausea and vomiting. There is also severe itching that includes clouded mental functioning.
ILLICIT DRUG USE
may think that he has the entire capability to control the amount as well as the frequency of
taking the drugs. However, in course of time, drugs start on altering the control of the brain. The
physical challenges are seen to last over a long period. The individual gradually starts to lose the
self-control and this in turn lead to damaging behaviors (Carlson et al. 2016).
Heroin can be defined as the opioid drug that is prepared from the substance called
morphine. It is also the natural substance that is usually extracted from the seedpod of the
various opium poppy plants. These are mainly grown in the regions like that of the southeast as
well as the southwest Asia, Mexico as well as Columbia (Johnston et al. 2018). It can be either a
white as well as the brown powder or it can also be a black substance which is quite sticky and is
called the black tar heroin as well. People are mainly seen to take in the drug either by injecting,
sniffing, snorting as well as smoking heroin. Many of the people are seen to form a mixture of
heroin with that of crack cocaine and different people mainly call this practice as the process of
speedballing.
Huge number of effects may result when persons gets engaged in problematic use of
drugs especially of that of heroin. It mainly enters the brain in a rapid manner and thereby binds
to opioid receptors on the cells that are located in different regions. These regions are involved in
the feelings of the pain as well as pleasure. These regions are also responsible for the controlling
of the heart rate as well as sleeping and even breathing. People who use heroin are seen to feel a
rush that is actually a surge for the pleasure as well as the euphoria (Roy et al. 2014). There are
many other common effects as well that include drying of the mouth as well as warm, flushing of
the skin. Moreover, the individuals also feel heavy on their arms and legs. They also suffer from
nausea and vomiting. There is also severe itching that includes clouded mental functioning.
3
ILLICIT DRUG USE
They have also stated in many interviews that they feel like going “on the nod” which is actually
a back and forth state of being conscious and semiconscious.
Some of the long-term effects of the use of heroin involve insomnia. They face situations
with collapsed veins and this occurs for individuals who inject the drug. The people who sniff or
snort the drug are mainly seen to have damaged tissues inside their nose. Infection in the heart
lining as well as valves are also seen to occur and symptoms of abscesses with swollen tissue
filled with pus are also noticed. Effects like constipation as well as stomach cramping also takes
place along with liver as well as kidney disorders (Wegmen et al. 2017). Therefore, all these
physical disorders give them a very hard time making them live poor quality lives. Many of the
researchers are also of the opinion that lung complications including the prevalence of
pneumonia in such individuals are noticed by them. The individuals going through the
problematic use of heroin are also seen to suffer from mental disorders that include depression as
well as anti-social personality disorder. Sexual dysfunction in the men as well as irregular
menstrual cycles in the women is seen to be some of the symptoms that affect such individuals.
Different types of potential effects are also seen to accompany such behavior. The heroin
is seen to comprise of additives that include sugar, starch as well as powdered milk. This has the
ability to clog blood vessels that lead to permanent damages to the lungs, kidney, brain and the
liver. Moreover, in many cases, it is seen that sharing drug injection and the equipments and
along wise having impaired judgment from drug abuse can in turn result in increasing the risk for
the contraction of the infectious disorders (Klimas et al. 2016). This might include HIV as well
as hepatitis that have huge impact on the quality of lives of the people. Overdose of heroin has
been seen to increase in the recent years where death due to overdose id reported. Overdose of
heroin is mainly seen to occur when an individual utilizes enough of the drugs for producing a
ILLICIT DRUG USE
They have also stated in many interviews that they feel like going “on the nod” which is actually
a back and forth state of being conscious and semiconscious.
Some of the long-term effects of the use of heroin involve insomnia. They face situations
with collapsed veins and this occurs for individuals who inject the drug. The people who sniff or
snort the drug are mainly seen to have damaged tissues inside their nose. Infection in the heart
lining as well as valves are also seen to occur and symptoms of abscesses with swollen tissue
filled with pus are also noticed. Effects like constipation as well as stomach cramping also takes
place along with liver as well as kidney disorders (Wegmen et al. 2017). Therefore, all these
physical disorders give them a very hard time making them live poor quality lives. Many of the
researchers are also of the opinion that lung complications including the prevalence of
pneumonia in such individuals are noticed by them. The individuals going through the
problematic use of heroin are also seen to suffer from mental disorders that include depression as
well as anti-social personality disorder. Sexual dysfunction in the men as well as irregular
menstrual cycles in the women is seen to be some of the symptoms that affect such individuals.
Different types of potential effects are also seen to accompany such behavior. The heroin
is seen to comprise of additives that include sugar, starch as well as powdered milk. This has the
ability to clog blood vessels that lead to permanent damages to the lungs, kidney, brain and the
liver. Moreover, in many cases, it is seen that sharing drug injection and the equipments and
along wise having impaired judgment from drug abuse can in turn result in increasing the risk for
the contraction of the infectious disorders (Klimas et al. 2016). This might include HIV as well
as hepatitis that have huge impact on the quality of lives of the people. Overdose of heroin has
been seen to increase in the recent years where death due to overdose id reported. Overdose of
heroin is mainly seen to occur when an individual utilizes enough of the drugs for producing a
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4
ILLICIT DRUG USE
life threatening situation mainly deaths. It is seen that when people overdose of heroin, , their
breathing is seen to stop and this can lead to decrease in the amount of the oxygen which reaches
the brain and this is called the hypoxia. This has the capability of short as well as long-term
effects along with different effects on the nervous system. This includes coma as well as
permanent damage of the brain (Surrat et al. 2017).
The effects of drugs on the society are quite dangerous. Utilization of heroin results in
imposing preventable health burden on the healthcare system of the nation. Abusing of the drugs
as well as alcohol can come with different types of side effects that require support as well as
resources from the healthcare, lost revenue and even damages and healthcare. Researchers have
found out rippling effects of heroin utilization that include different types of activities like sexual
assaults, prison sentences as well as foster care placements. It is also seen to include child abuse
as well as different work-related injuries. Many researchers are of the opinion that more the
certain individuals of the society utilize the drugs, the more the society or the nation pay as the
whole. It is also true that heroin use by individuals has the capability of monopolizing the
healthcare resources as it has been seen that every year the drug abuse costs around millions of
euro (Taylor et al. 2016). Healthcare is always found to be responsible for rehabilitation
programs as well as services and different mental disorders as well as other types of injuries that
relate to drug abuse and even addiction. Researchers are of the opinion that such drug abuse
seem to impose a demand of tax as well as healthcare resources which could be directed towards
different types of other positively beneficial costs and various types of life saving endeavors.
Therefore, such cases should be handled with strictness.
It is also seen to disrupt the family units resulting on extensive toll on the families. This
can in turn result in different negative impacts on the societies. One family member abusing the
ILLICIT DRUG USE
life threatening situation mainly deaths. It is seen that when people overdose of heroin, , their
breathing is seen to stop and this can lead to decrease in the amount of the oxygen which reaches
the brain and this is called the hypoxia. This has the capability of short as well as long-term
effects along with different effects on the nervous system. This includes coma as well as
permanent damage of the brain (Surrat et al. 2017).
The effects of drugs on the society are quite dangerous. Utilization of heroin results in
imposing preventable health burden on the healthcare system of the nation. Abusing of the drugs
as well as alcohol can come with different types of side effects that require support as well as
resources from the healthcare, lost revenue and even damages and healthcare. Researchers have
found out rippling effects of heroin utilization that include different types of activities like sexual
assaults, prison sentences as well as foster care placements. It is also seen to include child abuse
as well as different work-related injuries. Many researchers are of the opinion that more the
certain individuals of the society utilize the drugs, the more the society or the nation pay as the
whole. It is also true that heroin use by individuals has the capability of monopolizing the
healthcare resources as it has been seen that every year the drug abuse costs around millions of
euro (Taylor et al. 2016). Healthcare is always found to be responsible for rehabilitation
programs as well as services and different mental disorders as well as other types of injuries that
relate to drug abuse and even addiction. Researchers are of the opinion that such drug abuse
seem to impose a demand of tax as well as healthcare resources which could be directed towards
different types of other positively beneficial costs and various types of life saving endeavors.
Therefore, such cases should be handled with strictness.
It is also seen to disrupt the family units resulting on extensive toll on the families. This
can in turn result in different negative impacts on the societies. One family member abusing the
5
ILLICIT DRUG USE
drug has the ability to disrupt normal flow of quality life of all the other members as well. It
might create strains of the spousal relationship along with driving the partner of the patient into
frustration as well as fatigue. This disrupts their effort at the work as well as in parenting and
even affects friendships. It also affects the ability of caring for their own selves. When the
parents abuse drugs, it results in the children getting inadequate as well as improper care. This
results in poorer childhood health (Kolodny et al. 2015). This also results in reduction of
academic performance as well as neglected emotional support and more. As the children of such
abusers are denied necessities of the parenting like shelter and food, their involvement as well as
contribution to societies, participation in community later on is hindered. Emotional burden gets
heavier that makes the children to turn to drugs or alcohol as the coping mechanism and this
cyclical negative procedure continues.
Heroin abuse also results in occurrence of different types of crimes. Federal prison
occupancy is seen to be accounted for by the individuals that include incarcerations related to
drug abuse as well as addiction. Individuals commit all crimes like sexual harassment, theft,
ragging as well as threatening other individuals of the society, driving and accidents when they
come under the influence of the drug (Cicero et al. 2014). All these cost society its resources,
efforts, time as well as safety. The other negative outcome is that it indirectly affects the GDP of
the nation as drug abuse of heroin also causes bringing down of the productivity of the work. The
individuals who face the problematic drug use often get late, absent or mentally impaired on the
job. This often requires other employees for making up for their lack of productivity. It
encompasses straining the work capacity of fellow employees that causes triggering of the
irritation as well as exhaustion in these employees. This again has ripple effects on the
ILLICIT DRUG USE
drug has the ability to disrupt normal flow of quality life of all the other members as well. It
might create strains of the spousal relationship along with driving the partner of the patient into
frustration as well as fatigue. This disrupts their effort at the work as well as in parenting and
even affects friendships. It also affects the ability of caring for their own selves. When the
parents abuse drugs, it results in the children getting inadequate as well as improper care. This
results in poorer childhood health (Kolodny et al. 2015). This also results in reduction of
academic performance as well as neglected emotional support and more. As the children of such
abusers are denied necessities of the parenting like shelter and food, their involvement as well as
contribution to societies, participation in community later on is hindered. Emotional burden gets
heavier that makes the children to turn to drugs or alcohol as the coping mechanism and this
cyclical negative procedure continues.
Heroin abuse also results in occurrence of different types of crimes. Federal prison
occupancy is seen to be accounted for by the individuals that include incarcerations related to
drug abuse as well as addiction. Individuals commit all crimes like sexual harassment, theft,
ragging as well as threatening other individuals of the society, driving and accidents when they
come under the influence of the drug (Cicero et al. 2014). All these cost society its resources,
efforts, time as well as safety. The other negative outcome is that it indirectly affects the GDP of
the nation as drug abuse of heroin also causes bringing down of the productivity of the work. The
individuals who face the problematic drug use often get late, absent or mentally impaired on the
job. This often requires other employees for making up for their lack of productivity. It
encompasses straining the work capacity of fellow employees that causes triggering of the
irritation as well as exhaustion in these employees. This again has ripple effects on the
6
ILLICIT DRUG USE
relationship with the partners, friends as well as the families. This in turn affects the ability of
functioning optimally for the work.
Psychosocial interventions can be explained as the structured psychological as well as
social interventions that are used for addressing of the substance related problems like the
problematic use of heroin. Researchers are of the opinion that such therapies can be utilized at
different stages of drug treatment for identification of the problem, treating it as well as assisting
it with social reintegration. An effective way, which is often used, by counselors or other
healthcare professionals, is the motivational interviewing (Hassamal et al. 2017). It a
collaborative conversation method that remains mainly aimed at the strengthening of the
motivation of the person and committing to changes. It would be used in many different
situations where the healthcare professionals help the individuals to take decisions and
accordingly help individuals to overcome the disorder (Vasquez et al. 2017). Another therapy is
the brief intervention that mainly includes the collaborative conversation style of the
motivational interviewing helping to address the problematic or risky drug use but this is
delivered in a shorter timeframe ranging from 5 to 30 minutes. This is mainly believed to be
based on the 5As which are based on ask, advise, assess, assist and arrange. Professionals
including physicians, nurses and other healthcare workers provide such therapies (Blanken et al.
2016).
Cognitive behavioral therapy is one of the best therapies that help clients in building self-
confidence as well as address the thoughts that are believed to be at the root of the drug
problems. This therapy helps in learning the recognition and handling of the factors that trigger
them. Following the diagnosis of the heroin dependence, licensed therapists provide the therapies
in the outpatient settings. Such sessions are nowadays also provided in the residential treatment
ILLICIT DRUG USE
relationship with the partners, friends as well as the families. This in turn affects the ability of
functioning optimally for the work.
Psychosocial interventions can be explained as the structured psychological as well as
social interventions that are used for addressing of the substance related problems like the
problematic use of heroin. Researchers are of the opinion that such therapies can be utilized at
different stages of drug treatment for identification of the problem, treating it as well as assisting
it with social reintegration. An effective way, which is often used, by counselors or other
healthcare professionals, is the motivational interviewing (Hassamal et al. 2017). It a
collaborative conversation method that remains mainly aimed at the strengthening of the
motivation of the person and committing to changes. It would be used in many different
situations where the healthcare professionals help the individuals to take decisions and
accordingly help individuals to overcome the disorder (Vasquez et al. 2017). Another therapy is
the brief intervention that mainly includes the collaborative conversation style of the
motivational interviewing helping to address the problematic or risky drug use but this is
delivered in a shorter timeframe ranging from 5 to 30 minutes. This is mainly believed to be
based on the 5As which are based on ask, advise, assess, assist and arrange. Professionals
including physicians, nurses and other healthcare workers provide such therapies (Blanken et al.
2016).
Cognitive behavioral therapy is one of the best therapies that help clients in building self-
confidence as well as address the thoughts that are believed to be at the root of the drug
problems. This therapy helps in learning the recognition and handling of the factors that trigger
them. Following the diagnosis of the heroin dependence, licensed therapists provide the therapies
in the outpatient settings. Such sessions are nowadays also provided in the residential treatment
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ILLICIT DRUG USE
facilities as well as in the prisons. Family therapies are also another effective mode of
management interventions of heroin drug abuse and the different problems behaviors that remain
associated with it. This therapy is best applicable during the time of adolescence when heroin use
might cause various types of problems like psychiatric symptoms, different types of problems at
the schools and different high risk sexual behaviors (Cicero et al. 2017).
Contingency management is mainly seen to be referring to the set of interventions that
would involve different concrete rewards for the clients who would achieve their target
behaviors (Moore et al. 2016). The approach is also based around recognition and controlling of
the relationships between the different behaviors and their consequences. Contingency
management is helpful in maintaining the abstinence by the reinforcement of and rewarding of
the alternative behavior to the drug use. This is mainly done with the aim of making the
abstinence a more positive experience. For example, it can be used during heroin drug treatment
of the patient who has remained abstinent or for incentivizing the presence of the user at the
work in social re-integration programs. Self-help groups are voluntarily not for profit
organizations (Kanouse et al. 2015). In this region, people are mainly seen to meet for discussion
as well as addressing of the of the shred addiction problems. They also provide support for each
other with the senior members of the team mentoring or sponsoring the new ones. Researchers
are of the opinion that as the groups are led by former drug users and hence the situations are
well understood by them and interventions provided are much helpful. Such groups can work in
different places within the community as well as in healthcare settings and in prisons (Chang et
al., 2016).
From the entire discussion, it becomes clear that heroin is an illicit drug coming from
opium poppy and problematic use of the drug might lead to addiction. It affects the brain rapidly
ILLICIT DRUG USE
facilities as well as in the prisons. Family therapies are also another effective mode of
management interventions of heroin drug abuse and the different problems behaviors that remain
associated with it. This therapy is best applicable during the time of adolescence when heroin use
might cause various types of problems like psychiatric symptoms, different types of problems at
the schools and different high risk sexual behaviors (Cicero et al. 2017).
Contingency management is mainly seen to be referring to the set of interventions that
would involve different concrete rewards for the clients who would achieve their target
behaviors (Moore et al. 2016). The approach is also based around recognition and controlling of
the relationships between the different behaviors and their consequences. Contingency
management is helpful in maintaining the abstinence by the reinforcement of and rewarding of
the alternative behavior to the drug use. This is mainly done with the aim of making the
abstinence a more positive experience. For example, it can be used during heroin drug treatment
of the patient who has remained abstinent or for incentivizing the presence of the user at the
work in social re-integration programs. Self-help groups are voluntarily not for profit
organizations (Kanouse et al. 2015). In this region, people are mainly seen to meet for discussion
as well as addressing of the of the shred addiction problems. They also provide support for each
other with the senior members of the team mentoring or sponsoring the new ones. Researchers
are of the opinion that as the groups are led by former drug users and hence the situations are
well understood by them and interventions provided are much helpful. Such groups can work in
different places within the community as well as in healthcare settings and in prisons (Chang et
al., 2016).
From the entire discussion, it becomes clear that heroin is an illicit drug coming from
opium poppy and problematic use of the drug might lead to addiction. It affects the brain rapidly
8
ILLICIT DRUG USE
resulting in both short term and long term effects physically affecting the health of the person.
Moreover, it also affects the family of the users where spouse separation and emotional turmoil
results. Children in the household have poorer health deprived of healthy childhood, education,
shelter and food and in turn get involved in negative cyclical sequence and getting involved in
drug abuse. Moreover, it also results in increased expenditure of hospital resources which could
have been allocated for severe acute of chronic health issues of other citizens, crimes, jail times,
murders, accidents, sexual assaults also results them in legal punishments and hence impacts the
society. Moreover, it is also seen that communities can also be affected and productivity of the
organizations would be also hampered due to absenteeism, late coming, poor quality work and
many others. Different types of interventions can be applied which would include Psychosocial
interventions, Motivational interviewing, Brief interventions, Self-help groups, Cognitive
behavioral therapy (CBT), Family therapy as well as Contingency management. Healthcare
professionals have the responsibility of helping such individuals providing them a safe and
quality future.
ILLICIT DRUG USE
resulting in both short term and long term effects physically affecting the health of the person.
Moreover, it also affects the family of the users where spouse separation and emotional turmoil
results. Children in the household have poorer health deprived of healthy childhood, education,
shelter and food and in turn get involved in negative cyclical sequence and getting involved in
drug abuse. Moreover, it also results in increased expenditure of hospital resources which could
have been allocated for severe acute of chronic health issues of other citizens, crimes, jail times,
murders, accidents, sexual assaults also results them in legal punishments and hence impacts the
society. Moreover, it is also seen that communities can also be affected and productivity of the
organizations would be also hampered due to absenteeism, late coming, poor quality work and
many others. Different types of interventions can be applied which would include Psychosocial
interventions, Motivational interviewing, Brief interventions, Self-help groups, Cognitive
behavioral therapy (CBT), Family therapy as well as Contingency management. Healthcare
professionals have the responsibility of helping such individuals providing them a safe and
quality future.
9
ILLICIT DRUG USE
References:
Blanken, M. Hendriks, A. Huijsman, M. van Ree, and Wim van den Brink 2016. "Efficacy of
cocaine contingency management in heroin-assisted treatment: Results of a randomized
controlled trial." Drug and alcohol dependence 164: 55-63.
Bogenschutz, P., Dennis M. Raul N., Harold I. Perl, Alyssa A. Forcehimes, Cameron C, Robert
Lindblad 2014 "Brief intervention for patients with problematic drug use presenting in
emergency departments: a randomized clinical trial." JAMA internal medicine 174, no. 11: 1736-
1745.
Büchel, C., Peters, J., Banaschewski, T., Bokde, A. L., Bromberg, U., Conrod, P. J., ... and
Heinz, A. 201). Blunted ventral striatal responses to anticipated rewards foreshadow problematic
drug use in novelty-seeking adolescents. Nature communications, 8, 14140.
Carlson, G., Ramzi W. Nahhas, Silvia S, and Raminta 2016. "Predictors of transition to heroin
use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history
study." Drug and alcohol dependence 160 127-134.
Chang, Y, and Peggy C 2016. "Opioid misuse/abuse and quality persistent pain management in
older adults." Journal of gerontological nursing 42, no. 12 : 21-30.
Cicero, J., Matthew S. Ellis, L. Surratt, and Steven P. Kurtz 2014. "The changing face of heroin
use in the United States: a retrospective analysis of the past 50 years." JAMA psychiatry 71, no.
7: 821-826.
ILLICIT DRUG USE
References:
Blanken, M. Hendriks, A. Huijsman, M. van Ree, and Wim van den Brink 2016. "Efficacy of
cocaine contingency management in heroin-assisted treatment: Results of a randomized
controlled trial." Drug and alcohol dependence 164: 55-63.
Bogenschutz, P., Dennis M. Raul N., Harold I. Perl, Alyssa A. Forcehimes, Cameron C, Robert
Lindblad 2014 "Brief intervention for patients with problematic drug use presenting in
emergency departments: a randomized clinical trial." JAMA internal medicine 174, no. 11: 1736-
1745.
Büchel, C., Peters, J., Banaschewski, T., Bokde, A. L., Bromberg, U., Conrod, P. J., ... and
Heinz, A. 201). Blunted ventral striatal responses to anticipated rewards foreshadow problematic
drug use in novelty-seeking adolescents. Nature communications, 8, 14140.
Carlson, G., Ramzi W. Nahhas, Silvia S, and Raminta 2016. "Predictors of transition to heroin
use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history
study." Drug and alcohol dependence 160 127-134.
Chang, Y, and Peggy C 2016. "Opioid misuse/abuse and quality persistent pain management in
older adults." Journal of gerontological nursing 42, no. 12 : 21-30.
Cicero, J., Matthew S. Ellis, L. Surratt, and Steven P. Kurtz 2014. "The changing face of heroin
use in the United States: a retrospective analysis of the past 50 years." JAMA psychiatry 71, no.
7: 821-826.
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10
ILLICIT DRUG USE
Cicero, J., Matthew S., and Zachary A. 2017. "Increased use of heroin as an initiating opioid of
abuse." Addictive behaviors 74 63-66.
Johnston, D., Richard A. Miech, Patrick M. O'Malley, Jerald G. Bachman, John E. Schulenberg,
and Megan E. Patrick 2018.. "Monitoring the Future national survey results on drug use, 1975-
2017: Overview, key findings on adolescent drug use."
Jones, M., Joseph Logan, R. Matthew and Michele K.. "Vital signs: demographic and substance
use trends among heroin users—United States, 2002–2013." 2016: MMWR. Morbidity and
mortality weekly report 64, no. 26 719.
Kanouse, B., and Peggy C 2015. "The epidemic of prescription opioid abuse, the subsequent
rising prevalence of heroin use, and the federal response." Journal of pain & palliative care
pharmacotherapy 29, no. 2: 102-114.
Klimas, J, Evan W, Paul N, Huiru D, Michael J Milloy, Thomas K, and Kanna H 2016:. "The
impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among
people who use heroin." European addiction research 22, no. 4 210-214.
Kolodny, T. Courtwright, S. Hwang, Peter Kreiner, L. Eadie, Thomas W. Clark, and G. Caleb
Alexander 2015. "The prescription opioid and heroin crisis: a public health approach to an
epidemic of addiction." Annual review of public health 36: 559-574.
McIntosh, James. Beating the dragon: The recovery from dependent drug use. Routledge, 2014.
Moore, Brent A., David A., Christopher J., Frank D. Buono, Declan T. Barry, Lynn E., Patrick
G. O'Connor, and Richard S. 2016. "Cognitive behavioral therapy improves treatment outcomes
ILLICIT DRUG USE
Cicero, J., Matthew S., and Zachary A. 2017. "Increased use of heroin as an initiating opioid of
abuse." Addictive behaviors 74 63-66.
Johnston, D., Richard A. Miech, Patrick M. O'Malley, Jerald G. Bachman, John E. Schulenberg,
and Megan E. Patrick 2018.. "Monitoring the Future national survey results on drug use, 1975-
2017: Overview, key findings on adolescent drug use."
Jones, M., Joseph Logan, R. Matthew and Michele K.. "Vital signs: demographic and substance
use trends among heroin users—United States, 2002–2013." 2016: MMWR. Morbidity and
mortality weekly report 64, no. 26 719.
Kanouse, B., and Peggy C 2015. "The epidemic of prescription opioid abuse, the subsequent
rising prevalence of heroin use, and the federal response." Journal of pain & palliative care
pharmacotherapy 29, no. 2: 102-114.
Klimas, J, Evan W, Paul N, Huiru D, Michael J Milloy, Thomas K, and Kanna H 2016:. "The
impact of enrolment in methadone maintenance therapy on initiation of heavy drinking among
people who use heroin." European addiction research 22, no. 4 210-214.
Kolodny, T. Courtwright, S. Hwang, Peter Kreiner, L. Eadie, Thomas W. Clark, and G. Caleb
Alexander 2015. "The prescription opioid and heroin crisis: a public health approach to an
epidemic of addiction." Annual review of public health 36: 559-574.
McIntosh, James. Beating the dragon: The recovery from dependent drug use. Routledge, 2014.
Moore, Brent A., David A., Christopher J., Frank D. Buono, Declan T. Barry, Lynn E., Patrick
G. O'Connor, and Richard S. 2016. "Cognitive behavioral therapy improves treatment outcomes
11
ILLICIT DRUG USE
for prescription opioid users in primary care buprenorphine treatment." Journal of substance
abuse treatment 71 (2016): 54-57.
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I.I.,
Maynard, C., Atkins, D.C., Graves, M.C. and Joesch, J.M., 2014. Brief intervention for problem
drug use in safety-net primary care settings: a randomized clinical trial. Jama, 312(5), pp.492-
501.
Surratt, L., Steven P. Mance B, Maria A. Levi-Minzi, E. Pagano, and Theodore J. 2017. "Heroin
use onset among nonmedical prescription opioid users in the club scene." Drug and alcohol
dependence179: 131-138.
TaylorSt, Julian B, and Tammy A 201). "Prohibition, privilege and the drug apartheid: The
failure of drug policy reform to address the underlying fallacies of drug
prohibition." Criminology & Criminal Justice 16, no. 4: 452-469.
Vázquez, H., Alberto Forte, Sebastián C, Leonardo T, and Ross J. Baldessarini 2017. "Treatment
implications for bipolar disorder co-occurring with anxiety syndromes and substance abuse." The
Treatment of Bipolar Disorder: Integrative Clinical Strategies and Future Directions
Wegman, P., Frederick L, Sangeeth K, Vanesa R, Sutayut O, David W, David P. Wilson, and
Adeeba K 2017. "Relapse to opioid use in opioid-dependent individuals released from
compulsory drug detention centres compared with those from voluntary methadone treatment
centres in Malaysia: a two-arm, prospective observational study." The Lancet Global Health 5,
no. 2: e198-e207.
ILLICIT DRUG USE
for prescription opioid users in primary care buprenorphine treatment." Journal of substance
abuse treatment 71 (2016): 54-57.
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I.I.,
Maynard, C., Atkins, D.C., Graves, M.C. and Joesch, J.M., 2014. Brief intervention for problem
drug use in safety-net primary care settings: a randomized clinical trial. Jama, 312(5), pp.492-
501.
Surratt, L., Steven P. Mance B, Maria A. Levi-Minzi, E. Pagano, and Theodore J. 2017. "Heroin
use onset among nonmedical prescription opioid users in the club scene." Drug and alcohol
dependence179: 131-138.
TaylorSt, Julian B, and Tammy A 201). "Prohibition, privilege and the drug apartheid: The
failure of drug policy reform to address the underlying fallacies of drug
prohibition." Criminology & Criminal Justice 16, no. 4: 452-469.
Vázquez, H., Alberto Forte, Sebastián C, Leonardo T, and Ross J. Baldessarini 2017. "Treatment
implications for bipolar disorder co-occurring with anxiety syndromes and substance abuse." The
Treatment of Bipolar Disorder: Integrative Clinical Strategies and Future Directions
Wegman, P., Frederick L, Sangeeth K, Vanesa R, Sutayut O, David W, David P. Wilson, and
Adeeba K 2017. "Relapse to opioid use in opioid-dependent individuals released from
compulsory drug detention centres compared with those from voluntary methadone treatment
centres in Malaysia: a two-arm, prospective observational study." The Lancet Global Health 5,
no. 2: e198-e207.
12
ILLICIT DRUG USE
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