Yeast infection Cures

September 6th, 2009

Yeast infection is the colonization of yeast fungi in body areas in such an amount and such a way that damages or symptoms are produced. Usually the yeast invades only body cavities and the lining of these cavities, but can in serious cases grow into deeper tissue layers.

Yeasts very often infect the vagina and outer female genitals. Yeast infection also often occurs in the mouth, and is then called trash. The male genitals may be infected, but usually with fewer symptoms. There can also be an infective over-growth of yeast in the digestive tract, skin areas and the nose. Small children often get yeast infection in the diapered area, and this is commonly called diaper rash. Diaper rash can also be caused by irritation from urine or stool, from food allergy, from allergy against washing media, or from a combination of several factors.

Sometimes yeast infect several body areas at the same time, such a systemic infection is often called candidiatis. A systemic yeast infection can develop into a serious condition where the yeast invades deeper layers of the skin, the deeper tissues of several organs and even the blood stream.

Systemic yeast infection usually occurs in patients with bad immune defense, like HIV patients, diabetics or patients weakened by cytostatic or steroid medication.

WHAT CAUSES YEAST INFECTION

Usually species of the genus Candida, and especially the species Candida albicans, are the infective agents. These yeasts are normally found in the body, but the amount is held down by the normal body chemistry by friendly bacteria inhabiting the skin and body cavities, for example bacteria producing lactic acid (the genus Lactobacillus). When the yeast become infectious, it often changes from a round cellular form to a thread-like or branched form that can grow into tissues.

A disturbed bacterial flora in the skin and body cavities can make it easier for the yeast to grow excessively and infect. The skin, the outer genitals and body cavities like the mouth, vagina, and the colon contain the bacterium types Bifidobacteria and Lactobacteria together with the Candida yeasts, but these bacteria hold the growth of the yeast in check.

Use of antibiotics can kill these friendly bacteria and make it easier for the yeast to grow. A too eager use of antibiotics in children can cause a chronic overgrowth of yeasts in the body that will affect the health negatively long into adulthood.

Use of corticosteriods can also make a person susceptible for yeast infection. Asthma patients using inhaled coricosteroids often get yeast infection in the oral cavity.

A too eager hygiene, using bacterial killers, can kill friendly bacteria and cause a yeast infection to occur. However, lack of washing can also cause yeast infection.

If skin areas are constantly held wet or sweaty, Candida infections can easily occur, for example in diapered areas of small children or feet covered by tight shoes during long walks.

A diet with an excess of sugar and other carbohydrates may nourish the yeast and cause an infective growth of the yeast.

Mental and physical stress can decrease the effect of the immune defense against yeasts and make a person more susceptible for yeast infection.

THE SYMPTOMS OF YEAST INFECTION

Yeast infection in the female genitals gives itching or burning sensations in the vagina and genital lips, red rashes in the external female genitals and a whitish badly smelling discharge. The discharge may also be the only symptom.

In the male genitals yeast infection often gives itching sores around the base of the penis head. There may also be a smelling whitish fluid substance present that is different in consistence from the white smegma normally produced by glands in the same area. Red rashes with scaling can be present on the outer genitals and especially on the underside of the penis.

In the mouth, yeast infection gives sores covered with a whitish layer that give an itching or burning pain, so called trash. There can also be white or yellow layers on the tongue without any sores underneath or other symptoms. One often sees cracks at the corner of the mouth.

Yeast infection in skin areas will give symptoms like rashes, itching, sore areas oozing fluid and blisters. The symptom will most often be seen in areas like the under-side of the shoulders, the inner side of the elbow, skin folds, in the pelvic region and other areas that are somewhat hidden.

Yeast infection in the digestive tract can give symptoms in the whole digestive tract from the esophagus to the anus. Symptoms that can occur are problems and pain during swallowing, breast pain, bloating, cramping, excessive gas production, diarrhoea, itching and sores in the rectal opening and lactose intolerance.

An overgrowth of yeast in the digestive tract or a generalized yeast infection produces substances that can poison the whole body, and give symptoms also from body parts that are not directly infected, like: rashes, hives, and itching in the skin, allergic reactions in many body parts, fatigue or lethargy, muscle weakness, bone pain and nervous symptoms.

DIAGNOSIS OF YEAST INFECTION

Yeast infection is often diagnosed by a specimen from the affected area. The specimen is then cultured to investigate the microbial flora. Often bacterial infections give the same symptoms as yeast infection, especially from the vaginal area, and the specimen will also distinguish between yeast infection and bacterial infection.

STANDARD TREATMENT OF YEAST INFECTION

Yeast infection is commonly treated locally at the infected area with anti-fugal substances like clotrimazole (canesten), nystatin, fluconazole, ketoconazole, tioconazole (GyneCure), terconazole (Terazole), Monazole, miconazole (Monistat, Micozole), butoconazole (Femstat) and gentiana violet.

By vaginal infection tablets, creams or suppositories containing one or more of these substances are usually inserted into the vagina. Men having genital yeast infection or sexual partners of women with infection can be treated with local cream based on the same substances.

Some of the drugs, like fluconazole, are also used orally as a systemic medication.

For more severe infections the substances amphotericin B, caspofungin, or voriconazole is often used.

By localized infection, for example in the vagina, the pharmacological products usually take away the infection very effectively.

These products do not however take away the susceptibility for new infections, and can be less effective when the infection is spread in a more diffuse manner.

Lifestyle measures and natural supplements can be useful to reduce the susceptibility for yeast infection and to help cure yeast infection that is difficult to take away only with standard treatment.

ALTERNATIVE TREATMENT OF YEAST INFECTION

- Garlic helps to kill yeast, and can be used as an oral remedy for yeast infection.

- Flushing with a boric acid solution can help to kill yeast and rinse body cavities. Suppositories containing boric acid can also be used to kill yeast in the vagina or anus.

- Diluted tea tree oil may help for vaginal yeast infection by using it locally.

- The fatty acid caprylic acid can kill yeast, and a supplement of this acid may help against yeast infection.

- Propolis is an antibacterial substance made by bees. An oral supplement or local application of a propolis solution has shown to be useful against yeast infection.

- Cranberry juice helps against bacterial infection in the urinary tract and may also help for yeast infection by making the urine more acidic.

- Lactoferrin is a protein that can bind to iron and hold it away from pathogenic bacteria and yeast, and this will impair the growth of these organisms. The protein is naturally found in milk and in secretes in many parts of the body. It is a part of the natural defense against microbes.

- Products containing seeds for friendly bacteria (Lactobacteria and Bifidobacteria) can help reestablish a normal bacterial flora and be helpful against yeast infection. The friendly bacteria hinder the growth of the pathogenic microorganisms. Such seeds are often called probiotics. There are probiotic products for both oral and local use.

-Yoghourt contains seeds for friendly bacteria. Consuming yoghourt can help to normalize the microbial flora in the digestive tract and in the genital zone. Yoghourt may also be used as a local remedy, for example in the vagina.

LIFESTYLE MEASURES TO PREVENT OR CURE YEAST INFECTION

Many lifestyle measures can be used to prevent the outbreak of yeast infection and help to cure chronic yeast infection.

- One should avoid over-consuming carbohydrates, and avoid consuming carbohydrates that are rapidly taken up or utilized, like pure sugar, refined floor and bread made from refined floor. Instead use of full corn products, beans and peas that contain carbohydrates that are utilized gradually is recommended.

- One should wash or bath daily the whole body, including the genital area, with a mild soap or with pure water.

- One should not use anti-bacterial agents when one washes the skin, the genitals, the rectal opening or by mouth hygiene. For intimate wash, pure water is best.

- Unnecessary antibiotic cures or steroid medication should be avoided.

- Stressful elements and habits in the daily life should be avoided. Meditation is a good method to stress down.

- Clothes and shoes should give ventilation so that humidity does not aggregate at skin surfaces or in skin folds. Humid areas on the skin should be washed and dried regularly when it is not possible to avoid humidity.

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naltrexone

August 15th, 2009

Alcoholism and Treatment with Naltrexone- FAQs and Their Answers

What exactly is naltrexone?

It’s a medicine that blocks the “high” that you get from opiates like heroin, morphine, and codeine, keeping the drugs from ever reaching their receptors in the brain.  Of course, it was first used to treat opiate addiction, but it has just been FDA approved for the treatment of alcoholism.  Clinical trials show that patients on naltrexone were twice as likely to avoid relapse when compared to patients who only got a placebo.

How and why does naltrexone help with alcoholism treatment?

No one knows for sure, but anecdotal reports suggest that the effect is threefold.  Naltrexone can reduce the urge to drink, and it helps recovering alcoholics remain sober.  Naltrexone can also prevent a full-blown relapse if a patient has a “slip up”.

Can naltrexone make me sober if I’m drunk?

No!  Naltrexone doesn’t keep alcohol from impairing your judgment and coordination.

If I’m on naltrexone, do I need other alcoholism treatments?

Yes.  Naltrexone is only part of a comprehensive alcoholism treatment that can include psychological and social counseling, and group counseling as well.  The studies that showed the benefits of naltrexone proved that it was most effective when it was combined with other therapies.

How long does it take to see the full effect from naltrexone?

It begins to work shortly after you take your first dose.  Current findings also show that early-stage naltrexone use helps patients stay sober and avoid a relapse.

Who should NOT take naltrexone?

Women who are expecting shouldn’t take it.  Nor should anyone with kidney or liver damage, and anyone who cannot avoid drinking for five days prior to starting the medication should not take it either.  People who are addicted to opiates like heroin or morphine should be clean for seven days prior to starting naltrexone therapy.

How will naltrexone make me feel?

There are some side effects, but most times they are mild and of short duration.  Most patients even forget that they are on it!  Naltrexone rarely has psychological effects, meaning that people neither feel “up” or “down” when they are taking it.  It is non habit-forming.  It reduces the urge to drink but does not keep a person from feeling pleasure.

What are some of naltrexone’s side effects?

The biggest study showed that the most common side effects only affected a small portion of the study group.  They included:  headache, dizziness, nausea, insomnia, fatigue, anxiety, and sleepiness.  Each effect was experienced by ten percent or less of the study group.    Of those who experienced side effects, only about five percent were bothered enough to stop taking the medication.  You need to be aware that naltrexone can possibly harm your liver, so your doctor will do some blood testing before and during treatment to check your liver function.

Do I need some blood testing while I’m on the medication?

To be sure that you’re safe, your doctor will order some blood testing to be done before treatment starts.  After that, you’ll be tested every month for three months, with more infrequent testing following that.  If your liver isn’t in good health, your doctor may want you to have more frequent testing.

If I’m taking other medicines, can I take naltrexone?

As naltrexone is most effective on opiate drugs, taking it will block their effects.  You’ll have to use other non-narcotic pain relief while you’re on naltrexone.  The medicine will have little to no effect on other medicines like analgesics, antibiotics, and allergy medications.  Naltrexone is metabolized by the liver, so if you are taking other medications that affect liver function, your doctor may alter the dose of naltrexone.  You should tell your doctor what medicines you are taking to avoid any harmful interactions.

If I drink while I’m on naltrexone, will it make me sick?

No.  You may have a reduced feeling of intoxication, and the desire to drink more to get drunk, but you won’t get ill.

If I stop naltrexone therapy, will I get sick?

Naltrexone is non habit-forming, and can be stopped at any time.  And, those that take naltrexone and then stop are less likely to start drinking again.

What do I do if I need pain medicine or surgery?

You need to carry a card that says you are on naltrexone and gives your surgeon instructions on pain management.  There are many non-opiate pain medicines.  If you are having elective surgery, stop taking naltrexone three days before the operation.

Can I use naltrexone while I’m in AA?

Yes, you can.  Naltrexone is non habit-forming, and it doesn’t produce a “high”.  It can help a patient stay sober by reducing their urge to drink, especially in the first part of the recovery process.  It is especially effective for those who want to be totally abstinent.

How long will I take naltrexone?

If you can tolerate it, and you stop drinking (or reduce the amount that you drink), you may take it for three months to start.  At that point, your doctor will evaluate you and decide whether you need to remain on naltrexone.

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Naltrexone

August 11th, 2009

harmacodynamic Actions: Naltrexone is a pure opioid antagonist. It markedly attenuates or completely blocks, reversibly, the subjective effects of intravenously administered opioids.

When co-administered with morphine, on a chronic basis, Naltrexone blocks the physical dependence to morphine, heroin and other opioids.

Naltrexone has few, if any, intrinsic actions besides its opioid blocking properties. However, it does produce some pupillary constriction, by an unknown mechanism.

The administration of Naltrexone is not associated with the development of tolerance or dependence. In subjects physically dependent on opioids, Naltrexone will precipitate withdrawal symptomatology.

Clinical studies indicate that 50 mg of Naltrexone hydrochloride will block the pharmacologic effects of 25 mg of intravenously administered heroin for periods as long as 24 hours. Other data suggest that doubling the dose of Naltrexone hydrochloride provides blockade for 48 hours, and tripling the dose of Naltrexone hydrochloride provides blockade for about 72 hours.

Naltrexone blocks the effects of opioids by competitive binding (i.e., analogous to competitive inhibition of enzymes) at opioid receptors. This makes the blockade produced potentially surmountable, but overcoming full Naltrexone blockade by administration of very high doses of opiates has resulted in excessive symptoms of histamine release in experimental subjects.

The mechanism of action of Naltrexone in alcoholism is not understood; however, involvement of the endogenous opioid system is suggested by preclinical data. Naltrexone, an opioid receptor antagonist, competitively binds to such receptors and may block the effects of endogenous opioids. Opioid antagonists have been shown to reduce alcohol consumption by animals, and Naltrexone has been shown to reduce alcohol consumption in clinical studies.

Naltrexone is not aversive therapy and does not cause a disulfiram-like reaction either as a result of opiate use or ethanol ingestion.

Pharmacokinetics: Naltrexone is a pure opioid receptor antagonist. Although well absorbed orally, Naltrexone is subject to significant first pass metabolism with oral bioavailability estimates ranging from 5% to 40%. The activity of Naltrexone is believed to be due to both parent and the 6-β-naltrexol metabolite. Both parent drug and metabolites are excreted primarily by the kidney (53% to 79% of the dose), however, urinary excretion of unchanged Naltrexone accounts for less than 2% of an oral dose and fecal excretion is a minor elimination pathway. The mean elimination half-life (T-1/2) values for Naltrexone and 6-β-naltrexol are 4 hours and 13 hours, respectively. Naltrexone and 6-β-naltrexol are dose proportional in terms of AUC and Cmax over the range of 50 to 200 mg and do not accumulate after 100 mg daily doses.

Absorption: Following oral administration, Naltrexone undergoes rapid and nearly complete absorption with approximately 96% of the dose absorbed from the gastrointestinal tract. Peak plasma levels of both Naltrexone and 6-β-Naltrexone occur within one hour of dosing.

Distribution: The volume of distribution for Naltrexone following intravenous administration is estimated to be 1350 liters. In vitro tests with human plasma show Naltrexone to be 21% bound to plasma proteins over the therapeutic dose range.

Metabolism: The systemic clearance (after intravenous administration) of Naltrexone is ~3.5 L/min, which exceeds liver blood flow (~1.2 L/min). This suggests both that Naltrexone is a highly extracted drug (>98% metabolized) and that extra-hepatic sites of drug metabolism exist. The major metabolite of Naltrexone is 6-β-naltrexol. Two other minor metabolites are 2-hydroxy-3-methoxy-6-β-naltrexol and 2-hydroxy-3-methyl-Naltrexone. Naltrexone and its metabolites are also conjugated to form additional metabolic products.

Elimination: The renal clearance for Naltrexone ranges from 30 to 127 mL/min and suggests that renal elimination is primarily by glomerular filtration. In comparison, the renal clearance for 6-β-naltrexol ranges from 230 to 369 mL/min, suggesting an additional renal tubular secretory mechanism. The urinary excretion of unchanged Naltrexone accounts for less than 2% of an oral dose; urinary excretion of unchanged and conjugated 6-β-naltrexol accounts for 43% of an oral dose. The pharmacokinetic profile of Naltrexone suggests that Naltrexone and its metabolites may undergo enterohepatic recycling.

Hepatic and Renal Impairment: Naltrexone appears to have extra-hepatic sites of drug metabolism and its major metabolite undergoes active tubular secretion (see Metabolism above). Adequate studies of Naltrexone in patients with severe hepatic or renal impairment have not been conducted (see PRECAUTIONS: Special Risk Patients).

Clinical Trials:

Alcoholism: The efficacy of Naltrexone as an aid to the treatment of alcoholism was tested in placebo-controlled, outpatient, double blind trials. These studies used a dose of Naltrexone hydrochloride 50 mg once daily for 12 weeks as an adjunct to social and psychotherapeutic methods when given under conditions that enhanced patient compliance. Patients with psychosis, dementia, and secondary psychiatric diagnoses were excluded from these studies.

In one of these studies, 104 alcohol-dependent patients were randomized to receive either Naltrexone hydrochloride 50 mg once daily or placebo. In this study, Naltrexone proved superior to placebo in measures of drinking including abstention rates (51% vs. 23%), number of drinking days, and relapse (31% vs. 60%). In a second study with 82 alcohol-dependent patients, the group of patients receiving Naltrexone were shown to have lower relapse rates (21% vs. 41%), less alcohol craving, and fewer drinking days compared with patients who received placebo, but these results depended on the specific analysis used.

The clinical use of Naltrexone as adjunctive pharmacotherapy for the treatment of alcoholism was also evaluated in a multicenter safety study. This study of 865 individuals with alcoholism included patients with comorbid psychiatric conditions, concomitant medications, polysubstance abuse and HIV disease. Results of this study demonstrated that the side effect profile of Naltrexone appears to be similar in both alcoholic and opioid dependent populations, and that serious side effects are uncommon.

In the clinical studies, treatment with Naltrexone supported abstinence, prevented relapse and decreased alcohol consumption. In the uncontrolled study, the patterns of abstinence and relapse were similar to those observed in the controlled studies. Naltrexone was not uniformly helpful to all patients, and the expected effect of the drug is a modest improvement in the outcome of conventional treatment.

Treatment of Opioid Addiction:

Naltrexone has been shown to produce complete blockade of the euphoric effects of opioids in both volunteer and addict populations. When administered by means that enforce compliance, it will produce an effective opioid blockade, but has not been shown to affect the use of cocaine or other non-opioid drugs of abuse.

There are no data that demonstrate an unequivocally beneficial effect of Naltrexone on rates of recidivism among detoxified, formerly opioid-dependent individuals who self-administer the drug. The failure of the drug in this setting appears to be due to poor medication compliance.

The drug is reported to be of greatest use in good prognosis opioid addicts who take the drug as part of a comprehensive occupational rehabilitative program, behavioral contract, or other compliance-enhancing protocol. Naltrexone, unlike methadone or LAAM (levo-alpha-acetyl-methadol), does not reinforce medication compliance and is expected to have a therapeutic effect only when given under external conditions that support continued use of the medication.

Individualization of Dosage:

DO NOT ATTEMPT TREATMENT WITH Naltrexone UNLESS, IN THE MEDICAL JUDGEMENT OF THE PRESCRIBING PHYSICIAN, THERE IS NO REASONABLE POSSIBILITY OF OPIOID USE WITHIN THE PAST 7 to 10 DAYS. IF THERE IS ANY QUESTION OF OCCULT OPIOID DEPENDENCE, PERFORM A NALOXONE CHALLENGE TEST.

Treatment of Alcoholism:

The placebo-controlled studies that demonstrated the efficacy of Naltrexone as an adjunctive treatment of alcoholism used a dose regimen of Naltrexone hydrochloride 50 mg once daily for up to 12 weeks. Other dose regimens or durations of therapy were not studied in these trials.

Physicians are advised that 5% to 15% of patients taking Naltrexone for alcoholism will complain of non-specific side effects, chiefly gastrointestinal upset. Prescribing physicians have tried using an initial 25 mg dose, splitting the daily dose, and adjusting the time of dosing with limited success. No dose or pattern of dosing has been shown to be more effective than any other in reducing these complaints for all patients.

Treatment of Opioid Dependence:

Once the patient has been started on Naltrexone hydrochloride, 50 mg once a day will produce adequate clinical blockade of the actions of parenterally administered opioids. As with many non-agonist treatments for addiction, Naltrexone is of proven value only when given as part of a comprehensive plan of management that includes some measure to ensure the patient takes the medication.

A flexible approach to a dosing regimen may be employed to enhance compliance. Thus, patients may receive 50 mg of Naltrexone hydrochloride every weekday with a 100 mg dose on Saturday or patients may receive 100 mg every other day, or 150 mg every third day. Several of the clinical studies reported in the literature have employed the following dosing regimen: 100 mg on Monday, 100 mg on Wednesday, and 150 mg on Friday. This dosing schedule appeared to be acceptable to many Naltrexone patients successfully maintaining their opioid-free state.

Experience with the supervised administration of a number of potentially hepatotoxic agents suggests that supervised administration and single doses of Naltrexone hydrochloride higher than 50 mg may have an associated increased risk of hepatocellular injury, even though three-times a week dosing has been well tolerated in the addict population and in initial clinical trials in alcoholism. Clinics using this approach should balance the possible risks against the probable benefits and may wish to maintain a higher index of suspicion for drug-associated hepatitis and ensure patients are advised of the need to report non-specific abdominal complaints

Naltrexone

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Suboxone Treatment and Detox In Mass

August 11th, 2009

- Withdrawal, Abuse and Addiction
Drug dependence is a universal public health problem of which opioid dependence, notably involving heroin and morphine are a major component. In Europe alone, there are an estimated 1.1 million intravenous drug users and the number is estimated to be at least 3 times that many in North America. The majority of these individuals remain untreated. Opioid dependence is a chronic relapsing medical condition that requires long-term treatment and patient support. In addition, many of these intravenous drug users share syringes and needles, a practice that can lead to the transmission of serious blood-borne infections including human immunodeficiency virus (HIV), hepatitis B and hepatitis C.

Currently opiate dependence treatments like methadone can be dispensed only in a few centers that focus in addiction treatment. There are not enough addiction treatment clinics to assist all patients seeking treatment. Suboxone is the first narcotic drug available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed by a physician. Hopefully, this advance in therapeutics will provide more patients the opportunity to access treatment.

Suboxone (buprenorphine with naloxone) is currently available for the maintenance treatment of opioid addiction. The intention of adding naloxone to the formulation is to deter intravenous misuse and reduce the symptoms of opiate dependence. Suboxone treatment is intended for use in adults and adolescents more than 16 years of age who have agreed to be treated for addiction.

Once detoxification of the individual is completed, Suboxone is used during the maintenance phase of treatment. Suboxone has recently become the drug of choice instead of methadone in the treatment of opiate addiction. Suboxone use is less rigidly controlled than methadone because it has a lower potential for abuse and is less dangerous in an overdose. As patients progress on therapy, the physician may write a prescription for a take-home supply of the medication.

Suboxone Prescription

Only those physicians who have approval from the Drug Enforcement Agency (DEA) are able to start in-office treatment and provide prescriptions for ongoing medication. The Center for Substance Abuse Treatment (CSAT) maintains an active database to help patients locate qualified doctors.

Route of Administration

Suboxone is available as a tablet which is always administered sublingually. The pill is placed underneath the tongue until it is fully dissolved. Swallowing or sucking on the pill does not offer any therapeutic benefit. When placed underneath the tongue, the pill dissolves and is absorbed in 10 -20 minutes.

Suboxone treatment is generally done under medical supervision. During the induction phase, one is taught how to properly take the medications and dose adjustments are done during the phase. One is usually started on the smallest dose until the best therapeutic effect is obtained. Once the ideal dose is obtained, the individual is seen once in a while and prescriptions can generally be available from the same physician.

Suboxone is available as 2 and 8 mg tablets. Most anecdotal reports indicate that the response to the 2 mg dose is suboptimal. The majority of individuals report benefit at higher doses of 8-16 mg. The aim of the maintenance treatment is to rid the drug craving and decrease the anxiety. The dose is usually adjusted until the drug craving features are diminished.

Since Buprenorphine is a Schedule III drug, the physician is only allowed to prescribe 5 refills in 6 months.

Maintenance therapy

Although Suboxone can be used for detoxification, its intended use is for maintenance. The ideal candidate for maintenance therapy with Suboxone is an older individual who has previously been on drugs but now has a job and wants a stable lifestyle. The individual previously has failed detoxification and wants to live a simple life without the daily cravings of his previous addiction. The majority of past drug users immediately adjust to Suboxone as the cravings disappear immediately and a smoother life style are accessible.

Suboxone Control

Because of the great potential for abuse, FDA works closely with the drug manufacturer, Reckitt-Benckiser, and other agencies to develop an in-depth risk-management plan. The FDA receives quarterly reports from the manufacturer and pharmacies and maintains a comprehensive surveillance program. This monitoring allows for early detection of abuse of the drug. The major components of the risk-management program are preventive measures and surveillance. Preventive measures instituted include drug education, tailored distribution, Schedule III control under the Controlled Substances Act (CSA), child resistant packaging and supervised dose induction. The program regularly monitors local pharmacies and web sites. Numerous other agencies also monitor the abuse of Suboxone and these include:

-Drug Abuse Warning Network (DAWN). This agency run by the Substance Abuse and Mental Health Services Administration (SAMHSA) gathers data from emergency rooms related to the illicit use of drugs or non-medical use of a legal drug.

-Community Epidemiology Working Group (CEWG). This agency monitors the use of buprenorphine.

-National Institute of Drug Abuse (NIDA). NIDA frequently sends newsletters to physicians about the addictive drugs and to report it if necessary.

Side Effects

The most common reported side effect of Suboxone includes:

- Cold or flu-like symptoms
- Headaches
- sweating
- insomnia
- Nausea
- Mood swings
- Pain
- restlessness

Like other opioids, Suboxone have been associated with respiratory depression (difficulty breathing) especially when combined with other depressants.

Cautions

Intravenous use of Suboxone usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone has the potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. There are no adequate and well-controlled studies of Suboxone use in pregnancy. Due caution should be exercised when driving cars or operating machinery.

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