heroin and Remission--Spontaneous

An increasing number of heroin addicts-especially young and first-time users-prefer inhaling the drug to intravenous injection. A rare complication of inhaling heroin is the development of a spongiform leukoencephalopathy (HSLE).. Pathological background, symptoms, imaging, and therapeutical options are discussed on the basis of an example case.. Pathophysiologically, a dysfunction of the oligodendrocyte mitochondria is suspected. Three distinct stages based on key symptoms are defined. Patients may remain in one stage, or pass through two, or all three stages. Magnetic resonance imaging (MRI) is necessary for diagnosis. There are few therapeutical options. Antioxidants and coenzyme Q may be beneficial. The disorder is self-limiting in the majority of cases. Complications such as hydrocephalus and diffuse cerebellar swelling may, however, require neurosurgical intervention.. HSLE is a rare occurrence in patients with heroin abuse. The number of undetected cases in drug-related deaths may be high. Clinical appearance may be easily mistaken for withdrawal symptoms.

Topics: Administration, Inhalation; Adult; Apoptosis; Cerebellum; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Heroin; Heroin Dependence; Humans; Illicit Drugs; Image Enhancement; Image Interpretation, Computer-Assisted; Leukoencephalopathies; Magnetic Resonance Imaging; Mitochondria; Narcotics; Neurologic Examination; Neurotoxicity Syndromes; Oligodendroglia; Remission, Spontaneous; Tomography, X-Ray Computed

A case is reported of the Lazarus phenomenon (the return of spontaneous circulation after cardiopulmonary resuscitation had been abandoned) in a patient following recreational drug use. The implications for management of cardiac arrest in the emergency department are discussed.

Topics: Adult; Cardiopulmonary Resuscitation; Cocaine; Emergencies; Heart Arrest; Hemodynamics; Heroin; Humans; Male; Remission, Spontaneous; Substance Abuse, Intravenous

A study of 50 opiate addicts attending a London service for treatment of drug dependence found that 47 subjects had previously made at least one attempt at self-detoxification. These subjects reported 212 previous attempts. Although 30 subjects reported having managed to complete at least one attempt, the success rate per episode was low (24%). One of the most commonly reported methods, used by 28 subjects, involved an abrupt cessation of opiates ('cold turkey'). Of the drugs used in their attempts at self-detoxification, benzodiazepines were reported by 24 subjects and opiates by 20. Practical strategies such as distraction and avoidance were also used. Self-help detoxification materials for opiate addicts might be useful.

Topics: Adult; Female; Heroin; Heroin Dependence; Humans; Male; Narcotics; Opioid-Related Disorders; Remission, Spontaneous; Self Care; Substance Abuse Treatment Centers; Substance Withdrawal Syndrome

Topics: Adult; Amyloidosis; Female; Heroin; Humans; Kidney Diseases; Nephrotic Syndrome; Remission, Spontaneous; Substance-Related Disorders

The present study deals with pituitary-gonadal function in male heroin addicts, 6 patients with schizophrenia and 31 with mild personality disorders. We examined the serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone levels at the moment of hospitalization (at the maximum of heroin addiction), and 48 h and 10 days later. FSH levels were definitely reduced in all the patients and did not change during the period of heroin withdrawal. The LH levels were reduced to a lesser extent, but significantly, and did not change after 10 days of abstinence from the drug. Testosterone levels were very low and increased in the schizophrenics during withdrawal, but not in the other addicts. The possible influence of heroin addiction on catecholamine metabolism in the central nervous system and, therefore, on the hypothalamic releasing factor and pituitary gonadotrophins, and the peripheral effect on testicular function are discussed.

Topics: Adolescent; Adult; Follicle Stimulating Hormone; Heroin; Heroin Dependence; Humans; Hypothalamus; Luteinizing Hormone; Male; Personality Disorders; Pituitary Hormone-Releasing Hormones; Remission, Spontaneous; Schizophrenia; Testosterone; Time Factors

Topics: Adolescent; Adult; Allied Health Personnel; Appointments and Schedules; Attitude of Health Personnel; Emergency Service, Hospital; Employment; Evaluation Studies as Topic; Female; Heroin; Heroin Dependence; Hospitals, General; Humans; Male; Marriage; Methadone; Middle Aged; Outpatient Clinics, Hospital; Personnel, Hospital; Professional-Patient Relations; Psychiatric Department, Hospital; Remission, Spontaneous; Substance-Related Disorders

Topics: Adolescent; Adult; Attitude; Educational Status; Emotions; Family Characteristics; Father-Child Relations; Heroin; Humans; Intelligence Tests; Interpersonal Relations; Interview, Psychological; Middle Aged; MMPI; Morphine Dependence; Mother-Child Relations; Occupations; Peer Group; Psychological Tests; Remission, Spontaneous; Sex; Social Behavior; Substance-Related Disorders; Surveys and Questionnaires

Topics: Costs and Cost Analysis; Criminal Psychology; Drug Tolerance; Evaluation Studies as Topic; Heroin; Humans; Methadone; Morphine Dependence; Recurrence; Remission, Spontaneous; Social Problems; Stress, Psychological; Substance Withdrawal Syndrome

Topics: Adult; Criminal Psychology; Employment; Evaluation Studies as Topic; Follow-Up Studies; Heroin; Hospitalization; Humans; Methadone; Morphine Dependence; Remission, Spontaneous; Substance Withdrawal Syndrome; United States; Voluntary Health Agencies

Topics: Age Factors; Cannabis; Criminal Psychology; Employment; Ethnicity; Family Characteristics; Heroin; Hospitalization; Humans; Length of Stay; Male; Morphinans; Occupations; Puerto Rico; Remission, Spontaneous; Socioeconomic Factors; Substance-Related Disorders

Topics: Adult; Alcohol Drinking; Criminal Psychology; Evaluation Studies as Topic; Female; Follow-Up Studies; Heroin; Heroin Dependence; Humans; Jurisprudence; Male; Methadone; Middle Aged; Remission, Spontaneous; Social Adjustment; Substance Withdrawal Syndrome; Substance-Related Disorders