Fatal and non-fatal opioid overdoses resulting from opioid induced respiratory depression are a significant problem throughout the world. Whilst the opioid receptor antagonist, naloxone hydrochloride, can effectively reverse opioid overdoses, its use is limited because of the adverse effects it produces. These include severe withdrawal and the reversal of analgesia produced by opioid receptor agonists. In this project, the peripherally acting opioid receptor antagonist, naloxone methiodide, was investigated for its potential to reverse opioid induced respiratory depression without altering centrally mediated effects, such as withdrawal. In the publications presented in this thesis, naloxone hydrochloride and naloxone methiodide were shown to effectively reverse the decreases in respiratory rate produced by the administration of morphine, methadone and heroin in mice. Naloxone hydrochloride and naloxone methiodide also reversed the analgesia produced by these opioid receptor agonist treatments, but only naloxone hydrochloride induced significant withdrawal. The doses of naloxone methiodide required to produce the effects described above were higher than the naloxone hydrochloride doses required. Radioligand binding techniques indicated that this was due to a difference in the affinity of naloxone hydrochloride and naloxone methiodide for µ, δ and κ opioid receptor binding sites. Radioligand binding techniques were also used to confirm that naloxone methiodide, or its metabolites, could not readily cross the blood brain barrier. Therefore, the effects of naloxone methiodide appear to be mediated outside the central nervous system. The final publication aimed to extend our knowledge of opioid induced respiratory depression by utilising new radiotelemetry technology to test the efficacy of naloxone methiodide in rats subjected to a chronic opioid administration regime. This experiment showed that circadian rhythm plays a role in the development of tolerance to the cardiorespiratory effects of continuous and chronic methadone administration, and that naloxone hydrochloride and naloxone methiodide treatment can increase respiratory rate and heart rate after this methadone administration. Therefore, naloxone methiodide can effectively antagonise the peripheral effects produced by opioid receptor agonists. Peripherally acting opioid receptor antagonists should be developed in the future to prevent or treat the adverse effects of opioid receptor agonists. / Thesis (Ph.D.)--Department of Clinical and Experimental Pharmacology, 2004.

Increased demands on amphetamine dependence treatment services point to a need for effective pharmacotherapies for withdrawal symptom suppression. However, empirical data on which to base effective treatments are scarce. To address the need for an evidence base, four studies were conducted in two countries - Australia and Thailand. Firstly, the time course and severity of amphetamine withdrawal symptoms were characterised in two inpatient samples of amphetamine users. Results identified the first week of abstinence as an acute withdrawal phase characterised by increased sleeping, eating and a cluster of mood and anxiety - related symptoms. Following the acute phase, most withdrawal symptoms remained stable and at low levels for the remaining two weeks of abstinence ( the sub - acute phase ). Data from these two studies formed the basis for a new instrument, the Amphetamine Cessation Symptom Assessment scale ( ACSA ). On psychometric testing, the ACSA showed satisfactory reliability and a clear psychometric structure, delineating symptom clusters and their correlates with a three factor solution providing the best fit to the data. Using the ACSA to measure outcome, the safety and efficacy of the serotonin and noradrenaline reuptake inhibitor antidepressant mirtazapine ( 15 - 60 mg per day, n = 13 ), and the wake-promoting drug, modafinil ( 400mg per day, n = 14 ) were assessed in successive, open - label, inpatient pilot trials. Study medication was administered for up to ten days. An historical comparison group ( n = 22 ) who received treatment as usual consisting of pericyazine 2.5 - 10mg per day for control of agitation served as a comparison. Results showed that modafinil and mirtazapine were well tolerated, producing minimal positive subjective effects. There were significant group differences in withdrawal severity ( F = 18.6, df 2,219 p < 0.001 ). Post - hoc analysis showed that modafinil was more effective than mirtazapine ( p = 0.041 ), and both were more effective than treatment as usual ( both p < 0.001 ) in ameliorating withdrawal severity. Overall, these studies identified a peak in withdrawal severity during the first week of abstinence ; demonstrated the reliability and validity of the ACSA and identified modafinil as a safe and potentially effective pharmacotherapy for the treatment of amphetamine withdrawal symptoms. / Thesis (Ph.D.)--Medical School, 2005.

Thesis (M.A.)--University of Texas at El Paso, 2009. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.

Background World Drug Report estimates the number of opioid users at 53 million and identifies opioids as responsible for two thirds of the 585,000 people who died as a result of drug use in 2017. Purpose The purpose of this study was to analyze the testimonies of 30 people regarding their journeys from drug addiction to drug withdrawal in Taiwan. Methods This was a qualitative research design. The sample inclusion criteria were as follows: (a) being a drug abuser, (b) completed the Christian Gospel Drug Withdrawal Program or church-sponsored program, and (c) shared their related testimony on the Good TV television channel in Taiwan. The participants' stories were posted in Chinese, transcribed by the author, and translated from Chinese into English. Content analysis was used to identify the major themes. Results Of the 30 participants, 24 were male (80%) and six were female (20%). The major themes identified in their testimonies were: (a) Using illegal drugs related to peer recognition, lack of knowledge, and temptations; (b) drug addiction was an endless pain cycle; (c) turning points related to love, repentance, and hope; (d) drug withdrawal was related to avoiding temptation and overcoming the drug withdrawal syndrome through the Holy Spirit; and (e) outcomes were faith and new life. Conclusions/Implications for Practice In this study, people who received the gospel drug withdrawal programs expressed that their lives had changed, they had withdrawn from drugs successfully, they had become volunteers to help others, and interactions with their family had improved. These programs may be applied in the mental health nursing profession.

Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)—translated and summarized in this article—of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.