Posted by 3 Beer Effect on April 26, 2002, at 1:17:22
Substitution is a controversial practice in psychiatry & is commonly used in the case of heroin addicts who withdraw from heroin by the use of methadone.
An old & very controversial way of substitution as a cure for depressant/barbituate/alcohol addiction that has shown to be effective in psychiatry may be by taking high doses of stimulants.
[This method should NOT be attempted without direction from a licensed physician/psychiatrist or by those with any health problems whatsoever- especially including but not limited to hypertension (even low or moderate), history of seizures or seizure disorder, liver damage, renal problems, alkalosis, high cholestoral, heart problems, old age. I am not condoning or advocating the use of illegal drugs or illicit/improper use of scheduled or unscheduled stimulant medications, but merely repeating a psychopharmacological theory that has been around since the times of Sigmund Freud for academic/informational/historical value purposes only.]
This theory stems back to the days when Sigmund Freud cured a colleague's morphine addiction by introducing his friend to intranasal cocaine hcl. Morphine & opiate addiction was a huge problem in those days since both were so readily available in various otc concoctions. Freud's fellow colleague kicked the morphine habit quickly through the use of the cocaine powder but unfortunately became a cocaine addict & I believe either died or became a "lunatic". However, use of Cocaine as a substitute therapy or otherwise should be avoided at all costs because it can be both physically & psychologically addictive, clots the blood (causing heart attacks) & can cause convulsions. The fatal dose of pure cocaine is about 1.2 grams & so the dose required to produce the "high" and the fatal dose are too close to one another (narrow therapeutic index) & so unsurpisingly Cocaine results in more deaths & emergency room admissions than all the other illegal drugs combined.
This "Freudian" method of stimulant substitution as a cure for depressant/alcohol addiction could be done in a safer manner with prescribed pharmaceutical amphetamines such as Dexedrine/Dextostat (Dextroamphetamine), Adderall, Ritalin or even Desoxyn, all of which rarely result in overdose deaths.
Ephedrine or Ephedra should absolutely never be used as substitution therapy, & probably should never be used by anyone except diagnosed asthmatics. Ephedra & Ephedrine overdoses have likely killed more people in the last 10 years than Amphetamine overdoses have in the last 50 years because Ephedrine is very (too) potent at raising blood pressure per unit of "stimulation" while the pressor actions of Amphetamines & even Methamphetamine are much weaker. A dose of 100-150 mg of Ephedrine/ephedra could be fatal while people have ingested doses of amphetamines in one case as high as 4700 mg (amphetamine sulfate) intraveneously and still lived.
Dextroamphetamine (Dexedrine) & Ritalin are the preferred agents in substitution therapy because they have the least effect on blood pressure of the amphetamine-type stimulants. Dextroamphetamine also used to be a treatment for acute & chronic alcoholism.
Yes, you are in a sense substituting one addiction (a depressant) for another (amphetamine), but amphetamines & derivatives thereof are psychologically but not physically addictive & so are much easier to quit than depressants/barbituates/benzodiazepines & for a limited amount of people alcohol. The usual withdrawl symptoms associated with stopping chronic use of high doses consists of lethargy & depression (sometimes severe) both of which eventually fade over time, especially with anti-depressant medication. As with any psychiatric medication there is always a downside. The amphetamines when taken in extremely excessive doses do cause severe insomnia, anorexia, paranoid behavior, picking at the skin, & sterotypy closely resembling paranoid schizophrenia, & this syndrome has been associated with violent outbursts & subsequent arrests in Methamphetamine & Amphetamine Sulfate (Benzedrine) addicts.
On a side note: The fantastic sales of Metabolife & Xenadrine is quite disturbing since both of these ephedra containing weight-loss products are much less effective but much more dangerous than Dextroamphetamine (still the most effective weight loss medication ever created). Perhaps Doctors should start prescribing amphetamines again for obesity (a practice that has been discouraged since the 1960s) considering the incredible demand of Americans to self-medicate with ephedrine/ephedra to lose weight & the considerable health problems obesity eventually leads to. Easy access to amphetamines in the 1960s & 1970s did lead to a widespread abuse problem among the "baby boomer" generation, but drug abuse, especially in the 1970s was much more common than it is today (despite what you may hear on TV), & many of those abusers were poly drug abusers- those who to put it bluntly, abused any drug on the table or any drug that was "fashionable" at the time. The abuse of amphetamines by the baby boomer generation didn't lead to a generation of lifetime addicts, rather, experimentation with amphetamines was a fad just like Quaalude abuse, & was later replaced with powder cocaine abuse in the late 1970s disco/& early 1980s Wall Street materialistic "yuppie" era. Interestingly enough, the "baby boomer" generation has grown up to become the single wealthiest group of people in the history of the world!
poster:3 Beer Effect