Behavioral Therapies

Behavioral therapies are helpful to addicts in the following ways: by motivating people to participate in drug treatment offer strategies for coping with drug cravings; teaching addicts ways to avoid drugs and prevent relapse; and helping individuals deal with relapse if it occurs. Behavioral therapies can also help people improve communication, relationships and parenting skills, as well as aid family dynamics. Many treatment programs employ both individual and group therapies. Group therapy offers social reinforcement and helps enforce behavioral contingencies that promote abstinence and a lifestyle without drugs. Some physicians employ established behavioral treatments, like contingency management and cognitive behavioral therapy, in group settings to improve efficiency and cost-effectiveness. However, particularly with adolescents with addictions, there is a danger of iatrogenic or inadvertent effects of group treatment. Because behavioral therapies address different aspects of addiction, combinations of treatments and medications may be more effective than either approach alone. Doctors administer treatments for drug abuse and addiction in many different settings through a variety of behavioral and pharmacological approaches.

Isotretinoin

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis, Clarus) over a period of four to six months can cause long-term resolution or reduction of acne. Doctors believe that isotretinoin works primarily by reducing the secretion of oils from the glands, however some studies suggest that it affects other acne-related factors as well. Isotretinoin research shows it to be very effective in treating severe acne and can either improve or clear well over 80 percent of patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical supervision by a dermatologist because the drug has many known side effects (many of which can be severe). About 25 percent of patients may relapse after one treatment. In those cases, patients require a second treatment for another four to six months to obtain desired results. Doctors recommend that one allow a few months pass between the two treatments, because acne can actually improve somewhat over time. Occasionally a third or even a fourth course is used, but the benefits are often less substantial. The most common side effects are dry skin and occasional nosebleeds (secondary to dry nasal mucosa). Oral retinoids also often cause an initial flare up of acne within a month or so, which can be severe. There are reports that the drug has damaged the liver of patients. For this reason, doctors recommend that patients have blood samples taken and examined before and during treatment. In some cases, doctors terminate or reduce treatment due to elevated liver enzymes in the blood of the patient, which suggest a link to liver damage. Other dermatologists claim that the reports of permanent damage to the liver are unsubstantiated, and deem routine testing unnecessary. A doctor must also monitor the blood triglycerides. However, routine testing is part of the official guidelines for the use of the drug in many countries. Some press reports suggest that isotretinoin may cause depression but as of September 2005, there is no agreement in the medical literature as to this risk. The drug also causes birth defects if a woman becomes pregnant while taking it or takes it while pregnant. For this reason, female patients are required to use two separate forms of birth control or vow abstinence while on the drug. Many doctors only supply isotretinoin to women as a last resort after milder treatments have proven insufficient. The USA put into effect restrictive usage rules (see iPledge program) beginning in March 2006 to prevent misuse, causing occasioned widespread editorial comment.

West Hollywood

West Hollywood has borders to north of the Hollywood Hills neighborhood of Los Angeles and to the east by the Hollywood District of Los Angeles. To the west is the city of Beverly Hills, and on the south is the Fairfax District of Los Angeles. The irregular border of the city is in the city logo and developed from the unincorporated Los Angeles County areas that had not become part of the surrounding cities. West Hollywood benefits from its very compact urban form containing small lots, a mix of land uses and a walkable street grid. Commercial corridors include nightlife and dining areas that exist on the Sunset Strip, along Santa Monica Boulevard, and the Avenues of Art & Design along Robertson, Melrose and Beverly near the Pacific Design Center. Major residential neighborhoods in West Hollywood include the Norma Triangle, West Hollywood North, West Hollywood West, West Hollywood East and West Hollywood Heights. The city breaks down 11 preferential parking zones, which further define residential areas. Major intersecting streets provide amenities within walking distance of adjacent neighborhoods. West Hollywood is a city of Los Angeles County, California.

Treatment Medications

Medications can be an important component of effective drug abuse treatment for offenders. By allowing the body to function normally, prescription medications enable the addict to leave behind a life of crime and drug abuse. For example, opioid agonist and partial agonist medications, which act at the same receptors as heroin, morphine and natural brain endorphins, are effective at helping an individual remain in treatment. Antagonist medications, which work by blocking the effects of a drug, are effective but patients do not often take the drugs regularly. Despite evidence of the effectiveness of medicines, doctors prescribe addiction medications but patients underutilize them in the treatment of drug abusers within the criminal justice system. Still, some jurisdictions have found ways to successfully implement medication therapy for drug abusing offenders.

Opiates Heroin

Long term opiate abuse results in a desensitization of the opiate receptors to endorphins in the brain. Endorphins are natural opioids in the body. Methadone acts on the same receptors as the natural endorphins, stabilizing the craving that otherwise results in compulsive use of heroin or other illicit opiates. Methadone effectively reduces opiate use, criminal behavior related to drugs and risky HIV behaviors. Buprenorphine is a partial agonist and acts on the same receptors as morphine, a full agonist, but without producing the same level of dependence or withdrawal symptoms. Suboxone® is a unique formulation of buprenorphine that contains naloxone, an opioid antagonist, which limits diversion by causing severe withdrawal symptoms in those who inject it to get high, but has no adverse effects when taken orally, as prescribed. Naltrexone, an opiate antagonist, blocks the effects of opiates.