Nicotine Maintenance Therapy

[Vocalek]

Some folks have suggested a parallel between using a nicotine product instead of smoking on a long-term basis and methadone treatment for ...... addicts. Came across a very good explanation of the concept behind methadone.

Why methadone maintenance works

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[FONT=Tms Rmn,Times New Roman]The two major reasons for the success of methadone maintenance are surely no secret. Methadone is legal; hence the addict who enters a methadone maintenance program casts off his role of hated and hunted criminal when he downs his first methadone tablet or glass of methadone spiked orange drink. And methadone is cheap. The cost of the usual dose--- 100 milligrams per day--- is ten cents. It is supplied the addict either free or (in some programs with ancillary services outside New York) for $10 to $14 per week.[/FONT]

[FONT=Tms Rmn,Times New Roman]If morphine or ...... were legally dispensed at low cost, the same two advantages would be equally well achieved. Thus in those two respects the favorable results of methadone maintenance cannot be attributed solely to the methadone.[/FONT]

[FONT=Tms Rmn,Times New Roman]Like morphine and ......, methadone is a narcotic and therefore, by definition, an addicting drug. This fact is often cited as a disadvantage. Indeed, newspapers, politicians, and even some physicians have expressed the hope that a nonaddicting drug for the treatment of ...... addiction can be found.[/FONT]

[FONT=Tms Rmn,Times New Roman]This hope, however, is based on a misunderstanding. One main advantage of methadone is that it is addicting. For an addicting drug, it will be recalled, is one that an addict continues to take day after day and year after year.[/FONT]

[FONT=Tms Rmn,Times New Roman]In fact, several nonaddicting drugs for the treatment of ...... addiction have already been tried out. Among them are the narcotic antagonists; cyclazocine and nalaxone are examples. An addict who injects ...... while on one of these drugs perceives no effect. Thus the antagonists, like methadone, are "blocking agents." But they are inferior to methadone in at least two other major respects.[/FONT]

[FONT=Tms Rmn,Times New Roman]First, they do not assuage the postaddiction syndrome--- the anxiety, depression, and craving that recur for months and perhaps years after the last shot of ....... The contrast with methadone is readily visible. A psychiatrist who has had experience with both methadone and antagonist maintenance programs contrasts "the relaxed, jovial atmosphere of a methadone ward," where patients are free of the postaddiction syndrome, with "the tension, frustration, and anxiety that characterize a cyclazocine ward." [/FONT][FONT=Tms Rmn,Times New Roman]1[/FONT][FONT=Tms Rmn,Times New Roman] Clearly methadone is in this respect a far more hopeful base for building social rehabilitation.[/FONT]

[FONT=Tms Rmn,Times New Roman]The other major difference is that since the antagonists are not addicting, a patient can stop taking them at will. * Most patients do stop taking them--- and then promptly return to black-market ....... The greater success of methadone results in considerable part from the fact that it is an addicting drug.[/FONT]

[/FONT]Do you see the parallels?

 

[TropicalBob]

I sure see them, Vocalek. And I, like you, argue that there is nothing inherently wrong with lifetime use of nicotine. Smoking is the health hazard, not nicotine in the amounts we use. vaping is a great way to maintain nicotine levels in the blood without the health hazards of inhaling smoke.

But ... there are people on this forum who go bonkers when I correctly say that we are nicotine addicts, who spend much of each day assuring we have an adequate supply of our drug of addiction. Of course we are.

And I do see the parallels between us and methadone users. They're addicts needing a lifetime crutch to survive, just as we do.

 

[Kate51]

Not me TB, I know I am one of those heathen nicotine addicts, supposedly, and I believe in Maintenance too! Maintaining a more or less static disposition, more or less maintaining my weight and keeping my head together, and more or less telling people to ______off when they ask "you still sucking on that thing?" when they stand in front of me weighing a hundred pounds more than they did before the Cold Turkey treatment. How's that working out for you I'm thinking. But I wouldn't say that out loud, as long as I'm on my social rehabilitation maintenance program.

 

[Vocalek]

Not me TB, I know I am one of those heathen nicotine addicts, supposedly, and I believe in Maintenance too! Maintaining a more or less static disposition, more or less maintaining my weight and keeping my head together, and more or less telling people to ______off when they ask "you still sucking on that thing?" when they stand in front of me weighing a hundred pounds more than they did before the Cold Turkey treatment. How's that working out for you I'm thinking. But I wouldn't say that out loud, as long as I'm on my social rehabilitation maintenance program.

And I see that program is working well, Kate. You haven't scratched anyone's eyes out in hours and hours.


And you bring up the other point about nicotine abstinence. If you're asking "What was that first point again?" it's (as someone said to me in a PM the other day) "Quit Smoking - Go Crazy." [ASIDE" Why do I write such convoluted sentences at 5 a.m.?] I like the language used by the author of the methadone article to describe what goes on in our heads: "the postaddiction syndrome." It is not a pretty thing, is it?

And the other point is what goes on in our body when we are "being good" and stop using all forms of nicotine: weight gain, sleep disturbances, and hypertension, followed by diabetes if that runs in your family.

 

[Kate51]

Glad to see it's so obvious how absolutely loving I am!!
Add a few cups of nice 100% Columbian dark roast to the mix, I'm good to go!

 

[Vocalek]

And that you have a good sense of humor! Your kittie looks very loving. We had two gray tabbies. Tigre was the mommy cat and we kept one of her kittens. I named him Tom after my favorite actor Tom Selleck. One day when he decided to climb up my leg to get onto the couch -- and I was wearing shorts! -- I changed his name to Fred in honor of the parallel marks he left on my right leg (ouch!). Do you get the movie reference?

They lived long and happy lives. We have decided to not do any more pets at this time because we will be moving sometime in the next year and that can be upsetting for an animal. You hear so many stories about families moving and their pet disappears -- only to show up days, weeks, or months later at the old address.