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  quote[0]="<h3>The Dark Night: the Sinister Side of Sleeping Pills</h3><p> </p> <p>Five years ago I quit a cocktail of sleeping pills and anxiety medications and felt my world implode. I’ve had 34 surgeries on my spine and legs and thought I was strong. But I was not prepared for the horrific withdrawals from these medications. For many months I questioned my sanity without any belief that I could regain my cognitive function or normal sleep patterns. I am a writer and I lost that magical connection to the written word. It was the blackest of times, filled with the deepest despair.</p> <p>I was not a drinker nor did I doctor-shop, and I always waited for a consultation with my pharmacist to confirm my combination of medications was safe. Yet after a decade on the pills, I felt consumed by this chemical straightjacket and wanted my life back.</p> <p>All I was seeking was a good night’s sleep and instead I became trapped by medications I initially believed were my salvation. It started with one prescription, and as my body reached tolerance and the pills stopped working, others were added. By the end I was taking Ambien, Klonopin (Clonazepam), Restoril (Temazepam), Sinequan (Doxepin), <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=13&q=Effexor\">Effexor</a>, OxyContin, and Norco (Hydrocodone). I rarely slept and incessantly paced my home, filled with anxiety. I aged rapidly and my pain level soared, but it was the all-consuming fear that I found most debilitating. I became agoraphobic and did not leave my home.</p> <p>My cocktail of medications was similar to Heath Ledger’s and it saddens me greatly that he lost his life to prescription drugs. I’ve read interviews where Ledger spoke of his raging insomnia, and I knew that he found himself in the same trap I had faced. Even his appearance deteriorated as mine had. How I lived through my debacle is a mystery, but it had such a profound impact that I began an organization to help others escape the clutch of this epidemic.</p> <p>Ironically, mercury poisoning was the cause of my insomnia, but I would not discover this for many years. Instead, I became a willing participant to a chemical experiment that ripped through my world. Unfortunately the same is happening to millions of other people and often starts with insomnia.</p> <p>The sleeping prescription pill market is an enormous industry and we are essentially supporting products that are slowly hurting us. I didn’t know that forcing my brain into submission was not true sleep, but that natural sleep is a complex mechanism triggered by a group of hormones that create a state of rest for the body and mind. As we sleep, consciousness is suspended wh</p> <p>  ile the brain undergoes a cycle of brainwave activity that includes dreaming. The heart and lungs slow and our normally active brainwave patterns diminish tremendously, until we dream. Our blood vessels dilate and the blood that is usually stored in our organs moves into our muscles for tissue repair. The growth hormone in children is secreted during sleep, as are critical chemicals that protect the immune system. So it is no surprise that children placed on stimulant medication have stunted growth and weakened immune systems. I had reoccurring bronchitis and pneumonia and even contracted a staph infection in withdrawal.</p> <p>Natural sleep doesn’t just support physical health, but has a profound effect on our brain as it organizes and archives memories. It is also essential to the creative process. Rolling Stones’ guitarist Keith Richards claims the riff in “I Can’t Get No Satisfaction” came to him in his sleep, while Dmitri Mendeleev, the 19th century chemist, said he literally dreamed the periodic table of elements.</p> <p>During the night, we shift from the predominant NREM (non-rapid eye movement) dreamless sleep to short segments of REM (rapid eye movement) state where dreams occur. Both NREM and REM sleep cycles are necessary to have restorative effects. But sleep medications dramatically reduce the length of time we spend in the dream stage and instead keep us in a light dreamless sleep. To make matters worse, sleeping pills (Ambien, Lunesta) and benzodiazepines (Valium, Klonopin, Restoril, Xanax, Ativan) do not actually improve sleep, but rather create an amnesiac effect that make us forget we are waking up. Unfortunately, most of us misinterpret this memory loss as deeper sleep. The longer we take the pills, even the dreamless sleep shortens in duration and leads to deeper exhaustion and anxiety. To compound matters, sleeping pills only induce sleep an average of 12 minutes quicker and 30 minutes longer than without them. But chemical dependency can occur within three consecutive nights of use, causing painful rebound insomnia, raging anxiety, and memory impairment.</p> <p>Many people add herbs and over-the-counter medications in an attempt to gain a few hours of needed rest. It is not that herbs are dangerous—that is a misconception. But most people do not realize there is risk of a serious interaction when sleep medications are combined with items like passionflower, valerian, or antihistamines. Sleeping pills and benzodiazepines accentuate the GABA neurotransmitter, which keeps the nerve cells in the lung tissue from firing. That is why sleeping pills combined with over-the-counter medications or herbs that accentuate GABA or intensify the effect of the pills will overly suppress respiration, causing asphyxiation. This is what killed Heath Ledger.</p> <p>But GABA doesn’t just affect the lungs. It is an amino acid that naturally occurs in our nervous system. There are approximately 45 million GABA receptors in the body, and 75 percent are affected by sleeping pills and benzodiazepines. GABA regulates our sleep cycles, body temperature, muscles, and all hormone functions of the body. It’s no wonder the withdrawals from these drugs are deemed the most challenging—even more than heroin or cocaine. I remember clearly wishing I had been an illegal drug addict, as the cold-turkey withdrawals would have passed quickly. The only safe way to withdraw from these medications is through a gradual taper, which allows the brain and body a chance to adjust at each level of reduction.</p> <p>It wasn’t my path to have an easy withdrawal, and I firmly believe the reason was to help address this epidemic of pill usage. I’ve worked with people from all over the world who are addicted to these medications. Most are taking one or two prescriptions and suffering the same intensity of symptoms I did on a cocktail of drugs. I realized long ago that any dose of sleep medication is dangerous.</p> <p>In spite of the fact that I made every step of my medication journey improperly, I also made it back to complete health. I no longer suffer from pain, anxiety, or insomnia. My sleep patterns have returned, and at the age of 50, I feel better than I have in 20 years. You see, what I’ve also realized is that our bodies are amazing machines with a symphony of chemicals that yearn to be healthy. It has a remarkable capacity to heal if given the right nutrients.</p> <p>So now, in spite of the fact that I have chosen to help people in their darkest hour, I also get the privilege of watching them regain what I now have—freedom.</p> <p>Alesandra Rain is the author of Deeds of Trust. She is also the co-founder of Point of Return. For more information, visit www.PointofReturn.com or call 866-605-2333.</p> </p> <p>     Rain: L-on meds;  R-Current</p> <p> </p> "
  quote[1]="<h3>Part Two of Suboxone, a New Paradigm</h3><p>In Part One of this article I described the problems with traditional treatment of opiate addiction.  Suboxone is a revolutionary alternative.</p> <p> Suboxone consists of two drugs; buprenorphine and naloxone.  The naloxone is irrelevant if the addict uses the medication properly, but if the tablet is dissolved in water and injected the naloxone will cause instant withdrawal.  When suboxone is used correctly, the naloxone is destroyed in the liver shortly after uptake from the intestines and has no therapeutic effect.   Buprenorphine is the active substance; it is absorbed under the tongue (and throughout the mouth) but destroyed by the liver if swallowed. There is a formulation of buprenorphine without naloxone called subutex;  I have used this formulation when the patient has apparent problems from naloxone, including headaches after dosing with suboxone.  I have also treated addicts who have had gastric bypass, where the first part of the intestine is bypassed and the stomach contents empty into a more distal part of the small intestine.  In such cases the naloxone escapes ‘first pass metabolism’, the process with normal anatomy where the drug is taken up by the duodenum and transferred directly to the liver by the portal vein, where it is quickly and completely destroyed.  After gastric bypass naloxone can be taken up by portions of the intestine that are not served by the portal system, causing blood levels of naloxone sufficient to cause brief, relatively mild withdrawal symptoms.</p> <p> Buprenorphine has a ‘ceiling effect’—the narcotic effect of the drug increases with increasing dose up to about one or two mg, but then the effect plateaus and higher amounts of buprenorphine do not increase narcosis.  The average patient usually takes 12-24 mg of suboxone per day, and quickly becomes tolerant to the effects of buprenorphine (buprenorphine does have significant narcotic potency, but the potency usually pales in comparison to the degree of tolerance found in active opiate addicts)..  The opiate receptors in the brain of the addict become completely bound up with buprenorphine, and the effects of any other opiate medication are blocked.  Once the addict is tolerant to the correct dose of suboxone, the buprenorphine that is bound to their opiate receptors reduces cravings and prevents the effects—and so the use–of other opiates.  Suboxone is very effective in preventing relapse; the ‘choose to use’ issue is effectively removed by the fact that use would require the addict to go through several days of withdrawal in order to remove the receptor blockade and allow other opiates to have an effect.  Given addicts’ attitudes toward withdrawal, the appeal of this ‘choice’ is quite low.  The only real problem with suboxone treatment relates to specificity.  With suboxone, the addict stays off opiates, but there is nothing to prevent the substitution of alcohol.  On the other hand, naltrexone reduces alcohol cravings by blocking opiate receptors, and it is quite likely that suboxone, through its similar mechanism, will reduce alcohol cravings as well.  Such an effect has been reported to me by a number of suboxone patients, but has not been reported in the literature at this point.  The suboxone patients who move from one substance to another will likely require an approach that demands total sobriety.  But for pure opiate lovers, other benefits of suboxone are that only mild (and possibly medicated) withdrawal is required to start treatment, the drug is usually covered by insurers, prescribing restrictions are minor, and there are fewer stigmas associated with maintenance than there are with methadone. </p> <p> As I stated in part one of this article, I predict that suboxone will eventually be the standard treatment for opiate addiction, and will change the treatment approach for other substance addictions as well.  My only reservation with this statement is that it is unclear how the current recovering community will respond to patients treated with suboxone.   If suboxone patients are rejected by the recovering community, what will be the long-term outcome of their addictions when the substance is removed but the personalities and issues remain untreated?  Is it a given that all addicts have a disease that requires group therapy?  As things stand now, addicts maintained on suboxone are often referred for addiction counseling.  But the exact message to deliver with counseling is debatable.  In many ways, a patient maintained with suboxone becomes similar to a patient with hypertension treated for life with medication—the underlying problem persists, but the active disease is held in remission.  If the uncontrolled use of opiates is effectively treated, is that enough?  Should counseling be focused on removing the shame of having the disease of addiction, and on encouraging the treated addicts to get on with their normal lives?  Or should we continue to see addiction as a consequence of a deeper problem or faulty character structure, which requires groups and meetings if one hopes to become ‘normal’?  Unfortunately the use of suboxone runs counter to successful adoption of sobriety through 12-step programs, which in the first step require acceptance of the fact that the addict is powerless over the substance—that there is no amount of will power that will allow the addict to control the deadly effects of the drug.  By using suboxone the addict may develop the impression that he/she has control, particularly if suboxone becomes popular on the street for self-medication of withdrawal.</p> <p> Before suboxone, the only option for opiate addicts was to lose a sufficient number of things—family, employment, freedom, health—to cause them to accept treatment and recovery.  Only a small fraction of addicts recovered, and only after significant losses—and relapse rates were high.  Suboxone is an amazing breakthrough; one that for the first time allows treatment of addicts early in the course of their illness, and that reliably induces remission in most patients.  But there are some things to be concerned about, that have the potential to reduce the effectiveness of this amazing new drug and treatment approach.  First, some insurers demand that the drug be used only short-term, in some cases for only three weeks!  This requirement totally misses the nature of addiction, and ignores the known high relapse rate after short-term use of suboxone (and why wouldn’t it be high?).  Some physicians use the medication in this short-term way; hopefully the motivations for this ineffective treatment method are not related to the limits placed on the numbers of maintenance patients per physician.  Other physicians will transfer their attitudes toward opiate agonists to the use of suboxone, and place constant downward pressure on the daily dose of suboxone.  This approach is not appropriate with suboxone; the value of the drug requires adequate dosing to achieve the long half-life and repression of cravings.  At doses of less than 8 mg, suboxone becomes more similar to a pure agonist; one might as well be giving small doses of hydrocodone to prevent withdrawal.  There is no reason beyond drug cost to reduce the dose, as tolerance is limited by the ceiling effect that occurs with relatively low doses.  In other words, higher doses of suboxone do not result in eventual higher degrees of withdrawal.  Another issue is that the medication is sometimes prescribed carelessly, without emphasizing the need to dose once per day.  Patients left to their own devices will start using the medication multiple times per day as a ‘prn’ medication, and will remain in the same addiction behavior that brought them to treatment.  Once per day dosing is important because it allows the addictive behavior to be extinguished over time.  Initially patients will have increased anxiety as they lose the distraction and placebo effect of frequent drug use.  But over time the anxiety will fade, and the huge void left by the removal of addictive obsession will allow the development of relationships and other positive character traits that were forced out by their addiction.</p> <p> Given the time pressures and payment structures of modern medicine, suboxone may eventually replace residential treatment as a more reliable, less costly alternative.  I believe that the time has come to replace the ‘recovery’ model with a new ‘remission’ model, which allows treatment of a much higher percentage of users at an earlier stage of disease.  With time, will we find analogous agents that provide a low level of intoxication in return for receptor blockade?  While not likely with alcohol, such an outcome is certainly within the bounds of imagination for cocaine, benzodiazepines, and barbiturates.  While it is true that daily use of a partial agonist would represent a reversal from our current approach where all intoxicating substances are to be avoided, it is also true that the current approach has no bragging rights based on outcome.  Finally, perhaps the adoption of a remission model will lessen the time until opiate and other addictions carry as much moral stigma as hypertension or diabetes—two other diseases that are generally treatable, but that require long-term use of medications.</p> "
  quote[2]="<h3>New Arthritis Drug Guidelines… Do They Help… Or Do They Hurt?</h3><p>Non-steroidal anti-inflammatory drugs (NSAIDS) have been the mainstay of arthritis treatment for more than 50 years. Over this time multiple drugs have reached the market and have been used by millions of people. In most cases, the safety profile has been one that has been predictable. In a few unusual cases, safety has been problematic leading to the withdrawal from the market of at least three drugs- Oraflex, Vioxx, and Bextra.</p> <p> NSAIDS provide both analgesic (pain-relieving) as well as anti-inflammatory effects in arthritis.</p> <p> Their action is dependent upon their effect in blocking the cyclooxygenase pathway. Cyclooxygenase is an enzyme that is responsible for the production of inflammation producing enzymes called prostaglandins. There are at least two cyclooxygenase pathways. Pathway one- termed COX-1 is the pathway blocked by most NSAIDS. These include drugs such as ibuprofen (Motrin), naproxyn (Naprosyn), piroxicam (Feldene), sulindac (Clinoril), oxaprocin (Daypro), nabumetone (Relafen), etodolac (Lodine), ketoprofen (Orudis), and meloxicam (Mobic).</p> <p> COX-2 is the other pathway blocked by drugs like <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Celebrex\">Celebrex</a>.</p> <p> Because these drugs are prescribed so widely by many different types of physicians including family practitioners, internists, orthopedic surgeons, as well as by rheumatologists, the extent to which serious side-effect issues have been addressed is unknown. The American College of Rheumatology recently released their recommendations in a paper published in the August 15th issue of Arthritis Care & Research (Arthritis Care and Research. 2008; 59: 1058-1073).</p> <p> The authors recognized the fact that these drugs are often prescribed for patients with cardiovascular risk factors such as hypertension and hypercholesterolemia, as well as kidney dysfunction. What this means is that each patient needs to be evaluated as an individual. If the patient is on anti-cholesterol medicine or ACE inhibitors for hypertension, or aspirin for heart protection, these factors must be considered before prescribing NSAIDS.</p> <p> Patients must be counseled in regards to potential toxicities and drug interactions. If the patient agrees that they want to take an NSAID, the drug needs to be monitored. Also, if the patient fails one NSAID, they may respond to another. Low doses are safer than high doses.</p> <p> Monitoring of complete blood count as well as liver and kidney function should be done routinely.</p> <p> If a patient is taking aspirin for heart protection, NSAIDS should be taken cautiously and with stomach protection if possible.</p> <p> Unfortunately, there is a problem in that patients who need to be on heart-protective aspirin and who desperately need an NSAID for their arthritis are subject to a double whammy. The combination of low dose aspirin plus an NSAID increases the risk of gastrointestinal complications such as ulcer. At the same time NSAIDS themselves increase the risk for cardiovascular events such as stokes and heart attacks.</p> <p> Also, it has been shown that the combination of ibuprofen plus aspirin actually reduces the cardiac protection of aspirin and the drug, naproxyn, if used intermittently also increases cardiovascular risk.</p> <p> All NSAIDS increase the risk of kidney damage.</p> <p> Many NSAIDS, particularly diclofenac (Voltaren) increase the risk of liver damage and need to be monitored closely and avoided in patients with pre-existing liver damage.</p> <p> Patients on anticoagulant therapy should avoid drugs in the COX-1 class. Even COX-2 drugs may be problematic and should be evaluated carefully.</p> <p> What’s a mother to do?</p> <p> NSAIDS are potentially dangerous drugs that should be used by physicians who are experienced with this class of medications. Patients should realize the potential dangers and discuss them frankly with their physician.</p> "
  quote[3]="<h3><b>Tramadol</b> Precautions</h3><p><a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> can be simply understood as a pain relief medication. <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> medication was developed by the German drug maker, Grünenthal GmbH and marketed under the trade name Tramal. This pain relief medication, <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is available in the strength of 50mg as over-the-counter medication that is it does not necessitate any prescription for usage. It works on the mechanism of decreasing the body’s sense of pain, and is effectual relieving moderate to moderately severe pain. </p> <p>   For effectual pain relief results of <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> usage, it is essential to follow a few precautionary measures. Use of <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> pain relief medication does not necessitate to be planned along with meals. <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> medication can be consumed every 4-6 hours as needed. Consult your doctor to get well-acquainted with the adequate dosage in accordance to your specific medical requirements. On no account indulge in over dosage of <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> medication, as it maybe damaging for your health. </p> <p>   Notify your doctor about medical history prior to initiating Tramadol medication so that unforeseen medication complication can be averted. If you are allergic to any ingredient of Tramadol or any other narcotic medication, refrain from usage of Tramadol. Speak with your doctor pertaining to the maximum amount of Tramadol tablet consumption in the span of 24 hours. Women planning pregnancy, expectant women, and nursing mothers should not indulge in Tramadol medication. Women, who become pregnant during the Tramadol treatment, should consult their doctor for appropriate medical help.</p> <p>   Some of the adverse reactions which may be sourced as a result of Tramadol usage can be accounted as vomiting, nausea, and sweating. Report immediately to your doctor if you experience these or any other side effects for appropriate medical help. Tramadol is a habit-forming medication; thereby it should be administered under proper medical guidance. It is also not advisable to abruptly discontinue usage of Tramadol pain relief medication, as it can be detrimental for your health. </p> <p>   Shelve Tramadol medication in a tightly sealed container at room temperature away from sunlight and heat. Order and buy Tramadol by means of online pharmacies. Online pharmacy drugs are an easy way and feasible way to buy medications. Several online pharmacies offer you the facility of free shipping and free consultations. </p> "
  quote[4]="<h3>Slow Release in Every Sense of the Words</h3><p><a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Ultram\">Ultram</a> is marketed in some seventy countries around the world for the treatment of moderate to severe pain in multiple dose format. The simple rule is that the dose should be individualised so that each person takes the smallest dose required to produce the required relief from pain. Normally, this means that patients start with a very low daily dose and slowly increase the dosage every three days until a stable and effective concentration in the blood stream is achieved. After that, the level is maintained by taking one tablet every four to six hours. No-one should take more than 400mg per day. If there is a more urgent need for pain relief and that need outweighs the risk of dependence, people may take an initial high dosage. This well-established system may be about to change in the US.</p> <p>   Since 2006, Labopharm Inc. has been seeking approval from the Food and Drug Administration for the once-daily version of <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Ultram\">Ultram</a> already approved in twenty-two European countries. The format is based on Contramid technology which allows both rapid and sustained drug release to maintain stable blood levels within the therapeutic range over the twenty-four hour period. Now some two years into its campaign, the company is scheduled to meet with the director of the FDA’s Center for Drug Evaluation and Research which will trigger a thirty day deadline for the FDA to give its decision. If that decision is positive, Labopharm Inc. has a further sixty days to comply with the labelling requirements. This could mean a formal approval for the slow-release version of ultram issue