The Opiate includes chemicals such as Heroin, Smack or Browm Sugar, Opium, Cough Syrups such as phensidryl and Corex, Proxyvon, Spasmoproxyvon, Buprenorphine, Forthwin, Morphin and Tidigesic injections. The Opiate addict's fear of withdrawal perpetuates dependency to make it more permanent. For the last stage opiate addicted individual, fear of the pain from withdrawal can be the single factor that continues their dependency. They are so overwhelmingly frightened of the pain of Detox that they would much rather continue taking the drung than face the withdrawal. Ultra-rapid Detoxification id a painless way of withdrawal for Opiate addicts.

Fears and anxieties about withdrawal may deter some addicts from seeking treatment and such factors can also increase the level of distress experienced during withdrawal. An intriguing feature of this new procedure is that the withdrawal is maximally hastened while the addict is under the effect of LIGHT SEDATION. Therefore, the individual does not consciously experience any withdrwal sympotoms make this procedure non-threatening to the addicts and therefore very successful.

Rapid opiod detoxification under LIGHT SEDATION can be safely performed by adhering to medical standards. The efficacy of this rapid opiod detoxification followed by Naltrexone maintenance and psychotherapy has the potential to be an extremely efficacious treatment for opioip addiction. The detoxification process is 100% effective in that everyone who undergoes this procedure becomes detoxified, which is not the case with conventional, long drawn Detox where patients very often drop out of treatment.

Naltrexone is a narcotic antagonist. It works by blocking the opioip receptors in the brain, thereby blocking the effects of heroin and other opioids. Those who take it know that they cannot achieve a 'high' from using heroin and that any money therefore spent on heroin will be wasted. It does not directly stop a person from wanting to use opiates immediately but after sometime, the craving to do so starts to die.

Different Naltrexone implants give effective blood levels for EIGHT WEEKS UP TO ONE YEAR. The implent is usually inserted under local anesthesia after detoxification is over and 2-3 doses for the oral Naltrexone have been given. It is inserted through a 1 cm incisin in the lower abdomen or the back of the upper arm, 3-4 mm under the skin.

• Makes relapse almost implossible while the implant is effective.
• Avoids the need to supervise Naltrexone/Disulfiram and the arguments that ensure.
• Makes it possible to 'forget' to take Naltrexone/Disulfiram.
• Reduces craving much more than oral Naltrexone/Disulfiram because there is no point in carvong for what you can't have.

• Invloves (minor) surgery and produces a small scar with temporary tenderness and bruising.
• Occasional local infection or inflammation of implant site, responding well to antibiotics.
• Initially, more expensive than oral medicine.

It must be emphasized that the need for aftercare counseling to allow thorough socil integration is not reduced when implants replace oral medicine. Aftercare counseling is essntial to ensure that healthy and appropriate coping behaviors are learnt.

DR. SHARAD MAN TAMRAKAR
MBBS, MD (PSYCHIATRY)
CONSULTANT NEURO-PSYCHIATRIST