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D’Souza discusses heroin addiction

Dr. Manoranjan D'SouzaDr. Manoranjan (Mano) D'Souza, assistant professor of pharmacology, presented an overview of heroin addiction at a law enforcement seminar hosted by Stark County Prosecuting Attorney John D. Ferrero, on Sept. 5, 2014.

Heroin addiction is a major medical, social and economic problem across the United States. D’Souza discussed the history of heroin use and emphasized the changing trends in heroin addiction over the last two decades. He also explained the stages of heroin addiction and stressed the fact that heroin addiction is a brain disorder rather than just poor judgment by the patient.

Heroin is an opioid and opioid use disorder is classified as a medical condition according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V). D’Souza explained that DSM-V defines opioid use disorder as patients who exhibit at least two of the criteria described below over a 12-month period. These include:  

  • Tolerance to the drug (the need for more of the drug over time to get the same effect)
  • Withdrawal symptoms (physical symptoms when the drug is not present)
  • Craving (a strong desire or urge to use the drug)
  • Continued use of drug despite its harmful physical or psychological effects
  • Continued use despite social and interpersonal problems
  • Loss of control (the patient uses more drug than is necessary to get the desired effects)
  • Attempted reduction (the patient has tried but been unable to reduce or discontinue using the drug
  • Recurrent use resulting in failure to fulfill major obligations at work or at school
  • The importance of the drug in the patient’s life (patient spends a great deal of time trying to procure the drug)
  • Social isolation (the patient gives up normal social interactions or recreational activities to use the drug)

D’Souza’s talk included a brief lesson in pharmacology, explaining how heroin causes the alterations in brain function that are associated with pleasure. Importantly, he discussed how an overdose of the drug can lead to the signs and symptoms that officers must recognize to take appropriate, life-saving action.

“Methadone, buprenorphine, naloxone and naltrexone are each effective in managing heroin addiction, but work in different ways,” explained D’Souza. “Psychotherapy including cognitive-behavioral therapy, along with effective social support systems are also important in concert with medication therapy to effectively manage heroin addiction, and allow the patient to successfully return to contributing to society.”

Finally, D’Souza explained that relapse (return to drug use) among abstinent addicts remains a major problem in the treatment of heroin addiction and discussed strategies to prevent relapse amongst abstinent addicts so that they can maintain a drug-free life.