Word: heroines
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Dates: during 1980-1989
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When methadone was first introduced 24 years ago, it was hailed as a magic bullet aimed at the heart of heroin addiction. A neat, clean medical solution to a social problem. It has proved to be something less than that. Methadone is a treatment, not a cure, for addiction, and an imperfect one at that. But for some 100,000 of the country's half-million heroin addicts, it offers an alternative to shooting up as well as the possibility of a productive life...
...most promising of several drugs to combat addiction that are being tested is buprenorphine, a pain reliever that in early trials has shown clear advantages over methadone as a treatment for heroin addiction. Under development by a team at Yale University, the drug, like methadone, induces a generalized feeling of contentment rather than heroin's precipitate rush and euphoria. It is at least as effective as methadone in easing physical withdrawal and reducing cravings, and it is significantly more potent in blocking heroin's high if the addict tries to shoot up again. Unlike methadone, buprenorphine is relatively nonaddictive...
...bonus, buprenorphine seems radically to suppress the urge to take cocaine, which is abused by an estimated 70% to 80% of heroin addicts. Methadone also tends to reduce coke use, but less dramatically. While methadone may wean half of those treated from cocaine, buprenorphine could slash the number of coke abusers to almost nil, says Yale researcher Thomas Kosten. A Harvard study of rhesus monkeys habituated to using coke found that daily doses of buprenorphine led the monkeys to kick the habit completely...
Still, scientists are not expecting miracles, particularly in battling cocaine addiction. Unlike heroin, which acts on the pain-killing endorphin system alone, cocaine engages three separate neurotransmitter systems: those based on dopamine, serotonin and norepinephrine. Taken together, these networks govern the human ability to experience pleasure, from watching a sunrise to having sex. Blocking all these pleasure centers -- as methadone blocks the heroin high -- would literally take the joy out of life, says Yale's Kosten. "We'd turn out automatons." Addicts trying to quit cocaine go through a stage called anhedonia, a sort of spiritless limbo that typically drives...
...psychological and social causes of drug abuse. Even if an addict is weaned from one drug, they say, he will very often take up another. A federal study released in August found that as many as 47% of patients at 15 methadone clinics across the country continued to use heroin or other opiates, and up to 40% used nonopiate drugs, usually cocaine. So scientists find themselves aiming their magic bullet at a moving target. "We're constantly having to treat new disease," said Marvin Snyder, director of NIDA's medications- development program. "In five years, the problem...