Management

Management is complex because it includes the medical management not only of physical dependence and withdrawal but also of the individual complex social and emotional factors. The issue of HIV prevention also has to be addressed. Patients should be referred to a treatment clinic and then a shared care approach can be used. The treatments include cold turkey with pharmacological support, acupuncture, megadoses of vitamin C, methadone substitution and drug-free community education programs.

Methadone maintenance programs that include counselling techniques are widely used for heroin dependence. Acute toxicity requires injections of naloxone.

The natural history of the opiate dependence indicates that many patients do grow through their period of dependence and, irrespective of treatments provided, a high percentage become rehabilitated by their mid-thirties.

Cannabis is a drug that comes from a plant called Cannabis sativa or the Indian hemp plant. It contains a chemical called tetrahydrocannabinol, which makes people get 'high'. It is commonly called marijuana, grass, pot, dope, hash or hashish. Other slang terms are Acapulco Gold, ganga, herb, J, jay, hay, joint, reefer, weed, locoweed, smoke, tea, stick, Mary Jane and Panama Red. Marijuana comes from the leaves, while hashish is the concentrated form of the resinous substances from the head of the female plant and can be very strong (it comes as a resin or oil). The drug is usually smoked as a leaf (marijuana) or a powder (hashish), or hashish oil is added to a cigarette and then smoked. The effects of taking cannabis depend on how much is taken, how it is taken, how often, whether it is used with

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