History
Trombiculidae, from Greek (“to tremble”) and Latin culex, gen. culicis (“gnat” or “midge”), was first described as an independent family by H.E. Ewing in 1944. But references to chiggers go as far back as sixth century China, and by 1733, the first recognization of trombiculid mites in North America were made. In 1758, Linnaeus described a single species Acarus batatas (Now Trombicula batatas). However, most information about chiggers came from the problems arose during and after World War II.
Then, when the family was first described, it included two subfamilies, Hemitrombiculinae and Trombiculinae. Womersley added another, Leeuwenhoekiinae, which at the time only contained Leeuwenhoekia (Oudemans, 1911). Later he erected the family Leeuwenhoekiidae for the genus and subfamily, having six genera; they have a pair of submedian setae present on the dorsal plate.
Distribution
Trombiculid mites are found throughout the world. In Europe and North America, they tend to be more prevalent in the hot and humid parts. In the more temperate regions, they are found only in the summer (in French, harvest mites are called aotat, or “August” flies). In the United States, they are found mostly in the southeast, the south, and the Midwest. They are not present, or barely found, in far northern areas, in high mountains and in deserts. In the British Isles, the species Trombicula autumnalis are called harvest mites, in North America the species Trombicula alfreddugesi, and the species Trombicula (eutrombicula) hirsti which are found in Australia and are commonly called the scrub-itch mite.
Life cycle
The life cycle of a harvest mite
The length of the mite’s cycle depends on species and environment, but normally last 2 to 12 months (but may be longer). The number of cycles in a year depends on the region. For example, in a temperate region, there might only be 3 a year, but in tropical regions, the cycle might be continuous all year long. Adult harvest mites overwinter in protected places such as slightly below the soil. Females become active in the spring, and once the ground temperature is regularly above 60 (15.6 ), she lays eggs, up to 15 eggs per day in vegetation when soil temperatures are 60 (15.6 ). Therefore, from April through early autumn up until the first frost, humans are susceptible to chigger bites. The larvae congregate in groups on small clods of earth, in matted vegetation and even on low bushes and plants, where they have more access to a prospective host. The eggs are dormant for about six days, after which the non-feeding pre-larvae emerge, with only three pairs of legs. After about six days, the pre-larva grows into its larval stage.
Larva
The larvae, commonly called chigger, are about 0.170.21 mm (0.0070.008 in) in diameter, normally light red, covered in hairs, and move quickly relative to size. There is a marked constriction in the front part of the body in the nymph and adult stage. The eggs are round in shape.Chigger is also an alternate term for the chigoe flea (Tunga penetrans), a sand flea found in tropical and subtropical climates in the Americas and Africa.
The name chigger originated as a corruption of chigoe. Also called scrub mite, red mite and several other names, they are found throughout temperate and tropical zones. Chiggers come in 3 stages: the deutovum, unfed larva, and engorged larva. Once in the egg developing, the larvae enclosed in a membrane in addition to the eggshell, are called deutovum. After hatching, the unfed larvae migrate to the highest area and wait for a host.
The larval stage is the only parasitic stage of the mite’s life cycle. They are parasites to many animals. About 30 of the many species in this family, in their larval stage, attach to various animals, including amphibians, reptiles, birds, and mammals, and feed on skin. This often causes an intensely itchy red bump in humans (who are accidental hosts).
Chiggers attach to the host, pierce the skin, inject enzymes into the bite wound that digest cellular contents, and then suck up the digested tissue through a tube formed by hardened skin cells called a stylostome. They do not burrow into the skin or suck blood, as is commonly assumed. Itching from a chigger bite may not develop until 2448 hours after the bite, so the victim may not associate the specific exposure with the bite itself. The red welt/bump on the skin is not where a chigger laid eggs, as is sometimes believed. The larva remains attached to a suitable host for 3 to 5 days before dropping off to begin its nymph stage.
Chiggers do not like sunlight or humidity. During the wet season, chiggers are usually found in tall grass and other vegetation. During dry seasons, chiggers are mostly found underneath brush and shady areas.
Chiggers as disease vectors
For more details on this topic, see Scrub typhus.
Although the harvest mite chigger usually does not carry diseases in North American temperate climates, the Leptotrombidium deliense are considered a dangerous pest in East Asia and the South Pacific because they often carry Orientia tsutsugamushi, the tiny bacterium that causes scrub typhus, which is known alternatively as the Japanese river disease, scrub disease, or tsutsugamushi. The mites are infected by the Rickettsia passed down from parent to offspring before eggs are laid in a process called transovarial transmission. Symptoms of scrub typhus in humans include fever, headache, muscle pain, cough, and gastrointestinal symptoms.
Nymph
Once the larva has engorged itself on skin and has fallen off its host, the larva develops to its nymph stage. Like the larva, the nymphs are also sexually immature, but more closely resemble the adult.
This stage consists of three phases; the protonymph, deutonymph, and tritonymph, respectively. The protonymph and tritonymph morphology are unusual in species of Trombiculidae. The protonymph phase combines larval and protonymph characteristics with deutonymph and tritonymph morphology. The protonymph is an inactive transitional stage. The active deutonymph develops an additional pair of legs (for a total of eight). Lastly, it re-enters inactivity during its transitional tritonymph phase before growing to adulthood.
Adult
As a deutonymph and adult, trombiculid mites are independent predators that feed on small arthropods and their eggs, also found to eat plant material. They live in soil, often found when digging in yards and gardens. Adults can be beneficial to human beings, since they often eat the eggs of other pests, such as mosquitoes.
Trombiculiasis
Trombiculiasis, also called Trombiculidiasis, is the term coined for the rash caused by trombiculid mites.
Prevention
Chigger bites on the foot and ankle
Chiggers are commonly found on the tip of blades of grasses to catch a host, so keeping grass short, and removing brush and wood debris where potential mite hosts may live, can limit their impact on an area. Sunlight that penetrates the grass will make the lawn drier and make it less favorable for chigger survival.
Chiggers seem to affect warm covered areas of the body more than drier areas. Thus, the bites are often clustered behind the knees, or beneath tight undergarments such as socks, underwear, or brassieres. Areas higher in the body (chest, back, waist-band, and under-arms) are affected more easily in small children than in adults, since children are shorter and are more likely than adults come in contact with low-lying vegetation and dry grass where chiggers thrive.
Chigger bites can be minimized by the use of tightly woven protective clothing, including long pants, which make it hard for them to reach such spots. Application of repellent to the shoes, lower trousers and skin is also useful. Because they are found in grass, staying on trails, roads, or paths can prevent contact. Dusting sulfur is used commercially for mite control and can be used to control chiggers in yards. The dusting of shoes, socks and trouser legs with sulfur can be highly effective in repelling chiggers.
Another good strategy is to recognize the chigger habitat to avoid exposure in the first place. Chiggers in North America thrive late in summer, in dry tall grasses and other thick, unshaded vegetation. Insect repellents containing one of the following active ingredients are recommended: DEET, catnip oil extract – nepetalactone, citronella oil or eucalyptus oil extract. However, in 1993 issue a study reported on tests of two commercial repellants: DEET and citrus oil: “All chiggers exposed on the filter papers treated with DEET died and did not move off the treated papers. None of the chiggers that were placed on papers treated with citrus oil were killed.” It was concluded that DEET was more effective than citrus oil.
Chiggers can also be treated using common household vinegar (5% acetic acid). For personal protection, apply insect repellent to feet, legs, and mid-section.
Treatment
This section may require cleanup to meet Wikipedia’s quality standards. The specific problem is: date-June 2009. Please improve this section if you can. (June 2009)
Chigger rash 36 hours after exposure
To reduce the itching, an application of anti-itch cream containing hydrocortisone, calamine, or benzyl benzoate is often used (though calamine has been shown not to be effective). Hydrogen peroxide and capsaicin cream has also been effective. Another good way to relieve itching is to apply heat either by using a hand held shower with water hot as one can stand, or by heating the bite with a hair dryer. The heat method will relieve itching for about four hours and will require repeating. Applying fingernail polish to the affected area does not kill the chigger; the chigger is actually no longer present by the time a rash is noticed.
The most effective way of removing chiggers is by washing the affected areas with warm water and soap. This must be done as soon as possible after exposure or possible exposure. Carefully wash the ankles, feet, behind the knees, and under the arms and chest. An Epsom salt bath may help alleviate itching. If one is near the seashore, wading for a few minutes in salt water will both get rid of the mites on one’s skin and clothing and also alleviate the itching from their bites. Clothing, especially pants and socks, should be immediately discarded after returning from areas where exposure may have occurred. However, once symptoms appear, it may be too late to prevent further bites. Taking a hot bath when already covered with chigger bites may in fact be very uncomfortable and increase itching symptoms. Do not rub and scratch the skin aggressively, as this can break the skin and leave it vulnerable to a more serious infection.
Some claim that the chigger is still in the bite, perhaps mistaking the tiny red center of the bite for the chigger itself. In some cases, the chigger is still present when the bite appears. A 10X magnifier can be used to see the chigger and it may be removed with fine-tipped tweezers. Once it is gone, covering the bite with nail polish, calamine lotion, vaseline or other petroleum jelly, baby oil, or anything else may help the pain and itching, but will neither suffocate the chigger nor help the bites heal any faster. Medication such as antihistamines or corticosteroid creams may be prescribed by doctors, and might help in some instances.
References
^ “Trombiculidae Ewing, 1929 (Family)”. SysTax – database query. Universitt Ulm. http://www.biologie.uni-ulm.de/cgi-bin/system/zoosys.pl?id=97056&stufe=5&typ=ZOO&lang=e&sid=T&pr=nix&only=no&B4=ok&syno=y&valid=y. Retrieved 2009-03-06.
^ Shatrov, A. B.; Kudryashova, N. I. (2008). “”Taxonomic ranking of major trombiculid subtaxa with remarks on the evolution of host-parasite relationships (Acariformes: Parasitengona: Trombiculidae)”". Annales zoologici (Warsaw) 58: 279287.
^ Smith, GA; V Sharma, JF Knapp, BJ Shields (1998). Pediatric emergency care. ed. The summer penile syndrome: seasonal acute hypersensitivity reaction caused by chigger bites on the. 14 (2 ed.). U.S.: Pediatric emergency care. pp. 116118. http://scholar.google.com/scholar?hl=en&lr=&q=info:49gX7aDTc_oJ:scholar.google.com/&output=viewport&pg=1. Retrieved May 22, 2009.
^ Ballantine, Todd (1991). Tideland treasure: the naturalist’s guide to the beaches and salt marshes of Hilton Head Island and the southeastern coast. Columbia, South Carolina: University of South Carolina Press. pp. 14. ISBN 0-87249-795-X.
^ Mandell, Gerald L.; Bennett JE, Dolin R, (2005). “294″. in 6th. Principles and Practice of Infectious Diseases.. Philadelphia: Elsevier Churchill Livingstone. ISBN 0443086869, 9780443086861.
^ Goldman, Lee; Dennis Arthur Ausiello (2007). Cecil Medicine (23, illustrated, revised ed.). Elsevier Health Sciences. pp. 1032.
^ a b c d e f g Durden, Lance A. (2002). Medical and veterinary entomology (3rd ed.). Academic Press. pp. 458. ISBN 9780125104517. http://books.google.com/books?id=u4RGXGkRq5YC&pg=PA458&lpg=PA458&dq=trombiculidae+”life+cycle”&source=bl&ots=InFLxmvnBe&sig=tk8VWaihOEllvoiuzM9E49K32Cw&hl=en&ei=WFS8SYO6JJHAM92U0aoI&sa=X&oi=book_result&resnum=9&ct=result.
^ a b c d Potter, M. F.; P. G. Koehler (March 1995. Revised February 2000. Reviewed January 2006.). “Invisible Itches: Insect and Non-Insect Causes”. University of Florida, Depart. pp. 14. http://edis.ifas.ufl.edu/pdffiles/MG/MG34300.pdf. Retrieved 2009-05-22.
^ Scarborough, John (1998). Medical and Biological Terminologies. Oklahoma: University of Oklahoma Press. pp. 122. ISBN 0806130296.
^ Bowman, Dwight D.; Hendrix, Charles M.; Lindsay, David S.; Barr, Stephen C. (2002). Feline clinical parasitology. Wiley-Blackwell. pp. 38586. ISBN 0813803330.
^ E.W. Ewing (Oct. 1946). The Journal of Parasitology. 32. pp. 435440. http://www.jstor.org/pss/3272913.
^ “Aotat : Definition” (in French). Vulgaris – medical. http://www.vulgaris-medical.com/encyclopedie/aoutat-522.html. Retrieved 2009-05-19.
^ Vater, G. (2006). “The geographical distribution of the harvest mite Neotrombicula autumnalis (Acari: Trombiculidae).” (in German). CABI (Bezirks-Hygieneinspektion und -Institut Leipzig, Abteilung Medizinische Parasitologie, 7010 Leipzig, German Democratic Republic.: CABI): 12. http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=19830598840. Retrieved May 18, 2009.
^ Hirst, A. (1929). “”On the crub itch mite of North Queensland (Trombicula hirsti Sambon)” A possible carrier of tropical pseudotyphus”. Transactions of the Royal Society of Tropical Medicine and Hygiene 22 (5): 451452. http://download.journals.elsevierhealth.com/pdfs/journals/0035-9203/PIIS0035920329900675.pdf.
^ a b c “ArmaXX Pest Control”. http://www.armaxx.com/chigger.html. Retrieved 2008-06-24.
^ Gosling, Peter J. (2005). Dictionary of parasitology. Boca Raton: CRC Taylor & Francis. ISBN 0-415-30855-0.
^ “ACES Publications : CHIGGERS : ANR-1109″. http://www.aces.edu/pubs/docs/A/ANR-1109/. Retrieved 2008-06-24.
^ Finke, D.L. (1998-10-01). “University of MD Chigger Fact sheet” (PDF). http://www.hgic.umd.edu/_media/documents/hg66.pdf. Retrieved 2007-05/25.
^ About.com: Chiggers Pediatric Dermatology Basics
^ University of Florida: IFAS Extension
^ About.com: Chiggers Pediatric Dermatology Basics
^ Service, Mike. Medical Entomology for Students (4, illustrated, revised ed.). Published by Cambridge University Press, 2008. pp. 250252 of 289 pages. ISBN ISBN 0521709288, 9780521709286. http://books.google.com/books?id=wRrof4RLDuwC&pg=PA251&dq=harvest+mites+scrub+typhus.
^ “CDC – Scrub Typhus Reemergence in the Maldives”. http://www.cdc.gov/ncidod/eid/vol9no12/03-0212.htm. Retrieved 2008-06-24.
^ Takahashi, M; Misumi, H; Urakami, H; Misumi, M; Matsumoto, I (2003). “Life cycle of Leptotrombidium pallidum (Acari: Trombiculidae), one of the vector mites of scrub typhus in Japan (Author abstract)”. Ohara Sogo Byoin Nenpo (Japan) 45: 1930. ISSN 0285-3671. http://sciencelinks.jp/j-east/article/200401/000020040103A0828660.php.
^ Baumann T (March 2001). “New treatment for harvest mite infestation”. Archives of Internal Medicine 161 (5): 769. doi:10.1001/archinte.161.5.769. PMID 11231715. http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=11231715.
^ Ogg, Barb. “Itchy Chiggers”. http://lancaster.unl.edu/pest/resources/chiggers(008).shtml. Retrieved 2009-05-19.
^ a b c M Bennett, Stuart (2003). “Mites”. Self published by author. http://www.the-piedpiper.co.uk/th5i.htm. Retrieved 2009-05-19.
^ Ho TM, Fauziah MK (March 1993). “Laboratory evaluation of two commercial repellants against Leptotrombidium fletcheri (Acari: Trombiculidae)”. Southeast Asian Journal of Tropical Medicine and Public Health 24 (1): 1659. PMID 8362291.
^ Baumann T (March 2001). “New treatment for harvest mite infestation”. Archives of Internal Medicine 161 (5): 769. doi:10.1001/archinte.161.5.769. PMID 11231715. http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=11231715.
^ a b “Harvest mite infestation in cats”. Feline Advisory Bureau. November, 2008. http://www.fabcats.org/owners/skin/harvest_mite.html. Retrieved 2009-05-19.
^ Schalock, Peter C. (Last full review/revision December 2006). “Itching: itching and Noninfectious rashes”. The Merk Manuals Medical Library. http://www.merck.com/mmhe/sec18/ch203/ch203b.html. Retrieved 2009-05-19.
External links
“Chiggers!” at Missouri Department of Conservation
Chiggers at Pestproducts.com
Iowa State University Department of Entomology Insect Information Note
NIH Medline Plus
Ohio State University Extension Fact Sheet, Entomology, Chiggers, HYG-2100-98
Trombicula autmunalis
Taxonomic information at UniProt Consortium and NCBI
Categories: AcariHidden categories: Articles needing cleanup from June 2009 | All pages needing cleanup
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Dr. Dumyati Discusses Falling MRSA Infection Rates
What is the policy of the USA if you have an infectious disease?
lol ok last question i think i got a good topic in my head now. If you do have an infectious disease what is the USA doing to keep it from spreading, let say you found out you had SARS and was still healthy enough to go on a dream trip to France, how do they keep you from going there, or keep them from coming here? If ordered to quarantined next week, and the person does not want to go, can the person still buy a plane ticket and fly? Im gonna try to make my topic the policies of the USA on controlling infectious disease.
The US isn’t going to do much unless its a major public health concern (such as your example, SARS). ITs really not common as most people take the advice of health care providers who will tell you not to travel or go out in crowded places. So, its usually the person’s choice to quarenteen him or herself. But, if said person proves to not take this advise, then law enforcement may intercede. This happened recently with a case of multi-drug resistant TB:
The quarantine order was the first since the government quarantined a patient with smallpox in 1963, according to the CDC.
See attached source
Role of Disease Containment in Control of Epidemics (Panel)
what is the protective gear scientists wear when they attend to someone with a very contagious disease?
its kinda like an astronaut suit
Furr-nature, it is Individual Protective Equipment including a pressurized suit and a self-contained breathing apparatus with a HEPA filter that will screen out ALL infectious agents, including the deadliest of viruses. Sometime the air supply is by a back-strapped tank of pressurized air while it may also be done by a separate air hose for each room connected to filtered air. In a microbiologic lab safety hood, graded negative pressure devices control air flow from the outside to the room and out through HEPA filters. If we know what the very contagious or deadly disease agent is, and we have been previously immunized to safe levels, no protective gear is worn while Universal Precautions are used as prescribed.
Blablabla – Happiness/sadness is contagious disease
The FDA, CDC, and Costco Wholesale Corp. are warning consumers to avoid Bravo Farms Dutch Style Gouda Cheese because it may be related to an outbreak of E.coli infections. This is an alert, not a recall—at least not yet. So far, the cheese has been preliminarily linked to the outbreak, but the connection has not been confirmed. Perhaps the product is still being tested, and so far no positive results have been detected, explained food scientist Dr. Catherine Cutter.
The Gouda cheese was offered for sale and at cheese sampling events at Costco from October 5 – November 1 in Arizona, Colorado, New Mexico, Nevada, and the San Diego, California area from October 5 – November 1. The CDC (Centers for Disease Control and Prevention) has reported 25 cases of people sickened by E. coli in these five states during the same time period. Nine of them required hospitalization. E. coli symptoms include stomach cramps, diarrhea, and dehydration and sometimes require medical intervention.
Costco has removed the remaining Bravo Gouda cheese from its stores and has used purchase records to notify consumers about the alert. Consumers who have any of this product in their homes can return the cheese to the store for a refund.
For more information on E. coli, click here
http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/ecoli.html
Source(s):
Associated Press “Costco says avoid cheese linked to E.coli outbreak”
http://www.wreg.com/news/nationworld/kcpq-costco-gouda-cheese-recall-110410,0,6062853.story
Goodhousekeeping.com “Food Safety Alert: Cheese Sold at Costco”
http://www.goodhousekeeping.com/product-testing/ghri-test-kitchen/food-safety-alert-bravo-farms-cheese
Catherine N. Cutter, Ph.D., Pennsylvania State University, Dept. of Food Science
About the Author
ETHEL TIERSKY, the editor and frequent author for http://shelflifeadvice.com,has been a free-lance writer since 1963 and a food safety fanatic for even longer. She has published dozens of magazine articles and co-authored 14 grammar texts and readers for adults studying the English language. Developing http://shelflifeadvice.com has kept her busy since retiring from her teaching position as associate professor of English at Harry Truman College in Chicago. Some of her other writings for the site include “Don’t Let Those Food Expiration Dates Scare You,” product write-ups on mayonnaise and water, and “Pyrex Glassware: Is It Safe to Use?”
Lyme Disease: Challenges and Innovations
DRUG ADDICTION
Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to alcohol and drug t begins with the voluntary act of taking alcohol and drugs, over time a person’s ability to choose not to do so becomes compromised, and seeking and consuming the alcohol and drug becomes compulsive. This behavior results largely from the effects of prolonged alcohol and drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior.
Because alcohol and drug abuse addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple. Effective alcohol and drug treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Alcohol and drug treatment (drug Rehab) must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop using alcohol and drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.
Too often alcohol and drug addiction goes untreated: According to SAMHSA’s National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4 percent of the U.S. population) aged 12 or older needed alcohol and drug treatment (Drug Rehab) for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4 percent of those who needed Alcohol and drug treatment) (drug Rehab) received treatment at a specialty facility (i.e., hospital, drug or alcohol Rehab or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed alcohol and drug treatment (drug Rehab) for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.
Principles of Effective alcohol and Drug Treatment (Drug Rehab)
Scientific research since the mid–1970s shows that drug treatment (drug rehab) can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective alcohol and drug treatment programs:
* Addiction is a complex but treatable disease that affects brain function and behavior.
* No single alcohol and drug treatment (drug rehab) is appropriate for everyone.
* Treatment needs to be readily available.
* Effective alcohol and drug treatment (drug rehab) attends to multiple needs of the individual, not just his or her drug abuse.
* Remaining in alcohol anddrug treatment (drug rehab) for an adequate period of time is critical.
* Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of alcohol and drug treatment (drug rehab).
* Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
* An individual’s alcohol and drug treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
* Many drug–addicted individuals also have other mental disorders.
* Medically assisted detoxification is only the first stage of alcohol and drug addiction treatment (drug rehab) and by itself does little to change long–term drug abuse.
* Alcohol and Drug treatment (drug rehab) does not need to be voluntary to be effective.
* Drug use during treatment (drug rehab) must be monitored continuously, as lapses during treatment do occur.
* Drug Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.
Effective Treatment Approaches
Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of Alcohol and drug treatment (drug rehab); preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior alcohol and drug treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual’s life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person’s success in achieving and maintaining a drug–free lifestyle.
Medications
Medications can be used to help with different aspects of the drug treatment (drug rehab) process.
Withdrawal.
Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself Drug”treatment”—it is only the first step in the alcohol and drug treatment process. Patients who go through medically assisted withdrawal but do not receive any further alcohol and drug treatment (drug rehab) show drug abuse patterns similar to those who were never treated.
Treatment.
Medications can be used to help reestablish normal brain function and to prevent relapse and diminish cravings. Currently, we have medications for (heroin, morph opioidsine), tobacco (nicotine), and alcohol addiction and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. Most people with severe addiction problems, however, are polydrug users (users of more than one drug) and will require treatment for all of the substances that they abuse.
* Opioids: Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for the drug treatment (drug rehab) of opiate addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and should only be used in patients who have already been detoxified. Because of compliance issues, naltrexone is not as widely used as the other medications. All medications help patients disengage from drug seeking and related criminal behavior and become more receptive to behavioral treatments.
* Alcohol: Three medications have been FDA–approved for treating alcohol dependence: naltrexone, acamprosate, and disulfiram. A fourth, topiramate, is showing encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some but not all patients—this is likely related to genetic differences. Acamprosate is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (an unpleasant or uncomfortable emotional state, such as depression, anxiety, or irritability). It may be more effective in patients with severe dependence. Disulfiram interferes with the degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea, and palpitations if the patient drinks alcohol. Compliance can be a problem, but among patients who are highly motivated, disulfiram can be very effective.
Behavioral Treatments
Behavioral treatments help patients engage in the drug treatment (drug rehab) process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in drug treatment (drug rehab) longer. Treatment for drug abuse and addiction can be delivered in many different settings using a variety of behavioral approaches.
Outpatient behavioral treatment encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group drug counseling. Some programs also offer other forms of behavioral treatment such as—
* Cognitive–behavioral therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.
* Multidimensional family therapy, which was developed for adolescents with drug abuse problems—as well as their families—addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.
* Motivational interviewing, which capitalizes on the readiness of individuals to change their behavior and enter drug treatment (drug rehab).
* Motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs.
Residential drug treatment programs (drug Rehab) can also be very effective, especially for those with more severe problems. For example, therapeutic communities (TCs) are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. TCs differ from other treatment approaches principally in their use of the community alcohol and Drug Rehab staff and those in recovery—as a key agent of change to influence patient attitudes, perceptions, and behaviors associated with drug use. Patients in TCs may include those with relatively long histories of drug addiction, involvement in serious criminal activities, and seriously impaired social functioning. TCs are now also being designed to accommodate the needs of women who are pregnant or have children. The focus of the TC is on the reconciliation of the patient to a drug-free, crime–free lifestyle.
Criminal Justice Drug Treatment
Alcohol and drug treatment (drug rehab) in a criminal justice setting can succeed in preventing an offender’s return to criminal behavior, particularly when treatment continues as the person transitions back into the community. Studies show that drug treatment (drug rehab) does not need to be voluntary to be effective.
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Disease Detectives: Kitty Andersen Youth Science Center
