Credo Community Center for the Trt of Addictions Community Residence
(315) 788-6881
www.credocommunitycenter.com
138 Winthrop Street
Watertown NY 13601

Rehabilitation Services

Services Provided: Halfway house

Isotretinoin

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis, Clarus) over a period of four to six months can cause long-term resolution or reduction of acne. Doctors believe that isotretinoin works primarily by reducing the secretion of oils from the glands, however some studies suggest that it affects other acne-related factors as well. Isotretinoin research shows it to be very effective in treating severe acne and can either improve or clear well over 80 percent of patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical supervision by a dermatologist because the drug has many known side effects (many of which can be severe). About 25 percent of patients may relapse after one treatment. In those cases, patients require a second treatment for another four to six months to obtain desired results. Doctors recommend that one allow a few months pass between the two treatments, because acne can actually improve somewhat over time. Occasionally a third or even a fourth course is used, but the benefits are often less substantial. The most common side effects are dry skin and occasional nosebleeds (secondary to dry nasal mucosa). Oral retinoids also often cause an initial flare up of acne within a month or so, which can be severe. There are reports that the drug has damaged the liver of patients. For this reason, doctors recommend that patients have blood samples taken and examined before and during treatment. In some cases, doctors terminate or reduce treatment due to elevated liver enzymes in the blood of the patient, which suggest a link to liver damage. Other dermatologists claim that the reports of permanent damage to the liver are unsubstantiated, and deem routine testing unnecessary. A doctor must also monitor the blood triglycerides. However, routine testing is part of the official guidelines for the use of the drug in many countries. Some press reports suggest that isotretinoin may cause depression but as of September 2005, there is no agreement in the medical literature as to this risk. The drug also causes birth defects if a woman becomes pregnant while taking it or takes it while pregnant. For this reason, female patients are required to use two separate forms of birth control or vow abstinence while on the drug. Many doctors only supply isotretinoin to women as a last resort after milder treatments have proven insufficient. The USA put into effect restrictive usage rules (see iPledge program) beginning in March 2006 to prevent misuse, causing occasioned widespread editorial comment.

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Treatment Medications

Medications can be an important component of effective drug abuse treatment for offenders. By allowing the body to function normally, prescription medications enable the addict to leave behind a life of crime and drug abuse. For example, opioid agonist and partial agonist medications, which act at the same receptors as heroin, morphine and natural brain endorphins, are effective at helping an individual remain in treatment. Antagonist medications, which work by blocking the effects of a drug, are effective but patients do not often take the drugs regularly. Despite evidence of the effectiveness of medicines, doctors prescribe addiction medications but patients underutilize them in the treatment of drug abusers within the criminal justice system. Still, some jurisdictions have found ways to successfully implement medication therapy for drug abusing offenders.

Opiates Heroin

Long term opiate abuse results in a desensitization of the opiate receptors to endorphins in the brain. Endorphins are natural opioids in the body. Methadone acts on the same receptors as the natural endorphins, stabilizing the craving that otherwise results in compulsive use of heroin or other illicit opiates. Methadone effectively reduces opiate use, criminal behavior related to drugs and risky HIV behaviors. Buprenorphine is a partial agonist and acts on the same receptors as morphine, a full agonist, but without producing the same level of dependence or withdrawal symptoms. Suboxone® is a unique formulation of buprenorphine that contains naloxone, an opioid antagonist, which limits diversion by causing severe withdrawal symptoms in those who inject it to get high, but has no adverse effects when taken orally, as prescribed. Naltrexone, an opiate antagonist, blocks the effects of opiates.