Substitol (Morphine Sulfate) is semi-synthetic, highly potent and long acting opioid analgesic.
Substitol is a full opioid agonist with the high liability for abuse similar to that of morphine legally or illegally.
Substitol is a controlled-release oral medicine with two medical indications:
- for the management of severe chronic pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time;
- in opioid replacement therapy to treat Heroin addiction.
Substitol is produced in Austria and legally available in 5 countries of Central and Eastern Europe. In USA the similar medication is sold under name Morphine Sulfate ER (ER- Extended Release).
Substitol is available in form of pills of 120mg (green color) and 200mg (red color) for oral administration.
Substitol pills must be swallowed whole and must not be cut, broken or dissolved.
Using crushed or dissolved Substitol pills (can be intravenously injected) is a way to abuse Substitol with the purpose to get rush. Broken pills or iv. Injections lead to rapid release and absorption of a potentially fatal dose of morphine. Cases of overdose, respiratory and cardiac arrest resulting in death in case of Substitol abuse are not rare.
Substitol is a highly addictive opioid, abuse of which inevitably causes an addiction.
Substitol can be abused the same way as any other prescription opioid. These ways are:
- using Substitol along with Heroin;
- combined use of Substitol with other drugs or alcohol;
- using Substitol intravenously or in higher doses than it is prescribed;
- lying to a doctor about withdrawal symptoms in order to get a higher dose of Substitol;
- visiting several doctors at the same time under different names;
- buying and selling Substitol in the street.
Normally the daily dose of 200- 400mg of Substitol is enough to cover all withdrawal symptoms from any dose of Heroin. However, most of the patients who are on Substitol replacement therapy due to fast growing tolerance use no less than 600-1000mg of Substitol daily without any inclination to taper the dose off. The situation can be explained by attractiveness of Substitol to many drug addicts due to its pronounced euphoric effect, which is higher than that of Methadone and close to that of Heroin. Unbearable desire to get “high” from Substitol is the main cause of abuse. Being by nature a morphine-like medication, Substitol quickly creates strong physical and mental dependence on it. Substitol addiction is a serious medical problem. Clinically the beneficial and side effects of Substitol, as well as, the withdrawal symptoms from Substitol are similar to the that of any other opioid (see page “Opioid addiction”).
Addiction on Substitol must be medically addressed
Handled professionally substitol addiction can be conquered. The substitol addict is unlikely to be able to achieve the process of ‘getting clean’ by himself. Similar to the process of overcoming heroin or methadone addiction, the first step in treatment of substitol addiction is a drug detoxification.
Process of detoxification from Substitol that we exercise at our clinic consists of two parts. The initial one is a gradual cut back on the dosage during the few days. It helps to reduce dose of Substitol and minimize the extent and severity of withdrawal symptoms. As the weaning program continues and withdrawal symptoms are getting more intense, the patient goes into the second part of detoxification, the so called rapid opioid detox with the purpose to complete the cleaning process in a course of five days. Rapid detox itself consists of two anesthesia assisted procedures of 6-8 hours each with two day interval between. Method of rapid drug detoxification is safe and allows to eliminate up to 90% of withdrawal symptoms in most comfortable and painless for the patient way.
Once initially clean, it is vital that the care and support for the substitol convalescent continues as he/she gets used to regular life. There will inevitably be the moments of weakness, difficult times and setbacks, but in the ongoing process of recovery from substitol addiction the reward of drug free life is invaluable.
Related opioid addiction articles:
- Main opioid side effects: respiratory depression,increased body temperature,dry mouth,constipation. The long term effects from use, heroin effects can be devastating, especially if an addict continues abusing the drug without seeking medical help.
- Methadone withdrawal: is fairly similar to coming off Heroin or prescription opioid medications, its intensity is much more severe and it takes no less than 14 to subside the most major symptoms.
- Subutex addiction: treatment must be used in combination with other medical, social and psychological programs.
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