Medgend Icon

Ledgend of Medicine







discontinued


Combine

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, opioid use disorder (OUD) is still a possible risk.

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

What are the treatments for opioid use disorder (OUD)?

Treatments for OUD include:

  • Medicines; this kind of treatment is known as medications for opioid use disorder (MOUD)
  • Counseling and behavioral therapies
  • Residential and hospital-based treatment
Which medicines treat opioid opioid use disorder (OUD)?

The medicines used in MOUD are methadone, buprenorphine, and naltrexone:

  • Methadone, buprenorphine, and lofexidine, which can decrease withdrawal symptoms and cravings. They work by acting on one or another of the targets in the brain that opioids act on. But these medicines are different because they do not make you feel high. Some people worry that if they take methadone or buprenorphine, it means that they are substituting one addiction for another. But it is not; these medicines are a treatment. They restore balance to the parts of the brain affected by addiction. This allows your brain to heal while you work toward recovery.

    You may safely take these medicines for months, years, or even a lifetime. If you want to stop taking them, do not do it on your own. You should contact your provider first, and together you can work out a plan for stopping.

  • Naltrexone works differently than methadone and buprenorphine. It does not help you with withdrawal symptoms or cravings. Instead, it takes away the high that you would normally get when you take opioids. Because of this, you would take naltrexone to prevent a relapse, not to try to get off opioids. You have to be off opioids for at least 7-10 days before you can take naltrexone. Otherwise you could have bad withdrawal symptoms.

  • A combination drug that includes buprenorphine and naloxone. Naloxone is a drug to treat an opioid overdose. If you take it along with buprenorphine, you will be less likely to misuse the buprenorphine.

How does counseling help treat opioid use disorder (OUD)?

Counseling for OUD can help you:

  • Change your attitudes and behaviors related to drug use
  • Build healthy life skills
  • Stick with other forms of treatment, such as medicines

There are different types of counseling for OUD, including:

  • Individual counseling, which may include setting goals, talking about setbacks, and celebrating progress. You may also talk about legal concerns and family problems. Counseling often includes specific behavioral therapies, such as
    • Cognitive-behavioral therapy (CBT), which helps you recognize and stop negative patterns of thinking and behavior. It teaches you coping skills, including how to manage stress and change the thoughts that cause you to want to misuse opioids.
    • Motivational enhancement therapy, which helps you build up motivation to stick with your treatment plan.
    • Contingency management, which focuses on giving you incentives for positive behaviors such as staying off the opioids.
  • Group counseling, which can help you feel that you are not alone with your issues. You get a chance to hear about the difficulties and successes of others who have the same challenges. This can help you learn new strategies for dealing with the situations you may come across.
  • Family counseling, which includes partners or spouses and other family members who are close to you. It can help to repair and improve your family relationships.

Counselors can also refer you to other resources that you might need, such as:

  • Peer support groups, including 12-step programs like Narcotics Anonymous
  • Spiritual and faith-based groups
  • HIV testing and hepatitis screening
  • Case or care management
  • Employment or educational supports
  • Organizations that help you find housing or transportation
What are residential and hospital-based treatments for opioid use disorder (OUD)?

Residential programs combine housing and treatment services. You are living with your peers, and you can support each other to stay in recovery. Inpatient hospital-based programs combine health care and OUD treatment services for people with medical problems. Hospitals may also offer intensive outpatient treatment. All these types of treatments are very structured, and usually include several different kinds of counseling and behavioral therapies. They usually also include MOUD.

Combine FDA Approved Drugs

CYCLOSET [Bromocriptine MesylateC32H40BrN5O5CH4O3S]
RX
-
eq 0.8mg base (oral tablet)
VeroscienceMay 5, 2009
  • Administration once daily within two hours after waking in the morning for improvement of glycemic control in a type 2 diabetes patient.
  • Improvement of glycemic control in individuals with type 2 diabetes.
  • Improvements of glycemic control in individuals with type 2 diabetes who have one or more specified cardiovascular risk factors.
  • Treatment of type 2 diabetes by administering bromocriptine mesylate and a first-phase insulin secretagogue wherein the combined therapeutic effect is greater than the additive effect of administering each agent alone.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

WARNING: Consult a licensed physician in the appropriate field for medical treatment and drug prescription. Do not self medicate.


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Combine

ALOEALOE
   The dried juice of the leaves of several species of Aloe: (1) Aloe Perryi, Baker; (2) Aloe vera, Linné; (3) Aloe ferox, Miller. (Nat. Ord.... / ...e “Lapactic pill.” When sulphate of iron is indicated in chlorosis and anemia, aloes is generally combined with it. It has the effect of restraining the constipating action of the chalybeate. Aloes ...1

BALSAMUM PERUVIANUM
   A balsam obtained from Toluifera Pereirae (Royle) Baillon. San Salvador in Central America; called Balsam of Peru because first exported to Europe... / ...given the best of satisfaction in scabies and for the destruction of lice. For the former it may be combined with the sulphurated ointments, or may be used alone, with an oleaginous and petrolatum bas... / ...balsam should not be used in inflammatory or febrile conditions; and its use should be discontinued if it produces gastro-intestinal irritation.1

CALUMBA (Jateorhiza palmata)JAPA2
   The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A climbing perennial, the Kalumb of the Southeast coast of Africa.... / ...a, and dysentery it may be given to promote the appetite and digestion. When desired calumba may be combined with magnesia, bicarbonate of soda, senna, ginger, and aromatics, to meet special indicatio... / ...local action, and indirectly, by favoring better digestion, the quality of the blood is improved, hence its value in anemia during convalescence.1

CARBO LIGNI
   Charcoal prepared by burning soft wood. It must be kept in tightly-closed vessels. Common Names: Charcoal, Wood Charcoal; Synonym: Carbo... / ...cea, and sometimes in the acid vomiting of pregnancy, charcoal is a most effective agent. It may be combined, plain or aromatized with oil of peppermint, with sodium bicarbonate in acidity of the stom... / ...the belly-wall tumid and doughy, the tongue expressionless and pale with little coating and lenticular spots, or the coating may lift in patches.1

CONIUM
   The full grown fruit, gathered green, of Conium maculatum, Linné (Nat. Ord. Umbelliferae). Europe and Asia; naturalized in the United... / ...lls and respiration becomes paralyzed. The latter is the cause of death by conium and is due to the combined results of depression of the respiratory center in the medulla and the nervomuscular paraly... / ...be applied and be given to relieve pain even when a cure is not possible. It relieves the pain of swollen mammae during the menstrual periods a1

GLYCYRRHIZA
   The dried rhizome and roots of Glycyrrhiza glabra typica, Regel et Herder (Spanish Licorice), or of Glycyrrhiza glabra glandulifera, Regel et... / ...ss, dark-brown or red-brown scales; soluble in alcohol or water. It is derived from glycyrrhiza and combined with ammonia. Dose, 1 to 8 grains. Action and Therapy.—Glycyrrhiza root is demulcent, laxa... / ...and sodium salicylate are more or less masked by the fluidextract. Licorice root is an ingredient of Compound Licorice Powder. (See Senna).1

GRANATUM
   The dried bark of the stems and roots of Punica Granatum, Linné (Nat. Ord. Punicaceae). India, southwestern Asia, and the Mediterranean... / ...istered a light milk diet in the evening is followed in the morning by a saline purge, and then the combined alkaloids administered. In about one hour another dose of the purgative should be given. Ep...1

HAMAMELIS
   The leaves, bark and twigs of Hamamelis virginiana, Linné (Nat. Ord. Hamamelidaceae), collected in the autumn. Common in the United States.... / ...ation of the capillaries of the skin. They are cooling and relieve smarting and pain. Used alone or combined with an equal quantity of bay rum they form an elegant face wash to remove excess of soap a...1

HYDRASTISHYDRA2
   The dried rhizome and roots of Hydrastis canadensis, Linné (Nat. Ord. Ranunculaceae) United States and Canada in rich, shady woods. (Chiefly... / ...berine). A yellow powder. Dose, 1 to 5 grains. 4. Hydrastin (Resinoid), not now used. 5. Hydrastin (Combined Hydrastin). Only substance now sold as hydrastin. 6. Hydrastina, Hydrastine. (Alkaloid, bot... / ...The preparation preferred is the colorless, though other hydrastis preparations, particularly berberine and hydrastin salts are useful, b1

HYOSCYAMUS
   The leaves and flowering or fruiting tops of Hyoscyamus niger, Linné (Nat. Ord. Solanaceae). Europe; naturalized in waste places in the United... / ...s more powerfully upon the peripheral nerves, hence hyoscyamus is a better agent than belladonna to combine with cathartics to lessen griping and tormina. Moreover, it does not restrain secretion and ... / ...conditions best. Hence its value in nervous headache, the headache of debility, the vague pains of so-called chronic rheumatism, idiopath1

JUNIPERUS COMMUNIS
   The fruit (berries) of the Juniperus communis, Linné (Nat. Ord. Cupressaceae). An evergreen tree of Europe and America. Common Names: Juniper,... / ...s, to stimulate the sound tissues to functionate and relieve the attendant dropsy. Usually they are combined with agents like citrate or acetate of potassium or with spirit of nitrous ether. In these ... / ...may result from its use.1

LOBELIALOBEL
   The leaves, tops, and seeds of Lobelia inflata, Linné (Nat. Ord. Lobeliaceae). Abundant in the United States. Dose, 1 to 60 grains. Common... / ...Weed, Emetic Herb, Vomit Weed, etc. Principal Constituents.—The unstable liquid alkaloid lobeline, combined with lobelic acid; fixed and volatile oil, and an unimportant nonbasic substance, inflatin....1

RELATED MEDICINE
   Tobacco (Nicotiana Tabacum, Linné) and Nicotine. Tobacco was once used to a considerable extent upon painful inflammatory swellings and to... / ...otine is of toxicological interest chiefly, but rarely it is used to subdue pain. A solution of the combined alkaloids of tobacco, containing 1 per cent of nicotine, is on the market as Dynamyne, a pr... / ...be used with great caution, and care should be had in handling or inhaling it. A combination of tobacco alkaloids is an ingredient of Libradol.1

OLEUM OLIVAE
   Olive Oil, Sweet Oil. A fixed oil obtained from the ripe fruit of Olea europaea, Linné (Nat. Ord. Oleaceae). The olive tree of Asia and southern... / ... may be given immediately in poisoning by alkalies and other irritant substances. With the first it combines by saponification, and in the latter acts as a demulcent. It should not, however, be given ...1

OLEUM TEREBINTHINAE RECTIFICATUM
   Rectified Oil of Turpentine, Rectified Turpentine Oil. Description.—A thin colorless liquid corresponding to the properties described under Oleum... / ...be used to relieve chilblains and bunions and to stimulate repair in sluggish ulcers and bed sores. Combined with linseed oil it has been advised for small burns and scalds, but as this method is pain...1


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Materia Medica on Combine

ACETANILID (Phenylacetamide; Antifebrin.)
   Analgesic, antipyretic, antiseptic; a powerful depressant to the spinal nerve centers. Used especially in neuralgic and rheumatic affections to control pain. in migraine, in febrile conditions accom panied with pain. in delirium tremens, in insomnia and as a remedy for obstinate vomiting. Externally it is useful as a surgical dress ing, resembling iodoform in its action. Incompatible with bromides and iodides and with spirit of nitrous ether. It is advantageously combined with Caffeine which dim2

ACID GALLIC
   Astringent but not locally hemostatic, Prescribed in diarrheas, in atonic albuminuria, in hematuria, colliquative sweats, diabetes insipidus (combined with opium) and in internal hemorrhages. Ap plied locally in ointments in hemorrhoids and for unhealthy ulcers. Dose, 0.2 to 1.0 Grm. (3 to 15 grs.)2

ACID SALICYLIC and SALICYLATES
   a. Salicyi iC Acid . An energetic antiseptic with comparatively little poisonous action; inhibits fermentation; used chiefi y in rheuma tism, the free acid acting more powerfully than its salts (e. g. sodium salicylate) but more liable to cause gastric irritation. Dose (in rheu matism) 0.6 to 1.3 Grm. (10 to 20 grs.) four to six times a day. b. Ammonium Salicylate. Properties of Salicylic Acid with some stimulating action. Dose, 0.3 to 1.3 Grm. (5 to 20 grs.). c. Lithium Salicylate. Combines the2

ACID VALERIANIC AND VALERIANATES
   Compounds of Valerianic Acid produce a quieting effect in hysterical conditions and are prescribed usually with reference to that effect. The uncombined acid is never used. a. Ammonium Valerianate. This is the salt of Valerianic Acid most frequently prescribed. It is useful innervous headaches, hysteria and the nervousness connected with pregnancy or the meno pause. Very commonly combined with bromides. Dose, 0.12 to 0.6 (2 to 10 grs.). b. Ferric Valerianate. Prescribed commonly in combination w2

AMERICAN HELLEBORE
   The rhizome and root of VERATRUM VIRIDE, Solander. Cardiac - depressant. having remarkable power to reduce the pulse in fever. Its most- important use is in controlling blood pressure in aortic an eurism, in cerebral hyperemia and in certain heart affections. Apt to cause nausea unless combined with an opiate. Produces best ef fects when doses are frequently repeated. Dose 0.06 to 0.2 Grm. (1 to 3 grs-).2

BEEF EXTRACT
   A stimulant rather than a food; promotes appetite and increases the activity of the emunctories. Equally useful in the form of a hot broth or "tea” or combined with an alcoholic stimulant" wine. whis key or brandy.2

BLACK ALDER
   The bark of ILBX VERTICILLATA ( L.) Gray. Astringent, bitter tonic, alterative, antiperiodic. Serviceable in cutaneous diseases, in diarrhea and all debilitated conditions; in dyspepsia combined with Golden-seal.2

BUCKTHORN BERRIES
   The fruit of RHAMNUs CATHARTICA, Lin. Hydragogue cathar tic, liable to be harsh in operation. Should be combined with car minatives. Used in dropsy, rheumatism and gout.2

HAEMOGLOBOGEN
   A hematinic tonic, which combines the characters of a predigested nitrogenous food with those of a blood renewing agent. The pre paration is somewhat richer in iron than Haemo-mangan (q. v.), which preparation this resembles in composition and properties, Dose, 4 to 15 c. c. (1 to 4 fluidrachms) after each meal.2

IPECAC (ipecacuanha)CEIP
   The root of URAGOGA IPECACUANHA, (Brot.) Baill. Emetic; in small doses diaphoretic (especially when combined with opium), expectorant, stomachic. In large doses has a specific action in dysentery. Dose, as emetic, 1 to 1.5 Grm. (15 to 25 grs.), repeated if necessary, as diaphoretic. 0.06 to 0.120 Grm. (1 to 2 grs.); as expectorant or stomachic, 0.015 to 0.06 Grm. (1/4 to 1 gr.).2


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Therapeutics Memoranda on Combine

ACIDITY OF STOMACH
   If due to fermentation, use antacids as palliatives to relieve im mediate distress, but prescribe also gastric antiseptics. Avoid indigestible food, particularly lats. If acidity is irom hyper-secretion, the remedies are antacids and henbane, for its inhibitive action on the secretions. In chronic gastric catarrh, bismuth. silver nitrate, antacids combined with salines. In all severe cases. lavage is the most useful treatment.2

ANEMIA
   Nourishing and easily digested food with remedies for promoting digestion and overcoming a tendency to constipation may often ac complish more than... / ... Among the most eflicient preparations are Solution Gold and Arsenic Bro mide, N., B. & Co., Haemo-Mangan with Arsenic, and formulas in which iron is combined with manganese, or with arsenic.2

CHILBLAINS
   Useful remedies are; ointment of iodine, half strength; ointment of ichthyol, 20%, combined perhaps with tannin or resorcin or balsam Peru; tincture capsicum; carbolated ointment; resin cerate.2

DIARRHEA
   See also Cholera Infantum, Cholera Morbus and Dysentery. Simple Atonic Diarrhea is best treated by opium combined with gastric and intestinal stimulants, carminatives and astringents. Chlorodyne is an efficient remedy, also the sun cholera mixture and sim......s hot as can be borne will often cure. In Catarrhal Diarrhea, after an initial purge of magnesium sulphate or castor oil, give at first perhaps opium combined with lead acetate, or simple mineral acids, particularly the nitromuriatic; later ammonium chloride and potassium iodide. Chronic Diarrhea ca...2

EPILEPSY
   ... diluted, after meals. beginning with 10 grain doses and increasing to 25 or 30 grs., provided it does not disturb the digestion. If there is anemia, Combine with ferrous bromide or with Solution Gold and Arsenic Bmmides, N., B. & Co. Bromides of sodium and ammonium may be often advantage ously comb......assium bromide. In syphilitic cases potassium iodide in full doses must be used instead of the bromide. Other remedies of im portance are belladonna (combined with bromides), cannabis indica, digitalis, horse-nettle and chloral hydrate. In children, ascertain whether the irritation is due to worms a...2

FEVER
   The remedies commonly resorted to include; 1st cardiac or ar terial sedatives, particularly... / ...typhoid conditions, 3d applications of cold water which constitute a measure almost always serviceable, 4th sedatives and anodynes, which may well be combined with diaphoretics. These several classes of remedies must be suited to the individual case, bearing in mind the fact that fever is not in and...2

GASTRIC CATARRH
   At first withhold all food, later give milk and lime water. Cleanse stomach of irritating matters by... / ...odium phosphate in solution or effervescing granules, or ,a saline mineral water; bismuth; antacids and gastric antiseptics as needed; silver nitrate combined with ext. henbane. Let the diet be simple, and regulate the bowels by use of non-irritant laxatives. Tonics are almost always indicated.2

INCONTINENCE OF URINE
   In the nocturnal incontinence of children, remove first any source of reflex irritation, such as worms or long prepuce or excessive acidity or alkalinity of urine. Belladonna, nux vomica, ergot, rhus aroma tica, tincture ferric chloride are among the remedies found service able. Nervous incontinence in adults is best treated with can tharides (one drop of the tincture three times a day) combined with lithiated Ze-an.2

INFLUENZA
   The remedies most prescribed in the early stage are; aconlte and potassium citrate to control the febrile symptoms; phenacetin or acetanilid, often combined with salol, for their analgesic action; quinine salicylate, aspirin, salicylic acid; calomel followed by a saline purge. The bronchitis must ....... Cannabis indica is a safe sedative in these cases. Combat the peculiar depression as the case progresses by strychnine or nux vomica in full doses, combined often with belladonna.2

INSOMNIA
   Use drugsto induce sleep only when absolutely necessary. If bromides fail use hypnotics, chloral (combined with morphine if severe pain is present), sulphonal, chloralamide, chloretone, etc.2

PNEUMONIA (Croupous.)
   Only at the very outset are arterial sedatives useful, veratrum being best. When consolidation has begun, pyrexia is to be combat ed by cold... / ...asures and proper feeding. In the third stage prescribe expecto rants to aid in clearing the lungs, ammonium chloride being the most important, to be combined sometimes with the more stimulant am monium carbonate.2

PROSTATITIS
   General treatment for Inflammation, q. v. To relieve vesical tenesmus and pain, rectal suppositories of opium and henbane; Ze-an as diuretic, with which may be combined potassium citrate. In chronic cases, local treatment by steel sounds or application of suit able medicaments.2

SYPHILIS
   The usual treatment is by mercurials (mercurous iodide, blue mass. mercury and chalk or corrosive sublimate. the first being generally given preference) continued up to the point of tolerance as much as eighteen months. followed by a course of potassium iodide, sometimes combined still with mercury. Vegetable alteratives are generally prescribed also, and the mercury is sometimes reinforced by combination with gold, as in the Solution Gold and Arsenic Bro mide with Mercury, N., B. & Co.2

TETANUS
   Tetanus antitoxin should be administered at once, and convul sions combated by inhalations of chloroform or by chloral combined with potassium bromide (see Bromanodyne, Part I). Other remedies are cocaine or a combination of this with morphine and atropine, hypodermatically; Fowler’s solution; calabar bean; pilocarpine (the last to eliminate the toxin).2

WORMS (See also Tapeworm)
   For ascarides the best remedies are; Pink-root (especially Fluid Extract Pink-root and Senna), santonin (gencrally combined with calomel and given in lozenges-' and oil of wormseed. For pin worms santonin is often prescribed, but is less eflicient than infusion of quassia (10 per cent) given by injection.2


References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.