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Best Resume Formats 47+ Free Samples, Examples, Format Download! A Resume Template is an extremely important document which is essay outlines used in the case when a person or an applicant is applying for a job, a volunteership, an internship, an educational course or any other thing. The resume lists down the car accident essay incident various details about the candidate such as his/her name, address, phone number, email address, academic details, work experience, skills and qualities etc. Unlock A Great Career Ahead With A Perfect Resume. Your resume is your primary representative in the career world. Whether you are about to kick-start your career fresh out of your grad or planning a job change, a resume is always needed when you are applying for employment. It’s the first thing that your prospective employer will see about you and hence your CV has this duty to present you in the best possible light. 44 Modern Resume Templates Bundle for outlines $69. Stunning Resume Template Bundle for Job seekers $30. Modern Resume / CV Templates Bundle.
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It’s the traditional resume format where employment history is listed in gather analyse the reverse order- commencing with the outlines current one to the oldest or first job. Research? The tried tested format is a favorite of the HR professionals hiring managers all around. The chronological format will allow the candidate to showcase his upward mobility in the career. It would be useful for specialist mid-level applicants. You must follow the chronological resume when. Outlines? You have to research rubric, portray a vertical progression in your career You more or less had a consistent career with no such big work-experience gaps in between You are planning a change of company but in similar trade. The functional resume format focuses mostly on the skills of the applicant rather than his work experiences.
Unlike the conventional chronological format, this one ignores when where the applicant performed or learned those skills. It’s the essay fact that the candidate holds those skills relevant to the specific job opening, is highlighted in radio essay paper the functional format. The functional format would be useful for you when- You need to create a Fresher Resume Format Templates with no previous work experience but when you are confident about your skills You have big gaps in essay your career history You are looking forward to promote a particular skill set. As the name suggests, combination resume focuses on essay a fusion of the traditional chronological functional resumes. Such a resume would usually start with professional profile/summary of qualifications which will include your skills, abilities achievements that are pertinent to the specific job opening you are applying for- it’s for the functional side.
The introductory section would be followed by job experience, education (B.E) additional related sections in the reverse chronological format. Such a resume would be great when- You are looking forward to outlines, highlight a well-developed relevant skill set You have mastered your art You are planning a switch to another industry. For example, let’s say you are working as an investment banker but you are really good at cartoons or conceptual sketching- such artistic skills would be a wealth for advertising industry in case you are planning to car accident incident, turn your hobbies into your profession. Formatting a resume is no rocket science but you have to be really strategic with the overall planning.
As mentioned earlier, the traditional chronological approach is relevant when you are proud of the upward mobility that you have attained in your career. If you are a person with huge or at essay, least some professional experience in your industry- the chronological style would be the proper resume format for you. The best resume format for how to a functional resume strategically groups the key skills abilities of the candidate in various categories to explain his eligibility expertise for some particular job. The skill-based focus will enable you to pull the essay prospective employer’s attention on your strength which would in turn divert the focus from your absent or flawed employment record. For example, let’s say you are applying for write a journal in apa the position of a sales manager in a MNC with an international market- and in such a case your functional resume would stress on categories with headings like “team building leadership expertise”, “fluency in foreign languages” etc. In some of cases, the functional resume is essay outlines completely devoid of the employment history.
Even if it is essay mentioned, it appears at the very bottom of the resume or in the next page to de-stress on its importance. When you are planning a combination resume , you have to commence with your key qualifications skills. Essay Outlines? You can include your career objective, expertise, accomplishments pertinent training relevant to the job application here. The strategy here is to fill up 80-85% of your resume with your skills talents and the rest 15-20 percent would be about your career history. Unlike the functional resume, you cannot omit your career history here. Make sure it’s easy to read Use bullet points and adequate spacing- single spacing when you are writing about essay your skills under same category and double-spacing before the essay outlines start of another category. Use contextual keywords relevant to your job position industry. Use formal fonts and the font size should be 14 for analyse headings and 12 for essay the rest. You must use strong verbs such as “managed”, “handled”, “led”, “administered”, “charted” etc.
Begin the resume with summary sentence so that the hiring manager can have a blue-print of your skills abilities at analyse, a glance. Include personal accomplishments if they are pertinent to the relevant job opening. Essay Outlines? Focus on quantifiable accomplishments include facts figures. No grammar mistake or typo error is allowed in your resume. Don’t use generic words like hardworking or confident- rather use “efficient at write critique in apa format, handling big teams for outlines crucial projects”. Don’t use informal email ids in essay incident contact details. Don’t use chronological resume when you have big gaps in your career.
Don’t include irrelevant personal hobbies. No lengthy resume. Don’t lie in your resume and be honest. When you are looking for best resume format examples, we at template.net are ready to help you with your expert-designed resumes- whether you need a chronological one or a functional one or a combination resume. Ceative Resume Templates must be drafted using a formal format and a professional tone but it may not be possible for everyone to get it right. Thus one can make use of outlines a resume format.
A resume format is a detailed layout and format of radio movie a resume which can be used by those who are confused about the format of such a formal document. A resume format is divided into sections and categories in the exact same way as needed in a resume. It gives the users a reference point of essay outlines view and idea of how to write a journal article critique how a professional Resume Templates must look like. Resume formats may also be provided with the main headings like personal details, academic details, professional experience etc. for better use and essay outlines, reference of the users. What makes a resume format the best resume format is the incident manner in which it is drafted or framed and how much convenience it offers to the user. It must be time saving for the user to use and customize and should also be self-explanatory.
The following are some of the contents of a resume format which truly make it ‘best’: What is the essay format of a CV?(100 Words) When it comes to CV, it has to be professional. There are different types of CV possible depending on the purpose of its use and objectivity, the expectation of the essay targeted audiences. Similarly, different types of CVs will have different formats. For example, CV for car accident essay applying in an IT firm would be different from a CV to essay, apply for radio essay paper a marketing company. Instead of taking the essay outlines risk of designing CV format yourself, it is max weber better to download for sample CV collection. For example, if you download marketing resume collection, you will get a lot of Marketing Resume Format Templates and you can choose the best one that appeals to you and fill in the details to send it out. What kind of Resume Should I use?(100 Words) Basically, there are four types of resume available. They are chronological, functional, combinational and essay, targeted. Chronological resumes are most commonly used as it represents the data sequentially for the employers to essay on pro life, find them easily at the very first glance.
In case you have some lapse in essay outlines your work and study, then it is better to use a functional resume to write article critique, cover it up skillfully. Combinational resume must be used when you are very experienced and your work history matters more than basic data. Targeted resumes are most effective and you need to essay outlines, spend more time preparing it. Gather? Download some Basic Resume Format Templates and some samples to make a perfect resume yourself. Which Format do Most Employers Prefer for Resumes? Depending on the job requirement, different employers prefer different resume formats. If the job requirement is for freshers only, employers would like to receive chronological resumes as the essay outlines data and how to article, information about the candidate would be sequentially and it would be easy to locate required information easily. But in the case of essay hiring experienced professionals, employers prefer to have functional resumes where experience and skills get the priority. But in general, employers prefer chronological resume format.
Therefore, you need to download different formats like IT Resume Format Templates to format, apply in IT firm and then based on the job requirements, you have to form the resume that the employers would prefer the most. To write a resume, you have to collect all the outlines required data and information about research you in one place. Then you have to download some sample resumes and essay outlines, resume templates as per the purpose of the resume. Life Abortion? For example, if you are applying in essay an IT firm, you should download IT resumes or if you are applying for a post of HR, you should download HR Resume Format Templates. After downloading them, open them and start filling the details. If there are any unnecessary headings that do not match your profile, you have to omit and delete them. You should refer to sample resume for checking out argumentative paper rubric how exactly to fill the essay outlines data and essay on pro life abortion, information to look impressive. what are two of the essay Most Popular Resume Formats. Out of the four different types of resumes we listed above, chronological and functional are the most popular resume formats.
Chronological resume formats are popular among freshers or those who have light experience of how to write format a couple of years. On the other hand, functional resumes are popular among experienced professionals with at least experience of working in two and more companies. Essay? Freshers can also use it in case the candidate has diverse skills and analyse synthesise, has done many internships in essay outlines the past. There are multiple formats available in gather analyse synthesise these two categories and one should download freshers and Experienced Resume Format Templates to have different variations to choose from. A chronological resume is the essay most used resumes in essay the world. In a chronological resume, everything is listed from the outlines recent to the earliest format. For example, in academic background, your university degree would come first, followed by essay, the college degree and then at last school qualification.
Similarly, in work experience, your recent work would be listed and in the end, you can have your internships. This is the most preferred Writer Resumes format by the employers as it is easy for them to get a snapshot of everything very quickly in their mind. There are various types of chronological formats available and you should download freshers resume format templates to get all the variations and choose the best.
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Section 56:Business Customer Options. All references to BT Business One Plan apply equally to BT Business One Plan Plus unless otherwise stated. Changes to the Reward eligibility have been made - please refer to essay outlines “Benefits of BT Business One Plan” below. Radio Essay Paper. Please also see Special Notice 07/13 Withdrawal of End of Contract Period Credit, Reward Credit Reward payments . Special Offers appear in the Special Notices section of outlines, this BT Price List. Research Rubric. These Special Notices include information about the outlines terms and conditions (including the essay on pro abortion charges) applicable to the Special Offer. Customers requesting BT Business One Plan up to and including 29th June 2007 may benefit from a cap on their mobile calls (where mobile is essay, one of the incident qualifying services) under the essay outlines terms of radio movie essay paper, a Special Offer.
Details can be found at the Special Offer link above. Essay Outlines. Where customers take the Special Offer, the Minimum Period and Minimum Term for the Mobile Qualifying Service referenced under Eligible and Contributory Spend must be 24 months. “Subsequent Contract” means a Contract (either a Rollover or Non Rollover Contract) dated on or after the 20th August 2012 which replaces a Contract for research paper, BT Business One Plan (either a Rollover or Non Rollover Contract) dated before the 20th August 2012 (the “Original Contract”) and which is for the same BT Business One Plan option and includes the same Commitment Period and Nominal Committed Spend as those applicable to the Original Contract. All other definitions are detailed in the standard terms and conditions for BT Business One Plan which can be found at : BT Business One Plan is a converged pricing package which enables customers to essay outlines consolidate mobile calls in argumentative paper, order to benefit from essay outlines capped calls on movie essay paper fixed and mobile services dependent upon which options the essay outlines Customer takes. Essay. BT’s Standard Terms and Conditions apply including a 24 month Commitment Period. Outlines. Improved fixed PST call prices are available through a tiered commitment structure (as detailed below). BT Business One Plan is for the Customer's own use and must not be resold or otherwise transferred. BT Business One Plan is available to all business customers provided that they: a) Commit to an annual Committed Spend within one of the spend bands (which are referred to as Tiers) listed below. b) Have contracts with BT for at least one of the services listed in the Access column and a minimum of one other service from car accident essay incident either the Broadband column or from the Mobile column (the `Qualifying Services'). Essay. c) retain an Access Qualifying Service.
BT Business Total Broadband Products- see note 3. BT Business Mobile see Note 4. BT Business PSTN Access Line - See Note 1. BT Business Total Broadband Option 1. BT Business Mobile service taken with any of the following services or tariffs:
BT Business Standard. Business Circle VPN. Business Circle IA. Business Circle Fixed Link. Business Circle Complete VPN. Business Circle Complete IA. Business Circle Complete NI. BT Talk Time Sharer (previously known as Talk Time)- see note 5.
BT Talk Time Solo. Blackberry Internet Service (BIS) Blackberry Enterprise Server (BES) Blackberry Professional Service (BPS) BES Express - Managed Service. Business Highway - See Note 2. BT Business Total Broadband Option 2. BT Office Anywhere. BT Mobile Direct (Low, Medium and max weber essay High) for contracts signed prior to essay outlines 1st April 2008.
Not now available for new supply. ISDN-ISDN 2e, ISDN2, ISDN30 - See Notes 1 2. BT Business Total Broadband Option 3. BT Business Mobile Broadband - see note 6. BT Business Broadband Network. BT Business Broadband Network Premium. BT Business Mobile SIM Only. BT Business Mobile Solo. BT Business Mobile Sharer.
BT Business Mobile Flex. BT Business Mobile Extras. BT Business Broadband Advanced (SDSL) BT Infinity for essay on pro life abortion, business Option 1 (Advance Advance Support) BT Infinity for essay outlines, business Option 2 (Advance Advance Support) BT Infinity for business - Advance Support (Option 3)
BT Infinity for essay, business - Option 4 Advance Support (unlimited usage) BT Business Total Broadband Fibre. BT Business Total Broadband Fibre Plus. BT Business Total Broadband Office. BT Business Total Broadband Office Unlimited. BT Business Total Broadband Advance Support (Up to 15m) BT Business Total Broadband Advance Support (Fibre) Note 1 - BT Business PSTN (including BT Business Value PSTN and outlines BT Business Critical PSTN) and ISDN lines (including ISDN2e, ISDN2 and radio movie essay ISDN30) provided under a Contract to which Standard Charges apply*.
Lines provided under contracts where charges other than Published Charges apply are not Qualifying Services. Outlines. Business PSTN will not be an radio essay paper Access Qualifying Service where it is taken as part of a Business Broadband calls and lines package. Note 2 - ISDN and Business Highway cannot be provided over essay outlines, the same access as Broadband. Note 3 - BT Business Total Broadband products to which standard terms and conditions (including the charges) apply*. BT Business Total Broadband products will not be a Broadband Qualifying Service where they are taken as part of a Business Broadband calls and lines package. Note 4 - Mobile Qualifying Services. (i) Where the customer is including more than one Mobile Qualifying Service in BT Business One Plan, all of the Mobile Qualifying Services must be within the same eligibility category (which means either Eligible Contributory Spend or Non-Eligible Contributory Spend) as detailed in Eligible Contributory Spend paragraph 2 (b) below. For example a customer cannot include a Mobile Qualifying Service where the spend is Eligible Contributory Spend and a Mobile Qualifying Service where the radio paper spend is Non-Eligible Contributory Spend. The eligibility category that will be applied to all the Mobile Qualifying Services within the customer's BT Business One Plan is the eligibility category relevant to whichever Mobile Qualifying Service was first included within the customer's Business One Plan. (ii) Please see notes below under Eligible Contributory Spend regarding re-sign of contracts for Mobile Services.
Note 5 - Mobile Qualifying Services. BT Talk Time Sharer contracts signed before 12th March 2007are not compatible with BT Business One Plan and the spend will be neither Eligible Contributory Spend nor Non-Eligible Contributory Spend. Note 6 - BT Business Mobile Broadband will be included as a Qualifying Service from the 20th October 2008. Call and outlines Rental Spend on car accident essay BT Business Mobile Broadband from that date can be included as Eligible Contributory Spend or Non-Eligible Contributory Spend, as detailed in this BT Price List Entry within BT Business One Plan. BT Business Mobile Broadband when provided with BT Business Mobile Broadband Special Offer, Free BT Business Mobile Broadband with Option 3 and essay outlines Option 3 with Inclusive Mobile Broadband is not a Qualifying Service within BT Business One Plan.
Termination of max weber objectivity, Qualifying Service. Where the ending or modification of a Standard Contract causes a Qualifying Service to be withdrawn from the Inventory and as a result: (a) there is no longer an Access Qualifying Service in outlines, the Inventory, the analyse BT Business One Plan Contract will end immediately and outlines BT will apply the max weber objectivity reconciliation charges set out below; or. (b) the customer retains an Access Qualifying Service but the number of Qualifying Services is reduced, the BT Business One Plan contract will continue until the next Spend Measurement Date. If on the next Spend Measurement Date the Total Contributory Spend is less than the Adjusted Nominal Committed Spend, BT will apply the reconciliation charges set out outlines below as appropriate and essay on pro life abortion may also end the BT Business One Plan contract. The Customer must commit to a Committed Spend per annum within one of the Tiers below (which are exclusive of VAT). The stated minimum for outlines, each Tier is the essay Nominal Committed Spend. The Customer will benefit from: The call Prices shown in the tables at the end of this Part which are dependent upon the Tier within which the Committed Spend lies; and. Non Rollover Contracts * Minimum Committed Spend Per Annum. Maximum Committed Spend Per Annum.
*These are contracts which will not rollover to essay outlines a Subsequent Commitment Period. Max Weber Objectivity Essay. At the end of the Commitment Period the following will not apply: (a) A Subsequent Commitment Period; (b) The Committed Spend and associated reconciliation charges (for the avoidance of doubt any reconciliation charges due for the Commitment Period will apply). Contracts dated before the 20th August 2012 - these Contracts include a Reward details of which are set out outlines below under “Benefits of BT Business One Plan”. Rollover Contracts are not available to customers who have 10 or less employees. Minimum Committed Spend Per Annum. Maximum Committed Spend Per Annum.
**These are contracts which will rollover to a Subsequent Commitment Period (to which the Committed Spend will apply) upon analyse expiry of a Commitment Period or a Subsequent Commitment Period unless the Customer ends the Contract between the sixth day before the end of a Commitment Period or Subsequent Commitment Period and the 28th day after the end of essay, a Commitment Period or a Subsequent Commitment Period. Contracts dated before the 20th August 2012 - these Contracts include a Reward details of which are set out objectivity essay below under “Benefits of BT Business One Plan”. The Customer is outlines, responsible for identifying the argumentative paper rubric lines and services which are to be included within their BT Business One Plan. Essay Outlines. The Customer must therefore ensure that all services and essay lines are clearly identified on the order form (or provided to BT by any other means where no order form is outlines, completed) and on pro life abortion advise BT of any omissions or changes as soon as possible. Failure to do so may: 1. Outlines. Delay acceptance and activation of the Customer's order for BT Business One Plan which may delay the application of the benefits provided under BT Business One Plan; 2. Impact on the Customer's ability to meet the max weber objectivity essay Adjusted Nominal Committed Spend in which case a reconciliation charge will apply. Eligible Contributory Spend includes the following: 1) Rental and call spend (excluding VAT) on outlines the Access and Broadband Qualifying Services. Note: Eligible Contributory Spend includes any calls made within any inclusive call allowance within the Qualifying Service and any calls in incident, excess of the inclusive call allowance. Note: Featureline Corporate call spend - call spend on essay outlines Featureline Corporate Option A and essay on pro call spend charged at anything other than standard published charges is not Eligible Contributory Spend within BT Business One Plan.
2) Rental and call spend (excluding VAT) on the Mobile Qualifying Services. a) Subject to (b) below, in order for spend under a Mobile Qualifying Service to be Eligible Contributory Spend the Customer must sign a new mobile contract for the Mobile Qualifying Service with a new Minimum Period and essay a new Minimum Term. Where an existing customer does not wish to sign a new contract, the radio movie paper spend on the Mobile Qualifying Service will be Non-Eligible Contributory Spend. (b) Please note that where the essay tariff included within the Mobile Qualifying Service has been tailored using Mobile Selector Customers will be advised at the time they apply for BT Business One Plan whether the rental and on pro life call spend on these services is Eligible Contributory Spend or Non Eligible Contributory Spend and essay whether or not signature of a new Mobile contract is appropriate. (c) BT Talk Time Sharer contracts signed before 12th March 2007are not compatible with BT Business One Plan and essay on pro life the spend will be neither Eligible Contributory Spend or Non-Eligible Contributory Spend. (d) Call and Rental Spend on BT Talk Time Solo where the Customer has taken the option listed as Monthly Subscription Charges and UK Voice Extra under the essay outlines paragraph Benefits of BT Business One Plan below, will not be eligible for any Reward and max weber objectivity essay will not contribute to achievement of the Committed Spend it is essay outlines, therefore not Eligible Contributory Spend or Non-Eligible Contributory Spend. 3) Any additional spend on rental subscription charges on: (a) BT Office Anywhere (excluding BT WiFi usage); (b) Blackberry Enterprise Server (BES), Blackberry Internet Service (BIS), BES Express - Managed Service; (c) the 100MB UK Data Extra option (previously known as the 100MB data Option); (d) the 3GB UK Data Extra option (previously known as the 3GB data option); (e) the User 3000 Text Extra option available with BT Talk Time Sharer (previously known as the car accident incident User Unlimited Text Extra option and the Unlimited SMS option); (f) the UK Voice Extra option (previously known as the Unlimited UK Voice Extra option) and UK Landline Voice Extra option (previously known as the Unlimited Calls Bundle and Unlimited Landline Calls) and the SMS Allowance (previously known as the Unlimited SMS Allowance) available with BT Talk Time Solo; (g) the 500MB UK Data Extra option; (h) the essay 1GB UK Data Extra option; (i) the gather analyse synthesise Account 3000 SMS Text Extra option (previously known as the Account Unlimited SMS Text Extra option); (j) the essay User 3000 Text Extra option (previously known as the User Unlimited Text Extra option); (k) the on pro life abortion Helplines Voice Extra option; (l) the Europe Roamer Voice Extra option; (m) the outlines Talk Time Sharer Value Extra option; (n) the EU Roaming Data Extra Optional Extra (as detailed in Section 10 Part 7 ) where it is ordered at car accident essay incident, the same time as the Contract for the Mobile Qualifying Service. Note: Where an EU Roaming Data Extra Optional Extra is added to essay an existing Contract for a Mobile Qualifying Service, spend on EU Roaming Data Extra will not be Eligible Contributory Spend or Non-Eligible Contributory Spend. 4) Call and rental spend (excluding BT WiFi usage in analyse synthesise, excess of the inclusive allowance) on BT Business Mobile Broadband when provided with the BT Business Mobile Broadband Special Offer , Free BT Business Mobile Broadband with Option 3 and Option 3 with Inclusive Mobile Broadband. 5) Spend (excluding VAT) on: BT Internet Security Pack BT Internet Business Pack BT Business Email Plus (BT Business Email Plus Organise, BT Business Email Plus Organise Share, BT Business Email Plus Additional Storage) BT IT Support Manager (BT IT Manager PC, BT IT Support Manager Server, BT IT Support Network Manager) BT Static IP (BT Single Static IP, BT 5 Static IP, BT 13 Static IP) BT Business VoIP Services: (i) rental and call spend on essay outlines lines within the customer's One Plan inventory at standard published prices for Business Broadband Voice and BT Office Communicator. (ii) rental and call spend on lines within the customer's One Plan inventory at radio essay, standard published prices for BT Hosted VoIP. Essay. (iii) BT IP Trunk - access and call spend (iv) BT SIP Trunk - access and call spend. Note: Some Business VoIP call types will not be charged at BT Business One Plan rates under certain circumstances - please see Section 56 Part 18 for details.
6) Maintenance Spend (excluding VAT) on or after the 21st January 2008 on those switches listed at www.bt.com/oneplan , or any other online address that BT may advise the Customer, where that spend is incurred under a contract with BT for maintenance of those switches. 7) BT MeetMe (UK and abortion Global) bridge access spend, Inbound Outbound MeetMe call charges (excluding VAT) billed at least one month prior to the Spend Measurement Date. Note: Eligible Contributory Spend includes any calls made within any inclusive call allowance within the outlines Qualifying Service and any calls in excess of the inclusive call allowance. 1) Rental and call spend (excluding VAT) on Mobile Qualifying Services which does not qualify as Eligible Contributory Spend under 1 above, with the exception of Call and Rental Spend on radio movie paper BT Talk Time Solo where the Customer has taken the option listed as Monthly Subscription Charges and essay UK Voice Extra under the movie paragraph Benefits of BT Business One Plan below, which will not be eligible for any Reward and will not count towards achievement of the Committed Spend. Note: Where an EU Roaming Data Extra Optional Extra is added to essay an existing Contract for essay, a Mobile Qualifying Service, spend on EU Roaming Data Extra will not be Eligible Contributory Spend or Non-Eligible Contributory Spend. Note: BT WiFi usage: (a) on essay BT Office Anywhere; and. (b) in excess of the analyse inclusive allowances on essay BT Business Mobile Broadband under BT Business Mobile Broadband Special Offer, Free BT Business Mobile Broadband with Option 3 and Option 3 with Inclusive Mobile Broadband, is neither Eligible Contributory Spend nor Non-Eligible Contributory Spend. Note: BT Talk Time Sharer contracts signed before 12th March 2007are not compatible with BT Business One Plan and the spend will be neither Eligible Contributory Spend nor Non-Eligible Contributory Spend.
2) Call Centre Advance Spend will contribute towards the Non-Eligible Contributory Spend for contracts with a Committed Spend of research paper, ?5000.00 (exc VAT) per annum and essay above. Essay. The terms and conditions of Call Centre Advance are set out at Section 56 Part 19 Subpart 1 . Essay. The Contract between BT and the Customer for Call Centre Advance will be a Standard Contract for car accident incident, the purposes of BT Business One Plan. 3) IDC Call Charges made using the International Direct Connect product will contribute towards the essay outlines Non-Eligible Contributory Spend. Note - Where the Customer's calls and / or rental spend is radio movie, included in outlines, another calls and / or line package, that call and rental spend will not contribute to the Customer's Eligible and Contributory and/or Non Eligible and Contributory Spend. 4) Featureline Corporate call spend - call spend on Featureline Corporate Option A and call spend charged at anything other than standard published charges is not Non-Eligible Contributory Spend within BT Business One Plan. Mobile Subscription Charges. For BT Business One Plan Customers who order a new Mobile contract for BT Talk Time Sharer on or after 2nd July 2012: (a) the BT Talk Time Sharer Monthly Subscription Charge for each Secondary Connection will be reduced by how to write a journal article critique in apa format ?2.00 per month (excluding VAT); and. (b) where the Customer takes the UK Landline Voice Extra option, the additional Monthly Subscription charge per Connection for essay outlines, that option will be reduced by ?3.00 per month.
If the Customer’s contract for BT Business One Plan is terminated then the discounts stated in (a) and essay incident (b) above will no longer apply and the customer will be charged in accordance with the essay Standard Contract for BT Talk Time Sharer. For BT Business One Plan Customers who order a new Mobile contract for max weber, BT Business Mobile Sharer: (a) the BT Business Mobile Sharer Monthly Subscription Charge for each Secondary Connection will be reduced by ?2.00 per month (excluding VAT); and. (b) where the Customer takes the essay UK Voice Landline Extra, the radio movie essay additional Monthly Subscription charge per Connection for essay outlines, that Extra will be reduced by ?3.00 per essay month. If the Customer's contract for BT Business One Plan is terminated then the essay discounts stated in (a) and essay (b) above will no longer apply and the customer will be charged in accordance with the Standard Contract for BT Business Mobile Sharer. For BT Business One Plan customers who order a new BT Mobile contract with a 24 month Minimum Term for BT Talk Time Sharer, Business Circle Complete VPN and/or Business Circle Complete IA as one of the Mobile Qualifying Services before the essay outlines 1st September 2010, the following will apply: 1. Subject to paragraph 4 below, the customer will receive 3 months free mobile rental per connection on that Mobile Qualifying Service except: a) where the Mobile Qualifying Service(s) has been tailored or priced using Mobile Selector, and movie essay paper the customer has been advised at the time they apply for essay, BT Business One Plan that the 3 months free mobile rental will not apply, or. b) where the radio movie paper contract is for Blackberry Internet Services with Talk Time Sharer entered into on essay outlines or after the 1st July 2009; or. c) where otherwise stated in any special offer terms and conditions. 2. Synthesise. This will be applied to outlines months 22, 23 and 24 of the Minimum Term of car accident, that Mobile Qualifying Service as a credit on the applicable monthly bill. 3. Subject to paragraph 5 below, where the customer includes the essay outlines 100MB Data Option, the customer will receive a credit equal to the additional monthly subscription payable under the 100MB Data Option in months 22, 23 and 24 of the 100MB Data Option.
This credit will appear on the relevant monthly bill. 4. Should the Customer terminate the BT Talk Time Sharer, Business Circle Complete VPN and/or Business Circle Complete IA contract within the movie essay paper Minimum Term, the 3 months free mobile rental will not be applied. 5. Should the outlines customer terminate the 100MB Data Option prior to or during months 22, 23 or 24 of the on pro abortion 100MB Data Option, the 3 months free 100MB Data Option subscription will not be applied. 6. Outlines. The 3 months free mobile rental and the 3 months free 100MB Data Option will only apply once per connection. BT Talk Time Solo: Monthly Subscription Charges.
Customers signing a contract for BT Talk Time Solo on or after the 18th April 2011 and movie essay before the 19th September 2011, with a 24 month Minimum Period and Minimum Term, will receive the following: A ?2.00 (excluding VAT) discount will be applied to essay the Monthly Subscription Charge applicable to incident the Customer's Standard Contract for BT Talk Time Solo, the essay outlines ?2.00 (excluding VAT) discount will be applied once per Connection each month and write a journal article in apa will not be applied to any Monthly Subscription Charges levied for any additional options that the Customer has contracted for. For the purposes of Eligible Contributory Spend, the Monthly Subscription Charge will be included net of essay, discount. The ?2.00 (excluding VAT) discount will apply for life abortion, the Minimum Term of the Connection provided that the Customer has not terminated the BT Business One Plan Contract. Essay Outlines. Where the Customer terminates the BT Business One Plan Contract, the on pro life ?2.00 (excluding VAT) discount will cease to essay outlines apply. Monthly Subscription Charges and UK Voice Extra (previously known as Unlimited UK Voice Extra) For Customers who place an order for BT Talk Time Solo with a 24 month Minimum Period and Minimum Term, the research following will apply (provided that the Customer has not terminated the BT Business One Plan Contract): (a) Customers who order BT Talk Time Solo on essay or before 6th January 2013 will have a ?5.00 (excluding VAT) discount applied to the Monthly Subscription Charge applicable to synthesise the Customer's Standard Contract for BT Talk Time Solo, the ?5.00 (excluding VAT) discount will be applied once per Connection each month and will not be applied to any Monthly Subscription Charges levied for any additional options that the essay outlines Customer has contracted for. Write A Journal Critique. (b) In addition for Customers who order BT Talk Time Solo on or before the 30th June 2012 the Additional Monthly Subscription Charge applicable to the UK Voice Extra option will be 1 pence per month per Connection (excluding VAT) for the first 3 months of the Minimum Term of the Connection to which the outlines UK Voice Extra option has been applied. At the end of the 3 month period the objectivity Additional Monthly Subscription Charge applicable to the UK Voice Extra option will be as stated in the Standard Contract for BT Talk Time Solo.
Where the Customer terminates the BT Business One Plan Contract, the Monthly Subscription Charge and the Additional Monthly Subscription Charge for essay, the UK Voice Extra option will be charged as detailed in their Standard Contract for BT Talk Time Solo. Where the gather synthesise Customer has taken the essay option listed as Monthly Subscription Charges and UK Voice Extra under this paragraph (Benefits of BT Business One Plan), the Call and Rental Spend on BT Talk Time Solo will not be eligible for any Reward and will not contribute to achievement of the argumentative research paper Committed Spend it is essay outlines, therefore not Eligible Contributory Spend or Non-Eligible Contributory Spend. OTHER BENEFITS OF BT BUSINESS ONE PLAN. 1. The following products are provided at free or reduced connection or conversion prices for gather synthesise, BT Business One Plan customers, as detailed in Section 1 of essay outlines, this Price List: BT Business PSTN (including BT Business Value PSTN and BT Business Critical PSTN) (takeover only) ISDN2 ISDN30 Featureline. 2. The customer may also receive: BT Call Tracker - by registering on BT.COM via the My BT Account and this will subsequently be provided at no additional charge until the BT Business One Plan contract is terminated unless a contract with another qualifying package is signed. Please note that this service is not available on all lines. Max Weber Objectivity. Lines will be checked for eligibility at the point of order. BT Call Tracker is provided subject to its own terms and conditions available at essay outlines, http://www.bt.com/terms . BT Bill Direct. These products are provided under the relevant terms and conditions as detailed in this Price List. The following products when included in max weber objectivity essay, a BT Business One Plan contract with a Nominal Committed Spend of ?30000 or more, or a BT Business One Plan Special Offer, will receive a discount on the standard rental within BT Business One Plan.
Customer Achieves the outlines Adjusted Nominal Committed Spend. Where on the Spend Measurement Date, the Customer's Total Contributory Spend is research, equal to or more than the Adjusted Nominal Committed Spend, no reconciliation charges will apply. Customer Does Not Achieve the Adjusted Nominal Committed Spend. Where on the Spend Measurement Date the Customer's Total Contributory Spend is below the Adjusted Nominal Committed Spend the Customer will pay a reconciliation charge of 20% of the difference between the Total Contributory Spend and the Adjusted Nominal Committed Spend. All reconciliation charges which are below ?10.00 will be waived off by BT. Termination Before the End of the Commitment Period or a Subsequent Commitment Period. Where the essay Contract is max weber, terminated before the end of the Commitment Period or a Subsequent Commitment Period the following rule applies: On the essay outlines termination date, BT will measure the Customer's Total Contributory Spend for the year of the Commitment Period or Subsequent Commitment Period in which the termination took place. Where this Total Contributory Spend is less than the Adjusted Nominal Committed Spend due for the year in which termination took place, the Customer will pay a reconciliation charge which is 20% of the argumentative research rubric difference between this Total Contributory Spend and this Adjusted Nominal Committed Spend. In addition, where the termination has taken place in essay, the first twelve months of the Commitment Period or Subsequent Commitment Period, BT will apply a reconciliation charge for the second twelve months of the movie paper Commitment Period or Subsequent Commitment Period which will be 20% of the Adjusted Nominal Committed Spend due for the second twelve months of the Commitment Period or Subsequent Commitment Period.
Note: reconciliation charges are applied on essay outlines each Spend Measurement Date. Spend which has been included in BT's calculation of the Customer's Total Contributory Spend on one Spend Measurement Date cannot be included within the Customer's Total Contributory Spend on max weber any other Spend Measurement Date. This payment will be invoiced after cessation of the Contract against the Customer's PST nominated billing account or if not available any other billing account. Reconciliation Charge and Migration. Where a Customer is migrating from BT Business One Plan, in accordance with the migration rules below a reconciliation charge will apply as follows: Where, on the date of migration to another BT product, the Customer's Total Contributory Spend is less than 75% of essay outlines, the pro rata Adjusted Nominal Committed Spend due for the year in which the migration takes place, the customer will pay a reconciliation charge which is 20% of the difference between the pro incident, rata Adjusted Nominal Committed Spend and the Total Contributory Spend. Migration to or within BT Business One Plan. 1) Customers may (subject to the reconciliation rules above) at any time during the Commitment Period or Subsequent Commitment Period, move to an equal or higher Committed Spend within BT Business One Plan, but not to a lower Committed Spend to which an equivalent or greater Commitment Period applies. 2) Customers may migrate from outlines BT Business Plan to BT Business One Plan without incurring reconciliation charges provided that: a) At the date of migration they have achieved 85% of the pro-rata Adjusted Nominal Committed Spend: or. b) the Committed Spend under the research paper BT Business One Plan contract is equal to or greater than the Committed Spend applicable to their BT Business Plan contract (the Nominal Committed Spend under the BT Business One Plan contract may however be less than the Nominal Committed Spend applicable to the BT Business Plan contract). In all other circumstances, the essay reconciliation charges (due under the argumentative research paper BT Business Plan contract) will be applied.
Where the customer migrates to outlines BT Business One Plan from BT Business Plan, the original BT Business Plan contract will be terminated and a new Commitment Period will commence under the max weber essay BT Business One Plan contract. The new Contract will be for a full Commitment Period and essay spend under the ceased BT Business Plan contract will not count towards the Committed Spend for the new BT Business One Plan contract. 3) Where a Customer migrates from BT Business Reward to BT Business One Plan or BT Business One Plan Plus the customer will receive a pro-rata payment of any reward on their BT Business Reward contract provided that: a) at the date of gather, migration they had achieved their pro-rata Committed Spend. b) the essay outlines Committed Spend under the car accident BT Business One Plan contract is equal to or greater than the committed spend applicable to their BT Business Reward contract. In all other circumstances, the essay outlines Reward Credit (under the max weber BT Business Reward contract) will not be applied. Where the customer migrates to BT Business One Plan from BT Business Reward, the outlines original BT Business Reward contract will be terminated and radio movie a new Commitment Period will commence under the BT Business One Plan contract. The new Contract for outlines, BT Business One Plan will be for radio movie, a full Commitment Period and spend under the essay outlines ceased BT Business Reward contract will not count towards the objectivity essay Committed Spend for essay outlines, the new BT Business One Plan contract. Migration from BT Business One Plan. 1. Customers may (subject to the reconciliation rules above) at analyse, any time during the Commitment Period or Subsequent Commitment Period, move from BT Business One Plan to BT Business Complete and a reconciliation charge will not apply under the terminated BT Business One Plan Contract if: (a) The BT Business Complete Minimum Period is essay outlines, greater than or equal to the outstanding BT Business One Plan Commitment Period; and. (b) Either: (i) the BT Business Complete Committed Spend is greater than the BT Business One Plan Committed Spend; or (ii) the paper rubric BT Business Complete Committed Spend is greater than 85% of the Customer’s actual rental spend on outlines the Access Qualifying Services, Mobile Qualifying Services (the Monthly Subscription Charge) and the Broadband Qualifying Services included in the Customer’s BT Business One Plan Inventory measured over the 12 months immediately prior to the termination of the movie essay paper BT Business One Plan Contract or calculated pro rata if the essay Customer’s BT Business One Plan has not been in place for the full 12 month period. 2. Gather. Customers may (subject to the reconciliation rules above) at any time during the Commitment Period or Subsequent Commitment Period move from BT Business One Plan to BT Business Flex and a reconciliation charge will not apply under the terminated BT Business One Plan Contract if: (a) the essay outlines BT Business Flex Minimum Period is greater than or equal to the outstanding BT Business One Plan Commitment Period; and.
(b) the Customer includes the car accident lines that were included in the BT Business One Plan Inventory on the date of essay, termination as Lines within the objectivity essay BT Business Flex Inventory. 3. Outlines. Customers may (subject to the reconciliation rules above) at essay incident, any time during the essay outlines Commitment Period or Subsequent Commitment Period move from BT Business One Plan to another BT product and a reconciliation charge will not apply under the max weber terminated BT Business One Plan Contract if: (a) the Commitment Period (sometimes referred to as the Contract Period or Minimum Period) applicable to the new contract is greater than or equal to the BT Business One Plan Commitment Period; and. (b) the Committed Spend on the alternative BT product is essay, greater than or equal to the BT Business One Plan Committed Spend. Where paragraphs 1 to 3 above apply, the how to write critique original BT Business One Plan Contract will be terminated and outlines a new Commitment Period will commence under the new contract. Any period of time served on the BT Business One Plan Contract will not count towards the new contract.
Spend under the research BT Business One Plan Contract will not count towards any Committed Spend applicable to the new contract. 1) BT Business One Plan is provided under BT's Contract for essay, BT Business One Plan. Objectivity Essay. 2) The services listed under Eligible Contributory Spend and Non Eligible Contributory Spend are provided on the applicable standard terms and charges for those services (`Standard Contracts') as amended by BT's Contract for essay, Business One Plan and write article critique the charges listed below. Customers' are entitled to an average of four hours calling per day of Capped Calls (for each call type for which there is a Capped Call price) from any one line to any one number throughout each calendar month. Essay Outlines. Usage beyond this level will be subsequently charged at BT Business One Plan pence per minute prices as set out in Tables A, B and F, unless, in addition, the average number of car accident, calls per day per calendar month to the relevant number is 16 or greater. The average of four hours per day per calendar month is calculated by dividing the essay outlines total duration of Capped Calls to any one number in gather synthesise, any calendar month by the number of days in that calendar month. Outlines. The average number of argumentative, calls to any one number per essay outlines day per calendar month is radio essay, calculated by dividing the essay total number of Capped Calls to any one number in any calendar month by the number of days in that calendar month.
The following services are excluded: Residential Lines Service Provider Calls and Access lines Payphone lines Temporary Lines / Temporary Service Lines Rented Card Phone line Lines not provided by BT ISDN Connect BT Service lines FeatureNet Embark Private Circuits Business Start Up lines Incoming DDI lines Custodial Tagging Lines Chargecard Calls billed to a credit card Exchange Lines provided at non-served premises Inbound Service calls and Network Service facility fees. Essay Incident. Business PSTN and ISDN lines provided under a contract which includes charges other than Published Charges. No other PST call pricing packages (including BT Dual Discount, BT Exchange Line Credit Scheme, BT Access Credit Scheme and outlines BT Business Line Reward) bespoke package or BT Business Broadband calls and lines package may be taken in conjunction with BT Business One Plan on the same items that are in max weber objectivity, the inventory. * Charges for PSTN, ISDN2, Featureline and BT Total Broadband include charges where existing customers have applied for one of the essay following offers and been advised at the time of entering into car accident incident the contract that a credit would apply: (i) For PSTN, ISDN2 and Featureline. Between 11 January 2010 and 31 July 2010 inclusive for essay outlines, existing customers entering into a: (a) new PSTN (24 month Minimum Period) contracts a credit equivalent to 1 or 2 months (excluding VAT) line rental may be available or.
(b) new ISDN2 or Featureline long term contract (3 or 5 years), a credit equivalent to car accident 1, 2 or 3 months (excluding VAT) line rental may be available. (Excludes existing customers on ISDN2 Start Up, and essay outlines Call Plan who sign a new ISDN2 Start up, or Call Plan contract). (ii) For BT Total Broadband. Between 4 May 2010 and 4 August 2010 inclusive for existing customers resigning a further BT Total Broadband Option 1, 2, 3, Network, or Network Premium contract with a minimum contract period of paper, 12 or 24 months (Minimum Period) a credit equivalent to 1, 2 or 3 months rental charge (excluding VAT) may be available. Any rental and calls types not listed below will be charged in essay outlines, accordance with the Standard Contract. Some Business VoIP call types will not be charged at BT Business One Plan rates under certain circumstances - please see Section 56 Part 18 for details. Dialled Call Charges. See General Notes Section Dialled Call Charges for details of Call Duration and Call Charges rounding. The application of minimum call charges.
Minimum Call Charge applies. (See General Notes ) Where a minimum call charge is essay on pro abortion, applicable the outlines minimum call charge applies once the essay abortion call has been connected. Where the charge for the call exceeds the essay minimum call charge the charge for the call is applied rather than the minimum call charge. The following tables show the prices applicable for BT Business One Plan: Table A: Local and National Geographic Call Prices - See Note 1. Set Up Fee At All Times.
Per minute. Car Accident Essay Incident. At all times. Local and National Calls (1) Local and outlines National Calls (1) Changes to how to critique in apa this product from 1st May 2016 may be to the significant detriment of some customers. (1) Includes calls charged at essay outlines, g21 rate and shown as 11 under Categorisation for Customer Options in Section 2 Part 11. Table B: International Direct Dialled Call Prices.
Set Up Fee At All Times. At All Times (Day, Evening Weekend) pence per minute. pence per minute. See Table H for radio movie essay paper, a list of countries by essay outlines IDD chargeband. Table C: Access Charge for max weber objectivity, calls to essay 084, 087, 09 118 numbers. Table D: Calls to Mobiles (excludes ISDN 64Kbit/s data calls to mobile telephones - see Section 2 Part 25 for charges) Set Up Fee At All Times. Table E: International ISDN 64k/Bits Data Calls. The BT Business One Plan prices shown below for argumentative paper rubric, all tiers apply to International ISDN 64k/bits Data Calls. The chargebands are as shown below. International ISDN 64K/bit Chargebands.
Pence Per minute. See Table I for a list of essay outlines, countries by on pro life International ISDN 64k/bit chargebands. Table F: Prices for International Direct Dialled (IDD) Calls to Mobile Telephones for outlines, All Tiers. IDD calls to some mobile telephones and essay life other special and higher rate services registered in outlines, foreign countries will be charged at max weber, 35.00p (ex VAT)/ 42.00p (inc VAT) per minute more than the outlines equivalent pence per minute price shown in Table B above for an IDD call to a journal article critique format a fixed telephone in that country. Full details of the destinations and number ranges to which this applies are shown at Section 2 Part 17.
Prices for essay outlines, Calls From Northern Ireland to the Republic of car accident essay, Ireland for All Tiers. Calls from essay outlines Northern Ireland to fixed telephones in the Republic of Ireland will be charged at the appropriate Inland rate. Calls from car accident essay Northern Ireland to mobile telephones registered in essay outlines, the Republic of Ireland will be charged at car accident incident, the same rate as calls from the outlines rest of the United Kingdom to mobile telephones registered in the Republic of Ireland. Table G - BT Text Prices for all Tiers. Price in Pence per Text*
Text to how to a fixed line in the UK. Text to a mobile telephone in the UK. UK texts - to a premium rate service** * each text message is limited to 160 characters. Where a request is made to send a text which exceeds 160 characters the message will be delivered as multiple messages each up to 160 characters length. Each text will be charged at essay outlines, the rate appropriate to the destination telephone.
** Texts to premium rate services are not currently available. Please see Section 2. Part 1 Sub-Part `BT TEXT' for further information relating to how to a journal article the BT Text service. Table H - International Chargebands for essay, PSTN and ISDN Calls. Applicable to PSTN and ISDN calls for BT Business One Plan except for International ISDN 64k/bits Data Calls. Central African Rep. Democratic Republic of the Congo (formerly Zaire) Ethiopia (Federal Democratic Republic of)
Ireland (Republic of) Korea Republic (South) Malawi (The Republic of) Palestinian National Authority. Spain (inc. Balearic Islands) St Kitts Nevis (formerly St Christopher)
St Vincent the Grenadines. Togolese Republic (The) Turks Caicos Is. United Arab Emirates. Virgin Islands (UK) Virgin Islands (USA) Note 1 : Calls to on pro abortion all other countries are charged at BT standard prices, see Basic International Call Charges in Section 2 Part 2. For customers on the Capped Option, the Capped call price for these routes is essay outlines, ?50.00 (Exc.
VAT). Table I - Chargebands for how to a journal article, International ISDN 64k/Bits Data Calls.
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Pharmacology and Medical Aspects of Methadone Treatment. Addiction to opiates involves a complex interplay of physiological, psychological, social, and other variables. The primary purpose of methadone treatment is to rubric, intervene directly in the physiological processes that underlie addiction. Ideally, such treatment is supported by additional psychological and outlines, behavioral therapies. Paper Rubric! To understand why methadone treatment works, it is important to understand the physiological basis of outlines, heroin addiction. This chapter provides an overview of the essay development of pharmacotherapeutic approaches to the treatment of opiate addiction and summarizes the key basic scientific investigations of the physiological underpinnings of opiate effects, including the outlines discovery of the endogenous opioid system. In addition, the chapter describes the synthesise pharmacological and medical characteristics of methadone as a medication for the treatment of opiate addiction. The Rationale for Pharmacotherapy. Opiate addiction is operationally defined today as at least one year of daily opiate drug self-administration, with development of tolerance, physical dependence, and drug-seeking behavior.
The concepts of tolerance and essay, dependence are thus fundamental to understanding the physiological aspects of opiate addiction. When a person repeatedly uses an opiate drug-like heroin, over time, that person becomes tolerant to heroin; that is, he or she requires greater and greater doses of heroin to achieve the same physiological and write a journal article, psychological effects. The same is true for the opiate drug morphine. Tolerance. can be thought of outlines, as an adaptation of the functional (physiological) systems of the body to max weber objectivity, opiates. Outlines! During chronic use of an opiate, physical dependence also develops when the physiological systems have adapted to the point that they actually require the opiate just to maintain physiological equilibrium. Virtually all physiological systems are affected in how to format, opiate addiction. A reproducible syndrome occurs when an opiate addict goes through withdrawal. This syndrome includes yawning, lacrimation, piloerection, perspiration, mydriasis, tremor, gooseflesh, restlessness, myalgia, anorexia, nausea, vomiting, abdominal cramps, diarrhea, fever, hyperpnea, and hypertension.
When prolonged, the syndrome includes weight loss and, even after acute withdrawal, symptoms subside, persistent symptoms such as sleep disturbances, irritability, restlessness, and poor concentration which can be present for months or years. Both acute and chronic tolerance are physiological phenomena subserved by the central nervous system. However, both acute and essay, chronic tolerance may also be influenced by environmental variables, such as setting, conditioning, and learning. The pharmacological approach to essay on pro life abortion, long-term treatment of heroin addiction, first undertaken in early 1964, was rooted in what was then a hypothesis that opiate addiction is essay outlines a metabolic disease, caused by either intrinsic or drug-induced alterations in physiology. The original researchers in the field, Drs. Vincent Dole, the late Marie Nyswander and Mary Jeanne Kreek, hypothesized that in some or most cases of heroin addiction the addicted individuals had a intrinsic metabolic disorder, possibly with an underlying genetic predisposition, which expressed itself clinically after initial exposure to specific types of drugs or other chemical agents of abuse; and that in other cases, individuals who developed addiction were experiencing drug-induced metabolic disruptions in otherwise normal physiology. Gather Synthesise! They speculated that in the latter cases, heroin-induced changes in specific neurobiological systems persist over long periods and possibly become permanent. The researchers observed that gradual removal of essay, physical dependence upon on pro life, morphine or heroin (detoxification) followed solely by psychiatric or other behavioral treatment frequently failed to help addicts sustain abstinence. Similar observations had been made much earlier in some of the initial studies conducted between 1936 and essay, 1941 at the U.S.
Public Health Service (USPHS) Hospital in Lexington, Kentucky, which showed that less than ten percent of hard-core addicts were able to stay free from opiates after discharge from gather analyse synthesise, long stays in outlines, drug-free treatment programs that only offered counseling and psychiatric care. Thus, Dole, Nyswander, and Kreek sought an optimal pharmacological agent that could supplant or complement psychological and behavioral. treatment approaches. Their first study in 1964 was to repeat earlier studies that attempted unsuccessfully to use short-acting opiates, such as heroin and morphine, in a controlled fashion, in the management of opiate dependence. Morphine was again shown to be an unsuitable pharmacotherapeutic agent for several reasons: short duration of action, requiring four to six administrations per day; necessity for essay on pro, parenteral administration, because of lack of substantial bioavailability after oral administration; and essay, the rapid development of increasing tolerance. Regular, frequent increments in doses were needed to prevent the emergence of essay, withdrawal symptoms. The poor suppression of craving (drug hunger) and drug-seeking behavior, unless doses were regularly increased, made it difficult to reach a steady state. In view of the anticipated limitations of morphine as a maintenance agent, a search was made for a medication that would block withdrawal symptoms of heroin addicts and that would be orally effective, long-acting, nonsedating, and devoid of adverse side effects. Essay Outlines! Methadone, a synthetic opiate compound originally synthesized in Germany for use as an analgesic in World War II, was selected for study in 1964. Methadone had been introduced between 1958 and 1962 at the USPHS hospital in Lexington, at the Bellevue Medical Center in New York City, and at max weber objectivity essay, a limited number of other sites for detoxification treatment of outlines, heroin addiction. In the early detoxification programs it was given in three or four small daily doses, usually 5 to 10 mg each, because the prolonged duration of action was not yet appreciated and no analytical techniques existed for objective measurements of pharmacokinetics.
The purpose of these detoxification programs was to wean patients off heroin so that they could pursue a drug-free lifestyle. However, these efforts largely failed. Within weeks following methadone detoxification all patients quickly relapsed and max weber objectivity essay, returned for repeat detoxification in a revolving-door fashion. Certain characteristics were thought to be important for successful pharmacotherapy for essay outlines, opiate addiction, including systematic bioavailability after oral administration and prolonged duration of action. An oral route of administration was thought to radio paper, be more acceptable to patients and, thus, would enhance patient compliance. Oral medication would also eliminate the outlines risk of blood-borne infection (principally serum hepatitis) associated with intravenous administration coupled with use of unsterile or shared needles and syringes. Lastly, oral administration would disrupt the symbolic linkage to abortion, an illicit lifestyle and, practically, diminish the behavior of congregating to share needles and other drug paraphernalia. A prolonged duration of action (a long-acting pharmacokinetic profile) was desired so that the dosing regimen could be infrequent, preferably once daily. In addition to ensuring better compliance with the medication, long intervals between doses would minimize inter-dose opiate withdrawal or abstinence symptoms. It was hypothesized that such a long-acting pharmacokinetic profile.
would also permit normalization of specific physiological functions disrupted by chronic use of outlines, short-acting opiates such as heroin. It was further hypothesized, and later proven, that long-acting agents would be effective at a stable dose for a much longer period of write article critique in apa format, time owing to outlines, slower development and sustained level of tolerance. In fact, subsequent studies have shown that once the daily dose of methadone has been stabilized, tolerance does not develop to the essential effects of methadone (prevention of opiate abstinence symptoms and prevention of drug hunger or craving) as used in maintenance treatment. Thus, steady constant doses can be used for years to treat heroin addiction effectively. Objectivity Essay! In 1964, only methadone met the criteria of being orally effective and long-acting.
In 1993, another related synthetic opiate, LAAM, was approved by FDA as a pharmacotherapeutic agent for essay outlines, opiate addiction. LAAM has an radio essay paper, even slower onset of action than methadone and more prolonged duration of essay, action. 1 (See Pescor, 1943; Dole et al., 1966; Kreek, 1973c, 1987b; Dole, 1988; Kreek, 1991, Kreek 1992a, Kreek 1992b, Kreek 1992c.) While clinicians treating heroin addicts were developing new pharmacotherapeutic approaches, important discoveries from basic science regarding opiate physiology began to emerge. A breakthrough in the study of the neurobiological basis of opiate effects was the discovery in 1973 by three independent groups, those of Snyder at Johns Hopkins University, Simon at New York University, and Terenius at the University of Uppsala (Sweden), of specific opiate receptors.
These studies revolutionized the field of neuropharmacology and incident, neurochemistry and were based, in part, on essay the earlier work of Dole and Goldstein. Later, three typesmu, delta, and essay on pro, kappaof specific opiate receptors were identified. In 1975, the first class of endogenous opioid peptide ligands, the enkephalins, were discovered by Kosterlitz and Hughes. Such compounds, generically called endorphins, can be thought of as the body's endogenous morphine-like substances in that they share structural and physiological similarities with morphine and heroin. Soon thereafter, attention focused on three separate classes of endogenous opioid ligands that bind to the specific opioid receptors. In animals, many of the well-known opiate effects have been reproduced by administering large amounts of these endogenous opioids.
This pharmacologic effect depends primarily on the metabolism of the parent LAAM compound to two active metabolites, noracetylmethadol and dinoracetyl-methadol. These two metabolites are pharmacologically active and are even longer acting than LAAM, permitting an every two- or even every three-days dosing schedule. Tolerance develops to some of these natural opioid peptide effects. The specific relationships between the action of endogenous opioid peptides and discrete physiological functions are still being defined. Endogenous opioids or endorphins include the enkephalins, dynorphins, and beta-endorphin. The three opioid peptide genes have been cloned, and each encodes a single large peptide, which is then processed to yield all of the opioid peptides within a class: proenkephalin, prodynorphin, and proopiomelanocortin, the latter of which contains both beta-endorphin and other important nonopioid peptide hormones including adrenocorticotropin hormone (ACTH). As mentioned above, there are at least three types of specific opiate receptors, mu, delta, and kappa, each of which may have several subtypes. The genes for each of these receptor types have also been cloned very recently.
Recent studies using transfected opioid receptors have shown that methadone binds primarily or exclusively to the mu type of essay, opiate receptor, with greater selectivity than morphine or most other commonly used mu receptor preferring ligands. Currently, studies are in essay on pro abortion, progress to localize and characterize gene expression of the endogenous opioid system peptide and receptor genes, to assess the effects of drugs of abuse and essay, treatment agents on gene expression, and to understand the complex molecular biological interactions of this system. Both basic and clinical studies have focused on the possible role of the endogenous opioid system in max weber essay, the biological basis of addiction. This system involves numerous brain regions and types of opioid peptides. Although the complex interactions of this system within the brain are not fully understood, data suggest that cycles of heroin addiction severely disrupt this system and essay outlines, that chronic, steady-state methadone maintenance attenuates this disruption.
A metabolic disease concept has been suggested, in addition, which holds that some individuals may be predisposed to heroin addiction because variations in their genes result in abnormal levels of endogenous opioid peptides, levels that can be corrected by taking heroin (Goldstein, 1994). Research Paper Rubric! The effect of heroin addiction on essay the genetic regulation of the endogenous opioid system is car accident essay incident currently an active area of research that is beginning to outlines, reveal intriguing clues about the biological underpinnings of addiction. Another area of particular interest is the max weber possible role the endogenous opioid system plays in stress. It has been hypothesized that an essay, atypical responsivity to stress, including the common stresses in our daily environment, may contribute to the acquisition of drug-seeking behavior, and both laboratory and basic clinical research studies have been conducted to define the stress responsive axis in humans with addictive diseases and in essay incident, animal models. Essay Outlines! One of the most important modulators of stress responsivity is the max weber objectivity hormones of the outlines hypothalamic-pituitary-adrenal axis. It is known that a peptide hormone released from the hypothalamus, corticotropin releasing factor (CRF), drives.
the anterior pituitary in humans to release peptides from a journal critique, one important gene product, proopiomelanocortin (POMC), which yields both the long known peptide hormone ACTH and outlines, as one of the endorphins, beta-endorphin. ACTH then acts peripherally on car accident essay the adrenal gland to cause release of the critically important glucocorticoid steroid in humans, cortisol. Outlines! In addition to many peripheral actions, cortisol acts in a negative feedback control manner to control both CRF release from the hypothalamus and the release of max weber objectivity, POMC peptides, ACTH, and beta-endorphin, from the anterior pituitary in humans. Studies using opioid antagonists have shown that the endogenous opioids-like exogenous opiods, modulate the stress responsive axis. Essay! However, whether the effects of the antagonists are mediated wholly through central actions of the argumentative research rubric brain opiods, or whether peripheral βEndorphin plays a role remains to be determined. (See Dole, 1970; Ingoglia and outlines, Dole, 1970; Goldstein et al., 1971; Kreek, 1973a, Kreek, 1973c; Pert and Snyder, 1973; Simon et al., 1973; Terenius, 1973; Hughes et al., 1975; Kreek, 1978b; Kreek and Hartmen, 1982; Kreek, Schaefer, et al., 1983; Kreek, Wardlaw, et al., 1983; Kreek, Raghunath, et al., 1984; Kreek, Schneider, et al., 1984; Kreek, 1987a; Branch et al., 1992; Evans et al., 1992; Hurd et al., 1992; Kiefer et al., 1992; Kreek, 1992c; Chen et al., 1993a, 1993b; McGinty et al., 1993; Spangler et al., 1993a, 1993b, 1994; Wang et al., 1993; Yasuda et al., 1993; Unterwald et al., 1993; Kreek, Simon, et al., 1994; Spangler et al., (in press.) When methadone maintenance was in its early stages of research and development as a possible treatment for opiate addiction, there were no adequately sensitive and specific analytic methods (e.g., gas-liquid chromatography, mass spectrometry, high-performance liquid chromatography or radioimmunoassay techniques) with which to assess the pharmacokinetics of methadone (or any other opiate such as morphine and heroin); that is, the argumentative time course of distribution, metabolism, and clearance in the body.
Some researchers turned to animal models for initial pharmacodynamic and sometimes pharmacokinetic research. These were not helpful, however, because the pharmacokinetic profile and duration of action of methadone (and also LAAM) were much longer in humans than in essay, rodent models. Objectivity Essay! Consequently, the relative duration of action of opiates was assessed by careful clinical observations of pain patients and opiate addicts receiving methadone in clinical research settings. Both morphine-induced analgesia in outlines, pain patients and write a journal in apa format, euphoria in opiate addicts have a rapid onset and decline; within 46 hours, another dose is. required. However, clinical studies demonstrated important differences between morphine and outlines, methadone in these two patient groups. Although in early studies methadone seemed to provide full analgesia for only 46 hours in pain patients, similar to morphine, when repeated doses of methadone were given over 24 hours, opiate-like side effects were observed. Argumentative Paper Rubric! This suggested an accumulation of methadone and, thus, a much longer half-life of this medication. When methadone was given to heroin addicts, it seemed to prevent signs and symptoms of essay, withdrawal for 24 hours. During oral administration of methadone to opiate addicts on doses selected to be less than those to objectivity, which tolerance had been developed, the high or euphoria, and all other perceived opiate effects, are minimal or even absent.
In the early 1970s, appropriate analytical techniques were developed to measure plasma levels of methadone. These techniques substantiated the early clinical observations and showed that there was a gradual onset of action of orally administered methadone and that low peaks of methadone were reached. Peak plasma levels were usually less than twice the trough levels, and relatively steady-state sustained plasma levels of methadone were maintained during the remainder of the 24-hour dosing interval. The mechanisms that maintain the steady-state plasma levels were shown to outlines, include binding of methadone in body tissues (primarily the liver), with subsequent release into the circulation, and essay, extensive plasma protein binding, which limits plasma total and unbound concentrations of methadone and prolongs the pharmacological actions of methadone in patients receiving a daily maintenance dose. LAAM has also been shown to essay, share this reservoir property with methadone. Thus, methadone, unlike the short-acting opiates such as morphine and heroin, appears to max weber, have its own timed-release mechanism within the essay body and this makes it very well suited to daily interval dosing. The resultant prolonged pharmacokinetic half-life probably accounts for the diminished or absent physiological and behavioral effects typical of short-acting opiates. (See Inturrisi, and Verebely, 1972; Sullivan et al., 1972; Dole and Kreek, 1973; Kreek, 1973d; Anggard et al., 1974; Hachey et al., 1977; Kreek et al., 1978; Kreek, Hachey, et al., 1979; Nakamura et al., 1982; Kreek, 1991c) In maintenance treatment of opiate addicts, methadone is administered as a single constant daily dose after the induction period is over. On this schedule patients exhibit no signs of opiate withdrawal during the 24-hour interval between doses. If a daily dose is missed or omitted, however, a patient on.
methadone maintenance will exhibit signs and symptoms of opiate withdrawal, usually within 24 to 36 hours after the how to write article format last dose of methadone. The intensity of these signs and symptoms increases gradually if the patient remains off methadone. A daily dose of essay outlines, methadone stabilizes a maintenance patient pharmacologically by the creation of a drug reservoir in essay on pro life, the tissues of the essay outlines body that holds the plasma level within narrow limits. This buffering action makes short-term minor fluctuations in medication release from the tissue reservoir unimportant. Although opiate withdrawal symptoms can be prevented with low doses, it is important to provide adequate treatment doses (60120 mg/day in most patients) to assure plasma levels that blockade the effects of any superimposed short-acting opiates. The well-documented importance of constant, steady blood levels argues strongly against the sometimes-used practice of max weber essay, using methadone dose level as a reward or punishment variable in so-called contingency contracting or other behavioral interventions. There are conditions under which the tissue reservoir appears to be less effective and withdrawal symptoms may appear earlier or more often. One of these is severe, chronic liver disease, such as postviral or alcoholic cirrhosis, which probably results in a reduction in outlines, the amount of hepatic storage capacity for car accident essay, methadone. Less severe liver disease does not seem to have this effect. Also, drug interactions of specific types may accelerate the outlines metabolism of methadone and decrease its effectiveness (see below).
(See Dole et al., 1966; Kreek, 1973c; Kreek, 1978b; Kreek, Oratz, and Rothschild, 1978; Novick, Fanizza, et al., 1981; Kreek, 1983a; Novick, Kreek, Arns, et al., 1985; Ball and gather synthesise, Ross, 1991, Kreek, 1991c.) Effects, Side Effects, and Special Pharmacological Issues. In the essay outlines original maintenance research in 1964, divided methadone doses were used very briefly, but, as already mentioned, soon it was found that a single daily dose of methadone could suppress withdrawal symptoms for 24 hours. Then, cross-tolerance or narcotic blockade and treatment studies were conducted to determine if methadone could be used to stabilize former active heroin addicts on a single, steady, oral dose, and thus prevent withdrawal symptoms, craving, and drug-seeking behavior. The level of essay, tolerance to essay outlines, methadone developed during maintenance treatment, and cross-tolerance to other superimposed opiate drugs, is high. In the 1964 research, the phenomenon of narcotic blockade was described in which cross-tolerance blocks the effect of any superimposed short-acting opiate drug.
In double-blind studies conducted on argumentative rubric former heroin addicts stabilized on full treatment doses of methadone, doses of heroin far exceeding those that. might be used illicitly had no effects in the research subjects. Occasional medication errors have also been reported in which a stabilized, long-term, methadone-maintained patient has been given up to 10 times the essay usual dose of medication and, in most cases, there were no untoward effects except for in apa format, somnolence. The strength of essay outlines, narcotic blockade and the level of essay life abortion, tolerance and essay outlines, cross-tolerance in maintained patients, however, are dependent upon the dose of gather synthesise, methadone. For example, a 40-mg dose or less of methadone can easily be overridden by common street doses of heroin. Studies have confirmed that continued illicit heroin use is much more prevalent among addicts on lower doses of methadone compared with those receiving higher doses (60 mg and more daily). The early and subsequent ''blockade'' or cross-tolerance studies have shown that it is essay difficult for patients to override methadone doses of 60120 mg/day with heroin to get any euphoria or any other perceived or observable opiate effects. This lack of any override effect has been established in the clinical research laboratory and subsequently on the street. Studies have demonstrated that the double-blind administration of heroin, morphine, hydromorphoneall administered in typical street doses to methadone-maintained patient subjectsproduced no narcotic-like effects. In addition, single-blind administration of heroin in increasing doses to argumentative paper rubric, methadone-maintained research volunteers had no effects until the doses of heroin administered (up to 200 mg) exceeded street amounts commonly used at that time. Essay Outlines! Such studies have demonstrated that the margin of safety with respect to respiratory depression is analyse synthesise very high.
Consequently, if an individual maintained on methadone sought to get high on essay heroin (which frequently is attempted during the first few weeks in treatment), he or she is car accident essay not likely to experience any desired or adverse effects. Although some methadone is outlines diverted to the street, the instances of primary addiction to methadone are extremely rare. Illicit methadone is used primarily by addicts to self-medicate for a short time for detoxification purposes or for extended periods in a maintenance mode. (See chapter 4 for an extended discussion of diversion.) The acute effects of argumentative research rubric, any opiate in a naive individual are significantly different from chronic effects because tolerance develops, albeit at varying rates to essay, most, but not all, of the opiate effects. How To Critique In Apa Format! Diverse acute effects of opiates involving multiple organ systems have been recognized for years and more carefully defined and studied in recent years. The protocol for induction into methadone treatment that was developed in the initial studies of methadone maintenance treatment is still used today. During the first few weeks of maintenance treatment, the daily dose gradually is increased at a rate slow enough to prevent any appearance of narcotic-like effects. From around two months onward, doses are held constant at an adequate blockading level, usually of 60 to 120 mg, to provide cross-tolerance and thus prevent any appearance of euphoria if the patient should attempt to superimpose the use of outlines, illicit heroin. Radio! The patient is, thus, stabilized on essay pharmacotherapy so that withdrawal symptoms and drug hunger or craving are fully suppressed, but are unaccompanied by intolerable side effects.
The side effects, which may occur if methadone is used in write article in apa format, doses exceeding the degree of tolerance developed, are somnolence, drowsiness, nausea, vomiting, insomnia, difficulty in urination, edema of the lower extremities, and constipation (to be discussed later). They diminish as tolerance develops and may be prevented with administration of appropriate doses of methadone. Chronic liver disease is the most common medical problem seen in heroin addicts, and the chronic sequelae of essay outlines, liver infection or injury persist during methadone treatment. The majority of heroin addicts entering methadone maintenance treatment have biochemical evidence of chronic liver disease, and, until very recently, 80 to 90 percent have serological evidence of exposure to hepatitis B and/or hepatitis C. In some regions of the write a journal country, up to outlines, 30 percent also have serological evidence of infection with hepatitis delta. Of patients maintained on max weber essay methadone for months to outlines, years, over one-half have persistent biochemical liver abnormalities. Gather Synthesise! In these patients, the abnormalities result from the complications of previous heroin addiction and include viral hepatitis of one or more type, comorbidity with alcoholism, or both. Methadone itself is not hepatotoxic; patients entering treatment with normal liver function maintain normal liver function during long-term treatment. Chronic renal disease is a medical problem in some heroin addicts entering methadone maintenance, but the presence of chronic renal disease does not result in outlines, the systemic accumulation of methadone or its metabolites. In such patients plasma levels of methadone remained within the appropriate therapeutic ranges for the doses received. This is essay because methadone metabolites are inactive; also, unlike morphine and heroin, methadone and its metabolites are normally excreted in part in feces as well as in urine and essay, may be exclusively excreted by the hepatobiliary fecal route in the presence of renal disease.
The influence of movie, pregnancy on the use and effects of methadone has also been investigated. Plasma concentrations of methadone are significantly lower and systemic elimination of essay outlines, methadone more rapid as pregnancy progresses through the gather synthesise third trimester. Thus, some women report symptoms of opiate withdrawal during late pregnancy, even when the daily dose of methadone remains constant. Essay Outlines! Accordingly, increased methadone doses (and certainly no dose reduction) may be required to maintain adequate levels of methadone for effective treatment during the third trimester. In addition to minimizing risk of. relapse, it is essay life abortion important to suppress withdrawal symptoms, because they can trigger premature labor. To date, the only adverse effects of methadone maintenance treatment on the fetus have been the production of essay, physical dependence, which causes mild to max weber objectivity, modest opiate withdrawal signs and symptoms in the early postnatal period in many, but not all, babies.
This is readily managed by appropriate treatment with an opiate such as paregoric, tincture of essay, opium, or oral morphine. No chronic sequelae of maternal methadone treatment have been found, nor have any teratogenic effects been reported. (See Dole et al., 1966; Cherubin et al., 1972; Gordon and Appel, 1972; Kreek, Dodesn, et al., 1972; Kreek, 1973a; Stimmel et al., 1973; Kreek, Schecter, Gutjahr, Bowen, et al., 1974; Kreek, 1978b; Kreek, 1979; Beverly et al., 1980; Kleber et al., 1980; Kreek, Gutjahr, and Hecht, 1980; Hartman et al., 1983; Kreek, 1983b; Novick, Farci, Karayiannis, 1985; Pond et al., 1985; Kreek, Khuri, et al., 1986; Novick, Khan, and Kreek, 1986; Novick, Stenger, et al., 1986; Kreek, Des Jarlais, et al., 1990; Kreek, 1991c; Kreek, 1992b; Novick, Richman, et al., 1993; Novick, Reagan, et al., in press.) Physiological Functions Disrupted During Heroin Addiction. Addicts inject (or self-administer by another route) themselves repeatedly with increasingly larger doses of heroin, usually sufficient to achieve the desired euphoria or high effect during chronic use of a journal critique in apa format, opiates, and modified responses, or tolerance, to the drug develop. The first self-administrations of outlines, heroin by a curious adolescent are likely to cause nausea with or without an accompanying pleasurable feeling. Later, with repeated use of radio movie, heroin, tolerance rapidly develops to the nausea-producing effect and the euphoria predominates. Outlines! The euphoric experience becomes central to radio, the addict's life; but with additional heroin use, the addict finds it progressively more difficult to achieve euphoria, unless an increasing dose of heroin is used. Tolerance also develops at different rates to most of the opiate effects of methadone as used in maintenance treatment. Most of the initial opiate effects, predominantly somnolence, can be avoided by starting treatment at relatively low doses and increasing the dose gradually to appropriate treatment levels.
Other important physiological functions that are deranged during cycles of heroin addiction include (1) central nervous system stress responses that are mediated by the hypothalamic-pituitary-adrenal axis; (2) reproductive biology hormones of the hypothalamic-pituitary gonadal axis with resultant abnormal function; (3) various indices of immune function that are linked to or modulated by neuroendocrine function. These altered functions, which may contribute to or be part of the mechanism underlying drug-seeking behavior, have been shown to outlines, normalize during long-term steady-dose methadone treatment. Adverse neuroendocrine effects of heroin, which cause menstrual irregularities in heroin-addicted women, and sexual dysfunction in men and women, reverse in essay, over 80 percent of outlines, patients within one to three years. Constipation, a side effect of both short- and long-acting opiates, persists for a protracted period of time; with slow development of tolerance, this effect on the gastrointestinal tract diminishes. Gather! Excessive sweating is a side effect of outlines, methadone treatment that, in some patients, does not remit. Some patients (less than 20 percent) continue to complain of sleep and sexual dysfunction for up to one year or longer, and may experience constipation for up to three years; up to 50 percent experience excessive sweating for abortion, even longer periods of time. In contrast to the gradual development of tolerance expressed by reduction at different rates of these diverse side effects, tolerance to sedative and essay, also analgesic effects of opiates develops rapidly and fully in methadone-maintained patients. Paper Rubric! Consequently, such methadone-maintained patients will experience pain with delivery of a child, surgery, injury, and painful diseases and outlines, pharmacologic pain management is necessary.
Such management can be achieved by radio, use of the usual approved pharmacotherapeutic approaches normally used in outlines, each medical situation. This includes the essay incident use of opiate drugs, such as morphine, when these are the usually indicated medications. The upper range of normal doses of opiate medications, however, and shortened dosing intervals as clinically required of short-acting narcotics, are often necessary and effective. (See Blinick, 1968; Renault et al., 1972; Cushman, 1973; Kreek, 1973b; Santen, 1974; Mendelson et al., 1975a, 1975b; Santel et al., 1975; Kosten et al., 1986a, 1986b; Kreek 1987b; Kosten et al., 1992; Kreek, 1992c; Terenius, O'Brien, et al., 1992; Culpepper-Morgan et al., 1993.) Interactions of outlines, Methadone with Other Drugs. A fundamental public health issue related to methadone maintenance was whether or not a methadone-maintained patient would be in how to write a journal article critique in apa format, jeopardy of overdose if he or she self-administered heroin during methadone treatment. As noted above, the 1964 cross-tolerance studies documented that the essay outlines risk of morbidity or death in methadone patients receiving a full treatment dose (60 to max weber essay, 120 mg per essay day) is extremely low because of the incident high level of tolerance (and cross-tolerance to other opiates) developed during treatment. In addition to essay outlines, blocking the write a journal article critique euphoric effects of superimposed, short-acting opiate drugs, methadone and its accompanying narcotic blockade may serve. a relapse-prevention function. The suppression and ultimate extinction of drug-seeking behavior should result, theoretically at least, when illicit opiate self-administration is outlines uncoupled from the anticipated and desired opiate effect of euphoria.
The now well-documented significant reduction or cessation of how to article, illicit opiate use by former heroin addicts stabilized on steady and adequate doses of methadone suggests that this may be due partly to essay, the effects of counseling, as well as to the direct biological effects of the essay on pro abortion drug. As mentioned above, severe liver disease can impair the disposition and bioavailability of methadone, but it is not the sole cause. Outlines! One major, widely used, antituberculosis drug, rifampin, interacts with methadone to accelerate methadone metabolism in the liver. This interaction is max weber objectivity essay important because opiate addicts are particularly vulnerable to tuberculosis. Rifampin has been shown to alter significantly the outlines clinical efficacy of objectivity, methadone by accelerating its metabolism in the liver and thus its rapid removal from the body. This rapid biotransformation of methadone leads to the appearance of withdrawal symptoms in patients otherwise well-maintained on methadone. The two major effects of rifampin on outlines methadone metabolism, a lowering of plasma concentrations and increased urinary excretion of the major metabolite, suggest that the drug exerts its effect by enhancing hepatic microsomal enzyme activity.
Another important interaction occurs between the antiseizure drug phenytoin and objectivity essay, methadone. Maintained patients can experience moderately severe opiate withdrawal within three to essay outlines, four days of beginning phenytoin therapy for management of epileptic seizures. Studies have shown that phenytoin accelerates methadone metabolism, and methadone dosing adjustments need to be anticipated when phenytoin is initiated or discontinued. Although the question of a possible interaction of car accident essay incident, methadone with cocaine has been raised, no conclusive data have been forthcoming. Preliminary studies suggest that methadone does not alter cocaine metabolism. However, some studies have suggested that cocaine may, in some cases, accelerate the essay outlines metabolism of argumentative, methadone. Also common in a heroin-addicted population is the comorbid incidence of alcohol abuse.
It is estimated that at least one in four or five heroin addicts, and outlines, former addicts maintained on radio methadone, abuse alcohol. Methadone treatment has been positively associated with reduced alcohol consumption while alcoholic heroin-addicted patients are in treatment; also, increased alcohol consumption is reported by alcoholic heroin addicts when not taking heroin or methadone. Disulfiram (Antabuse) has been used to deter alcoholic abusers from further drinking on the basis of aversive effects of the essay alcohol-disulfiram interaction. Although alcoholic opiate addicts maintained on methadone can usually be treated safely with disulfiram, in a few patients unwanted side effects have been observed, suggesting a possible methadone-disulfiram interaction that could lead to how to write format, excess sedation. A theoretical basis for. this effect could include a disulfiram-induced inhibition of the liver microsomal enzymes that are responsible for the metabolism of methadone, but such an interaction was not found in one study in which average doses of disulfiram were administered to methadone-maintained subjects. This phenomenon, however, might occur when high doses of disulfiram are used, or in patients with severe alcoholic cirrhosis with compromised hepatic drug-metabolizing enzyme capacity. High levels of alcohol itself have been shown to have two opposing interactions with many therapeutic agents, including methadone, and chronic addicts with comorbidity may use large amounts of alcohol. Alcohol is metabolized by the hepatic microsomal enzymes. When present in large amounts, alcohol may retard the biotransformation of medications that are metabolized by the hepatic P450 enzyme related systems; yet when alcohol levels fall, drug metabolism may be accelerated due to the chronic effects of alcohol on hepatic microsomal enzyme activity. (See Kreek, 1973; Kreek, Garfield, et al., 1976; Kreek, Gutjahr, et al., 1976; Kreek, 1978a; Tong et al., 1980; Kreek, 1981; Tong et al., 1981; Kreek, 1983a; Kreek, 1987a; Kreek, 1990a; Borg et al., 1993.)
Impact of Methadone Maintenance on Infectious Diseases. By the essay outlines late 1960s, infectious serum hepatitis could be defined more precisely owing to the development of serological tests for hepatitis B disease. The injecting heroin addict was identified as being at very high risk for essay incident, acquisition and spread of hepatitis B. In multiple studies, over 80 percent of the injecting heroin addicts entering methadone treatment had markers of prior infection and 5 to 15 percent had hepatitis B antigenemia. 2 However, studies have also shown that after 10 years or more in maintenance treatment, the percentage of patients with hepatitis B antigenemia drops to outlines, less than 5 percent. By the late 1970s a second and lethal form of hepatitis, caused by a viroid-like circular RNA agent (delta agent) that requires hepatitis B for its own infectiousness, was discovered and its biology defined.
By retrospectively examining banked sera and by prospectively testing those entering treatment for addiction, it was found that hepatitis delta had entered the untreated heroin addict population in New York City by the mid-1970s. Analyse Synthesise! By 1984, approximately 90 percent of the essay untreated heroin addicts on essay paper the streets of New York City. A positive marker for hepatitis B virus antigen, indicating the outlines presence of live hepatitis B virus and thus potential viral replication. continued to show evidence of having been infected with hepatitis B, as evidenced by the presence of some marker for that disease; and approximately 30 percent by that time had evidence of hepatitis delta infection. Recently, the third type of hepatitis virus infection, hepatitis C, was identified. Studies have shown hepatitis C virus infection in 80 to paper, 90 percent of heroin addicts and former heroin addicts in essay, methadone treatment.
In 1981, shortly after the essay abortion clinical symptoms of AIDS were characterized, the etiological viral agent HIV-1 was identified. By examining blood samples that had been banked prospectively from 1969 onward, it was found that HIV-1 infection had reached the outlines drug-injecting population in New York City in 1978 and argumentative research paper rubric, infection had progressed rapidly until 19831984, when the outlines prevalence of HIV-1 infection reached a level of over 50 percent of intravenous users in the inner city area. Of public health importance, investigators further found that heroin addicts in New York City who had entered effective methadone maintenance treatment programs before the 1978 advent of the AIDS epidemic and who remained in radio movie essay paper, treatment displayed a much lower incidence of HIV-1 infection in essay outlines, 1984 than did untreated heroin addicts: less than 10 percent of such methadone patients were infected in 1984, compared to over 50 percent of untreated heroin addicts. Studies of HIV-1 infection in long-term, methadone-maintained patients have been reported in Sweden and other countries worldwide with similar findings of efficacy of methadone treatment in the prevention of essay abortion, HIV-1 infection. It should be recognized that sharing of essay outlines, unsterile needles is not the only mode of HIV-1 transmission among addicts.
Cocaine use by methadone patients is also a risk factor for HIV-1 infection, owing to promiscuous sexual behavior commonly associated with cocaine, including sex as payment for the drug. Concurrent use of cocaine by heroin addicts is estimated to be between 50 and gather analyse synthesise, 90 percent and, thus, is an added risk factor in the heroin-using population. Once in outlines, treatment, the prevalence of cocaine use among heroin addicts generally drops to a journal article critique in apa, between 20 and 40 percent. Finally, and of potentially great importance, studies have shown that multiple indices of immune function are deranged during cycles of heroin addiction, probably because of many factors, including lifestyle, multiple infectious diseases, and possible direct or indirect effects of the drug use. Immune factors, however, normalize during chronic long-term methadone treatment. Natural killer cell activity is essay outlines not altered by methadone in vitro . Gather! Long-term methadone maintenance permits return to normal levels of natural killer cell activity, as well as to outlines, normal absolute numbers of B cells and T cell subsets, which may have important implications for immune system function and, possibly, for retarding the progress of HIV-1 infection to AIDS. (See Kreek, Dodesn, et al., 1972; Kreek, 1978b; Kreek, 1983b; Des Jarlais, Marmor, et al., 1984; Novick, Farci, Karayiannis, et al., 1985; Kreek, Khuri, et al., 1986; Novick, Khan, et al., 1986; Novick, Kreek, Des Jarlais, et al., 1986; Blix, 1988; Novick, Farci, Croxson, et al., 1988; Chaisson et al., 1989; Des Jarlais et al., 1989; Kreek, 1989; Novick, Ochshorn, Ghali, et al., 1989a; Ochshorn et al., 1989; Kreek, 1990b, 1990c; Kreek et al., 1990; Ochshorn et al., 1990; Kreek, 1991b; Novick, Ochshorn, and Kreek, 1991; Novick, Reagon, et al., in press.) Albeck, H, Woodfield, S, and Kreek, MJ. 1989. Quantitative and pharmacokinetic analysis of naloxone in plasma using high performance liquid chromatography with electrochemical detection and solid phase extraction. Paper Rubric! Journal of essay, Chromatography 488:435445.
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Blix, O. 1988. AIDS and IV heroin addicts: The preventive effect of methadone maintenance in Sweden. Outlines! Proceedings of the 4th International Conference on AIDS, Stockholm . Borg, L, Ho, A, and Kreek, MJ. 1993. Availability of reliable serum methadone determination for management of symptomatic patients. In: Problems of Drug Dependence, 1992; Proceedings of the 54th Annual Scientific Meeting of the College on Problems of Drug Dependence . L.S. Harris, ed. National Institute on Drug Abuse Research Monograph 132, Rockville, Md., DHHS Publication No. Synthesise! (ADM) 933505. P. 221. Branch, AD, Benefeld, BJ, Baroudy, BM, Wells, FV, Gerin, JL, and outlines, Robertson, HD.
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Journal of the American Medical Association 261:10081012. Des Jarlais, DC, Marmor, M, Cohen, H, Yancovitz, S, Garber, J, Friedman, S, Kreek, MJ, Miescher, A, Khuri, E, Friedman, SM, Rothenberg, R, Echenberg, D, O'Malley, PO, Braff, E, Chin, J, Burtenol, P and Sikes, RK. Essay! 1984. Antibodies to a retrovirus etiologically associated with Acquired Immuno-deficiency Syndrome (AIDS) in populations with increased incidences of the syndrome. Life! Morbidity and Mortality Weekly Report 33:377379. Dole, VP. Essay! 1970. Biochemistry of addiction.
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1966. Narcotic blockade. Outlines! Archives of Internal Medicine 118:304309. Evans, CJ, Keith, DE, Jr., Morrison, H, Magendzo, K, Edwards, RH. 1992. Cloning of a delta opioid receptor by functional expression. Science 258:19521955. Goldstein, A, Lowney, LT, and Pal, BK. Analyse! 1971.
Stereospecific and nonspecific interactions of the morphine congener levorphanol in subcellular fractions of mouse brain. Proceedings of the National Academy of Sciences of the United States of America 68:17421747. Goldstein, A, and Freeman, WH. 1994. Addiction: From Biology to Drug Policy , New York. Gordon, NB, and Appel, PW. 1972. Performance of effectiveness in relation to methadone maintenance. In: National Association for the Prevention of Addiction to Narcotics, Proceedings of the Fourth National Conference on Methadone Treatment . Pp.
425427. Hachey, DL, Kreek, MJ and Mattson, DH. 1977. Quantitative analysis of methadone in biological fluids using deuterium-labeled methadone and GLC-chemical-ionization mass spectrometry. Journal of Pharmaceutical Sciences 66:15791582. Hartman, N, Kreek, MJ, Ross, A, Khuri, E, Millman, RB, and essay, Rodriguez, R. 1983. Alcohol use in youthful methadone-maintained former heroin addicts: Liver impairment and gather synthesise, treatment outcome. Alcoholism, Clinical, and Experimental Research 7:316320. Hughes, J, Smith, TW, Kosterlitz, HW, Fothergill, LA, Morgan, BA, and outlines, Morris, HR. 1975.
Identification of two related pentapeptides from the brain with potent opiate agonist activity. Nature 258:577580. Hurd, YL, Brown, EE, Finlay, JM, Fibiger, HC, and Gerfen, CR. 1992. Cocaine self-administration differentially alters mRNA expression of striatal peptides. Molecular Brain Research 13:165170. Ingoglia, NA, and Dole, VP. 1970. Localization of d- and l-methadone after intra ventricular injection into rat brain.
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1992. The delta-opioid receptor: Isolation of a cDNA by expression cloning and pharmacological characterization. Proceedings of the National Academy of Sciences 89:12,04812,052. Kleber, HD, Slobetz, F, and Mezritz, M, eds. 1980. Medical Evaluation of Long-Term Methadone-Maintained Clients . National Institute on outlines Drug Abuse.
DHHS Publication No. (ADM) 811029. Washington, D.C.: U.S. Essay On Pro Life Abortion! Government Printing Office. Kosten, TR, Kreek, MJ, Raghunath, J, and Kleber, HD. Essay Outlines! 1986a. Cortisol levels during chronic naltrexone maintenance treatment in ex-opiate addicts. Biological Psychiatry 21:217220. Kosten, TR, Kreek, MJ, Raghunath, J, and Kleber, HD. 1986b. A preliminary study of beta-endorphin during chronic naltrexone maintenance treatment in ex-opiate addicts.
Life Sciences 39: 5559. Kosten, TR, Morgan, C, and Kreek, MJ. Incident! 1992. Beta-endorphin levels during heroin, methadone, buprenorphine and naloxone challenges: Preliminary findings. Biological Psychology 32:523528.
Kreek, MJ. 1973a. Medical safety and side effects of methadone in tolerant individuals. Essay! Journal of the American Medical Association 223:665668. Kreek, MJ. 1973b. Physiological implications of methadone treatment. In: Methadone Treatment Manual . U.S. Department of Justice. Movie Essay! Publication No. 2700-00227.
Washington, D.C.: U.S. Government Printing Office. Pp. 8591. Kreek, MJ. 1973c. Physiological implications of methadone treatment.
In: National Association for the Prevention of essay, Addiction to Narcotics, Proceedings of the Fifth National Conference on Methadone Treatment . Pp. 8591. Kreek, MJ. 1973d. Plasma and urine levels of argumentative rubric, methadone. New York State Journal of essay outlines, Medicine 73:27732777. Kreek, MJ. 1978a. Effects of drugs and alcohol on research paper opiate disposition and action. In: Factors Affecting the Action of Narcotics , M.W.
Adler, L. Manara, and essay outlines, R Samnin, eds. New York: Raven Press. Pp. 717739a. Kreek, MJ. 1978b. Medical complications in methadone patients. Annals of the New York Academy of Sciences 311:110134.
Kreek, MJ. 1979. Methadone disposition during the perinatal period in humans. Pharmacology Biochemistry Behavior . 11(Suppl.):17. Kreek, MJ. Argumentative Research Rubric! 1981. Metabolic interactions between opiates and alcohol. Outlines! Annals of the New York Academy of Sciences 362:3649. Kreek, MJ. 1983a.
Factors modifying the pharmacological effectiveness of methadone. In: Research in the Treatment of argumentative paper rubric, Narcotic Addiction: State of the outlines Art , J.R. Cooper, F. Altman, B.S. Brown, and D. Essay! Czechowicz, eds. NIDA Research Monograph Series, Rockville, Md., DHHS Publication No. (ADM) 83-1281. Pp. 95114a. Kreek, MJ. 1983b.
Health consequences associated with use of methadone. In: Research in the Treatment of Narcotic Addiction: State of the outlines Art , J.R. Cooper, F. Altman, B.S. Brown, and D. Czechowicz, eds. How To Write Critique In Apa Format! NIDA Monograph Series, Rockville, Md., DHHS Publication No. (ADM) 83-1281.
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NIDA Research Monograph Series, Rockville, Md., DHHS Publication No.(ADM) 87-1508. Outlines! Pp. How To A Journal In Apa! 76:5361. Kreek, MJ. 1989. Immunological approaches to clinical issues in drug abuse. In: Problems of Drug Dependence, 1988; Proceedings of the 50th Annual Scientific Meeting of the Committee on Problems of Drug Dependence . L.S. Harris, ed.
NIDA Research Monograph 90, Rockville, Md., DHHS Publication No. (ADM) 89-1605. Pp. 7786, 1989. Kreek, MJ. 1990a. Drug interactions in humans related to essay outlines, drug abuse and its treatment. Modern Methods in Pharmacology 6:265282. Kreek, MJ. Essay Abortion! 1990b. HIV infection and outlines, parenteral drug abuse: Ethical issues in max weber objectivity essay, diagnosis, treatment, research and outlines, the maintenance of critique, confidentiality.
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Immune function in heroin addicts and former heroin addicts in treatment: Pre/post AIDS epidemic. Current Chemical and Pharmacological Advances on Drugs of Abuse Which Alter Immune Function and Their Impact Upon HIV Infection , P.T.K. Essay Outlines! Pham and K. Rice, eds. NIDA Research Monograph 96, Rockville, Md. Pp. 192219. Kreek, MJ. 1991b.
Immunological function in active heroin addicts and methadone-maintained former addicts: Observations and possible mechanisms. In: Problems of Drug Dependence, 1990; Proceedings of the essay 52nd Annual Scientific Meeting of the Committee on Problems of Drug Dependence . Essay! L.S. Harris, ed. Max Weber Objectivity Essay! NIDA Research Monograph 105, Rockville, Md., DHHS Publication No. Essay Outlines! (ADM) 91-1753. Pp. 7581.
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Jaffe, eds. New York: Raven Press. Essay On Pro Life! Pp. 205230. Kreek, MJ, Des Jarlais, DC, Trepo, CL, Novick, DM, Abdul-Quader, A, and Raghunath, J. Outlines! 1990. Contrasting prevalence of on pro life, delta hepatitis markers in parenteral drug abusers with and essay outlines, without AIDS. Car Accident! Journal of essay, Infectious Diseases 162:538541. Kreek, MJ, Dodes, L, Kane, S, Knobler, J, and Martin, R. 1972. Long-term methadone maintenance therapy: Effects on liver function. Annals of Internal Medicine 77:598602. Kreek, MJ, Garfield, JW, Gutjahr, CL, and Giusti, LM.
1976. Rifampin-induced methadone withdrawal. New England Journal of Medicine 294:11041106. Kreek, MJ, Gutjahr, CL, Garfield, JW, Bowen, DV and Field, FH. 1976. Drug interactions with methadone.
Annals of the New York Academy of life, Sciences 281:350370. Kreek, MJ, Hackey, DL, and Klein, PD. 1979. Stereoselective disposition of methadone in man. Life Sciences 24:925932. Kreek, MJ, and Hartman, N. 1982. Chronic use of outlines, opioids and research, antipsychotic drugs: Side effects, effects on endogenous opioids and outlines, toxicity. Annals of the New York Academy of Sciences 398:151172. Kreek, MJ, Khuri, E, Fahey, L, Miescher, A, Arns, P, Spagnoli, D, Craig, J, Millman, R, and Harte, E. 1986. Long-term follow-up studies of the medical status of adolescent former heroin addicts in chronic methadone maintenance treatment: Liver disease and on pro life abortion, immune status.
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Hepatic extraction of long-and short-acting narcotics in the isolated perfused rabbit liver. Gastroenterology 75:8894. Kreek, MJ, Raghunath, J, Plevy, S, Hamer, D, Schneider, B, and Hartman, N . 1984. ACTH, cortisol and beta-endorphin response to metyrapone testing during chronic methadone maintenance treatment in rubric, humans. Outlines! Neuropeptides 5:277278. Kreek MJ, Schaefer, RA, Hahn, EF, and Fishman, J. 1983. Naloxone, a specific opioid antagonist, reverses chronic idiopathic constipation. Lancet (Feb. 5) 261262. Kreek, MJ, Schecter, A, Gutjahr, CL, Bowen, D, Field, F, Queenan, J, and Merkatz, I. Life! 1974.
Analyses of methadone and other drugs in maternal and neonatal body fluids: Use in evaluation of symptoms in essay outlines, a neonate of mother maintained on methadone. American Journal of Drug and Alcohol Abuse 1:409419. Kreek, MJ, Schecter, AJ, Gutjahr, CL, and car accident essay, Hecht, M. 1980. Methadone use in patients with chronic renal disease. Drug and Alcohol Dependence 5:197205. Kreek, MJ, Schneider, BS, Raghunath, J, and Plevy, S. 1984. Prolonged (24 hour) infusion of the essay opioid antagonist naloxone does not significantly alter plasma levels of cortisol and incident, ACTH in humans. Abstracts of the Seventh International Congress of Endocrinology, Excerpta Medica , International Congress Series 652, Amsterdam Oxford-Princeton. Essay! P. 845. July.
Kreek, MJ, Simon, E, Evans, C, Uhl, G, Wang, J-B, Johnson, P, Imain, Y, Waltherm, D, Wu, JM, Wang, WF., Moriwaki, A, Yu, L, Min, B, Augustin, L, Felsheim, R, Fuchs, J, Hoh, H, and Inturrisi, C. In press. Essay! Symposium for 20th anniversary. In: Problems of Drug Dependence, 1994; Proceedings of the 56th Annual Scientific Meeting of the Committee on Problems of Drug Dependence , L.S. Harris, ed. NIDA Research Monograph Series, Rockville, Md. Kreek, MJ, Wardlaw, SL, Hartman, N, Raghunath, J, Friedman, J, Schneider, B, and essay, Frantz, AG. Essay On Pro Life Abortion! 1983. Essay Outlines! Circadian rhythms and levels of beta-endorphin, ACTH, and cortisol during chronic methadone maintenance treatment in humans. Article Format! Life Sciences 33 (Suppl.
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1975b. Effects of heroin and methadone on gather plasma cortisol and testosterone. Journal of Pharmacology and Experimental Therapeutics 195:296302. Nakamura, K, Hachey, DL, Kreek, MJ, Irving, CS, and Klein, PD. Outlines! 1982. Quantitation of methadone enantiomers in humans using stable isotope-labeled 2H3, 2H5, 2H8 methadone. Journal of Pharmaceutical Sciences 71:3943.
Novick, DM, Farci, P, Croxson, ST, Taylor, MB, Schneebaum, CW, Lai, EM, Bach, N, Senie, RT, Gelb, AM and life, Kreek, MJ. 1988. Hepatitis delta virus and outlines, human immunodeficiency virus antibodies in life abortion, parenteral drug abusers who are hepatitis B surface antigen positive. Journal of Infectious Diseases 158:795803. Novick, DM, Farci, P, Karayiannis, P, Gelb, AM, Stenger, RJ, Kreek, MJ, and essay outlines, Thomas, HC. 1985. Hepatitis D virus antibody in HBsAg-positive and HBsAg-negative substance abusers with chronic liver disease. Journal of Medical Virology 15:351356. Novick, DM, Khan, I, and Kreek, MJ.
1986. Acquired immunodeficiency syndrome and infection with hepatitis viruses in individuals abusing drugs by on pro, injection. Outlines! United Nations Bulletin on Narcotics 38:1525. Novick, DM, Kreek, MJ, Arns, PA, Lau, LL, Yancovitz, SR, and Gelb, AM. 1985. Effects of severe alcoholic liver disease on the disposition of methadone in maintenance patients.
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318320. Novick, DM, Kreek, MJ, Fanizza, AM, Yancovitz, SR, Gelb, AM, and Stenger, RJ. 1981. Methadone disposition in patients with chronic liver disease. Clinical Pharmacology and Therapeutics 30:353362. Novick, DM, Ochshorn, M, Ghali, V, Croxson, TS, Mercer, WD, Chiorazzi, N, and Kreek, MJ. 1989. Natural killer cell activity and lymphocyte subsets in parenteral heroin abusers and long-term methadone maintenance patients. Journal of Pharmacology and Experimental Therapeutics 250:606610. Novick, DM, Ochshorn, M, and Kreek, MJ.
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Hepatitis C virus serology in parenteral drug users with chronic liver disease. In: Problems of Drug Dependence, 1994: Proceedings of the how to write a journal article in apa 56th Annual Scientific meeting of the Committee on Problems of Drug Dependence , L.S. Harris, ed. NIDA Research Monograph Series, Rockville, Md. Novick, DM, Richman, BL, Friedman, JM, Friedman, JE, Fried, C, Wilson, JP, Townley, A, and Kreek, MJ. 1993. The medical status of methadone-maintained patients in treatment for 1118 years. Drug and Alcohol Dependence 33:235245. Novick, DM, Stenger, RJ, Gelb, AM, Most, J, Yancovitz, SR, and Kreek, MJ. 1986.
Chronic liver disease in abusers of alcohol and essay, parenteral drugs: A report of essay life abortion, 204 consecutive biopsy-proven cases. Alcoholism, Clinical, and Experimental Research 10:500505. Ochshorn, M, Kreek, MJ, Khuri, E, Fahey, L, Craig, J, Aldana, MC, and Albeck, H. 1989. Normal and abnormal natural killer (NK) activity in methadone maintenance treatment patients. Essay Outlines! In: Problems of Drug Dependence, 1988: Proceedings of the 50th Annual Scientific Meeting of the Committee on Problems of Drug Dependence , L.S.
Harris, ed. NIDA Research Monograph Series, Rockville, Md., DHHS Publication No. (ADM) 89-1605. P. Car Accident Essay! 369. Ochshorn, M, Novick, DM, and Kreek, MJ. 1990. In vitro studies of methadone effect on natural killer (NK) cell activity. Israel Journal of Medical Sciences 26:421425. Pert, CB, and Snyder, SH.
1973. Essay! Opiate receptor: demonstration in nervous tissue. Science 179:10111014. Pescor, MJ. On Pro Life! 1943. Follow-up study of treated narcotic drug addicts. Public Health Report (Suppl.) 170:1. Pond, SM, Kreek, MJ, Tong, TG, Raghunath, J, and Benowitz, NL. 1985. Altered methadone pharmacokinetics in methadone-maintained pregnant women. Journal of Pharmacology and Experimental Therapeutics 233:16.
Renault, PF, Schuster, CR, Heinrich, RL, et al. 1972. Altered plasma cortisol response in patients on methadone maintenance. Clinical Pharmacology and Therapeutics 13:269273. Santen, RJ. 1974. How narcotics addiction affects reproductive function in essay, women. Contemporary OB/GYN 3:9395. Santen, RJ, Sofsky, J, Bilic, N, et al. 1975.
Mechanism of action of narcotics in the production of menstrual dysfunction in women. Car Accident! Fertility and Sterility 26:538548. Simon, EJ, Hiller, JM, and Edelman, I. Essay! 1973. Stereospecific binding of the potent narcotic analgesic [3H]Etorphine to rat-brain homogenate. Proceedings of the National Academy of analyse synthesise, Sciences 70:19471949.
Spangler, R, Unterwald, EM, Branch, A, Ho, A, and Kreek, MJ. 1993a. Chronic cocaine administration increases prodynorphin mRNA levels in the caudate-putamen of rats. In: Problems of Drug Dependence, 1992; Proceedings of the essay 54th Annual Scientific Meeting of the Committee on Problems of Drug Dependence . L.S. Harris, ed, NIDA Research Monograph Series, Rockville, Md. DHHS Publication No. (ADM) 93-3505. P. 142.
Spangler, R, Unterwald, EM, and Kreek, MJ. Essay Incident! 1993b. ''Binge'' cocaine administration induces a sustained increase of prodynorphin mRNA in rat caudate-putamen. Molecular Brain Research 19:323327. Spangler, R, Zhou, Y, Unterwald, EM, and essay outlines, Kreek, MJ. In press. Opioid receptor mRNA levels in the rat brain determined by TCA precipitation of mRNA:cRNA hybrids. Analyse! In: Problems of Drug Dependence, 1994; Proceedings of the 56th Annual Scientific Meeting of the essay outlines Committee on car accident incident Problems of outlines, Drug Dependence , L.S. Harris, ed. NIDA Research Monograph Series, Rockville, Md. Stimmel, B, Vernace, S, Heller, E, et al. 1973.
Hepatitis B antigen and antibody in former heroin addicts on methadone maintenance: Correlation with clinical and max weber objectivity, histological findings. In: National Association for the Prevention of Addiction to Narcotics, Proceedings of the outlines Fifth National Conference on on pro life abortion methadone Treatment . Vol. 1. New York: NAPAN. Pp. Essay! 501513. Sullivan, HR, Smits, SE, Due, SL, Booher, RE, and rubric, McMahon, RE. 1972. Metabolism of d -methadone: Isolation and identification of analgesically active metabolites. Life Sciences 11(1):10931104. Terenius, L. 1973. Essay Outlines! Stereospecific interaction between narcotic analgesics and a synaptic plasma membrane fraction of rat cerebral cortex.
Acta Pharmacologica ET Toxicologica 32:317320. Terenius, L, and max weber objectivity, O'Brien, CP. 1992. Receptors and endogenous ligands: Implications for addiction. In: Addictive States CP O'Brien and JH Jaffe, eds. New York: Raven Press. Pp. 123130. Tong, TG, Benowitz, NL, and Kreek, MJ.
1980. Methadone-disulfiram interaction during methadone maintenance. Journal of Clinical Pharmacology 20:506513. Tong, TG, Pond, SM, Kreek, MJ, Jaffery, NF, and Benowitz, NL. 1981. Phenytoin-induced methadone withdrawal. Annals of Internal Medicine 94:349351.
Unterwald, EM, Horne-King, J, and Kreek, MJ. 1993. Chronic cocaine alters brain mu opioid receptors. Brain Research 584:314318. Unterwald, EM, Rubenfeld, JM, Spangler, R, Wang, JB, Uhl, GR, and outlines, Kreek, MJ. 1994. Mu opioid receptor mRNA levels following chronic naltrexone administration. Abstracts of the International Narcotics Research Conference . Unterwald, EM, Rubenfeld, JM, and Kreek, MJ. Analyse Synthesise! In press.
Repeated cocaine administration upregulates κ and μ, but not δ, opioid receptors. Essay! NeuroReport . Wang, JB, Imai, Y, Eppler, CM, Gregor, P, Spivak, C, and Uhl, GR. 1993. Mu-opiate receptor: cDNA cloning and expression. Proceedings of the National Academy of Sciences 90:10,23010,234. Yasuda, K, Raynor, K, Kong, H, Breder, CD, Takeda, J, Reisine, T, and Bell, GI.
1993. Cloning and functional comparison of paper rubric, kappa and delta opioid receptors from mouse brain. Proceedings of the National Academy of Sciences 90:67366740. 500 Fifth St., NW | Washington, DC 20001. For nearly three decades, methadone hydrochloride has been the primary means of treating opiate addiction. Today, about 115,000 people receive such treatment, and thousands more have benefited from it in outlines, the past. Even though methadone's effectiveness has been well established, its use remains controversial, a fact reflected by life abortion, the extensive regulation of its manufacturing, labeling, distribution, and use.
The Food and Drug Administration regulates the safety and effectiveness of essay, methadone, as it does for all drugs, and the Drug Enforcement Administration regulates it as a controlled substance. However, methadone is also subjected to a unique additional tier of regulation that prescribes how and under what circumstances it may be used to treat opiate addiction. Federal Regulation of Methadone Treatment examines current Department of Health and Human Services standards for narcotic addiction treatment and objectivity essay, the regulation of methadone treatment programs pursuant to those standards. Essay! The book includes an evaluation of the effect of federal regulations on the provision of methadone treatment services and incident, an exploration of options for modifying the regulations to essay outlines, allow optimal clinical practice. The volume also includes an assessment of alternatives to the existing regulations. Front Matter i–xii Executive Summary 1–16 Introduction 17–36 Pharmacology and Medical Aspects of objectivity essay, Methadone Treatment 37–60 Who Are the Recipients of outlines, Treatment? 61–91 Methadone Diversion Control 92–119 Federal Regulation of Methadone Treatment 120–150 Methadone Treatment 151–184 Treatment Standards and Optimal Treatment 185–216 Implementing Standards--And Beyond 217–238. You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on max weber essay feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Do you want to take a quick tour of the OpenBook's features? Show this book's table of contents , where you can jump to any chapter by name.
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