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Narcotic Blockade

VINCENT P. DOLE, MD; MARIE E. NYSWANDER, MD; MARY JEANNE KREEK, MD
Arch Intern Med. 1966;118(4):304-309. doi:10.1001/archinte.1966.00290160004002.
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Heroin, as used by addicts, produces quite different effects than are seen with use of narcotic drugs in ordinary medical practice. Addicts inject themselves repeatedly with larger doses of a narcotic than are usually prescribed for analgesia, and develop modified responses to the drug. In particular, the euphoric effect appears to be a learned phenomenon, like pleasure from smoking; the first shots of heroin taken by a curious adolescent are more likely to cause nausea than pleasure. Later, the euphoric experience becomes central to the addict's life and leaves little room for other interests. With continued use of narcotics, however, the addict finds it progressively more difficult to achieve euphoria, because a chronic exposure to narcotic drug induces a state of tolerance that diminishes the euphoric response. At the same time the increase in physical dependence obliges the subject to continue drug use or suffer abstinence. An advanced state of

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