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The Influence of a Female Journalist on Journalism and germany Women or the Story of Nellie Bly. In many societies of the past, women have been relegated to plagiarism scan, very few roles including nanny, maid, teacher, factory girl and housewife. These roles were unfulfilling, and watchpeopledie were generally very poorly paid. Women were expected to eventually find a husband then stay home to fiske, care for her children, so very little time and money was put into educating girls. Some women, despite these challenges and expectations, managed to watchpeopledie, become successful in traditional “men’s fields.” One such field was journalism. John Fiske Genre Theory? One of these women was named Elizabeth Jane Chochran, but was known to the world as Nellie Bly. Bly was the first “woman stunt reporter.” This role would later influence the watchpeopledie field of investigative journalism.

However, Bly used her role to not only to show some of the horrors of the plagiarism scan world but to convey herself as a strong, competent, fearless woman. Bly’s two most famous stunts, recorded in the books “Ten Days in a Madhouse” and “Around the World in Seventy-Two Days” help to germany, convey this thought. Nellie Bly is more than just a name in theory of mind example a history book, her efforts prove that she was a major influence in both the field of germany journalism and Essay on Caregiver the field of feminism. Before Bly entered the world of journalism, other women had already left their mark. The book “Great Women of the Press” mentions the women who all participated in watchpeopledie “firsts” for women journalists.The female journalist is Stress thought to watchpeopledie, be Anne Newport Royall, who became a journalist at the age of fifty-five. She is the first woman journalist to “initiate her career and not merely to inherit one as a widow.”[1] Before Royall, other women had been employed in john the field but had mostly gained employment after their husbands had died. She was a travel correspondent, and journeyed throughout the United States, reporting on stories. She was an activist as well. Watchpeopledie Germany? She argued for laws such as tolerance for states’ rights in the matter of slavery, free public education and rights for theory example, Native Americans.

She was editor of her own newspaper “The Huntress.”[2] Her title of “First Female Journalist” is forgotten. Sometimes it is mistakenly given to Bly, which is an incredible disrespect to Royall’s memory and germany undermines what she did for future female journalists. Royall died in 1854. [3] Other notable newspaper woman include: Sarah Josepha Hale who was the first women’s magazine editor as well as the author of the beloved children’s rhyme “Mary Had a Little Lamb.”[4] The magazine she was in charge of, Godey’s Ladies’ Magazine , was considered the Applied Essay “Bible” of nineteenth century women’s culture.[5] She was editor for forty years. Hale’s magazine focused on fashion, literature, entertain and morals.[6] Margaret Fuller was the editor of the watchpeopledie New York Tribune , the Stress first woman literary critic and germany the first woman foreign correspondent. She certainly would have done much more but she died at the age of forty.[7] Cornelia Walter was editor of the Boston Transcript, making her the first woman editor of a daily newspaper.[8] Jane Grey Swisshelm was one of the first female journalists to write for theory of mind example, the Tribune under Horace Greely’s editorship as well as the first woman to germany, sit in why did lee harvey oswald kill the Senate press gallery. Besides those she was also “a feared and respected lecturer on women’s rights, abolition and germany temperance.” [9] Had it not been for these women, Nellie Bly would have never been able to enter the world of journalism in the first. Each of these women had been the first woman journalist to do something, and Nellie Bly was not to fiske genre theory, be out-done.

Her experiences ended up creating an entire new field of journalism for both men and women. Bly wanted to call attention to the issues that plagued her day. Watchpeopledie? She was especially observant of the john fiske genre mistreatment of the poor and those less fortunate. Her favorite causes were widows, single mothers and germany abused or orphaned children. These charitable feelings, as well as her career as a journalist, were both due to Bly’s difficult childhood. The book, “Nellie Bly: Daredevil, Reporter, Feminist” by Brooke Kroeger remains the only comprehensive biography on Bly’s life and different ciphers confirms the truth of her sad childhood. Bly was born on May 5, 1864 in Pennsylvania. She was the thirteenth of watchpeopledie germany fourteen children. When she was seven, Bly’s father died.

Her family was left with very little money, as her dad had not left behind a will. Her mother eventually remarried, as she did not have another way to care for her family.[10] The man Bly’s mother married was poor, abusive and constantly drunk. Ciphers? Her mother was able to divorce Bly’s stepfather, in 1879 though the germany process was long and plagiarism scan humiliating.[11]Eventually, she and her children tried to erase the events from their family history by pretending they never happened. Her mother’s experience with divorce became the inspiration for Bly’s second article for The Pittsburg Dispatch , “Mad Marriages.” But at this time, Bly still had no idea that she would become a journalist. Due to a desire to go away to school and get a job, Bly went to train as a teacher at the State Normal School in Indiana, Pennsylvania. This dream failed. Bly was forced to drop out of the school before the end of her first semester in 1879, because of financial issues. While at the school, Bly attempted to reinvent her identity. Watchpeopledie? She dropped her childhood nickname “Pink” and added an “e” to the end of her last name. The “e” gave her the same last name as a prominent but unrelated family from her town.

Her mother and two of her brothers eventually followed suit.[12] This name change would not matter, as in a few short years she would become Nellie Bly. However, the theory change showed how readily she could adapt to new situations, an important skill for a journalist. Though it was the norm, Bly did not marry when she returned home. There is no record of the jobs worked for germany, the five years between leaving school and fiske theory getting hired as a reporter, but it appears that she was not successful at watchpeopledie germany, any of them. Why Did Lee Harvey Oswald? Bly’s struggles to maintain employment echo those of the watchpeopledie children of “Anxious Father.” Anxious Father was a man who wrote to The Dispatch wondering what he could do about his five unmarried daughters. “Quiet Observer,” a columnist, also known as Erasmus Wilson wrote back to the father. His article talked about how horrible it was that children were not being reared correctly, especially girls. In an earlier column Wilson wrote that women should not be allowed in the workplace; “Her sphere is defined and located by a single word-home.” [13] His articles provoked many readers to respond, including Bly who wrote a reply under the pseudonym “Lonely Orphan Girl.”

Wilson and his editor read Bly’s letter. Both decided to give “Lonely Orphan Girl” an different, opportunity to write a new response to Wilson’s article. This was the beginning of Bly’s careers as a journalist. Her first article was called “The Girl Puzzle” and remains the watchpeopledie germany only article she wrote that is not under the pen name “Nellie Bly.” Her article focused on Anxious Father’s letter and asked the readers to john fiske genre theory, his question not in terms of the wealthy and privileged, but in watchpeopledie terms of those “without talent, without beauty, without money” and of course, those who were widowed. Of Mind? [14] This article demonstrated Bly’s feminist beliefs. Rather than saying that girls should get married, or take on jobs as teachers or factory girls they should be given similar opportunities to watchpeopledie, boys. These opportunities included jobs as messengers or office runners would also allow them the kill kennedy opportunity to work their way up through the company if they had the ambition. Watchpeopledie? She wrote: “Here would be a good field for john genre, believers in women’s rights. Let them forego their lecturing and writing and go to work; more work and watchpeopledie germany less talk. Essay? Take some girls that the watchpeopledie ability, procure for them situations, start them on their own way and by doing so accomplish more than by plagiarism scan years of talking.” [15]

Her second article, as mentioned previously, focused on watchpeopledie germany the theme of divorce. It was a controversial topic to pick, but it was something she knew a lot about. Bly wrote that she believed that divorce should be made illegal, and in order to prevent disastrous marriages from occurring certain people should not be allowed to marry. Lee Harvey Kill Kennedy? This list included: men who could not support themselves or who were alcoholics, and women who were not good homemakers. Due to her experience, Bly believed that never marrying was preferable to marrying somebody who would make the home miserable.[16] It also relates back to watchpeopledie, Bly’s belief that women could support themselves. Applied Essay? If they were permitted to get the watchpeopledie germany same jobs as men, women would have no need to marry a horrible man to Essay, simply ensure that they would not starve. This article was also the first to mention the name “Nellie Bly.” In those days, out of respect for privacy, women who wrote for newspapers did not use their real names.

Her name came from an old song “Nelly Bly” which had been offered up by her co-workers. Due to watchpeopledie, a mistake made by one of the Essay on Caregiver editors, the name was written as “Nellie Bly” instead. Other famous pseudonyms included: Bessie Bramble, Dorothy Dix, Jennie June, and Pearl Rivers. All of these names have a few things in common; they were all short, sweet, catchy and feminine. Bly’s first set of articles focused on the working girls of Pittsburgh. She visited several factories where she would interview the watchpeopledie germany female workers and fiske theory report on the working conditions. Though some believe that Bly’s articles were meant to bring awareness to the horrid conditions that the women were forced to work in, they would be wrong. Watchpeopledie Germany? She saw nothing wrong with the working conditions, the labor was not too difficult, and the foremen were kind. They were so kind in fact, that they occasionally hired little girls from poor families, so that they might be able to earn some extra pennies to bring home: “The ‘helpers’ are the smallest girls in the works.

The foreman states that it is lee harvey oswald kill not their custom to take such young girls, but mothers come with tears in their eyes and beg for work for them to watchpeopledie germany, help along at home. Upon investigation if their story is found to Marxism, be correct, the firm employs the little ones. This undoubtedly an act of kindness and charity…”[17] As a work of investigative journalism Bly’s style was poor and germany underdeveloped. Theory Of Mind Example? She took everything she saw at face value, without thinking that it might not be the watchpeopledie truth.

Since this was Bly’s first investigative work, she can be granted some leniency. Also at that time investigative journalism was not thought of Marxism as important, and as such the skills were not taught to anybody. As an observational piece, however, Bly did well. Like in “The Girl Puzzle,” she wrote about her subjects in a way that allowed the reader to germany, identify with them. Bly focused on what the different ciphers girls did when they were not working, how they went out dancing and drinking, and how they felt they had no reputations to uphold. She also focused on their workplace gossip. She did not talk about the day-to-day drudgery of their lives in the workplace, as she thought it would be boring and obvious.

Rather than making them objects of pity, Bly showed them as human beings. Germany? After the series, which was eight articles long, Bly was moved into the women’s interest section of the paper. Not too long later, Bly quit The Dispatch . After a half-year long stint in theory of mind Mexico, where she worked as a foreign correspondent, she went to New York City to seek her fortune. Bly’s dream was to work at the New York World . She already had an idea in mind for watchpeopledie, her first “stunt;” she would travel to Europe then return to America by Essay steerage so she could report on what it was like to be an immigrant. Watchpeopledie? Undoubtedly, it would have been interesting to john fiske genre theory, read and would have gained her fame but it was rejected. However, she approved of the idea that the editor set before her: pretend to be insane to get committed to the local insane asylum and report on the conditions there.[18] The World had reported on accused abuses that happened in the Women’s Lunatic Insane Asylum on Blackwell’s Island but they were not sure of the extent or if they were actually happening. They thought that they would get a more accurate view of the watchpeopledie asylum from somebody on the inside rather than just from a reporter.

But they needed the right person. Bly was given no training or preparation by the paper though she did not go in unprepared. Theory Of Mind? She practiced looking insane in front of the mirror until she found the expression she thought made her appear the most insane. Then she wandered the watchpeopledie streets in a daze until she checked herself into a boardinghouse using her fake name. While there, she pretended to go insane. Most of the women were afraid of her. One woman thought that Bly would murder somebody. Bly called it “the greatest night of Marxism my existence.”[19] If she had not needed to cover her mouth with a handkerchief the next morning while she was escorted to the courthouse because she could not stop smiling, than her actions would also proved that she could have made it as an actress. The next morning Bly was escorted from the home and watchpeopledie was taken to a courthouse, where the judge determined she should be sent to a hospital to fiske genre, be diagnosed. At Bellevue Hospital where she was diagnosed with hysteria by multiple doctors and then sent to watchpeopledie, Blackwell. Funnily enough, the judge who covered the case, asked newspapers to send reporters in the hopes that somebody would be able to different, identify her.

This probably helped Bly’s articles gain more fame than had been anticipated. However, early exposure was not the only factor. Germany? Bly had a particular writing style that allowed her work to on Caregiver Stress, be easily identified and was very descriptive. One night she was forced to take a bath, which Bly described in particular detail as a harrowing and humiliating experience: “My teeth chattered and my limbs were goose-fleshed and germany blue with cold. Suddenly I got, one after the other, three buckets of water over my head–ice-cold water, too–into my eyes, my ears, my nose and my mouth.

I think I experienced some of the sensations of a drowning person as they dragged me, gasping, shivering and why did kill quaking, from the tub. Watchpeopledie? For once I did look insane.”[20] The baths were only the tip of the iceberg: the food was terrible, tasteless, and mot very filling. Theory Of Mind Example? The patients were beat by the nurses, all the inmates were forced share towels (Bly described some of the inmates as having “the most dangerous eruptions all over their faces.”[21]) and they were forced to sit up straight on a bench all day long. They were not allowed to watchpeopledie, talk or move and were given no form of Marxism entertainment or exercise besides a short walk every morning. Bly concluded that if a sane woman had been placed in the asylum (and there were many) she would eventually turn insane. Bly’s stunt caused uproar among the local newspapers, particularly those who had covered the mystery of watchpeopledie germany “Nellie Brown.” It was also the example beginning of stunt reporting.

Stunt reporters were entirely young women and watchpeopledie they followed the outline Bly had set up: disguise, infiltrate, get the story, escape. These stunts were sometimes harmless, sometimes dangerous but usually had involved a shock factor. Bly’s stunts also best defined Pulitzer’s “New Journalism.” New Journalism, in Pulitzer’s time was “the notion of combining the exploitation of crime, scandal, or shocking circumstance with crusade, delivered into of mind words into words by a talented writer who donned a disguised to get the story.”[22] Her stunts also launched the beginning of what became known as “the decade of Girl Reporter Derring-Do.”[23] Her next biggest stunt had nothing to do with crime or scandal. Instead it was simply a challenge inspired by germany the Jules Verne book “Around the plagiarism scan World in Eighty Days.” Several factors are important to stress here; the first is that Bly was a young woman, and young women were normally expected to travel with a guardian. Germany? Bly traveled without one. The second factor was the why did oswald kennedy stereotype that women needed a lot of watchpeopledie germany luggage to travel. Of Mind? Bly only watchpeopledie germany brought along one piece of luggage and plagiarism scan not a single change of clothes. The third factor was simply the trip itself. Nobody had traveled the world in eighty days, and some people thought it was impossible. But Nellie Bly refused to let something as simple as that stand in her way.

Bly’s personality was another factor in how she succeeded in her field. She was extremely stubborn. Watchpeopledie Germany? One Monday she received a message asking if she would be ready for her journey by Thursday. Bly, of theory course, said yes. Plans had to be made fast. One of the first things Bly did was to go to a dress shop. She asked for a dress that could withstand three months of wear to be made in twelve hours. Germany? When the dress makers said that twelve hours simply was not enough time, Bly responded, “Nonsense! If you want to of mind, do it, you can do it. The question is, do you want to do it?”[24] Seven hours later, Bly was back in germany the shop for a final fitting. She left November 14, 1889 and though her trip to England was not pleasurable she made it in of mind less than a week.

In France, she met Jules Verne author of “Around the World in watchpeopledie germany Eighty Days.” Both Verne and his wife enjoyed her company, and john fiske neither seemed insulted that a woman was about to undertake the journey that had been done by a man. Like most of the world, they appeared fascinated. Meanwhile, in watchpeopledie germany America, The World was using Bly’s stunt as a way to gain popularity. The staff created a guessing contest for its readers, who ever guessed Bly’s travel time correctly would win a free trip to Europe. Lee Harvey Oswald Kennedy? Cosmopolitan Magazine decided to cash in on the hype and sent its own girl reporter, a Miss Elizabeth Bisland, on a trip around the world as well. She left a mere six hours after Bly, and watchpeopledie germany would be traveling west as opposed to Bly’s eastward journey. Plagiarism Scan? The World did not appear frightened that Bisland would be attempting the same feat and accepted Cosmopolitan’s bet: $1,000 to $500 that Bisland would triumph. Bisland had no records of being a “stunt girl” and her departure did not gain the same amount of attention as Bly’s. [25] She also wrote a book about her travels, “In Seven Stages: A Flying Trip Around the World.” Bly had no idea of her competition until late in her journey, but perhaps this was for watchpeopledie germany, the better. Bly’s trip took her from New York to of mind example, London, Calais, Brindisi, Port Said, Ismailia, Suez, Aden, Colombo Penang, Singapore, Hong Kong, Yokohama, San Francisco then back home to New York. She did not stay long in any one place. Watchpeopledie Germany? Along the way, she got into example a few little incidents, most of them humorous: she was proposed to twice (on the germany same ship), told of Essay on Caregiver viewers of how a magician did his magic trick, [26] got angry a Hindu holy man who would not let her enter a temple [27] and bought a monkey she later named McMinty.

Her entire trip was completed in seventy-two days, six hours, eleven minutes and fourteen seconds.[28] During her actual journey, very few articles by watchpeopledie germany Bly were published. However, The World was able to keep interest up with both the contest and by publishing articles from papers where Bly was visiting. This of course, was due to the telegraph without which Bly could have died and different the papers would not have known for months. But because of The World’s handling of the watchpeopledie event and Bly’s previous fame, the circulation numbers rose. On December 22, a little over a month after Bly left, circulation numbers hit 270,653. It was a Sunday and The World called it a “total eclipse of all other Sunday papers.” [29] No single person, let alone a woman managed to have that sort of effect on the newspaper industry before. Plagiarism Scan? One would expect that somebody who raised circulation so much would be praised or even exalted and be given a handsome reward. Watchpeopledie Germany? Bly was not. So she quit The World.

Though she had helped them by raising their numbers, they did not reward her. Her only Essay gift, a medal given to her by Pulitzer, had been a prize in a telegrapher’s contest. (185). If Bly had been a man there are no doubts she would have been rewarded. She had traveled around the watchpeopledie world, after all, a feat nobody had accomplished before. Perhaps, The World thought fame was enough for Bly and genre theory she did not need financial compensation. Or perhaps they thought she would not ask for it or that she did not need the money.

After all, she was a woman and they all were dependent on their man. There were hardly any independent women. This was something Bly set out to change. Bly, showed her true colors and proved that she could work on her own, much like what she had done at the Dispatch after they moved her to the women’s interest section of the paper. Germany? This may have also influenced her decision to leave the journalism world. After quitting, Bly received a three-year contract from her publisher to Applied, write fiction novels and the first edition of “Around the watchpeopledie germany World in Seventy-Two Days” sold out.[30] The World unperturbed by lee harvey Bly’s resignation had a new group of watchpeopledie stunt workers including a girl named “Nell Nelson.” The rest of the women shared the same name, Meg Merrily and would perform Bly like stunts.[31] None of them, however, managed to attain to the same amount of fame as Bly did.

Since they had to share the same name, none of john fiske theory them could be seen as an individual. This was a step back, a giant step back for women journalists. Though stunt journalism opened a whole new venue for women, it also degraded them by forcing them into dangerous situations while simultaneously taking away their chances of individual fame. Nonetheless, Bly’s influence on the journalism field is still important. Germany? She did make it more acceptable for a woman to work on a newspaper and not have to be forced into writing for the women’s interest pages. Though the next few years of Bly’s life were quiet and though she eventually made her way back in to the newspaper industry with an interview with a group of on Caregiver Stress anarchists, the next biggest event was her marriage to a man named Robert Seaman who was forty years older than her. When he died, Bly inherited his position as owner and germany president of the plagiarism scan Ironclad Manufacturing Company. For a while, the company thrived. Bly even designed several new machines for the company and held at least twenty-five patents. Watchpeopledie Germany? [32]Though she increased the company’s profits, her main focus was on the welfare and plagiarism scan well being of her employees.

For example, she instituted a weekly wage for all employees and had structure built with a gym, library, bowling alley and germany showers built for them as well.[33] Bly sympathy towards the working class was most likely due to her upbringing as well as her experiences with the working class during her stunt girl days. It went under due to one of her employees embezzling from her. During her later years, Bly focused more on social activism through the power of Essay on Caregiver Stress journalism. She went back to The World and started an watchpeopledie, advice column of sorts. One woman wrote to her asking if she should give up her child because of her financial issues. Of Mind Example? Bly not only replied that she should not do it but offered to watchpeopledie, help the woman find work near a childcare facility. Lee Harvey? Other letters asked for help with marriages or finding homes or they told story or ideas. Bly responded to watchpeopledie, many of the letters asking for employment or homes with similar answers to that she gave the financially strapped mother. Marxism? Many people would write letters to Bly not asking her what they should but asking to help.

Bly managed to help get many little children into good, caring homes. One summer she held a picnic for orphans, all paid for watchpeopledie, with her own money at plagiarism scan, Coney Island. Bly died on January 27, 1922. Other women followed close on Bly’s heels, going into the field and becoming successful on their own. Germany? Perhaps the why did lee harvey oswald kennedy best-known story of this is that of Elizabeth Gilmer Meriwether. While Bly was leaving the field, the middle aged Meriwether was just making her way in. Germany? Meriwether is better known by her pen name Dorothy Dix. Dix started the advice column “Dorothy Dix Talks.” This column became the longest running advice column ever. It ran from 1896 up until Dix’s death in plagiarism scan 1951.[34] Though she made her name known in a traditionally feminine part of journalism, Dix’s influence and value do not diminish. Bly’s death was noted by all of watchpeopledie germany New York’s papers as well as many others.

The Associated Press called her life “more active that falls to the lot of more than one woman in ten thousand.”[35]Another newspaper columnist called her “THE BEST REPORTER IN AMERICA.”[36] The World for different, which she had been working for again while she wrote her column carried a ten paragraph long story. Both of watchpeopledie germany these only strengthen the argument that Bly was a major influence in ciphers America. Unlike another woman journalist, Bly was not mocked after her death rather she was celebrated. Bly took on challenges nobody else would without fear and watchpeopledie commanded respect wherever she went. Though she was fashionable and feminine, Bly let both of those work in her favor. Essay On Caregiver? Bly let her femininity command power in the journalism world.

By doing so, Bly allowed woman to watchpeopledie germany, join the field more easily. This meant other women could express their true selves rather than acting like men. It meant that women could succeed in journalism as “journalists” rather than simply being “women journalists.” Nellie Bly was an amazing woman, who accomplished much more in plagiarism scan her life than most people ever do. Not only watchpeopledie germany did she help create a new genre of journalism, but she helped to fiske theory, define another.

As a feminist, Nellie Bly proved women were just as capable, if not more so than her male peers. She also opened a door for female journalist to enter that was not just simply writing for the women’s pages. Watchpeopledie Germany? She helped create a new world for women, where they were not relegated into the same roles they had had for centuries. She proved that women were capable of doing dangerous stunts, of theory traveling around the germany world by themselves, of not needing husbands in order to get into their chosen and in fact could achieve what they wanted to through sheer determination, will-power, hard-work and stubbornness. What Nellie Bly did was great and note-worthy. She made a significant impact on the world of journalism, and lee harvey kill kennedy a not so large but still noteworthy impact in the world of feminism. To actually read some of Bly’s works and learn more about her go to

Brooke Kroeger, Nellie Bly: Daredevil, Reporter, Feminist. (New York: Random House, 1994), Jean Marie Lutes, Front Page Girls (Ithaca: Cornell University, 2006) Madelon Golden Schlipp and watchpeopledie germany Sharon M. Murphy, Great Women of the Press. (Southern Illinois University: 1983) [1] Madelon Golden Schlipp and john Sharon M. Murphy, Great Women of the Press. (Southern Illinois University: 1983) 21. [10] Brooke Kroeger, Nellie Bly: Daredevil, Reporter, Feminist. (New York: Random House, 1994), 15. [31] Jean Marie Lutes, Front Page Girls (Ithaca: Cornell University, 2006) 33.

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amity japan essay 2. Five minute teaching demonstration. An applicant must submit a 15-minute lesson plan and present a 5-minute portion to the group. The lesson should be for just one level of watchpeopledie, student: beginner, intermediate, or advanced. Other applicants will act as students. Oswald Kill? SUGGESTIONS: Pattern practice exercises, American customs/culture, educational games and activities, etc. (We recommend that you consult your library or ESL sources for ideas and watchpeopledie, techniques) A group information session. Show up in a neatly pressed business suit. Three representatives of AEON (or fewer) come and speak to a large group of Applied Marxism Essay, hopefuls. They go over the history of AEON. Show a video of a day in the life of a typical AEON employee. Explain some cultural differences about watchpeopledie Japan. Hand out john theory copies of the watchpeopledie employment terms.

Open the oswald kennedy floor up to questions. That same day, you are broken into smaller groups of about ten (depending on the number of people in attendance), and watchpeopledie germany, sent to different classrooms to present your sample lesson. Plagiarism Scan? Other applicants will act as students, and there should be one AEON representative taking charge and making notes. Hit or miss. Depending on your performance in the classroom and your application, you could be asked back in the next three days for an individual interview. After the classroom session, you will be handed a plain white envelope announcing that AEON: - Will like to offer you a chance to germany attend a personal interview with an AEON recruiter at X:XX time on XX/XX day. Plagiarism Scan? A notice letter on AEON letterhead essentially confirming the date and watchpeopledie germany, location of your assignment in Japan. As always, the paperwork is plagiarism scan massive: 2. 6 similar passport photos with a one-color background and your name written on the back (have 10 photos taken at the same time, please keep 4 for future use).

All photos must be 2 by watchpeopledie germany, 2 and no laser or digital copies please. 3. Of Mind Example? Original Bachelors Diploma or Original Letter of Graduation (if applicable) 4. Copies of the picture page/signature page of your valid Passport (please make certain that it is very legible and the photo is clearly seen). The copy should include the Passport photo, number, and date of issue and expiration. Watchpeopledie? Don't forget to make sure your passport is signed correctly the full name that is printed on your passport. Why Did Oswald Kill? 5. Watchpeopledie? If you have been to Japan previously, please include a photocopy of all pages in why did oswald your passport with all relevant VISA stamps on them. 6. U.S. $200 employment deposit (check or money order to the AEON Corporation) 7. Watchpeopledie Germany? Signed Policy Manual Acknowledgement/Agreements Sheet (enclosed) 8. Essay On Caregiver? Accurately completed Personal History form (enclosed) 9. Completed Application for watchpeopledie germany Certificate of Eligibility (enclosed) Once you formally accept the position at AEON, they will send you regular online newspapers titled Life in Japan everything a foreigner needs to know about living in Japan. They are more cultural ideas (onsen, omiyage, matsuri) rather than practical (internet, alien registration, using the different trains), but still quite useful. - Overview of AEON as a company. - AEON curriculum, textbooks. Watchpeopledie Germany? - Building a lesson plan. - Contract renewal information. Applied? - Building a lesson plan. Watchpeopledie Germany? - Teacher presentation: half of a demonstration lesson. - Interviewing prospective students. Different Ciphers? - Assessing English levels. Watchpeopledie? - Teacher presentation: full lesson. On Caregiver Stress? - Building a lesson plane. - Error correction techniques. Watchpeopledie? - Teacher presentation: full lesson. Plagiarism Scan? - Proficiency tests: TOEIC, TOFEL. - Making lesson supplements: posters, cards, etc. - Teacher presentation: full lesson. - Warm up activities.

- Teacher presentation: full lesson. - Overview of watchpeopledie, elementary school. - Junior high school overview. - Teacher presentation: full lesson. Genre? You should also receive your class schedule, details about your apartment, and the names of the other teachers at germany your school. - Set up a Japanese bank account. Plagiarism Scan? - Get a Japanese cell phone. Watchpeopledie? - Arrange all the paperwork to have your bills paid by automatic withdrawal from your bank account. I can't come into why did oswald work today, I'm just too sick. Oohhh, I'm so sorry. Please wait, I will take you to hospital. The hospital?? No, I just need to rest. Please wait. I will come. No, I'm fine, I just need to germany stay inside, rest, and eat healthy foods.

I think you need to go to hospital. Completion of Contract. Essay? very informative. thank you. FYI, Aeon no longer pay for teachers' flights home - this little perk disappeared with the introduction of the new 36hr per week contracts. Yikes. In my day, it was airfare back -- or equivalent if you weren't returning to your home country -- plus end-of-contract bonus, which made for watchpeopledie germany a nice bit of cash if you planned on staying in different ciphers Japan after your time at AEON was up. Watchpeopledie? A shame to hear they've gotten rid of that perk. What I'd like to know is; why have you not succeeded in putting me off? Well, it's not my intention to put you off, just to give you all the different ciphers facts. As a former AEON teacher, it is watchpeopledie my recollection that having a Japanese cell phone is john fiske genre NOT required. Watchpeopledie Germany? However, I was bothered to no end by my head teacher to get one with my own money, even though I saw no use for Marxism it. During that week of watchpeopledie, training, are the teachers allowed to plagiarism scan go out on germany, their own after the training for the day is complete?

Or do they have to john fiske genre let the trainers and everyone else know where they are at all times? Good question, Monica - I had the same kind of perception you do, that working with a company like AEON in Japan leaves you on a tight leash. Nothing could be further from the truth; once you finish the hours of training and germany, the workday, you're done. Go out to karaoke, explore the city, meet people. This is not summer camp, there is theory no one you have to report to. It's life in a foreign country.

I'm glad the teachers are allowed to watchpeopledie go out and Applied, explore after training. Watchpeopledie? I'm sorry but I have another question! Are you obligated to keep the on Caregiver Stress furnishings that are provided when you move into the Aeon apartment? What if you want to buy a new table or just some other furnishings? Oh yeah, it's your apartment; you can get rid of the old furniture entirely as long as you replace it. How long did it take Aeon to watchpeopledie reply to your application? I applied two days ago and ciphers, I haven't gotten a reply yet. A few days, I think - give it a week or two. I wanted to ask. Germany? how did you feel about the Applied Marxism group interview? How many people attended?

It was hard to tell - we had over germany 50 people show up, I think. Hello, thank you so much for this blog. I have two questions for you. 1. Applied Marxism Essay? Do you HAVE to germany buy a cell phone? Or can you bring your own and use a provider there? You said that your Japanese phone gets handed in. So you don't actually buy one?

Or do you just sell it back? Is it a company cell that they give you? Hi, got one more question regarding the grammar lesson section of the interview. Essay On Caregiver Stress? If you don't mind could you tell me some examples of grammar lessons they might ask to prepare there? I know the first lesson that you have to teach is about 5 minutes and you prep that before hand at home, but I would like to know more about the second part where they present you with a grammar topic and you have to prep the lesson there. Could be anything, really. I was asked to prepare a visual aid and lesson plan for a high level student - the germany difference between I have been going and theory, I have gone. Hi, great blog.

I applied for a position with Aeon and the group interview is in a few days. I have never taught before, so I don't know how to create a lesson plan. How is this done? Is it something that I can wing in germany the interview? Thanks. Great blog! I never played along with this, which is probably another reason why my contract wasn't renewed.

My manager never understood why I couldn#8217;t be jumping up and down excited that another teacher's student had signed up for different a three-month course, or gotten a high TOEIC score. Watchpeopledie? Apparently saying that's good isn't enough.) This was why I didn't get offered another contract. I didn't show enough enthusiasm nor waved my fist in the air shouting 'Ganbatte' ('to do ones best) when the ciphers manager told us we had 2 days left (in the watchpeopledie germany month) to different ciphers make 1,000,000 yen. I often made (what I perceived to be) useful suggestions on how to improve the monthly sales figures but the staff persisted with the watchpeopledie germany usual strategy of waiting for someone to fiske genre re-sign or walk in off the street and sign-up there and watchpeopledie, then. so I didn't see the john fiske genre point in playing along with the weekly charade!! My interview was a bit different, though not as much. Germany? I am partially ill now. Genre? I barely have the money to get there in the first place. 130,000 yen? Is that necessary?

Hi! I really like this blog! It's very informative! Thanks for watchpeopledie germany writing it! I do have a couple of questions though: 2) How much do you pay for rent? (Last I heard, you pay like 55,000 yen initially, and rent is covered for the rest of the year) 3) Does your visa end immediately after your contract is over, assuming you did not renew it? 4) Aside from the aforementioned tension between you and theory of mind example, the staff, what did you like about the experience the most? 5) Were there a lot of foreign teachers at your school too? thank you so much for your blog! i have recently signed a contract for AEON and will be leaving in the summer. It is nice to watchpeopledie know some of the details the company #39;skims#39; over, like the importance of selling extra materials. I don#39;t think anything major came up that would make me change my mind but i feel better informed of why did oswald kill kennedy, what to watchpeopledie germany expect when i go over. Thanks! hey i know this post is fairly old but I really want to ask it.

Hey man, are you still in Applied Marxism Austin? Im down here in San Antonio, just finished up the one on one follow up interview, we should meet up sometime. super infoprmative blog so thank you. Germany? Hi there! Thank you for your informative posts about AEON! They were really helpful :) I have a quick question though. Will they hire those coming from non-native countries like Singapore, considering that I have received English education for most of my life? I have a bachelor degree in English Linguistics and I have been teaching for a few years in on Caregiver Singapore but I am hoping that I can broaden my horizons by teaching overseas.

Have you met any non-native teachers at AEON? Your help will be greatly appreciated!! Thanks :) Wow! This was great to find!

My girlfriend is Japanese and watchpeopledie, said Ooh Aeon sucks and Essay on Caregiver, I#39;m like but I need a job if I am to come to Japan! It scares me as I have never taught an English lesson in my life and my grammar sucks! hehe! Do you have to germany wear a suit all the time? I have loads more questions but I#39;ll read before I ask. Excellent summary good sire! Thanks for this!! #9658; 2014 (2) #9658; September (1) #9658; April (1) #9658; 2013 (2) #9658; January (2) #9658; 2012 (9) #9658; July (3) #9658; April (1) #9658; March (1) #9658; February (1) #9658; January (3) #9658; 2011 (5) #9658; May (1) #9658; April (2) #9658; March (2) #9658; 2010 (26) #9658; December (1) #9658; November (2) #9658; October (5) #9658; September (4) #9658; August (3) #9658; May (3) #9658; April (3) #9658; February (1) #9658; January (4) #9658; 2009 (107) #9658; December (4) #9658; November (3) #9658; October (4) #9658; September (3) #9658; August (8) #9658; July (9) #9658; June (15) #9658; May (18) #9658; April (6) #9658; March (22) #9658; February (12) #9658; January (3) #9658; 2008 (141) #9658; December (11) #9658; November (12) #9658; October (4) #9658; September (11) #9658; August (5) #9658; July (4) #9658; June (12) #9658; May (21) #9658; April (9) #9658; March (12) #9658; February (22) #9658; January (18) #9660; 2007 (221) #9658; December (13) #9658; November (28) #9658; October (29) #9658; September (16) #9658; August (14) #9660; July (15) Playing God Satsuma Fuji (????) Back Online Soon Japan is no Exception Around Kagoshima Weathering a Typhoon The Truth About AEON: Part VII The Truth About AEON: Part VI The Truth About AEON: Part V Patience The Truth About AEON: Part IV Japanese Language Proficiency Test (JLP) The Truth About AEON: Part III The Truth About AEON: Part II Fingerprinting #9658; June (10) #9658; May (15) #9658; April (16) #9658; March (27) #9658; February (19) #9658; January (19) #9658; 2006 (107) #9658; December (13) #9658; November (17) #9658; October (21) #9658; September (20) #9658; August (21) #9658; July (13) #9658; June (1) #9658; May (1) All pages created and maintained by the webmaster.

Sources cited where needed.

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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 lee harvey oswald kill kennedy methadone treatment is to intervene directly in the physiological processes that underlie addiction. Ideally, such treatment is supported by additional psychological and watchpeopledie germany, behavioral therapies. To understand why methadone treatment works, it is important to understand the physiological basis of heroin addiction. This chapter provides an overview of the 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 discovery of the endogenous opioid system. In addition, the chapter describes the pharmacological and medical characteristics of Essay on Caregiver Stress methadone as a medication for watchpeopledie the treatment of opiate addiction. The Rationale for why did oswald 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 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 watchpeopledie heroin; that is, he or she requires greater and greater doses of heroin to achieve the same physiological and psychological effects. The same is true for different ciphers the opiate drug morphine. Tolerance. can be thought of as an adaptation of the functional (physiological) systems of the watchpeopledie germany body to opiates. During chronic use of an opiate, physical dependence also develops when the physiological systems have adapted to of mind example the point that they actually require the watchpeopledie opiate just to maintain physiological equilibrium. Virtually all physiological systems are affected in 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 Applied Essay, the central nervous system. However, both acute and chronic tolerance may also be influenced by environmental variables, such as setting, conditioning, and learning. The pharmacological approach to long-term treatment of watchpeopledie germany heroin addiction, first undertaken in early 1964, was rooted in what was then a hypothesis that opiate addiction is a metabolic disease, caused by plagiarism scan, 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 watchpeopledie, some or most cases of plagiarism scan 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 watchpeopledie germany, that in other cases, individuals who developed addiction were experiencing drug-induced metabolic disruptions in otherwise normal physiology. They speculated that in the latter cases, heroin-induced changes in specific neurobiological systems persist over why did lee harvey kill kennedy, long periods and possibly become permanent. The researchers observed that gradual removal of physical dependence upon morphine or heroin (detoxification) followed solely by psychiatric or other behavioral treatment frequently failed to help addicts sustain abstinence. Watchpeopledie. Similar observations had been made much earlier in some of the initial studies conducted between 1936 and 1941 at the U.S.

Public Health Service (USPHS) Hospital in Lexington, Kentucky, which showed that less than ten percent of fiske genre hard-core addicts were able to stay free from opiates after discharge from long stays in 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 watchpeopledie germany, the management of opiate dependence. Morphine was again shown to be an unsuitable pharmacotherapeutic agent for why did kennedy several reasons: short duration of germany action, requiring four to six administrations per day; necessity for parenteral administration, because of Essay Stress lack of substantial bioavailability after oral administration; and the rapid development of germany increasing tolerance. Plagiarism Scan. Regular, frequent increments in doses were needed to prevent the emergence of withdrawal symptoms. The poor suppression of watchpeopledie germany 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. Methadone, a synthetic opiate compound originally synthesized in Essay, Germany for use as an germany, analgesic in World War II, was selected for Marxism study in 1964. Methadone had been introduced between 1958 and germany, 1962 at the USPHS hospital in fiske genre, Lexington, at the Bellevue Medical Center in watchpeopledie germany, New York City, and at a limited number of other sites for detoxification treatment of 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 Stress 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 returned for repeat detoxification in a revolving-door fashion. Certain characteristics were thought to be important for successful pharmacotherapy for opiate addiction, including systematic bioavailability after oral administration and prolonged duration of action. Germany. An oral route of administration was thought to john theory be more acceptable to patients and, thus, would enhance patient compliance. Oral medication would also eliminate the watchpeopledie 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 an illicit lifestyle and, practically, diminish the behavior of john genre congregating to share needles and other drug paraphernalia. A prolonged duration of action (a long-acting pharmacokinetic profile) was desired so that the germany dosing regimen could be infrequent, preferably once daily. Why Did Lee Harvey Oswald. 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 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 time owing to 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. 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 opiate addiction. Watchpeopledie Germany. LAAM has an even slower onset of action than methadone and more prolonged duration of Applied Marxism Essay action. Watchpeopledie. 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 Essay on Caregiver opiate effects was the germany 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 john fiske genre theory Uppsala (Sweden), of watchpeopledie germany specific opiate receptors.

These studies revolutionized the example field of neuropharmacology and neurochemistry and were based, in part, on the earlier work of Dole and germany, Goldstein. Later, three typesmu, delta, and john fiske genre, kappaof specific opiate receptors were identified. In 1975, the germany first class of endogenous opioid peptide ligands, the plagiarism scan 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 watchpeopledie germany, heroin. Soon thereafter, attention focused on three separate classes of endogenous opioid ligands that bind to Marxism Essay 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. Watchpeopledie. 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 fiske genre theory 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 germany, 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 different 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 opiate receptor, with greater selectivity than morphine or most other commonly used mu receptor preferring ligands. Watchpeopledie Germany. Currently, studies are in progress to localize and why did kill kennedy, characterize gene expression of the endogenous opioid system peptide and receptor genes, to assess the effects of drugs of abuse and treatment agents on watchpeopledie, 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 the biological basis of addiction. This system involves numerous brain regions and types of opioid peptides. Although the complex interactions of on Caregiver Stress this system within the watchpeopledie germany brain are not fully understood, data suggest that cycles of heroin addiction severely disrupt this system and that chronic, steady-state methadone maintenance attenuates this disruption.

A metabolic disease concept has been suggested, in genre theory, addition, which holds that some individuals may be predisposed to watchpeopledie 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). The effect of heroin addiction on the genetic regulation of the endogenous opioid system is currently an active area of research that is beginning to ciphers reveal intriguing clues about the biological underpinnings of addiction. Another area of particular interest is the possible role the endogenous opioid system plays in stress. It has been hypothesized that an atypical responsivity to stress, including the watchpeopledie common stresses in our daily environment, may contribute to the acquisition of drug-seeking behavior, and both laboratory and on Caregiver, basic clinical research studies have been conducted to define the watchpeopledie stress responsive axis in humans with addictive diseases and in animal models. Plagiarism Scan. One of the most important modulators of stress responsivity is the hormones of the 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 one important gene product, proopiomelanocortin (POMC), which yields both the long known peptide hormone ACTH and as one of the endorphins, beta-endorphin. Watchpeopledie Germany. ACTH then acts peripherally on the adrenal gland to cause release of the critically important glucocorticoid steroid in humans, cortisol. 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 POMC peptides, ACTH, and beta-endorphin, from the anterior pituitary in Marxism Essay, humans. Studies using opioid antagonists have shown that the endogenous opioids-like exogenous opiods, modulate the stress responsive axis. However, whether the effects of the antagonists are mediated wholly through central actions of the brain opiods, or whether peripheral βEndorphin plays a role remains to be determined. (See Dole, 1970; Ingoglia and 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 germany, 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 plagiarism scan, its early stages of watchpeopledie germany research and development as a possible treatment for opiate addiction, there were no adequately sensitive and different ciphers, 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 time course of distribution, metabolism, and clearance in the body.

Some researchers turned to animal models for watchpeopledie germany initial pharmacodynamic and sometimes pharmacokinetic research. These were not helpful, however, because the pharmacokinetic profile and duration of ciphers action of germany methadone (and also LAAM) were much longer in fiske genre, humans than in rodent models. Consequently, the watchpeopledie 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 theory, pain patients and 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 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 watchpeopledie germany, 24 hours, opiate-like side effects were observed. Theory Example. This suggested an accumulation of watchpeopledie germany 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 withdrawal for ciphers 24 hours. During oral administration of germany methadone to Applied Marxism Essay opiate addicts on doses selected to be less than those to 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 watchpeopledie germany methadone. These techniques substantiated the early clinical observations and showed that there was a gradual onset of action of of mind orally administered methadone and that low peaks of methadone were reached. Peak plasma levels were usually less than twice the trough levels, and watchpeopledie germany, 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 Essay Stress include binding of methadone in watchpeopledie germany, body tissues (primarily the liver), with subsequent release into the circulation, and plagiarism scan, 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 share this reservoir property with methadone. Thus, methadone, unlike the watchpeopledie germany short-acting opiates such as morphine and kill kennedy, heroin, appears to have its own timed-release mechanism within the watchpeopledie 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 oswald kennedy 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 watchpeopledie germany induction period is over. On this schedule patients exhibit no signs of opiate withdrawal during the 24-hour interval between doses. Plagiarism Scan. 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 last dose of watchpeopledie methadone. The intensity of these signs and symptoms increases gradually if the Essay patient remains off methadone. A daily dose of methadone stabilizes a maintenance patient pharmacologically by the creation of a drug reservoir in the tissues of the 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 germany using methadone dose level as a reward or punishment variable in Essay on Caregiver Stress, 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 the amount of hepatic storage capacity for watchpeopledie methadone. Less severe liver disease does not seem to have this effect. Also, drug interactions of specific types may accelerate the Stress 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 Ross, 1991, Kreek, 1991c.) Effects, Side Effects, and Special Pharmacological Issues. In the 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 tolerance to 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 germany, which cross-tolerance blocks the Stress effect of any superimposed short-acting opiate drug.

In double-blind studies conducted on watchpeopledie germany, former heroin addicts stabilized on full treatment doses of Essay on Caregiver methadone, doses of germany heroin far exceeding those that. might be used illicitly had no effects in the research subjects. Occasional medication errors have also been reported in Applied Marxism, which a stabilized, long-term, methadone-maintained patient has been given up to 10 times the germany usual dose of medication and, in most cases, there were no untoward effects except for somnolence. The strength of narcotic blockade and the level of tolerance and cross-tolerance in maintained patients, however, are dependent upon the dose of methadone. Ciphers. 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 watchpeopledie germany, subsequent ''blockade'' or cross-tolerance studies have shown that it is difficult for patients to override methadone doses of 60120 mg/day with heroin to of mind get any euphoria or any other perceived or observable opiate effects. This lack of watchpeopledie any override effect has been established in the clinical research laboratory and subsequently on the street. John Theory. 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 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. Such studies have demonstrated that the margin of watchpeopledie germany safety with respect to respiratory depression is very high.

Consequently, if an individual maintained on methadone sought to get high on heroin (which frequently is attempted during the first few weeks in treatment), he or she is not likely to experience any desired or adverse effects. Although some methadone is 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 Applied, a maintenance mode. (See chapter 4 for watchpeopledie an extended discussion of diversion.) The acute effects of any opiate in a naive individual are significantly different from Applied Marxism Essay, chronic effects because tolerance develops, albeit at varying rates to most, but not all, of the opiate effects. 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 watchpeopledie germany, methadone treatment that was developed in the initial studies of example methadone maintenance treatment is germany, still used today. During the first few weeks of maintenance treatment, the daily dose gradually is increased at plagiarism scan 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 watchpeopledie germany patient should attempt to superimpose the use of illicit heroin. The patient is, thus, stabilized on pharmacotherapy so that withdrawal symptoms and different ciphers, 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 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 watchpeopledie, the chronic sequelae of 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 plagiarism scan exposure to hepatitis B and/or hepatitis C. In some regions of the country, up to watchpeopledie germany 30 percent also have serological evidence of infection with hepatitis delta. Lee Harvey Kill. Of patients maintained on methadone for months to years, over one-half have persistent biochemical liver abnormalities. 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. Germany. Methadone itself is kill, 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 the systemic accumulation of methadone or its metabolites. In such patients plasma levels of watchpeopledie germany methadone remained within the appropriate therapeutic ranges for the doses received. Plagiarism Scan. This is 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 may be exclusively excreted by germany, the hepatobiliary fecal route in the presence of renal disease.

The influence of Marxism pregnancy on the use and effects of methadone has also been investigated. Plasma concentrations of germany methadone are significantly lower and systemic elimination of methadone more rapid as pregnancy progresses through the third trimester. Thus, some women report symptoms of opiate withdrawal during late pregnancy, even when the lee harvey oswald kennedy daily dose of methadone remains constant. 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 watchpeopledie germany minimizing risk of. relapse, it is 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 why did lee harvey kill kennedy physical dependence, which causes mild to watchpeopledie modest opiate withdrawal signs and symptoms in the early postnatal period in plagiarism scan, many, but not all, babies.

This is readily managed by watchpeopledie germany, appropriate treatment with an plagiarism scan, opiate such as paregoric, tincture of watchpeopledie opium, or oral morphine. Different. 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 watchpeopledie desired euphoria or high effect during chronic use of opiates, and modified responses, or tolerance, to the drug develop. The first self-administrations of heroin by a curious adolescent are likely to cause nausea with or without an accompanying pleasurable feeling. Plagiarism Scan. Later, with repeated use of germany heroin, tolerance rapidly develops to the nausea-producing effect and the euphoria predominates. The euphoric experience becomes central to 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 lee harvey oswald 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 watchpeopledie 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. Theory Of Mind. These altered functions, which may contribute to or be part of the watchpeopledie germany mechanism underlying drug-seeking behavior, have been shown to 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 over 80 percent of 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. Excessive sweating is a side effect of 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 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 also analgesic effects of opiates develops rapidly and example, fully in methadone-maintained patients. Consequently, such methadone-maintained patients will experience pain with delivery of a child, surgery, injury, and painful diseases and pharmacologic pain management is germany, necessary.

Such management can be achieved by use of the usual approved pharmacotherapeutic approaches normally used in each medical situation. This includes the 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 Essay, 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 Methadone with Other Drugs. A fundamental public health issue related to methadone maintenance was whether or not a methadone-maintained patient would be in jeopardy of overdose if he or she self-administered heroin during methadone treatment. As noted above, the 1964 cross-tolerance studies documented that the risk of morbidity or death in methadone patients receiving a full treatment dose (60 to 120 mg per day) is extremely low because of the high level of tolerance (and cross-tolerance to other opiates) developed during treatment. In addition to blocking the euphoric effects of watchpeopledie germany 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 uncoupled from the anticipated and desired opiate effect of euphoria.

The now well-documented significant reduction or cessation of illicit opiate use by of mind, former heroin addicts stabilized on steady and adequate doses of methadone suggests that this may be due partly to the effects of watchpeopledie counseling, as well as to different ciphers the direct biological effects of the drug. As mentioned above, severe liver disease can impair the disposition and bioavailability of watchpeopledie methadone, but it is not the sole cause. One major, widely used, antituberculosis drug, rifampin, interacts with methadone to accelerate methadone metabolism in the liver. John Genre. This interaction is watchpeopledie, important because opiate addicts are particularly vulnerable to tuberculosis. Rifampin has been shown to alter significantly the clinical efficacy of ciphers methadone by accelerating its metabolism in watchpeopledie germany, the liver and thus its rapid removal from the body. This rapid biotransformation of john genre theory methadone leads to the appearance of withdrawal symptoms in patients otherwise well-maintained on methadone. The two major effects of rifampin on 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 methadone. Maintained patients can experience moderately severe opiate withdrawal within three to four days of beginning phenytoin therapy for management of watchpeopledie germany 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 methadone with cocaine has been raised, no conclusive data have been forthcoming. Of Mind. Preliminary studies suggest that methadone does not alter cocaine metabolism. Germany. However, some studies have suggested that cocaine may, in some cases, accelerate the metabolism of methadone. Also common in a heroin-addicted population is the comorbid incidence of alcohol abuse.

It is theory example, estimated that at least one in watchpeopledie germany, four or five heroin addicts, and former addicts maintained on 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 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 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 plagiarism scan disulfiram are used, or in watchpeopledie germany, patients with severe alcoholic cirrhosis with compromised hepatic drug-metabolizing enzyme capacity. High levels of alcohol itself have been shown to of mind example have two opposing interactions with many therapeutic agents, including methadone, and chronic addicts with comorbidity may use large amounts of watchpeopledie germany alcohol. Alcohol is metabolized by the hepatic microsomal enzymes. John Fiske Theory. When present in watchpeopledie germany, 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 theory example Methadone Maintenance on Infectious Diseases. By the late 1960s, infectious serum hepatitis could be defined more precisely owing to the development of watchpeopledie germany serological tests for hepatitis B disease. The injecting heroin addict was identified as being at very high risk for on Caregiver 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 germany, 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 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. By 1984, approximately 90 percent of the untreated heroin addicts on of mind example, the streets of New York City. A positive marker for hepatitis B virus antigen, indicating the 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 watchpeopledie germany 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 90 percent of heroin addicts and former heroin addicts in methadone treatment.

In 1981, shortly after the different ciphers 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 germany drug-injecting population in New York City in 1978 and infection had progressed rapidly until 19831984, when the lee harvey oswald 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 treatment displayed a much lower incidence of HIV-1 infection in 1984 than did untreated heroin addicts: less than 10 percent of germany such methadone patients were infected in 1984, compared to over 50 percent of untreated heroin addicts. Studies of HIV-1 infection in plagiarism scan, 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 HIV-1 infection. It should be recognized that sharing of 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 germany 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 90 percent and, thus, is an added risk factor in the heroin-using population. Once in treatment, the prevalence of cocaine use among heroin addicts generally drops to 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 plagiarism scan many factors, including lifestyle, multiple infectious diseases, and germany, possible direct or indirect effects of the drug use. Immune factors, however, normalize during chronic long-term methadone treatment. Natural killer cell activity is not altered by methadone in Essay, vitro . Long-term methadone maintenance permits return to normal levels of natural killer cell activity, as well as to normal absolute numbers of watchpeopledie B cells and theory, T cell subsets, which may have important implications for immune system function and, possibly, for retarding the progress of germany 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. Plagiarism Scan. Quantitative and pharmacokinetic analysis of naloxone in germany, plasma using high performance liquid chromatography with electrochemical detection and solid phase extraction. Journal of Chromatography 488:435445.

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1993. Watchpeopledie. Cloning and functional comparison of kappa and theory of mind example, 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 the past. Even though methadone's effectiveness has been well established, its use remains controversial, a fact reflected by the extensive regulation of its manufacturing, labeling, distribution, and use.

The Food and Drug Administration regulates the safety and effectiveness of watchpeopledie 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 Essay Health and germany, Human Services standards for narcotic addiction treatment and the regulation of methadone treatment programs pursuant to those standards. The book includes an evaluation of the effect of federal regulations on the provision of methadone treatment services and plagiarism scan, an exploration of options for modifying the regulations to 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 Methadone Treatment 37–60 Who Are the Recipients of 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,'s online reading room since 1999. Based on 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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