Apomorphine: Emetic or True Detox Tool?

Yes, I read Burroughs. (Specifically `Deposition: Testimony Concerning a Sickness,’ part of Naked Lunch.) No real need to reference it here, except as a jumping-off point to a factual discussion of the current use of apomorphine, if any.

From my reading of Burroughs, apomorphine seems to transcend the aversion therapy mode of treating opiate addicition. Also, from my reading of Burroughs, police officers can turn into blobs that get a contact high from junkies.

Fortunately, my research goes beyond one text. But, surprisingly, not much beyond.

Dr. John Yerbury Dent apparently discovered it, and treated Burroughs, apparently successfully. He apparently tried to popularize the treatment, but … nothing. I’ve found nothing beyond the famous Burroughs treatment.

There is some mention of its use in treating Parkinson’s.

Google repeats itself, so I turn to the people of the SDMB. What is the Straight Dope on apomorphine’s current use?

http://www.geocities.com/Athens/Crete/9445/apo.html – English/French bilingual of Dr. Dent’s writings and Burroughs’ writings.

http://www.firehorse.com.au/addict/treatments.html#JUMP2 – People having the same problems I’m having regards finding cites. Probably not the best of cites, either.

Interesting, irreproducable. So, is that it? Is it not being used in humans anymore?

What about the promise it showed in ending opiate dependence?

Failed promise, I’m afraid. Like so many other things. It might be helpful in acute opiate detox, but opiate detox is never fatal anyway, and we have better, safer drugs to help with the opiate withdrawal process. Apomorphine can cause mild neurophsychiatriac side effects including increased cognitive impairment, personality changes and dyskinesia. And it does not prevent future drug-seeking behavior.

QtM, MD

Qadgop, thank you for your reply. First truly modern info on the subject yet. :slight_smile:

And as for preventing drug-seeking behavior: That’s the difference between detox (ending physical dependence) and rehab (ending emotional dependence and changing behavior patterns). Apomorphine is less magical than I’d hoped, but I don’t think anything is magical enough to fully rehab someone.

Qadgop, you are a font of opiate info : ) I read in Discover about a drug in testing derived from another named Ibogaine. Have you heard of it, and what do you think of it’s chances for success? It seems to be very promising, and a great leap ahead of methadone and other treatments.

Ibogaine is a fairly powerful hallucinogen. It’s derived from some african plant IIRC. I’ve been hearing about it’s potential use in withdrawal for a while now(about 6 years), though up until now, I’d heard it referanced WRT alcohol rather than smack. given that very similar claims were made about LSD 50 years ago, I’m not all that hopeful, but… any info qadgop?

Ibogaine seems to represent another medication which makes opiate withdrawal less uncomfortable. Here is a nice summary on some research done for this purpose.

Again, I see no evidence that its use will lead to long-term abstinence. Reducing cravings during acute withdrawal does not mean it will prevent the user from relapsing in 2 weeks, 2 months, or 2 years.

Frankly, speaking as a physician, I think there is some therapeutic benefit to having the opiate addict experience acute opiate withdrawal (under medical supervision). Treating symptoms in these people seems to me to be sparing them from the consequences of their opiate use.

And before anyone goes medieval on me for this opinion, recognize that speaking as a recovering addict, I myself have gone thru opiate withdrawal more than once. Twice I had the “benefit” of medications to blunt my discomfort, and subsequently I did not remain clean. The last time (well over a decade ago, thankfully) I was told “Well, sometimes you just have to sit and feel the pain. It won’t kill you”. I haven’t had to use since. Note that I don’t claim its experiencing the withdrawal fully that got me clean and sober, but I think that episode played at least a small part in my total recovery.

So I’m automatically dubious about any claim of a new medication to “cure” opiate addiction. Use of certain things like opiate receptor blockers, mood stabilizers, and other physiopharmaceuticals have a definite role in helping an addict stay clean in that difficult early recovery period, but making the detox process painless might not produce the desired result. In my personal and professional opinion.

Hi Derleth, First time poster here.

APOMORPHINE was primarily used by Dent to relieve people from anxiety. Subsequently he used it to treat people who were alcohol dependent. It was the emetic property of Apomorphine which led him to believe that his treatment was purely aversive. One day, however, he treated two brothers who he subsequently discovered had no sense of smell or taste. :smack: He was very disappointed because he believed that the treatment would fail…but it didn’t…it was an unqualified success! Both patients remained sober reporting no cravings.:):):slight_smile:
Dent realised that something else other than aversion was at play…and he continued to treat alcoholism with apomorphine until his death in 1962. Burroughs was treated in London by Dent in 1957. It is, unfortunately not clear whether Dent used Apomorphine with alcohol on Burroughs or Apomorphine with heroin. My feeling is that it was alcohol but Burroughs biographer says it was heroin. No matter, what is clear is that Dent knew that Apomorphine rebooted the neuronal pathways which left patients feeling refreshed, free from anxiety and craving. Dent was by no means the only practitioner to find success with Apo and it is one of the enduring mysteries of recent pharmacotherapy that nobody has had the sense to examine this in great detail using modern means of analysis. People say that Apomorphine has been superseded but they are unable to say whether they are talking about the drug or Apomorphine modus Dent.