Opioid replacement therapy

Opioid replacement therapy (ORT) (also called opioid substitution therapy (OST) or opioid maintenance therapy) is a medical treatment that involves replacing an illegal opioid, such as heroin, with a longer acting but less euphoric opioid; methadone or buprenorphine are typically used and the drug is taken under medical supervision. Some formulations of buprenorphine incorporate the opiate antagonist naloxone during the production of the pill form to prevent people from crushing the tablets and injecting them, instead of using the sublingual (under the tongue) route of administration.

In some countries, such as Switzerland, Austria, and Slovenia, patients may be treated with slow-release morphine when methadone is deemed inappropriate due to the individual's circumstances. In Germany, dihydrocodeine has been used off-label in ORT for many years, however it is no longer frequently prescribed for this purpose. Extended-release dihydrocodeine is again in current use in Austria for this reason. Research into the usefulness of piritramide, extended-release hydromorphone (including polymer implants lasting up to 90 days), dihydroetorphine and other drugs for ORT is at various stages in a number of countries. The prescription of medicinal heroin or morphine for people with long-term addictions, particularly those who have difficulty with methadone programs, is also legal in some countries.

Substitution

Substitution may refer to:

Science and mathematics

Other uses

Opiate

Opiates are analgesic alkaloid compounds found naturally in the opium poppy plant Papaver somniferum. The psychoactive compounds found in the opium plant include morphine, codeine, and thebaine. The term opiate should be differentiated from the broader term opioid, which includes all drugs with opium-like effects, including opiates, semi-synthetic opioids derived from morphine (such as heroin, hydrocodone, hydromorphone, oxycodone, and oxymorphone), and synthetic opioids which are not derived from morphine (such as fentanyl, buprenorphine, and methadone). All opioids, including the opiates, are considered drugs of high abuse potential and are listed under the Controlled Substances Act.

In 2013 between 13 and 20 million people used opiates recreationally (0.3% to 0.4% of the global population between the ages of 15 and 65).

Overview

Opiates belong to the large biosynthetic group of benzylisoquinoline alkaloids, and are so named because they are naturally occurring alkaloids found in the opium poppy. The major psychoactive opiates are morphine, codeine, and thebaine. Papaverine, noscapine, and approximately 24 other alkaloids are also present in opium but have little to no effect on the human central nervous system, and as such are not considered to be opiates. Very small quantities of hydrocodone and hydromorphone are detected in assays of opium on rare occasions; it appears to be produced by the plant under circumstances and by processes which are not understood at this time and may include the action of bacteria. Dihydrocodeine, oxymorphol, oxycodone, oxymorphone, metopon and possibly other derivatives of morphine and/or hydromorphone also are found in trace amounts in opium.

Moldova

Coordinates: 47°N 29°E / 47°N 29°E / 47; 29

Moldova (ⁱ/mɒlˈdoʊvə, mɔːl-/ or sometimes UK /ˈmɒldəvə/. Romanian: [molˈdova]), officially the Republic of Moldova (Romanian: Republica Moldova,  listen  ), is a landlocked country in Eastern Europe, bordered by Romania to the west and Ukraine to the north, east, and south. The capital city is Chișinău.

Moldova declared independence on August 27, 1991 as part of the dissolution of the Soviet Union. The current Constitution of Moldova was adopted in 1994. A strip of Moldovan territory on the east bank of the river Dniester has been under the de facto control of the breakaway government of Transnistria since 1990.

Due to a decrease in industrial and agricultural output following the dissolution of the Soviet Union, the service sector has grown to dominate Moldova's economy and currently composes over 60% of the nation's GDP. However, Moldova remains the poorest country in Europe.

Moldova is a parliamentary republic with a president as head of state and a prime minister as head of government. It is a member state of the United Nations, the Council of Europe, the World Trade Organization (WTO), the Organization for Security and Cooperation in Europe (OSCE), the GUAM Organization for Democracy and Economic Development, the Commonwealth of Independent States (CIS) and the Organization of the Black Sea Economic Cooperation (BSEC) and aspires to join the European Union.

Design thinking

Design thinking refers to design-specific cognitive activities that designers apply during the process of designing.

Origins of the term

The notion of design as a "way of thinking" in the sciences can be traced to Herbert A. Simon's 1969 book The Sciences of the Artificial, and in design engineering to Robert McKim's 1973 book Experiences in Visual Thinking. Peter Rowe's 1987 book Design Thinking, which described methods and approaches used by architects and urban planners, was a significant early usage of the term in the design research literature.Rolf Faste expanded on McKim's work at Stanford University in the 1980s and 1990s, teaching "design thinking as a method of creative action." Design thinking was adapted for business purposes by Faste's Stanford colleague David M. Kelley, who founded IDEO in 1991. Richard Buchanan's 1992 article "Wicked Problems in Design Thinking" expressed a broader view of design thinking as addressing intractable human concerns through design.