Answer to Question 1
Most heroin-associated deaths are due to the life-style of the addict, e.g., poor nutrition, sharing of needles, drug deals that turn violent. As a result AIDS and other infectious agents are most common causes of death. Also, interactions between heroin and other drugs, e.g., alcohol, cocaine, can also cause death. Sometimes, adulterants mixed with heroin are implicated in heroin deaths.
Answer to Question 2
Methadone and naltrexone are both orally effective and long-lasting drugs that reduce (methadone) or eliminate (naltrexone) the reinforcing effects that might accompany heroin administration. Methadone does this because it is an opiate agonist and produces cross-tolerance to heroin, whereas naltrexone is an opiate antagonist and blocks heroin's access to brain receptors. Methadone also decreases heroin craving considerably. It can be given to the physically dependent addict and used to either gradually wean the addict off opiates with gradual decrease in dose. Naltrexone would only be used with addicts that are no longer physically dependent, but because it doesn't reduce the craving for opiates, the person would have to be highly motivated to maintain abstinence.
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