AFTER TREATMENT.
The thorough cure of an opium or morphine habituè does not consist alone in stopping the use of the drug. This is certainly a very important step, but there yet remains much to be done, especially in those cases where the person became habituated to the use of the drug through its employment in some extremely painful neuralgic affection. This disease may still persist or return in full force on the withdrawal of the drug.
The use of the drug being discontinued, attention should be at once directed to the treatment of the original affection or of any disease that may lead the patient to again return to the use of the drug.
There are, too, certain troublesome symptoms, about some of which I have already spoken, that come on a few days after the opium or morphine is stopped. The most troublesome of these is “soreness of the throat,” consisting in congestion of the pharynx, tonsils, larynx and vocal cords. There is a sensation of tickling and a short, dry, annoying cough, that comes on in paroxysms and is especially troublesome at night. It is best treated by the local application of nitrate of silver (twenty to forty grs. to the ounce) and five-drop doses of benzoic acid given several times daily.
The insomnia is usually relieved by exercise better than by drugs, although I have often found bromide of potassium and hyoscyamus of service. On no account use chloral hydrate, or give stimulants at bedtime. Exercise is by far the best remedy. Walking, running, making garden, etc., sufficient to tire the patient out thoroughly, is an almost certain sleep producer, appetizer and hastener of tissue metamorphosis. The cold pack or a hot bath at bedtime often proves of service.
The appetite usually needs no stimulation by drugs. It is, as a rule, ravenous for the first few weeks after the morphine is stopped, so much so that ten-grain doses of pepsine will often be found necessary after each meal, the patients usually over eating. As a rule, I give the following mixture, as much for its effect on the nervous system as for the appetite:—
| ℞. | Strychniæ sulph., | gr. ss. vel gr. j | ||
| Tinct. gentian co., | ||||
| Tinct. cinchona co., | āā | ℥ ij. | M. | |
Sig.—One drachm half an hour before meals.