Joanne Kimes Jeffrey Kimes Popular Books
Joanne Kimes Jeffrey Kimes Biography & Facts
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis. The benefits of this treatment include a more manageable withdrawal experience, cognitive improvement, and lower HIV transmission. The length of OAT varies from one individual to another based on their physiology, environmental surroundings, and quality of life. The term medication for Opioid Use Disorder (MOUD) is used to describe medication including methadone and buprenorphine, which are used to treat patients with OUD. Terminology Other terms that appear in the professional and popular literature include opioid replacement therapy, medication-assisted treatment (MAT) and medications for opioid use disorder (MOUD). Biological understanding An opioid is considered a ligand, which is an ion or a molecule. An opioid ligand travels to the brain and attaches itself to an opioid receptor, which begins the effects of opioids. The mesolimbic system, which is the biological system that moderates the feeling of reward generated by dopamine, is the main system that is effected by opioids. Opioids stimulate the mesolimbic system to release a large amount of dopamine in the brain, which increases the effects of opioids: euphoria and numbness. The difference between an opioid and an opioid agonist is that opioids induce more intense effects and stay in the brain for a short amount of time. Conversely, an opioid agonist induces minimal effects and stays in the brain for a long time, which prevents the opioid user from feeling the effects of natural or synthetic opioids. However, the opioid receptors are still being used when an opioid agonist attaches, which prevents the effects of opioid withdrawal and can help prevent relapse. The two most common opioid agonists are methadone and buprenorphine. Methadone Methadone is an opioid agonist that binds to the same receptors in the brain as heroin and other opioids. Introduced as an analgesic in the US in 1947, methadone has been used in maintenance treatment—also known as substitution treatment, or drug replacement therapy—since 1964. Methadone treatments usually last for multiple years, although they can last for decades. A dose of methadone often minimizes the effects of withdrawal for approximately 24 hours and the lowest optimal dose is 60 mg. Methadone functions via competitive antagonism; while the prescribed agonist is in the opioid user's body, the use of illicit opioids (illicit heroin or fentanyl) will not produce the effects of illicit opioids. Methadone has a slower onset than illicit opioids and it produces less effects than illicit opioids. Side effects of methadone may include "constipation, weight gain, reduced libido, and irregular menses".(p. 467) Methadone maintenance reduces the cravings for other opioids, and reduces the risk of fatal overdose from street drugs since the purity and strength of methadone is known, whereas substances obtained from the street vary significantly in strength and purity. Therapeutic dosing is contingent upon individual patient needs, with a dosage range generally between 20 and 200 mg. Doses are unsafe for opioid-naive individuals, and administration of methadone is gradually increased to reach a therapeutic dose under medical supervision to reduce the risk of overdose. The amount of oral methadone a patient will require is dependent on the amount and power of opioids they consumed prior to initiating treatment, with an assessment in the mid-2000s (prior to the widespread introduction of fentanyl into street heroin supplies in the US) finding that 1 gram of street heroin is roughly equivalent to 50 to 80 mg of methadone. Methadone is taken either orally as a mixture of 1 mg/1ml supplied as a red or clear liquid, or as a mixture containing 10 mg of methadone in 1ml of liquid (green color) or 20 mg in 1ml of liquid (brown color). The latter is often used when a person is on a large amount of methadone, and is rarely permitted for unsupervised consumption. Since the formulations are not as viscous as the 1 mg/1ml mixture, they are more prone to misuse since they are easier to inject, and due to the high risk of overdose if diverted to an individual not accustomed to such a large dose. Methadone also comes in 40 mg dispersible tablets called "diskettes", as well as 5 and 10 mg pills that are round or "coffin" shaped. These pills are only given in hospital settings. Methadone can also be delivered by either IV or IM injection, as well as ampoules which come in various strengths ranging from 10 mg up to 50 mg. This method is often used for individuals who have a "needle fixation" and who would otherwise revert to using IV heroin. With the emergence of other medications for the treatment of opioid addiction such as buprenorphine and long-acting naltrexone, MMT is no longer the dominant medically assisted addiction treatment. Methadone maintenance has been termed "a first step toward social rehabilitation" because it increases the retention of patients in treatment, relieves them from the need to find, buy, and use multiple daily doses of street opioids, and offers a legal medical alternative. Methadone is one of the most researched treatments for opioid use disorder and has significant research support for its efficacy. Dispensing Methadone maintenance generally requires patients to visit the dispensing or dosing clinic daily, in accordance with state-controlled substance laws. Methadone, when administered at constant daily milligram doses, will stabilize patients so they feel a "high" from it and will not require additional street opioids. Most clinics will work with patients to get to a dosing level that will take away all cravings for other opiates without feeling too much of a "high" so they can function correctly throughout their day. In the U.S., patients that attend methadone clinics regularly and abstain from the use of street opioids or other controlled substances can be permitted to take home doses known as privileges, though this is at the discretion of the clinic's medical staff. Depending on the state's law, some clinics will allow the use of drugs like cannabis and still permit take home doses. Some states allow methadone clinics to close on Sundays and provide take-home medication the day before. Clinics that offer take-home privileges will usually do so by slowly offering more take-home days over a period of time, as long as their standards of clean drug tests are met. In some states, these take-home privileges can work their way to people getting take-home doses that would last them 2–4 weeks maximum. Another way take-homes are permitted is if the clinic puts the patient on a split dose schedule where they take part of their dose in the morning and take home a dose to take.... Discover the Joanne Kimes Jeffrey Kimes popular books. Find the top 100 most popular Joanne Kimes Jeffrey Kimes books.
Best Seller Joanne Kimes Jeffrey Kimes Books of 2024
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Get Lucky
Lila MonroeFall for the hot and hilarious romcom spin on 'The Hangover', perfect for fans of Tessa Bailey, Ali Hazelwood, and Emily Henry! What happens when you wake up in a hotel s...
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Pretty Little Lies
Ivy ThornFour years ago, Nicolo Marchetti took my innocence. But he left me with something else Nicolo almost took everything from me. My virginity, my reputation, and very nearly my future...
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Think and Grow Rich
Greg Habstritt & Napoleon HillThink and Grow Rich is one of the most popular success book of alltime, having sold more than 60 million copies since it was first published more than 70...
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Bewitching a Highlander
Roma CordonDefying all for the love of a bewitching lass. Breena MacRae, a healer from Skye with a touch of witchery in her blood, embarks on a dangerous search for her missing father. She ar...
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Hard Love
Peyton BanksHe was football royalty. Legendary quarterback. A champion.  Reiner Strickland had led his team to three national championships and playing a knight in shining armor was a...
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The Odyssey
HomerAn Apple Books Classic edition. Homer’s eighthcentury epic poem is a companion to The Iliad . It tells the story of Odysseus, who journeys by ship for 10 years after the Trojan War...
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Never Enough
Lexy TimmsBe good enough never is... Anthony Accardi is a man on a mission: make his father's watch company a success while bringing in millions of dollars. To do that, he needs an assi...
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The Seduction Series Boxset
Roxy Sloane“Sensual, thrilling and wild!”   Discover the bestselling series in one collection: THE SEDUCTION, THE BARGAIN, and THE INVITATION. Perfect for fans of Ana Huang, Sierra S...
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Dracula
Bram StokerAn Apple Books Classic edition. Few characters have seized readers’ imaginations quite like Count Dracula of Transylvania, the hero of Bram Stoker’s classic. The 1897 novel put vam...
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You Are Kind
Michael GordonA little kindness goes a long way. How can you help encourage your kids to be kind from a young age? Teach kindness to preschoolers Acts of kindness can be fun, easy, and make a ...
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Dream Psychology
Sigmund FreudAn Apple Books Classic edition. Written by the founding father of psychoanalysis, Sigmund Freud’s 1899 book is the definitive text on learning to interpret dreams. Freud’s groundbr...
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Masters of Restraint
Ines JohnsonMy new boss is good at giving orders. But his latest demand is NSFW. Especially when his two business partners want in on our deal. My new boss My boss’s boss Their investor &#...
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Always Yours
Claire RayeSome things are just meant to be... Ellen Somerville and Will McIntyre met by accident and under unusual circumstances. Getting sprayed by a skunk in a parking lot wouldn’t normall...
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Man In The Water
Jon HillAn attempted murder. A missing spouse. And an international conspiracy that could change the world. Jack Green has always been skeptical of socalled facts. Though he's forced ...
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Tempting the King
Jessa YorkAn escaped Mafia Queen, hiding from her past. A Mafia King who wants to claim her… Giselle They think I'm lostbut I know better. I can never be found. The path I've creat...
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The Icing on the Cake
Linda SeedShe’s a baker without a kitchen. He’s got a double oven to spare. It’s a recipe for success, until his mother starts stirring up trouble … Cassie Jordan has a sweet dream to open a...
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A Christmas Carol
Charles DickensAn Apple Books Classic edition. It’s Christmas Eve in Victorian England. While some families don’t know where their next meal will come from, Ebenezer Scrooge sits in his large hom...
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Meditations
Emperor of Rome Marcus AureliusMeditations is a series of personal writings by Marcus Aurelius, Roman Emperor 161–180 CE, setting forth his ideas on Stoic philosophy.
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Awaken Me
Jenna JacobHe was more than a ghost haunting my dreams…he was real. By day, I’m Julianna Garrett …a prim, proper accountant. By night, I’m tormented by dreams of an alpha, ambereyed Adonis wh...
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His Own Heaven
Jennie KewWinner of the 2021 Passionate Plume Award for BDSM Romance Finalist in the 2021 Stiletto Contest for Contemporary Romance He taught her to trust, she taught him to love. Lucy Bar...
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Dark Psychology and Manipulation
Margaret MorrisonTHE MENTAL MANIPULATOR WILL NO LONGER KEEP SECRETS FROM YOU! Are you fed up with the wool being pulled over your eyes?Are you prepared to stand up to those who believe they can man...
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Inception of Gold
Lexy TimmsThings are not as bad as they seem. They are worse. Being the personal assistant to a narcissistic actress who just happens to own the key to my family's undoing isn't ex...
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Teach Me
Cassandra DeanFrom awardwinning author Cassandra Dean comes a tale where lessons of pleasure between a curious, sunshine widow and a dissolute, grumpy earl leads to passion and allconsuming love...
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Teased by Fire
Molly O'HareFrom USA Today bestselling author Molly O’Hare comes an enemiestolovers, older brother’s best friend, romantic comedy with a curvy, antisocial, supernaturalobsessed, allyearround h...
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Peace on Earth
Maia RossCrime never takes a holiday. Why should Irma? Irma Abercrombie is an energetic retiree with a shadowy past, a mean right hook, and a profound love of Christmas. Surrounded by seaso...
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Good Guy
Kate MeaderHe's a Special Forces veteran making his pro hockey debut. She's a dogged sports reporter determined to get a scoop. She's also his best friend's widow . . . Fa...
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School of Potential
W.J. MayUSA Today Bestselling author, W.J. May brings you a continuation of the international bestselling series, The Chronicles of Kerrigan! Come back and enjoy the famous characters, or ...
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Hot Off the Press
Lexy Timms"This is what really happened… reported by a free press, for a free people…" Wes Shaw leads a secret double life. As the secret owner of a billion dollar newspap...
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How to Choose a Guy in 10 Days
Lila MonroeThe only thing more hilarious than the movies is… real life?! Fall in love with the sizzling grumpysunshine romantic comedy perfect for fans of Sophie Kinsella and Ali Hazlewood! ...
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Little Women
Louisa May AlcottAn Apple Books Classic edition. Meet the Marches! Louisa May Alcott’s classic introduces us to four unforgettable sisters: beautiful Meg, tomboyish Jo, delicate Beth, and Amy, the ...
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Whiskey Girl
Melissa BelleThey'll do anything for each other…except commit. Logan Wild isn’t just the hottest broncriding cowboy in Texas. He’s also my best friendwith benefits. And that’s all we’ll ev...
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The Wonderful Wizard of Oz
L. Frank BaumAn Apple Books Classic edition. You’ve seen the iconic 1939 movie, but do you know about the talking field mice, the Winkies, and the Witch of the North that appear in the original...
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Just Me
Lexy TimmsWe all need somewhere where we feel safe… After leaving her abusive husband, Katherine Marshall is out on her own for the first time. She's hopped from city to city to avoid t...
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Noxious
Lexy TimmsStop setting yourself on fire to keep someone else warm. Brady and Levi have been together since high school, since before he became famous and started thinking only about himself....
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Becoming Lady Dalton
Carrie LomaxA dance of desire and deceit... In the glittering world of London's ton, Mrs. Viola Cartwright revels in her newfound freedom as a lady of leisureuntil a series of jewel theft...
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All Fired Up
Kathryn ShayCaptain Jarek Zenko, a war veteran and firefighter, meets Lacey Roth at a bar one night. They don’t share their real identities, even when they retreat to a hotel. When they meet t...
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Silver Santa
Lacey SilksTrapped together on Christmas, their unintended onenight stand becomes a lifechanging encounter amidst the snow. Laura Young's professional role as a security guard at the Sil...
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Holy Bible
The Church of Jesus Christ of Latter-day SaintsThe 2013 edition of the Holy Bible contains all of the study aids contained in the 1979 edition and includes revisions to the study aids, several new photos, updated maps, and adju...
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The Four Loves
C. S. LewisThe Four Loves summarizes four kinds of human loveaffection, friendship, erotic love, and the love of God. Masterful without being magisterial, this book's wise, gentle, candi...
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Eternal
W.J. MayShe will fight for what is hers. When the king is murdered, Katerina, his only daughter, must flee for her life. She finds herself on a strange and dangerous path. Alone for the fi...
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The Target
Lexy TimmsWhen you seek revenge be sure to dig two graves… Revenge was the only thing I had going for me. It kept me awake at night and drove me into desperate situations in dive bars across...
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Law of Attraction
Jordan HollisHow to Finally Overcome the Hurdles of Manifesting Proven, effective and enjoyable ways to help you manifest faster… Right now, think of something that makes you successful. If you...
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The Scarlet Letter
Nathaniel HawthorneAn Apple Books Classic edition. Hester Prynne lives in infamy. After committing adultery and bearing a child with a man whose name she refuses to divulge, the heroine of Nathaniel ...
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Nothing to Hide
Scarlett FinnPrize of a lifetime: travel the world with a celebrity billionaire. Come to LA with us, Roxie… It will be so much fun! We have tickets for a latenight talk show! What could possibl...
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His Girl Next Door
Khardine GrayFrom USA Today Bestselling author Khardine Gray comes a sizzling hot single dad romance you won't want to miss. No strings attached fun with the ubergorgeous single d...
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Salvation
Meghan O'FlynnIf you like mouthy detectives, serial killers, and suspenseful mysteries that don't quit, this chilling and actionpacked hardboiled detective series has you covered! Try this ...
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The Art of War
Sun TzuAn Apple Books Classic edition. It’s believed that Sun Tzu wrote this Chinese military primer during the 5th century BChundreds of years before the Bible. The book’s 13 chapters ex...
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Silenced Girls
Roger Stelljes“ Wow wow wow!  Grips you in a choke hold and  does not let go … Oozes suspense and  bonechilling twists and turns .  Astonishing … One of those...
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The Count of Monte Cristo
Alexandre DumasAn Apple Books Classic edition. Alexandre Dumas’ classic paints a portrait of Edmond Dantès, a dark and calculating man who is willing to wait years to exact his perfect plan for r...
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Once Upon A One-Night Stand
Zoey LockeAt first sight, there was electrifying chemistry.  So why not go for it? After all, Lynx Grove, the city's most eligible bachelor, wants to claim her, at least for th...