Methadone, sold under the brand name Dolophine among others, is an opioid used for opioid maintenance therapy in opioid dependence and for chronic pain management. Detoxification using methadone can be accomplished in less than a month, or it may be done over as long as six months. While a single dose has a rapid effect, maximum effect can take up to five days of use; the pain-relieving effects last about six hours after a single dose. After long-term use, in people with normal liver function, effects last 8 to 36 hours. Methadone is taken by mouth and by injection into a muscle or vein. Side effects are similar to those of other opioids; these includes dizziness, sleepiness and sweating. Serious risks include a decreased effort to breathe. Abnormal heart rhythms may occur due to a prolonged QT interval; the number of deaths in the United States involving methadone poisoning declined from 4,418 in 2011 to 3,300 in 2015. Risks are greater with higher doses. Methadone is made by chemical synthesis and acts on opioid receptors.
Methadone was developed in Germany around 1937 to 1939 by Max Bockmühl. It was approved for use in the United States in 1947, it is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. In 2013, about 41,400 kilograms were manufactured globally, it is regulated to other narcotic drugs. It is not expensive in the United States. Methadone is used for the treatment of opioid use disorder, it may be used as a maintenance therapy or in shorter periods for detoxification to manage opioid withdrawal symptoms. A 2009 Cochrane review found methadone was effective in retaining people in treatment and in the reduction or cessation of heroin use as measured by self-report and urine/hair analysis but did not affect criminal activity or risk of death. Treatment of opioid-dependent persons with methadone follows one of two routes: maintenance or detoxification. Methadone maintenance therapy takes place in outpatient settings, it is prescribed as a single daily dose medication for those who wish to abstain from illicit opioid use.
Treatment models for MMT differ. It is not uncommon for treatment recipients to be administered methadone in a specialist clinic, where they are observed for around 15–20 minutes post dosing, to reduce risk of diversion of medication; the duration of methadone treatment programs range from a few months to several years. Given opioid dependence is characteristically a chronic relapsing/remitting disorder, MMT may be lifelong; the length of time a person remains in treatment depends on a number of factors. While starting doses may be adjusted based on the amount of opioids used, most clinical guidelines suggest doses start low and are incremented gradually. Methadone maintenance has been shown to reduce the transmission of blood borne viruses associated with opioid injection, such as hepatitis B and C, and/or HIV; the principal goals of methadone maintenance are to relieve opioid cravings, suppress the abstinence syndrome, block the euphoric effects associated with opioids. Chronic methadone dosing will lead to neuroadaptation, characterised by a syndrome of tolerance and withdrawal.
However, when used in treatment, maintenance therapy has been found to be medically safe, non-sedating, can provide a slow recovery from opioid addiction. Methadone has been used for pregnant women addicted to opioids. Methadone is approved in the US, many other parts of the world, for the treatment of opioid addiction, its use for the treatment of addiction is strictly regulated. In the US, outpatient treatment programs must be certified by the federal Substance Abuse and Mental Health Services Administration and registered by the Drug Enforcement Administration in order to prescribe methadone for opioid addiction. Methadone is used as an analgesic in chronic pain in rotation with other opioids. Due to its activity at the NMDA receptor, it may be more effective against neuropathic pain. Adverse effects of methadone include: Sedation Diarrhea or constipation Flushing Perspiration and sweating Heat intolerance Dizziness or fainting Weakness Chronic fatigue and exhaustion Sleep problems such as drowsiness, trouble falling asleep, trouble staying asleep Constricted pupils Dry mouth Nausea and vomiting Low blood pressure Hallucinations or confusion Headache Heart problems such as chest pain or fast/pounding heartbeat Abnormal heart rhythms Respiratory problems such as trouble breathing, slow or shallow breathing, light-headedness, or fainting Loss of appetite, in extreme cases anorexia Weight loss or weight gain Memory loss Stomach pains Itching Difficulty urinating Swelling of the hands, arms and legs Feeling restless or agitated Mood changes, disorientation Nervousness or anxiety Blurred vision Decreased libido, missed menstrual periods, difficulty in reaching orgasm, or impotence Skin rash Seizures Central sleep apnea Physical symptoms Lightheadedness Tearing of the eyes Mydriasis Photophobia Hyperventilation syndrome Runny nose Yawning Sneezing Nausea and diarrhea Fever Sweating Chills Tremors Akathisia Tachycardia Aches and pains in the joints or legs Elevated pain sensitivity Blood pressure, too high Cognitive symptoms Suicidal ideation Susceptibility to cravings Depression Spontaneous orgasm Prolonged insomnia Delirium Aud
Holy Trinity Church is a former Anglican church in Hove, in the English city of Brighton and Hove. Built in the early 1860s to provide extra capacity for Anglican worshippers in the growing town of Hove, its use declined in the 20th century and it was closed in 2007 following a Diocesan review; until 2015—when a planning application to convert the building into a doctors surgery was approved—its future was uncertain, a heritage group has described it as one of Britain's top ten threatened Victorian and Edwardian buildings. The church has Grade II listed status, reflecting its historic importance. Hove expanded in the second half of the 19th century, the Cliftonville estate—developed from 1852—was one of its earliest areas of growth, it was situated directly east of the old centre of Hove village on high-quality agricultural land, used to grow food for the nearby Brunswick estate. The land was bought by four businessmen from Brighton and was developed with nearly 300 houses, in various architectural styles, in the next nine years.
St Andrew's, the old parish church of Hove, was close to the newly developed streets, but its capacity was reached at services. Rev. John Fraser Taylor, a curate at St Andrew's, started planning a new church in 1861. James Woodman, a local architect, was responsible for the design, a builder named Cane constructed it; this took 14 months and cost a further £9,000. The Bishop of Chichester, Ashurst Gilbert—who laid the foundation stone on 7 April 1863—consecrated the church on 15 June 1864. At that time, it consisted of chancel, side chapels and a south aisle. A spire was never added. In 1868, an aisle was built on the north side at a cost of £1,200. In 1912, the church was given an open-air pulpit; this rare feature associated with churches with an evangelical tradition, was unique in Brighton and Hove. Additions included rooms under the wooden gallery in 1949, a vicarage in 1952 and a church hall in 1953. At first, Holy Trinity Church operated as a chapel of ease to St Andrew's Church. After All Saints Church was built in 1892 and gained the status of parish church, Holy Trinity became part of its parish.
This arrangement continued after the church was threatened with closure in the 1920s because of falling attendances, although it was allocated its own district. The Diocese of Chichester carried out a review of Anglican churches in the city of Brighton and Hove between 2002 and 2003, its report, published in June 2003, recommended. It was said to have "no future" within the proposed Central Hove Collaborative Ministry, whose area would incorporate six places of worship in Hove, it was stated that the nearby Holy Cross church offered a similar type and tradition of worship, no other church communities in the city were found to be suitable for church planting. The Diocese of Chichester declared the church redundant on 1 September 2008, meaning it was no longer open for regular public worship; the church is built in red brick with stone dressings and some black and yellow brickwork. Its architectural style is difficult to specify; the design has been criticised as "ignorant beyond belief", echoing architect and architecture lecturer Harry Stuart Goodhart-Rendel's comments about another Hove church, St John the Baptist's, in 1918.
Holy Trinity Church has a nave of four bays, aisles on each side, apse, gallery at the west end with two rooms below, organ chamber on the northeast side, vestry at the southeast corner and entrance porch on the south side, above which the battlemented tower rises in three stages. The font consists of Caen stone and marble from Sicily; the interior is plain. Some of the windows contain stained glass. In March 2009, the church was threatened with demolition and a housing development was proposed for the site. Local residents, including actor Brian Capron, have campaigned against this; the diocesan review in 2003 proposed using the building as second-stage accommodation for homeless people who had lived in the St Patrick's Church homeless shelter. Brighton and Hove City Council has considered using the land for a new primary school. In 2008, The Victorian Society, an architectural study and preservation group and national charity, identified the church as one of Britain's ten most threatened Victorian and Edwardian structures.
In March 2011, Brighton and Hove NHS Trust announced that it was considering combining two local doctors' practices and moving them from their existing premises in central Hove into the former church. If local people approved and planning permission had been granted, the Trust would have created a "spacious accessible medical centre on three floors within the shell" of the church. A completion date of the end of 2012 was suggested; this scheme was abandoned. This proposal again involves the conversion of the church into a three-storey medical centre housing two general practices, but it includes a single-storey extension to accommodate a pharmacy. Brighton and Hove City Counci
Gurnam Singh was an Indian politician and the Chief Minister of Punjab from 8 March 1967 to 25 November 1967, again between 17 February 1969 to 27 March 1970. He was the first Shiromani Akali Dal Chief minister of Punjab, his ministry fell due to defection of Lachhman Singh Gill, who became the next Chief Minister with the support of the Indian National Congress. He died in an air crash in Delhi on 31 May 1973. Singh was born in Ludhiana on 25 February 1899 in a Grewal family, he graduated from Lahore. He captained the hockey team of Punjab University. Singh practiced Law in Lyallpur, he served as the president of the Bar Association, there. During the partition of Punjab, Singh moved to India, he was made the judge of the PEPSU and Punjab High Courts in 1950. He retired from this post in 1959. In 1959, he joined Shiromani Akali Dal. In 1962, he became the member of Punjab Vidhan Sabha from Raikot, he defeated congress candidate Inder Mohan Singh. Akali Dal president Sant Fateh Singh made Gurnam Singh the head of the legislative wing of the party.
He served as the leader of opposition in Punjab Vidhan Sabha from 1962 to 1967. In 1967, he won from Qila Raipur constituency. In 1967 he became the first non-Congress Chief Minister of Punjab of Punjab, he led a coalition government of Jana Sangh and communists. However, his government could not complete the full term, he again became chief minister in 1969. He served as High Commissioner of India in Canberra, Australia. Singh died in an air crash in Delhi on 31 May 1973