Medications Used for Substance Abuse: Helping People Beat Addiction
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Drug addiction is a major public health concern in the United States and around the world. According to SAMHSA, more than 22 million Americans seek treatment for alcohol or illicit drug use every year. People who are dependent on opioids and hard drugs such as cocaine, heroin, methamphetamines, and morphine need all the help they can get to overcome their addiction.
Although taking drugs is initially a voluntary activity, over time a person’s ability to control intake becomes compromised and the habit becomes a compulsive one. During addiction treatment, some people respond well to drug counseling, but for many, this standard treatment approach is not sufficient. Behavioral therapy addresses the emotional conflicts and hurdles faced by people in recovery, but it does not break the chain of physical dependency cultivated by years of abuse.
Fortunately, a number of effective medications are available to treat drug addiction and help recovering addicts get clean. Some of these medicines work by blocking the drug euphoria which drives the addiction. Others work by reducing cravings and act as a relapse prevention measure. Read on to find out more about medications for drug addiction treatment.
Table of Contents
- Treatment Choices for Substance Abusers
- What Do Drug Addiction Medications Do?
- Natural Treatment for Substance Abuse
- What Medications are Used During Drug Rehab?
- Ritalin Use for Substance Abuse
- Buprenorphine for Addiction Treatment
- Naltrexone for Substance Abusers
- Suboxone for Treating Drug Addiction
- Methadone for Opioid Dependency
Beating Addiction: Treatment Choices for Substance Abusers
Addiction treatment has two angles – a behavioral one and a pharmaceutical one. Both attempt to restore some normalcy to brain function and behavior in recovering addicts. Research has shown that although these treatments are extremely useful in their own right, for some addicts, a combination of both modalities is more successful.
Medicines to stop addiction are not without risk, but they are a less harmful alternative to illicit drugs. These medicines are effective in helping addicts overcome the unpleasant effects of withdrawal. This makes it more likely that a recovering addict will stay in rehab.
A number of medications are used during the rehab process. They work in conjunction with behavioral counseling to address all the addict’s needs. Some medications help an addict stay in treatment longer. Others are used to effectively manage unpleasant withdrawal symptoms. Yet others treat coexisting mental disorders that influence substance abuse. Medications are also available to assist with detoxification in the first stage of treatment.
Addicts must make a lifelong commitment to recovery from addiction. For long-term success and relapse prevention, it is critical to tailor the addiction treatment program to address the unique needs of each addict. Treatment should ideally include a mix of medications and mental health services as well as family-based and community support systems.
How Do Medications for Addiction Treatment Work?
The ultimate goal of any drug rehab program is to ensure an addict stops using drugs, stays drug-free, and leads a productive life. No single treatment works for everyone. The most common forms of drug treatment are counseling and behavioral therapies, but medications are an equally important part of the rehab process.
Illicit drugs are addictive because they manipulate the pleasure centers in the human brain. Addicts come to rely on illegal substances as a source of comfort, excitement, or euphoria. Medications for drug addiction work in the following ways:
Withdrawal Symptom Management: Some medications help suppress unpleasant withdrawal symptoms during detoxification. Detox, which is a medically managed withdrawal from drugs, is usually the first step in the drug rehab process. In fact, medications are used in about 80 percent of detox programs.
Relapse Prevention: Certain medicines help decrease cravings and normalize brain function. These medicines are used to treat tobacco, alcohol, and opioid addiction. Medicines to prevent relapse to cocaine, methamphetamine, and marijuana addiction are under development. Poly-drug abusers often need to be treated for all the illicit substances they use.
Non-Pharmacologic Addiction Treatment
According to the National Institute on Drug Abuse, more than 800,000 Americans are addicted to cocaine. So, one form of treatment or the other is a necessity. However, for many people, fighting drugs with drugs seems counterintuitive. Is it possible to use natural supplements to treat the withdrawal symptoms of hard drugs?
Addicts going cold turkey on illicit drugs experience a number of unpleasant withdrawal symptoms that can persist for up to two weeks. Orthomolecular medicine is a natural addiction treatment that does not use medicines and has shown some promise. It was conceptualized by Nobel Laureate Linus Pauling. It restores an optimum environment in the body by correcting imbalances and deficiencies based on the individual’s biochemistry. It uses natural substances which are neutral to the body, such as vitamins, minerals, amino acids, and essential fatty acids. There are case reports of massive amounts of vitamin C helping addicts reduce or eliminate withdrawal symptoms after going cold turkey on drugs.
Anti-Addiction Medications for Drug Withdrawal
Medications for addiction are one of the treatments for substance abuse disorders. In fact, in combination with behavioral therapies and counseling, medication-assisted treatment offers a holistic approach to recovery from substance abuse. Medicines are primarily used to treat addiction to opioids such as heroin and opiate-containing prescription pain pills. These medications work by normalizing the chemical environment in the addict’s brain, relieving cravings, and blocking the euphoric effects of the drug.
It is a common misconception that pharmacotherapy treatment for addiction is simply substituting one drug for another. In fact, medicine-assisted drug abuse treatment offers a comprehensive, customized drug rehab. It is proven to be effective in reducing the need for repeat inpatient detoxification. When used at the proper dose under medical supervision, these addiction medicines have no adverse effects on the individual’s physical or mental health. Medicines help addicts achieve full recovery by:
- Ensuring survival
- Increasing compliance with treatment
- Decreasing illicit drug use
- Improving outcomes in pregnant substance abusers
- Lowering the risk of contracting HIV and hepatitis C
- Treating comorbid mental health issues
- Reducing the risk of relapse
- Increasing the ability to become and remain employed
What medications are used during drug rehab? A number of medicines are used to treat opioid addiction. These include buprenorphine or probuphine, which triggers the same receptors as opioids, but induces a weaker response. Naltrexone works by blocking opioid receptors and keeping responses at bay. Suboxone is a combination of buprenorphine and naltrexone that is used in people with an opiate dependence. Methadone is used to prevent opioid dependence and withdrawal symptoms.
Ritalin for Cocaine Addiction Treatment
Studies have shown that methylphenidate (Ritalin) may be the answer to breaking free of cocaine addiction. Researchers have found that Ritalin, which is a stimulant drug prescribed to treat attention deficit and hyperactivity disorder (ADHD), is also useful in regulating the nerve pathways that are out of control in recovering addicts. Interestingly, this powerful stimulant is very similar in structure to cocaine. Both substances increase dopamine levels in the brain. However, the uptake of Ritalin in the brain is much slower than cocaine.
Researchers have studied adults addicted to cocaine. The participants were given either Ritalin pills or a placebo. MRI scans of the study participants showed that brain activity had normalized in the individuals who received Ritalin. However, since the study relied purely on brain imaging, it did not confirm actual treatment of cocaine addiction.
Despite extensive research, no medication has been found to be consistently effective in treating cocaine addiction. Some promising medicines for cocaine addicts include Baclofen, topiramate, tiagabine, and modafinil. These are known as GABAergic medicines and are administered as relapse prevention drugs. For people who have been sober from cocaine for a period of time, relapse prevention is often the most difficult phase of rehab.
GABA is an inhibitory neurotransmitter in the central nervous system in humans. When GABAergic neurons are activated, they decrease the activation of the dopamine reward system. GABAergic medicines foster this reaction and decrease the brain’s response to cocaine intake. These compounds also reduce recollections of past cocaine use.
At this time, there is no FDA-approved medication to treat cocaine addiction. However, with advances in medical science and a better understanding of the cocaine dependence cycle, researchers are getting closer to finding a solution.
Buprenorphine to Quit Heroin and Other Opiates
Buprenorphine is a medicine that is used to treat opioid dependence, including heroin abuse, by reducing cravings and lowering the potential for abuse. This medicine triggers the same receptors as the addictive drug it treats but produces a safer reaction. Contrary to popular belief, buprenorphine is not an opioid antagonist which completely blocks receptors and interferes with the opiate response.
Scientifically, buprenorphine is known as a partial opioid agonist, i.e., it activates opioid receptors but produces a smaller response. In this manner, it gradually weans off dependence. It is a very powerful trigger of opiate receptors, so it basically acts as a strong painkiller. It is more powerful than methadone or oxycodone in terms of its pain-relieving effect and is safe and effective for opioid dependency.
Unlike methadone, which must be dispensed in a highly structured manner, buprenorphine can be prescribed by a physician’s office and is, therefore, much more accessible. Buprenorphine is available under brand names such a Subutex, Norspan, Temgesic, and Cizdol.
Naltrexone: Medication for Opiate Addiction
Naltrexone is an FDA-approved opiate antagonist that completely blocks receptors and inhibits the brain’s response to these substances. Therefore, it works by a different mechanism of action than buprenorphine or methadone. Naltrexone makes it impossible for opiate drugs to provide an addictive high. If an individual suffers a relapse, naltrexone is used to block the sedative and euphoric effects of the abused substance. By preventing feelings of euphoria, naltrexone discourages the addict from abusing the opiates.
Naltrexone comes in pill or injectable form. It is not addictive or sedative. It can be easily administered and has minimal side effects. However, it is not particularly effective because addicts often have trouble sticking to treatment. Naltrexone is given after medically supervised detox has been completed. If it is administered while opiates are still in the system, it can lead to exceptionally bad withdrawal symptoms. Naltrexone is available under the brand name Vivitrol (injectable) and ReVia and Depade (pills).
Suboxone: Combating Heroin Addiction with Medication
In the United States, suboxone is specifically indicated for the treatment of heroin and prescription opioid drug addiction. It is a combination of buprenorphine and naltrexone. As mentioned, naltrexone is an opiate antagonist that is administered intravenously. In combination with buprenorphine, naltrexone is a pill which addicts cannot shoot intravenously.
Suboxone is indicated for opiate dependence treatment. A starting dose of 2 mg once a day is prescribed, which is gradually increased to a maximum dose of 32 mg per day. Most addicts benefit from an 8-mg daily dose. In fact, this accounts for about 80 percent of opiate addiction treatments. Suboxone is given to recovering addicts after opiates are already out of their system. Typically, the last dose of opiate medicine should be at least 16-24 hours before suboxone is used.
Methadone: Beating Opioid Dependence
Methadone is a powerful medicine that is used to alleviate severe pain. Addiction to this drug is a common problem because some people make the mistake of taking it without proper medical supervision. Interestingly, it has been found to be useful in treating opioid dependency. Essentially, methadone tricks the addict’s brain into believing it is getting the abused substance, and thereby, reduces cravings. In fact, methadone is a slow-acting agonist that cushions the high experienced with the abused drug. This prevents unpleasant withdrawal symptoms.
Methadone has long been the medicine of choice for individuals who do not respond well to other forms of addiction medications. Women who are pregnant or breastfeeding should consult their obstetrician before starting treatment with methadone. It is available through outpatient programs and is usually dispensed on a daily basis through a highly structured medicine program. Methadone is available under the brand names Methadose and Dolophine.
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