Medications

Taking prescribed medication for drug addiction and detox can be a great way to help those who suffer from substance abuse quit and get started on the path to successful recovery. Medication can potentially help to change the negative effects that occur when someone engages in chronic substance abuse as well as helping to relieve some of the cravings. Sometimes, the medication might mimic the effects of the substance to help patients avoid having to go through the full-on effects of withdrawal. At the moment, vaccines are in development could possibly stop people from feeling the addictive high from drugs altogether, rendering their consumption essentially useless. Unfortunately, though, not all addictive substances have medications that have been approved for use to minimize withdrawal effects. 

The most commonly used drug detox medications include: 

Methadone

Methadone is one of a small variety of drugs approved to treat opioid addiction and dependence. If a patient has an addiction to morphine, heroin or a prescription painkiller, then methadone may be authorized to manage the addiction. There are a few reasons why methadone is considered to be an invaluable tool in opioid recovery.

While heroin has a half-life of only 30 minutes, methadone has a half-life of 22 hours. When heroin addicts reach the half-life of their dose, they tend to experience extreme highs and overwhelming lows. With Methadone, the swings are far less severe and the drug itself is much less stronger compared to heroin. Because of this, methadone has proved useful in managing the withdrawal symptoms of heroin as well as other opioids. The process of medically managing opioid addiction with this type of addiction medicine is called methadone maintenance therapy, which usually happens at a methadone clinic. However, methadone can also be abused.

The physical signs of methadone abuse are:

  • Nausea and vomiting
  • Sweating
  • Constricted pupils
  • Constipation
  • Increased pain
  • Slowed breathing

It’s important to remember that although methadone is used for medical management of opiate addiction, it also has the potential to be abused on its own, which can lead to a new addiction. The signs that someone might be addicted to methadone are:

  • Attempting to obtain more prescriptions than necessary, which is also called “doctor shopping.”
  • More frequent use, in higher doses than prescribed. Although clinics usually require patients to take the drug under supervision, some users might be allowed to use outside, which can lead to abuse and addiction.
  • Skipping regular doses in order to “stockpile” pills so that a higher dose can be taken later
  • Going to alternative sources to obtain drugs. This may include associates or even friends who have access to the drug. This can also include using other opioids alongside methadone like oxycontin or morphine.
  • Allowing methadone use to interfere with other aspects of life like work or relationships.

Methadone has tough regulations and must be used while in the presence of an experienced medical practitioner during addiction treatment.  People who are in need of methadone have to make daily trips to a licensed methadone clinic to get their dose. Over time, as they show their ability to stay sober and maintain their daily dosage, they will be given “take-homes,” which are doses that they are allowed to take home in order to make fewer trips to the clinic. The benefits of using methadone are:

  • Decreases cravings for drugs
  • Alleviates the unpleasant symptoms of withdrawal
  • Has a much longer half-life, lasting between 24 to 36 hours
  • Doesn’t give user euphoric effects.

Although there are numerous benefits to using methadone as a treatment option, there are also disadvantages such as:

  • Because it’s a Schedule II drug, it presents a risk of abuse.
  • The side effects are similar to other opioids and include respiratory depression, excessive sweating, constipation, sexual dysfunction, nausea, itchy skin, and constipation.

Methadone has been the most commonly used form of prescription medication to treat opioid addiction for the past six years. In 2011, more than 30,000 patients were treated for opioid addiction. Additionally, up to one-fourth of patients receive methadone maintenance.

Luckily, though, there are an enormous amount of methadone abuse treatment centers located all countrywide, and many centers are specifically designed to manage opioid withdrawal symptoms as an initial part of rehabilitation from opioid addiction.

If you are seeking to put an end to your methadone use, it is best to seek evaluation from a trusted addiction counselor or facility. Your specific situation might need proper assessment to understand the frequency, level and intensity of your dependency problem. Depending on how you respond, you will be recommended to a detox period followed by residential rehab or outpatient care.

Detox is essential and the goal is to stop opioid use completely. Detox effectively reduces the amount of the drug in your bloodstream until it’s completely removed. Supervision from medical professionals is important to ensure the utmost in safety and comfort.

Some rehab programs utilize different medication such as Suboxone or Subutex to treat opioid dependence. The residential setting of a professional treatment center lets you focus on aspects of recovery while avoiding temptation and dangerous triggers present in home life. It is also important to note that no treatment is complete without outpatient treatment. Therapists may use skills and interventions that are similar to motivational interviewing or cognitive-behavioral therapy to handle the underlying factors and triggers of your addiction in order to build your motivation for abstinence.

Studies have shown the support and fellowship of 12-step programs can drastically help patients along the process of recovery while building additional sober support systems.

Statistics from the Drug Enforcement Administration:

Methadone

  • Nearly 2.5 million Americans 12 and older said they abused methadone in their life in 2012. This shows a jump from 2.1 million in 2011.
  • In 2011, it was reported that more than 65,000 emergency room visits were because of methadone use.
  • From 1999 to 2005, methadone overdose-related deaths rose by around 460%

Buprenorphine

Buprenorphine, either prescribed by itself or with naloxone (also known as Suboxone), is a partial opioid agonist drug approved for use in treatment for opioid dependence and is currently prescribable by qualified doctors. In addition to treating opioid dependence, there is a small amount of evidence that supports the claim that Buprenorphine might have antidepressant capabilities as well. Studies by the National Drug Intelligence Center say that there is very low risk abusing the drug during recovery. Some of the advantages of using buprenorphine during opioid rehabilitation include:

  • Can be given by a licensed doctor at health offices, hospitals, doctors offices, and correctional institutions, unlike the similar drug methadone.
  • Decreased cravings
  • Lessened withdrawal symptoms
  • The drug’s effect plateau’s at a certain point to prevent overdose or abuse.
  • Is commonly mixed with the drug naloxone to lower the chances of abuse

Although there are plenty of advantages, there are also some disadvantages to taking buprenorphine. These include similar side effects to those of other opioids.

  • Trouble sleeping
  • Nausea
  • Constipation
  • Muscle cramps
  • Vomiting

Beginning in the 1960s until 2000, methadone was primarily used to help people looking narcotic replacement therapy to lessen symptoms caused by withdrawal. Methadone is an opiate agonist that is usually prescripted in controlled circumstances in order to help treat opiate withdrawal symptoms. Buprenorphine became the very first narcotic prescription drug that could be administered and prescribed by qualified physicians to treat opioid dependence under the Drug Addiction Treatment Act in 2000. That year anywhere from 810,000 to 1 million Americans were actively addicted to heroin, according to the National Alliance of Advocates for Buprenorphine Treatment.

Dissimilar to the drug methadone, buprenorphine is not deemed as a Schedule II drug, meaning that its likelihood for abuse is considerably lower. Methadone is only prescribed by doctors who have been officially registered by the Drug Enforcement Agency’s Narcotic Treatment Program, and the drug can only be given out at qualified clinics. Doctors must first go through training and earn certification from the Center for Substance Abuse Treatment in order to prescribe buprenorphine. It is widely seen as safer, as well as more accessible rehabilitation option than other medications such as methadone.

Buprenorphine is an opiate agonist. This means that, like heroin and drugs that come from morphine, buprenorphine has chemicals that connect to receptors in the brain and decrease pain and produce an overall feeling of well-being. Before it became the prominent opioid addiction treatment drug it is today, buprenorphine was prescribed for a long time as a painkiller. When the patient takes buprenorphine as prescribed, it replicates the effects of opioid drugs to a considerably lower degree.

In What Ways Can Buprenorphine Aid Me In Recovery?

According to the Drug Policy Alliance, buprenorphine can be a very effective aid in opioid addiction treatment. When used in conjunction with counseling and behavioral modification, buprenorphine-based therapy can:

  • Help patients stay relaxed while starting recovery
  • Stop cravings for heroin and other opioids
  • Lowers your probability of relapsing drastically
  • Helps to safely and gradually control your dependence on the substance in question

Buprenorphine can commonly be found under its brand name, Subutex. Subutex is usually taken as sublingual tablets and are placed under the tongue and allowed to dissolve. When taken in prescribed doses, Subutex often does not generate the same level of drowsiness, euphoria or central nervous system suppression as illicit substances. Subutex should not be taken on an as-needed basis; it should be taken under professional supervision and must be used as directed to produce successful treatment outcomes.

Some patients have abused Subutex by crushing the tablets and either snorting or injecting them to get a more powerful, concentrated effect. When this is done, the drug can suppress breathing and cause confusion, dizziness, unconsciousness and even death.

Suboxone is the brand name for when buprenorphine is mixed alongside naloxone, an opioid antagonist. Subutex was the first variant of buprenorphine to be approved and prescribed to those suffering from opioid dependence. Suboxone was first created in order to prevent users from abusing buprenorphine by snorting or injecting it to get high. Naloxone was added to keep patients from abusing the substance.

When Suboxone is taken sublingually, the user does the not feel the effects of the naloxone. However, if they are first crushed and then either snorted or injected, the naloxone will block the pleasurable sensations. Suboxone has recently been released onto the market as a film, which reduces the potential for users to abuse the substance even more.

Although both Subutex and suboxone are both helpful aids in treatment, they are still just one element of productive rehabilitation. To become clean and maintain sobriety, you will need the best professional addiction treatment that can properly address both the physical aspect as well as the emotional, personal and social aspects particular to your opioid addiction.

Naltrexone

Naltrexone connects to the parts of the brain that respond to opioids and stops the user from feeling the
euphoric effects entirely. This helps to deter individuals from relapsing because they can no longer benefit from using the substance. Naltrexone can also be used to effectively aid in detoxing from alcohol. In either case, the use of the drug can reduce cravings.

A few of the advantages of using Naltrexone are:

  • Naltrexone is available in injection form where the effects can last for up to a month
  • Can help prevent relapse
  • Does not cause withdrawal symptoms when use is decreased.

Some disadvantages of using the drug are:

  • If any opioids are still present within the user’s body, it cannot be used because it can trigger acute opioid withdrawal symptoms.
  • It can produce negative effects including muscle and joint pain, anxiety, diarrhea, vomiting, headaches and fatigue
  • Patients with liver damage should not take it.

If taken with opiates, naltrexone can trigger immediate withdrawal symptoms. It is not given by a naltrexone rehab facility until it is certain that the patient is no longer using drugs or alcohol. There is a chance that withdrawal symptoms might increase when naltrexone is taken and it has a higher chance of serious symptoms occurring if mixed with opiates or alcohol. Overdose with the drug is, in fact, possible when combined with alcohol or opiate use, as well as from taking too much of the drug itself.

Acamprosate

Acamprosate is usually prescribed when the user experiences withdrawal symptoms that last longer than normal and are associated with detox. These symptoms can include anxiety, rest
lessness, and insomnia. The advantages of using the drug are:

  • Helps to bring brain activity back to normal
  • It lowers the intensity of cravings associated with alcohol
  • Patients with liver damage can take it
  • Has no potential for addiction

The disadvantages of this drug are:

  • Side effects can include stomach cramps, dizziness, headache and nausea among others.
  • People who have existing kidney problems should not take it

A couple of studies comparing the drug to placebo showed that 27% of patients who take acamprosate achieved and maintained abstinence for a full year, while only 13% of placebo patients were able to do the same. Additionally, acamprosate decreased the frequency of drinking use compared to patients who were not fully abstinent.

Acamprosate is commonly used to treat alcohol dependence. Treatment specialists who work at alcohol rehabilitation facilities use acamprosate in conjunction with psychological counseling to help people overcome their alcohol dependency as best as possible. Despite the medical uses it has, acamprosate is still a mind-altering drug that can be physically and psychologically addictive., and there are established rehab centers available for those who have become addicted to it.

According to MedlinePlus, more than 17 million people suffer from alcohol addiction here in the U.S. Many of these people have chosen to enroll in professional treatment at an inpatient or outpatient facility. Acamprosate is one drug that medical practitioners use to ease the detoxification and withdrawal process.  It can take the form of an extended-release tablet or intravenously. Acamprosate helps alcoholics lose their desire to drink. It does this by changing the way your brain reacts to alcohol.

Disulfiram

This drug is used to help alcoholics stop drinking by causing its users to become violently ill if they ingest alcohol. Disulfiram is most usually given at special disulfiram rehab facilities. Although it doesn’t completely get rid of cravings, it often makes consuming alcohol so unpleasant that patients don’t want to drink anymore.

Disulfiram is usually included in alcohol rehab treatment programs. Most facilities that use Disulfiram tend to be inpatient disulfiram rehab centers. Inpatient programs require the person addicted to living at the treatment facility. These are several of the advantages to using Disulfiram:

  • Patients live among people who are or have already faced similar problems with alcohol abuse. This can add support to the patient and help them feel less alone. In addition, great built-in support systems for recovering alcoholics like counseling and education help as well.
  • Alcoholics have 24/7 access to treatment. Most disulfiram facilities have psychotherapists and medical staff always available. Usually, recovering alcoholics get individual therapy once a day as well as opportunities to participate in group therapy with their peers. Therapists are also available for emergencies.
  • Recovering alcoholics are in a safe environment away from the temptation to relapse. This can be extraordinarily helpful for a patient seeking recovery.

Disulfiram can be prescribed to patients after detox from alcohol once they’re stabilized and in addiction treatment but are also concerned about relapsing. The drug works by eliciting a few adverse effects when someone with alcoholism drinks an alcoholic beverage. The effects include:

  • Sweating
  • Nausea
  • Hyperventilating
  • Flushing of the face
  • Heart palpitations
  • Vertigo or spinning and dizziness

Once the person suffering from substance abuse experiences these negative side effects, they’ll likely not want to drink again while on medication. A few more advantages of using the drug in treatment include:

  • Discourages drinking behavior because of uncomfortable physiological effects
  • Can be an effective tool for patients who are motivated to quit
  • Can be used to help addicts resist the temptation to relapse in stressful situations

There are some disadvantages of using the drug during treatment such as:

  • Does Not decrease cravings
  • Does Not normalize brain function
  • Might not be that helpful if the person is not motivated to quit
  • Can possibly have strong negative side effects if the patient drinks an excessive amount of alcohol while on the drug including damage to peripheral nerves, damage to the liver, delirium, and psychosis.
  • Patients with liver damage should not take Disulfiram.

The length of the program usually depends on the patient and their doctor. In general, inpatient disulfiram rehab usually lasts anywhere between 30 to 90 days. Many people start with the 30-day program but go on to stay longer if needed.

The amount of time you need in an inpatient disulfiram program depends heavily on how well you do in other treatment programs for alcoholism. Disulfiram doesn’t get rid of cravings, so if you leave too early there may be a high chance of relapse without continued use of the drug.

In some cases, rehabilitation with the drug may take longer than 90 days. Court-ordered treatment programs sometimes can last for up to a year. Some people choose to voluntarily stay though because they believe they need the extra help.

Disulfiram treatment for alcoholism has multiple stages. First, you will speak to a counselor who will find out your needs and determine if you have any co-existing mental or physical health issues that are influencing your dependence. They will also be the ones to determine the best course of action in terms of treatment.

Next, you will likely need to detoxify your body from alcohol. This involves slowly withdrawing from the substance under close, professional supervision so they can minimize the uncomfortable side effects. Most doctors will insist on detoxification before beginning the disulfiram treatment so you can have the best chance of maintaining abstinence while in treatment.

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