Navigation: What is Medication-Assisted Treatment?, Most Effective Medicines for Treating Drug Addiction, Addiction Treatment Options, Conclusion
Addiction is a chronic and relapsing disorder that affects millions of people around the world. It can be caused by a variety of factors, including genetics, environment, and mental health issues.
Substance use disorder (SUD) has previously been compared to the likes of hypertension and diabetes type II due to its strong genetic component.
Due to the neurobiological changes in the brain, the risk for relapse is heightened. However, medications may play a significant role in preventing relapse. This is why certain medications are used in the treatment of various addictions. [1]
Medications may reduce cravings, help manage withdrawal symptoms, normalize brain function, and combat co-occurring disorders. There is no one-size-fits-all solution for treating addiction. However, there are several effective medicines and treatment options available.
In this article, we will explore the most effective medications for drug addiction treatment. We will also talk about how medications can help those who are on their journey to recovery.
What is Medication-Assisted Treatment?
Medication-assisted treatment or MAT is an approach used to treat substance use disorders like drug addiction. However, it is most commonly used for opioid addiction and alcohol addiction treatment.
MAT combines medications with behavioral therapy and counseling to address addiction. This treatment primarily involves the use of FDA-approved medications in conjunction with therapy and support services.
For opioid addiction, medications like methadone, buprenorphine, and naltrexone are used. These are the three FDA-approved medications for the treatment of opioid use disorder (OUD). These medications work by reducing withdrawal symptoms and cravings. They can also block the euphoric effects of opioids, allowing patients to focus on their recovery.
All three of these medications have been demonstrated to be safe and effective. They are especially great when used in combination with behavioral therapy and psychosocial support. [2]
Here are some of the medications approved for the treatment of opioid dependence:
- Brixadi (buprenorphine) injection for subcutaneous use
- Bunavail (buprenorphine and naloxone) buccal film
- Cassipa (buprenorphine and naloxone) sublingual film
- Probuphine (buprenorphine) implant for subdermal administration
- Sublocade (buprenorphine extended‐release) injection for subcutaneous use
- Suboxone (buprenorphine and naloxone) sublingual film for sublingual or buccal use, or sublingual tablet.
- Subutex (buprenorphine) sublingual tablet
- Zubsolv (buprenorphine and naloxone) sublingual tablets
- Dolophine (methadone hydrochloride) tablets
- Methadose (methadone hydrochloride) oral concentrate
- Vivitrol (naltrexone for extended-release injectable suspension) intramuscular
As for alcohol addiction, medications like naltrexone, Acamprosate, and disulfiram may be used. Just like with opioid addiction treatment, their purpose is to help reduce cravings and manage withdrawal symptoms. Some medications even create adverse reactions when alcohol is consumed. This discourages alcohol abuse.
Helping more people secure medication-assisted treatment requires us to break the stigma that is commonly associated with drug addiction and rehab.
Addiction is not a sign of weakness nor is it a moral failure. Breaking the stigma means helping people understand that addiction is a medical condition that requires proper treatment. It is also important to break the stigma associated with the medications used in MAT. [2]
Remember that MAT is best used as a comprehensive treatment plan that includes counseling, therapy, support groups, and other behavioral interventions. It’s designed to help recovering individuals manage their addiction. By reducing their risk of relapse, they can achieve long-term sobriety.
Most Effective Medicines for Treating Drug Addiction
The treatment of drug addiction involves a multifaceted approach that may include medications, therapy, and support programs. That said, many patients may receive certain medications throughout their addiction treatment journey.
Because there isn’t a one-size-fits-all solution for drug addiction, this applies to medications as well. Medications as well as their dosages and method of administration may vary from one patient to another. Your healthcare provider will give you the right medication for your specific condition and needs.
Generally speaking, a lot of medications are used to alleviate the withdrawal symptoms experienced by patients with severe drug dependence. Medications may help make them feel more comfortable during the treatment process. This is especially important during the early stages because this is when withdrawal symptoms may reach their peak. [1]
By reducing the impact of withdrawal, patients are able to focus on staying abstinent. This protects them from the vicious cycle of addiction.
Other medications are used to keep cravings under control. They may even discourage the use of certain drugs, making them less appealing to the user. It helps keep them on the right track as they battle against addiction.
Here are some of the best medicines used in medication-assisted treatment.
Methadone
Methadone is a synthetic opioid medication primarily used in the treatment of opioid addiction. It is a long-acting opioid agonist, meaning it activates the same receptors in the brain that opioids like heroin or prescription painkillers do, but in a milder, more controlled way.
During MAT, methadone is administered orally, usually in the form of a liquid. The medication then helps reduce the person’s withdrawal symptoms and cravings. This is especially important for those who are dependent on opioids.
Methadone is used as a substitution therapy, allowing patients to stabilize their lives without experiencing the extreme highs and lows associated with opioid use.
One of the significant benefits of methadone in MAT is its long duration of action. This helps in preventing withdrawal symptoms and cravings throughout the day. With this, recovering individuals are able to function normally without seeking out other opioids.
That said, methadone treatment should be closely monitored and administered under strict medical supervision due to its potential for abuse and dependence. After a period of stability, patients may be allowed to take methadone at home between program visits. This depends on their consistency and progress when it comes to taking the right dosages. [3]
Healthcare providers will also work with the patient to gradually reduce their methadone intake to prevent withdrawal after treatment.
The National Institute on Drug Abuse (NIDA) says that the length of methadone treatment should be a minimum of 12 months.
Buprenorphine
Buprenorphine is a medication primarily used in the treatment of opioid addiction. It’s classified as a partial opioid agonist, meaning it binds to the same receptors in the brain that opioids do but produces weaker effects. This helps reduce cravings and withdrawal symptoms without causing the same level of euphoria or sedation associated with full opioid agonists like heroin or oxycodone.
Buprenorphine is often prescribed in MAT to help individuals manage their addiction. It can be administered in different forms, including sublingual tablets, buccal films, or implants placed under the skin. With buprenorphine, it is easier for recovering individuals to abstain from illicit drug use.
Not only does it help with cravings, it also helps manage and alleviate the uncomfortable withdrawal symptoms that often occur when someone stops using opioids. Due to its partial agonist properties, buprenorphine can block the effects of other opioids, reducing the likelihood of relapse.
Much like methadone, buprenorphine treatment is typically done as part of a comprehensive approach. In combination with therapy, it can be highly effective in helping patients recover from opioid addiction by stabilizing their condition and reducing the risk of relapse.
To begin treatment, a person with an opioid use disorder has to abstain from opioids for at least 12 to 24 hours. This puts them in the early stages of opioid withdrawal. Taking buprenorphine when you already have opioids in your bloodstream may cause acute withdrawal. [4]
Once a patient has already discontinued or reduced their opioid intake, the dose of buprenorphine may be adjusted. Since this medication is a long-acting agent, it may be possible to switch from every day to alternate-day dosing once the patient has stabilized.
Treatment duration may vary from one patient to another. In some cases, buprenorphine treatment may even go on indefinitely. [4]
Naltrexone
Naltrexone is a medication primarily used in the treatment of alcohol and opioid dependence. It belongs to a class of drugs known as opioid antagonists, which means it can also block the effects of opioids in the brain.
In medication-assisted treatment, naltrexone is used to help patients manage cravings and prevent relapse. It does this by blocking the euphoric effects of opioids or alcohol.
Naltrexone can bind to opioid receptors in the brain. This effectively prevents opioids or alcohol from binding to these same receptors. In the process, it keeps the patient from experiencing the usual high that keep them addicted. Used properly, naltrexone can help reduce the desire to use these substances.
There are different forms of naltrexone available for treatment, including an oral tablet taken daily or a monthly extended-release injection. The choice of formulation often depends on the individual’s preferences and adherence to the treatment plan.
This anti-craving medication is also perfect for the long-term treatment of alcohol dependence. It can block the rewarding aspects of alcohol.
This means when naltrexone is present in the brain, alcohol cannot stimulate the release of dopamine. This reduces or negates alcohol’s intoxicating effects. [1]
Again, naltrexone should be used as part of a comprehensive treatment program that includes counseling, therapy, and support to address the psychological and behavioral aspects of addiction.
Acamprosate
Acamprosate is a medication used in the treatment of alcohol dependence. Unlike some other medications used in MAT, such as naltrexone or disulfiram, Acamprosate doesn’t directly interfere with the effects of alcohol or cause unpleasant reactions when alcohol is consumed.
Instead, Acamprosate is believed to help maintain abstinence by reducing cravings for alcohol. It works by affecting certain neurotransmitters in the brain, potentially stabilizing the chemical balance disrupted by long-term alcohol use. This can help those who have stopped drinking alcohol to remain abstinent as part of their overall recovery program.
This medication was approved by the FDA in 2004 as a medication for relapse prevention for those with alcohol dependence. Acamprosate affects different neurotransmitters in the brain and decreases the effects of withdrawal. [1]
Acamprosate works best when used in conjunction with counseling, support groups, and other behavioral therapies aimed at addressing the psychological and social aspects of alcohol dependence. This comprehensive approach increases the chances of successful recovery from alcohol addiction.
Disulfiram
Just like Acamprosate, disulfiram is a medication primarily used to support individuals with alcohol use disorder (AUD).
This medication works by creating an unpleasant reaction in the body when alcohol is consumed, discouraging people from drinking.
When someone on disulfiram ingests alcohol, it interferes with the breakdown of alcohol in the body, causing a buildup of a toxic substance called acetaldehyde. This buildup leads to symptoms like nausea, vomiting, flushing, palpitations, and headache.
Also known by its brand name Antabuse, disulfiram is the first FDA-approved medication for alcohol dependence. In fact, it has been available for over 50 years. [1]
Disulfiram is used in MAT to reinforce abstinence. The idea is that the negative consequences of consuming alcohol while taking disulfiram will deter people from drinking. However, it’s crucial for patients to be fully informed about the potential effects and to remain committed to abstinence because the reaction can be severe and uncomfortable.
It’s important to note that disulfiram should only be used under the supervision of a healthcare professional due to its potential side effects and interactions with other medications.
Additionally, it’s not the only option in MAT for alcohol dependence—other medications like naltrexone and Acamprosate are also used, each with its own mechanisms of action and considerations for use.
Addiction Treatment Options
Aside from MAT, it is important to discuss that there are many other treatment options available for drug addiction. These include counseling services, inpatient care, outpatient care, and detoxification.
Patients will likely go through a combination of these treatments throughout their recovery journey. Each rehab facility may offer different programs. But the best rehab centers will offer a personalized treatment plan that is based on the patient’s specific needs and circumstances.
Depending on the severity of the addiction, you or a loved one may require either 1 level of care or multiple levels to achieve long term recovery. The following are the types of rehab where therapy programs will be utilized:
Detoxification
Medical detoxification, often referred to as medical detox, is a process used to manage withdrawal symptoms when someone stops using addictive substances such as alcohol, opioids, benzodiazepines, or other drugs. It’s a crucial initial step in the treatment of substance use disorders.
Medical professionals evaluate the patient’s substance use history, physical health, and mental health to determine the appropriate detox approach.
During detox, the person stops using the substance, and the body begins to eliminate it. Withdrawal symptoms can be severe and sometimes life-threatening during this process. However, healthcare providers may use medications to alleviate withdrawal symptoms and manage any complications that may arise.
As we mentioned earlier, medications like methadone or buprenorphine may be used in opioid detox to help manage cravings and reduce withdrawal symptoms.
Throughout the process, the patient undergoing medical detox will be closely monitored by healthcare professionals.
They may adjust the treatment as needed to ensure the patient’s safety and comfort. Eventually, their body will adjust to the drug-free lifestyle. Afterwards, they may need an inpatient program. [5]
Detox alone is not usually sufficient for long-term recovery. Once detox is completed, individuals are often encouraged to continue their treatment through therapy, counseling, support groups, or inpatient/outpatient rehabilitation programs to address the underlying causes of addiction and learn coping strategies to prevent relapse.
Medical detox is typically recommended for those with moderate to severe addiction, as well as those who are addicted to substances that cause dangerous withdrawal symptoms. It’s essential to undergo detoxification under medical supervision to ensure safety and increase the likelihood of a successful recovery.
Behavioral Therapy and Counseling Services
Behavioral therapy and counseling for addiction involve various approaches aimed at modifying harmful behaviors, addressing underlying issues, and fostering positive changes in patients struggling with addiction.
These therapies are often tailored to the specific needs of the person and can include techniques such as cognitive-behavioral therapy (CBT), motivational interviewing, and contingency management.
CBT, for instance, helps people identify and change thought patterns and behaviors associated with substance abuse. It focuses on understanding triggers, managing cravings, and developing coping strategies to prevent relapse.
Motivational interviewing is a collaborative approach that enhances motivation to change by exploring and resolving ambivalence. It helps patients find their internal motivations for quitting addictive behaviors.
Contingency management utilizes positive reinforcement by rewarding desired behaviors such as abstaining from substance use with incentives or rewards.
Counseling sessions often provide a supportive environment where individuals can explore the root causes of their addiction, address co-occurring mental health issues, and develop healthier coping mechanisms. The combination of these therapeutic approaches can be highly effective in helping individuals overcome addiction and maintain long-term recovery.
Inpatient Care
Inpatient treatment, often referred to as residential rehab, is a structured and immersive program where addicted individuals live within a treatment facility for a specified period.
This type of treatment offers a highly supportive and focused environment where there are no triggers, stressors, temptations, and distractions. Inpatient rehab programs typically range from a few weeks to several months, depending on the severity of addiction. [5]
It encompasses various therapies, including individual counseling, group therapy, behavioral therapies, and sometimes medical interventions such as medication-assisted treatment.
Inpatient treatment provides a comprehensive approach, addressing not only the addiction itself but also the underlying psychological, emotional, and social factors contributing to substance abuse. Additionally, these programs often include education on relapse prevention, coping strategies, and life skills training to equip individuals for sustained recovery post-treatment.
Outpatient Care
Outpatient care is a less intensive treatment option that allows patients to live at home while attending therapy and other treatment sessions. Outpatient care provides flexibility for individuals to keep up with their usual responsibilities while still receiving the care that they need for their addiction.
Outpatient treatment for drug addiction involves therapy, counseling, and support services that are conducted without requiring the patient to reside in a facility. This type of treatment allows recovering individuals to receive care while continuing with their daily responsibilities like work, school, or family commitments.
This approach involves frequent visits to the treatment facility. It may be done in a treatment center, hospital-affiliated clinic, community health clinic, or another facility. [5]
Outpatient programs vary in intensity and duration, offering flexibility in scheduling therapy sessions, group meetings, and medical check-ins. These programs often employ various therapeutic approaches, including cognitive-behavioral therapy (CBT), motivational interviewing, and support groups like Narcotics Anonymous (NA) or Alcoholics Anonymous (AA).
Outpatient treatment may also include medication-assisted treatment for patients who need it. The structure of outpatient programs aims to provide a supportive environment while empowering individuals to apply learned coping mechanisms and skills in their daily lives.
This option is best for those with a strong support system at home. However, because it is less intensive than residential rehab, it is only recommended for those who have mild to moderate cases of addiction.
Conclusion
In conclusion, the most effective medicine for treating addiction is a combination of counseling services and medication-assisted treatment. However, it is important to note that what works for one person may not necessarily work for another. Patients must work closely with their healthcare provider to determine the best treatment plan for their specific needs. With the right treatment and support, recovery from addiction is possible.
If you or a loved one is struggling with addiction, do not hesitate to seek help and explore the various treatment options available. Look for a rehab near you today.
Sources:
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767185/
[2]: https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
[5]: https://americanaddictioncenters.org/therapy-treatment
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