Addiction is a complex brain disease. There is no single way to treat this disorder. Even though traditional 12-Steps programs work, they, however, do not work for everyone. As such, it is essential to consider other modalities of treatment. For example, the use of medications.
Withdrawal symptoms and cravings can make staying in recovery difficult. Some people who are very determined and motivated may still relapse. This struggle is usually due to the severity of the symptoms they experience. Thus, other ways of helping the withdrawal process and dealing with cravings can go a long way.
Medication-Assisted Treatment (MAT) is an evidence-based treatment approach that involves the use of medications with counseling and behavioral therapies to treat substance use disorders.
MAT helps treat addiction to opioids, alcohol, and nicotine. The goal of Medication-Assisted Treatment is to provide a “whole-patient” approach to treatment.
Let us talk about some helpful addiction medications.
Buprenorphine helps treat opioid use disorder. It was approved by the Food and Drug Administration (FDA) in 2002. Healthcare professionals in an outpatient clinic prescribe this medication. Thus, patients can take the medication home. Most clinics will require you to visit once a month to get a new script.
This flexibility increases access to treatment for people struggling with opioid use disorder. Healthcare professionals must get an X-license to prescribe buprenorphine.
It is essential to know that this medication is part of a comprehensive treatment plan. Counseling and social support are crucial components of successful treatment with buprenorphine.
This medication comes in different preparations:
Most of the tablets and films are given once or twice a day. Sublocade injection is administered under the skin (subcutaneously) once a month. Probuphine is a skin implant that lasts for six months.
Buprenorphine acts like opioids. It is classified as a partial opioid agonist. Thus, it works in the same area as opioids, but the effects are weaker.
The use of buprenorphine is NOT replacing one addiction with another. This medication can lower the potential for misuse of opioids. It also decreases the effects of physical dependence on opioids, such as withdrawals and cravings. Furthermore, it increases safety in cases of overdose.
The effects of buprenorphine increase with each dose until it gets to moderate doses. At this point, it levels out. Thus, further increases do not yield any effects. This “ceiling effect” lowers the risk of misuse, dependence, and side effects.
Because buprenorphine acts in the same part of the brain as opioids, the side effects are similar. They include:
So, why is naloxone a component of some buprenorphine products? The reason for this is to stop people from misusing this medication. Suboxone, Zubsolv, and Bunavail contain naloxone.
Naloxone is an antagonist (or blocker) at opioid receptors. It has no effect when products containing it are taken as prescribed. However, if someone with opioid dependence injects a product containing naloxone, severe withdrawal symptoms will occur. Thus, this combination decreases the likelihood of misuse and diversion.
Methadone for opioid addiction is only administered in federally regulated clinics. The goal of methadone is to sustain long-term success. As such, it helps people live healthier and more fulfilling lives.
Methadone acts in the same region of the brain as opioids. These are called opioid receptors. Thus, methadone helps to decrease opioid withdrawal and cravings.
The prescription of this medication must be part of a comprehensive treatment plan. Counseling and social support are essential to the success with methadone.
Methadone prescription comes with tight regulations. It is available only via SAMHSA-certified opioid treatment programs. As a result, you will need to attend a clinic every day to get this medication.
How long do you need to be on methadone? The duration is variable. According to the National Institute on Drug Abuse (NIDA), the length of methadone treatment should be a minimum of 12 months. Many people take methadone for several years.
Methadone is safe when taken as prescribed. It has a very long half-life. Because of this, it stays in the body long after the effects wear off.
Naltrexone helps treat addiction to opioids and alcohol. It comes as a pill and also as an injection (Vivitrol). Naltrexone tablets are taken daily. Vivitrol injections are, however, given once a month.
One advantage of this medication is that it is readily available. Any healthcare provider licensed to prescribe can write scripts for naltrexone. On the contrary, buprenorphine and methadone have specific requirements.
Abstaining from any opioids at least 7-10 days before taking naltrexone is necessary. The goal is to avoid precipitated withdrawals. It is, therefore, essential to get a proper timeline before treatment.
Naltrexone acts on the same region of the brain as opioids. It, however, blocks these areas and stops opioids from working. As a result, it prevents the ability to get high from using heroin, morphine, and other opioids.
On another positive note, naltrexone is not abused as it does not lead to a “high.” It is, however, essential to note that stopping naltrexone can increase sensitivity to opioids. Thus, doses of opioids that were previously tolerated can lead to an overdose.
Again, as with other MAT medications, naltrexone is usually part of a comprehensive treatment plan. Counseling and social support are vital components of success.
You must wait at least 7-10 days after your last dose of opioids before you take naltrexone. Otherwise, precipitated withdrawals can occur.
Naloxone helps reverse the effects of an opioid overdose when given immediately. It acts on the same region of the brain as opioids. Naloxone, however, blocks these opioid receptors. As such, it is referred to as an opioid antagonist.
Naloxone can be given in the following ways:
Naloxone is readily available from healthcare providers. In some states, pharmacists can dispense naloxone without a prescription. Hence, friends, family, and others can administer this drug in emergencies. The auto-injector (Evzio) and nasal spray (Narcan) versions of naloxone are easy to use.
The use of medications to treat addiction increases your chances of recovery. Medications must be used in combination with counseling and support. A comprehensive approach to treatment is crucial for sobriety.
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The entire content of AddictionBlueprint, including content on drugs and alcohol, medications, therapies, facilities, spotlights, recommendations, and other features is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. This does not constitute a physician-patient relationship. Please seek the advice of your physician or other qualified health providers regarding your addiction, mental and medical issues.
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