Medications are the go-to solutions for all sorts of medical problems. People with strep throat, for example, just can’t get better without a boost of antibiotics.
Similarly, people with diabetes may not be able to keep their illness under control without medications. There are all sorts of pharmacies out there made to help people with serious conditions only medications can heal. Sometimes, those pharmacies dispense medications made to help curb or control addictions.
Typically, the medications are used in concert with therapy programs, so they augment (not replace) the help a therapist can provide. For people with serious addictions, medications can mean the difference between continued drug use and ongoing addiction. The help they provide might very well be crucial.
These are just a few of the medications available in the fight against addiction.
Heroin users and prescription drug abusers may benefit from treatment with buprenorphine, as it works on the same receptors that are targeted by opiate drugs.
In simple terms, a buprenorphine dose creates a chemical tie with brain cells normally attuned to opiates. That tie, says the Substance Abuse and Mental Health Services Administration, keeps a person with an opiate addiction from experiencing uncomfortable drug withdrawal symptoms. When the medication is working, a drug user’s mind is fooled into believing that opiates are present. The lack of withdrawal symptoms can keep that person focused on therapies that lead to long-term sobriety.
While buprenorphine can be an effective medication for people in the early stages of recovery, the first dose must be taken when the person is already in drug withdrawal, says the National Alliance of Advocates for Buprenorphine Treatment. If people aren’t in withdrawal when that first dose is given, they might be pushed into violent withdrawal with the first dose, and that sudden illness might make them less likely to take buprenorphine again. By using the dose only when they’re in withdrawal, they’ll feel relief with the dose, and that will help prompt them to take the drug as directed.
During early withdrawal, very high doses of buprenorphine might be required to stave off withdrawal symptoms, but in time, therapists can provide smaller and smaller doses as the brain heals. Some people stop taking buprenorphine altogether once they’re feeling healthy and their therapy has given them the tools they’ll need to stay sober. Others keep taking buprenorphine indefinitely, as they have such brain damage from drugs that they feel withdrawal symptoms when the drug is gone.
While buprenorphine can be helpful, there are some people who choose to abuse this drug. They can take very high doses of the drug, and at that point, they can feel a sense of euphoria. In a study of the issue cited in the Journal of Neurosciences in Rural Practice, researchers found that diversion of buprenorphine happens in about 20 percent of people who get the drug. That is an unacceptably high rate, some researchers say, and that prompted pharmaceutical companies to come up with solutions.
Suboxone came out of these conversations. This medication contains buprenorphine tempered by naloxone. The buprenorphine can ease drug withdrawal, but the naloxone works like a damper on abuse. At very high doses, naloxone renders drugs useless. That means people who hope to get high on Suboxone may feel nothing at all.
The U.S. Food and Drug Administration approved Suboxone for use in 2002, after looking at research conducted on more than 2,000 people. The FDA found that the drug was safe, but it was associated with some unpleasant side effects, including:
- Mood changes
Those symptoms could be so unpleasant that they prompt people to stop taking the drug, and they need to take the medication daily. Skipping doses leaves a window wide open for abuse, and many drug users know that. If they skip a dose, just once, they can get high, and the temptation might be too overwhelming to ignore.
Since it’s all too easy to skip a Suboxone dose and get high, manufacturers went back to work to develop new therapies that are harder to skip. One such solution is an extended-release form of naltrexone. This medication also helps opiate-addicted people to overcome feelings of withdrawal and illness, but it’s provided in a shot format. Once per week, people head to the doctor for an injection.
In an overview of this medication option, provided by the Partnership for Drug-Free Kids, a practitioner reports that his patients felt a buzz of a high when they held anti-abuse drugs in their hands, as they knew skipping a dose meant getting high. The shots are better, this researcher says, because they don’t force people to choose sobriety every single day. They just need to keep one appointment per week instead. For someone new to sobriety with poor sobriety skills, this could be vital.
Naltrexone is technically designed to help people with opiate addictions. It’s also been used to treat people with addictions to alcohol, and according to research in the Journal of Clinical Psychopharmacology, it’s quite effective in helping people who drink excessively. In this review, 19 in 27 studies measured reductions in heavy drinking, and researchers found that naltrexone helped more than a placebo drug did. This seems to suggest that people with deep alcohol addictions could benefit from treatment with this particular medication.
This is one of the oldest medications available in the fight against addiction, and it’s primarily used to help people with opiate addictions. It binds to the receptors that light up when an opiate is available, and it helps people to avoid and/or ignore cravings for the drugs they’re accustomed to. Methadone has been in use for decades, and in theory, it may have helped hundreds of thousands of people to overcome an addiction during that time period.
Methadone is also a very strong medication. People who take it for addiction may not feel altered or high with their methadone doses, but if they give their drugs to people who don’t have a high opiate tolerance or they combine their methadone with another drug, euphoria can take hold. Sometimes, high doses come with side effects that are just short of tragic.
For example, a news report from Bloomberg recounts the case of a person who gave some of her methadone to a friend. That friend then overdosed, and the person with the addiction was arrested for dealing drugs. It’s a serious problem, and it’s something that could be handled. For example, people with methadone doses could enroll in residential programs, so they won’t have access to others who want their methadone. That could keep them from giving the drug away.
If disulfiram causes reactions that are just a touch too severe, there is another option. Acamprosate is also made for people with addictions to alcohol, and it doesn’t cause profound illness on that first sip. What it does do, according to American Family Physician, is make sips of alcohol less rewarding. All the chemical reactions that are typically triggered by alcohol are muted when acamprosate is on board. That could keep people from drinking, as the alcohol just doesn’t seem to bring the pleasure it once did.
This drug is also quite effective in the fight against an opiate addiction. It has the ability to bind tightly to the receptors used by opiates, so drugs like heroin and prescription painkillers won’t pull a big punch for people who take those drugs. It can also soften symptoms of drug withdrawal, so people will feel well enough to focus on therapies.
Since some people with opiate addictions need to take methadone for years due to the damage their brain cells have endured, they’ll need to make sure they can comply with the therapy day in and day out. If they can’t, another medication might be a better choice.
Most of the medications mentioned so far provide people with a sense of calm during drug recovery, so they can get through to sobriety without feeling ill. There’s one medication that does something just a little bit different, and it’s made for people with addictions to alcohol.
This medication, disulfiram, causes a severe reaction when people are exposed to alcohol. According to the U.S. National Library of Medicine, a person taking disulfiram can experience these symptoms about 10 minutes after drinking alcohol:
Those symptoms get more severe with higher alcohol doses, and the drug can cause these reactions for up to two weeks after the last dose.
People with alcohol addictions may anticipate relaxation and bliss when they drink, and that association between drink and pleasure can keep them drinking much more than they should. Disulfiram works by breaking that link between pleasure and drink.
People who take this drug may find that it’s profoundly effective. As some suggest, even smelling alcohol can trigger a wave of nausea. For those who want to make sure that they simply can’t relapse, this drug may be the answer. Again, it only works as long as people take it. People who are certain they’ll skip doses might best try another route to recovery.
Which Option Is Best?
Clearly, there are a lot of different options available for people who want to stop abusing drugs. Medications can help by soothing withdrawal, by quelling cravings, or by making drugs a little unpleasant. All of these attributes could be very helpful for people who need to get sober and stay sober, and who just don’t have the skills to do that independently. The drugs help to buffer, mute and soothe, and that help can provide people with the space they need to work on their sobriety skills, so they can get sober for good.
Not everyone needs medications, and not all people need the same dose of medications for the same period of time. Instead, treatment teams tend to customize their plans to the specific needs of the people in their care. When you arrive at the facility for treatment, your team will ask you about the drugs you’ve taken and the doses of those drugs you’re accustomed to. Then, the team can help to pull together a plan that includes the right drug at the right pace for you. Over time, you’ll adjust that plan as your treatment progresses. You could get just the help you need.
If you’d like to find out more about how treatment with medications really works, please contact us at Michael’s House. We can outline our treatment program, and if you’re ready, we can even start your enrollment process. Just call us to find out more.