Which medications are prescribed for addiction treatment?

It might sound strange, even counterintuitive, that you would need a drug in order to get off of another drug. However, years of research has demonstrated that addiction is a chronic disease, and, just like many other diseases and disorders, can be effectively treated with a combination of behavioral and medicated therapies. The different kinds of medications are considered based on the needs of the individual patient. It takes more than just willpower and psychological treatment to break a drug addiction — drugs affect the chemistry of the brain itself, and therefore those chemical changes in the brain need to be addressed with their own special methods.

Addiction treatment not only involves addressing the problem of the patient through behavioral methods, but also prescribes medications to help treat the addiction. Medication-assisted treatment (MAT) is combined with psychosocial support systems or other behavioral therapies in order to bring the chances of relapse outside of a treatment center and the fullest extent of recovery to the best level possible.

Addiction is a chronic disease that affects the chemistry of the brain — therefore, it is often necessary for the addiction treatment center to administer medications to counter and rectify the chemical damage to the brain caused by substance abuse. Medications are used to restore the balance of brain functions that was interfered with by the toxins of drugs, alcohol, and other substances.

Even though Medication-assisted treatment is the standard for treating drug addictions, many fewer people benefit from it than should. Not everyone with drug use disorders will seek out treatment, and of those who do receive treatment, they won’t always receive medications. According to the most recent studies, of all those who are admitted into addiction treatment centers, only 18 percent receive treatment programs that include medicated treatment for addiction. This is due to the limited capacity of programs that are allowed to dispense medicated treatments and the regulatory limits set in place for doctors that can prescribe medications for treatment.

How are medications used to treat addiction?

Medical professionals at the addiction treatment center will use prescription medication in multiple phases of treatment: alleviating withdrawal symptoms, preventing relapse as well as treating co-occurring conditions.

Withdrawal

Medications are used during the detoxification stage by keeping the symptoms of withdrawal under control and making it easier for the patient to endure this rather uncomfortable part of the treatment. Most people can barely make it through one day of withdrawal without the assistance of medications. Mind you; detoxification is not itself actual treatment — if an addict only goes through detoxification without following up with further treatment, in most cases the patient will return to their substance addiction. According to a study by SAMHSA, medications are used in almost 80 percent of detoxifications.

Relapse Prevention

Medications are also used to assist the patient in resuming a normal life free of substance abuse. These medications are meant to allow the brain to function without the need or craving for the substance. Medications can be used to treat addictions including opioids (heroin and prescription pain relievers), tobacco (nicotine), and alcohol addiction. Research is also being performed to one-day use medication to treat addictions to other substances, including cocaine, methamphetamine, and marijuana. All medications are meant to decrease drug-seeking criminal behavior in patients and to make patients more receptive to behavioral therapy.

 

Opioids

Medications to treat opioid addiction include methadone (Dolophine®, Methadose®), buprenorphine (Suboxone®, Subutex®, Probuphine®), and naltrexone (Vivitrol®). Methadone and buprenorphine affect the same areas of the brain that are targeted by heroin and other opioids, which decreases the withdrawal symptoms as well as cravings. Naltrexone neutralizes the effects of opioids at the neural receptor sites and are used once the patient has finished with detoxification.

Tobacco

There are several methods of replacing nicotine, including spray, gum, patches and lozenges, which are available over-the-counter. Bupropion (Zyban®) and varenicline (Chantix®) can be prescribed, and while each works differently than the other, both have the same effect of decreasing nicotine dependency in the brain and reducing the chances of relapse. These medications’ effects are maximized when coupled with behavioral therapy.

Alcohol

There are three medications approved by the Food and Drug Administration (FDA):

Naltrexone

This blocks the neural receptors that receive the reward messages that affect the brain when consuming alcohol, thus diminishing the euphoria from drinking alcohol and reducing the craving for it. In some patients, it is extremely effective at reducing relapses into heaving drinking, though there are differences in effect that are based on genetics.

Acamprosate (Campral®)

This can reduce the symptoms of alcohol withdrawal, which include insomnia, anxiety, restlessness and dysphoria. It is possible that this medication is more effective in patients who have had a stronger addiction to alcohol.

Disulfiram (Antabuse®)

This influences and reduces the metabolic breakdown of alcohol in the body. When acetaldehyde accumulates in the body, it leads to negative symptoms — including flushed and warm face, nausea, and irregular heartbeat — if the patient consumes alcohol. This medication is effective in patients who are strongly motivated to quit drinking.

Will the medication used to treat a drug addiction just replace it with another one?

There is a prevailing belief that medications with an antagonist activity against a drug or substance, such as methadone or buprenorphine, will only end up replacing your addiction to a drug with another addiction to the prescribed treatment medication. Fortunately, it’s not true. Drug disorders in the brain negatively affect the processes in the brain that control reward, decision-making, memory, learning, and other functions, throwing all of these activities off balance. Medications prescribed for addiction treatment don’t replace one chemical dependency with another — the medications act to restore the balance in your brain that was disrupted by opioids or other drugs, allowing the patient to be able to act and think in a normal state.