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Medical Treatment

Addiction Treatment Medications

Most people cannot overcome the disease of addiction alone. They need medical and behavioral assistance to return to a normal, healthy life. One important aspect of this help is the use of addiction treatment medications.

Common Addiction Treatment Medications

Addiction treatment medications are increasingly popular in the rehab community, and their use is increasingly accepted. Although there is some debate as to the benefits of prescribing individuals who suffer from substance addiction additional medications, there is a growing body of evidence that suggests that not only are these medications effective, but critical in many circumstances.

Clonidine

Clonidine is a prescription medication that is commonly used to treat high blood pressure. Other uses for the drug include treating conditions such as attention deficit hyperactivity disorder (ADHD), Tourette’s syndrome in children, anxiety, and addiction-related withdrawal. People experiencing alcohol and/or narcotic withdrawal often find their symptoms minimized when managed by Clonidine, particularly in those that are detoxing from Opioids. However, individuals with an extremely high tolerance to opioids probably won’t derive as much benefit from Clonidine than individuals with a lower tolerance. Clonidine is also used to reduce symptoms of Cocaine, Benzodiazepine, and Meth withdrawal.

Withdrawal symptoms that may be alleviated by Clonidine include:

  • Agitation
  • Anger
  • Cravings
  • Anxiety
  • Cognitive Deficits
  • Depression
  • Facial Flushing
  • Diarrhea
  • Fever
  • Headache/Migraine
  • Hot Flashes
  • Insomnia
  • Irritability
  • Mood-swings
  • Pain
  • Restlessness
  • Restless Leg Syndrome
  • Sleep disturbances
  • Muscle Spasms
  • Tension
  • Tremors
  • Twitching

Clonidine is an antihypertensive that works by slowing down the heart rate and blocking chemicals in the brain that trigger sympathetic nervous system activity. This reduces many of the debilitating symptoms of withdrawal experienced during detoxification, such as: sweating, hot flashes, headaches, and insomnia. Clonidine not only assists in making detox an easier process to get through, it can also even speed it up.

Although the drug presents multiple benefits, there is a risk for abuse in long-term users. According to the Journal of Addiction Medicine, Clonidine is often abused with opioid narcotics such as Methadone, Codeine, and Heroin. This is generally done to decrease the amount of the other drug they are using, so that they can use less of the other drug and still achieve their desired effect. Others use Clonidine to cause the action of an opioid to last longer, which is dangerous as it prolongs use and can lead to an accidental overdose.

Methadone

Methadone is a synthetic opioid medication that is commonly prescribed to treat moderate to severe pain and opioid addiction, particularly in those suffering from Heroin addiction. Programs that use methadone to help combat opioid addiction are known as Methadone maintenance programs. The drug comes in either a tablet, liquid, or powder form and is available only by prescription.

Methadone works by blocking certain receptors in the brain that are affected by opioids like Heroin or Oxycodone, which alters how the brain and nervous system respond to pain. This allows users to have a more gradual detox process while reducing the severity of withdrawal symptoms, such as cravings. Methadone also blocks euphoric effects of opioids.

Methadone is also used as an Opioid replacement therapy (ORT). ORT is a medical treatment which involves replacing an illegal opioid, such as heroin, with a longer acting, less euphoric opioid, such as Methadone or Buprenorphine. Medical supervision is required when using ORT programs to provide monitoring, including drug screens and regularly scheduled follow-up appointments. Furthermore, these programs also recommend engagement in counseling, such as cognitive behavioral therapy (CBT), to learn healthy coping strategies and relapse prevention skills.

Methadone may be habit forming, and people that begin using the medication to overcome addiction are at a higher risk of abuse because they already have a history of opioid dependency. Some of the side effects associated with Methadone include:

  • Weight gain
  • Mood changes
  • Insomnia
  • Difficulty urinating
  • Nausea
  • Lowered libido
  • Vision problems
  • Itchy skin
  • Hives
  • Extreme drowsiness
  • Sweating
  • Constipation
  • Swelling of the face
  • Chest pain
  • Irregular menstruation
  • Erectile dysfunction
  • Restlessness
  • Pinpoint pupils
  • Vomiting
  • Increasing tolerance levels

Methadone can be very challenging to quit – just like any other opiate. However, addiction rates are low if used as directed by a doctor. Methadone is a great addiction treatment medication option as it significantly reduces chance of relapse, especially in recovering Heroin users. People taking the prescription as part of a medication assistance program (MAT) won’t experience cravings for Heroin or the intense withdrawal symptoms associated with Heroin detox. Therefore, those in treatment can fully focus on therapy and not have to constantly battle urges to use or worry about relapse.

Naloxone

Naloxone is a treatment medication designed to reverse the harmful effects of opiate overdose. Common opioids that naloxone treats include: Heroin, Hydrocodone, Morphine, and Oxycodone. As the number of Opioid-related deaths on the US continues to rise, the drug offers lifesaving treatment that almost anyone can administer until emergency medical technicians can arrive. Naloxone should only be used if there are Opioids in a person’s system.

There are currently three FDA-approved formulations of Naloxone: a generic brand injectable, an autoinjectable (Evzio), and a prepackaged nasal spray (Narcan). The injectable form is intended to be injected directly into the muscles on the upper thigh or upper arm. Evzio gives electronic, voice-guided, step-by-step directions on how to administer the drug. Narcan is inserted into a person’s nostril, and with the touch of a button sprays an entire dose into that one nostril. The Naloxone in Narcan is then immediately absorbed into the bloodstream.

Seven states (Delaware, Hawaii, Maine, Michigan, Nebraska, Oklahoma, and Wyoming) require a prescription to obtain Naloxone, while pharmacies can freely distribute the drug without a prescription in other states. Evzio and Narcan are the fastest acting and easiest to administer of the formulas; both families and emergency personnel can easily utilize either drug during overdose emergencies. Evzio and Narcan are both packaged in a carton containing two doses to allow for repeat dosing, as sometimes more than one dose is needed to help the person start breathing again.

Naloxone is an extremely safe medication that only has noticeable side effects in a small minority of people. Naloxone can sometimes cause side effects in some, but none are life-threatening; these symptoms include:

  • Headache
  • High blood pressure
  • Rapid heart beat
  • Sweating
  • Nausea
  • Vomiting
  • Tremors
  • Diarrhea
  • Flushing
  • Dizziness
  • Tiredness
  • Weakness
  • Nervousness
  • Restlessness
  • Irritability
  • Body aches
  • Stomach pain
  • Fever
  • Chills
  • Goosebumps
  • Sneezing and runny nose
  • Shortness of breath

Although these side effects may be uncomfortable, they are nothing compared to the devastation of overdose. Naloxone is a break-through and lifesaving drug that has saved tens of thousands of people in the midst of an opioid overdose in just the past ten years.

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Naltrexone

Naltrexone is used to help both recovering alcoholics and drug addicts stay sober. The medicine is not a cure for addiction; it is simply one part of a multi-disciplinary treatment program for substance abuse that may also include counseling, group meetings, detoxification, and other treatments. Naltrexone comes in either a tablet (ReVia, Depade) or injectable form (Vivitrol) and is available only by prescription.

Naltrexone is an opiate antagonist and works by blocking the effects of narcotics, especially the “high,” euphoric feelings that causes people to want to use. Naltrexone also decreases the desire to drink alcohol, causing people to drink less or quit drinking altogether. The drug will not cause any narcotic-like effects or cause mental or physical dependence; however, Naltrexone can induce withdrawal symptoms in people that begin using the medication while still taking other opioids.

Some side effects associated with using Naltrexone include:

  • Headache
  • Abdominal pain
  • Dizziness
  • Indigestion
  • Fever
  • Diarrhea
  • Hives
  • Nervousness
  • Mood swings
  • Joint and/or muscle pain
  • Anxiety
  • Restlessness
  • Trouble sleeping
  • Nausea or vomiting
  • unusual tiredness

To reduce the risk of acute Opioid withdrawal symptoms, patients are warned to abstain from using illegal opioids, opioid medications, and alcohol for a minimum of 7-10 days before starting the drug.

Suboxone

Suboxone is used to reduce symptoms of opiate addiction and withdrawal during detox and to prevent relapse and reduce cravings in long-term treatment. Suboxone is actually composed of a combination of two other addiction treatment drugs: Buprenorphine (a partial opioid agonist) and Naloxone (an opioid antagonist). The two drug counterparts work together to prevent withdrawal symptoms in recovering opioid users; Buprenorphine triggers opiate receptors while Naloxone blocks opiate receptors and reduces a person’s urges. Suboxone has proven to reduce the use of not just Opioids, but other drugs, as well as increase the retention of rehabilitation concepts in patients. Individuals who use Suboxone as a medication-assisted treatment option should combine the drug with cognitive behavioral therapy and other therapy techniques.

There is a risk of developing a dependency on Suboxone and suffering from withdrawal once usage stops, as the drug is similar in composition to the opioids that the patients that are taking it are addicted to. Some symptoms of withdrawal may include:

  • Nausea
  • Excessive sweating
  • Constipation
  • Anxiety
  • Insomnia
  • Fever
  • Diarrhea
  • Confusion
  • Mood swings
  • Back pain

Although physical dependency is possible, opiate addiction is so strong that the safest option for recovering users is to expose them to a similar substance like Suboxone because of the comparable effects. The drug allows for an easier process of weaning away use by diluting cravings until patients are strong enough to deal with them on their own.

Which Addiction Treatment Medication Is Best for Me?

There are multiple addiction treatment medications available, and deciding which one would be best is a personal choice that should be made between an individual and their supervising doctor. In addiction treatment, an individual undergoes an assessment upon arrival that the treatment team will then use to devise an optimal treatment plan for that individual.  If you’re struggling with addiction and need rehab-related help, contact a dedicated treatment provider today.

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