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Drug And Alcohol Addiction Treatment Medications
1 in 12 American adults have substance use disorder, and many of them have the desire to be clean and sober. Unfortunately, the path to sobriety is long and challenging for many. Addiction treatment medications have been developed to ease withdrawal symptoms and keep people off some drugs. Although not all addictions can be treated with medication at this time, many can. A list of addictions that have had medications approved to treat them appears below.
Opioid Addiction Medications
Opioids are a class of drugs that include prescription pain relievers, Heroin, and synthetic Opioids like Fentanyl. Currently, we are in the midst of an Opioid epidemic with more than 130 Americans overdosing on Opioids and dying every day. Prescription painkillers often start people on the path to illegal street drugs. In fact, 80% of people who use Heroin first misused prescription Opioids. With the high number of deaths and $78 billion economic burden, getting drug users clean is a top priority. There are several medications that have shown success in helping people with an Opioid use disorder (OUD).
Methadone is a synthetic, long-acting Opioid that aims to act as a substitute for Heroin or other Opioid drugs. It works to prevent withdrawal symptoms while users go through recovery in a treatment program. Not having to go through withdrawal helps patients not be preoccupied with drug seeking behaviors. It further helps to prevent relapse caused by discomforting withdrawal symptoms. In transitioning from an intravenous use to swallowing a Methadone tablet by mouth, users’ risk of hepatitis C and HIV are dramatically reduced.
Another medication for Opioid addiction treatment is Buprenorphine. Buprenorphine was approved by the Food and Drug Administration (FDA) to aid in treatment for OUD. It produces a similar but weaker effect as Opioids and helps diminish cravings for Opioids. Buprenorphine is also used during detox to reduce the symptoms of withdrawal in a tapering method. Medication is usually combined with counseling and behavioral therapies. Buprenorphine can be prescribed and dispensed in a doctor’s office and sent home with the patient, unlike Methadone that must be given in a structured clinic. This helps patients with treatment access.
Naltrexone For Opioid Use Disorder
Naltrexone can be used for both Opioid use disorder and alcohol use disorder (AUD). It blocks the euphoric and sedative effects of drugs by binding to and blocking Opioid receptors. If someone in treatment relapses, it blocks the feeling of getting high. Patients must be clean from Opioids for at least 7 days before starting Naltrexone, which can make it difficult to initiate treatment in users, so some users will start with Methadone and work their way to Naltrexone.
Alcohol Addiction Medications
Problematic and uncontrolled drinking is called alcoholism, or alcohol use disorder. About 88,000 people die every year from excessive alcohol use, and it has a long list of health risks including heart disease, cancer, and stroke. Alcohol withdrawal can be extremely dangerous and life threatening, so it is wise for users to detox in a treatment center instead of trying to do it on their own. Seizures, fever, irregular heartbeats, and hallucinations are some of the symptoms that may occur during alcohol withdrawal. The most serious is delirium tremens, which can cause lead to cardiovascular collapse and death. Medications can help with withdrawal and dependence.
Disulfiram was the first FDA approved drug for AUD in 1951. It changes the way the body breaks down alcohol, and if someone drinks while on the medication, it will make them sick with nausea, vomiting, and headaches. This helps with associating alcohol with feeling horrible physically and is motivation to not consume alcohol. There has been an issue with compliance in clinical studies, but if someone is motivated to stop drinking, Disulfiram can have great results.
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Naltrexone For Alcohol Use Disorder
Naltrexone blocks the rewarding aspects of drinking alcohol by occupying Opioid receptors. You can still consume alcohol on the medication, but there will be no pleasure. It works best for people who have been sober for at least 4 days. Naltrexone reduces the intensity and frequency of drinking, reduces the risk of relapse, and increases the number of days abstinent. It can be administered as an injection once a month (Vivitrol), and releases slowly into the body which helps with compliance.
Acamprosate aids in easing post-acute withdrawal symptoms (PAWS), such as anxiety, restlessness, depression, and insomnia. It works best for patients who have already stopped drinking and are working through recovery. Acamprosate is taken in a pill form 3 times a day.
Topiramate is primarily used to treat seizures and sometimes used to prevent migraine headaches. It is often used off label to treat alcohol dependence and has been shown to reduce heavy drinking, reduce drinks per day, and increase the number of abstinent days.
Nicotine Addiction Medications
About one fourth of Americans use tobacco products, and use is particularity high in people with mental illness and substance use disorders. Nicotine is highly addictive and despite the fact that about 50% of smokers try to quit each year, only 6% are successful. Most smokers try to quit multiple times before having success, but support groups, like Nicotine Anonymous, and medications can help.
Nicotine Replacement Therapy
Nicotine replacement therapies (NRTs) include patches, gum, lozenges, nasal spray, and inhalers. These are usually available over the counter. They release nicotine into the blood stream without the harmful effects of tobacco products. This can help relieve withdrawal symptoms which include intense cravings for nicotine, sweating, headaches, coughing, sore throat, abdominal cramping, and irritability. NRTs improve cessation outcomes and work better than cold turkey attempts.
Bupropion (Zyban) is an atypical antidepressant that increases levels of brain chemicals that are also increased by nicotine. It is started 1 to 2 weeks before the smokers quit date, and then continued after. It increases quit rates and can also minimizes weight gain.
Varenicline (Chantix) works by stimulating the alpha-4 beta-2 nicotinic receptor. It decreases withdrawal symptoms and reduces the feelings of pleasure from smoking. Some studies have found that it is more effective than NRTs and Bupropion. Some people find success in combining Varenicline with NRTs.
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Cocaine Addiction Medications
Currently, there are no FDA approved medications to aid in Cocaine addiction treatment, despite the fact that millions of Americans regularly use Cocaine and thousands die from an overdose every year. However, a study from the University of Maryland School of Medicine found that Topiramate, used to treat epilepsy and migraines, increased the number of days that study participants did not use Cocaine and increased the likelihood that they would have Cocaine free weeks. Disulfiram has also been tested and showed promise, but it does not work for everyone.
There is a vaccine developed by Weill Cornell Medicine and NewYork-Presbyterian that is supposed to blunt the effects of cocaine. After success in animal models, the vaccine moved to human trials and is awaiting results.
Meth Addiction Medications
Methamphetamine (Meth) is an addictive stimulant that affects the central nervous system. Like Cocaine, currently there are no approved medications for addiction treatment. Researchers are studying various options, such as the University of California – Los Angeles studying Naltrexone. Typically used for Opioid or alcohol dependence treatment, Naltrexone blocks the Opioid receptors in the brain. When tested in Meth addicts, it reduced the craving for the drug, made subjects less interested in Meth, and subjects had lower heart rates and pulses.
Addiction Treatments: More Than Just Medication
Most treatments for a substance use disorder include a personalized plan including medications, behavioral counseling, treatment for co-occurring mental health issues, and follow-up to prevent relapses. Over 22 million Americans need treatment for a drug or alcohol use problem, but only 18.5% of them receive treatment. Overcoming an addiction is a challenge, but it is possible. To get more information on options, contact a treatment provider today.
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